The marginal adaptation of Cold Ceramic sealer, Endoseal MTA, and AH26: A scanning electron microscope study

Objective: The current study evaluated the marginal adaptation of different endodontic sealers based on epoxy resin, mineral trioxide aggregate (MTA), and cold ceramic (CC) to intraradicular dentin using scanning electron microscopy (SEM).Methods: Forty-five extracted single-rooted teeth were obtained. After root canal instrumentation, the samples were obturated using the lateral condensation technique with gutta-percha and one of the following sealers (n=15 for each group): 1) An epoxy resin-based sealer (AH26), 2) an MTA-based sealer (Endoseal MTA), and 3) a cold ceramic-based sealer (CC sealer). A cross-section was prepared 3 mm from the apex of each tooth. Using scanning electron microscopy (SEM), we measured the average maximum distance between the root filling material and the canal walls in four sectors of the root cross-section. Data were analyzed using one-way ANOVA and post-hoc Tukey’s test (α=0.05).Results: The average linear distance between the sealer and dentinal wall significantly differed among the three groups (P=0.001). Pairwise comparisons revealed that the mean distance in the AH26 group (11.99 ± 4.31 µm) was significantly higher than that in the CC sealer (7.25 ± 1.94 µm; P<0.001) and Endoseal MTA group (8.86 ± 3.33 µm; P=0.014). The marginal gap between the CC sealer and Endoseal MTA group was statistically comparable (P = 0.735).Conclusion: The CC sealer and Endoseal MTA exhibited similar marginal adaptation to root canal dentin, which was superior to the epoxy resin-based AH26 sealer. Endoseal MTA and cold ceramic sealers could be recommended for endodontic treatments to reduce the risk of reinfection.