Dentinal tubule penetration of a silicone-based endodontic sealer following N-acetyl cysteine intracanal medicament removal using ultrasonic agitation and laser activated irrigation - An in vitro study

Abstract

Context: The removal of intracanal medicament is essential for sealer penetration and the success of endodontic therapy. Aims: To evaluate and compare the dentinal tubule penetration of a silicone-based endodontic sealer following N-acetyl cysteine (NAC) intracanal medicament removal using ultrasonic agitation and laser-activated irrigation. Materials and Methods: Eighty-one extracted single-rooted mandibular premolars were decoronated and prepared with ProTaper Universal rotary files up to MAF F3. To prepare medicament, NAC powder was mixed with propylene glycol in the ratio of 1:1, placed using a size #30 Lentulospiral, and specimens stored in an incubator for 14 days. The specimens were then instrumented with #30 Hedström and divided into three groups according to final irrigant activation techniques: Group I: Diode laser activation, Group II: Passive Ultrasonic agitation, Group III: No agitation (positive control). Canals were obturated with GuttaFlow bioseal sealer mixed with 0.1% Rhodamine B dye and gutta-percha cones and incubated for 7 days. The specimens were sectioned horizontally to obtain 1 mm thick sections from 2, 5, and 8 mm from the apex. Sections were examined under Confocal Laser Scanning Microscope to measure the depth of sealer penetration (in μm). Statistical Analysis: One-way analysis of variance and Tukeys multiple post hoc test. Results: The highest mean depth of penetration of 728.52 μm was seen with Group I, followed by Group II and least was seen in Group III. Conclusions: Diode laser activation group was most effective in the removal of NAC intracanal medicament from all the three regions of the root canal.