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Comparative Analysis of Microleakage and Seal for 2 Obturation Materials: Resilon/Epiphany and Gutta-Percha
Howard E. Strassler, DMD
Aptekar A, Ginnan K. J Can Dent Assoc. 2006;72:245.
OBJECTIVE: Microleakage continues to be a main reason for failure of root canal therapy, where the challenge has been to achieve an adequate seal between the internal tooth structure and the main obturation material, gutta-percha. The Resilon/Epiphany (R/E) system uses a new obturation material that bonds chemically with the internal tooth structure, thereby decreasing the possibility of microleakage. The purpose of this study was to compare dye leakage in root canals filled with R/E and those in which gutta-percha was used. METHODS AND MATERIALS: Pulpectomies were performed on 105 extracted human single canal mandibular incisors. The teeth were then randomly divided into 2 groups: 1 was obturated with gutta-percha and the other with R/E. Obturation was performed using the lateral condensation technique. The teeth were then incubated for 10 days, 1 month or 3 months in a heated water bath solution with dye to simulate conditions in the human oral cavity. Teeth were sectioned and examined under dissecting and scanning electron microscopes to assess dye penetration, seal and bonding. RESULTS: Resilon as the main obturation material consistently resulted in less microleakage than gutta-percha at all 3 time intervals. CONCLUSION: The R/E system provides a new material for root canal treatment. R/E creates a chemical bond with the internal tooth structure over the entire root area that is maintained over time, thus representing a better option than gutta-percha. Further studies on R/E will help validate its use and determine its long-term success rates in vivo.
Gutta-percha was introduced as an endodontic filling material in 1914, and continues to be the standard obturation material for endodontic therapy. While gutta-percha fulfills many of the properties desired of a root canal filling material, including chemical stability, radiopacity, biocompatibility, and ease of manipulation, it lacks one very important criteria—it does not adhere to tooth structure and, therefore, requires additional techniques and materials to reduce microleakage and achieve an apical seal.
In recent years, the concept of placing a root canal filling material that provides the necessary properties combined with a chemical–micromechanical bond to the tooth structure has been introduced. One of these products is Resilon/ Epiphany (R/E) (Pentron Clinical Technologies, Wallingford, CT). This system is a synthetic, thermoplastic resin filling material that it is believed to have overcome the limitations and problems associated with gutta-percha.
This well-designed study used standard techniques for canal instrumentation and gutta-percha master cone with lateral condensation obturation using Tubli-Seal (Sybron Dental Specialties Inc, Orange, CA) and the manufacturer’s recommendations for the use of R/E. For all three incubation periods, there was less leakage with the R/E system, while a complete seal was not observed in any of the gutta-percha samples. This confirms other studies that have evaluated the R/E system for root canal obturation. It is time to look to new biomaterials and technologies for endodontic obturation. The R/E system provides a new material that not only creates adhesion to the internal, instrumented tooth structure within the root canal, but the seal is maintained over time to a greater degree than a conventional gutta-percha filling technique.
|About the Author|
Howard E. Strassler, DMD