Obturation Length Research Articles

Comparative Evaluation of the Quality of Obturation Between Three Obturation Techniques in Primary Canines: An In Vitro Study.

Aims This study compares three obturation techniques (rotary lentulo spiral, handheld lentulo spiral, and pressure syringe) for the quality of two filling pastes (zinc oxide eugenol (ZOE) paste and Metapex (Meta Biomed Co., Ltd., Chungcheongbuk-do, Korea). Methods and materials Sixty extracted primary canines were instrumented and obturated by filling materials. The obturation techniques were divided into three groups according to different obturation techniques.Obturation quality was evaluated for length, density, and presence of voids by using digital radiography. Results This study showed that the handheld lentulo spiral technique using Metapex and ZOE exhibited more optimal fillings for obturation length. The highest density obturation was achieved using the syringe injection approach with Metapex and ZOE. The highest incidence of both external and internal voids was observed in the group using ZOE with the handheld lentulo spiral technique Conclusions Based on the findings of this study, for both filling materials, the handheld lentulo spiral technique had the greatest number of optimal lengthsbut there were also more voids.

Assessment of dental students’ knowledge and performance of master gutta-percha cone selection and fitting during root canal treatment: a pilot study

BackgroundMisconceptions should be detected early in dental students’ training to improve their clinical performance. Accordingly, this study aimed to assess undergraduate dental students’ knowledge and performance of master gutta-percha (GP) cone selection and fitting during clinical endodontic courses at the College of Dentistry, King Saud University.MethodsNinety-nine undergraduate dental students completed an online survey about their knowledge of master GP cone selection. Forty-five of these students were observed by faculty members in clinical endodontic courses while they fitted master GP cones during root canal treatments. The observers recorded the details of each student’s cone-fitting techniques. The data were analysed using t-tests, one-way analysis of variance, and chi-square tests (p < 0.05). Inter- and intra-observer reliability were tested using Fliess’ Kappa.Results SurveyAll participants had good knowledge of over-extended cone management, while 80.8% knew how to properly manage a short cone. The proper flaring assessment method was selected by 86.9% of the female and 34.2% of the male students, and this difference was statistically significant (p = 0.0001).ObservationThe students labelled the working length on the master GP cone with an indentation in 64.4% of the cases and by bending the cone 35.6% of the time. Of all students, 84.4% encountered an apical stop, and this rate correlated significantly with the length of the cone on the master apical cone radiograph (p = 0.001). Improper shaping of the canal was the most common cause of ill-fitting cones (83.3%), while 16.7% of the students chose the wrong cone size. The final obturation length was adequate in 80% of the cases; 57.8% of the students were helped by instructors.ConclusionsMost students had the basic knowledge required to solve problems related to the selection of master GP cones. However, in the clinical setting, more than half of the students required the assistance of an instructor to adjust their cone’s fit. The presence of an apical stop had the most significant effect on the length of the fitted master GP cone on radiography. The most common cause of ill-fitting master cones was improper shaping of the canal.

Assessment of Two Different Obturation Systems in Primary Teeth: A Comparative Study

ABSTRACT Aim: The purpose of this study was to evaluate the efficacy of two distinct obturation techniques in primary teeth. Materials and Methods: For this investigation, 40 primary molar teeth were taken into consideration. Every sample underwent sample preparation. All teeth were evenly split into two groups: Group 1-obturation using the lentulospiral method and Group 2-obturation using the NaviTip method. The comparison between the two procedures was established through radiographic evaluation of the obturation quality and voids in the obturated canals. Results: In the lentulospiral method, 12 (60%) were optimal filling, 6 (30%) were underfilling, and 2 (10%) were overfilling. In the lentulo spiral method, 40% voids were present, and in the NaviTip method, 15% voids were present. Conclusion: The present study concluded that the NaviTip syringe method was sufficiently effective in regulating voids and yielded the best results for the apical seal, whereas the lentulo spiral approach generated the best results in terms of length of obturation.

The association of endodontic prognostic factors with the presence of periapical lesion, its volume, and bone characteristics in endodontically treated molars: a cross-sectional study

BackgroundThis study intended to evaluate the association between several endodontic prognostic factors with the presence of periapical lesions (PLs), their volume, and bone characteristics including cortical bone destruction (CBD) and buccal plate bone height (BPBH) in root-filled molar teeth using cone-beam computed tomography.MethodsA collection of 143 scans of endodontically treated maxillary/mandibular first or second molars recorded over 8 years, were obtained from a specialized radiology center. Data on prognostic factors including tooth number, gender, jaw type, the status and number of missed canals, obturation length, restoration type, presence of a separated instrument, presence of a post or screw in the canals, and presence of perforation were collected. The assessed outcomes included PL presence, PL volume, CBD, and BPBH. The association between prognostic factors and outcomes was evaluated using multiple logistic regression models with adjusted covariates and multifactorial ANOVA at a significance level of 0.05.ResultsA total of 282 molars from 82 women and 50 men with a mean age of 40.6 ± 12.27 were included. Among those, 139 teeth presented PL with a mean volume of 18.68 mm3. CBD was prevalent in 137 teeth and the mean BPBH appeared to be 9.45 mm. The presence of a missed canal (OR = 10.022, P < .05), underfilled canal (OR = 3.725, P < .05), overfilled canal (OR = 15.859, P = .018), and perforation (OR = 15.261, P = .013) was significantly associated with PLs. None of the prognostic factors could considerably contribute to the CBD (P > .05). The presence of a missed canal was positively associated with the PL volume (P < .05). Similarly, missed canals (P < .05), perforation (P < .05), and separated instruments (P = .004) were associated with a significantly reduced BPBH.ConclusionsOverfillings, perforations, missed canals, and underfillings were identified as remarkable predictors of PL, arranged in descending order of their respective impact. The only factor capable of significantly increasing the PL volume was the missed canal. In brief, obturation length errors, perforations, missed canals, and separated instruments were robustly correlated with endodontic failure, which highlights the importance of mitigating the potential for errors by following the fundamentals of endodontics.

Success of Nonsurgical Endodontically Treated Posterior Teeth with Complex Restorative/Prosthodontic Treatments: A Retrospective Study.

Endodontic therapy has been regarded as a safe treatment option with highly promising results in preserving natural teeth. Numerous factors may influence the longevity of endodontically treated teeth (ETT), thus altering their success/survival rate. This study aimed to determine the survival and success rates of endodontically treated premolars and molars with different complex restorative/prosthodontic treatments. A total of 190 patients with an ETT were included, who had received final coronal restoration up to 14 days after the temporary one and at least one year prior to the enrollment. The investigator evaluated the quality of endodontic filling, coronal restoration, mobility, and proximal contacts. Data were analyzed with multiple binary logistic regression and the Chi-Square test. The average duration of follow-up was 28.6±11.9 months. Overall, 89.4% (170/190) of the teeth survived. The overall success rate for the investigated teeth was 70.5% (134/190). Success rates of 100% for crown, 95.7% for post and core crown (PCC), and 94.7% for amalgam build-up with post were achieved. However, the success rates were 75%, 52.5%, and 50% for amalgam build-up, composite build-up, and PCC with crown lengthening, respectively. The Chi-square test revealed that there was a significant difference between the different restorations in terms of success (P<0.001). Multiple binary logistic regression models revealed that coronal leakage (P=0.048), obturation void (P=0.037), obturation length (P=0.020), mobility (P=0.002), type of the restoration (P<0.001), and proximal contact (P<0.001) were significant predictors for success. However, apical lucency, root length, marginal caries, tooth type, and post did not appear to be significant indicators of success (P>0.05). ETT with minimal mobility, exhibiting underfilled obturations without visible voids, and having received crown/PCC/amalgam build-up with a post, along with the presence of both proximal contacts, tend to exhibit a significantly high success rate.

Lisans Öğrencileri Tarafından Manuel Aletlere Karşı Döner Aletler Kullanılarak Gerçekleştirilen Kök Kanal Tedavisinin Teknik Kalitesi: Bir Retrospektif Çalışma

Background: The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice.&#x0D; Objective: To compare the technical quality of RCT where rotary or manual step-back canal preparatory technique was employed in an undergraduate dental clinic in Turkey. Additionally, the present study aimed to compare radiographically commonly seen complications in both instrumentation systems.&#x0D; Materials and Methods: Dental records of 270 patients who received RCT undertaken by dental students were investigated by retrospective chart review. 565 root canals belonging to 270 patients were randomized into two groups [(rotary, n=280, and manual hand instruments, n=285)]. Root canal obturation was evaluated on the basis of the length of obturation being &gt;2mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as perforation, ledge, transportation, instrument separation. Descriptive statistics were used to define categorical variables (n, %) and the level of significance was set at 0.05. &#x0D; Results: The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 75% and 53.7% of the cases, respectively for rotary and manual groups, respectively (p &lt; 0.05). The highest procedural errors were seen in molars. Occurrence of procedural errors differed significantly between the groups, being 6.4% in rotary group and 12.3% in manual group (p = 0.017). However, occurrence of ledge formation was higher in manual group than that of rotary group (p = 0.007). &#x0D; Conclusion: In view of our findings, RCT performed by undergraduate dental students using rotary instrumentation systems is of higher technical quality and also has fewer procedural errors than manual instrumentation.

Cone-Beam Computed Tomography Assessment of Quality of Endodontic Treatment and Prevalence of Procedural Errors in Mandibular Molars.

This study assessed the quality of endodontic treatment and the prevalence of procedural errors in permanent mandibular molars using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 328 CBCT scans (182 females and 146 males) of endodontically treated mandibular molars retrieved from the archives of two radiology centers in Ardabil city, Iran, in 2019. Mandibular molars were evaluated on sagittal, coronal, and axial sections regarding obturation length, obturation density (voids), missed canals, broken instruments, apical perforation, strip perforation, ledge formation, transportation, root fracture, root resorption, and periapical lesions by a senior dental student under the supervision of an oral and maxillofacial radiologist and an endodontist. Differences between the frequency of procedural errors and tooth type and gender were analyzed by the chi-square test. The frequency of underfilling, missed canals, overfilling, voids, apical perforation, transportation, ledge formation, broken instruments, root fracture, strip perforation, root resorption, and periapical lesions was 34.8%, 17.4%, 16.8%, 14.3%, 7.3%, 6.1%, 4.3%, 3%, 1.2%, 0.6%, 5.5%, and 46%, respectively. The frequency of root fracture was significantly higher in females than in males (P < 0.05). The prevalence of underfilling was the highest in right second molars (47.2%), followed by right first molars, left second molars, and left first molars (P < 0.005). The frequency of transportation was maximum in right first molars (10%), followed by right second molars, left first molars, and left second molars (P < 0.04). Underfilling, missed canals, and overfilling were the most prevalent procedural errors in mandibular molars in our study population.

Cone-Beam Computed Tomography Assessment of Prevalence of Procedural Errors in Maxillary Posterior Teeth.

A range of procedural errors can occur when performing endodontic treatment on posterior teeth. These errors may decrease the success rate in endodontic practice. This study assessed the prevalence of procedural errors and the quality of endodontic treatments in maxillary molars and premolars using cone-beam computed tomography (CBCT). CBCT scans from two private radiology centers were assessed retrospectively to ensure the same calculated sample size of 327 teeth for each of the four maxillary posterior tooth types (a total of 1,308 endodontically treated teeth). Image sets were evaluated for procedural errors categorized as follows: obturation length (overfilling or underfilling by >2 mm short of the root apex), missed canals, perforations, strip perforations (with extrusion of material into the furcation area), separated instruments in the root canal space, and root fracture. Data were analyzed with SPSS version 20 (SPSS Inc., Chicago, IL, USA), and frequency data was assessed using the Monte Carlo test at the 0.05 level of significance. The procedural errors most commonly reported in the present study were from most frequent to least frequent: underfilled canals (50.0%), missed canals (27.5%), overfilled canals (12.5%), apical perforations (5.0%), separated instruments (3.1%), and root fractures (1.9%). No strip perforations (with extrusion of material into the furcation area) were seen in the study (0%). Underfilled and missed root canals were the most frequent procedural errors identified in the present study. These findings underline the importance of more consideration of critical working length management during all stages of root canal treatment, greater awareness of root canal anatomy, and the use of imaging and diagnostic devices that enhance the ability to identify and treat root canals both safely and effectively.

Post-treatment Apical Periodontitis in Primary Non-surgical Root Canal Treatment: A Multiple Correspondence Analysis.

The presented study aimed to characterise periapical disease in teeth with primary non-surgical root canal treatment in persistent or emergent categories and their risk association. A retrospective observational study that evaluated permanent teeth with primary non-surgical root canal treatment, was conducted clinically and radiographically for over one year. The following variables were analysed: gender, age, type and location of tooth, previous diagnosis, treatment conditions, and type of coronal restoration. The supplementary variables included the perspectives of the treatment outcome, such as Remains normal, Improvement, and Failure. Statistical analysis was performed using a univariate analysis that estimated the average and proportion for each factor according to the result of the primary non-surgical root canal treatment. The multiple correspondence analysis identified the hierarchy between active variables and their association with the results. A total of 232 teeth in 155 participants were analysed. A χ2 value, (P=0.023) showed that the emergent disease is associated with patients around the age of 50. The multiple correspondence analysis identified a tendency of grouping between the emergent disease and the short filling category, followed by symptomatic pulpitis as a previous diagnosis. The persistent disease was associated with errors and overfillings. An inadequate root filling and taper density adversely impacted the treatment outcome. The length of obturation influenced the presence of failure. Short fillings were associated with emerging periapical disease. Errors and overfillings contributed to the persistent disease in the populations studied.

Influence of technical quality and coronal restoration on periapical health of root canal treatment performed by Malaysian undergraduate students

Introduction: Root canal treatment (RCT) and its coronal restoration should be regularly assessed to ensure a successful treatment outcome. The aim of the current study is to evaluate the relationship between the obturation technical quality and coronal restoration in the clinical and radiographic outcome of RCT provided by Malaysian undergraduate students. Materials and Methods: A total of 143 root-treated teeth from 136 patients were evaluated through clinical examinations and periapical radiographs with a mean follow-up period of 2.4 (standard deviation = 1.59) years. The quality of the coronal restoration was classified according to modified United States Public Health Service criteria and the technical quality of the obturation was assessed based on two variables: length and density. Periapical status was evaluated according to periapical index scores. Results: About 64% of the teeth were classified as healthy with a significant reduction of apical periodontitis from 70.3% preoperatively to 36% at reassessment (P &lt; 0.001). About 92.1% of obturation was of acceptable length, whereas 5% underfilled and 2.9% overfilled. Teeth with acceptable obturation length were five times less likely associated with apical periodontitis than the inadequately filled ones. 90% of canals had adequate obturation density with no significant association to apical periodontitis. Teeth restored with intracoronal restorations had 50% more chance of developing apical periodontitis. Inadequately restored teeth and teeth with poor obturation quality were associated with three times more likely apical periodontitis occurrence. The quality of endodontic treatment and the coronal restoration significantly influenced the periapical status (P &lt; 0.001). Conclusion: The radiographic obturation quality and coronal restorations of the RCTs performed by the undergraduate students in a Malaysian public dental school were acceptable in 63.8% of cases with a 64% favorable outcome.

Retrospective study of endodontic treatment performed by undergraduate students using reciprocating instrumentation and single-cone obturation.

The aim of this cross-sectional retrospective study was to evaluate radiographically the technical quality of root canal treatment performed by undergraduate students using reciprocating NiTi instrumentation and single-cone obturation. Endodontic treatment on 1102 teeth performed by undergraduate students from the School of Dentistry of the University of Santa Cecilia (Brazil) was evaluated. All root canal preparations were performed using Reciproc files and were irrigated with 1% NaOCl. The root canal was filled with gutta-percha, along with AH Plus sealer, using the single-cone obturation technique. The technical quality of the root canal treatment was evaluated based on immediate postoperative radiographs. Distance between the end of the filling and the radiographic apex, the filling density, and the taper of the root filling was assessed. Inter-examiner agreement statistic (Kappa) and Chi-square statistic test were used for statistical evaluation of the results. Differences were considered statistically significant when p < 0.05. Anterior teeth, maxillary premolars, and molars presented better results than mandibular premolars and molars (p < 0.05). Mandibular premolars presented a high incidence of a short length of obturation (33.34%) and mandibular molars presented a high incidence of overfilling (6.55%). The majority of the treatment analyzed (62.46%) fulfilled all the criteria showing acceptable working length, taper, and density of obturation. Instrument fractures occurred in eighteen root canals (0.81%). The use of NiTi reciprocating instruments with the single-cone obturation technique provided an acceptable quality of endodontic treatment in the majority of the cases performed by undergraduate students.

Technical Quality of Endodontic Treatment Performed by Underperforming Undergraduate Dental Students

Objectives: This study aimed to evaluate the technical quality of root canal treatment performed by fifth-year underperforming students, in the extra sessions of the 2018–2019 academic year.&#x0D; Methods: Periapical radiographs of teeth endodontically treated by underperforming undergraduate students at King Abdulaziz University Faculty of Dentistry, were collected. The quality of obturation was evaluated radiographically in relation to the length of obturation to root apex, homogeneity and density of obturation, root canal tapering, and incidence of mishaps (such as perforation, ledge, missed canal, separated instruments). The data were subjected to descriptive analysis.&#x0D; Results: The periapical radiographs of 70 treated teeth showed acceptable length, filling density and root canal taper in 96 (80%),50 (41.7%) and 66 (55%) root canals, respectively. Only four teeth were subjected to mishaps.&#x0D; Conclusion: Under the circumstances of this study, the quality of endodontic treatment performed by underperforming students at the extra session was low. More studies are needed to address the student underperformance source and hence amend the quality of root canal filling.

Retrospective audit for quality assessment of root fillings performed by undergraduate dental students in clinics

ObjectivesTo evaluate the technical quality of root canal obturations performed by undergraduate students. MethodsThe records of 347 patients who underwent endodontic treatment by undergraduate students of Qassim University between 2018 and 2020 were assessed using standardised criteria based on obturation length, density and taper. All teeth that received primary endodontic treatment and had post-obturation periapical radiographs depicting the entire radicular length and the 2–3-mm periradicular area were included in the study. ResultsA total of 653 canals of 397 teeth were evaluated. The maxillary central incisor was the most commonly assessed tooth (15.1%). Overall, 80.2% of the evaluated canals were deemed acceptable based on all three assessment criteria. Maxillary teeth had significantly better obturation quality than the mandibular teeth. The mesio-lingual canal had the lowest quality in all three criteria. ConclusionsThe technical quality of root canal obturations performed by undergraduate students in Qassim University was acceptable in the majority of the evaluated cases. Among the evaluated parameters of obturation quality, length control was the most frequently observed deficiency. Additional measures are therefore required to improve the quality of the obturation length.

Influence of Preclinical Training on Root Canal Treatment Technical Quality and Confidence Level of Undergraduate Dental Students.

Objectives The aim of this study was to investigate the influence of exposure to additional preclinical endodontic training on undergraduate students' technical quality of root canal treatment and overall confidence levels in endodontics. Methods Technical quality of root canal treatment performed clinically by fifth-year undergraduate students was evaluated and divided into two groups: Group 1, teeth treated by students who had attended both a preclinical endodontic block course and an elective preclinical course. Group 2: teeth treated by students who had not attended the elective preclinical course. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing endodontic treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and t-test. A p-value <0.05 was considered statistically significant. Results There was no significant difference between the two groups in overall obturation quality (p=0.619). However, more teeth treated by attendees were of adequate obturation length (p=0.015) and lacked procedural errors (p=0.004). Significantly more elective course attendees rated their undergraduate endodontic training as adequate (p=0.002), but there was no significant difference in the level of confidence between the attendees and the non-attendees. Conclusion Within the limitations of this study, additional preclinical training showed minimal effect on overall quality of root canal treatment performed clinically by undergraduate students and did not enhance their confidence levels; however, it was associated with more satisfaction with their undergraduate endodontic education.

Quality of Root Canal Filling Using a Bioceramic Sealer in Oval Canals: A Three-Dimensional Analysis.

Objectives The oval canals may be associated with inadequate debridement, which can affect the quality of the root canal filling, thus the treatment outcome. The aim of the present work was to compare the quality of oval canals fillings using EndoSequence BC sealer with the single-cone technique or cold lateral compaction. Materials and Methods Thirty-eight human single-rooted premolars with oval canals were instrumented to 1 mm from the apical foramen with hand nickel–titanium files, followed by circumferential filing with Hedstrom files. Teeth were paired into two groups based on their micro-computed tomography (CT) morphological parameters. Both groups were filled using EndoSequence BC sealer. The first used a single cone and the other with the cold lateral compaction technique. The voids volume was evaluated by micro-CT and the percentage was calculated for the total length and for the apical 5 mm of each canal. The Mann–Whitney U test was used to assess whether the surface area and obturation length differed significantly between the groups and to compare the percentage of voids for each technique. Results Both techniques resulted in less than 16% voids, with no statistically significant difference between them for the total canal length and for the apical 5 mm ( p > 0.05). Conclusions The quality of the obturation performed with the single-cone technique was similar to that achieved with lateral compaction using EndoSequence BC sealer in oval canals.

Evaluation of Dental Students' Skills Acquisition in Endodontics Using a 3D Printed Tooth Model.

Objective:The purpose of this prospective quantitative study was to assess the improvement of skills among pre-clinical dental students who practiced root canal obturation on a 3D-printed tooth model.Methods:Preclinical students at the dental school (n=145) enrolled in the 2-week endodontic rotation course were invited to participate in the study. Four alphabetically distributed intact groups of first-year students were randomly allocated to either the control or the experimental group that obturated canals of a 3D-printed tooth. The plastic model was obtained from a microCT scan and based on an STL data set. The model was an identical replica of a natural mandibular molar that had been instrumented, ready for obturation. The control group did not obturate the tooth model but received identical instruction. Later in the course all students obturated an extracted human mandibular molar tooth. Technical obturation quality was assessed by two blinded evaluators. Radiographs were used to evaluate obturation length and density. Inter-observer reliability of average performance scores was calculated with the intra-class correlation coefficient for both consistency and absolute agreement. Obturation skills of those who practiced with the model were statistically compared to students who did not use the model with the Mann-Whitney U-test.Results:Inter-observer reliability was very high for both consistency and absolute agreement. No significant differences were found in obturation skills between the experimental and control group (P>0.05).Conclusion:Under the condition of this study, dental students’ obturation skills did not significantly improve by further practicing obturation using a 3D-printed model.

Assessment of Postoperative Obturation Quality of Retreatment Cases - A Retrospective Study

Conventional endodontic therapy emphasizes many factors which mainly emphasize root canal disinfection.However there is a probability of endodontic therapy to give an unfavourable outcome such as persistentclinical symptoms and unfavourable periapical healing. The frequency of failure is reported to be around 20%and various factors contribute to it which mostly relies on the treatment procedure followed by the previousoperator. It is of paramount importance that postgraduate doctors should learn to treat these case scenarioswith high effectiveness. This study aims to assess the postoperative obturation quality of retreatment casesdone by graduate doctors. The study was done by using data collected from electronic medical records ofSaveetha Dental College, Chennai, India. The time frame of data collection was seen from June 2019 toMarch 2020. A total sample size of 230 was assessed radiographically and the quality of obturation wasanalyzed using 2 grading criteria in compliance with 2 operators. From the cases assessed, about 80% hadachieved correct radiographic length of obturation and about 70% of obturation was not of optimal quality.Quality of obturation was not adequate. The length of root canal filling was desirable whereas the quality ofcondensation was not adequate about 60% of the assessed cases

Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p&gt;0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

Comparison of Selected Anatomical and Treatment-related Diagnostic Parameters Estimated by Cone-Beam Computed Tomography and Digital Periapical Radiography in Teeth with Apical Periodontitis.

ABSTRACTObjectivesTo compare selected anatomical and treatment-related diagnostic parameters estimated by cone-beam computed tomography and by digital periapical radiography in teeth with apical periodontitis, and to evaluate reliability of different examiners in interpretation of images obtained by both methods.Material and MethodsTeeth with apical periodontitis were evaluated independently by 2 endodontists and 1 radiologist based on 128 cone-beam computed tomography (CBCT) and 162 digital periapical radiography (DPR) images. Anatomical (size, relation with root, location of periapical radiolucency) and treatment-related (canal obturation length, homogeneity, coronal seal) parameters were assessed. Fleiss kappa reflected inter-observer agreement while intra-examiner agreement was estimated by Cohen’s kappa. McNemar and McNemar-Bowker tests served for evaluation of differences between CBCT- and DPR-based estimates.ResultsCohen’s kappa ranged from 0.62 to 1 for all examiners. Fleiss kappa values were nearly perfect for majority of parameters. Diagnostic discrepancy between methods was found for size of radiolucency that in 15 - 17% cases was larger, and in 25 - 28% smaller in DPR than in CBCT images. DPR revealed 20% of root canals scored as non-obturated while in CBCT - obturation present. Canal obturation was rated as homogenous by CBCT, while absent or non-homogenous by DPR, in 17 - 23%, and 11 - 14% of cases, respectively. Radiologist detected more root perforations in CBCT than in DPR images.ConclusionsGood intra- and inter-examiner agreement for anatomical and treatment-related diagnostic parameters was achieved using cone-beam computed tomography and digital periapical radiography methods and demonstrated similar diagnostic capability, although variation regarding root perforations and canal obturation quality was observed.

Apical periodontitis in relation to radiographic quality of endodontic treatment in a selected adult Turkish population: A cross-sectional study

Objective: The aim of this study was to examine the quality of root canal fillings and their relationship with apical periodontitis (AP) in a selected Turkish population. Material and Methods: The cases in this study was formed of patients attending routine dental treatment at the Faculty of Dentistry, University of Birun. 1024 patients were examined with panoramic radiographs and 1780 endodontically treated teeth with present periapical radiographs. Endodontic treatment quality was evaluated by obturation length, density, taper quality and iatrogenic errors. Presence of AP was analysed according to Ørstavik’s periapical index (PAI). The chi-square test was used for statistical analyses. Results: Statistically significant relationship was found between both the tooth type and location with obturation quality (p: 0.000; p &lt; 0.05). Obturation quality of maxillary and mandibular molars are significantly less than the other tooth types in the same location. Apical periodontitis were noticed in 740 teeth (41.6%). Inadequate obturation quality was found to be significantly effective on the periapical status of tooth types both in maxilla and mandible (p &lt; 0.05). Conclusion: The frequency of inadequate root canal obturations of endodontically treated teeth of the selected Turkish population was high, especially in molar teeth and women. Even though radiographic obturation quality is not the only success criteria in endodontic treatment, it is still one of the most important criteria regarding the positive correlation of “inadequate” obturations with AP.KEYWORDSPeriapical periodontitis; Radiography; Root canal obturation; Root canal theraphy.