Microcomputed Tomographic Assessment of the Single Cone Root Canal Fillings Performed by Undergraduate Student, Postgraduate Student and Specialist Endodontist.

Saulius Drukteinis,Vytaute Peciuliene,Goda Bilvinaite,Hagay Shemesh,Paulius Tusas

doi:10.3390/jcm10051080

Saulius Drukteinis, Vytaute Peciuliene + Show 3 more

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https://doi.org/10.3390/jcm10051080

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Abstract

The present study evaluated the obturation quality of root canals filled with BioRoot RCS sealer and single gutta-percha point by undergraduate student (US), postgraduate student (PS) and endodontist (ED). Twenty-one plastic models of upper premolars were enlarged with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into three groups (7 teeth/14 canals per group): US, PS and ED. After the obturation of root canals with BioRoot RCS and one HyFlex EDM size 40 gutta-percha point, plastic models were scanned using micro-computed tomography scanner (µCT) SkyScan 1272 at isotropic resolution of 10 µm. The porosity distribution was evaluated separately for the apical, middle and coronal thirds. The Kruskal–Wallis, Mann–Whitney, Friedman and Wilcoxon tests with the significance level set at 5% were used for data analysis. The µCT evaluation revealed open pores being the dominant type of porosity in all experimental groups and root canal thirds, with the highest percentage of pores in the apical third of root canal fillings. The quality and homogeneity of single cone root canals fillings remained similar between the groups in the apical and middle thirds (p > 0.05). Significant differences were observed only in the coronal third (p < 0.05).

Highlights

The quality of root canal obturation plays an essential role to ensure the successful long term outcome of endodontic treatment [1]
It should be mentioned that there is no single protocol in which scanning resolution is optimal, and there is no reliable scientific background if the pores of the size of 4 μm would have a different impact on the microleakage and outcome of endodontic treatment comparing to the pores with a diameter of 10 μm
Previous clinical studies revealed high success rates of endodontic treatment when root canals were obturated by specialists endodontists using single cone (SC) technique with a hydraulic calcium silicate-based sealer: Chybowski et al (2018) reported the success rate up to 90.9% after an average follow-up of 30.1 months [24], while the study conducted by Zavattini et al (2020) demonstrated success rates varying from 84% to 90% [25]

Summary

Introduction

The quality of root canal obturation plays an essential role to ensure the successful long term outcome of endodontic treatment [1]. Studies show that approximately 60% of endodontic treatment failures can be associated with a poor root canal obturation [2]. There are two types of pores identified in root canal fillings: closed (internal) or open (external) pores [6]. Closed pores are surrounded by the filling material and have no contact with the root canal walls, making them clinically less significant for endodontic treatment outcomes [7]. The open pores formed between the filler material and the canal walls can have a substantial clinical impact [8]. The network of open pores can be an excellent pathway for microleakage and possible worse clinical outcome [9]

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