Evaluation of Apical Sealing Ability of Different Endodontic Sealers: A Stereomicroscopic Study

Introduction: The introduction of the adhesive dentistry concept has allowed materials to bond and provide intimate contact with the dentin walls of the root canal. Bondable root canal sealers, such as methacrylate resin sealer, can form a monobloc system within the root canal space, which improves the seal and fracture resistance of the filled canals. Recently, bioceramics have become one of the most popular biomaterials used in Endodontics after the clinical success of Mineral Trioxide Aggregate (MTA). Aim: The present study aimed to evaluate the sealing ability of three endodontic sealers (AH Plus, MTA Fillapex and Bio-C sealer) through an in-vitro dye leakage test. Materials and Methods: The present in-vitro study was conducted in Bharati Vidyapeeth Deemed to be University Dental College and Hospital, Pune, Maharashtra, India, from April 2024 to September 2024. Thirty intact single-rooted single-canaled teeth extracted for orthodontic/periodontal reasons were used in this study. These teeth were decoronated, chemomechanical preparation was done till size F3, and they were divided into three groups of 10 each. The samples in Group A were obturated with F3 Gutta-Percha (GP) cone and AH Plus sealer, in Group B, MTA Fillapex sealer was used, and in Group C, Bio-C sealer was used. The apical microleakage was measured microscopically using the linear dye penetration method. The intergroup comparisons of microleakage were made using the One-way Analysis of Variance (ANOVA) test, followed by a post-hoc Tukey test for pairwise comparisons. A p-value of less than 0.05 was considered statistically significant. Results: The MTA Fill-apex sealer group exhibited the highest level of microleakage, with a mean value of 1.48 mm, followed by the Bio-C sealer, which had a mean microleakage of 0.78 mm. In contrast, the AH Plus sealer group showed the lowest microleakage, with a mean of 0.59 mm. The differences in microleakage among the three groups were statistically significant at p≤0.05. Specifically, a significant difference was observed between AH Plus and MTA Fill-apex (p=0.002), as well as between MTA Fill-apex and Bio-C (p=0.015). However, the difference between AH Plus and Bio-C was not statistically significant (p=0.702). Conclusion: The present study findings indicated that AH plus sealer exhibited superior sealing ability compared to MTA Fillapex and Bio-C sealer. Hence, it can be concluded that AH Plus provides more effective sealing, making it a more reliable option during obturation procedures and contributing to better long-term treatment outcomes.