Effect of ultrasonic activation on dentinal tubule penetration of BIO-C® Temp and Ultracal XS:
a comparative CLSM assessment

Fernando PEÑA-BENGOA,1 María Consuelo MAGASICH,2  Delia BUSTAMANTE,2  Catalina WASTAVINO,2  Sven Eric NIKLANDER,3  Carolina CÁCERES1

1Department of Endodontics, Universidad Andres Bello Faculty of Dentistry, Viña del Mar, Chile 2Private Practice, Viña del Mar, Chile
3Department of Oral Pathology and Medicine, Universidad Andres Bello Faculty of Dentistry, Viña del Mar, Chile
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Objective:
The goal of this study was to compare the effect of ultrasonic activation (UA) on dentinal tubule penetration between the intracanal medications BIO-C® Temp and Ultracal XS.
Clinical Implications:
‍When an intracanal medication is able to penetrate the dentinal tubules, it means that it will come into contact with a larger area of the root canal system, especially areas that are difficult to access (which can only be reached by mechanically agitating the solutions). In the case of necrotic pulps, bacteria lodge in these areas, so it is critical that the antibacterial product reaches them to eliminate them, increasing the likelihood of treatment success.
HIGHLIGHTS• BIO-C® Temp is a calcium silicate-based intracanal medication that has been proposed to as an alternative to calcium hydroxide.
• A comparison of these new drugs with those considered the "Gold Standard" is essential for evaluating their performance.
• The physical properties of BIO-C® Temp associated with ultrasonic activation may include a more homogeneous distribution and greater penetration into the dentin.
• The results showed that BIO-C® Temp has a greater depth and area of penetration into the tubules than Ultracal XS after ultrasonic activation.
FIGURE 3Image of the apical third demonstrating the maximum penetration depth achieved by (a) BIO-C® Temp + UA and (b) UltraCal XS + UA.
UA: Ultrasonic Activation
FIGURE 4Penetration area (μm²) achieved by: (a) BIO-C®Temp vs. BIO-C®Temp + UA; (b) UltraCal XS vs. UltraCal XS + UA; (c) BIO-C®Temp + UA vs. UltraCal XS + UA. *: p=0.0339, **: p<0.008. ns: No significant differences; UA: Ultrasonic activation
When comparing the two drugs in the apical third after ultrasonic activation, BIO-C® Temp + UA showed a statistically significant greater maximum penetration depth than UltraCal XS + UA (p=0.0005) (Figure 2c and Figure 3). No differences were found when comparing both drugs without ultrasonic activation, either in the middle or apical third (p>0.05).
Ultrasonic activation increased the penetration area of BIO-C® Temp in both the middle and apical thirds, but the increase was only statistically significant in the apical third (p=0.0016) (Figure 4a). UA slightly increased the penetration area of UltraCal XS in the middle and apical thirds, but the changes were not statistically significant (p>0.05) (Figure 4b).
FIGURE 5. Image of the apical third showing the penetration area achieved by (a) BIO-C®Temp + UA and (b) UltraCal XS + UA. UA: Ultrasonic activation
The penetration area of BIO-C® Temp + UA was significantly greater than that of UltraCal XS + UA, both in the middle third (p=0.0339) and the apical third (p=0.0075) (Figure 4c and Figure 5).

CONCLUSIONS:
‍· Ultrasonic activation increases the tubular penetration (both in depth and in area) of BIO-C® Temp in the apical third, but has no significant effect on Ultracal XS.
· BIO-C® Temp has a greater depth and area of tubular penetration than Ultracal XS after ultrasonic activation.