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Objective <p>This study aims to evaluate the penetration of a bioceramic sealer into dentin tubules when activated with three different irrigation activation techniques—conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF)—using two different sequential chelating agents, namely, ethylenediaminetetraacetic acid (EDTA) and glycolic acid (GA), and a continuous chelating agent, Dual Rinse HEDP (DR HEDP).</p> Materials and methods <p>Ninety-nine extracted healthy human mandibular premolar teeth were included in this study. They were divided into three main groups (<i>n</i> = 33) according to the irrigation regimen and three subgroups (<i>n</i> = 11) according to the activation type. The main groups were Group 1: sodium hypochlorite (NaOCl) followed by EDTA (17%), Group 2: NaOCl followed by GA (17%), and Group 3: NaOCl with DR HEDP mixture. The subgroups were Group a: CSI; Group b: PUI; and Group c: XPF. After the root canals were filled with AH Plus<sup>®</sup> Bioceramic sealer and gutta-percha, horizontal sections of 1&#xa0;mm thickness were taken from the apical and middle regions. These sections were evaluated for penetration depth, percentage, and area using confocal laser scanning microscopy. The data were analyzed via the Shapiro–Wilk test and a three-way robust analysis of variance test.</p> Results <p>In terms of the main effects of activation type and solution, no significant differences were found in penetration depth, percentage, or area among the groups (<i>p</i> &gt; 0.05). With respect to the main effect of the section, the penetration parameters in the apical Sect.&#xa0;(390&#xa0;μm, 64.2%, 1.460.000 µm2) were significantly lower than those in the middle Sect.&#xa0;(691&#xa0;μm, 80.1%, 4.350.000 µm2) (<i>p</i> = 0.001). No statistically significant differences were observed in the three parameters measured among the groups in the activation type–section and solution–section interactions (<i>p</i> &gt; 0.05).</p> Conclusion <p>Continuous chelation protocols applied under different irrigation activation systems did not show superiority over traditional sequential chelation protocols in terms of bioceramic sealer penetration. Chelator and activation combinations were insufficient in the apical region.</p>

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The effects of sequential and continuous chelation on the dentine tubule penetration of a bioceramic sealer: a confocal laser scanning microscopy study

  • 期刊论文

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  • 发表日期：

    2025年11月17日

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  • Muharrem Batur,
  • Merve Yeniçeri Özata,
  • Seda Falakaloğlu

摘要

Objective

This study aims to evaluate the penetration of a bioceramic sealer into dentin tubules when activated with three different irrigation activation techniques—conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF)—using two different sequential chelating agents, namely, ethylenediaminetetraacetic acid (EDTA) and glycolic acid (GA), and a continuous chelating agent, Dual Rinse HEDP (DR HEDP).

Materials and methods

Ninety-nine extracted healthy human mandibular premolar teeth were included in this study. They were divided into three main groups (n = 33) according to the irrigation regimen and three subgroups (n = 11) according to the activation type. The main groups were Group 1: sodium hypochlorite (NaOCl) followed by EDTA (17%), Group 2: NaOCl followed by GA (17%), and Group 3: NaOCl with DR HEDP mixture. The subgroups were Group a: CSI; Group b: PUI; and Group c: XPF. After the root canals were filled with AH Plus® Bioceramic sealer and gutta-percha, horizontal sections of 1 mm thickness were taken from the apical and middle regions. These sections were evaluated for penetration depth, percentage, and area using confocal laser scanning microscopy. The data were analyzed via the Shapiro–Wilk test and a three-way robust analysis of variance test.

Results

In terms of the main effects of activation type and solution, no significant differences were found in penetration depth, percentage, or area among the groups (p > 0.05). With respect to the main effect of the section, the penetration parameters in the apical Sect. (390 μm, 64.2%, 1.460.000 µm2) were significantly lower than those in the middle Sect. (691 μm, 80.1%, 4.350.000 µm2) (p = 0.001). No statistically significant differences were observed in the three parameters measured among the groups in the activation type–section and solution–section interactions (p > 0.05).

Conclusion

Continuous chelation protocols applied under different irrigation activation systems did not show superiority over traditional sequential chelation protocols in terms of bioceramic sealer penetration. Chelator and activation combinations were insufficient in the apical region.