Open Journal of Stomatology, 2013, 3, 14-21 OJST
http://dx.doi.org/10.4236/ojst.2013.39A003 Published Online December 2013 (http://www.scirp.org/journal/ojst/)
Fluid filtration and dye leakage testing of Resilon/Epiphany
and guttapercha/Pulp Canal Sealer root canal fillings
Gabriele Conte1, Manuele Mancini1, Loredana Cerroni1, Marco Costantini2, Luigi Cianconi2
1Department of Dental Materials, University of Rome “Tor Vergata”, Rome, Italy
2Department of Operative Dentistry and Endodontics, University of Rome “Tor Vergata”, Rome, Italy
Received 9 September 2013; revised 25 October 2013; accepted 7 November 2013
Copyright © 2013 Gabriele Conte et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
The aim of the present study was to compare sealing
abilities of Resilon/Epiphany (R/E) with those of gut-
tapercha and Kerr Pulp Canal Sealer EWT (GP/PCS).
50 single rooted teeth were randomly divided into 2
groups (n = 22) (R/E; GP/PCS), and 2 control groups
(n = 3) (Positive, Negative). Fluid flow rate through
the filled roots was measured using a fluid filtration
device. The same specimens were immersed in a 2%
Methylen Blue Solution. Roots were embedded in
clear epoxy resin and cross sectionet at 1 mm inter-
vals along the length of the root. Circumferential dye
penetration was evaluated at 40× magnification. Fluid
filtration of teeth obturated with the R/E system
(0.085 [0.057, 0.113] μL·min−1), and dye penetration
test showed no statistically significant difference com-
pared to those obturated with GP/PCS (0.113 [0.057,
0.141] μL·min−1). Within the limits of the present
study, there is no statistically significant difference
between R/E and GP/PCS sealing abilities.
Keywords: Resilon; Epiphany; Fluid Filtration; Root
Canal Filling Materials; Dye Leakage
1. INTRODUCTION
The aim of endodontic treatment is to prevent or heal
infective and inflammatory processes in periradicular
structures. Apical periodontitis is mainly caused by bac-
teria and their by-products [1-3]. Disinfection of the root
canal space is achieved through the use of various me-
chanical shaping techniques and chemical irrigants [4-7].
However, a complete eradication of endodontic patho-
gens is not always possible [4]. Thus, a three-dimen-
sional sealing of the entire root canal system is required
to entomb any surviving microorganism which could
cause or sustain periradicular pathosis [8].
Techniques using a combination of gutta-percha cones
and a sealer are considered the gold standard in root ca-
nal obturation. Although good clinical results for many
years, some in vitro and in vivo studies have demon-
strated that they fail to achieve a complete root canal seal
[9-12]. The presence of microleakage is attributed to the
lack of an effective bond at both the sealer/dentin and
sealer/gutta-percha interfaces [13,14].
Adhesive resins are commonly employed in operative
dentistry to bond resin-based restorative materials to
tooth structures. In the past decade, dentin adhesives
have been used in attempts to bond to intraradicular den-
tin and have been shown to reduce apical and coronal
leakage [15,16].
In that perspective, a syntetic thermoplastic polymer-
based root canal filling material (Resilon™, Resilon Re-
search LLC, Madison, CT), has been developed. This
root canal filling material behaves like gutta-percha, has
similar handling properties, and may be softened with
heat or dissolved in solvents such as chloroform. Based
on polycaprolactone, a biodegradable aliphatic polyester
[17], Resilon contains bioactive glass, dimethacrylates,
bismuth oxychloride and barium sulfate [18]. As it con-
tains dimethacrylates, it is bondable to a variety of
methacrylate-resin-based sealers such as Epiphany (Pen-
tron Clinical Technologies, Wallingford, CT), Real Seal
(SybronEndo, Orange, CA), and Next (Heraeus-Kulzer,
Armonk, NY). These dual-curable dental resin composite
sealers are bonded to dentinal walls using a correspond-
ing self-etching primer. By bonding to both the obturat-
ing core material and the dentinal walls [19], Epiphany
sealer claims to be more resistant to bacterial leakage in
vitro [19] and in vivo [20] and may help to reinforce the
teeth lessening the chance of vertical root fracture [21].
These favourable results require experimental confirma-
tion.
Several methods have been employed to evaluate the
sealing properties of root canal filling materials, includ-

G. Conte et al. / Open Journal of Stomatology 3 (2013) 14-21 15
ing dye penetration [22], bacterial leakage [23], radio-
labeled tracer penetration [24], glucose penetration [25],
and electrochemical methods [26]. As none of the above-
mentioned methods alone completely cover the complex
nature of root canal sealing, all these techniques are
valuable to higher or lower extent [27-29]. However, a
universally accepted golden standard for the evaluation
of leakage does not yet exist.
The aim of the present study was to use the fluid fil-
tration and dye penetration methods to compare the seal-
ing ability of gutta-percha combined with a zinc-oxide/
eugenol-based root canal sealer (Pulp Canal Sealer
EWT-Kerr Sybron Dental Specialities, Romulus, USA)
to that of Resilon combined with Epiphany Root Canal
Sealer.
2. MATERIALS & METHODS
Fifty single-rooted human teeth extracted for periodontal
reasons were used after the patient’s informed consent.
The Ethical Committee of the Rome Tor Vergata Uni-
versity approved the research protocol. Each tooth was
carefully cleaned with curettes to remove any calculus or
soft tissue debris and stored in 0.5% Chloramine T
aqueous solution until use. The crowns were sectioned
below the cementum-enamel junction with a low speed
diamond saw (Isomet, Buehler, Lake Bluff, NY) so that
the length of the remaining root was approximately 15
mm. The working length was visually established by
subtracting 0.5 mm from the length of a size 15 K-type
file (Maillefer, Baillaguets, Switzerland) at the apical
foramen. The coronal third was prepared using ISO size
3 and 4 Gates Glidden drills (Maillefer, Ballaigues, Swit-
zerland).
All teeth were instrumented with a crown-down tech-
nique using a set of ProTaper Universal rotary instru-
ments (Dentsply Maillefer, Ballaigues, Switzerland) as
follows: the ProTaper Sx instrument was advanced into
the root canal to just short of the working length. The
other files were used in the following sequence, and all
were advanced to working length: S1, S2, F1, F2 and F3.
The root canals were then further instrumented with GT
System (Dentsply Maillefer, Ballaigues, Switzerland) ro-
tary files to obtain an ISO size #40, 0.10 taper apical
preparation. Apical preparation to size 40 was chosen to
standardize apical diameters between the specimens and
to improve the apical cleanliness. RC Prep (Premier,
Plymouth, PA) served as a lubricant during the cleaning
and shaping procedure.
A 1 ml aliquot of 5.25% NaOCl warmed to 37˚C was
delivered between each instrument with a 30G endodon-
tic needle (Navitip, Ultradent, UT) 1 mm short of the
working length. The patency of the apical foramen was
maintained with a #20 K file. Finally, the root canals
were flushed with 5 mL of 5.25% NaOCl for 5 minutes,
5 mL of 17% EDTA for 5 minutes, and 3 mL of distilled
water.
The prepared specimens were then randomly divided
into 2 groups of 22 specimens each (Resilon/Epiphany;
Guttapercha/Pulp Canal Sealer EWT) with the remaining
6 used as controls.
2.1. Resilon/Epiphany Group (R/E) (n = 22)
After instrumentation, root canals were dried with sterile
paper points (Dentsply Maillefer) and then a self-etching
primer (Epiphany Primer; Pentron Clinical Technologies)
was placed into the canal with a thin needle. Excess
primer was then removed with paper points (Dentsply
Maillefer). Roots were filled with a master cone of Resi-
lon and Epiphany sealer using the continuous wave of
condensation technique (Elements Obturation Unit, Sy-
bron Endo Corporation, Orange, CA, USA) and a back-
fill with thermoplasticized Resilon injection was per-
formed with the Extruder Handpiece (Elements Obtura-
tion Unit). The coronal 5 mm of each root canal were not
filled.
The roots were then light cured according to the ma-
nufacturer’s recommendation for 40 seconds using an
LED curing unit (Smartlite PS; Dentsply, DeTrey, Kon-
stanz, Germany) to create an immediate coronal seal.
2.2. Guttapercha/Pulp Canal Sealer EWT
Group (GP/PCS) (n = 22)
Root canals were dried with sterile paper points (Dents-
ply Maillefer). A guttapercha master cone was fitted
apically and vertically thermoplasticized using continu-
ous wave of condensation technique (Elements Obtura-
tion Unit). A backfill with thermoplasticized guttapercha
injection was performed with the Extruder Handpiece
(Elements Obturation Unit). Pulp Canal Sealer EWT was
used when placing the master cone. The coronal 5 mm of
each root canal were not filled.
2.3. Positive Control Group (n = 3)
The Instrumented root canals were left unfilled.
2.4. Negative Control Group (n = 3)
The Instrumented root canals were left unfilled with the
apical thirds sealed with wax and totally covered with
three layers of nail polish.
The length and density of the fill for both experimental
groups was confirmed using analogic radiography with
Kodak Insight xr dental film (Eastman Kodak Company,
Rochester, N.Y.).
All 50 roots were covered with two layers of nail var-
nish except for 2 mm of the apical and coronal regions,

G. Conte et al. / Open Journal of Stomatology 3 (2013) 14-21 16
wrapped in gauze dampened with sterile saline, and en-
closed in sealed tubes stored at 37˚ for 7 days to allow
the sealer to set [30].
2.5. Fluid Filtration Test
The fluid filtration device was built ad hoc by techni-
cians of the Dental materials department of the Univer-
sity of Rome Tor Vergata according to the design pro-
posed by Wu et al. [31] (Figure 1) The roots from
GP/PCS, R/E, negative and positive control group, were
mounted on plexiglass blocks with viscous cyanoacrylate
cement (Fill-It, American Dental Supply, Easton, PA).
The plexiglass blocks were penetrated by 18 gauge
stainless steel tubes that permitted water to be introduced
into the coronal portion of the roots. The coronal end was
connected by polyethylene tubing to a T-tube connector,
which joined a microsyringe to the fluid-filled system.
The microsyringe was used to introduce a minute air
bubble into a glass capillary tube of uniform diameter
(25 μl Microcap, Fisher Scientific, Atlanta, GA) equip-
ped with a ruler (Fisher Scientific, Atlanta, GA) to per-
mit accurate measurement of the air-bubble displacement.
Leakage was assessed at 3.6 psi (0.25 atm) [32]. Meas-
urements of fluid movement were performed at 2 minute
intervals for 60 min and averaged. Fluid flow rates (i.e.
leakage) were expressed as μL·min−1. The data were
analyzed using the Kruskal-Wallis test to compare leak-
age of the obturated canals. The level of significance was
set at 0.05.
2.6. Dye Leakage Test
The specimens were removed from their plexiglass
Figure 1. The fluid filtration apparatus realized following the
model proposed by Wu et al. (1993) consist of a liquid pressur-
ized (250 mBar) reservoir (a); a micro-syringe to adjust the
micro air bubble (b); a micro-capillary tube connected to the
specimen (c); a ruler to measure the movement of the micro air
bubble (d); a tap to give and remove pressure to the microcapil-
lary tube (e); a tap to adjust the pressure of the reservoir (f)
monitorized with a manometer (g).
stands and immersed in a neutral-buffered 2% aqueous
solution of methylene blue for 48 h at 37˚C. The roots
were then copiously rinsed with water, dried, and em-
bedded in clear epoxy resin. The teeth were sectioned at
1-millimeter intervals perpendicular to the long axis of
the root using a water-cooled low-speed diamond disk
(Isomet, Buehler, Lake Bluff, NY) 0.3 mm thick, result-
ing in a series of 0.7 mm-thick slices. The bottom surface
of each section was identified as the “n” level of the root
canal, while the top surface corresponded to the “n” +
0.7 mm level. The top and bottom surfaces of each sec-
tion were evaluated by an independent observer under
40× magnification using a stereomicroscope (Olympus
SZ40, Japan) to assess the extension of dye penetration
along the root canals at various distances from the apex
(0, 0.7, 1.0, 1.7, 2.0, 2.7, 3.0, 3.7, 4.0, 4.7, 5.0, 5.7, 6.0,
6.7, 7.0, 7.7, 8.0, 8.7, 9.0, and 9.7 mm) (Figure 2).
Scores to describe the degree of circumferential dye
penetration (dp) for each surface were assigned as re-
ported in Table 1.
The non-parametric Kruskal-Wallis test was used to
compare the medians in the two groups.
3. RESULTS
3.1. Fluid Filtration Test
The leakage of the negative control group as measured
by the fluid filtration model was uniformly zero, and the
leakage of the positive control group was immeasurably
Figure 2. 40× magnification images of a Resilon/Epiphany
specimen (A) showing a score 4 circumferential dye penetra-
tion, and a gutta-percha/Pulp Canal Sealer specimens (B) show-
ing a score 1 circumferential dye penetration.
Table 1. Circumferential dye penetration scores.
Score Dye Penetration
0 0˚
1 0˚ < dp ≤ 90˚
2 90˚ < dp ≤ 180˚
3 180˚ < dp ≤ 270˚
4 270˚ < dp ≤ 360˚

G. Conte et al. / Open Journal of Stomatology 3 (2013) 14-21 17
Several methods exist to evaluate the sealing ability of
root canal sealers. Most widespread methods to evaluate
the dye penetration along the root canal consist of linear
measurements following the tooth clearing or sections of
the specimen along the main root canal axis [33].
high. This confirmed the reliability of the fluid filtration
apparatus.
The median fluid microleakage in the R/E group was
0.085 [0.057, 0.113] μL·min−1. The median fluid micro-
leakage in the GP/PCS group was 0.113 [0.057, 0.141]
μL·min−1. Figure 3 summarizes the median linear fluid
movement in μL·min−1 for the GP/PCS and R/E groups.
During this study, specimens were sectioned perpen-
dicular to the long axis of the root and the circumferen-
tial interfaces between the root canal walls and the filling
material were examined and scored for dye penetration at
the upper and the lower surface of each section. This
enabled partial quantification of the three-dimensional
extent of dye penetration and to obtain more reliable
measurements.
Two of the 22 specimens in the Resilon/Epiphany
group experienced no leakage at the end of the experi-
mental period (60 min), and none of the 22 specimens in
the GP/PCS group were leak-free at the end of the ex-
perimental period. The R/E group leaked less than the
GP/PCS group, although the difference was not statistic-
cally significant (p = 0.0525). The fluid transport model proposed by Wu et al. [31]
offers several advantages over more commonly used
techniques of assessing leakage. It has been suggested
that the fluid transport model is both highly reproducible
and more sensitive than dye penetration for the detection
of full-length voids along the root canal [34]. Because
this method does not destroy the samples, it is possible to
obtain measurements of microleakage from the same
specimens at intervals over extended periods [35], or
other tests may be successively performed on the same
specimens. On the other hand, the fluid filtration tech-
nique, is not able to discern the root canal level at which
the microleakage is located. As an example, consider a
material able to perfectly seal the coronal millimeter of
the root canal but which completely fails to seal the rest
of the canal. The fluid filtration results would indicate a
perfect seal. In the results of the current study this is
demonstrated by the absence of any fluid movement
through the negative control group specimens in which
the hollow roots were sealed only at the apex with wax
and nail varnish coating.
3.2. Circumeferential Dye Penetration Test
Statistical analysis indicated no significant differences (p
> 0.05) between R/E and G/P at each root canal level
except for the 5.0, 5.7, and 6.0 mm level, where GP/PCS
performed statistically better than R/E. As shown in Fig-
ure 4 the mean GP/PCS leakage scores were lower than
the corresponding R/E values at almost all distances
from the apex although differences were not statistically
significant. In the most coronal sections of the R/E group
a slightly reduced dye penetration with respect to the
GP/PCS samples was evident, although the differences
were not statistically significant.
4. DISCUSSION
The aim of this study was to use the fluid filtration and
dye leakage tests to compare the sealing properties of a
resin-based adhesive root canal obturating material (Re-
silon/Epiphany) to gutta-percha/zinc-oxide eugenolate
sealer (Pulp Canal Sealer EWT), the current gold stan-
dard for endodontic filling materials.
Although the dye leakage test is not reliable or sensi-
tive enough to effectively assess the sealing properties of
Figure 3. Fluid filtration test results. Values are expressed in μL·min−1.

G. Conte et al. / Open Journal of Stomatology 3 (2013) 14-21 18
Figure 4. Mean circumferential dye penetration scores of Resilon/Epiphany and gutta-percha/Pulp
Canal Sealer groups at any top and bottom level of sections. The graphs show how the mean
circumferential dye penetration scores were always lower for the GP/PCS group except in the last
coronal millimiter where R/E group performed slightly better than GP/PCS group.
an endodontic filling material, Pitout et al. [33] have
already reported the use of a dye leakage test to corrobo-
rate results of a bacterial leakage study. The present
study is focused on a combined analysis of fluid filtration
and dye leakage results not only to evaluate the extension
of R/E and GP/PCS microleakage, but also to locate ar-
eas of more extensive leakage.
The results of both the fluid filtration test and the dye
leakage test indicate that there are no statistically sig-
nificant differences both in the amount of fluid leakage
and in the microleakage distribuition between R/E and
GP/PCS. The few statistical significances found during
dye leakage testing in the middle portion of the root ca-
nals were not convincing enough conclude in favour of
either method.
The current results are in agreement with the findings
of studies using similar laboratory [36-38]. In these
studies, an epoxy resin based sealer was used for filling
the root canals. On the contrary, other fluid filtration
studies demonstrated better sealing properties of Resi-
lon/Epiphany combination respect to gutta-percha/epoxy
resin based sealer although all of them experienced some
degree of leakage [8,39-41]. However, even the com-
parison between fluid filtration studies is made difficult
by multiple variable such as the use of different irrigants,
sealers, condensation techniques, testing pressures or
storage time.
The results of the present study are consistent with
those of several studies with bacterial leakage model,
which have found no enhanced sealing properties of Re-
silon/Epiphany as compared with other filling materials
[33,42-44].
Nevertheless, Shipper et al. [16-19] with two studies
based on a bacterial leakage model, compared lateral and
vertical condensations of gutta-percha with AH26 to lat-
eral and vertical condensations of Resilon/Epiphany.
They found the Resilon/Epiphany leaked significantly
less than the gutta-percha groups.
The periapical inflammatory response to microbial
innoculation of dog roots filled with gutta-percha with
AH26 versus Resilon/Epiphany indicated that Resilon
provided superior apical sealing in dogteeth in vivo [20].
In the above three studies [16,19,20] note that smear
layer was not removed.
Cobankara et al. [45] showed significantly more leak-
age if the smear layer was not removed compared to be-
ing removed when they studied two sealers (not Resi-
lon/Epiphany).
The formation of the monoblock claimed by the
manufacturers of Resilon/Epiphany has been questioned
by many authors [46-48]. While the goal of creating a
monoblock of material between a root canal filling mate-
rial and a sealer certainly does have merit [12], this goal
may be prevented by various weak links in the two fill-
ing systems. In gutta-percha-filled canals, the weak link
occurs between the gutta-percha and the sealer. Unlike
gutta-percha specimens, the weak link in Resilon-filled
root canals was the sealer-dentin interface [49].
A study by Tay et al. [49] using the transmission elec-
tron microscopy has shown the presence of silver depos-
its along the sealer-hybrid layer interface in Epiphany-
Resilon combination, and between the AH Plus sealer
and gutta-percha. Authors also concluded that the quality
of apical seal achieved with Epiphany-Resilon combina-
tion is not superior to AH Plus gutta-percha combination.
Perdigao et al. [50] found evidence of hybrid layers
with adhesive materials but also reported areas of inter-
facial separation. They stated that despite the hybridiza-

G. Conte et al. / Open Journal of Stomatology 3 (2013) 14-21 19
tion of resin-filling materials, a tight seal is difficult to
achieve because of the complex anatomy and mechanical
challenges such as polymerization shrinkage and unfa-
vourable C-factor inside the root canals. Bouillaguet et al.
[51] reported that C-factors in post spaces may exceed
200, compared to values between 1 and 5 in intracoronal
restoration. Tay et al. [48] estimated that in a 20 mm
long root canal the adhesive filling procedure with a 25
μm adhesive sealer thickness the theoretical C-factor
could reach 954.
Many authors have suggested factors that could nega-
tively influence adhesion of methacrylate-based root
canal sealers to the root dentinal walls, for instance re-
moval of the smear layer, diffusion of the primer, mois-
ture control, oxygen polymerization inhibition, and high
resin-based sealer shrinkage. The results of microshear
bond tests [40,49,52] and push-out tests [53] have dem-
onstrated that the bonding of Resilon to Epiphany is
weak (1 - 3 MPa).
Strengthening this last issue Onay et al. [37] also
demonstrated that both the AH Plus/gutta-percha combi-
nation and the Epiphany/guttapercha combination had
higher sealing ability than the Epiphany sealer and Resi-
lon core combination suggesting that the Resilon core
material, rather then the methacrylate-based sealer, could
represent the weak point in the Resilon/Epiphany system.
The results of the present study confirm the absence of
a monoblock seal. The presence of some amount of
leakage and above all the presence of deep dye penetra-
tion both coronally and apically in both experimental
groups suggest the lack of a tight and continuous seal
along the root canal.
It should also be pointed out that, although the present
study focused on Resilon/Epiphany sealing abilities at
time 0, several studies have already demonstrated the
weakening of Resilon/epiphany seal even after relatively
short storage periods due to degradation of adhesive in-
terface [8,30,43,54] and enzymatic degradation of poly-
caprolactone [10,49,55-57].
5. CONCLUSION
Under the experimental conditions of this study, Resi-
lon/Epiphany sealed root canals as well as Guttaper-
cha/Pulp Canal Sealer. Short-term evaluations suggest
that a monoblock seal is not being achieved.
6. ACKNOWLEDGEMENTS
Authors would like to thanks Mr. Massimo Tolu for his precious tech-
nical support.
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