Original Article

Comparative evaluation of the apical sealing ability and

adaptation to dentine of three resin-based sealers: An in
vitro study
Anil Kumar S, Vasundhara Shivanna, Mohan Thomas Naian, GB Shivamurthy
Deptartment of Conservative Dentistry and Endodontics, College of Dental Sciences, Davangere, Karnataka, India

Abstract
Objective: To evaluate the apical sealing ability and adaptation of three resin-based sealers to the dentine.
Materials and Methods: A total of 66 recently extracted human maxillary anterior teeth were subjected for the study. The
teeth were prepared and obturated with gutta-percha by a lateral condensation using AH Plus, Endorez and Epiphany sealers.
Fifteen teeth from each group were used for the apical leakage test and the remaining five teeth from each group were used for
examination under the scanning electron microscope. Data were analyzed using one-way ANOVA and the Student Newman-
Keuls test.
Results: Epiphany sealer showed better sealing ability and adaptation to dentine.
Conclusion: The Epiphany sealer has a better apical sealing ability and adaptation to dentine than the AH Plus and Endorez
sealers.
Keywords: AH plus; apical leakage; Endorez; Epiphany; lateral condensation; resin-based sealer; scanning electron
microscope

INTRODUCTION the individual gutta-percha points and between the gutta-

The root canal system is the clinician’s road wayto
success.[1] Numerous studies have been conducted to evaluate
the success and failure of endodontic treatment.[2-4]
The current concept among clinicians is that after complete
debridement, a three-dimensional obturation of the root
canal space that is free of inflammation constitutes the key
factor for successful endodontic therapy.[5] However, it has
been reported that a complete seal of the root canal system
is almost impossible with the currently accepted materials
and obturation techniques using a combination of gutta-
percha and root canal sealer.[6]
Several materials and techniques have been advocated for
filling root canals with lateral condensation of gutta-percha
cones complemented with sealer cement being the most
widely accepted technique.[7] Many techniques have been
suggested and evaluated, most of them advocating the
use of gutta-percha as the core material and with sealer of
a different composition to fill the residual gaps between
percha and the canal wall.[8]
Different sealer formulations have been subjected to
extensive research with respect to their mechanical and
biological properties, reflecting the prevailing belief
that the appropriate selection of a sealer and its clinical
performance may influence, at least in part, the outcome
of endodontic therapy.[9]
Ideally, the root canal sealer should be capable of producing
a bond between the core material and the dentine of the
root canal, effectively preventing leakage. It should also
be non-toxic and, preferably, have a positive effect on the
healing of periapical lesions.[8]
A great variety of endodontic sealers are available
commercially and they are divided into groups according
to their chemical composition. There are sealers based on
zinc oxide and eugenol, epoxy resin, calcium hydroxide and
glass ionomer.[10]

Address for correspondence: Access this article online

Dr. Anil Kumar S, Room No. 9, Department of Conservative Quick Response Code:
Dentistry and Endodontics, College of Dental Sciences, Website:
Davangere – 577004, Karnataka, India. www.jcd.org.in
E-mail: anilendo@yahoo.com
Date of submission: 19.01.2010 DOI:
Review completed: 18.03.2010 10.4103/0972-0707.80724
Date of acceptance: 03.07.2010

16 Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1


Endodontic sealers based on zinc oxide and eugenols
have been used clinically for several decades because they
have satisfactory physicochemical properties.[11] The glass
ionomer sealers were introduced into root canal treatment
because of their adhesion to dental hard tissues.[12]
At present, sealers based on epoxy resins afford very
good physical properties and ensure adequate biological
performance. Excellent apical sealing has been found with
epoxy resin-based sealers.[13] Previous studies showed
that the epoxy resin-based root canal sealer, AH Plus, is
cytocompatible,[14] biocompatible and has good tissue
tolerance,[15] long-term dimensional stability[16] and good
sealing ability.[17]
Recently, Endorez, a new resin-based sealer, has
been introduced and its active ingredient is urethane
dimethacrylate (UDMA). The UDMA is a monomer forming
the organic matrix of composite resins. Materials including
resin adhere adequately to the dentine. According to
the manufacturer, Endorez is biocompatible and has
satisfactory sealing properties, hydrophilic characteristics
and early delivery system.[18]
Epiphany is a new material that was developed to replace
gutta-percha and traditional sealers for root canal
obturation. The Epiphany sealer is a dual curable dental
resin composite sealer.[19]
The purpose of this in vitro study was to compare the apical
sealing ability and adaptation of three resin-based sealers
to dentine.
MATERIALS AND METHODS
A total of 66 recently extracted intact, non-carious, non-
restored human maxillary anterior teeth that were free
from malformed roots, calcified root canals, open apices
and had straight roots were subjected for the study. All 66
teeth were cleaned to remove surface calculus and stains.
The teeth were placed in 5.25% NaOCl (Vensons, Bangalore,
India) solution for 8 h to remove the surface soft tissues
and debris, then washed with tap water and, subsequently,
stored in saline solution until they were used.
The crowns of the teeth were sectioned at the cemento-
enamel junction using a water-cooled diamond disc.
Routine access openings were prepared and then the
working lengths were visually determined by subtracting 1
mm from the length of a size 10 K-file (Dentsply, OK, USA)
at the apical foramen. All the canals were instrumented to
the working length with a size 50 K-file (Dentsply) using
the step-back technique. The middle and coronal thirds
were prepared using size 2–4 Gates Glidden drills (Mani
Inc., Tochigi, Japan) with a low-speed hand piece. The root
canals were irrigated with 1 ml of 5.25% NaOCl (Vensons)
after each file while instrumenting the canals. The patency
of the apical foramen were confirmed with a size 10–15
Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1
Kumar, et al.: Sealing ability of resin based sealers
K-files (Dentsply). Following the root canal preparation, in
order to remove the smear layer, the canals were irrigated
with 10 ml of 17% ethylenediaminetetraacetic acid (EDTA)
(Septodont, Cedex, France) for 1 min and 10 ml of 5.25%
NaOCl (Vensons).[18] A syringe with a 23-gauge needle was
used for irrigation. Finally, the root canals were flushed with
3 ml of distilled water and then dried with paper points.
The teeth were randomly divided into three groups of 20
teeth each and the remaining six teeth served as a dye
leakage control.
Group 1: Gutta-percha with AH Plus sealer.
Group 2: Gutta-percha with Endorez sealer.
Group 3: Gutta-percha with Epiphany sealer.
Control groups
Group 4: Positive control of gutta-percha with AH Plus
sealer.
Group 5: Positive control of gutta-percha with Endorez
sealer.
Group 6: Positive control of gutta-percha with Epiphany
sealer.
Group 7: Negative control of gutta-percha with AH Plus
sealer.
Group 8: Negative control of gutta-percha with Endorez
sealer.
Group 9: Negative control of gutta-percha with Epiphany
sealer.
Each sealer was prepared according to the manufacturer’s
instructions and the canal walls were slightly coated with
a sealer using a size 45 K-file (Dentsply) with a counter-
clockwise motion.[18] The apical part of the master gutta-
percha cone was coated with the mixed sealer and placed
in the canal. The canals were filled with accessory cones by
the lateral condensation technique.
The access openings were closed with Cavit and all
specimens were kept in 100% humidity at 370C for 72 h to
allow the sealers to set.
Fifteen teeth from each group were used for the apical
leakage test and five teeth were reserved for examination
with a scanning electron microscope (SEM). Three teeth,
which served as negative controls, were filled with sealers
and gutta-percha points. Three teeth, which served as
positive controls, were left unfilled.
Apical leakage test
Apical leakage was estimated by a dye penetration test.
The root surfaces of all specimens were coated with two
layers of nail varnish and sticky wax with the exception
of the apical 1 mm, but the root surfaces of the negative
control teeth were entirely coated with two layers of nail
varnish and sticky wax to prevent possible leakage.
17
Kumar, et al.: Sealing ability of resin based sealers
Table 1: Mean microleakage, SD and SE in the study groups
Groups Mean ± SD
Group I: Gutta-percha and AH Plus 6.9 ± 0.62
Group II: Gutta-percha and Endorez 9.36 ± 0.86
Group III: Gutta-percha and Epiphany 3.85 ± 0.89
*One-way ANOVA test.
Table 2: Multiple comparisons among the three groups
Groups P*-value Significance
Group I and group II <0.05 Significant
Group I and group III <0.05 Significant
Group II and group III <0.05 Significant
*Student Newman-Keuls test.
The specimens were then immersed in 2% methylene blue
solution for 7 days at 370C. After being removed from the
dye solution, the specimens were washed with tap water
and dried and then the nail varnish and sticky wax were
removed with a scalpel. The root of each tooth was grooved
longitudinally in the bucco-lingual direction using a low-
speed diamond disc under constant cooling with distilled
water, without disturbing the gutta-percha filling and then
the root was longitudinally sectioned.
Maximum dye penetration was measured in millimeters in
each half of each tooth from the apex to the most coronal
part of the root canal to which the dye had penetrated
using a stereomicroscope.
Scanning electron microscope examination
Reserved five specimens from each group were prepared for
SEM examination. The roots were grooved longitudinally
as it was mentioned above. They were then split into two
halves by placing a cement spatula in the grooves and
applying gentle pressure. Both fractured halves of each
root were mounted on aluminum stubs, vacuum-dried,
coated with 20 nm of gold and then examined under
SEM. The penetration of sealers into dentinal tubules and
adaptation to dentinal walls were examined from the apical
to the coronal and microphotographs were taken at 1500×
magnification.
The results were statistically analyzed using one-way
ANOVA and the multiple comparisons among the groups
was carried out by the Student Newman-Keuls test. The
level of significance was fixed at P <0.05.
RESULTS
Analysis of results
Apical leakage test
The positive control teeth showed complete leakage
throughout the length of the root canal, whereas the
negative control teeth revealed no dye penetration. Dye
penetration in the experimental groups occurred mainly at
18 Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1
Std. error of mean F*-value P-value Significance
0.19 179.47 <0.001 Highly significant
0.27
0.25
the interface of the sealer and the root canal wall in the
majority of the specimens.
Table 1 shows the mean microleakage (mm), SD and SE for
each study groups.
The mean value of dye penetration for the AH Plus root
canal sealer was 6.9 ± 0.62 mm, Endorez sealer was 9.36
± 0.86 mm and Epiphany sealer was 3.85 ± 0.89 mm.
Table 2 shows the multiple comparison of mean leakage
and SD of each study groups.
Multiple paired comparisons (Student Newman-Keuls Test)
showed that group 3 (GP and Epiphany) had the least
amount of microleakage than all the other groups; group 1
(GP and AH Plus) proved to have the second-least amount of
microleakage among the groups. Group 2 (GP and Endorez)
demonstrated the greatest amount of microleakage. There
was a significant difference between group 3 (GP and
Epiphany) and group 2 (GP and AH Plus) (P < 0.05).
Scanning electron microscope examination
The SEM study was carried out for dentine adaptability.
SEM examination showed better dentine adaptability for
group 3 (GP and Epiphany) than group 1 (GP and AH Plus)
and group 2 (GP and Endorez).
(Please refer for the Tables 1 and 2 and Figure 1)
DISCUSSION
Ideally, the root canal sealer should be capable of producing
a bond between the cone material and the root dentine
effectively preventing leakage.[8] Three-dimensional sealing of
the root canal is one of the main goals of endodontic treatment
and is essential for preventing reinfection of the canal and for
preserving the health of the periapical tissues, thereby ensuring
the success of root canal treatment. Thus, several types of
endodontic sealers have been recommended to achieve this
goal and, consequently, the evaluation of the apical sealing
ability of the sealers is important. It is important to point out
that not only is the apical seal of the root canal but the coronal
seal is of equal importance for the success of endodontic
treatment.[10] In this study, apical sealing and adaptation of three
resin-based sealers to dentine was assessed.
Many techniques have been suggested and evaluated,

10
9
8
Mean Microleakage (mm)
7
6
5 9.36
4 6.9
3 were compared. Group 1 (GP and AH Plus) showed less
2 microleakage than group 2 (GP and Endorez).
1
0 These results are in agreement with the following studies.
Gutta Percha&A H Plus Gutta Percha& Endorez
Figure 1: Comparison of microleakage among three sealers
most of them advocating the use of gutta-percha as the
core material and with sealers of a different composition
to fill the residual gaps between the individual gutta-
percha points and between the gutta-percha and the canal
wall.[8] Different sealer formulations have been subjected
to extensive research with respect to their mechanical
and biological properties, reflecting the prevailing belief
that the appropriate selection of a sealer and its clinical
performance may influence, at least in part, the outcome
of endodontic therapy.[9]
Ideally, further directions should focus on materials that
penetrate the patent dentinal tubules, bind intimately to
both organic and inorganic phases of dentin, neutralize or
destroy microorganisms and their products, predictably
induce a cemental regenerative response and strengthen
the root system.
Resin-filling materials have steadily gained popularity
and are now accepted as a root canal filling materials
(ADA Council on Scientific Affairs 1998). AH Plus is
a two-component paste root canal sealer, based on
polymerization reaction of epoxy resin-amines.[20] Recently,
a new methacrylate-based endodontic sealer, Endorez,
was introduced as root canal sealer.[21] Epiphany sealer
is a dual curable dental resin composite sealer. The resin
matrix is a mixture of BisGMA, ethoxylated methacrylates,
urethane dimethacrylate resin and hydrophilic difunctional
methacrylates.[22]
Leakage studies on the sealing properties of endodontic
materials are still important and relevant.[17] Different
methods have been used to evaluate the sealing of
endodontic cements. Assessment of linear dye penetration
is a common method used to explore apical leakage of
root fillings after splitting the roots. The leakage marker
used in this study was methylene blue because it has a
low molecular weight and penetrates more deeply along
the root-canal filling.[23] It is well known that root-filling
materials penetrate better into dentinal tubules in the
absence of the smear layer.[24] In this study, 17% EDTA and
Kumar, et al.: Sealing ability of resin based sealers
5.25% NaOCl were used as irrigation solution to remove the
smear layer.[18]
Results of this study showed that group 3 (GP and
Epiphany) showed less microleakage than group 1 (GP
and AH Plus) and group 2 (GP and Endorez). There was a
statistically significant difference when the three groups
3.85
Gutta Percha & Epiphany
A recent study compared the apical sealing ability of the
new resin-based Epiphany-Resilon root canal filling system
with the sealing abilities of different pairings of AH Plus,
gutta-percha, Epiphany and Resilon. This study showed
that the Epiphany gutta-percha combination had a lower
amount of microleakage than the AH Plus gutta-percha
combination.[25]
A study evaluated the setting time, solubility and
disintegration, flow, film thickness and dimensional change
following setting in a dual-cured resin root canal sealer
Epiphany compared with an epoxy-resin-based sealer AH
Plus. This study showed that the setting time, flow and
film thickness tests for both cements conformed to ANSI/
ADA standards. The dimensional alteration test for both
cements was greater than the values considered acceptable
by ANSI/ADA. Epiphany values regarding solubility were
also greater than values considered acceptable by ANSI/
ADA.[26]
A study assessed the bond strength of the new resin-based
Epiphany-Resilon root canal filling system and compared
this with bond strengths of different pairings of AH Plus,
gutta-percha, Epiphany and Resilon. The Epiphany gutta-
percha combination showed significantly (P < 0.001)
greater bonding strength than all the other groups.[27]
An in vitro study was conducted to evaluate the apical
leakage of three root-canal sealers: AH Plus, Diaket and
Endorez, using a new computerized fluid filtration meter.
This study showed that the root fillings with Diaket in
combination with the cold lateral condensation technique
showed lower apical leakage than AH Plus and Endorez.[28]
The scanning electron microscopy showed that Epiphany
had adapted better to dentine and penetrated more into
dentinal tubules than the AH Plus and Endorez root canal
sealers from apical to coronal of root canal. All the sealers
showed poorer adaptation and penetration in the apical
third than the coronal and middle thirds of the root canal.
This difference may be due to the removal efficiency of the
smear layer in the apical third of the canal. In addition, the
number and size of the dentinal tubules and the structure
of the dentine (tubule density) in the apical third and the
Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1 19
Kumar, et al.: Sealing ability of resin based sealers
employed obturation techniques may affect the adaptation
and penetration of sealers.
The probable reason for less microleakage for the
combination of gutta-percha and Epiphany sealer are:
The configuration factor (C-factor), defined as the ratio of
bonded to unbonded surface areas of cavities, in a root
canal is highly unfavorable and contributes to maximizing
the polymerization stress of resin-based materials along
the root canal walls. There is extremely high C-factor
encountered in long, narrow root canals, tending to
cause a resistance in the relieving of shrinkage stresses
during polymerization. Focusing on this issue becomes
more critical as the resin sealer is light cured to create an
immediate coronal seal. Because this prevents stress relief
by resin flow and the resin sealer may detach from dentin
walls thus creating interfacial gaps. However, despite these
problems, the results for the present study indicated that
the Epiphany sealer and the gutta-percha core combination
had the least amount of microleakage than all the other
groups. One possible explanation is that the gutta-percha
is more compactable than Resilon and thus may partially
compensate for interfacial stresses by lateral compaction
and also helps to resist dislodgement.[25]
Self-etching primer was used with Epiphany sealer in this
study. This might probably have increased the penetration
of Epiphany sealer into the root canal dentine. Therefore,
this increased the adaptability of sealer to root canal
dentine, thereby decreasing the apical leakage.[26]
CONCLUSION
According to results of this study, the dual curable
methacrylated resin with a self-etching primer Epiphany
had better apical sealing ability and better adaptability to
dentine than epoxy-based AH Plus sealer and methacrylate-
based Endorez sealer. But, further studies using different
sealers and techniques are warranted before Epiphany can
be recommended for clinical application.
REFERENCES
1. West JD, Roane JB. Cleaning and shaping the root canal system. In:
Cohen S, Burns RC, editors. Pathways of the pulp chapter-8. 7th ed.
St.louis: Mosby Inc; 1998. p. 203-357.
2. Swartz DB, Skidmore AE, Griffin JA. Twenty years of endodontic success
and failure. J Endod 1980;9:198-202.
3. Matsumoto T, Nagai T, Ida K, Ito M, Kawai Y, Horiba N, et al. Factors
affecting successful prognosis of root canal treatment. J Endod
20 Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1
1987;13:239-42.
4. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long
–term results of endodontic treatment. J Endod 1990;16:498-504.
5. Nguyen TN. Obturation of the root canal system. In: Cohen S, Burns RC,
6. Gutmann JL. Adaptation of injected thermoplasticized gutta-percha in
the absence of the dentinal smear layer. Int Endod J 1993;26:87-92.
7. Itoh A, Higuchi N, Minami G, Yasue T, Yoshida T, Maseki T, et al. A survey
of filling methods, intracanal medications and instrument breakage. J
Endod 1999;25:823-4.
8. Ahlberg KM, Tay WM. A methacrylate-based cement used as a root
canal sealer. Int Endod J 1998;31:15-21.
9. Orstavik D, Kereker K, Eriksen HM. Clinical performance of three
endodontic sealers. Int Endod J 1981:14:27-34.
10. De Almeida WA, Leonardo MR, Tanomaru Filho M, Silva LA. Evaluation
of apical sealing of three endodontic sealers. Int Endod J 2000;33:25-7.
11. Benatti O, Stolf WL, Ruhnke LA. Verification of the consistency, setting
time and dimensional changes of root canal filling materials. Oral Surg
Oral Med Oral Pathol 1978;46:107-13.
12. Aboush Y, Jenkins CB. An evaluation of the bonding of glass ionomer
restorative to dentin and enamel. Br Dent J 1986;16:179-84.
13. Limkangwalmongkol S, Abbott PV, Sandler AB. Apical dye penetration
with four root canal sealers and gutta-percha using longitudinal
sectioning. J Endod 1992;18:535-9.
14. L eyhausen G, Heil J, Reifferscheid G, W aldmann P, Geurtsen W.
Genotoxicity and cytotoxicity of the epoxy resin-based root canal sealer
AH Plus. J Endod 1999;25:109-13.
15. Leonardo MR, Silva LA, Almeida WA, Utrilla LS. Tissue response to an
epoxy resin - based root canal sealer. Endod Dent Traumatol 1999;15:28.
16. Al-khatar N, Kunzelmann K, Hickel R. Apical leakage of new root canal
sealers. J Dent Res 1995;74:945.
17. Miletic I, Ribaric SP, Karlovic Z, Jukic S, Bosnjak A, Anic I. Apical leakage
of five root canal sealers after one year of storage. J Endod 2002;28:
431-2.
18. Sevimay S, Kalayci A. Evaluation of apical sealing ability and adaptation
to dentine of two resin-based sealers. J Oral Rehabil 2005;32:105-10.
19. Tunga U, Bodrumlu E. Assessment of the sealing ability of a new root
canal obturation material. J Endod 2006;32:876-8.
20. Versiani MA, Carvalho-Junior JR, Padilha MI, Lacey S, Pascon EA,
Sousa-Neto MD. A comparative study of physicochemical properties of
AH Plus and Epiphany root canal sealants. Int Endod J 2006;39:464-71.
21. Sousa CJ, Montes CR, Pascon EA, Loyola AM, Versiani MA. Comparison
of the intraosseous biocompatibility of AH Plus, Endorez, and Epiphany
root canal sealers. J Endod 2006;32:656-62.
22. Key JE, Rahemtulla FG, Eleazer PD. Cytotoxicity of a new root canal
filling material on human gingival fibroblasts. J Endod 2006;32:756-8.
23. Schafer E, Olthoff G. Effect of three different sealers on the sealing ability
of both thermafil obturators and cold laterally compacted Gutta-Percha.
J Endod 2002;28:638-42.
24. Torabinejad M, UNG B, Kettering JD. Invitro bacterial penetration of
coronally unsealed endodontically treated teeth. Part II, sealer types. J
Endod 1990;13:109-12.
25. Onay EO, Ungor M, Orucoglu H. An in vitro evaluation of the apical
sealing ability of a new resin-based root canal obturation system. J
Endod 2006;32:976-8.
26. Leonard JE, Gutmann JL, Guo IY. Apical and coronal seal of roots
obturated with a dentine bonding agent and resin. Int Endod J
1996;29:76-83.
27. Ungor M, Onay EO, Orucoglu H. Push-out bond strengths: The
Epiphany-Resilon endodontic obturation system compared with
different pairings of Epiphany, Resilon, AH Plus and gutta-percha. Int
Endod J 2006;39:643-7.
28. Orucoglu H, Sengun A, Yilmaz N. Apical leakage of resin based root
canal sealers with a new computerized fluid filtration meter. J Endod
2005;31:886-90.
Source of Support: Nil, Conflict of Interest: None declared.