MTA-Fillapex sealer penetration following activation with various irrigation protocols: a scanning electron microscopy study.

Purpose: The purpose of this study was to compare the penetration of MTA-fillapex sealer in dentinal tubules after activation with different irrigation procedures.

Materials: This in-vitro study involved 40 mandibular premolar teeth which were divided into four groups: (1) control group (without activation) (2) activation with ultrasonic, (3) XP-Endo Finisher, and (4) 980-diode laser. The teeth were filled with MTA-fillapex using single cone method. Sealer penetration in dentinal tubules was examined by scanning electron microscope at 2, 5, and 8 mm from apex under x1000 magnification. The data were analyzed using Shapiro-Wilk test, mixed analysis of variance, paired t test and post hoc Bonferroni (α = 0.05).

Result: The average sealer penetration rate in laser 980 nm laser group was significantly higher (p-value < 0.001). In 2 and 5 mm depth, there was no significant difference between Ultra X and XP-Endo (p-value > 0.05). While at 8 mm depth average, penetration rate in XP-Endo Finisher was significantly higher than with Ultra X (p-value > 0.001). The average sealer penetration at 8 mm from the apex was significantly higher than at 5 mm from the apex (p-value < 0.001), and at 5 mm was significantly higher than at 2 mm (p-value < 0.001).

Conclusion: Our findings suggested that type of irrigation protocol plays an important role in MTA fillapex sealer penetration. Root canal irrigation with 980 nm laser potentially leading to improved sealing ability, especially in the apical third."