Basic Research—Technology
Push-Out Bond Strength of a New Endodontic Obturation
System (Resilon/Epiphany)
Marilia M. Sly, DDS, MSD, B. Keith Moore, PhD, Jeffrey A. Platt, DDS, MS, and
Cecil E. Brown, DDS, MS
Abstract
Endodontic sealers should demonstrate adhesive
properties to dentin to reach the objectives of the
obturation of the canal space and seal the canal
space both apically and coronally, thus decreasing
the chance of endodontic treatment failure. Adhe-
sion to dentin with bonding to the tooth structure in
the canal may provide greater resistance to tooth
fracture and greater clinical longevity of an endodon-
tically treated tooth. In this study, human single-
canal canines were endodontically treated and ob-
turated with two different endodontic obturation
systems (Epiphany/Resilon system and gutta-per-
cha/AH 26). Thirty roots (divided into two groups)
were horizontally sliced for a push-out strength test,
which was performed from apical to coronal in the
universal testing machine. Differences in push-out
bond strength between the two different material
systems were obtained using repeated measures
analysis of variance on ranks. Gutta-percha had sig-
nificantly higher push-out bond strength than Epiph-
any (p ⬍ 0.0001). (J Endod 2007;33:160 –162)
Key Words
AH 26, bond strength, gutta-percha, push-out test,
Resilon
From the Indiana University School of Dentistry, Dental
Materials, Indianapolis, Indiana.
Address requests for reprints to Dr. Marilia Mattos Sly,
Indiana University School of Dentistry, Dental Materials, 1121
West Michigan St., Room 118, Indianapolis, IN 46202. E-mail
address: msly@iupui.edu.
0099-2399/$0 - see front matter
Copyright © 2007 by the American Association of
Endodontists.
doi:10.1016/j.joen.2006.09.014
160 Sly et al.
G utta-percha is the most commonly used core filling material for endodontic obtu-
ration. Although it is not the ideal filling material, it has been used in conjunction
with a sealer as the material of choice for over 100 years.
The objectives of the canal space obturation are to prevent leakage from the oral
cavity and the periradicular tissues into the root canal system and to seal any microor-
ganisms that could not be entirely removed during cleaning and shaping procedures
(1). In addition, sealers should demonstrate adhesive properties to dentin, decreasing
the chance of endodontic treatment failure. Increased adhesive properties to dentin
may lead to greater strength of the restored tooth, which may provide greater resistance
to tooth fracture and clinical longevity of an endodontically treated tooth.
The Epiphany/Resilon obturation system is a new thermoplastic synthetic polymer-
based root canal filling material. The manufacturer claims that it performs, handles, and
looks like gutta-percha. They also claim that it forms a monoblock that bonds to the
dentinal walls when the Epiphany points are used in conjunction with the Epiphany
dual-cured resin sealer (Resilon) and the Epiphany primer (2–5).
The purpose of this in vitro study is to evaluate the push-out bond strength to
intraradicular dentin of two polymeric endodontic obturation systems, Epiphany/Resi-
lon and gutta-percha/AH 26. The null hypothesis tested was that there is no difference
in the push-out bond strength between the two types of obturation systems.
Materials and Methods
An in vitro study was conducted using 30 extracted human canines. The crown
portion of each tooth was removed by means of a water-cooled saw (Gillings Hamco
Thin Sectioning Machine, Hamco Machines, Inc., Rochester, NY). Working length of
each tooth was determined by a K-file #10, until it reached the apical foramen, sub-
tracting 1 mm from this measurement. The teeth were endodontically treated according
to a crown-down Profile Series 29 technique. The irrigation solutions used for cleaning
and shaping procedures were 5.25% sodium hypochlorite and RC Prep (Premier Den-
tal Products, Tulsa, OK). After the cleaning and shaping processes, 17% ethylenedia-
minetetraacetic acid (EDTA) for 1 minute was used followed by sterile water as a final
rinse. Paper points were used to dry the canals before obturation.
The 30 teeth were randomly divided into two groups of 15 specimens each. For
each group, a different obturation system was used. The tested materials were (for
group EP) Epiphany Soft Resin Endodontic Obturation System (Pentron Clinical Tech-
nologies, LLC, Wallington, CT) and (for group GP) gutta-percha points (Dentsply
Maillefer NA, Tulsa, OK) and AH26 Root Canal Sealing (Dentsply Maillefer NA). The
obturation systems were used with the System B Heat Source (Analytic Technology, San
Diego, CA) and the Obtura II system (Obtura/Spartan, Fenton, MI) and were handled
according to the manufacturers’ instructions. Although the Epiphany sealer is a dual-
cured resin system, the coronal aspect of the tooth was not light activated because only
the most coronal section would likely be influenced by light activation.
After the canal obturation, the teeth were radiographed to make sure the canals
were fully obturated. The 15 roots from each group were embedded in epoxy resin and
sliced for the push-out bond strength evaluation in a universal testing machine (MTS
Sintech ReNew 1123, Eden Prairie, MN).
Before testing, each root was horizontally sectioned into approximately 2-mm-
thick slices from the cement-enamel junction with a water-cooled precision saw
(Isomet 1000 Precision Saw, Buehler, Lake Bluff, IL). The slices were kept moist in
JOE — Volume 33, Number 2, February 2007
 Basic Research—Technology
TABLE 1. Push-out bond strength
Mean
Group N SD SE Min. Max.
(MPa)
EP 78 0.51 0.30 0.08 0.06 1.29
GP 78 1.70 0.71 0.18 0.99 3.43
p-value obtained from the rank transformation (not shown) (p ⬍ 0.0001).

area (of the bonded interface) is the average value of the perimeter
times the thickness. Differences in push-out bond strength between the
two different material systems were analyzed using repeated measures
analysis of variance on ranks.

Figure 1. Diagram for the push-out bond strength test.
Results
Push-out bond strengths in MPa were recorded. A total of 78 slices
per group (approximately 5 slices each for 15 teeth) were tested. Ac-
cording to Table 1, the mean push-out bond strength ranged from 0.51
(⫾0.30) MPa for group EP and 1.70 (⫾0.71) for group GP.
Table 2 lists the group-by-location push-out bond strength distri-
butions. Location 1 and location 6 are, respectively, the most coronal
and the most apical slices obtained. N represents the number of slices of
each location that were submitted to the push-out test. The group-by-
location interaction was not significant (p ⫽ 0.59), so the group com-
parisons were not dependent upon the location in the canal.

Discussion
containers and the order of the slices (from coronal to apical) as well as The concept of bonding resin materials to enamel was first intro-
each slice’s apical side was identified. Each slice was positioned in a duced by Buonocore (6) in 1955. The development of resin bonding to
reflected light microscope (Neophot 21 Metallograph, Leco Corp., St. tooth structure progressed through a number of distinct stages, com-
Joseph, MI), where the perimeter and diameter of each obturation site monly referred to as generations. As a greater understanding of the
were measured and pictures of both sides of each slice were taken with nature and composition of the bonding interface was developed, the
a digital camera (Digital Microscope Camera DMC 1, Polaroid, strategies applied for resin retention were modified to take advantage of
Waltham, MA). On the coronal side of the slices, the larger diameter was this knowledge. Because of distinctions in composition and morphology
measured to select a support jig with a large enough hole to provide between enamel and dentin, the need for wet bonding arose, and tech-
clearance for the obturating material when it was dislodged from the niques for preparing the interface for increasingly hydrophobic mono-
tooth slice. On the apical side of the slices, the smallest diameter was mers were developed. The success of this restorative dentistry concept
measured to select a punch to be used to supply load with that side, has resulted in the acceptance of the use of polymer-based sealers for
making sure that the punch would not contact the dentin around the treatment of endodontically treated teeth (7). These materials have
obturating material, causing a crack and erroneous results. The thick- been introduced as root canal sealers to obtain dentinal tubular pene-
ness of each slice was measured by means of a digital caliper; this tration, bond to the collagen matrix, and, consequently, adhesive
measurement and the perimeter measurements were used by the com- strength to dentin (8).
puter in the push-out test to calculate the bonded area. A push-out test is one measure of the effectiveness of an endodon-
Each specimen was attached to a support jig with clearance for the tic obturation technique or material. Other evaluation methodologies
dislodged material on the base of the Universal Testing Machine (MTS should include bacterial or other leakage material, light or electron
Sintech ReNew 1123) with the coronal end facing the support jig and the microscopic evaluation, and resorbability. There is no evidence that any
apical end facing the load cell for the punch affixed to the crosshead to
contact the apical part of the specimen. The punch moved downward at
a crosshead speed of 0.5 mm per minute until extrusion of the obtura- TABLE 2. Group-by-location push-out bond strength
tion from the specimen was manifested, which usually resulted in an Mean
abrupt decrease in the applied load. Figure 1 illustrates the test meth- Group Location N SD SE Min. Max.
(MPa)
odology used in this study. The punch was positioned so that it only EP 1 15 0.29 0.21 0.05 0.01 0.76
contacted the specimen’s obturation site, generating shear stresses on 2 14 0.35 0.27 0.07 0.02 0.89
the areas to be debonded. The computer and software connected to the 3 15 0.51 0.55 0.14 0.02 1.67
universal testing machine calculated the push-out bond strength 4 14 0.54 0.44 0.12 0.03 1.42
value for each specimen from the average of the two perimeters 5 12 0.75 0.55 0.16 0.07 2.02
6 8 0.68 0.87 0.31 0.00 2.67
(coronal and apical) and the thickness of the specimen from the GP 1 15 1.60 0.97 0.25 0.45 4.37
formula: 2 14 1.60 1.06 0.28 0.59 4.71
3 14 1.65 0.83 0.22 0.73 3.66
Debonding force 共N兲 4 15 1.67 0.90 0.23 0.22 3.59
Debond stress 共MPa兲 ⫽ 5 14 1.84 0.74 0.20 0.80 3.14
Area 共mm2兲 6 6 1.87 0.85 0.35 1.02 3.37
Where debonding force is the maximum force before debonding and p ⫽ 0.59.

JOE — Volume 33, Number 2, February 2007 Push-Out Bond Strength 161
Basic Research—Technology
of these methodologies is the best one for measuring effectiveness of an
endodontic obturation material.
The results reported in the present study are similar to results
reported in other studies (9, 10). The study by Gesi et al. (9) compared
the interfacial strengths of Resilon/Epiphany and gutta-percha/AH Plus.
It was concluded that the interfacial strength achieved with Resilon/
Epiphany to intraradicular dentin is not superior to that of gutta-per-
cha and a conventional epoxy-resin sealer. In addition, the study of
Tay et al. (10) evaluated the adhesive strength of Resilon to a metha-
crylate-based root canal sealer. The authors found that adhesive failure
was characteristic of the Resilon group, and it was concluded that the
amount of dimethacrylate incorporated in Resilon might not be opti-
mized for effective chemical coupling to methacrylate-based sealers.
The push-out test used in the current study should result in shear failure
of the bonded specimens. Comparison of the strength value for Epiph-
any to shear bond strengths reported to dentin from restorative dental
materials studies show much lower values, which brings into question
the efficacy of the bond between Resilon and root canal dentin (11).
The variation in push-out bond strength seen between groups EP
and GP may be in part attributed to the presence of voids between the
dentinal walls and the endodontic obturation. Voids could have been
caused by incorporation of air during placement of primer and/or
sealer.
Polymerization shrinkage of the sealer might also contribute to the
lower bond strength value observed in group EP. The amount of shrink-
age depends on the type, size, and content of filler particles as well as the
type of matrix used. The stress associated with this shrinkage may result
in separation of the resin-based sealer from the dentinal walls, and,
consequently, the bond strength value of this interface would decrease.
In addition, according to the study by Tay et al. (12), as the thickness of
the adhesive is reduced, the volumetric shrinkage is reduced, resulting
in a reduction of shrinkage stress. Furthermore, the interaction of the
two geometrically related C- and S-factors predicts that bonding of ad-
hesive root-filling materials to root canals is highly unfavorable when
compared with indirect intracoronal restorations with a similar resin
film thickness.
According to the manufacturer of the Epiphany Soft Resin End-
odontic Obturation System, this material performs, handles, and looks
like gutta-percha and forms a monoblock that bonds to the dentinal
walls when its three components are used in conjunction. It is also
claimed that this monoblock is formed by the bonding of the Resilon
core to the resin sealer, which attaches to the primed root dentin (2–5).
As previously noted, findings of the study by Tay et al. (10) do not
support the monoblock concept, showing that the core part of the
Epiphany system may not yet be optimized for effective chemical cou-
pling to methacrylate-based sealers, which is the case of both the Epiph-
162 Sly et al.
any and RealSeal sealers. Resilon is the primary component of both
RealSeal and the Epiphany sealer. Because of their findings, the authors
suggest further research on the ability of the sealer and the core material
to bond together.
In the study by Teixeira et al. (3), the authors evaluated the frac-
ture resistance of endodontically treated teeth filled with either gutta-
percha or Resilon. It was concluded that Resilon increased the resis-
tance to fracture. However, the results of the study by Williams et al.
(13) show that the cohesive strength and modulus of elasticity of gutta-
percha and Resilon are relatively low. It was concluded that the stiffness
of Resilon and gutta-percha is too low to reinforce roots after root canal
therapy.
The hypothesis that there would be no difference in the push-out
bond strength between the two types of canal obturation systems has to
be rejected. Gutta-percha had significantly higher push-out bond
strength than Epiphany (p ⬍ 0.0001).
Therefore, it may be concluded from the present study that the
push-out bond strength of gutta-percha/AH 26 to intraradicular dentin
is higher than that of the new obturation system Resilon/Epiphany.
These results challenge some of the claims for this new endodontic
obturation system.
References
1. Cohen S, Burns R. Pathways of the pulp, 8th ed. St Louis, MO: Mosby, 2002.
2. Shipper G, Ørstavik D, Teixeira FB, Trope M. An evaluation of microbial leakage in
roots filled with a thermoplastic synthetic polymer-based root canal filling material
(Resilon). J Endod 2004;30:342–7.
3. Teixeira FB, Teixeira ECN, Thompson JY, Trope M. Fracture resistance of roots
endodontically treated with a new resin filling material. JADA 2004;135:646 –52.
4. Teixeira FB, Trope M. Gutta-percha: the end of an era? Alpha Omegan 2004;97:16 –22.
5. Teixeira FB, Teixeira ECN, Thompson J, Leinfelder KF, Trope M. Dentinal bonding
reaches the root canal system. J Esthet Restor Dent 2004;16:348 –54.
6. Buonocore MG. A simple method of increasing the adhesion of acrylic filling mate-
rials to enamel surfaces. J Dent Res 1955;34:849 –53.
7. Rueggeberg F. From vulcanite to vinyl, a history of resins in restorative dentistry.
J Prosthet Dent 2002;87:364 –79.
8. Spångberg L. Instruments, materials, and devices. In: Cohen S, Burns R, eds. Path-
ways of the pulp, 8th ed. St Louis, MO: Mosby, 2002;550 –3.
9. Gesi A, Raffaelli O, Goracci C, Pashley DH, Tay FR, Ferrari M. Interfacial strength of
Resilon and gutta-percha to intraradicular dentin. J Endod 2005;31:809 –13.
10. Tay FR, Hiraishi N, Pashley DH, et al. Bondability of Resilon to a methacrylate-based
root canal sealer. J Endod 2006;32:133–7.
11. Oliveira SSA, Pugach MK, Hilton JF, Watanabe LG, Marshall SJ, Marshall GM Jr. The
influence of the dentin smear layer on adhesion: a self-etching primer vs. a total-etch
system. Dent Mat 2003;19:758 – 67.
12. Tay FR, Loushine RJ, Lambrechts P, Weller RN, Pashley DH. Geometric factors affect-
ing dentin bonding in root canals: a theoretical modeling approach. J Endod
2006;31:584 –9.
13. Williams C, Loushine RJ, Weller RN, Pashley DH, Tay FR. A comparison of cohesive
strength and stiffness of Resilon and gutta-percha. J Endod 2006;32:553–5.
JOE — Volume 33, Number 2, February 2007