Influence of dentin moisture conditions on the wetting action of different endodontic sealers using Rame-Hart goniometer: An in vitro study

Sivaji Kauravi; Shruthi H Attavar; Gyanendra Pratap Singh

doi:10.4103/jioh.jioh_110_22

ORIGINAL RESEARCH

Year : 2022 | Volume : 14 | Issue : 6 | Page : 624-628

Influence of dentin moisture conditions on the wetting action of different endodontic sealers using Rame-Hart goniometer: An in vitro study

Sivaji Kauravi¹, Shruthi H Attavar², Gyanendra Pratap Singh³
¹ Department of Conservative and Endodontics, Anil Neerukonda Institute of Dental Sciences, Vishakapatnam, Andhra Pradesh, India
² Department of Conservative and Endodontics, A B Shetty Memorial Institute of Dental Sciences, NITTE (deemed to be University), Mangalore, Karnataka, India
³ Private Practitioner, Ghaziabhad, Uttar Pradesh, India

Date of Submission	20-May-2022
Date of Acceptance	07-Oct-2022
Date of Web Publication	30-Dec-2022

Correspondence Address:
Dr. Shruthi H Attavar
Department of Conservative and Endodontics, A B Shetty memorial Institute of Dental Sciences, NITTE (deemed to be university), Deralakatte, Mangalore 575018, Karnataka
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jioh.jioh_110_22

Abstract

Aim: To evaluate the influence of different dentin moisture conditions on the wetting action of different classes of endodontic sealers, that is, Bioceramic based sealer – Smart Paste Bio, Resin based sealer - AH Plus and Zinc oxide eugenol based sealer – Tubliseal. Materials and Methods: The present research is an in vitro comparative study in which the samples were selected by random sample method. A total of 54 dentin samples were prepared by longitudinally sectioning 27 freshly extracted single rooted mandibular first premolars. 54 samples were then allocated into three groups of 18 each based on the sealer used. Irrigation of the dentin samples were done with 5.25% sodium hypochlorite followed by 17% EDTA and a final rinse with distilled water.18 samples in each sealer group were further divided into separate subgroups of six each on the wide variety of dentin moisture conditions subjected to dry, moist and wet conditions. 0.1ml of sealer was deposited on flat dentin surface and contact angles were measured. Statistical evaluation was done using Analysis of variance and Post-hoc Tukey test at 95% confidence interval and P value <0.05 was considered statistical significant. Results: One way ANOVA was done to analyse the statistical significant difference between the wetting ability of three different sealers under different moisture condition the P Value was <0.001 which was considered statistically significant. Post hoc Tukeys test was done to analyze the contact angle between the two groups in dry, moist and wet condition with P value =0.001 which is <0.05 hence there is a statistical significant difference among all the subgroups. Conclusion: Within the limitation of this in vitro study it can be concluded that the wetting behavior of Resin based sealer - AH Plus was significantly better than Bioceramic sealer - Smart Paste Bio and Zinc oxide eugenol sealer - Tubliseal during dry and moist dentin conditions.

Keywords: Contact Angle, Dentin Moisture Conditions, Root Canal Sealers

How to cite this article:
Kauravi S, Attavar SH, Singh GP. Influence of dentin moisture conditions on the wetting action of different endodontic sealers using Rame-Hart goniometer: An in vitro study. J Int Oral Health 2022;14:624-8

How to cite this URL:
Kauravi S, Attavar SH, Singh GP. Influence of dentin moisture conditions on the wetting action of different endodontic sealers using Rame-Hart goniometer: An in vitro study. J Int Oral Health [serial online] 2022 [cited 2023 Oct 5];14:624-8. Available from: https://www.jioh.org/text.asp?2022/14/6/624/366425

Introduction

Root canal treatment refers to a set of operations aimed at disinfecting and closing the root canal system.^[1] The ability to achieve a fluid impermeable barrier in the canal space is critical for the prolonged effectiveness of endodontic procedure, as it prevents microorganism and their byproducts from penetrating the periradicular tissues, preventing recontamination. As a result, having good sealing ability is a desired attribute of a root canal sealer.^[2]

Cleaning and shaping are critical phases in the elimination of microorganism in the treatment process. Instrumentation removes the majority of the microbes from the root canal system’s exposed sections while also allowing irrigation to remove the pathogens chemically.^[3]Ideally the irrigants must come in contact with the canal wall for better disinfection of the root canal system. The wettability of the irrigating solution on solid dentin, which is directly proportional to its surface tension, determines the proximity of this contact.^[4]

The smear layer may hinder the penetration of irrigants, medicaments, and sealers into the dentinal tubule. It’s also thought to have an impact on the dentin’s surface energy. In terms of hydrophobic vs. hydrophilic characteristics, the smear layer looks to be mostly hydrophobic. As a result, it is suggested that the smear layer be completely removed from the root canal surface.^[5]

Treating the dentin surface with various irrigating solutions will not only eliminate the smear layer, but will also improve the surface free energy of the dentinal surface, resulting in higher sealer wettability and hence a fluid impermeable seal. To adequately moisten the root canal dentin, the root canal irrigants should have a very low surface tension.^[6]

The surface free energy of the solid surface has a major role in adhesion. Wettability is considered to be the essential physiochemical characteristic, and it is measured in terms of the contact angle established between a liquid drop and a solid’s flat surface. 3.15% the surface free energy has an inverse relationship with the contact angle. These interactions are crucial for understanding wettability, as well as wetting, spreading, and adsorption of liquids.^[7]

Different types of sealers have been introduced to endodontics, with zinc oxide-eugenol formulations, calcium hydroxide sealers, glass ionomers, and a variety of resins being the most common. Bio ceramic-based sealers have recently been launched as a result of their seal ability and biocompatibility.^[8]

The nature of sealing of the conventional and resin-based sealers has been demonstrated to be affected by residual moisture at various levels in the pulp space. The quality of adherence of the endodontic sealer into the canal wall depends on the moisture condition and the variability in the surface moisture conditions may modify the surface free energy of a solid surface, resulting in a change in wettability.^[9]

Various studies have been conducted to analyze the effect of root canal sealers to root dentine moisture condition; however there were no studies till date to analyze the effect of bioceramic sealer on moisture condition on root dentin. Therefore the aim was to investigate the influence of different dentin moisture conditions on the wetting behavior of three different classes of root canal sealers.

Research hypothesis was that there is a significant difference in the wetting nature of different sealers on the wet, moist and dry condition to the tooth dentine.

Materials and Method

Setting and design

The present in vitro experimental study included a total of 27 human mandibular premolars that were extracted for orthodontic purposes. The teeth were ultrasonically scaled to remove soft tissue, calculus, and debris, and then preserved in normal saline until the study was completed. The specimens were decoronated, at the CEJ and further sectioned longitudinally in a bucco-lingual direction using a rotary diamond disc spinning at low speed under cooling system.^[2]

After that, the samples were flattened and smoothed with no.100 sandpaper to get a smooth and level surface. The samples were kept in a normal saline solution until they were needed. Based on the sealers used, the samples were sorted into three groups of 18 each.

Sampling criteria

Sample size determination

Based on the pilot study the pooled Standard deviation for 3 groups =0.523, mean difference 0.61,effect size 1.16, alpha error 5%, power 80%, for 2 sided test the required sample per group is 27. This was calculated using nMaster software Version 2.

Ethical approval

Study was conducted after obtaining ethical clearance from the institutional review board (Ref/KCDS /10–2099). The study has been accomplished in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standard.

Grouping and allocation

GROUP I: Calcium silicate based Bio Ceramic Sealer - Smart Paste Bio

GROUP II: Resin based Sealer - AH Plus

GROUP III: ZnOE based Sealer - Tubli Seal

Randomization/Bias

Extracted teeth were kept in distilled water for not more than one month prior to the study. Teeth were kept hydrated all the time before the evaluation to avoid any bias in the results.

Methodology

The longitudinal slices of dentin were irrigated with 2ml of 5.25 percent NaOCl and subsequently with 2ml of 17 percent EDTA solution using a syringe, replicating the chemo mechanical preparatory irrigation. Each irrigant solution was rinsed for 1 minute on the dentin slices. Following this method, each group was further grouped into three subdivisions each with six teeth and three dentin moisture conditions.^[1]

SUB-GROUP A (DRY)n = 6: The dentine sections were immersed in 2ml of 90% of ethanol solution for 1 min following which the ethanol was removed using paper point to ensure complete dryness.

SUB-GROUP B (MOIST)n = 6: The dentine sections were dried using the paper point till the last paper point appear dry

SUB-GROUP C (WET)n = 6: Dentin slices were kept completely wet with irrigant solution followed by single paper point application for one second.

Analysis method

The samples were subsequently fixed on a microscopic glass slide with cyanoacrylate adhesive to create a clean level foundation for the Rame-Hart goniometer to measure the contact angle between the dentin surface and sealers.

Measurement of contact angle between dentin samples and sealers

The Contact Angle Analyzer (Model - Phoenix 300 Plus) was used to assess the contact angle between chemically treated dentin samples and experimental sealers. After depositing a drop of experimental sealer (0.1ml) on the chemically treated dentin surface, the contact angle was measured using a Rame-Hart goniometer.^[10]

Statistical analysis

Data was analyzed using SPSS Software version 20 (IBM SPSS Software) Analysis of variance and Post-hoc Tukey test was used to determine the group differences and effects. At confidence interval 95%, power 80%, std dev 0.523, P value <0.05, was considered statistical significant

Results

The tooth samples in the following study was divided into 3 groups based on the type of sealer used ie Zinc oxide based sealer (Tubli seal), resin based sealer (A H plus) and bioceramic sealer (Smart paste bio). Further the samples are divided into subgroups based on the dentine moisture into dry, moist and wet.

Descriptive statistics was done to represent the mean and standard deviation of the measured Contact Angle on dentin surface in different moisture conditions among the three sealers. On the dentine surface the contact angle formed in dry condition by bioceramic sealer is 49.73 ± 2.04,AH Pus sealer is 32.60 ± 0.82 and Tubli sealer is 80.05 ± 1.94. under the moist conditions the contact angle of bioceramic sealer is 44.06 ± 0.91,AH Pus sealer is 36.25 ± 1.20 and Tubli sealer is 75.26 ± 1.39. consequently under the wet condition the contact angle formed by bioceramic sealer is 34.40 ± 0.79,AH Pus sealer is 41.33 ± 0.64 and Tubli sealer is 65.03 ± 1.03.

[Table 1] represents the measured Contact Angle (degrees) on dentin surface in different moisture conditions among the three sealers. One-way ANOVA analysis was done to analyse the contact angle of three groups of sealers to the root dentine. The P value =0.001 which was <0.05 therefore there was a statistical significant difference between the contact angle of the three groups.

Table 1: Comparison of the measured contact angle (degrees) on dentin surface in different moisture conditions among the three sealers

Click here to view

[Table 2] represents the Contact Angle Between the Two Subgroups of the three different sealers. Post hoc Tukeys test was done to analyze the contact angle between the two groups in dry, moist and wet condition with P value =0.001 which is <0.05 hence there is a statistical significant difference among all the subgroups.

Table 2: Comparison of contact angle between the two subgroups of the three different sealers

Click here to view

Discussion

The most important concept for an adhesive material to come in close proximity with the tooth substrate is by molecular attraction, chemical adhesion or by micromechanical surface attachment. The contact angle created between a drop of liquid and the planar surface of the solid on which it sits can be used to calculate surface free energy.^[11] The contact angle is inversely proportional to the surface free energy; the higher the surface free energy, the lower the contact angle, and hence the higher the adhesion. Contact angle has been the subject of research in a variety of fields, and it is regarded as a trustworthy approach for analyzing sealant wetting behavior.^[12]

The chemical composition of human dentin may be altered by irrigating the dentin surface with various irrigating solutions. Sealer adherence to the dentin surface may be compromised as a result of these changes.^[13] As a result, all of the specimens in this investigation were treated to the identical irrigation technique, which included 5.25 percent NaOCL followed by 17 percent EDTA. Because an increase in temperature might produce a drop in cohesive forces in the sealer due to increased molecular mobility, the cohesive link weakens, causing a decrease in surface tension, all sealers were kept at room temperature.^[14]

Apart from the surface features of dentin, the hydrophilic and hydrophobic nature of sealers should be taken into account while measuring the contact angle of sealers. Smart paste Bio (Bioceramic based sealer) and Tubli-seal (Zinc oxide eugenol based sealer) are both hydrophilic sealers, whereas AH Plus (Epoxy resin based sealer) is hydrophobic. The sealing ability of the resin based root canal depends on the degree of the remaining moisture content which is the main cause for failure in the bonding of resin based sealer.^[15],[16] The state of hydration of the dentin surface is shown to affect the contact angle. Hence in the present study all the dentin samples were further subdivided into three subgroups based on different moisture conditions subjected.^[17],[18]

The lower contact angle value of AH plus during dry and moist dentin conditions in this study could be attributed to the sealer’s hydrophobic character, which is consistent with the findings of Kontakiotis et al.^[19] Who found that superior wetting of AH Plus sealer on the root dentin surface could be due to its ability to penetrate into micro irregularities better.

This is due to the high adhesive properties of AH Plus sealer, as demonstrated in studies by Nunes et al.^[20] which complement the findings of the current study. Because AH Plus is a hydrophobic sealer, swelling of the epoxy resin component of AH Plus following water sorption may have resulted in an increase in its contact angle while the dentin was wet. This finding is consistent with Roggendorf et al.^[13] who found that AH Plus had better sealer adhesion in dry conditions than in moist or wet conditions. The low viscosity and better flow rate of AH Plus sealer can be ascribed to superior outcomes in all dentin moisture levels when compared to competing sealers. Tyagi et al.^[21] observed that because AH Plus is an epoxy resin–based sealer, it has better adherence to root dentin. Because excessive desiccation may eliminate the water existing in the dentinal tubules, which may obstruct efficient penetration of hydrophilic sealers and hence decrease adhesion quality, Smart Paste Bio has a greater contact angle value when dry. Smart Paste Bio had a lower contact angle under moist conditions than in dry conditions, which might be ascribed to the sealer’s hydrophilic feature. This finding is consistent with Nagas et al.^[22] study,’s which found that moist root canal dentin favoured sealer adherence. Smart Paste Bio has a smaller contact angle in wet conditions than AH Plus and Tubli-seal, which might be due to the fact that it is a hydrophilic sealer that leverages the moisture within the dentinal tubules following canal irrigation to commence and complete the setting reaction.

Tubli-high seal’s viscosity and flow rate are responsible for the sealer’s increased contact angle in all dentin moisture conditions. This finding is consistent with Bossardi et al.^[23] who found that a zinc oxide eugenol sealer had poor wetting on the root dentin surface due to the sealer’s increased viscosity.

According to the result of the present study the research hypothesis has been accepted and it can be concluded that there was a difference in the dentin moisture condition which can affect the wetting ability of root canal sealer.

Limitation and future scope

The present study is quite scarce to provide any recommendation about the use of a particular sealer at various dentin moisture conditions. The present research might provide a strong reference for further trials in this field advocating larger sample size and a standardized methodology to eradicate alterations and assortments in the samples.

Conclusion

Within the limitations of the study, the following conclusions can be drawn:

Dentin moisture conditions significantly affects the wetting ability of the sealers in dry, moist and wet intraradicular dentin moisture conditions.

The wetting behavior of Resin based sealer - AH Plus was significantly better than Bioceramic sealer - Smart Paste Bio and Zinc oxide eugenol sealer - Tubliseal during dry and moist dentin conditions.

Moist and wet dentin conditions favour the wettability of hydrophilic sealers and dry condition favour the wettability of hydrophobic sealers.

Acknowledgment

The authors would like to acknowledge Krishnadevaraya College of Dental Sciences, Bangalore for providing us the facility to conduct the study.

Financial Support and Sponsorship

The present study was self-funded.

Conflicts of interest

The authors have no conflicts of interest.

Authors contributions

SK: primary author, concept designs, data extraction, writing original draft, methodology, and resources; SH: concept designs, data extraction, writing original draft, methodology, resources, conceptualization, validation, data curation, article review, and guarantor; GPS: concept designs, data extraction, writing original draft, methodology, resources, article review, and guarantor; SH: corresponding author, concept designs, data extraction, writing original draft, methodology, resources, conceptualization, validation, data curation, article review, and guarantor.

Ethical policy and institutional review board statement

The present study was approved by the institution ethics committee of Krishnadevaraya College of Dental Sciences.

Patient declaration of consent

Not applicable since it is an in vitro study.

Data availability statement

All data that support the study results are available from the corresponding author [email protected].

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