Cold Lateral Compaction Research Articles

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.

Scanning electron microscopy assessment of tubular penetration depth of root canal sealers combined with different obturation techniques

Background/Aim. The ability to effectively and consistently penetrate dentinal tubules is considered a favorable factor for the evaluation of root canal sealers (RCSs). The aim of the study was to assess the penetration depth into dentinal tubules of three RCSs combined with four obturation techniques. Methods. The mesial canals of 66 extracted human mandibular molars were endodontically prepared and randomly allocated into 12 experimental groups depending on the RCS type used (AH Plus?, EndoREZ?, Sealapex?) as well as the obturation technique applied [cold lateral compaction, cone-fit, carrier-based (with heated gutta-percha), warm vertical compaction]. Using scanning electron microscopy, transversal root cross-sections were analyzed, and the maximum depth of RCS penetration was measured (396 sections, in total, corresponded to the apical, middle, and coronary third). Results. Group AH Plus?/warm vertical compaction yielded the highest penetration depth ? 1,165 ?m, followed by EndoREZ?/cone-fit ? 1,154 ?m; the lowest depth was measured for EndoREZ?/warm vertical compaction ? 502 ?m. The mean value of the maximum penetration depth of RCS yielded 1,204 ?m in the coronary thirds, 1,005 ?m in the middle thirds, and 770 ?m in the apical thirds. The AH Plus? RCS penetrated deeper into dentinal tubules when the obturation techniques with heated gutta-percha were applied, while the opposite findings were obtained for the EndoREZ? RCS. Conclusion. According to our research, the RCS penetration depth appears to be influenced by the RCS type used, as well as the obturation technique applied.

Impact of Root Canal Taper on Fracture Resistance of Endodontically Treated Teeth Prepared by Hero Shaper and RaCe File Systems: An In-vitro Study

Introduction: Tooth fracture is one of the most undesirable phenomena in Endodontically Treated Teeth (ETT) and usually leads to tooth extraction. Basically, removal of any hard tissue from the canal walls raises the chance of root fracture. Aim: To evaluate the impact of root canal taper on fracture resistance of ETT prepared by two different file systems (Hero Shaper and RaCe file systems). Materials and Methods: This in-vitro study was conducted in the Department of Conservative Dentistry and Endodontics at Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli and Praj Metallurgical Laboratory Pune, Maharashtra, India, frome February 2021 to November 2021. The study included 44 freshly extracted mandibular premolar teeth were randomly divided into four groups. Group 1a had Hero Shaper 4%, group 1b had 6% Hero Shaper, group 2a had RaCe 4% and group 2b had RaCe 6% file system. After cleaning and shaping the root canals, obturation was completed using cold lateral compaction and root canals were embedded in standardised autopolymerising acrylic resin blocks, subjected to a vertical load in universal testing machine to cause vertical root fracture. The forces required to induce fractures were measured in Newtons. Data was analysed by using independent t-test and two-way Analysis of Variance (ANOVA) test for intergroup comparison. A p-value≤0.05 was considered as statistically significant. Results: Among instrumented groups, group 1a (Hero Shaper 4%) showed higher fracture resistance of 372.5 Newtons and group 2b (RaCe 6%) showed lowest fracture resistance of 314.56 Newtons as compared to other groups. Statistically significant difference (p-value=0.026) was seen in the mean fracture resistance among the group 1a and 1b, and group 2a and 2b. At pair wise comparison there was statistically significant difference in group 1a and group 2a (p-value=0.016). Conclusion: Amongst the instrumented groups, Hero Shaper file system showed the higher fracture resistance, than RaCe file system. Marked reduction in fracture resistance of ETT was seen with the use of greater taper instruments.

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 &lt; 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.

The push out bond strength of bioceramic seal-er (Total Fill) after warm and cold obturation tech-niques An in vitro comparative study

Background: The goal of a root canal treatment is three dimensional obturation with a complete seal of the root canal system. The aim of this study was to evaluate and compare the effect of two warm obturation techniques, warm vertical compaction (WVC) and, carrier based obturation technique Gutta Core (GC), versus two cold obturation techniques, cold lateral compaction (CLC) and, single cone (SC) on push-out bond strength of bioceramic sealer (Total Fill) at three different root levels. Materials and Methods: Forty extracted maxillary first molars teeth with a straight round palatal root canal and mature apices were selected for this study. After sectioning the palatal roots to 11 mm from the root apex, the canals were prepared with EDGEENDO X7 rotary system file from size 20 up to size 40 taper 04. The samples were then randomly separated into four groups based on obturation procedures (each group n = 10), with group A: obturated by WVC, group B: GC, group C: CLC, and group D: SC. Following obturation, the teeth were kept in an incubator at 37°C and 100% humidity for two weeks. Three slices of 2 mm thickness were cut horizontally at 2, 4.5, and 7 mm from the root apex in each of the three sections (apical, middle and coronal). The data were investigated using one-way ANOVA and Tukey's test with a significance level (p&lt; 0.05). A digital microscope with a magnification of 60 X was used to establish the failure mode. Results: There was a significant increase in push-out bond strength following canal obturation with GC and WVC, particularly at the apical third (9.48, and 8.11 MPa, respectively) , compared to canals obturated with SC and CLC in all root levels except the middle third, at the (p&lt; 0.05) significance level. The cohesive mode of failure was the most prevalent in all groups. Conclusio: BC (TotalFill) sealer showed higher bond strength when used in WVC and GC compared to other techniques. SC and CLC were showed comparable bond strength values.

Comparative evaluation of the fracture resistance of roots after the application of three different root canal sealers

Introduction: Root canal fillings using Gutta-percha and root canal sealers are considered the gold standard in endodontics. Bondable root canal sealers help in strengthening the root by penetrating into the dentin. Aim: The aim was to compare and evaluate the fracture resistance of root dentin following the application of AH Plus sealer, MTA Fillapex sealer, and BioRoot RCS sealer. Materials and Methods: Decoronation was performed on 70 extracted single-rooted premolars at the cementoenamel junction. The samples were divided into three experimental and two control groups. Fourteen samples served as the negative control (Group 4), which were left unprepared. The remaining 56 samples were prepared with ProTaper rotary files up to F3. The roots were obturated using cold lateral compaction using Gutta-percha and AH Plus sealer (Group 1), MTA Fillapex (Group 2), and BioRoot RCS (Group 3). Group 5 served as the positive control group. A universal testing machine was used to compress the samples until fracture occurred. One-way analysis of variance with post hoc Tukey's test was used to analyze the data. Results and Discussion: The highest resistance to fracture was shown by Group 4 (negative control), followed by Group 1 (AH Plus), Group 3 (BioRoot RCS), Group 2 (MTA Fillapex), and the least by Group 5 (positive control). There was a statistically significant difference between all the groups (P = 0.00) except between AH Plus and BioRoot RCS (P &gt; 0.05). Conclusion: Samples in all the groups fractured when vertical force was applied. The maximum resistance to fracture was shown by the roots which were neither instrumented nor obturated. AH plus sealer showed the highest resistance to fracture among the three experimental groups, followed by BioRoot RCS and MTA Fillapex.

Optimizing root canal obturation

Aim. Optimization of root canal filling.Materials and methods. The determination of apical hermeticity was performed on extracted single root teeth and obturation was performed using three techniques: cold lateral compaction, hot vertical compaction and hybrid technique.Results. The optimal obturation technique is the hybrid technique, which has a stable and minimal gap between the obturation material and the root canal wall.Conclusions. Obturation techniques such as lateral compaction and vertical compaction are the quality standard, but the most optimal technique is the hybrid technique, which has taken only the positive qualities of both previously presented techniques.

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.

Apical Sealing Ability of Experimental Apatite Calcium Phosphate based Coated Gutta-percha Points

Aims: This study aimed to assess the apical sealing ability of experimental apatite-coated gutta-percha points compared to various coated gutta-percha root filling materials.&#x0D; Study Design: Experimental in-vitro study.&#x0D; Place and Duration of Study: Department of Restorative Dentistry, University of Malaya, June 2014 and November 2014.&#x0D; Methodology: Ninety-six extracted permanent maxillary central incisors were standardized and prepared by ProTaper universal rotary files. The specimens were allocated into six groups (n=15) and filled using matching single cone technique as follows; EndoREZ points with EndoREZ sealer, Bioceramic coated points (BCGP), Active GP (ActiV GP), Conventional gutta-percha (GP), apatite coated GP (HAGP) all in combination with Endosequence BC sealer. The sixth group was filled using cold lateral compaction of Conventional GP and Endosequence BC sealer. The specimens were subjected to a dye leakage test. The remaining six teeth were divided equally to be used as a negative and positive control. One-way analysis of variance (ANOVA) followed by the post hoc Dunnett T3 test was performed for data analysis, and the significance value was set at P =.05.&#x0D; Results: ActiV GP had the least leakage followed by BCGP, HAGP, cold lateral compaction, conventional GP, and EndoRez.&#x0D; Conclusion: HAGP as root canal filling showed favourable sealing ability comparable to ActiV GP, BCGP, and conventional GP and it was superior to EndoREZ.

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.

Comparative Evaluation of Efficacy of Protaper Universal Retreatment System, R-Endo System and Hedstrom File in Gutta Percha Removal During Root Canal Retreatment- An In Vitro Study.

Background:The complete removal of residual filling materials from the root canal determines the success of root canal retreatment.Aim:To evaluate and correlate the efficacy of ProTaper retreatment system, R-Endo retreatment system, and Hedstrom file in the removal of gutta-percha and sealer from root canal during endodontic retreatment in addition to the period desired for the elimination of gutta-percha and sealer.Methodology:Thirty extracted premolars were prepared and filled by cold lateral compaction with gutta-percha and sealer. Retreatment was finished with ProTaper retreatment files, R-Endo files, Hedstrom files with Endosolv E as the solvent for 10 specimens each. Each half of the root was imaged using the image analyzer software Chroma allied to a stereomicroscope with 10× magnification via a charge-coupled device sensor. For statistical analysis, parametric one-way ANOVA test and Scheffe post hoc multiple range test were utilized at a significance level of P < 0.05.Results:There is no significant difference among the three groups at P < 0.0001 in removing filling material. However, the rotary files needed significantly less time for removing gutta-percha along with sealer than H-file (P < 0.0001).Conclusion:The gutta-percha and sealer were found in the root canal subsequent to all the retreatment techniques, especially in the apical third. Retreatment time was less only for the rotary system.

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.

Light and shade of Single Cone Technique in root canal obturation

The conventional principle of root canal obturation is to make the gutta percha(GP) ratio high and the sealer ratio low. Many studies suggested that continuous wave technique(CWT) was superior to cold lateral compaction(CLC) in teeth with complex anatomical structures, but CWT also has many disadvantages. With the recent development of the calcium silicate based sealer(CSS), single cone technique(SCT) is back in the spotlight as a root canal obturation technique. Due to the advantages of clinical convenience, many dentists obturate root canal by SCT. When obturating the root canal by SCT, it is likely that the quality of the root canal obturation will decrease as compared to CLC or CWT depending on tooth anatomic complexities, and it is dif-ficult to remove the CSS from root canals in the cases of retreatment. Therefore, it is recommended to be carefulin selecting case when obturating the root canal by SCT.

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.

Dentinal tubule penetration of gutta-percha with syringe-mix resin sealer using different obturation techniques: A confocal laser scanning microscopy study.

This study aimed to evaluate dentinal tubule penetration of the root canal filling material using various techniques such as cold lateral compaction, new generation thermoplastic core carrier and continuous-wave obturation. The root canals of premolar teeth were instrumented, and the teeth were allocated randomly to three groups (n = 15/group). After the obturation with three different techniques, three sections of 2-mm thickness at 2, 5 and 8-mm from the apex were examined under a confocal laser scanning microscope. The data were analysed of variance with a significance level of P < 0.05. There was no significant difference between techniques when parameters were evaluated in total (penetration depth P = 0.418, penetration area P = 0.701). The mean value of the cold lateral compaction group for maximum penetration depth was obtained higher than continuous wave (P = 0.004), whilst there was no significant difference between the thermoplastic core carrier and the other groups.

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.