Basic Research—Technology
Assessment of the Sealing Ability of a New Root Canal
Obturation Material
Umut Tunga, PhD, DDs,* and Emre Bodrumlu, PhD, DDs*
Abstract
This study was designed to compare the leakage al-
lowed by different obturation materials, using a fluid-
transport method. Sixty-six single-rooted human ante-
rior teeth were fully instrumented by using the “step-
back” technique and irrigated with 5.25% sodium
hypochlorite. The smear layer was removed by washing
in 10 ml of 17% EDTA. The specimens were randomly
divided into three experimental groups of 18 teeth
each, plus two groups of 6 teeth each for positive and
negative controls. The specimens were obturated by the
lateral condensation technique, with gutta-percha and
AH 26 or AH plus sealers, or Epiphany sealer and
Resilon core material. The fluid transport method used
in this study gave quantitative results and allowed
nondestructive evaluation of the specimens. The teeth
filled with gutta-percha and AH 26 exhibited the most
leakage. The least leakage was seen with Epiphany
sealer and Resilon core material. The differences in
leakage among the groups were statistically significant
(p ⬍ 0.05). It was concluded that of the materials
tested under the conditions of this study, Epiphany
allowed the least leakage. (J Endod 2006;32:876 – 878)
Key Words
Epiphany, fluid transport method, leakage
*From the Department of Operative Dentistry and End-
odontics, Ondokuz Mayis University Faculty of Dentistry, Sam-
sun, Turkey.
Address requests to Assist. Prof. Umut Tunga, Department
of Operative Dentistry and Endodontics, Ondokuz Mayis Uni-
versity Faculty of Dentistry, 55139 Kurupelit-Samsun, Turkey.
E-mail address: utunga@omu.edu.tr.
0099-2399/$0 - see front matter
Copyright © 2006 by the American Association of
Endodontists.
doi:10.1016/j.joen.2006.02.005
876 Tunga and Bodrumlu
I t is well known that root canal obturation is a very critical determinant of the success
or failure of endodontic treatment, as it directly affects the outcome of endodontic
therapy (1). This emphasizes the need for using materials that are able to create a
hermetic seal. Microleakage studies on the sealing properties of endodontic materials
have thus played an important role in their development. The adhesion of endodontic
sealers to both the obturation material and to dentin may improve their sealing prop-
erties, even if the correlation between dentin bond strength and microleakage is still
questioned because of the humidity of the root canal system and resultant destruction of
the bonding agent (2– 4). To date, many different materials have been proposed as root
canal fillings, but none have replaced gutta-percha (5, 6).
Epiphany (Pentron Clinical Technologies, Wallingford, CT; also RealSeal,
SybronEndo, Orange, CA) is a new material that was developed to replace gutta-percha
and traditional sealers for root canal obturation. The Epiphany obturation system con-
sists of three main items: the core material, the sealer, and its bonding agent. Resilon
core material is a thermoplastic synthetic polymer-based (polyester) root canal core
material that contains bioactive glass, bismuth oxychloride, and barium sulfate. The
sealant (Epiphany Root Canal Sealant, RealSeal Root Canal Sealant) is a dual-curable
dental resin composite sealer. Resilon bonding agent is a self-etching primer that
contains sulfonic acid-terminated functional monomer, HEMA, water, and polymeriza-
tion initiator.
Leakage studies on the sealing properties of endodontic materials constitute an
important area of research. The variety of evaluative methodologies and their assess-
ment parameters are major reasons for such disagreement (7). This lack of standard-
ization and consequent noncomparability of studies led Wu and Wesselink (8) to
question the relevance of leakage studies and to recommend the use of a fluid trans-
portation system to enhance reliability.
To date, no information is available on the sealing ability of Epiphany when it is
used as the sealer cement with Resilon as the core material. The purpose of this study
was to compare the sealing ability of Epiphany sealer and Resilon core to that of
gutta-percha AH26 and AHplus. The fluid transport model was used for microleakage
assessment.
Materials and Methods
Sixty-six maxillary and mandibular anterior human teeth with single, straight root
canals were used in this study. Roots with open apices, cracks, and resorptive defects
were excluded. Teeth were carefully cleaned with curettes to remove soft tissue rem-
nants, and were stored in saline solution before instrumentation. The crowns of the
teeth were sectioned at the cemento-enamel junction using water-cooled diamond
discs. The canal lengths were visually established by placing a size 15 K file (Kerr,
Romulus, MI, USA) into each root canal until the tip of the file was visible at the tip of the
apical foramen. The working length was established 1 mm short of the apex. The canal
systems were instrumented to the working length with a size 40 K file by using a
step-back technique. The coronal thirds of the roots were flared up to a 2-6 Gates
Glidden bur (Dentsply, Maillefer, Switzerland) with a low speed handpiece. The root
canals were irrigated with 10 ml of 5.25% NaOCl after the use of each file throughout the
preparation. The smear layer was removed by washing in 10 ml of 17% EDTA (Canal⫹,
Septodont, France) for 60 s, followed by 10 ml of 5.25% NaOCl. Finally, the root canals
were flushed with 3 ml saline solution and then dried with paper points.
JOE — Volume 32, Number 9, September 2006

TABLE 1. The mean and standard deviations of leakage measurements (X ⫾ Sx)
Materials
First hour
Gutta-percha & AH26 0.51␮L (0.608)
Gutta-percha & AH plus 0.43␮L (0.540)
Epiphany & Resilon 0.41␮L (0.490)
The specimens were randomly divided into three equal groups of
18 samples each, setting aside six teeth as negative and six as positive
controls. Three roots were only filled with gutta-percha without any
sealer and another three were merely filled with Resilon core material
without its own Epiphany sealer, and these six roots served as the pos-
itive control group.
Roots were filled using the lateral condensation technique with
gutta-percha and AH 26 (group 1) and gutta-percha and AH plus (group
2) root canal sealers. The group 3 roots were prepared as follows:
Epiphany bonding material was applied to the root canal. The Resilon
master cone, coated with Epiphany sealer, was placed in the root canal
using the lateral condensation technique. Light curing was applied for
40 s with a standard light-curing unit (Hilux, Ledmax-550, Benlioglu,
Turkey), according to the manufacturer’s instructions.
Another six roots that were filled with gutta-percha and sealer and
entirely coated with two layers of nail varnish served as the negative
control group. In the positive control samples, roots were coated with
two layers of nail varnish, except for the apical foramen and the coronal
access. After the filling process, all samples were stored in saline solu-
tion at 37°C for 48 h. Leakage was estimated by a fluid transport device,
as described previously (8). Leakage along the root filling was mea-
sured every hour during a 3-h period under a headspace pressure of 1.2
atmospheres to meet the “bacteria-tight” criteria determined previously
(9, 10). Fluid movement was determined from the air bubble movement
and the mean value was calculated. The results were expressed in mi-
croliters. The Friedman and Kruskall-Wallis tests were used to deter-
mine whether there were significant differences among the mean values
of groups. Differences between means for each group were tested using
the Wilcoxon test.
Results
The mean results of the quantitative evaluation of the sealing prop-
erties of root canal sealers are exhibited in Table 1. All experimental
groups showed penetration to varying degrees. In the positive controls,
the air bubble moved too quickly to be measured, while no movement of
the air bubble was observed in the negative controls. The mean leakage
values of group 3 were significantly different from those of groups 1 and
2 (p ⬍ 0.05). Epiphany (group 3) exhibited the best sealing values in
all observation periods (p ⬎ 0.05). Additionally, the group 2 findings
were statistically different from those of group 1 (p ⬍ 0.05): gutta-
percha with AH 26 (group 1) showed significantly more leakage when
compared to the other sealers, at all periods (p ⬍ 0.05).
Discussion
Ideally, a root canal sealer should be capable of producing a bond
between the core material and the root dentin, effectively preventing
leakage. Obturation of the canal with gutta-percha and any sealer will
not result in a seal that is dependable over the long term (6, 11).
Leakage studies on the sealing properties of endodontic materials are
still important and relevant. Recently, the fluid transport method has
been demonstrated to be the method of choice in the determination of
leakage. Leakage can be measured with greater sensitivity with this
method than with dye penetration along the root canal (8, 12, 13). The
JOE — Volume 32, Number 9, September 2006
Basic Research—Technology
Measurements
Second hour Third hour
0.60␮L (0.658) 0.67␮L (0.665)
0.53␮L (0.613) 0.57␮L (0.617)
0.46␮L (0.534) 0.52␮L (0.561)
biggest advantage of the fluid transport model is that it examines the
leakage without destroying the root specimens. This model exploits
positive pressure, while the dye penetration method uses entrapped air
or fluid pressure and is thus unreliable (14). The sensitivity of the fluid
transport method system can be adjusted by altering the pressure. Thus,
we used the pressure used in previous studies (8 –10) to standardize
the evaluation.
The removal of the smear layer may be considered an essential step
in the process of successful root canal treatment (15). For this reason,
the smear layer was removed to evaluate the penetration and adaptation
of root canal filling materials in our study. To avoid anatomical varia-
tions and to standardize the leakage measurements in this study, the
length of the specimens was kept constant. Wu et al. (16) also advised
controlling the length of samples, the canal diameter, and the canal
anatomy to reduce the variability of these studies.
A wide variety of root canal sealers is commercially available and
there is no consensus on which material seals most effectively. We chose
epoxy-resin-based sealers for this evaluation because they provide ex-
cellent sealing properties (17, 18). The lack of bonding between gutta-
percha and the sealers, AH 26/AH plus may allow an avenue for leakage
(18). However, in the Epiphany root obturation system, the Epiphany
sealer’s attachment to the root canal walls and to the Resilon core
material seems to be more suitable. According to the study by Shipper et
al. study (19), the excellent sealing capability of Epiphany may be at-
tributed to its integrity, which is provided by the adhesion of the Resilon
filling material to the Epiphany sealer and, in turn, the Epiphany sealer’s
adhesion to the dentin walls in the root canal system. In the present
study, the Epiphany root obturation system provided an adequate seal.
Similar results have been reported by Shipper et al. (19). However,
these findings are in contrast with the results reported by Tay et al. (20)
and Gesi et al. (21). In the Tay et al. study, it was concluded that the
quality of apical seal achieved with Resilon core material and Epiphany
sealer is not superior to gutta-percha and a conventional epoxy-resin
sealer. Discrepancies between the two studies are probably because of
differences in methodology. In the study by Gesi et al., gutta-percha
exhibited higher interfacial strength than the Resilon between root fill-
ing and intraradicular dentin. This discrepancy may be ascribed to the
differences in methodology and also application time and the quantity of
EDTA. However, in our study, according to the manufacturer of Epiph-
any, sterile saline solution is used as a final flush.
The results of this study indicate that both of the tested root canal
filling materials and the associated sealers allowed some leakage. The
results obtained for group 3, in which a Resilon cone and its bonding
agent were placed in the root-canal system, is important when com-
pared with group 1. The mean leakage with Epiphany was lower than
that for gutta-percha and AH plus. This difference may well be because
of the attachment of the sealer to the root canal walls by its bonding
agent. Adhesion of the sealers to both the obturation material and to
dentin may also improve the sealing properties of Epiphany. Addition-
ally, the number and size of dentinal tubules, the structure of dentin, and
the obturation techniques employed may affect the adaptation and pen-
etration of the materials. The results suggest that the Epiphany root
canal obturation system might provide a better seal.
Sealing of New Material 877
Basic Research—Technology
Even though the Epiphany system allowed the least microleakage,
the placement of the Epiphany bonding agent and Epiphany sealer re-
quires additional steps such as etching and a drying process. However,
it remains an open question whether it has the required properties for
removing the root filling material from the root-canal system when
necessary and setting time periods in different microbiologic environ-
ments (22).
The results of this study showed that the Epiphany obturation sys-
tem is a promising root canal sealer with good sealing ability. Results
obtained by in vitro sealing studies cannot be directly evaluated clini-
cally, but they do permit reasonable comparisons. While Epiphany may
have created a better seal in this in vitro study, in vivo results may differ.
Acknowledgments
The authors thank Prof. Dr. Gokhan Açıkgoz for assistance in
technical information and Assoc. Prof. Dr. Cihad Dundar for assis-
tance in statistical analysis.
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