Original article / research
Effect of Sonic versus Ultrasonic Irrigant Activation on Dentinal Tubule Penetration
of AH Plus Bioceramic Sealer and ReGen Bioactive Endosealer: An In-vitro Confocal Laser Scanning Microscopy Study
ZC12-ZC17
Correspondence
Dr. Sai Meghana Bapatu Yeruguti,
Postgraduate Student, Department of Conservative Dentistry and Endodontics,
Sibar Institute of Dental Sciences, Takkellapadu, Guntur-522509,
Andhra Pradesh, India.
E-mail: saimeghanareddy14@gmail.com
Introduction: Successful root canal therapy relies on thorough canal disinfection and the ability of sealers to penetrate the dentinal tubules effectively. Although mechanical shaping and irrigation lower bacterial presence, irrigant activation, especially using sonic or ultrasonic devices, boosts smear layer elimination and overall cleaning. The clinical success of Bioceramic Sealers (BCS) depends on their deep penetration into dentinal tubules for a fluid-tight seal. However, there is limited comparative evidence on whether sonic or ultrasonic activation better enhances intratubular adaptation of newer sealers like AH Plus Bioceramic and ReGen Bioactive Endosealer. This study uses Confocal Laser Scanning Microscopy (CLSM) to evaluate and compare these methods and aims to provide a standardised basis for selecting optimal irrigation activation protocols.
Aim: To evaluate and compare the maximum depth of penetration of AH Plus BCS (AHPB) and ReGen Bioactive Endosealer sealer after sonic and ultrasonic activation.
Materials and Methods: The present in-vitro study was conducted in the Department of Conservative Dentistry and Endodontics at Sibar Institute of Dental Sciences in Guntur, Andhra Pradesh, India, from July 2023 to September 2024. A total of 60 extracted human mandibular premolars with single roots were extracted for reasons related to periodontal or orthodontic reasons. Standard access cavities were prepared, followed by Working Length (WL) determination, and shaping was done with ProTaper Gold files up to size F3. Samples were randomly assigned to four experimental groups (n=15) depending on the combination of sealer and activation method: Group-1 (SLP-EA + AHPB), Group-2 (SLP-EA + ReGen Bioactive Endosealer), Group-3 (Ultra X + AHPB), and Group-4 (Ultra X + ReGen Bioactive Endosealer). Post-irrigation and activation, root canals were filled using Rhodamine B-stained sealers along with gutta-percha. Samples were then sliced at the middle and apical thirds and examined using Confocal Laser Scanning Microscopy (CLSM). Statistical analysis was performed using One-way Analysis of Variance (ANOVA), significant value was set at p<0.05, followed by Tukey’s post-hoc test.
Results: A statistically significant difference (p<0.05) in maximum sealer penetration was identified in the middle third, with Group 3 (Ultra X + AHPB) showing the greatest depth, followed by Groups 1, 4 and 2. No significant differences were found at the apical third, though AHPB-based groups showed marginally deeper penetration.
Conclusion: AH Plus Bioceramic Sealer demonstrated greater dentinal tubule penetration than ReGen Bioactive Endosealer, particularly when used with ultrasonic activation. These findings indicate that both the sealer type and the irrigant activation technique influence dentinal tubule penetration under the experimental conditions of this in-vitro study.