Comparing Bioceramic Sealing Methods to Traditional Techniques

Objectives: We analyzed and compared the middle and apical push-out strength of EndoSequence BioCeramic sealer (Brasseler USA, Savannah, GA) using several application techniques.
Methods: Single-root-canal canines (n=50) were cut coronally and the root canal prepared using Wave One (Dentsply Sirona, Charlotte, NC). Samples were randomized into three groups according to the sealer application method: (1) sealer was injected into the canal before placing sealant-covered gutta percha; (2) sealer was placed into the canal via a sealant-coated Wave One rotary file that was rotated counterclockwise three times before inserting sealant-covered gutta percha; (3) AH Plus sealer, as a control, following manufacturer instructions. Following treatment, the apical two-thirds of the teeth were soaked in water for 24hr. Samples were sectioned horizontally in 1mm slices beginning 2mm from the apex. Sample slices were grouped into apical (A, first 3 from apex) and non-apical (B, the rest) sections. Section thicknesses were measured and push-out tests performed using a universal testing machine (Shimadzu universal testing machine, Kyoto, JP) with indenter diameters of 0.5-0.9mm and a crosshead speed of 1mm/min. Statistical analysis was performed using ANOVA and Tukey test (α=0.05).
Results: Group A had significantly higher push-out strengths compared to those in group B. Group 2 (using the counter rotation file) had the highest push-out strength, and the smallest variation within the data.
Conclusions: Using the counterrotation file technique as a delivery method for Bioceramic sealer provided an easy method to achieve a more uniform distribution of the sealer, and perhaps provide better apical sealing.