Microleakage in Root Canal Obturation: A Narrative Review of Contemporary Sealers and Obturation Techniques

Abstract

Root canal obturation plays a critical role in the long-term success of endodontic treatment by avoiding apical and coronal microleakage, which is one of the primary causes of endodontic failure. The new advancements in root canal sealers and obturation techniques have led to the improvement of sealing ability, biocompatibility, and adaptation to canal walls. This review evaluated the available evidence concerning the sealing ability of current endodontic sealers and the influence of different obturation methods on microleakage. The evidence indicated that bioceramic sealers generally exhibited superior sealing performance, greater dentinal tubule penetration, improved adaptation, and lower microleakage compared with conventional resin-based sealers. Bioactive glass-based sealers, particularly GuttaFlow Bioseal, also demonstrated favorable sealing characteristics and bioactive properties. While warm obturation techniques may enhance material adaptation and distribution, single-cone obturation combined with modern bioceramic sealers frequently achieved comparable sealing outcomes. Nevertheless, substantial methodological heterogeneity among studies, including differences in leakage assessment methods, sealer types, and obturation protocols, limits direct comparison of results. Current evidence suggests that contemporary bioceramic and bioactive sealers provide promising improvements in root canal sealing; however, a more standardized and clinically relevant investigations are mandatory to establish definitive recommendations concerning the optimal sealer and obturation technique combination for long-term endodontic success.