Effect of Different Sealer Placement and Activation Techniques on Sealer Penetration Depth and Penetration Area

Abstract

This study evaluated the effect of different activation methods (no activation, sonic, ultrasonic, and XP-Endo Finisher) on the penetration depth and area of AH Plus and MTA Fillapex sealers. Two hundred single-rooted teeth were prepared and randomly divided into eight groups (n = 25). Sealers stained with rhodamine B were inserted and activated as follows: Group 1 (control, no activation, G1A, G1M), Group 2 (sonic: G2A, G2M), Group 3 (ultrasonic: G3A, G3M), and Group 4 (XP-Endo Finisher: G4A, G4M). The single cone technique was used for filling, and specimens were sectioned perpendicularly. Confocal laser scanning microscopy (CLSM) measured penetration depth, while penetration area was calculated as the sealer's penetration relative to the canal area. Two-way ANOVA was used for statistical analysis. Ultrasonic and XP-Endo Finisher activation significantly increased the penetration depth of MTA Fillapex compared to the control group (p < 0.05), while no significant difference was found for AH Plus (p > 0.05). MTA Fillapex also demonstrated a significantly greater penetration area than AH Plus when ultrasonic and XP-Endo Finisher activation were applied (p < 0.05). No significant differences were observed between sealers in the control and sonic groups (p > 0.05). Activation methods did not significantly affect the penetration area of AH Plus (p > 0.05). XP-Endo Finisher and ultrasonic activation significantly improved both penetration depth and area for MTA Fillapex but had limited effect on AH Plus. These findings highlight the clinical importance of selecting the appropriate activation technique based on the type of sealer used, as enhanced penetration may contribute to improved sealing ability and long-term endodontic success.