Dentin tubule penetration of a calcium silicate-based sealer after removal of calcium hydroxide or N-acetylcysteine medicaments: an in vitro study.

BACKGROUND

This study aimed to evaluate, using confocal laser scanning microscopy (CLSM), the dentin tubule penetration of a calcium silicate-based root canal sealer after removal of calcium hydroxide (Ca(OH)2) or N-acetylcysteine (NAC) intracanal medicaments with needle irrigation or EDDY sonic activation.

METHODS

Root canals of 128 extracted single-rooted mandibular premolars were prepared with ProTaper Next. Canals received Ca(OH)2 (Kalsin) or (NAC) for 7 days. Medicaments were removed using conventional needle irrigation or EDDY sonic activation. Specimens were obturated with a calcium silicate-based sealer Bioserra using the single-cone technique. CLSM quantified residual medicament and sealer penetration into dentin tubules. Statistical analyses were performed using the Mann-Whitney U and Kruskal-Wallis tests, with the significance level set at p < 0.05.

RESULTS

Neither the type of intracanal medicament nor the activation technique significantly affected the residual medicament amount (p > 0.05). However, the type of medicament significantly influenced sealer penetration, with NAC showing greater dentin tubule penetration than Ca(OH)₂ (p < 0.05). The activation technique did not significantly influence sealer penetration (p > 0.05). Sealer penetration was highest in the coronal third and lowest in the apical third (p < 0.05).

CONCLUSION

Within the limitations of this in vitro study, NAC enhanced the dentin tubule penetration of a calcium silicate-based sealer compared with Ca(OH)₂. The activation technique did not affect sealer penetration or residual medicament.