Assessment and comparison of the incidence and degree of extrusions with TotalFill®BC and AH Plus™ sealers when using single-matched cone and warm vertical compaction as obturation techniques


  • Beleva Irina BUPA Dental Care, Newark, United Kingdom
📧Corresponding author


Background: Extrusions of endodontic materials after root canal treatments are scarcely commented upon in the existing literature. Although they can cause serious complications depending on their size and the area they have occurred.

Literature review: AH Plus™ is a conventional endodontic sealer, which has been established as the “gold standard” for root canal treatments (Roggendorf, 2004). Bioceramic sealers (TotalFill®BC Sealer™) are novel and promising endodontic materials, which have not been comprehensively scrutinised. The limited research available shows comparable success of the treatments with both types of sealers, as well as similar complications.

Method: A laboratory experiment involving 108 plastic teeth was conducted in order to assess and compare the likelihood of extrusions with both types of sealers in combination with two different obturation techniques. The acrylic teeth were instrumented with the same type of endodontic files, according to the same protocol, and divided in four groups. Each group received a different treatment (a combination of one sealer and one obturation method), where an equal amount of sealer was injected in each canal- 0.3ml, in order to assess which treatment caused less number and amounts of extrusions.

Results: The percentage of extrusions was higher and statistically significant (with P-value 0.0114<0.05) in the groups obturated with TotalFill®BC Sealer™- 51.85% and 44.44%, compared to the groups obturated with AH Plus™- 11.11% and 33.33%. The same was evident regarding the sizes of extrusions. The obturation method did not seem to affect the extrusion occurrences in the TotalFill®BC Sealer™ groups. However, it seemed to have an effect on the frequency of extrusions in AH Plus™ groups as a difference of 22.22% was evident.

Conclusion: Based on the findings of this study and the scientific data from the existing literature, it is recommended that extrusions should be avoided. The choice of obturation technique and sealer should be carefully considered in accordance to the specific case and in order to prevent extrusions.


sealer extrusions AH Plus™ bioceramic sealer TotalFill®BC Sealer™ warm vertical compaction single matched cone

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