Comparison of the Radiopacity of Zinc Oxide-eugenol Cements using Different Radiographic Methods

Abstract

Aims: To evaluate whether there is a difference in the radiopacity of four endodontic sealers, using two imaging techniques. Study Design: Experimental study, with a quantitative approach. Place and Duration of Study: Research Laboratory - Dentistry Course at the University of Fortaleza (UNIFOR), between June 2024 and May 2025. Methodology: Four endodontic sealers (Endofill, Ciment-Fill, Pulp Fill, and Fill Canal) were prepared according to the manufacturer's instructions and inserted into 10 mm diameter x 1 mm high rings, with three samples per group (n = 3), totaling n = 12. After complete setting, the samples were positioned on radiographic occlusal films, next to an aluminum penetrometer and exposed to X-rays (60 kV, 10 mA, 0.3 s, at 30 cm), using a digital sensor and analog method. Radiopacity was analyzed in the Photopea program, converting the radiographic density into millimeters of aluminum. Results: Digital radiography showed greater sensitivity in detecting radiopacity, with a statistically significant difference compared to the analog technique (P < 0.05). Endofill showed the highest radiopacity in both methods, significantly surpassing Pulp Fill and Fill Canal. Ciment-Fill presented intermediate values, similar to Pulp Fill, with no statistical difference between them (P > 0.05). Fill Canal presented the lowest radiopacity, significantly lower than the others (P < 0.05), which may compromise its clinical visibility. Conclusion: The materials tested are within the values ​​proposed by the American Dental Association (2000), specification no. 57 and no. 6876 of the International Organization for Standardization (ISO). In addition to evaluating the radiopacity density, the digital radiographic technique presented superior results to the analog, both revealing positive results.