Sarı Merve, Tüfenkçi Pelin
Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey.
Head Face Med. 2025 Jul 26;21(1):54. doi: 10.1186/s13005-025-00530-9.
This study aimed to evaluate the effects of access cavity design and activation procedures on the penetration depth and bond strength of calcium silicate-based sealers to dentin, while also distinguishing the influence of the root level as an anatomical reference point.
Sixty-six mandibular molars were randomly divided into two groups based on the access cavity design (traditional (TEC) or conservative (CEC)). The distal root canals were prepared using Reciproc files (40.06). The fluorescent calcium tracer Fluo-3 was added to the calcium silicate- based sealer CeraSeal to evaluate sealer penetration into dentinal tubules in confocal laser scanning microscopy (CLSM).Each access cavity group was further divided into three subgroups according to the sealer activation technique (Non-activation (NA), EDDY, XP-Endo Finisher (XP-F)) (n = 11). Root slices of 2.0 mm thickness (± 0.1 mm) were obtained at 3-5 mm and 8-10 mm from the root apex for CLSM to evaluate the percentage of sealer penetration. The bond strength was assessed with an Instron machine. Statistical analysis was performed using three-way ANOVA with Bonferroni correction, with the significance level set at 0.05.
There were no significant interaction effects among the independent variables (access cavity design, activation procedures and root level) (P > 0.05); however, each variable individually showed a significant main effect on both the percentage of sealer penetration and bond strength (P < 0.001). A significant main effect of access cavity design was observed, with TECs exhibiting significantly higher values than CECs in both outcomes (P < 0.001). Similarly, the root level significantly influenced results, with greater sealer penetration and bond strength at 9 mm compared to 4 mm (P < 0.001). The activation procedure also had a significant impact (P < 0.001). Post hoc comparisons using the Bonferroni correction revealed that both EDDY and XP-F significantly improved sealer penetration and bond strength compared to no activation (NA) (P < 0.001). However, no statistically significant difference was observed between EDDY and XP-F (P > 0.05).
The TEC design, the use of EDDY and XP-Endo Finisher activation techniques and the examination of coronal root levels resulted in a greater percentage in sealer penetration and higher values of bond strength.
Clinical Trial Number: Not applicable.
本研究旨在评估开髓腔设计和激活程序对硅酸钙类封闭剂渗入牙本质的深度及与牙本质粘结强度的影响，同时区分牙根水平作为解剖参考点的影响。
66颗下颌磨牙根据开髓腔设计（传统开髓腔（TEC）或保守开髓腔（CEC））随机分为两组。使用Reciproc锉（40.06）预备远中根管。将荧光钙示踪剂Fluo-3添加到硅酸钙类封闭剂CeraSeal中，以通过共聚焦激光扫描显微镜（CLSM）评估封闭剂渗入牙本质小管的情况。每个开髓腔组根据封闭剂激活技术（未激活（NA）、EDDY、XP-Endo Finisher（XP-F））进一步分为三个亚组（n = 11）。在距根尖3 - 5 mm和8 - 10 mm处获取2.0 mm厚（±0.1 mm）的牙根切片，用于CLSM评估封闭剂渗入百分比。使用Instron机器评估粘结强度。采用具有Bonferroni校正的三因素方差分析进行统计分析，显著性水平设定为0.05。
各独立变量（开髓腔设计、激活程序和牙根水平）之间无显著交互作用（P > 0.05）；然而，每个变量单独对封闭剂渗入百分比和粘结强度均显示出显著的主效应（P < 0.001）。观察到开髓腔设计有显著的主效应，在两项结果中，传统开髓腔组的数值均显著高于保守开髓腔组（P < 0.001）。同样，牙根水平显著影响结果，与4 mm处相比，9 mm处封闭剂渗入和粘结强度更高（P < 0.001）。激活程序也有显著影响（P < 0.001）。使用Bonferroni校正进行的事后比较显示，与未激活（NA）相比，EDDY和XP-F均显著提高了封闭剂渗入和粘结强度（P < 0.001）。然而，EDDY和XP-F之间未观察到统计学上的显著差异（P > 0.05）。
传统开髓腔设计、使用EDDY和XP-Endo Finisher激活技术以及检查冠方牙根水平导致封闭剂渗入百分比更高且粘结强度值更高。
临床试验编号：不适用。
