Cold Lateral Condensation Technique Research Articles

The Effect of XP-endo Finisher R and PIPS Technique Using Er: YAG Laser on Removal of Gutta-percha in Root Canals Obturated with Two Different Obturation Techniques

Background: The aim of this study is to compare the efficacy of XP-endo finisher R file and PIPS technique using Er: YAG laser on removal of gutta-percha in root canals obturated with two different obturation techniques. Methods: The root canals of sixty single-rooted teeth were prepared with ProTaper Next Rotary instruments up to X3 (Dentsply, Ballaigues, Switzerland). Half of the root canals were obturated with cold lateral condensation technique and the other half with System B technique (Kerr Corporation, CA, USA) and BioRoot RCS sealer (Setodent, Louisville, USA) was used in all groups as a root canal sealer. After one week, all root canals were retreated using Protaper Universal retreatment instruments (Dentsply, Ballaigues, Switzerland) and enlarged to ProTaper Next X5 File at the working length. Both groups were divided into 3 subgroups according to the additional cleaning methods: control group without an additional cleaning method, XP-endo Finisher R or PIPS technique using Er: YAG laser. Finally, all teeth were split longitudinally and images were taken using an operation microscope (Carl Zeiss, Heidelberg, Germany). The images were analyzed by Image J program. Two-way ANOVA and Tukey tests were used for statistical analysis. Results: There was a statistically significant difference between the canal filling techniques applied in the evaluation of remnants (p=0.010). There was no significant difference between additional cleaning methods (p=0.196). Conclusion: Within the limitations of this study, cleanliness is more difficult in root canals obturated with System B technique. Use of additional cleaning method was not effective in removal of root canal filling materials.

Three-Dimensional Measurement of Obturation Quality of Bioceramic Materials in Filling Artificial Internal Root Resorption Cavities Using Different Obturation Techniques: An In Vitro Comparative Study

IntroductionPathologic conditions such as internal root resorption (IRR) may complicate root canal filling. This study aimed to evaluate and compare the obturation quality by measuring the percentage of obturation volume (POV) in root canals with artificial IRR obturated with different materials and techniques using cone beam computed tomography (CBCT). MethodsForty single canal extracted mandibular premolars were decoronated to standardize their length to 14 mm. Following instrumentation, the roots were cut horizontally, and artificial IRR cavities were made at the level of 7 mm from the apex. The root halves were joined using cyanoacrylate adhesive. The samples were randomly assigned to 4 groups (n = 10), and the canals were filled as follows: single-cone technique (SC), bulk-fill Bio-C Sealer (BF), and Bio-C Repair for the coronal and middle third (BCR) + cold lateral condensation technique (CLC) for the apical third and continuous wave compaction technique (CWC). The pre- and postobturation volumes and the POV were measured in the total canal and for the apical, middle, and coronal thirds separately using CBCT and Mimics Medical software. The results were analyzed statistically using one-way ANOVA and Tukey HSD test, and statistical significance was set at P < .05. ResultsBF group resulted in significantly lower total, coronal, middle and apical POV values compared to SC, BCR + CLC, and CWC groups (P < .05), respectively. Also, at the apical third, the BCR + CLC group showed significantly lower POV than the SC and CWC groups (P < .05), respectively. The intra-group comparison showed that BF and BCR + CLC groups had a significantly lower POV in the apical third compared to the middle third (P < .05). Conversely, the CWC group had a significantly higher apical POV than the middle third (P < .05). ConclusionsThe maximum POV was obtained using the CWC technique, Bio-C Repair, and SC technique with Bio-C Sealer, making their application in IRR more preferable than the BF Bio-C Sealer.

Management of Separated Endodontic Instrument in Mandibular Second Molar with Bypass Technique

One of the most common mishaps in root canal treatment is a separated endodontic instrument. Bypass technique is an effective alternative besides file retrieval while clinical conditions have lack of access and visibility. Other than, this technique gives a more conservative outcome because it prevents more dentin removal. The aim of this case report was to describe management of separated endodontic instruments in the mandibular second molar with bypass technique during endodontic treatment. A 3,5 mm F1 ProTaper Hand Use file was separated in the mesiobuccal canal of the mandibular second molar. Radiograph examination was taken to make sure the level of fragment. Bypass was performed with #10 until #25 K-File to pass the separated instrument through the gap between it and the root canal wall. Obturation has been done with gutta percha and resin-based sealer using cold lateral condensation technique. Direct restoration was chosen as final restoration after 6 days follow up. Bypass technique can be performed as management of separated instrument considering the risks involved fragment extrusion to apical region, secondary separated instrument, and conservative aspect.

ProTaper universal retreatment retreatment potential in oval-shaped canals filled with different obturation techniques—A micro-computed tomography study

Abstract Aim: The objective of this in vitro micro-computed tomography investigation is to assess the efficacy of the ProTaper Universal Retreatment System in retreating oval-shaped root canals filled with three obturation procedures. Materials and Methods: Thirty-six lower incisors with a single oval root canal were prepared using XP-Endo Shaper up to size 30/0.04, and allocated into three equal groups based on the filling technique: Group 1: Warm vertical condensation technique; Group 2: GuttaCore obturators; Group 3: Cold lateral condensation technique. All samples were further retreated using the ProTaper Universal Retreatment system. Micro-CT analysis was performed before and after the retreatment procedure. Statistical analysis was performed with a significance level of 0.05. Data analysis was conducted using the Kolmogorov-Smirnov and Kruskal–Wallis H tests. Results: The best performance of the files was achieved when the removal of the filling in the entire canal was considered. However, this outcome was not statistically significant when compared with the other observed root canal levels. The retreatment procedure could not ensure thorough cleanliness of the canal walls from filling remnants, regardless of the obturation technique and observational level. Conclusions: The ProTaper Universal Retreatment system used for the removal of gutta-percha and sealer in oval-shaped root canals demonstrated equal effectiveness, regardless of the obturation technique used.

Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study.

The aim of this present study was to compare the dislodgement resistance of calcium silicate-based sealer, zinc oxide sealer, and a new sealer combining both zinc oxide and calcium silicate-based sealer in vitro. 60 single-rooted human teeth were instrumented with F3 Protaper Gold. All endodontic canals were filled using gutta percha cones using the cold lateral condensation technique in combination using one of the mentioned sealers (n = 20 per group). The teeth were divided into three groups: group A consisted of Sealite® Ultra, group B consisted of K-Sealer®, and group C consisted of BioRoot® RC. After 2 months of incubation (37°C, 100% humidity) and after cutting out 2 mm from the most apical portion of the root apex, six slices of 1 mm thickness were generated. Mechanical dislodgement resistance was examined using a universal pressure-testing machine and the push-out bond strength (POBS) was calculated. Specimens were examined under 20× magnification to define the bond failure mode. Statistical analysis was executed using ANOVA, post hoc Turkey test for pairwise comparisons and Kruskal-Wallis tests. The POBS of BioRoot® was significantly higher than the POBS of the two other sealers with a mean of 10.54 MPa ± 2.10 and 5.73 MPa ± 2.34, respectively (p < 0.001). Sealite® and K-Sealer® showed similar results in the median and coronal part. K-Sealer® revealed highest POBS compared with Sealite® in the apical part (p < 0.05). The POBS of the zinc oxide and calcium silicate-based sealer was significantly lower compared with calcium silicate. Sealite® and K-Sealer® exhibited almost same results. BioRoot showed the highest POBS of all sealers. The current study was needed to evaluate the bond strength of three different cements to dentinal walls, by evaluating their respective POBS in vitro. The findings of this study may provide guidance for the clinician in the selection of an adequate endodontic sealer that guarantees an enhanced adhesive seal between the Gutta-percha and the dentinal canal walls. How to cite this article: Makhlouf MP, El Helou JD, Zogheib CE, et al. Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study. J Contemp Dent Pract 2024;25(1):15-19.

Assessment of the Penetration of an Endodontic Sealer into Dentinal Tubules with Three Different Compaction Techniques Using Confocal Laser Scanning Microscopy.

Adequate root canal sealing is essential for the success of endodontic treatment. There are numerous techniques available; identifying simple and efficient techniques is important to provide good patient care. The purpose of the study was to compare the maximum penetration depth and the percentage of sealant penetration of an endodontic sealer into dentine tubules using cold lateral condensation, continuous wave, and hybrid techniques, and to contrast the effectiveness of two different tapered gutta-percha master cones (0.02 and 0.04). A sample of sixty single root teeth was used. Six experimental groups were formed from the three filling techniques and the two tapered master cones. Images were acquired using a confocal laser scanning microscope. In the apical root third, the penetration percentage was higher in the hybrid compared with the continuous wave technique. The results indicated a higher penetration depth of hybrid compared with cold lateral condensation in the middle and coronal thirds, and in the apical third, a higher penetration was identified in the hybrid group compared with the continuous wave group. No significant differences in penetration were found comparing 0.02 with 0.04 taper gutta-percha groups. The coronal cross-sections presented a higher penetration than the apical third sections. In conclusion, the hybrid technique a had higher maximum sealer penetration than the continuous wave in the apical third, and the coronal third hybrid and continuous wave had a higher penetration than cold lateral condensation.

Single visit root canal treatment versus pulpotomy in management of pulpitis

AimTo clinically and radiographically evaluate single visit root canal treatment (RCT) and pulpotomy in management of mature teeth with irreversible pulpitis.Patients and methodsTwenty-four patients diagnosed with irreversible pulpitis in their mature permanent mandibular molars, were selected and randomly divided into two equal groups according to the treatment protocol either single visit RCT or pulpotomy. For single visit RCT group, ProTaper NEXT rotary system was used for canal preparation and obturation was done using cold lateral condensation technique. While in pulpotomy group, after coronal pulp amputation and hemostasis, Biodentine was used as the pulpotomy agent. The clinical examination of tested groups was performed immediately after completing the procedure (baseline), 3, 6, 9, and 12 months posttreatment. While the radiographic examination using cone-beam computed tomography was carried out at baseline and 12 months postoperatively. Statistical analysis was performed by χ2 test for clinical evaluation criteria and t test for radiographic data.ResultsSingle visit RCT had clinical success rate of 91.67%, while pulpotomy group showed 83.33% success rate. Radiographically, both groups showed normal width of periodontal ligament membrane space and normal bone density after follow-up. There was no statistically significant difference between two groups (P > 0.05).ConclusionsSingle visit RCT and pulpotomy had high success rate in management of mature permanent teeth diagnosed with irreversible pulpitis. Pulpotomy can be considered as an alternative treatment option.

Penetration of Three Endodontic Sealers in Simulated Lateral Canals during the Lateral Condensation Technique: An In Vitro Study.

This study aimed to compare the penetration depths of AH Plus, BioRoot RCS, and GuttaFlow 2 into simulated lateral canals when used with the cold gutta-percha lateral compaction technique. Twelve resin training blocks (4 canals perch each resin block) were used. Each primary artificial canal had two lateral canals (apical and coronal). The main canals were instrumented with WaveOne Gold and irrigated with distilled water. The resin blocks were divided into three groups (N = 4 each/16 artificial canals), according to the type of root canal sealer; Group I: AH Plus, Group II: BioRoot RCS, and Group III: GuttaFlow 2. All canals were obturated with the cold lateral condensation technique. The linear extension of each endodontic sealer into the apical and coronal lateral canals was measured using a digital stereomicroscope and measuring software. Data were statistically analyzed using a one-way analysis of variance. The percentages of filling of the lateral canals were calculated and statistically compared using the Mann-Whitney test. The experimental sealers exhibited variable penetration depths into the lateral canals. All sealers showed significantly better penetration ability into the apical lateral canals than the coronal lateral canals (P < 0.05). AH Plus (3.184 ± 0.012 mm/99.5%) and GuttaFlow 2 (3.176 ± 0.017 mm/99.25%) were significantly better than BioRoot RCS (3.096 ± 0.026 mm/96.75%) in filling the apical lateral canals (P < 0.05). BioRoot RCS was the best sealer to fill coronal lateral canals (3.322 ± 0.085 mm/83.05%). During the lateral condensation technique, the filling of the lateral canals is affected by the type of root canal sealer and the location of the lateral canals All the sealers tested have a good ability to fill the apical lateral, while BioRoot RCS was effective in filling both the coronal and apical lateral canals.

Technical quality of endodontic obturation performed in a paediatric dental department.

Technical quality of endodontic obturation performed in a paediatric dental department.

Effect of Different Obturation Techniques on Sealer Penetration into Dentinal Tubules after Final Irrigation with XP-Endo Finisher File

The first objective of this research was to evaluate the effectiveness of XP-Endo Finisher on dentinal tubule penetration of irrigation solution using confocal laser scanning microscopy. The main purpose of this research was to compare the effect of cold lateral condensation, continuous wave obturation and core-carrier based techniques on sealer penetration. Sixty mandibular premolars were prepared and allocated into two experimental groups (n=30) as the final irrigation technique and obturation technique experiment. In the final irrigation technique experiment, final irrigation was performed with XP-Endo Finisher, passive ultrasonic irrigation (PUI) and conventional needle irrigation (CNI) (n=10). The roots in the obturation technique experiment were also assigned into 3 groups and obturated with cold lateral condensation, continuous-wave obturation and core-carrier techniques (n=10). The most effective activation method, which emerged as a result of the first part of this study, was used as the final irrigation method in the obturation technique experiment. Then, all roots were sectioned in 1-mm-thick slices at 3mm from the apex for scanning. In terms of depth and percentage of material penetration, CNI exhibited significantly the lowest values and no significant difference was found between others. Also, there was no significant difference among obturation methods. In conclusion, XP-Endo Finisher and PUI are more effective than CNI on irrigant penetration. Sealer penetration into dentinal tubules is independent of obturation techniques.

Evaluation of sealing ability of four different root canal sealers using stereomicroscope: An in vitro study

Introduction: The most commonly used core material for root canal filling is gutta-percha and as the gutta-percha by itself cannot obturate the complete root canal system, owing to its poor sealing properties hence, a sealer is used in combination with root filling material. Sealer is more important than the core obturating material. Sealer plays a secondary role by merely reinforcing (binding or luting) the gutta-percha to the canal walls, however, it is now confirmed that the sealer has a prime role in sealing the canal by blocking the irregularities between the canal space and the core filling material. Aim: To investigate the effectiveness of the apical seal obtained by different sealers used in conjugation with cold lateral condensation technique of obturation using gutta-percha under stereomicroscope. Materials and Methods: One hundred single-rooted extracted human permanent teeth with a single root canal were used in this in-vitro study. The sealers tested were conventional Zinc oxide eugenol ealer, Apexit, AH-Plus and Roekoseal Automix (RSA). The specimens were examined under a stereomicroscope. For the analysis of data Snedocor’s F test for the quality of variances among the experimental group and control group (One-Way ANOVA) were employed. Results: The polydimethylsiloxane endodontic root canal sealer RSA provided a significantly better apical seal followed by AH plus and Apexit whereas conventional zinc oxide eugenol showed the lowest sealing ability. Conclusion: It was concluded that there were statistically significant differences amongst the experimental groups. The shrinkage related to setting and potential dissolution might risk the proper seal of the root canal leading to treatment failure.

The Effect of Different Final Irrigation Regimens on the Dentinal Tubule Penetration of Three Different Root Canal Sealers: A Confocal Laser Scanning Microscopy Study In Vitro.

This study evaluated the effects of different final irrigation regimens on the dentin tubule penetration of three different root canal sealers using confocal laser scanning microscopy (CLSM). A total of 160 single-rooted extracted mandibular premolar teeth were divided into five groups (n = 32 each) according to the solution used in the final rinse protocol, as follows: 17% ethylenediaminetetraacetic acid (EDTA) (group 1), 17% EDTA and 2% chlorhexidine gluconate (CHX) (group 2), 7% maleic acid (MA) (group 3), 7% MA and 2% CHX (group 4), and 5.25% NaOCl (group 5). Two roots from each group were examined under scanning electron microscopy (SEM) to visualize smear layer removal. Experimental groups were then split randomly into three subgroups (n = 10) and obturated using a cold lateral condensation technique with 0.1% rhodamine B-labelled sealers [either AH Plus (group A), EndoREZ (group E), or Tech BioSealer Endo (group T)] and gutta-percha. Specimens were sectioned and observed by CLSM to evaluate the percentage and maximum depth of sealer penetration at the apical, middle, and coronal levels. Statistical comparison was performed on grouped (apical, middle, and coronal segments) and ungrouped data using two-way ANOVA with Bonferroni post hoc test (p < 0.01). AH Plus showed the greatest tubule penetration while Tech BioSealer Endo showed the least. Resin-based sealers displayed deeper and more consistent penetration. CHX irrigation positively influenced sealer tubule penetration.

Complete Obturation-Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies.

To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods—cold lateral condensation and warm gutta-percha techniques—using micro-CT (PROSPERO reg no. 249815). Materials and Methods: A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies. Results: A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation. Conclusion: Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.

SURVEY OF STANDARD PROTOCOLS FOR ENDODONTIC TREATMENT IN CHITWAN, NEPAL

Background: Endodontics is one of the fastest-growing disciplines which involves the introduction of many new instruments, materials, and techniques. This study aimed to assess the practice of the international standard protocol during the endodontic treatment among dentists in Chitwan, Nepal. Methods: The present cross-sectional study was conducted on August 2020 among the dentist working in Chitwan, Nepal. 120 questionnaires were distributed to the dentist working in Chitwan, Nepal. The data were collected and descriptive analysis was done using SPSS ver. 22. Results: From the total respondent, 104 were included in the survey. Fully filled form and those who perform endodontic treatment were included in the survey for further analysis. Cotton rolls with suction (93.3) and a radiograph with a file in the canal (85.6%) was the most common method for isolation and working length determination respectively. Most of the respondents (81.7% ) used k-files with 84.6% following step-back technique for instrumentation of root canal. Autoclave is mostly (47.1%) used sterilization procedure autoclave. Sodium Hypochlorite and calcium hydroxide (CH) are the most common chemicals used for irrigation and intracanal medication respectively. Eugenol based sealer (76%) was the most common intracanal sealer used for obturation used commonly (82.7%) for cold lateral condensation technique. Cavit (89.4%) was the most popular temporary filling material. Difficulty cases are mostly referred (86.3%) for endodontic consultation. Conclusions: Upgrading and reinforcement of knowledge about newer materials and techniques following protocols is required for endodontic treatment.

Evaluation of the sealer/gutta-percha ratio on sets of root section surfaces of some extracted teeth sealed using the cold lateral condensation technique.

Canal filling must be well adapted to the walls of the root canal to prevent bacterial infiltration. Endodontic seals play an essential role in ensuring tightness, without which the canal filling would suffer infiltrations. This study aimed to evaluate the areas occupied by the two components of the canal filling, as well as the sealer/gutta-percha ratio in the root canals of the maxillary central incisors after their filling using the cold lateral condensation technique with gutta-percha. Thirty extracted upper central incisors were rotatably prepared with ProTaper Universal up to F3 and sealed using the cold lateral condensation technique with gutta-percha. After setting the sealer, the roots of the teeth were sectioned perpendicularly to 1 (L1), 3 (L3), 6 (L6), and 8 (L8) mm from the apex. The surface of the sections was analyzed with a Leica EZ4D stereomicroscope and photographed at two magnification orders: 10x and 25x. The areas corresponding to the gutta-percha, sealer, gaps, and root canal were expressed in pixels using the ImageJ software, version 1.50i. The difference in the representation of sealer areas, gutta-percha and voids was statistically significantly different for all four sections analyzed. The best adaptation of the canal obturation was observed in L1 and L3. The gutta-percha area was statistically significantly higher than that of the sealer for the L1, L3, and L6 levels, while the sealer/gutta-percha ratio recorded the lowest value at the L3 level (0, 30) and the highest at its L8 (0.70) level, without registering statistically significant differences regarding the area at the four analyzed levels. The voids were mostly absent or recorded a minimal percentage area (<1%). Cold lateral condensation of gutta-percha has led to a good adaptation of gutta-percha to the root canal wall, with a small amount of sealer, especially to the sections made at 3 mm from the apex. Given the limitations of this study, we noted that the voids were few – observed in the 6 and 8 mm sections – and were negligible in many cases.

An assessment of the efficacy of a rotary and a reciprocating retreatment file system for removal of gutta-percha from root canals: An in vitro cone-beam computed tomography study

Aim: The aim of this study was to compare the NeoEndo and WaveOne retreatment systems concerning the effective removal of epoxy resin-based sealer and gutta-percha during the retreatment of straight root canals.Materials and Method: Sixty extracted, human mandibular first premolars with single straight roots were selected based on cone-beam computed tomography (CBCT) evaluations. The root canals were instrumented with the ProTaper system up to the F3 file and filled with gutta-percha and epoxy resin-based sealer using the cold lateral condensation technique. After 1 month, the samples were randomly divided into two groups (n = 30) according to the retreatment system used: NeoEndo and WaveOne. A CBCT device scanned specimen after the root filling and retreatment procedures, and the decrease in the volume of filling material after each retreatment protocol was measured. The results were analyzed using the paired t-test and additional box-and-whisker plots.Results: The WaveOne removed significantly more material than the NeoEndo (P = 0.005) system.Conclusion: The WaveOne system was more effective than the NeoEndo retreatment system during the removal of filling material.

Effect of different clinical practices on postoperative pain in permanent mandibular molar teeth with symptomatic apical periodontitis: A randomized controlled clinical trial.

This clinical study aimed to evaluate the effect of different clinical practices with endodontic emergency treatment on postoperative pain in mandibular permanent molar teeth with symptomatic apical periodontitis. In the present study, root canal treatment was applied to 100 patients who met the inclusion criteria. Patients were randomly assigned to 5 groups (control, nonsteroidal anti-inflammatory drug [NSAID], NSAID and antihistaminic drug combination, placebo drug, and intracanal cryotherapy) using a web program. In the first visit, after preparation with the WaveOne Gold file system, calcium hydroxide (Ca(OH)2) medicament was placed on the root canals. However, after the treatment of the patients was completed, six patients patients were excluded from the study because they did not come to the control appointment 7 days later. After the removal of Ca(OH)2 medicament in the second session, the root canals were obturated according to cold lateral condensation technique and final restorations of the teeth were performed. Patients' preoperative and postoperative pain values (4-8-12-24-48 and 72 hours) determined by visual analog scale (VAS) were recorded. The data were analyzed statistically using analysis of variance, Kruskal-Wallis test, Friedman test, Wilcoxon test, and Chi-square test. According to the results of our study; there was no significant difference between the groups in terms of age, gender, preoperative pain, and postoperative analgesic requirement (P > 0.05). In all groups, there were significant differences between the values of different times (P < 0.05). While initial pain values were higher than the hours after treatment (P < 0.05), there was no significant difference between postoperative pain values (P > 0.05). When the groups in terms of pain scales measured at different times compared with each other; in all times there was no significant difference between the groups (P > 0.05). It was observed that all clinical practices significantly reduced preoperative pain.

Physicomechanical Properties of Tertiary Monoblock in Endodontics: A Systematic Review and Meta-analysis.

A systematic review and meta-analysis were conducted to evaluate the physicomechanical properties of tertiary monoblock obturation with different obturation techniques. PubMed (MEDLINE), Web of Science, Scopus, the Cochrane Library, LILACS, IBECS, and BBO were searched time. PICO question was: "In extracted human teeth (Population), does tertiary monoblock obturation (Intervention) have superior physicomechanical properties (Outcome) compared to conventional obturation systems (Comparison)?". Statistical analyses for push-out bond strength were performed with RevMan software by comparing the mean differences of each study, with a 95% confidence interval. Inverse variance was used as statistical method, random-effects models as analysis model, and heterogeneity between studies was assessed by Cochran's Q test and I2 statistic (P <0.05). Of 2162 studies retrieved, 31 were included in this review for "Study Characteristics". Ten studies were included in the meta-analysis. Analysis demonstrated that conventional obturation had significantly higher push-out bond strength than tertiary monoblock obturation (P <0 .01), with a mean difference of -1.00 (95% CI, -1.41 to -0.58; I2=100%). Subgroups using single-cone and cold lateral condensation techniques showed significantly lower push-out bond strength for tertiary monoblock obturation (P <0.01), respectively with a mean difference of -0.09 (95% CI, -1.13 to -0.67; I2=97%) and of -1.97 (95% CI, -3.19 to -0.75; I2=100%). The warm vertical compaction subgroup showed no statistically significant difference between tertiary monoblock and conventional systems (P =0.13), with a mean difference of 0.49 (95% CI, -0.14 to 1.12; I2=10%). Tertiary monoblock systems have a push-out bond strength similar to conventional systems when used with warm vertical compaction.

Management of Calcified Root Canal: A Case Report

Background: Calcification of root (calcific metamorphosis) is usually seen as defensive reaction of pulp totrauma. Intensity of trauma/hit, time span since trauma, pulp response to trauma are multiple factor decidingdegree of calcification. Calcification may be seen partially or entirely in root canal. Usually calcifiedtooth remain asymptomatic, but when tooth becomes symptomatic endodontic treatment need to be done.Treatment of calcified canal is challenge to dentist.Case report: A female patient reported to the department of conservative dentistry and endodontics at sharadpawar dental college with chief complain of pain in upper front region of jaw. On radiographic examinationcalcified root canal was associated with upper anterior teeth. Root canal treatment was planned for calcifiedtooth. Access opening was carried out using BR45. To achieve patency within canal file#8, 10 were used, butinitally patency could not be achieved due to calcified canal. With help of chelating agents 17% EDTA liquidand gel and small size K file #8,10 canal negotiation was carried out to achieve patency. Working lengh wasthen determined and canal was instrumented. Naocl, EDTA was used as intermittent irrigant. Final rinse wasdone using 2%CHX. Canal was obturated using cold lateral condensation technique followed by permanentrestoration. Entire procedure was carried out under magnification.Conclusion: Calcified canal treatment is bit tedious then routine endodontic procedure. But it can bemanaged if procedure is carried out under proper illumination, magnification, CBCT, understanding rootcanal anatomy, use of dye, modified access bur, files, chelating agent, irrigants and irrigation activationsystem.

Comparison of dentin penetration ability of different root canal sealers used with different obturation methods.

This in vitro study aimed to investigate the tubular penetration depth of four different sealers used with two different obturation methods in the apical, middle, and coronal root canal dentin. Eighty-four single-rooted teeth were instrumented until the F4 ProTaper universal rotary file and filled with AH26, AH Plus (Dentsply, DeTrey, Konstanz, Germany), RealSeal (SybronEndo, Orange, CA), and MTA Fillapex (Angelus, Londrina, Brazil) using cold lateral condensation (CLC) and single-cone (SC) obturation techniques. Thereafter, the roots were sectioned longitudinal and prepared for scanning electron microscope evaluation. The maximum and minimum sealers penetration depth into dentinal tubules at the apical, middle, and coronal regions and the average depth of sealer penetration were calculated. The data was statistically analyzed two-way ANOVA and post hoc Tukey and Dunnett tests and independent samples t test using maximum mean values. There was no statistically difference between the obturation methods (p > .05). When the sealers are evaluated within themselves AH26 was affected by obturation methods significantly (p < .05). Also the results revealed a significant difference between root regions (p < .05). AH26 and RealSeal root canal sealers had the highest penetration values with CLC and SC obturation techniques, respectively. The obturation method did not affect the penetration amount of root canal sealers. RealSeal root canal sealer performed better penetration ability than the other sealers. Apical third of the root in all groups showed lowest penetration depth.