Sealers and warm gutta-percha obturation techniques

Introduction: Warm vertically compacted gutta-percha obturation techniques use root canal sealers that are heated during the obturation. This study aims at investigating the suitability of selected sealers with warm gutta-percha obturation techniques.

Methods: The composition of an experimental sealer (Septodont; Saint Maur-des-Fosses, France), MTA Fillapex (Angelus, Londrina, Brazil), Apexit Plus (Ivoclar, Schaan, Lichtenstein), and AH Plus (Dentsply International, Addlestone, UK) was assessed by scanning electron microscopic and energy-dispersive spectroscopic analysis. The effect of temperature during warm vertical compaction technique was investigated by testing the sealers' properties after 1 minute to 100°C or 37°C. The reaction products after setting were assessed by X-ray diffraction analysis and Fourier transform infrared spectroscopy. Changes in setting time, flow, and film thickness were determined using ISO 6876 (2012) specifications.

Results: The experimental tricalcium silicate-based sealer and Apexit Plus contained calcium hydroxide peaks after setting, which were absent in MTA Fillapex. The properties of AH Plus and the experimental sealer were modified by heat; the setting time was reduced, and film thickness increased. AH Plus had diminished N-H groups when heated to 100°C for 1 minute. MTA Fillapex, Septodont sealer, and Apexit Plus were unaffected by heat application.

Conclusions: The choice of sealer should be considered when selecting the obturation technique. The Septodont sealer is recommended for obturations using cold laterally condensed gutta-percha, whereas MTA Fillapex and Apexit Plus were suitable with warm gutta-percha obturation techniques.