Basic Research—Technology
An In Vitro Comparison of the Intraradicular Dentin Bond
Strength of Resilon and Gutta-Percha
Lance J. Skidmore, DDS, David W. Berzins, PhD, and James K. Bahcall, DMD, MS
Abstract
The purpose of this study was to compare the micro-
push-out bond strength of Resilon to that of gutta-
percha. Extracted human anterior teeth were used for
evaluation. The crowns were removed and the root
canals were instrumented with Gates Glidden drills and
0.06 Profile rotary files. Instrumentation was performed
with 5.25% sodium hypochlorite irrigation and a final
rinse of 17% EDTA. The teeth were randomly divided
into two groups. Gutta-percha group: obturation with
gutta-percha and Kerr Pulp Canal Sealer EWT. Resilon
group: obturation with Resilon points, Epiphany Primer,
and Root Canal Sealant. The teeth were cut perpendic-
ular to their long axis to obtain a series of 1.0 mm thick
disks (n ⫽ 15 per group). Micropush-out bond
strengths to root canal dentin were measured. The
results show that the mean bond strength to root canal
dentin was significantly higher (p ⬍ 0.05) in the Resi-
lon/Epiphany group as compared to the gutta-percha/
Kerr Pulp Canal Sealer EWT group. (J Endod 2006;32:
963–966)
Key Words
Bond strength, Epiphany, micropush-out, Resilon
From the Department of Endodontics, Marquette Univer-
sity, School of Dentistry, Milwaukee, Wisconsin.
Address requests for reprint to Dr. Lance J. Skidmore,
Marquette University, School of Dentistry, Department of
Endodontics, 1801 West Wisconsin Avenue, Room 245, Mil-
waukee, WI 53233. E-mail address: lance.skidmore@
marquette.edu.
0099-2399/$0 - see front matter
Copyright © 2006 by the American Association of
Endodontists.
doi:10.1016/j.joen.2006.03.020
JOE — Volume 32, Number 10, October 2006
T he principal objectives of endodontic therapy are to first chemomechanically clean
and shape the root canal system, and second to completely obturate the canal system
in three dimensions (1). Because bacteria and their byproducts have been shown to
cause apical periodontitis and root canal failure (2– 4), the objective of three dimen-
sional obturation is to completely seal the canal system from any bacterial ingress from
the oral cavity and periradicular tissues. Additionally, the obturating materials seal
within the canal system any irritants that are not removed during chemomechanical
preparation. Gutta-percha and traditional sealers have been the most commonly used
and accepted materials for the obturation of endodontically treated teeth. However,
leakage and recontamination of the root-canal system continue to cause post treatment
complications (5).
Khayat et al. (6) examined the microbial leakage of extracted maxillary and man-
dibular molars and found that canals were completely contaminated on average within
28 days regardless of the gutta-percha obturation method. To minimize the likelihood
of contamination, new materials and methods are continually developed to improve the
seal of endodontic obturation.
Resilon (Resilon Research LLC, Madison, CT) is a new material that has been
introduced for the obturation of endodontically treated teeth. Resilon is a synthetic
polycaprolactone polymer based on the polymers of polyester. This material contains
dimethacylates and can bond to methacrylate-based resin sealers (7). Resilon points
look and handle like gutta-percha, and when used with a self etch primer and a resin
sealer, the manufacturer claims a bonded obturation between the intraradicular dentin
and the root canal filling is formed.
Several studies have evaluated this material (8 –12). Shipper et al. (8) used a split
chamber microleakage test to compare the resistance to leakage of Resilon and Epiph-
any sealer to that of gutta-percha and AH26 sealer and found Resilon had significantly
less leakage over 30 days. The results of Tay et al. (11) are in contrast to those of Shipper
et al. (8). Tay et al. found that the quality of apical seal with Resilon was not superior to
gutta-percha and a conventional epoxy-resin sealer when compared using a silver
tracer penetration technique. Teixeira et al. (9) evaluated the fracture resistance of
endodontically treated teeth filled with either gutta-percha or Resilon and found that the
mean fracture loads of the gutta-percha groups were lower than the Resilon groups.
However, the results of Gesi et al. (12) challenge the concept of the ability to increase
fracture resistance of root canal treated teeth using Resilon, because their Resilon/
Epiphany group exhibited significantly lower interfacial strength compared with gutta-
percha/AH Plus group.
One of the main claims of those advocating the use of Resilon is its ability to
produce a bonded monoblock filling. This is created by the adhesion of the Resilon cone
to the resin based sealer, which adheres to the dentinal wall and penetrates the dentinal
tubules. Shipper et al. (10) referred to this bonded root canal filling as the Resilon
“Monoblock” System (RMS). In their study, a dog model was used to compare the
efficacy of gutta-percha and AH26 sealer versus RMS in preventing apical periodontitis
after coronal microbial inoculation. The results showed the RMS was associated with
significantly (p ⬍ 0.05) less periapical inflammation.
An improved bond and the creation of a monoblock root canal obturation would
be the main advantages of this new material. Therefore, the purpose of this study was to
evaluate the bondability of this new material by comparing the micropush-out bond
strength of Resilon/Epiphany filled teeth to that of teeth filled with gutta-percha and Kerr
Pulp Canal Sealer EWT (Kerr Corporation, Orange, CA). The null hypothesis is that there
Comparing Bond Strength of Resilon and Gutta-Percha 963
Basic Research—Technology
is no difference in the micropush-out bond strength of Resilon and
gutta-percha based obturating systems.

Materials and Methods

Twelve recently extracted human anterior teeth with straight roots
were used in this study. The crowns were removed at the cementoe-
namel junction using a high-speed carbide bur with water coolant. A
#15 K-type file was inserted until it could be seen at the apical foramen,
and then 1 mm was subtracted from this to determine the working
length. The root canals were instrumented with Gates Glidden burs and
0.06 Profile nickel-titanium rotary instruments (Dentsply Tulsa Dental,
Tulsa, OK) to a size 40 file at working length. To remove the smear layer,
instrumentation was performed with 5.25% sodium hypochlorite irri-
gation and a final rinse of 17% ethylene diamine tetra-acetic acid
(EDTA) as per manufacturer’s instructions. Sodium hypochlorite was
not used for final irrigation because it may negatively alter the bond of
the sealer to the dentinal wall. The teeth were dried with paper points
then randomly divided into two equal groups.
Gutta-percha group: Obturation with gutta-percha and Kerr Pulp
Canal Sealer EWT using a warm vertical compaction technique.
Resilon group: Obturation with Resilon Points, Epiphany Primer,
and Root Canal Sealant (Pentron Clinical Technologies, Walling-
ford, CT) using a warm vertical compaction technique.
In the gutta-percha group, a #40 .06 tapered cone (Dentsply Tulsa
Dental) was fit with tug back. The point was coated with Kerr Pulp Canal
Sealer EWT (mixed according to manufacturer’s instructions) and in-
troduced into the canal and pumped a few times. The cone was re- Figure 1. Schematic representation of tooth sample preparation and micro-
push-out set-up used for testing the bond strength.
moved, re-coated with sealer, and inserted again to ensure adequate
sealer coverage. A downpack and backfill were completed using a Sys-
tem B (System B, SybronEndo, Orange, CA) and Obtura II (Obtura (Instron Corp., Norwood, MA) at a speed of 0.5 mm/min until bond
Corp., Fenton, MO). failure occurred. The bond strength expressed in MPa at failure was
In the Resilon group, the Epiphany self-etch primer was brought calculated by dividing the load in Newtons by the area of the bonded
into the canal by the insertion of a saturated fitted paper point. This step interface. The area of the bonded interface was calculated with the
was done two times to ensure adequate primer placement. Excess formula, area ⫽ 2␲r ⫻ h, where ␲ is the constant 3.14 and r and h are
primer, if any, was removed with a dry paper point. The sealer was then the measured radius and height in millimeters of the filling material that
expressed using the auto mix syringe tip. The fitted master cone was was pushed out. The bond strength results were statistically evaluated
coated with the sealer and placed into the canal and pumped. The cone using the Shapiro-Wilk test to determine whether the data were nor-
was removed, re-coated with sealer, and inserted again to ensure ade- mally distributed. As the data were not normally distributed, the Mann-
quate sealer coverage. The downpack and backfill were then completed Whitney test was performed with statistical significance set at 95% (p ⬍
using the same technique as the gutta-percha group. 0.05). For each group, bond strength data for the middle and coronal
All bonded samples were stored in 100% humidity for 24 h at levels of the root were pooled as no difference (p ⬎ 0.10) was found
37°C. The samples were cut perpendicular to their long axis using an between the different areas.
Isomet saw (Buehler Ltd., Lake Bluff, IL) with water lubrication. The After the measurement of bond strength, both sides of the failed
samples in both groups were collected from the middle and coronal bond were evaluated microscopically to determine modes of bond fail-
thirds of the canal. Because of the small size of the filling material in the ure. Each sample was evaluated and placed into one of 3 failure modes:
apical 3 mm of the root, this portion was not evaluated using the mi- type I, adhesive failure, at sealer and dentin interface; type II, cohesive
cropush-out technique. If the sample contained filling material of a failure, within sealer or dentin; type III, mixed failure, failure in both the
noncircular shape, it was discarded, as this would result in nonuniform sealer and dentin.
stress distributions during testing and inaccurate measurements. Over- Four randomly selected intact and failed samples were prepared
all, this step produced a series of 1.0 mm thick disks (n ⫽ 15 per for scanning electron microscopy (SEM) evaluation. Each sample was
group) with seven and six of the 15 disks for the gutta-percha and sputter coated with gold (Hummer I, Technics Electron Microscopy
Resilon groups, respectively, arising from the middle third of the teeth. Systems, Inc., Munich, Germany) and evaluated under SEM (JSM-35,
The exact dimensions of each disk were measured with a digital caliper Jeol Ltd. Tokyo, Japan) at magnifications ranging from 300 to 2000⫻.
to within 0.01 mm. The filling material was loaded with a 0.76 mm
diameter cylindrical stainless steel plunger that provided the most ex- Results
tended coverage over the filling material without touching the canal wall The mean micropush-out bond strength of the Resilon group
(Fig. 1). The teeth were marked as to ensure that the direction of the (1.51 ⫾ 1.22 MPa) was significantly higher (p ⬍ 0.05) than that of the
plunger push was in the apical to coronal direction, to avoid any inter- gutta-percha group (0.66 ⫾ 0.39 MPa). Modes of failure are shown in
ference owing to any root canal taper. Micropush-out bond strengths to Table 1. Inspection of the samples revealed the bond failure to be
root canal dentin were measured using a universal-testing machine predominantly adhesive between the sealer and dentin interface for

964 Skidmore et al. JOE — Volume 32, Number 10, October 2006

TABLE 1. Mean Micropush-Out Bond Strength
Resilon Group Gutta-Percha Group
1.51 ⫾ 1.22 MPa 0.66 ⫾ 0.39 MPa
both groups. SEM evaluation of intact samples revealed incomplete
bond formation at the resin/dentin interface (Fig. 2) and empty dentinal
tubules (Fig. 3) could be seen on the dentinal surface of the tested
samples.
Discussion
The results show that there is a significant difference between the
Resilon and gutta-percha groups, and thus the null hypothesis is re-
jected. The results of this study should be viewed in conjunction with
those of Gesi et al. (12). They found that the bond strength of the Resilon
system was significantly lower than that of gutta-percha and an epoxy-
resin sealer. Other research has established that the bond strengths of
zinc oxide eugenol based sealers, as used in this study, to dentin are
lower than those of the polymer and epoxy based sealers (13). There-
fore, the Resilon system may be viewed as having intermediate bond
strengths compared to gutta-percha with other types of sealers com-
monly used. Although interstudy comparison of data may be problem-
atic, it may be worth noting that the Resilon group had a mean bond
strength of (0.50 ⫾ 0.41 MPa) in the Gesi et al. (12) study compared to
(1.51 ⫾ 1.22 MPa) in this study, despite similar methodologies. A
possible explanation for the differences and that may require further
investigation, is that in their study, the coronal surface was light cured
for 40 s. Light curing of a composite resin causes rapid polymerization
and prevents stress relief by resin flow which has been shown to intro-
duce interfacial stresses because of polymerization shrinkage (14, 15).
They also included six premature failures in the calculation of the mean
bond strength. Using the thin slice method of sample preparation, we
had no premature failures in either the Resilon or gutta-percha groups.
Figure 2. Lower magnification view of an intact Resilon sample showing both
complete bond formation (A) and lack of bonding (B).
JOE — Volume 32, Number 10, October 2006
Basic Research—Technology
Bond strength evaluations have become popular to determine the
effectiveness of the adhesion of dental materials to root canal dentin. In
this study, a micropush-out bond strength test was used. There is no
generally accepted superior test for bond strength evaluation. Another
test frequently used is the microtensile test (16, 17). However, in a
preliminary study, the microtensile method produced an excessive
amount of premature bond failures during the cutting phase of the
sample preparation, and it was not found to be a reliable test method for
this study. Similar difficulties were reported by Goracci et al. (18) when
comparing microtensile and push-out bond strength measurements. It
was then decided to use the micropush-out test to evaluate bond
strength. Some have objected to the use of the push-out test due the
possible nonuniform stress distribution (19). In this study, we sought to
overcome this limitation by using thin-slice samples, only 1-mm thick.
Using this method, it was possible to reliably produce a sample capable
of bond strength evaluation.
Sodium hypochlorite was not used as the final irrigation solution
because several studies have shown that exposure to sodium hypochlo-
rite results in reduced resin bond strengths (20, 21). It is believed that
this occurs because sodium hypochlorite is an oxidizing agent that leads
to the oxidation of some component of the dentin matrix. Oxygen also
has been shown to inhibit the polymerization of resins (21). In this
study, as part of the final rinse, dentin was treated with 17% EDTA to
remove the smear layer and to provide better adhesion of the sealers to
the root canal dentin. The removal of the smear layer permits the pen-
etration of the sealer into the dentinal tubules, and has been shown to
increase the dentin bond strength of resin based sealers and an en-
hanced seal (22, 23). However, in this study, SEM evaluation showed
successful removal of smear layer (Fig. 3), but Resilon was still not able
to form a complete monoblock bond in some areas.
The finding that the Resilon-filled canals had more than two times
the mean micropush-out bond strength of the gutta-percha group, sug-
gests that, though it is a weak bond, there is bonding occurring. Spec-
imen evaluation by SEM revealed gaps between the sealer and dentin in
the Resilon-filled root canals (see Fig. 2). This point of weakness was
also evidenced by the finding that 14 of 15 specimens experienced
adhesive failure at the sealer-dentin interface (Table 2). This finding
suggests that the weak link in Resilon-filled root canals lies at the sealer-
dentin interface, which is in agreement with others (11).
Figure 3. SEM image showing open dentinal tubules (arrow) of failed interface
of Resilon group.
Comparing Bond Strength of Resilon and Gutta-Percha 965
Basic Research—Technology
TABLE 2. Modes of bond failure 7. Jia WT, Alpert B. Root canal filling material. United States Patent & Trademark Office,
United States Patent Application 20030113686, June 19, 2003.
Failure mode Gutta-Percha group Resilon group 8. Shipper G, Orstavik D, Teixeira FB, Trope M. An evaluation of microbial leakage in
I - Adhesive 13 14 roots filled with a thermoplasitic synthetic polymer based root canal filling material
II - Cohesive 0 0 (Resilon). J Endod 2004;30:342–7.
III - Mixed 2 1 9. Teixeira FB, Teixeira ECN, Thompson JY, Trope M. Fracture resistance of roots
Total samples 15 15 endodontically treated with a new resin filling material. JADA 2004;135:646 –52.
10. Shipper G, Teixeira FB, Arnold R, Trope M. Periapical inflammation after coronal
microbial inoculation of dog roots filled with gutta-percha or Resilon. J Endod
2005;31:91– 6.
In conclusion, the Resilon/Epiphany filled root canals have signif- 11. Tay FR, Loushine R, Weller N, et al. Ultrastructural evaluation of the apical seal in
icantly (p ⬍ 0.05) higher mean micropush-out bond strength to in- roots filled with a polycaprolactone-based root canal filling material. J Endod
traradicular dentin than that of gutta-percha and Pulp Canal Sealer EWT. 2005;31:514 –9.
12. Gesi A, Raffaelli O, Goracci C, Pashley DH, Tay FR, Ferrari M. Interfacial strength of
However, SEM evaluation challenges the idea of producing a complete Resilon and gutta-percha to intraradicular dentin. J Endod 2005;31:809 –13.
monoblock obturation without gaps. The clinical significance of these 13. Lee KW, Williams BS, Camps JJ, Pashley DH. Adhesion of endodontic sealers to dentin
findings will require further in vivo evaluation. and gutta-percha. J Endod 2002;28:684 – 8.
14. Alster D, Feilzer AJ, de Gee AJ, Davidson CL. Polymerization contraction stress in thin
resin composite layers as a function of layer thickness. Dent Mater 1997;13:146 –50.
Acknowledgments 15. Ferracane JL. Developing a more complete understanding of stresses produced in
The authors wish to thank Jim Brozek for the drawing and Dr. dental composites during polymerization. Dent Mater 2005;21:36 – 42.
Raymond A. Fournelle, Department of Mechanical and Industrial 16. Erdemir A, Eldeniz AU, Belli S, Pashley DH. Effect of solvents on bonding to root canal
Engineering, Marquette University, for use of the SEM. dentin. J Endod 2004;30:589 –92.
17. Pashley DH, Carvalho RM, Sano H, et al. The microtensile bond test: a review. J Adhes
Dent 1999;1:299 –309.
References 18. Goracci C, Tavares AU, Fabianelli A, et al. The adhesion between fiber posts and root
1. Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967; canal walls: comparison between microtensile and push-out bond strength measure-
1:723– 44. ments. Eur J Oral Sci 2004;112:353– 61.
2. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental 19. Sudsangiam S, Van Noort R. Do dentin bond strength tests serve a useful purpose? J
pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Path Adhes Dent 1999;1:57– 67.
1965;20:340 –9. 20. Morris MD, Lee KW, Agee KA, Bouillaguet S, Pashley DH. Effects of sodium hypochlo-
3. Siqueira JF Jr. Aetiology of root canal treatment failure and why well-treated teeth can rite and RC-Prep on bond strengths of resin cement to endodontic surfaces. J Endod
fail. Int Endod J 2001;34:1–10. 2001;27:753–7.
4. Lin LM, Skribner JE, Gaengler P. Factors associated with endodontic treatment fail- 21. Ari H, Yasar E, Belli S. Effects of NaOCl on bond strengths of resin cements to root
ures. J Endod 1992;18:625–7. canal dentin. J Endod 2003;29:248 –51.
5. Torabinejad M, Ung B, et al. In vitro bacterial penetration of coronally unsealed 22. Eldeniz AU, Erdemir A, Belli S. Shear bond strength of three resin based sealers to
endodontically treated teeth. J Endod 1990;16:566 –9. dentin with and without the smear layer. J Endod 2005;31:293– 6.
6. Khayat A, Lee SJ, Torabinejad M. Human saliva penetration of coronally unsealed 23. Behrend GD, Cutler CW, Gutmann JL. An in-vitro study of smear layer removal and
obturated root canals. J Endod 1993;19:458 – 61. microbial leakage along root-canal fillings. Int Endod J 1996;29:99 –107.

966 Skidmore et al. JOE — Volume 32, Number 10, October 2006