Significance of Moist Root Canal Dentin with the Use of Methacrylate-based Endodontic Sealers: An In Vitro Coronal Dye Leakage Study

This in vitro study compared the effect of different levels of moisture of root canals, from none to wet, on the coronal seal after filling with resin-coated gutta-percha cones/EndoRez [RGPC/ER (groups 1-4)], Resilon/Epiphany [RE/EP (groups 5-8)], and gutta-percha/Grossman's cement [GP/G (groups 9-12)]. The length of 76 single-rooted extracted human teeth was standardized to ∼17 mm. After instrumentation with size 10 K-Files, #2 and #3 Gates Glidden burs, and preparation to the working length with K-Type files, the smear layer was removed with 17% ethylenediaminetetraacetic acid followed by flooding with distilled water. On the basis of similarities of canal shape determined by x-rays, roots were assigned to the groups (n = 5 per group) and treated according to one of the following protocols. (I) ETOH: excess distilled water was removed with paper points followed by dehydration with 95% ethanol; (II) PAPER POINTS: the canals were blot-dried with paper points with the last one appearing dry; (III) MOIST: the canals were dried with low vacuum by using a luer adapter for 5 seconds followed by 1 paper point for 1 second; and (IV) WET: the canals remained totally flooded. The roots were then filled with one of the obturation systems outlined above. The teeth were coated with 2 layers of nail varnish and 1 layer of sticky wax, except for the coronal access. In addition, positive and negative controls were added. After immersion in 2% methylene blue dye for 7 days, the samples were embedded in clear orthodontic resin and cross-sectioned at 0.5-mm intervals along the length of the roots. Dye penetration was evaluated by an independent investigator with a stereomicroscope at 40× magnification. The results indicated that dye leakage was affected by the degree of moisture. All materials evaluated showed some evidence of dye penetration, however, root canals filled with resin-coated gutta-percha/EndoRez and Resilon/Epiphany demonstrated significantly less leakage (P < .05) when moist conditions II and III were present.