Comparative Evaluation of Sealer Voids Using Single-Cone Obturation With Different Root Canal Sealers: An In Vitro...

An effective three-dimensional seal is essential for the long-term success of root canal treatment. The presence of sealer voids may compromise the integrity of obturation by permitting bacterial leakage and reinfection. Contemporary root canal sealers differ in their physicochemical and biological properties, which may influence their adaptation to the dentinal walls and the occurrence of voids. Therefore, evaluating the sealing quality of different sealers is important for selecting the appropriate obturation material. Therefore, the aim of this study was to evaluate and compare the sealer void area produced by BioRoot RCS (Septodont, Saint-Maur-des-Fossés, France), Sealapex (Kerr Corporation, Orange, CA, USA), and AH Plus (Dentsply DeTrey GmbH, Konstanz, Germany) following single-cone obturation using scanning electron microscopy (SEM).

Forty-five extracted human single-rooted mandibular premolars were instrumented using the ProTaper Universal rotary system (Dentsply Sirona, Ballaigues, Switzerland) to size F3 and were randomly allocated into three groups (n = 15): BioRoot RCS, Sealapex, and AH Plus. Following standardized irrigation and single-cone obturation, all specimens were stored under humid conditions to allow for complete setting of the sealers. The roots were sectioned into apical, middle, and coronal thirds and examined using SEM. The sealer void area was measured for each section. Data normality was assessed using the Shapiro-Wilk test. Repeated-measures analysis of variance (ANOVA) was used for intragroup comparisons, whereas one-way and two-way ANOVA were performed for intergroup comparisons. Statistical significance was set at p < 0.05.

Sealer voids were identified in all three experimental groups. The cumulative mean void area was the lowest for BioRoot RCS (0.0275 ± 0.0164 mm²), followed by AH Plus (0.0430 ± 0.0396 mm²), whereas Sealapex demonstrated the highest mean void area (0.0465 ± 0.0385 mm²). However, the intergroup comparison revealed no statistically significant difference among the three sealers (one-way ANOVA, p = 0.261, η² = 0.062). Intragroup analysis showed no significant variation in void distribution among the apical, middle, and coronal thirds for BioRoot RCS (p = 0.678), Sealapex (p = 0.984), and AH Plus (p = 0.229). Furthermore, two-way ANOVA demonstrated that neither the sealer type (p = 0.254, partial η² = 0.0215) nor the root canal level (p = 0.472, partial η² = 0.0119) significantly affected void formation. The interaction between sealer type and root canal level was also not significant (p = 0.553, partial η² = 0.0236), indicating comparable sealing performance among all the tested sealers.

Under the conditions of this in vitro study, BioRoot RCS, Sealapex, and AH Plus demonstrated comparable sealing performances when used with the single-cone obturation technique. Although minor variations in the mean void area were observed, these differences were not statistically significant. These findings suggest that all three sealers provide satisfactory adaptation to canal walls, and factors other than void formation may guide material selection in clinical practice.