Abstract
The objective of this study was to evaluate, in vivo, coronal bacterial infiltration after endodontic treatment with different obturation technique. Forty-five dogs’ root canals, originated from incisors and premolars, were used. The animals were intubated after general anesthesia. After local antisepsis and placement of rubber dam isolation, teeth were opened and instrumented up to a Kerr handfile #40, followed by three obturation protocols with Endofill®: Lateral condensation, Lateral condensation with a coronal plug of set Endofill® and Tagger hybrid technique. Access openings were not sealed and root fillings remained exposed to oral environment for 90 days. After this period, animals were euthanized and specimens were histologically processed and stained with Brown and Brenn. Dentinal tubules were evaluated with presence or absence of bacteria descriptive analysis. Bacterial infiltration was identified on root canal walls in six out of 14 root canals filled with the lateral condensation technique (42,8%), two out of 15 canals filled with Lateral condensation with a plug of set Endofill® (13,3%) and in two out 13 root canals filled with the Tagger hybrid technique (15,3%). Although the use of a coronal plug or a thermomechanical compaction technique showed less bacterial infiltration than conventional lateral condensation, none of the obturation techniques prevented bacterial infiltration to periapical area, evidencing the importance of a proper coronal seal or final restoration.
Highlights
The objective of endodontic therapy is to prevent or heal periapical periodontitis, mainly caused by microorganisms and their by-products
Periapical tissue is the most common affected area by endodontic disease, special attention should be directed to the coronal portion of the root canal, since an adequate coronal sealing is primordial for healing after endodontic treatment, previously associated with less inflammatory infiltrate (Yamauchi et al 2006) or even reduction of apical periodontitis (Shiper et al 2005)
Microorganisms in the oral fluid may infiltrate through the dentin/temporary restorative sealer interface, highlighting the importance of restorative procedures, which may avoid marginal microleakage (Nakamura et al 2006), leading authors to state that the integrity of coronal restoration is as important as the obturation quality (Ray & Trope 1995, Tronstad et al 2000)
Summary
The objective of endodontic therapy is to prevent or heal periapical periodontitis, mainly caused by microorganisms and their by-products. Microleakage may occur after obturation, recontaminating root canal system (Yamauchi et al.2006, Braz Junior et al 2021), defined as “the clinically undetectable passage of bacteria, fluids, molecules or ions between tooth and the restorative or filling material” and may be considered one of the most important risk factor for apical periodontitis in endodontically treated teeth (Muliyar et al 2014). The recontamination of obturated root canal via coronal leakage allows bacteria to reach periapical tissues, and can occur in cases where obturation is exposed to the oral environment, usually found in: (a) loss, fracture or failure of restoration; (b) recurrent caries; (c) delay in restoration, with infiltration through temporary restorative material; and (d) during the restorative procedure (Khayat et al 1993). Microorganisms in the oral fluid may infiltrate through the dentin/temporary restorative sealer interface, highlighting the importance of restorative procedures, which may avoid marginal microleakage (Nakamura et al 2006), leading authors to state that the integrity of coronal restoration is as important as the obturation quality (Ray & Trope 1995, Tronstad et al 2000)
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