Radiopacity of calcium silicate-based endodontic sealers using digital imaging

Introduction. Adequate radiopacity of endodontic sealers allows radiographic visualization, assessment of root canal filling quality and its clinical follow-up after obturation. The aim of our study was to evaluate the radiopacity of Bio-Root RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal in comparison to AH Plus sealer, as a gold standard in clinical practice. Material and methods. Sealer specimens, 2 mm thick and 5 mm in diameter, were radiographed with an aluminum stepwedge using digital imaging system. Radiographic densities of the specimens were shown as mean greyscale values (Adobe Photoshop CS4 software) and expressed as mmAl/mm of the material. ANOVA with a post hoc Tukey test was used, significance was set at 0.05. Results. Differences in radiopacity between tested endodontic sealers were statistically significant except the difference between BioRoot RCS and GuttaFlow Bioseal. Conclusion. Radiopacities of all evaluated calcium silicate-based sealers were higher than minimal values recommended by standards. AH Plus sealer had the highest radiopacity, while calcium silicate-based sealers showed lower values, from BioRoot RCS, followed by GuttaFlow Bioseal, to MTA Fillapex, in descending order, and Bioceramic Root Canal Sealer with the lowest values.