The impact of the filling technique with two sealers in bulk or associated with gutta-percha on the fatigue behavior and failure patterns of endodontically treated teeth

PeerJ. 2024 Oct 28:12:e18221. doi: 10.7717/peerj.18221. eCollection 2024.

Abstract

Background: The present in vitro study aimed to evaluate the fatigue behavior of teeth filled with a calcium silicate-based sealer (Bio-C Sealer, BC) or an epoxy resin-based sealer (AH Plus, AH), in bulk or associated with gutta-percha as main core material.

Methods: Seventy-two sound human maxillary anterior teeth were initially selected. Sixty of them, were randomly chosen, and had their root canals prepared using nickel-titanium reciprocating instruments, being again randomly assigned to five experimental groups (n = 12): C+ (control + prepared but not filled); BC-B (BC in bulk); BC-GP (BC+ gutta-percha); AP-B (AH in bulk); AP-GP (AH+ gutta-percha). An additional negative control group (C-) was considered (n = 12), consisting only on sound teeth, without preparation and filling. The specimens were submitted to a survival analysis after the cyclic fatigue test.

Results: Sound teeth (C-) presented the best fatigue performance (P < 0.05), being similar only to the AP-GP group (P > 0.05). Despite that, all experimental groups showed similar fatigue behavior (P > 0.05) to C+ (BC-B = BC-GP = AP-B = AP-GP = C+). Based on that, it can be seen that the use of gutta-percha, as a main core material, associated with the AH Plus sealer, reestablished the mechanical fatigue performance of endodontically treated teeth comparable to sound teeth, still consisting on the most promising approach to rehabilitate such scenario. Teeth filled in bulk, had discreetly higher risk of premature failures and inferior fatigue performance.

Keywords: Endodontic sealers; Endodontically treated teeth; Fatigue; Root canal filling; Root fracture.

MeSH terms

  • Calcium Compounds / chemistry
  • Dental Restoration Failure
  • Dental Stress Analysis
  • Epoxy Resins* / chemistry
  • Gutta-Percha*
  • Humans
  • In Vitro Techniques
  • Materials Testing
  • Root Canal Filling Materials*
  • Root Canal Obturation / methods
  • Silicates / chemistry
  • Tooth, Nonvital

Substances

  • Gutta-Percha
  • Root Canal Filling Materials
  • Epoxy Resins
  • Calcium Compounds
  • Silicates
  • calcium silicate
  • epoxy resin-based root canal sealer

Grants and funding

This study was financed by the Brazilian Federal Agency for Coordination of Improvement of Higher Education Personnel–CAPES (Isabella Marian Lena Doctorate’s scholarships; Finance code 001), and by the Brazilian National Council for Scientific and Technological Development–CNPq (Rafaela Oliveira Pilecco’s doctorate scholarship, project #140118/2022-5; Renan Vaz Machry’s post-doctoral scholarship #151004/2022-6; Gabriel Kalil Rocha Pereira’s research productivity scholarship Pq2, process number #304665/2022-3). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.