Evaluating the penetration efficacy of calcium silicate-based bioceramic sealers into dentinal tubules with cold lateral compaction technique using confocal laser scanning microscopy: An in vitro study.

Background: The micromechanical interlocking between dentinal walls and root canal sealer aids in achieving a three-dimensional impermeable hermetic seal. Calcium silicate-based bioceramic sealers are promising, but their comparative effectiveness in sealing dentinal tubules still needs further research.

Objective: This study evaluated the penetration efficacy of four calcium silicate-based bioceramic sealers - CeraSeal (Meta BIOMED Co., Cheongju, Korea), BioRoot™ (Septodont, Saint-Maur-des-Fosses, France), Bio-C (Angelus, Londrina, Brazil), and SafeEndo BioActive RCS (SafeEndo, Vadodara, Gujarat) - into dentinal tubules using confocal laser scanning microscopy (CLSM).

Methodology: Forty extracted single-rooted human mandibular premolars were decoronated, prepared with ProTaper rotary files, and randomly divided into four groups according to the type of sealer used. Canals were filled using a cold lateral condensation technique, and sealer penetration was assessed at the middle third of the root with CLSM. Statistical analysis was performed using one-way ANOVA and post hoc Bonferroni tests.

Results: Significant differences in dentinal tubule penetration were found among the sealers. CeraSeal (Meta-BIOMED Co., Cheongju, Korea) achieved the highest mean penetration at 1511.8 µm, followed closely by BioRoot™ (Septodont, Saint-Maur-des-Fosses, France) at 1488.6 µm (P < 0.05), indicating superior performance.

Conclusion: CeraSeal and BioRoot™ demonstrate superior tubular penetration, suggesting their advantages for effective sealing in root canal therapy. Future studies should investigate their long-term clinical efficacy in complex root canal systems.