Crown-down Pressureless Technique Research Articles

Evaluation of single root canals filled using the lateral compaction, tagger's hybrid, microseal and guttaflow techniques

The aim of this study was to determine the percentage of voids, gutta-percha and root canal sealer using 4 different filling techniques. Fifty-two extracted maxillary lateral incisors were prepared using the crown-down pressureless technique. The teeth were randomly divided in 4 groups (n=13): Lateral compaction (LC), Tagger's hybrid (TH), MicroSeal (MS) and GuttaFlow (GF) techniques. Horizontal cross-sections were made at the 2, 10 and 15 mm levels from the apex. Digital images of the root canal areas were acquired using a stereomicroscope and examined using the Image Tool 3.0 software. Statistical analysis was performed using the Kruskal-Wallis test (α=0.05). In general, a significant decrease in the gutta-percha filled area and increase of sealer area were observed at the apical level for all the evaluated techniques (p<0.05). With regard to the presence of voids, no significant difference was found. MS and TH techniques showed a larger gutta-percha filled area than LC and GF techniques at the coronal and middle third level (p<0.05). From the results of the present study, it may be concluded that the gutta-percha filled area of fillings decrease at the apical level, regardless of the filling technique used.

Outcome of Root Canal Treatment Using Soft-Core™ and Cold Lateral Compaction Filling Techniques: A Randomized Clinical Trial

The purpose of this clinical and radiographic investigation was to evaluate the treatment outcomes of endodontically treated teeth obturated with Soft-Core versus cold lateral compaction. A total of 98 teeth were endodontically prepared using the Quantec LX rotary system with a crown-down pressureless technique and obturated with either Soft-Core or cold lateral compaction. The outcome of treatments were evaluated clinically and radiographically by two blinded evaluators after three years. Statistical analysis was performed using an unpaired t-test and the Mann Whitney test at the level of significance set at 95%. Regardless of the periapical status of the teeth, no statistically significant difference was found between the two obturation techniques (p > 0.05). The Kappa value for the interobserver agreement was 0.73. Within the limits of the study, it is concluded the Soft-Core obturation technique did not result in a significantly different treatment outcome when compared with cold lateral compaction after three years. Further investigations should be carried out on the Soft-Core technique. Using the Soft-Core system reduced working time, and the difference was found to be statistically different (p = 0.00056) from the working time required for cold lateral compaction. This reduction in canal filling time holds the potential for cost savings for clinicians while maintaining the quality of the clinical outcome.

Apical extrusion of intracanal debris and irrigant following use of various instrumentation techniques

The purpose of this study was to compare in vitro the amount of debris and irrigant extruded apically from extracted teeth, using manual technique and crowndown pressureless technique by K3, RaCe, and FlexMaster instruments. Sixty human single-rooted mandibular premolar teeth were randomly assigned to 4 groups, 15 teeth each. The teeth in 4 groups were instrumented until the working length with RaCe, K3, FlexMaster, and K-type stainless steel instruments respectively. Debris and irrigant extruded from the apical foramen were collected into vials and the amounts were determined. The data obtained were analyzed using Kruskal-Wallis 1-way analysis of variance and Mann-Whitney U tests, with alpha = 0.05 as the level for statistical significance. No statistically significant difference was observed among the groups in terms of debris extrusion (P > .05). On the other hand, a statistically significant difference was observed between K3 and manual technique groups in terms of irrigant extrusion (P < .05). The difference between other groups was not statistically significant (P > .05). Based on the results, all instrumentation techniques produced extruded debris and irrigant; however, the engine-driven nickel-titanium systems were associated with less apical extrusion and irrigant.

A comparison of spreader penetration depth and load required during lateral condensation in teeth prepared using various root canal preparation techniques

To compare the influence of various root canal preparation techniques on spreader penetration depth and load required during lateral condensation with gutta-percha and sealer. Eighty extracted human teeth with single and straight canals were used. Twenty teeth were instrumented using one of four root canal preparation techniques. The four preparation techniques were: step-back technique without Gates-Glidden drills, step-back technique with Gates-Glidden drills, crown-down pressureless technique and hybrid technique (step-down/step-back). After root canal preparation had been completed a simulated periodontal ligament was fabricated from a uniform layer of silicone impression material. The roots were then mounted in an acrylic resin to simulate the physical condition found in tooth socket. A standardized stainless steel hand spreader of the same size as the master apical file was mounted in an Instron testing machine and lateral compaction with gutta-percha and sealer was performed. The load value was recorded from the Instron testing machine. The spreader penetration depths were measured with an endodontic ruler. The data obtained were analysed statistically using anova and Student's t-tests. No significant difference in initial spreader load needed to condense the master cone was found amongst the four canal preparation techniques (P > 0.05). The step-back technique with Gates-Glidden drills and the hybrid technique demonstrated the least difference between the initial spreader penetration and the working length (mean 1.925 and 2.25 mm, respectively). The step-back technique without Gates-Glidden drills and the crown-down pressureless technique had the greatest difference between initial spreader penetration and the working length (mean 4.425 and 4.75 mm, respectively). The flare created by canal preparation affected spreader penetration depth, but had no effect on the spreader load.

Comparison of cold lateral compaction and continuous wave of obturation techniques following manual or rotary instrumentation

To compare different combinations of root canal preparation and obturation technique. A total of 48 freshly extracted human maxillary central incisors were divided into two identical groups on the basis of root canal length and apical diameter. The root canals were prepared by manual crown-down pressureless technique or with a rotary system (ProFile; Dentsply Maillefer, Ballaigues, Switzerland) in a crown-down technique. The coronal diameter and apical size of the root canals were standardized in both preparation techniques. Each main group was then divided into two subgroups and obturated with either cold lateral compaction or continuous wave of obturation with System B (EIE-Analytic Technology, Orange, CA, USA). The distribution of filling material in each canal was assessed by stereomicroscopic examination of eight cross-sections on each tooth. Areas of sealer, gutta-percha and voids were measured on the digital images of a total of 384 samples. Manipulation time and apical extrusion for each group was also determined. Data were statistically analysed using Kruskal-Wallis, anova (Bonferroni/Dunn) or Student's t-test. The percentage of sealer, gutta-percha and voids area between the obturation techniques was not significantly different (P > 0.05). Continuous wave groups had significantly more apical extrusion of sealer (P < 0.05), while none of the obturation techniques had gutta-percha extrusion. Rotary instrumentation was significantly faster than the manual technique (P < 0.05); continuous wave obturation was significantly faster than lateral compaction (P < 0.05). Total manipulation time in the rotary/continuous wave group was significantly shorter than the other groups (P < 0.0001). The distribution of filling materials was similar in all combinations of instrumentation and obturation techniques. The continuous wave technique was faster than lateral compaction and it extruded more sealer.

The change of canal configuration after instrumentation by several nickel-titanium files in the simulated canal with abrupt curvature

The purpose of this study was to evaluate which type of Ni-Ti files are able to maintain canal configuration better in the simulated canal with abrupt curvature near it's apex. Ninety six simulated root canals were made in epoxy resin and 15 finger spreader was used as root canal templates. The simulated root canals were made with radius of curvature of 1.5mm, 3.0mm, 4.0mm, 6.0mm respectively and the angle of curvature of all simulated canals were adjusted to 90 degree. The simulated canals were instrumented by ProFile, ProTaper, Hero 642, and at a 300 rpm using crown-down pressureless technique. Pre-instrumented and post-instrumented images were taken by digital camera and were superimposed with Adobe Photos hop 6.0 program. Images were compared by image analysis program. The changes of canal width at the inner and outer side of the canal curvature. canal transportation were measured at 9 measuring point with 1 mm interval. Statistical analysis among the types of Ni-Ti files was performed using Kruskal-Wallis test and Mann-Whitney U-test. The result was that ProFile maintain original canal configuration better than other engine driven Ni-Ti files in the canals above 3.0mm radius of curvature, and in the 1.5mm radius of curvature, most of Ni-Ti flies were deformed or separated during instrumentation.

A comparative study on the canal configuration after shaping by ProFile, ProTaper™ and K-Flexofile in simulated canals with different angles of curvature

The purpose of this study was to evaluate the canal configuration after shaping by ProFile. ProTaper and K-Flexofile in simulated resin canals with different angles of curvature. Three types of instruments were used: ProFile. ProTaper. K-Flexofile. Simulated root canals. which were made of epoxy resin. were prepared by ProFile. ProTaper with rotary instrument using a crown-down pressureless technique. and hand instrumentation was performed by K-Flexofile using a step-back technique. All simulated. canals were prepared up to size 25 file at end-point of preparation. Pre and post instrumentation images were recorded with Scanner. Assessment of canal shape was completed with Image Analysis program. Measurements were made at 1. 2. 3. 4. 5. 6. 7. 8. 9 and 10mm from the apex. At each level. outer canal width. inner canal width. total canal width. and amount of transportation from original axis were recorded. Instrument deformation and fracture were recorded. Data were analyzed by means of one-way ANOVA analysis of variance and the Sheffe's test. The result was that ProFile and ProTaper maintain original canal shape regardless of the increase of angle of curvature than K-Flexofile. ProFile show significantly less canal transportation and maintained original canal shape better than ProTaper.

A comparative study of the canal configuration after shaping by protaper rotary and hand files in resin simulated canals

The purpose of this study was to compare the canal configuration after shaping by ProTaper rotary files and ProTaper hand files in resin simulated canals. Forty resin simulated canals with a curvature of J-shape and S-shape were divided into four groups by 10 blocks each Simulated root canals in resin block were prepared by ProTaper rotary files and ProTaper hand files using a crown-down pressureless technique All simulated canals were prepared up to size file at end-point of preparation. Pre- and post-instrumentation images were recorded with color scanner. Assessment of canal shape was completed with an image analysis program. Measurements were made at 0, 1, 2, 3, 4, 5, 6 and 7 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrumentation time was recorded. The data were analyzed statistically using independent t-test. The result was that ProTaper hand files cause significantly less canal transportation from original axis of canal body and maintain original canal configuration better than ProTaper rotary files, however ProTaper hand files take more shaping time.

Lateral Perforation in Parallel Post Space Preparations

This study evaluates the amount of remaining tooth structure and possibility of producing lateral perforation following the use of different diameters of parallel-sided Parapost drills in groups of different canal curvatures (0 degrees-15 degrees, 16 degrees-25 degrees, 26 degrees <) in distal canals of first and second mandibular molar teeth. After enlargement of root canals using the crown-down pressureless technique, Parapost drills #1, #2, and #3 were used in the different canal groups for the preparation of a post space. Standardized digital radiographs were taken before the post space preparation and after each Parapost drill application. Four horizontal lines (a, b, c, and d) were drawn at equal distances on these images, starting from the pulp chamber floor moving apically at 2 mm increments. There were no significant differences between the different curvature groups at the a, b, c, and d levels for the critical level of the remaining tooth structure (multiple comparison test; p>0.05). However, in considering root perforation, both at the inner and outer side of the roots, there were statistically significant differences at "c" and "d" levels in group 3 (#3 drill) without taking into account the root curvature (ANOVA; p< 0.5). None of the specimens showed strip perforation.

Analysis of forces developed during mechanical preparation of extracted teeth using Profile NiTi rotary instruments

The aim of this study was to analyse the vertical forces and torque developed in the root canal system of extracted teeth during mechanical preparation using ProFile NiTi instruments. Instrument wear and fracture is in great part due to the repeated application of forces and torque during the course of root-canal preparation but research into the direct relationship has been hampered by the lack of adequate measuring devices. Measurements of these forces and torque were made with a new force analyser device, the Endographe, that was equipped with a holder to record and generate graphs of the vertical forces and torque exerted during the preparations. These preparations was performed by endodontists or students either with a series of instruments of increasing size or with the crown-down pressureless technique. The mean values for the endodontists of the generated vertical forces and torque varied, respectively, from 4 to 6N and from 7.105 to 12.105 Nm for the step-back technique and from 2.9 to 4.2 N and from 18.105 to 20.105 Nm for the crown-down technique. This suggested that the crown-down technique generated lower stresses (lower torque and lower vertical forces), although these findings also depend on the shape of individual canals. The students initially showed wide variations in generated forces, with significantly lower vertical force the torque values. By the end of the experimental sessions their values were similar to those of the endodontists, which indicated improvement in the efficiency of manipulation. Further work is needed to investigate the relationship between the force and the torque data from this study and the incidence of instrument fracture with the two techniques, as the clinical implications are considerable. It must be noted, however, that the Endographe is unable to take into account the cutting efficiency of the instruments. The use of graphs provides a new approach to the analysis of mechanical preparation.

An evaluation of the crown-down pressureless technique

Forty single-canal extracted human teeth with apical curvature of 10 to 35 degrees were instrumented using the crown-down pressureless technique and the other half using a traditional filing technique. Five similar uninstrumented teeth served as controls. Xantopren Blue impression material was injected under vacuum into the root canal systems of all of the specimens, which were then cleared. The specimens were evaluated by five independent evaluators according to several desirable and undesirable instrumentation parameters, and an overall rating was given. Statistical analysis showed a significant difference only in the overall rating. The crown-down pressureless technique received significantly more excellent ratings, while the conventional method received significantly more poor ratings. The crown-down pressureless technique was shown to be an effective method for instrumenting the curved root canals in this study.