Comparative Micro-CT Analysis of Bioceramic Sealer Activation Techniques in Distal Root Canals of Mandibular Molars

To investigate the effectiveness of various bioceramic sealer activation techniques in reducing void formation during cold obturation of distal canals in mandibular molars.

Sixty mandibular molars with Vertucci's type I distal canals were instrumented using Reciproc Blue R40 files and obturated with iRoot SP sealer. Samples were randomly allocated into six groups (n = 10): No activation (control), lentulo spiral, sonic activation, ultrasonic activation, XP-endo Finisher, and lateral compaction. The obturated samples were scanned by micro-CT to assess the percentage of void volumes at the coronal, middle, and apical thirds of the canal space. Statistical analysis was conducted using a one-way ANOVA test (p < 0.05).

Activated sealer groups exhibited significantly lower void percentages compared to the nonactivated control at apical, middle, and total canal sections (p < 0.05). No significant differences were observed among activated groups.

Activation techniques significantly enhance the quality of bioceramic sealer obturation by reducing void formation in distal canals of mandibular molars compared to nonactivated methods.

Using activation techniques with bioceramic sealers during cold obturation enhances filling quality and may improve clinical outcomes in endodontic treatment. How to cite this article: Dewi A, Soonthornpusit A, Jittarat W. Comparative Micro-CT Analysis of Bioceramic Sealer Activation Techniques in Distal Root Canals of Mandibular Molars. J Contemp Dent Pract 2025;26(6):533-539.