Correlation of dentinal penetration and microleakage of bioceramic with calcium hydroxide and resin based root canal sealers- A CLSM study

Context: The role of Root canal sealers is a very crucial role in endodontic therapy by forming a hermetic seal within the canal, filling minor voids between the dentinal wall and gutta-percha to prevent microleakage from bacterial infiltration from the oral cavity and tissues of periapical areas. Aim: This study aims to compare and evaluate the depth of penetration and microleakage of AH Plus, Bio-C, Sealapex, and MTA Fillapex using a confocal laser scanning microscope (CLSM). Subjects and Methods: This study evaluated sealer penetration and microleakage in 170 single-rooted teeth divided into two groups ( n = 85 each). Group A assessed sealer penetration of Group I: MTA Fillapex, Group II: Selapex, Group III: Bio-C, Group IV: AH Plus, and Group V: Control group (obturated without sealer) using 0.1% Rhodamine B-labeled sealers, and CLSM was done at 3 mm and 5 mm from the apex. Group B measured microleakage in the above-mentioned 5 groups, after 7-day immersion of samples in 0.1% Rhodamine B and evaluating dye penetration longitudinally from the cemento-dentinal junction. Statistical Analysis: Data were analyzed using paired t-tests, Tukey Honestly Significant Difference, ANOVA, and Pearson’s correlation as statistical tools. Results: Group III has demonstrated the highest sealer penetration at both 3 mm and 5 mm levels, and exhibits the best microleakage resistance. However, minimum penetration has been shown by Group I and Group II at 3 mm and 5 mm, respectively. Group II has shown the highest microleakage among the sealers. Conclusion: Bio-C sealer performed best, whereas Sealapex has shown the worst both in sealer penetration and microleakage.