The ability of different compositions of calcium silicate and epoxy sealers to withstand gutta percha removal via in vitro pull-out testing

Objective: Examination of the influence of chemical composition changes on the ability of sealers to withstand a pull-out test. Materials and Methods: Fifty distal or palatal canals of extracted teeth were prepared with DC Taper files and divided into five groups: AH Plus, BJM RCS, Total Fill BC, AH Plus Bioceramic, and a gutta-percha (GP) only group. Ten days after obturation, each cone underwent a pull-out test using a Shimadzo Universal Testing Machine; the maximum force (N) was recorded along with whether the cone was torn or removed. Results: The force required to remove or rupture the cone was significantly higher in all sealer groups compared to AH Plus Bioceramic. AH Plus required about double the force of AH Plus Bioceramic (1.87 ± 0.53 N vs 0.93 ± 0.48 N, P < 0.001). All cones (n = 10) in the AH Plus Bioceramic group were removed in their entirety (P = 0.01 versus each other group). Conclusions: Adding macromolecules to an epoxy sealer did not change its performance in the pull-out test. Reducing tri- and di-calcium silicate and increasing zirconium oxide in a bioceramic sealer significantly decreased its ability to withstand the pull-out test.

Idan Stiklaru, Ella Lalum, Sobhi Hamoud, Maayan Paz, Avi Levin, Joe Ben Itzhak, Nirit Yavnai, Pavel Gorenbein, Michael Solomonov