Skip to main content

Effect of obturation technique on penetration of calcium silicate–based sealer into dentinal tubules after endodontic retreatment of mandibular premolars



Confocal laser scanning microscopy (CLSM) was used to investigate the penetration of endodontic sealers into the dentinal tubules after retreatment using two different obturation techniques.

Materials and methods

Thirty mandibular premolars were prepared up to instrument F3 (ProTaper Universal, Dentsply) and filled with Endofill using the single cone technique. The canals were retreated using Mtwo instruments. Reobturation was performed with the Bio-C sealer mixed with a fluorophore dye (Fluo-3) using either the lateral condensation technique (group LC) or the single cone technique (group SC) (n = 15). Teeth were sectioned 2, 4, and 6 mm from the apex and analyzed with CLSM to assess the penetration of the sealer into the canal perimeter and the maximum depth of penetration of the sealer into the dentinal tubules. Data were analyzed using ANOVA and the Student-t and Holm-Sidak tests.


In the apical segment, the penetrated perimeter was significantly higher in the LC group than in the SC group (p < 0.05); no significant difference was found in the middle and cervical segments (p > 0.05). In terms of penetration depth, no significant differences were found for any of the segments studied (p > 0.05).


The LC technique promoted a higher percentage of canal circumference penetrated by the sealer than the SC technique in the apical segment after endodontic retreatment.

Clinical relevance

CLSM demonstrated that the LC technique promoted a higher percentage of canal perimeter penetrated by the Bio-C sealer than the SC technique in the apical segment of mandibular premolars after retreatment.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Rached-Junior FJA, Sousa-Neto MD, Souza-Gabriel AE, Duarte MH, Silva-Sousa YT (2014) Impact of remaining zinc oxide-eugenol-based sealer on the bond strength of a resinous sealer to dentine after root canal retreatment. Int Endod J 47(5):463–469.

    Article  PubMed  Google Scholar 

  2. Ruddle CJ (2002) Nonsurgical endodontical retreatment. Elsevier

    Google Scholar 

  3. Martins MP, Duarte MA, Cavenago BC, Kato AS, da SilveiraBueno CE (2017) Effectiveness of the ProTaper Next and Reciproc Systems in removing root canal filling material with sonic or ultrasonic irrigation: a micro-computed tomographic study. J Endod 43(3):467–471.

    Article  PubMed  Google Scholar 

  4. Bernardes RA, Duarte MAH, Vivan RR, Alcade MP, Vasconcelos BC, Bramante CM (2016) Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. Int Endod J 49(9):890–897.

    Article  PubMed  Google Scholar 

  5. Zavattini A, Knight A, Foschi F, Mannocci F (2020) Outcome of root canal treatments using a new calcium silicate root canal sealer: a non-randomized clinical trial. J Clin Med 9(3):782.

    Article  PubMed Central  Google Scholar 

  6. Graunaite I, Skucaite N, Lodiene G, Agentiene I, Machiulskiene V (2018) Effect of resin-based and bioceramic root canal sealers on postoperative pain: a split-mouth randomized controlled trial. J Endod 44(5):689–693.

    Article  PubMed  Google Scholar 

  7. Jeong JW, DeGraft-Johnson A, Dorn SO, Di Fiore PM (2017) Dentinal tubule penetration of a calcium silicate-based root canal sealer with different obturation methods. J Endod 43(4):633–637.

    Article  PubMed  Google Scholar 

  8. López-García S, Pecci-Lloret MR, Guerrero-Gironés J, Pecci-Lloret MP, Lozano A, Llena C et al (2019) Comparative cytocompatibility and mineralization potential of Bio-C Sealer and TotalFill BC Sealer. Mater (Basel) 12(19):3087.

    Article  Google Scholar 

  9. Faul F, Erdfelder E, Buchner A, Lang A-G (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Beha Res Methods 41(4):1149–1160.

    Article  Google Scholar 

  10. Chandra SS, Shankar P, Indira R (2012) Depth of penetration of four resin sealers into radicular dentinal tubules: a confocal microscopic study. J Endod 38(10):1412–1416.

    Article  PubMed  Google Scholar 

  11. Candeiro GT, Correia FC, Duarte MA, Ribeiro-Siqueira DC, Gavini G (2012) Evaluation of radiopacity, pH, release of calcium ions, and flow of a bioceramic root canal sealer. J Endod 38(6):842–845.

    Article  PubMed  Google Scholar 

  12. Mamootil K, Messer HH (2007) Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J 40(11):873–881.

    Article  PubMed  Google Scholar 

  13. Yang R, Tian J, Huang X, Lei S, Cai Y, Xu Z et al (2021) A comparative study of dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow, iRoot SP, and AH Plus with different obturation techniques. Clin Oral Investing 25(6):4163–4173.

    Article  Google Scholar 

  14. Sanz JL, López-García S, Lozano A, Pecci-Lloret MP, Llena C, Guerrero-Gironés J (2021) Microstructural composition, ion release, and bioactive potential of new premixed calcium silicate–based endodontic sealers indicated for warm vertical compaction technique. Clin Oral Investig 25(3):1451–1462.

    Article  PubMed  Google Scholar 

  15. Rossi-Fedele G, Ahmed HM (2017) Assessment of root canal filling removal effectiveness using micro-computed tomography: a systematic review. J Endod 43(4):520–526.

    Article  PubMed  Google Scholar 

  16. Perez AR, Alves FRF, Marcelino-Alves MF, Provenzano JC, Gonçalves LS, Neves AA et al (2018) Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine removal: a micro-computed tomography study. Int Endod J 51(6):684–690.

    Article  PubMed  Google Scholar 

  17. Jardim Del Monaco R, Tavares de Oliveira M, de Lima AF, Navarro RS, Zanetti RV, Teixeira da Silva DF et al (2018) Influence of Nd:YAG laser on the penetration of a bioceramic root canal sealer into dentinal tubules: A confocal analysis. PLoS ONE 13(8):e0202295.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Coronas VS, Villa N, Nascimento AL, Duarte PH, Rosa RA, Só MV et al (2020) Dentinal tubule penetration of a calcium silicate-based root canal sealer using a specific calcium fluorophore. Braz Dental J 31(2):109–115.

    Article  Google Scholar 

  19. Aguiar BA, Frota LMA, Taguatinga DT, Vivan RR, Camilleri J, Duarte MH et al (2019) Influence of ultrasonic agitation on bond strength, marginal adaptation, and tooth discoloration provided by three coronary barrier endodontic materials. Clin Oral Investig 23(11):4113–4122.

    Article  PubMed  Google Scholar 

  20. Kok D, da Rosa RA, Barreto MS, Busanello FH, Santini MF, Pereira JR et al (2014) Penetrability of AH plus and MTA fillapex after endodontic treatment and retreatment: a confocal laser scanning microscopy study. Microsc ResTech 77(6):467–471.

    Article  Google Scholar 

  21. Canali LCF, Duque JA, Vivan RR, Bramante CM, Só MV, Duarte MH (2019) Comparison of efficiency of the retreatment procedure between Wave One Gold and Wave One systems by micro-CT and confocal microscopy: an in vitro study. Clin Oral Investig 23(1):337–343.

    Article  PubMed  Google Scholar 

  22. Van Meerbeek B, Vargas M, Inoue S, Yoshida Y, Perdigão J, Lambrechts P, et al. (2000) Microscopy investigations: techniques, results, limitations. Am J Dent 13(Spec No):3D–18D. PMID: 11763917

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ana Grasiela Limoeiro.

Ethics declarations

Compliance with ethical standards/Ethical approval

This study was approved by the Institutional Research Ethics Committee (registration number 2.730.978) and was conducted in compliance with all ethical standards of the Declaration of Helsinki of the World Medical Association.

Informed consent

All patients signed a free and informed consent form before being enrolled in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Martins, M.P., de Andrade, F.B., Bramante, C.M. et al. Effect of obturation technique on penetration of calcium silicate–based sealer into dentinal tubules after endodontic retreatment of mandibular premolars. Clin Oral Invest (2022).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI:


  • Confocal laser scanning microscopy
  • Dentin permeability
  • Endodontic retreatment
  • Root canal filling materials
  • Root canal obturation