The effect of EDTA, phytic acid and glycolic acid on dentinal tubule penetration of bioceramic root canal sealer: A confocal analysis study

Aim: This study aims to evaluate the effects of ethylene diamine tetra acetic acid (EDTA), phytic acid (IP6) and glycolic acid (GA) on the dentin tubule penetration of bioceramic root canal sealer. Material and Method: In our thesis study, 60 single rooted single canal human mandibular premolar teeth were used. The roots of the teeth were separated from their crowns with a root length of 14 mm. Canal shaping was performed with Reciproc file no. 40 and pre-expansion of canal was performed with K type hand files. During shaping, the canals were irrigated with 2.5% sodium hypochlorite (NaOCl) at each file change. After completing the shaping process, the canals were washed with 5 ml of distilled water (DW) to prepare for the final irrigation. The teeth whose preparations were finished were randomly divided into 4 groups including 15 teeth in each group for final irrigation. Group 1: 2.5 ml 5.25% NaOCl + 5ml DW +5 ml 17% EDTA + 5ml DS ultrasonic activation (UA) (30 sec) Group 2: 2.5 ml 5.25% NaOCl +5 ml DW+ 5 ml 1% IP6 + 5 ml DS (UA 30 sec) Group 3: 2.5 ml 5.25% NaOCl + 5ml DW + 5 ml 10% GA + 5 ml DS (UA 30 sec) Group 4: 2.5 ml 5.25% NaOCl + 5 ml DW + (UA 30 sec) (control group) 3 The teeth, whose irrigation procedures were completed, were dried with paper cones. The bioceramic sealer to be used for canal filling was marked with 0.1% Rhodamin B. The canal filling was filled with gutta percha, compatible with the R40 file, and marked canal sealer. The filling was supported by lateral condensation. Then, the teeth were embedded in cold acrylic and kept in the incubator for 1 week. Two horizontal sections were taken from the roots at the apical 3 mm and 7 mm level with the help of IsoMet (IsoMet 1000, Buehler, IL, ABD) and a diamond disc (Metkon, Microcut precisioncutter, Bursa, Türkiye). The obtained sections were examined with a laser scanning confocal microscope (CLSM) and the images were transferred to digital media. Dentinal tubule penetration depth, penetration area and percentage of the dentinal tubule sealer penetration were calculated in the 'Zen' computer program. Results: While normally distributed penetration depth and percentage data were analyzed with Two-Way Analysis of Variance; non-normally distributed penetration area data were analyzed with Two-Way Robust Analysis of Variance. Multiple comparisons were made with Bonferroni Correction. According to the analysis; the penetration depth and penetration percentage of the bioceramic-based root canal sealer was significantly higher than the chelation-free control group. This difference is not significant for the penetration area. The penetration depth, percentage and area of the sections from the apical 7 mm level is significantly higher than that of the sections from the apical 3 mm level. Conclusion: The effect of glycolic acid and phytic acid on tubule penetration of bioceramic based root canal sealer showed similar results with EDTA. Keywords: confocal, phytic acid, glycolic acid, penetration, EDTA