Dentinal tubule penetration of a bioceramic sealer after different irrigant and activation regimens: An in vitro confocal laser scanning microscopy study.

BACKGROUND: Proper sealer adaptation relies on effective smear layer removal and adequate irrigant penetration. Intratubular entry of sealers is influenced by both the irrigant used and the method of activation. Nevertheless, evidence regarding the impact of newer chelators and activation strategies on bioceramic sealer penetration remains limited. AIM: This study aimed to assess and compare how various irrigating solutions and activation techniques influence the extent to which a bioceramic sealer penetrates the dentinal tubules, as observed through confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS: Sixty-three single-rooted teeth were prepared to F3 and randomly assigned to three activation groups (n = 21): sonic, diode laser, and passive ultrasonic. Each group was subdivided by the final irrigant - 17% ethylenediaminetetraacetic acid (EDTA), 1-Hydroxyethylidene-1,1-Diphosphonic Acid (HEDP), or 0.2% chitosan (n = 7). After placement of Rhodamine B-labeled bioceramic sealer, apical sections were analyzed using CLSM. STATISTICAL ANALYSIS: Data were examined with one-way ANOVA and Tukey's post hoc test at a significance level of P < 0.05. RESULTS: Diode laser activation demonstrated significantly greater sealer penetration than sonic and passive ultrasonic irrigation (PUI) techniques (P < 0.001). Among the irrigants, EDTA exhibited the highest sealer penetration, particularly when combined with diode laser activation. HEDP and chitosan showed comparatively lower penetration values in most groups; however, under PUI, HEDP demonstrated the greatest sealer penetration compared with the other irrigants. CONCLUSION: Both irrigant type and activation method significantly influenced bioceramic sealer penetration. Diode laser activation was the most effective, while EDTA remained superior to HEDP and chitosan according to this study.