The document summarizes a study that evaluated the marginal adaptation of three root canal sealers - epoxy resin-based MM-Seal, MTA-based MTA Fillapex, and bioceramic sealer EndoSequence BC - to root canal dentin using scanning electron microscopy. The study found that MM-Seal showed superior adaptation to dentin, while MTA Fillapex showed the poorest adaptation. Apical regions generally showed larger marginal gaps than coronal regions for all sealers. The results suggest that epoxy resin-based sealers may provide better sealing than bioceramic or MTA-based sealers.

3. Marginal adaptation of newer
root canal sealers to dentin:
A SEM study.
Swapnika Polineni, et al.
Journal of Conservative Dentistry
Jul-Aug 2016 | Vol 19.

4. INTRODUCTION
The primary objective of root canal
obturation is to obtain a fluid hermetic seal.
According to Strindberg and Allen:
long-term endodontic failure is due to lack of
complete canal seal.
[Dent Res J (Isfahan) 2014;11:599-603.]

5. To overcome these drawbacks new systems
have been introduced to enhance the sealing
ability.
 Endosequence bio-ceramic sealer.
 MTA Fillapex.
 Micro-Mega seal.

6. EndoSequence Bio-Ceramic Sealer
 Recently introduced obturation system.
 COMPOSITION:
 zirconium oxide,
 calcium silicate,
calcium phosphate ,
 calcium hydroxide.

7.  Premixed and injectable.
 PROPERTIES:
 Hydrophilic.
 Bio compatible.
 Non resorbable.
 Dimentionally stable.
 Bacteriocidal/ bacteriostatic.
Antibacterial activity of endodontic sealers by modified direct
contact test against Enterococcus faecalis.
Hui Zhang et al.
JOE vol: 35, number: 7, July 2009.

8. MTA Fillapex
 MTA-based sealer.
 Two paste system.
 COMPOSITION:
MTA
 Salicylate resins
 Bismuth oxide
 Silica nanoparticles
 Pigments.
 PROPERTIES:
 Good sealing ability,
 Bactericidal effect,
 High biocompatibility,
 Low solubility.

9. MM (Micro Mega)-Seal
 Epoxy resin-based RC sealer.
 Packaged in a dual syringe.
 Two pastes:
It has better chemical and physical properties,
biocompatible, and provides excellent sealing.
BASE CATALYST
Epoxy oligomer resin Polyamine benzoate
Ethylene glycol salicylate Triethanolamine
Calcium phosphate Calcium phosphate
Bismuth subcarbonate Bismuth subcarbonate
Zirconium oxide Calcium oxide

10.  To compare and evaluate the quality of adaptation
of recently introduced EndoSequence BC sealer,
MTA Fillapex and epoxy resin-based MM-Seal to
root canal dentin using scanning electron
microscope.

11. Mandibular
premolars
n=30
Saline
solution
Diamond
disc

12. Crown down technique
Pro taper rotary files

13. Group 1
Group 2
Group 3
• Epoxy resin-based
sealer (MM-Seal
MicroMega)
• MTA-based sealer
(MTA Fillapex
Angelus,Londrina,
Brazil)
• Bioceramic Sealer
(EndoSequence
BC brasseler,
USA).
SAMPLES

14. MM seal
• Base : catalyst
2:1
• Mixing time 15-
20 s.
• Creamy &
homogenous
mix.
• Sealer
application.
• obturation.
MTA
Fillapex
• Self mixing tip.
• Sealer
application.
• Obturation.
Endoseque
nce BC
• Pre-mixed
sealer applied
with syringe
tip.
• Endosequence
verifier.
• C points for
obturation.

15. In all the samples obturating material was
removed 3 mm beneath the cemento-enamel-
junction and restored with Cavit G (3M ESPE,
Seefeld, Germany).
 Samples were stored at more than 95%
relative humidity at 37°C for 10 days in a
humidifier.

16. All the samples were vertically
sectioned using a hard tissue
microtome.
Marginal gap at sealer and root dentin
interface was evaluated under SEM at
×2000 magnification at coronal, and apical
halves of root canal.
Hard tissue microtome

17. SEM ANALYSIS
1
• Samples mounted on
aluminium stub
2
• Placed in a chamber of
gold coated sputter.
3
• Viewed under scanning
electron microscope.

18. Aluminium stub Sample placement Gold coated sputter
SEM

19. To assess the marginal adaptation the
following variable was measured:
Maximum gap width =
Measured directly at ×2000 magnification by other examiner
to avoid examiner bias.
 DATA ANALYSIS:
Two-way ANOVA
Tukey’s multiple post hoc test.
SPSS 20, (IBM, Armonk, NY, USA).
max. distance between obturated
material and RC dentin.

21. CORONAL HALVES APICAL HALVES
MM
seal
MTA
Fill-
apex
Endo
sequ
-ence
BC

22. DISCUSSION
3D seal

23.  Gutta percha
 gold standard in root canal therapy.
Demerits:
 Inability to bond with root canal dentin.
 Hydrophobic nature.
 Sealer tends to pull away from the Gutta–
percha on setting.

24.  In this study, scanning electron microscope
was utilized for marginal gap assessment.
 The advantage of using SEM over various
micro leakage methods is, in SEM
 defects at the submicron level can be
observed at required magnification.
 final evaluation can be done by preserving
microphotographs.

25.  The major function of a root canal sealer:
 Fill imperfections
 Increase adaptation of the root filling material to the canal
walls.
 An ideal RC sealer:
 Biocompatible.
low surface tension
 Better wettability
 About 60% of endodontic failures are due to inadequate filling
of root canal space.
[Muliyar et al., J Int Oral Health 2014;6:99-104.]
good penetration into irregularities
fluid tight seal

26. Adhesion of RC sealer to root dentin is a
basic requirement of any root filling material.
 In the present study, MM-Seal showed
superior marginal adaptation and MTA
Fillapex showed poor adaptation.
 Higher interfacial gaps were observed at the
apical level of all sealer types than at the
coronal level.

27. Discrepancy
↓ density & diameter of dentinal tubules
↓ sealer penetration
Smear layer [apical 3rd ]
Interfere with sealer adaptation

28. Resin-based sealers have gained popularity in recent years
Better flowability penetrate deep into the dentinal tubules
 Long setting time.
 Long-term dimensional stability.
.
MM-Seal
Reacts with amino groups
of root dentin collagen
Covalent bond between
resin & collagen
Superior adaptation.

29. Endosequence BC sealer
Penetration into dentinal tubules
Denature dentinal collagen fibers
Alkalinity of BC bye-products
Hydrophilic nature of polymeric endodontic
points uses residual moisture and expands
radially without expanding axially forming a
self-seal on setting.

30. In spite of better penetration, marginal
gaps were observed with Endosequence BC
sealer.
Decreased wetting ability of the dentin
surface prohibited the adhesion of any
hydrophilic materials like EndoSequence BC
sealer.

31. MTA Fillapex, showed statistically significant difference
compared to MM-Seal and EndoSequence BC sealer groups.
 Sarkar et al. suggested that calcium and hydroxyl ions will be
released in the presence of phosphate containing fluids which will
result in the formation of apatite that promotes controlled
mineral nucleation on dentin which can be seen as the formation
of an interface layer with tag-like structures.
[Physicochemical basis of the biologic properties of MTA.
J Endod 2005;31:97-100.]

MTA Fillapex

32.  According to a study done by Nagas et al.,
there is better bonding of MTA Fillapex when
the canals are finally rinsed with distilled water
and blot dried with paper points to
achieve moist condition.
[Dentin moisture conditions affect the
adhesion of root canal sealers. J Endod
2012;38:240-4.]

33. However in this study, MTA Fillapex displayed
little or no tags under SEM which may be
attributed to the unpredictable moisture content
in the canal.
 The reason for the inferior marginal
adaptation of MTA Fillapex could be the low
adhesion of the material due to poor microtags
formed on setting.

34. Sealer penetration and adaptation in the dentinal
tubules: a scanning electron microscopic study.
Balguerie E et al.
Conclusion:
The tubular penetration and adaptation varies with the
different physical and chemical properties of the sealers used.
AH Plus showed the most optimal tubular penetration and
adaptation to the root canal wall of the sealers tested.
Journal of Endodontics 2011 Nov;37(11)

35. Interfacial adaptation and thickness of bioceramic-
based root canal sealers.
Al-Haddad et al.
Conclusion:
 Bioceramic-based sealers exhibited more gap-
containing regions when compared with AH Plus.
 EndoSequence BC sealer produced the highest sealer
thickness.
Dental Materials Journal 2015;34:516-21.

36. Dentin moisture conditions affect the adhesion of
root canal sealers.
Nagas et al.
Conclusion:
The degree of residual moisture significantly
affects the adhesion of root canal sealers to
radicular dentin. For the tested sealers, it may be
advantageous to leave canals slightly moist before
filling.
J Endod 2012 Feb;38(2):240-4.

37. Evaluation of Apical Micro-leakage of Different
Endodontic Sealers in the Presence and Absence of
Moisture
Ehsani et al.
Conclusion:
AH26 provided the least apical micro-leakage under dry
conditions while ZOE had the highest micro-leakage under
moist conditions.
MTA Fillapex provided acceptable apical seal regardless
of moisture.
J Dent Res Dent Clin Dent Prospects 2014;8:125-9.

38. Evaluation of the apical sealing ability of bioceramic
sealer, AH plus & epiphany: An in vitrostudy
Pawar et al.
Conclusion:
Newer root canal sealers like Endosequence BC, AH
plus & epiphany seal the root canal better but cannot
totally eliminate leakage.
J Conserv Dent 2014;17:579-82.

39. Bacterial leakage in root canals filled with resin-based
and mineral trioxide aggregate-based sealers
Dent Res J 2014 Sep-Oct; 11(5): 599–603.
Razavian et al.
Conclusion:
Both AH26 & Fillapex had bacterial leakage.
Sealing ability of AH26 was significantly higher than
that of Fillapex

40. Push-out bond strength of two new calcium silicate-
based endodontic sealers to root canal dentine.
Sagsen et al.
Conclusion:
MTA Fillapex had the lowest push-out bond values to
root dentine compared with other sealers.
Int Endod J 2011 Dec;44(12):1088-91.

41. Within the limitations of this study apical halves
showed poor adaptation regardless of the material
used than the coronal halves.
 Epoxy resin-based MM-Seal showed good
marginal adaptation than the Bioceramic sealer
(EndoSequence BC sealer) and MTA Fillapex.
Further studies are essential to confirm its clinical
superiority.