Bonding of Self-adhesive (Self-etching) Root Canal Sealers to Radicular Dentin

Abstract 

The latest generation of methacrylate resin–based sealers has eliminated the use of separate self-etching primers by incorporating acidic resin monomers in the sealers to render them self-adhesive to dentin. This study examined the adhesive strengths, interfacial ultrastructure, and tracer penetration of a nonetching (EndoREZ; Ultradent, South Jordan, UT) and two self-adhesive methacrylate resin–based sealers (MetaSEAL; Parkell, Farmington, NY, and RealSeal SE; SybronEndo, Orange, CA) when they were applied to radicular dentin following the manufacturers' recommended use of EDTA as the active final rinse. A modified push-out testing design was used to evaluate the dislodgement of core-free sealers. The mixed sealers were placed in dimensionally identical, artificially created canal spaces prepared in the coronal, middle, and apical thirds of radicular dentin. After setting, each sealer-filled cavity was subjected to compressive loading until failure. Additional specimens were prepared for transmission electron microscopy to examine the ultrastructure and nanoleakage within the sealer-radicular dentin interface. The two self-adhesive sealers MetaSEAL and RealSeal SE exhibited higher push-out strengths than the nonetching sealer EndoREZ when EDTA was used as the active final rinse. All three sealers showed a 1- to 1.5-μm thick zone of partially demineralized dentin, with the EDTA dentin demineralization effect masking the true self-etching potential of MetaSEAL and RealSeal SE. The true self-etching potential of self-adhesive sealers is a clinically important attribute that should be further investigated. Incomplete smear layer removal from the apical third of instrumented canal walls may jeopardize the performance of self-adhesive sealers should they fail to self-etch without the adjunctive use of calcium chelating irrigants.

Key Words: Adhesion, dislocation resistance, EDTA, hybrid layer, nanoleakage, push-out test, root canal sealers