Obturation of Simulated Internal Resorption Cavities With Four Different Techniques and a Hydraulic Root Canal Sealer: A Comparative Stereomicroscopic Evaluation

Aim To compare the quality of obturation using WVC (warm vertical compaction), CLC (cold lateral compaction), injectable (iFill), and Thermafil (GuttaCore) techniques, along with hydraulic condensation of bioceramic (BC) sealer, and evaluating the percentage of gutta-percha (GP), sealer, and voids in simulated internal resorptive lesions, using an advanced stereomicroscope with ImageJ software (National Institutes of Health, Bethesda, MD, USA). Methods and material In this study, 40 freshly extracted maxillary incisors were collected, and endodontic instrumentation was done to working length using hand K-files. Simulated internal resorption cavities were created in the middle-apical third of the roots after horizontal sectioning and were re-cemented. The root canals were obturated using four techniques: WVC, CLC, iFill, and Thermafil, along with BC sealer. After one week, the samples were resectioned, the surfaces were photographed, and the percentage of GP, sealer, and voids in resorptive cavities was calculated using an advanced stereomicroscope and ImageJ software, respectively. The data were statistically analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey tests. Results The iFill approach had the highest total filled area in the simulated resorptive region (96%), followed by WVC (92%), CLC (91%), and GuttaCore (77%). CLC had a notably high percentage of sealers (46%), compared to WVC (40%) and Thermacore (41%). With 23% of voids, the GuttaCore technique was considered the least successful. Conclusions Warm GP condensation techniques, combined with hydraulic sealer in filling artificial resorption cavities, outperformed the other obturation procedures.