The apical seal of root canal sealing cements using a radionuclide detection technique

The aim of this study was to evaluate the apical seal obtained with various root canal sealing cements using a new method based on the use of a radionuclide and an external detection technique. A total of 150 maxillary incisors and canines, which had been kept in saline solution, were used. The root canals were instrumented with a stepback technique and circumferential filing. Six experimental groups and two control groups were randomly formed. Each experimental group was obturated by a lateral condensation technique with gutta-percha points and a different sealing cement (two based on zinc oxide-eugenol cement, two based on resins and two on calcium hydroxide); the positive control used gutta-percha without sealing cement, while in the negative control the apex was covered with nail varnish, leaving the root canal empty. The apical leakage was measured using an external detection technique after submerging the root apices in a solution containing the radioisotope metastable 99Tc. No leakage was observed in the negative control group. There was a large difference between the leakage observed in the positive control group and the experimental groups. The best seal was obtained using Sealapex cement, which differed significantly from AH26, Tubli-Seal and Diaket; there was no significant difference between the latter. The poorest results were obtained with Endomethasone and CRCS; there was a significant difference between these and the previous three sealing cements.