Cold Lateral Compaction Technique Research Articles

Evaluation of Density and Homogeneity of Three Different Root Canal Obturation Techniques: A Three –Dimensional Computed Tomography In Vitro Study

The aim of this in vitro study was to compare three dimensionally the density and homogeneity of cold lateral compaction, warm vertical compacti on and guttaflow root canal obturation techniques using computed tomography. Thirty canals of 12 mm from extracted lower single canal premolars were selected then instrumented and divided randomly into 3 groups with 10 roots in each group. Group I was obturation with cold lateral compaction technique, group II was obturated with warm vertical compaction technique and group III was obturated with guttaflow system. The specimens were then analyzed for the density and homogeneity in both vertical and hor i zontalsections in apical, middle and coronal third with 1 mm section thickness using computed tomography. The data obtained in hounsefield units were subjected to statistical analysis. In conclusionguttaflow was superior in the apical part and none of the tested obturation techniques can achieve three dimensional dense and homogenous obturation from apical to coronal parts of root.

Effect of Different Obturation Techniques on the Amount of Debris Extrusion During Endodontic Retreatment Using XP Endo Retreatment Set Files (In vitro Study)

Objective: This study aimed to assess the effect of the cold and warm obturation techniques on the amount of apically extruded debris (AED) and time needed for the removal of filling material during endodontic retreatment using the XP endo retreatment files.
 Methods: Sixty single-rooted lower premolars with round-shaped canals were selected for the study. The canals were prepared and obturated with one of four obturation techniques (N=15): cold lateral compaction (CLC), single-cone (SC), thermoplasticized gutta percha injection (TGP), and gutta core (GC) obturation techniques. All the root canal fillings were removed using XP endodontic retreatment files. The mean weight of the AED was estimated with an analytical balance to an accuracy of 10-4 g. AED data were subjected to Kruskal-Wallis and a one-way ANOVA, post hoc Tukey's test for the time factor, with a significance level ≤ 0.05.
 Results: AED data revealed significant differences among groups (p=0.039). The CLC technique was significant compared to TGP, with a significance level of p=0.018, and significant compared to the SC technique, with a significance level of p=0.034. Also, there were highly significant differences between groups regarding the time needed for retreatment (p=0.000).
 Conclusions: The obturation technique influences AED, and time for root canal retreatment. CLC resulted in less debris extrusion, while SC resulted in higher debris extrusion and TGP required the least time for root canal retreatment.

COMPARATIVE EVALUATION OF EFFECT OF 0.2% CHITOSAN, COMBINATION OF 5.25% SODIUM HYPOCHLORITE (NAOCL) AND 17% ETHYLENE DIAMINE TETRAACETIC ACID (EDTA) AS FINAL IRRIGANTS ON PUSH-OUT BOND STRENGTH OF MTA FILLAPEX-AN IN VITRO STUDY

Context:The push-out bond strength of a sealer depends on removal of smear layer and its adhesion to dentin. This can be achieved by using potential final irrigants. Aim:To evaluate and compare effect of 0.2% chitosan and 5.25% Sodium Hypochlorite (NaOCL) followed by 17% ethylene diamine tetraacetic acid (EDTA) on the push-out bond strength of MTA Fillapex. Methods and Material:45 single rooted mandibular premolar teeth divided into three groups where final irrigation was done using Group 1 - 0.2% Chitosan for 1 minute Group 2 - 5.25% NaOCL followed by 17%EDTA for 1 minute Control group – 0.9% saline. Obturation was done using MTA Fillapex sealer and cold lateral compaction technique. Two horizontal sections of each sample were tested using universal testing machine for push-out bond strength. Statistical analysis used: Data was assessed using one way ANOVA with Tukeys post-hoc analysis. Results:The results showed that both in coronal and middle third, irrigation with 0.2% chitosan showed higher push-out bond strength. In intra-group comparison, coronal third showed highest pushout bond strength compared to middle third. Conclusion:0.2% chitosan can be used as an alternative to NaOCL and EDTA as it effectively removes the smear layer without causing erosionof intra-radicular dentin.

Interfacial adaptation of NeoMTA Plus, BioRoot RCS and MTA in root-end cavities: A micro-CT study.

This study aimed to use the micro-computed tomography to evaluate the interfacial adaptation and the presence of gaps of NeoMTA Plus, BioRoot RCS, and MTA in the root-end cavities. Thirty standardized bovine roots measuring 15 mm in length were selected. Chemical-mechanical preparation was performed up to instrument #80 and obturation with the cold lateral compaction technique with cement based on zinc oxide and eugenol. The roots were kept at 37°C for 7 days. Afterward, apicectomy of the apical 3 mm and a root-end filling cavity was performed at 3 mm depth. Micro-computed tomography (micro-CT) was performed to measure the volume of the retroactivity. The roots were divided by stratified randomization into three groups according to the retro-end filling material: NeoMTA Plus, BioRoot RCS, and MTA. A new micro-CT was performed to assess the presence of voids in the root-end filling material and between it and the canal wall. One-way ANOVA and Tukey tests were performed using the BioEstat 4.0 program. There was no difference in the initial volume values of the root-end cavities (p > .05). After the insertion of root-end filling materials, the most significant volumes of voids were observed in the NeoMTA Plus group (p < .05), with no difference for the BioRoot RCS and MTA Angelus groups (p > .05). Micro-computed tomography showed that MTA and BioRoot RCS have better interfacial adaptation and presented fewer number of gaps than NeoMTA Plus when used as root-end filling materials. Micro-computed tomography evaluation of different root-end fillings materials.

Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth With Simulated Apical Root Resorption: An In Vitro Study.

Aim The aim of this study was to compare the amount of debris produced apically during the removal of root canal obturating material by using various files in extracted teeth with simulated apical root resorption. Materials and methods An in vitro study was conducted in the root canals of 90 extracted mandibular premolar teeth that were prepared with a ProTaper Gold rotary file (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and an AH Plus sealer (Dentsply Maillefer, Ballaigues, Switzerland) using a cold lateral compaction technique. A total of 45 mandibular premolar teeth were randomly assigned to three control groups (i.e., the ProTaper Universal retreatment file (Dentsply Maillefer), the Reciproc Blue file (VDW, Munich, Germany), and the HyFlex Remover file(Coltene/Whaledent, Altstatten, Switzerland)for the removal of root canal filling material, whereas the remaining 45 teeth were treated as the experimental group and their apical portion was modified to simulate apical root resorption. The teeth of this experimental group were randomly divided into three subgroups according to the same three techniques used with the control groups for the removal of root canal filling materials. The apically extruded debris was collected into pre-weighed borosilicate glass tubes and then dried. The mean weight of the apically extruded debris was assessed using an analytical balance to an accuracy of 10-4 g. Further, the data were analyzed using the Kruskal-Wallis test and Tukey's post hoc test. Results In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion than the groups without simulated root resorption (a< 0.05). In both the control groups and experimental groups, the ProTaper Universal retreatment file was associated with the least weight of the apically extruded debris (a < 0.05), followed by the Reciproc Blue file and the HyFlex Remover file. Conclusion The amount of debris extruded apically was significantly greater in the teeth with simulated apical root resorption than in those without it. Further, during the removal of the root canal filling materials, HyFlex Remover was associated with significantly more apically extruded debris in all groups.

A Scanning Electron Microscopy Study Comparing 3 Obturation Techniques to Seal Dentin to Root Canal Bioceramic Sealer in 30 Freshly Extracted Mandibular Second Premolars.

BACKGROUND Obturation is a crucial step in dentistry, involving the filling and sealing of a prepared root canal with sealer and core material to prevent bacterial invasion and ensure successful treatment. This study employed scanning electron microscopy to compare the effectiveness of 3 obturation techniques - single-cone technique (SCT), cold lateral compaction technique (CLCT), and continuous-wave technique (CWT) - in sealing dentin to recently introduced root canal bioceramic sealer in 30 extracted mandibular second premolars. The goal was to determine the optimal technique for minimizing gaps at the sealer-dentin interface. MATERIAL AND METHODS Thirty premolars were divided into 3 groups (n=10 each) based on obturation technique: SCT, CLCT, and CWT. All groups used CeraSeal bioceramic root canal sealer. Root samples were sectioned at apical, middle, and coronal thirds, and high-resolution scanning electron microscopy was performed to measure marginal/internal gaps. Data were analyzed using one-way ANOVA and Tukey range test, with P≤0.05 considered statistically significant. RESULTS CWT showed fewer voids at all levels, with non-significant differences within a technique. Among the techniques, SCT had the largest mean gaps at all levels [apical (5.43±0.16), middle (5.28±0.20), coronal (5.73±0.24)], while CWT had the smallest mean gaps [apical (3.02±0.19), middle (2.95±0.14), coronal (2.76±0.15)]. The differences in means between techniques were statistically significant (P≤0.05). CONCLUSIONS CWT obturation with CeraSeal root canal sealer produces fewer marginal gaps at the sealer-dentin interface.

Sealing Efficiency of BeeFill 2in1 Filling Technique and Cold Lateral Compaction Technique

Objective: To discuss sealing properties between BeeFill 2in1 warm vertical compaction technique and cold lateral compaction technique. Methods: Group1 BeeFill 2in1, Group 2: cold lateral compaction. The leakage specimens were measured using the transverse root sectioning, after 1 month. Results: The statistical analysis showed that the frequency of section with void, the percentage of void area and the percentage of sections at 1 mm–13 mm levels, the BeeFill 2in1 group were lower than those of the cold lateral compaction group. Conclusion: BeeFill 2in1 warm vertical compaction technique has its advantage in dealing with the long oval canal.

Comparative evaluation of the quality and homogeneity of different obturating systems using cone-beam computed tomography - An in vitro study.

The aim of this study was to evaluate the homogeneity and quality of different obturating systems using cone-beam computed tomography (CBCT). One hundred and twenty extracted maxillary and mandibular molars were included in this study which was decoronated first and then dissected into palatal and distal roots. After working length determination, all the roots were biomechanically prepared with ProTaper universal system. The prepared roots were evaluated using CBCT, and volumetric analysis was done. Samples were then randomly divided into three groups corresponding to the obturation method used - cold lateral compaction technique, single-cone technique, and BeeFill 2 in 1 system. After obturation, CBCT imaging and volumetric analyses were performed again to compare and analyze the amount of volume of obturation in different obturating techniques. To standardize the volume, pre-and postobturation images were superimposed. To avoid errors, for each section, measurements were repeated three times and the means were calculated. The data were statistically analyzed using one-way analysis of variance, followed by post hoc test. Results showed a statistically significant difference of the single cone with lateral compaction and the BeeFill system (P < 0.001). Maximum volume of obturating material was found in BeeFill at all levels - Coronal, middle, and apical, followed by cold lateral compaction and single-cone technique (P < 0.001). It could be concluded that the thermoplasticized obturating technique can be a better choice for obturation rather than the single cone and lateral compaction technique.

Single Cone Obturation versus Cold Lateral Compaction Techniques with Bioceramic and Resin Sealers: Quality of Obturation and Push-Out Bond Strength.

This study compared the obturation quality and push-out bond strength of single cone obturation (SCO) and cold lateral compaction (CLC) with AH-Plus and Sure Seal Root (SSR). This in vitro experimental study was conducted on 88 single-rootedsingle-canal teeth with straight roots that were randomly divided into four groups (n = 22). All teeth were decoronated and underwent cleaning and shaping. Obturation was performed with AH-Plus and SCO technique in group 1 (SAH), AH-Plus and CLC technique in group 2 (LAH), SSR and SCO technique in group 3 (SS), and SSR and CLC technique in group 4 (LS). The roots were then sectioned into 3-mm thick slices and underwent digital photography at x25 magnification to assess the quality of obturation in the coronal, middle, and apical thirds by Image J software. The PBS was measured by a universal testing machine. The mode of failure was also determined under a stereomicroscope. The PBS was significantly higher in the LSS group than LAH and SAH groups, and also in the SSS group than the SAH group in all sections. The PBS in the LSS group was significantly higher than SSS in the coronal and middle thirds. Voids were significantly lower in LAH than in the SAH group in all sections. In LSS, voids in the coronal third were significantly lower than in LAH. In the middle third, voids in SSS were significantly lower than in SAH. The groups had no significant difference in the mode of failure (P > 0.05). The mean percentage of gutta-percha in the use of AH-Plus sealer was significantly higher than SSR (P < 0.05). The mean percentage of gutta-percha in the coronal third was lower than that in the middle and apical thirds (P < 0.05). SSR showed higher PBS and less voids than AH-Plus. High PBS of the CLC/SSR group showed that CLC should still be preferred to SCO, and in the case of using SCO, SSR should be preferred to AH-Plus.

Inflammatory response and immunohistochemical characterization of experimental calcium silicate-based perforation repair material.

This study compares the immunohistochemical reaction of a new experimental tricalcium silicate perforation repair material to mineral trioxide aggregate (MTA) and Biodentine. A total of 162 mature premolar teeth from 12 dogs were divided into three experimental groups (n=54 teeth each) according to the evaluation period: 1, 2 and 3months. Each group was further divided into two equal subgroups (n=27 teeth each) according to the time of repair: immediate repair and delayed repair. Each subgroup was subdivided according to the material used into three experimental subdivisions (n=8 teeth each): MTA, Biodentine (Septodont) and experimental material, and two control subdivisions: positive control (n=2 teeth) and negative control (one tooth). Under general anaesthesia, access cavity was done. Cleaning and shaping were performed using ProTaper universal rotary instruments. The canals were obturated using cold lateral compaction technique with Gutta percha and Adseal sealer. Furcation perforations were created then randomly sealed using the three materials either immediately or after onemonth (delayed repair). Inflammatory cell count and immunohistochemical analysis of osteopontin-positive area fraction were digitally analysed using the ImageJ software. Delayed furcal perforation repair showed significantly higher inflammatory cell count than immediate repair. No significant difference in inflammatory cell count and immunohistochemical analysis was detected between the three tested materials. The immunohistochemical analysis revealed the highest immunopositive area fraction in the 3-month evaluation period. The experimental tricalcium silicate cement performed similarly to Biodentine and MTA regarding the osteopontin expression during perforation repair, suggesting it is a suitable alternative with favourable handling characters.

Evaluation of microleakage of three different endodontic sealers in the presence and absence of moisture

Background and aims: AH26, Master-Dent, and Endoseal mineral trioxide aggregate (MTA) are three different types of sealers. The purpose of this study was to assess and compare THE apical seal of the root canal-treated teeth with the above-mentioned sealers in the presence and absence of moisture using the fluid filtration method. Methods: To this end, 54 freshly extracted single root canal human canines were selected for this study. The canals were prepared using rotary instruments, and then sodium hypochlorite was applied as an irrigation solution in this protocol. The specimens were randomly divided into three groups of 18. One group was obturated with the gutta-percha by the cold lateral compaction technique. Half of one of the aforementioned sealers belonged to the group of moistened teeth and the other half to the group of the dried teeth. Microleakage in all groups was assessed 3 months after the obturation of canals by the fluid filtration method. The data were analyzed using ANOVA and Tukey’s post hoc tests, and the level of significance was set at P&lt;0.05. Results: The results showed that the minimum and maximum micro-leakage belonged to Masterdent dry (mean leakage = 1.7778 μL/ min/CmH20) and Endoseal-MTA dry (mean leakage = 3.5000 μL/min/CmH20), respectively. All three groups of sealers exhibited a significant difference in apical micro-leakage between dry and moist conditions (PMasterdent &lt;0.001, PAH26=0.002, and PEndoseaL-MTA =0.007). Conclusion: The findings of this experimental study demonstrated that Masterdent provided the least apical micro-leakage under dry conditions while Endoseal-MTA had the highest micro-leakage under these conditions. There was a significant difference between dry and moist conditions in all groups.

Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review.

This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

Reinforcement of endodontically treated teeth by different intraorifice barrier materials

Background: Fracture incidences are more common in teeth with endodontic therapy and hence endodontic therapy should aim toward the reinforcement of such teeth by placing various restorative materials. Aims: Comparative evaluation of different intraorifice barrier material on strengthening the fracture resistance of teeth requiring endodontic therapy. Methods: Sixty extracted human mandibular premolars with one root were divided into four groups (n = 15); Group 1- Light cured Glass ionomer cement, Group 2 - Nanohybrid composite (NHC), Group 3 - High copper amalgam, Group 4-Control. Decoronation of specimens was done to a standardized length of 14 mm and was instrumented up to International Organization for Standardization (ISO) #30 size master apical file. Gutta percha was used to carry out the obturation by the cold lateral compaction technique. With the exception of the control group, elimination of 3 mm obturation from the coronal portion was done and intraorifice barrier materials were placed. Universal Testing Machine was used for testing fracture resistance. Statistical Analysis: Analysis of variance was applied to analyze the data obtained and pairwise comparison was done by post hoc tukey's test (P < 0.05). Results: Better resistance to fracture incidence was seen with NHCs. Control group presented the least values. Conclusion: On placement of intraorifice barrier materials in teeth with endodontic therapy, there was a reduction in fracture incidence.

Post-Operative Pain after Single-Visit Endodontic Treatment Using Different Root Canal Irrigation Activating Techniques

Aim: To clinically evaluate the effect of different irrigation activation techniques (needle irrigation, passive ultrasonic irrigation (PUI) and EndoVac) on post-operative pain after single-visit endodontic treatment. Materials and methods: Thirty patients aged between 16 and 40 years requiring endodontic therapy of asymptomatic vital/non vital maxillary central or canine teeth were selected for this study. In all cases, root canal treatment was done is single-visit in which root canals were prepared using nickel-titanium ProTaper Universal rotary system in crown down manner up to master apical file size F4 or F5 according to the initial apical canal size. Irrigation was done using 2.5% NaOCl. Patients were randomly assigned into three groups according to the final irrigation activation method, group 1 (control group) needle irrigation, group 2 PUI and group 3 EndoVac system. Obturation was done using cold lateral compaction technique. Post-operative pain was assessed after 6, 12, 24, 48 hours, one week and two weeks respectively. Post-operative pain evaluation was done using Visual Analogue Scale (VAS). Results: EndoVac group showed the least post-operative pain values while needle irrigation group showed the highest values. This was statistically significant at 6 and 48 hours time intervals. PUI group showed lower pain values than needle group and this was significant at 48 hours time interval. In all groups the intensity of post-operative pain decreased over time. Conclusion: EndoVac system and PUI reduce post-operative pain after single-visit endodontic treatment than needle irrigation in the first 48 hours.

Influence of Root Canal Sealers and Obturation Techniques on Vertical Root Fracture Resistance. An In Vitro Experiment

The aim of the present study was to determine the vertical root fracture (VRF) resistance of roots obturated with TotalFill BC Sealer and AH Plus sealer using lateral condensation and single cone techniques in comparison to untreated controls. Sixty single rooted mandibular premolars were sectioned and divided into six groups. Ten teeth were left untreated (positive control-Gp 1) and fifty teeth were cleaned and shaped. Ten root specimens were left unfilled (negative control-Gp 2) and the remaining roots were divided into 4 groups. Gp 3, GP and AH Plus sealer (AH Plus) using the cold lateral compaction (LC) technique; Gp 4, GP and AH Plus using the Single Cone (SC) technique; Gp 5: TotalFill GP and TotalFill BC sealer using the LC technique; Gp 6: TotalFill GP and TotalFill BC sealer with SC. VRF was performed for all specimens using a universal testing machine. Analysis of variance (ANOVA) and Tukeys post-hoc multiple comparison test was used to compare the means among tested study groups. Group 1 (positive control) displayed the highest fracture resistance (946.61 ± 166.465 N); however, the lowest fracture strength was demonstrated by the specimens in group 2 (negative control) (433.31 ± 129.350 N). Specimens treated with AH plus using different obturation techniques (group 3 and 4) showed comparable outcomes (p &gt; 0.05). Similarly, specimens treated with TotalFill BC sealer with different obturation techniques showed statistically similar outcomes (p &gt; 0.05). It was also observed that specimens in groups 3, 4, 5 and 6 demonstrated comparable outcomes of fracture strength (p &gt; 0.05). The use of TotalFill-BC sealer showed similar vertical root fracture resistance as AH plus sealer in root canal treated teeth. Use of total fill-BC and AH Plus sealer in root canal treatment showed vertical root fracture resistance comparable to untreated natural teeth (positive controls).

Confocal laser scanning microscopic evaluation of depth of penetration and Sealer/Dentin interface between endodontic sealers - An in-vitro study

An endodontic sealer contributes in obtaining an appropriate seal for the root canal system by establishing an association between the root canal walls and coronal restoration thereby promoting healing. This present research intended to compare the penetrating capacity and to determine sealer/dentin interface among various endodontic sealers. Horizontally sectioned tooth samples were obtained at 3 and 5mm and randomly divided into three groups: Group I - Chemically cured (AH Plus) sealer; Group II - Dual cured (EndoREZ) sealer; Group III – BioCeramic Nano sealer (iRoot SP). All three groups were coated with their respective sealers and obturated using cold lateral compaction technique. The samples were observed using Confocal Microscope for penetrating capacity evaluation and reviewing of sealer/dentin junction at 3 and 5mm depth. The results were statistically analyzed using one-way ANOVA and Tukey's Post-Hoc method. On depth of penetration evaluation, one-way ANOVA analysis showed Group II exhibited maximum depth of penetration in contrast to Group III and Group I. Group I showed the least average depth of penetration among the other two groups at both 3 and 5mm. On sealer/dentin interface evaluation at 3mm, Group II showed increased interface in comparison with to Group III and Group I. No statistical significance evident among the groups at 5mm. EndoREZ showed maximum depth of penetration in comparison with iRoot SP and AH Plus sealer at both 3 and 5mm. EndoREZ also showed significant sealer/dentin interface at the level of 3mm when compared to other sealers used.

Evaluation of Push-out Bond Strength of CeraSeal Bioceramic sealer with Different Obturation Techniques

Aim: The aim of the present study was to compare the push-out bond strength of CeraSeal Bioceramic sealer used with Gutta percha in single cone (SC), cold lateral compaction (CLC) and warm vertical compaction(WVC) obturation techniques. Materials and Methods: Thirty single-rooted extracted mandibular premolars were selected and mechanically prepared by ProTaper Next rotary files. The canals were allocated into three equal groups (n=10) based upon the obturation technique as follow; Group I: Bioceramic sealer (CeraSeal) with single cone, Group II: Bioceramic sealer (CeraSeal) with cold lateral compaction technique, Group III: Bioceramic sealer (CeraSeal) with warm vertical compaction technique. Roots were sectioned transversally to a thickness of 1 mm at the middle third. The specimens were subjected to push-out test using the Universal Test Machine. The maximum load utilised at the time of dislodgment was recorded. Intergroup comparisons were performed by one-way ANOVA followed by Tukey’s post hoc test. Results: WVC group showed the highest statistically significant mean push-out bond strength value (6.98±1.99) followed by CLC group (1.06±0.15), while the lowest value was presented in SC group (0.66±0.22) (p < 0.001). Conclusions: CeraSeal Bioceramic sealer showed higher push-out bond strength when used in WVC technique compared to single cone and lateral compaction techniques.

The Effect of Obturation Technique on the Fracture Resistance of Endodontically Treated Teeth Obturated with Bioceramic Sealer. (In Vitro Study)

Aim of the study: This study evaluated the effect of obturation technique on the fracture resistance of endodontically treated teeth obturated with bioceramic sealers compared to resin-based sealers. Methods: Ninety-one (n=91) freshly human extracted single rooted teeth were selected. The samples were biomechanically prepared and classified according to the obturation technique and type of the sealer used into five groups as follows: Group 1 (n=21) obturated with cold lateral compaction technique using gutta-percha and AD-seal sealer (Meta Biomed, Korea). Group 2 (n=21) obturated with warm vertical compaction technique using gutta-percha and AD-seal sealer. Group 3 (n=21) obturated with cold lateral compaction technique using gutta-percha and MTA filapex sealer (Angelus, Brazil). Group 4 (n=21) obturated with warm vertical compaction technique using gutta-percha and MTA filapex sealer. Group 5 (n=7) Control group (unobturated). The samples were further classified according to the observation time into: subgroup A (n=7) evaluated after one week, subgroup B (n=7) evaluated after two weeks and subgroup C (n=7) evaluated after one month. Samples were loaded vertically after obturation using Universal Testing Machine until fracture. Results: MTA filapex group showed higher fracture resistance values than the other groups with no significant difference. No significant difference was found between the subgroups evaluated at different time intervals. Conclusion: The technique of root canal obturation didn’t significantly affect tooth fracture resistance of either teeth obturated with Bio-ceramic sealer or resin sealer at different time intervals.

Evaluation of The Periapical Healing Following Pulp Revascularization Using Injectable PRF VS nonsurgical Root Canal Treatment in Mature Permanent Teeth with periapical periodontitis. A Clinical Study

Aim:the aim of the current study was to evaluate the effect of injectable platelet rich fibrin (i-PRF) revascularization technique VS conventional endodontic treatment on the periapical healing of mature permanent teeth with periapical periodontitis. Materials and Methods: A total of 30 patients with apical periodontitis related to permanent central incisors were included in the study. The control group (n=15) has undergone conventional root canal treatment using crown down technique on 2 visits with calcium hydroxide intracanal dressing in between visits and obturation was done using cold lateral compaction technique. The intervention group (n=15) has undergone regenerative procedures. Regenerative protocol was carried out using 1.5% sodium hypochlorite irrigation and DAP intracanal medicament for 3 weeks. At the second visit, i-PRF was prepared and injected inside the root canal. The orifice was sealed with MTA followed by double sealing of the access by glass ionomer and composite-resin restoration. Clinical and radiographic evaluation was done for 1, 3, 6, 9, and 12 months, and CBCT imaging was done after 12- month follow-up period. Results: The i-PRF group recorded more decrease in the lesion size than the control group. However, the difference was not statistically significant yet, there was a highly significant statistical difference between the preoperative and postoperative measurements with great lesion size reduction within the i-PRF group Conclusion: i-PRF revascularization is an effective treatment of apical periodontitis in permanent teeth with mature apex. Key words: Regeneration, i-PRF, Mature teeth, Apical healing, Root canal treatment, Pulp revascularization.

Percentage of Gutta-percha filled area in canals shaped with Nickel-Titanium instruments and obturated with GuttaCore and Conform Fit gutta-percha cones

Aim: The purpose of this study is to compare continuous wave with conform fit gutta-percha point and the core-carrier system with GuttaCore assessing the percentage of gutta-percha filled areas (PGFA), sealer filled areas (PSFA) and voids (PVA) in extracted teeth. Methodology: Seventy-five extracted single rooted premolars were assigned to 5 groups, groups A and C were shaped with WaveOne Gold medium, groups B and D with ProTaper Next X3, and group E with manual instruments #35 K-file. Obturations were managed with GuttaCore in groups A and C; with Conform fit gutta-percha points in groups B and D; and with ISO-sized 35 gutta-percha master cones and cold lateral compaction technique in group E. The teeth were sectioned at 2, 4, 6, and 8 mm from the apex and for every section the percentages of gutta-percha and sealer filled, and void areas with respect to the total area were calculated. Data obtained were analysed for each variable at each level by using a one-way ANOVA with group as dependent variable (α=0.05). Multiple comparisons between the five experimental groups were conducted by using the Student’s t-test with Sidak alpha correction. Results: At all levels group E produced significantly less PGFA and higher PSFA and PVA than all the other experimental groups. At 2 mm from the apex, group A showed significantly higher PGFA than group C and a significantly lower PSFA than C and D. At 4 mm from the apex groups A and B produced significantly better results in terms of PGFA than groups C and D. The PSFA and PVA were significantly lower in group D with respect to groups A and B. PVA were statistically significant lower in group C than in group B. At 8 mm from the apex group A showed significantly higher PGFA than groups B and D, a significantly lower PSFA and PVA than group B. Conclusions: Independently of the instrument used for preparation (WaveOne gold versus ProTaper Next) Conform Fit point and GuttaCore produced very homogeneous obturations with high PGFA. The association of WaveOne Gold file system shaping and the GuttaCore obturation technique produced better results in terms of PGFA, PSFA and PVA than all the other techniques especially in the apical portion of the root canals. Manual instrumentation and the cold lateral obturation technique yield poor quality root canal obturations.