Obturation Techniques Research Articles

The effect of sealer type and obturation technique on the fracture resistance of endodontically treated roots.

This study evaluated the effect of sealer type with various obturation techniques on the fracture resistance of root filled teeth. Eighty mandibular premolars were collected, and root canals of 70 of them were prepared by Mtwo system up to 40/04. Thirty teeth were obturated using TotalFill BC sealer, and 30 using AH Plus sealer, with one of the obturation techniques (N = 10), namely cold lateral compaction (CLC), warm vertical compaction (WVC), and single cone (SC). Ten teeth were left without obturation as a positive control, and the other 10 teeth were not prepared serving as a negative control. Teeth were stored for 3weeks, and the crowns were separated and the roots were subjected to fracture test using a universal testing machine. Data was analyzed by ANOVA followed by Tukey's test. Fracture resistance of the TotalFill groups was significantly higher than the AH Plus groups in each obturation technique, and SC had the highest fracture resistance regardless of sealer used (P < 0.05). Obturation of the root canal by TotaFill BC sealer increased the calcium/phosphorous ratio in the dentin of the root. Obturation with TotalFill BC sealer improved the fracture resistance of the roots more than AH Plus sealer, and obturation with SC resulted in higher fracture resistance than CLC and WVC. Obturation of the root canal with Bioceramic sealer with single cone obturation technique could reduce the incidence of vertical root fracture.

Evaluation of Different Techniques and Materials for Filling in 3-dimensional Printed Teeth Replicas with Perforating Internal Resorption by Means of Micro–Computed Tomography

IntroductionThe aim of this study was to evaluate the filling ability of 2 obturation techniques in 3-dimensional (3D) printed teeth with perforating internal resorption (PIR). MethodsA maxillary central incisor was instrumented and scanned by micro–computed tomographic (micro-CT) imaging. The 3D model was exported in the stereolithographic format and, with the aid of OrtogOnBlender software (Cícero Moraes, Sinop, SP, Brazil), a PIR in the middle third of the root canal was designed. Thirty-two replicas were printed in surgical resin and distributed into 4 groups (n = 8) according to the obturation technique and the material used: 2 groups used the hybrid technique, 1 with Bio-C Sealer (BCS; Angelus, Londrina, PR, Brazil)/gutta-percha (GP; VDW GmbH, Munich, Germany) + Bio-C Repair (BCR; Angelus, Londrina, PR, Brazil) and the other with BioRoot (BR; Septodont, Saint Maur des Fosses, France)/gutta-percha (GP) + Biodentine (BD; Septodont, Saint Maur des Fosses, France), and 2 groups used the incremental technique, 1 with BCR and the other with BD. Postobturation micro-CT imaging was performed to measure the percentage volume of voids and laser confocal microscopy to measure the surface roughness (μm) of the repair cements. Data were compared using analysis of variance and Kruskal-Wallis tests. ResultsRegarding the filling volume in the apical third, the BCS/GP + BCR (89.70 ± 5.15), BR/GP + BD (87.70 ± 8.43), and BCR (84.20 ± 9.00) groups showed the highest percentages compared with the BD group (69.70 ± 6.88) (P < .05). In the area of internal resorption, the BCS/GP + BCR (96.00 ± 2.64) and BCR (95.30 ± 2.93) groups showed the highest percentages compared with the BR/GP + BD group (91.50 ± 1.35) (P < .05). The BD group showed intermediate values that were sometimes similar to the BCS/GP + BCR and BCR groups and similar to the BR/GP + BD group (P > .05). Regarding the quality of the filling in the perforation area, the BCR group showed better results compared with the BD group (P < .001). Regarding roughness, the BCR group (1.66 ± 0.65) showed lower surface roughness compared with the BD group (2.51 ± 0.89) (P < .05). ConclusionsThe capacity and quality of the filling in teeth with PIR were superior with the incremental technique with BCR and the hybrid technique with BCS/GP + BCR.

Effectiveness of Four Different Obturation Techniques on the Penetration Depth of Bioceramic Sealers into the Dentin Tubules: An In Vitro Study

Introduction: We aimed to assess the penetration depth of bioceramic sealers into the dentin tubules following different root canal obturation techniques included (A) warm vertical compaction, (B) carrier-based technique, (C) cold lateral compaction, and (D) single-cone obturation. Methods: This study utilized 40 extracted lower first premolars with developed apices and circular and straight root canals. The roots were eliminated to achieve an 11-mm length with a coronal flat measurement point. ProTaper Next rotary system was used for instrumentation. For obturation procedures, gutta-percha and Bio-C bioceramic sealer were employed, and the roots were randomly divided into four study groups, including (A) warm vertical compaction, (B) carrier-based technique, (C) cold lateral compaction, and (D) single-cone obturation. Depth of sealer penetration into the tubules was assessed using scanning electron microscopy. Result: We found significant differences in the penetration depth of bioceramic sealers based on obturation techniques (p &lt; 0.001), location of dentin tubules (coronal, middle, or apical third) (p &lt; 0.001), and the interaction between obturation techniques and location (p = 0.042). Conclusion: The warm vertical compaction and carrier-based technique showed superior penetration depth into the dentin tubules.

Fracture Resistance of Roots Obturated with Bioceramic and Epoxy Resin- Root Canal Sealers Using Different Obturation Techniques: An Ex-vivo study.

Fracture Resistance of Roots Obturated with Bioceramic and Epoxy Resin- Root Canal Sealers Using Different Obturation Techniques: An Ex-vivo study.

Influence of sealer type on treatment outcome of teeth with apical periodontitis: a systematic review.

The purpose of this article was to Evaluate the influence of sealer on the outcome of non-surgical endodontic treatment or retreatment of permanent teeth with apical periodontitis (PROSPERO registration: CRD42020205951). A systematic review of original clinical studies was carried out following PRISMA guidelines to answer whether the type of sealer used in endodontic treatment or retreatment influences the repair of apical periodontitis determined by clinical and radiographic parameters. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library database, until May 2023. Gray literature and a hand search of reference lists were also performed. The risk of bias was assessed using Cochrane RoB2 for randomized trials and the Newcastle-Ottawa Scale (NOS) for prospective and retrospective cohort and case-control studies. Among 1046 studies, a total of 819 were selected by title and abstract, resulting in 23 for full-text review. In total, 11 studies met the inclusion criteria (1467 patients/teeth with apical periodontitis). The quality assessment using RoB2 included five randomized control trials, of which four had medium risk and one had a low risk of bias. According to the NOS scale, five studies were classified as low risk and one study was considered as medium risk of bias. The sealer type and obturation techniques varied, and the mean follow-up time was 3.7 years. Most studies used two-dimensional radiographic criteria to assess the treatment outcome sealers and not cements. Eight studies did not find significant differences when comparing cements. The healing rates ranged from 56.7% to 90%. The results of this review support that the current endodontic sealers do not seem to influence the treatment outcome of permanent teeth with apical periodontitis. Although the studies had medium and low risk of bias, the results should be interpreted with caution. More randomized studies of long-term outcomes comparing filling materials are needed to strengthen this claim and allow for a meta-analysis.

An In Vitro Comparative Study of the Push-out Bond Strengths of Various Endodontic Sealers to Radicular Dentin.

The bond strength of an endodontic sealer to the root dentin is an important factor in maintaining the integrity of the root canal seal. The present study aimed to assess the push-out bond strength of three endodontic sealers used with the single-cone obturation technique. The root canals of 40 central maxillary incisors were instrumented using ProTaper Universal NiTi rotary files. The roots were divided into 4 groups (N = 10) according to the type of root canal sealers: Group 1 (control group): AH Plus/Gutta-percha lateral condensation technique (LC); Group 2: AH Plus/Gutta-percha single-cone technique (SC); Group 3: GuttaFlow 2/SC; Group 4: Realseal SE/SC. After obturation, each tooth was prepared for push-out assessment. The total and sectional push-out bond strengths were measured and statistically analysed. Furthermore, failure modes were identified microscopically. The results indicated that samples in the first group showed the highest total and sectional bond strengths. Samples from other groups showed statistically similar total bond strengths. The highest sectional bond strength was found mainly in the apical root sections. Cohesive failure was predominant for the first group, whereas adhesive failure was predominant in the other groups. It could be concluded that the dentin bond strengths of the tested sealers used with the single-cone technique were nearly similar but lower than those of AH Plus/LC. The highest sectional bond strength was observed in the apical thirds. The failure mode was mostly cohesive for AH Plus/LC and adhesive for sealers used with the single-cone obturation technique.

Comparing and evaluating the obturation techniques by 3 type of delivery system: An invitro method

: The purpose of this study was to compare in vitro three methods of root canal obturation technique in deciduous dentition using conventional radiographic technique.: 45 root canals of primary molars were prepared by regular manual technique and obturated using zinc oxide eugenol and calcium hydroxide-based syringe form. Obturation methods compared were lentulo spiral, plugger and Iodontin syringe form. Conventional radiographic technique was used to evaluate the Root canal length, Obturation and the presence of voids. The obtained data were analyzed using Chi-square test.The results showed significant differences between the three groups for the radioopacity of obturation (P &amp;#60; 0.05). The results showed Iodontin syringe form has fewer voids compared to lentulo spiral ZOE paste and Plugger for obturation quality. Statistically significant difference was found between Iodontin syringe form and Plugger technique (p= &amp;#60;0.05).: Iodontin syringe form showed the best results in the length of obturation and as well as controlling paste extrusion through the apical foramen. The lentulo spiral and plugger can also be used as an alternative method.

“Effect of Heat Generated by Endodontic Obturation Techniques on Bond Strength of Bioceramic Sealers to Dentine”

IntroductionGutta-percha combined with an endodontic sealer remains the most widely used obturation technique. Bioceramic sealers (BS) were developed for root canal obturation in combination with gutta-percha cones using the cold single-cone technique. Few studies have assessed the effect of thermal treatment on the performance of BS. The present study evaluated the effect of heat on BS adhesion to root dentine in the apical third of the root canal of extracted human lower premolars. Materials and MethodsThree BS combined with a hydraulic condensation technique, a warm vertical compaction technique, and a carrier-based technique were evaluated. Sixty three lower premolars were prepared following the same surgical protocol to standardize root canal shape at the level of the apex, randomly assigned to one of nine groups, and obturated accordingly. One millimeter-thick sections were subjected to a push-out test using a universal testing machine and classified according to mode of failure. Two-way ANOVA was applied using SPSS software (IBM Corp). ResultsNo significant differences in maximum load or failure mode were observed among BS, techniques, or when considering the interaction between sealers and techniques. ConclusionsThe heat generated by the obturation techniques used here did not affect BS adhesion to the dentinal wall.

Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment.

The aim of the study was to evaluate the impact of kinematics and irrigation protocols on the extrusion of apical debris during removal of different obturation techniques. A total of 144 single-rooted teeth were instrumented and obturated with Thermafil+AH Plus, Thermafil+AH Plus Bioceramic and single gutta-percha cone+AH Plus Bioceramic. Samples were divided according to the retreatment kinematics: continuous rotation or Jeni motion. Each sub-group was subjected to conventional irrigation or irrigation activated by EDDY. Extruded debris was collected in Eppendorf tubes, weighted and retreatment time was digitally recorded. Data were analysed with two-way ANOVA (p < 0.05). Debris extrusion was not significantly different between all groups. EDDY activation system and CanalPro Jeni required significantly longer time compared with other groups to remove Thermafil+AH Plus and single cone+AH Plus Bioceramic. Within current limitations, obturation technique, irrigation protocol and kinematics tested had no influence on apical extrusion debris, while they significantly impacted the retreatment time.

Clinical Approaches to the Three-Dimensional Endodontic Obturation Protocol for Teeth with Periapical Bone Lesions

Knowledge of dental anatomy and the three-dimensional principles of debridement, sterilization and obturation is necessary for effective root canal treatment. The chemo–mechanical preparation of the root canal biomechanically significantly reduces the number of microorganisms present. However, research has demonstrated that microorganisms frequently persist. The antimicrobial effect of the irrigants is essential to their biological function. Several obturation techniques are currently available, the selection of which depends on the canal’s morphology and the individual therapeutic goals of each instance. New sealing materials and methods for regenerative root canal obturation are enhancing and improving the predictability of three-dimensional (3D) sealing procedures. Epoxy sealers and gutta-percha are currently employed by clinicians as the gold standard in obturation procedures. The most recent developments in endodontic sealing materials are related to bioceramic sealers. Reports indicate that bioceramic sealers are biocompatible, harmless, hydrophilic, expandable and antibacterial. In the therapy of teeth with periapical lesions, not only the effective treatment of the root canal system but also the quality of the used sealer are of particular importance. Regenerative processes in the bone lesion are potentiated by the action of the sealer due to its highly biocompatible, non-toxic, aluminum-free and antibacterial capabilities. This paper discusses sophisticated root canal sealing materials and contemporary filling techniques in the regenerative therapy protocol for teeth with periapical bone lesions.

Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study.

To evaluate the clinical outcome of root canal treatment by obturation technique, root canal filling quality, and tooth- and patient-related variables. This clinical study investigated the endodontic outcome of 114 teeth treated between the years 2009 and 2012. Three different obturation methods were used: (1) adhesive obturation using the continuous wave of condensation technique with Resilon® (CWR), (2) matching-taper single-cone technique with gutta-percha and AH Plus® (SCGP), and (3) matching-taper single-cone technique with gutta-percha and GuttaFlow® (SCGF). Pre- and postoperative periapical radiographs were performed to detect the presence of endodontic lesions (PAI classification) and to assess the quality of both the obturation and the restoration. Tooth- and patient-related data were collected. The overall endodontic success rate was 75.4% after a mean observation period of 6.3 years. There were no significant correlations between the type or overall quality of obturation and the treatment outcome. Teeth with preoperative lesions had the highest odds ratio (factor of 4.98) for endodontic failure. Tooth- and patient-related variables had no significant effect on endodontic outcome. The preoperative periapical status of teeth requiring endodontic treatment was a substantial prognostic factor for endodontic outcome, whereas the type of obturation material or technique did not affect it.

External Root Surface Temperature Control with 1,1,1,2-Tetrafluoroethane Intracanal Cryotherapy during Thermoplastic Obturation: An In Vitro Study.

The aim of this in vitro study was to determine the effectiveness of 1,1,1,2-tetrafluoroethane (TFE) intracanal cryotherapy for external root surface temperature control during thermoplastic obturation. Thirty extracted adult single-rooted mandibular incisors were selected for this study. Endodontic shaping was performed until size X3 Protaper Next Rotary endodontic file. The teeth were divided into three groups: Group I-Control group wherein conventional irrigation was done using physiologic saline stored at room temperature, Group II-Irrigational Cryotherapy group using physiologic saline at 2.5°C, and Group III-Intracanal TFE cryotherapy group with intracanal refrigerant TFE application. Temperatures were recorded in the apical 3 mm before and after completion of each intervention and post thermoplastic obturation using a noncontact digital laser infrared thermometer. Intracanal cryotherapy with TFE resulted in a mean decrease of 9.27°C compared with conventional irrigation that exhibited in a mean decrease of 2.13°C. Also, in intracanal cryotherapy group with TFE application, compared with the baseline (24.50°C), no significant differences were observed post obturation (24.61°C) with high-temperature-injectable gutta percha technique indicating good control of temperature rise on the external root surface. Intracanal cryotherapy with refrigerant TFE was highly effective in controlling temperature rise on the external root surface during injectable thermoplastic obturation technique. Minimizing deleterious effects due to high temperatures generated during the thermoplastic obturation is critical. Clinically feasible measures to reduce the transmission of heat generated during thermoplastic obturation have been searched since long. In this regard, intracanal cryotherapy with TFE can be effectively used to control the rise of temperature on the external root surface when employing thermoplastic obturation technique.

Cone-Beam Computed Tomography Evaluation of Rotary MM Files vs Manual K Files in Primary Molars: An In Vitro Study.

Rotary instrumentation in pediatric dentistry is an emerging concept, thus this study was performed to evaluate the remaining dentine thickness (RDT), canal transportation, centering ability, quality of obturation using cone-beam computed tomography (CBCT), and the time efficiency of rotary versus manual instrumentation in mandibular second primary molars. Forty mandibular primary second molars (160 canals) were randomly and equally allocated to four groups. Instrumentation was done using K files in groups I and II; in each group, the obturation was done by two different obturation techniques; incremental technique and disposable syringe technique, respectively. MM rotary files (Innovative Material and Devices, Inc. [IMD], Shanghai, China) were used in groups III and IV; in each group, the obturation was done by incremental technique and disposable syringe technique. Preoperative and postoperative CBCT scans were performed and evaluated for the RDT, centering ability, canal transportation, and the canal filling quality, which was assessed as (underfill, optimal fill, and overfill). Instrumentation time was recorded for groups I and II collectively (manual instrumentation), and groups II and III collectively (rotary instrumentation). Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey tests, at p < 0.05). The MM rotary file removed a significantly less amount of dentine at all levels specifically at the middle section (p = 0.003). The canal transportation was significantly higher in the manual group at the cervical level (p = 0.022). In all sections, the rotary group had significantly higher values of centering ratio than the manual group (p < 0.05), which means a lower deviation of rotary instruments. For both types of files, there was no significant difference between different obturation techniques (p > 0.05). Instrumentation time was significantly lower in the rotary group (p < 0.001). Regarding the dentine removal and the shaping ability of MM files acceptable results were obtained; however, no significant difference between the different obturation techniques. Notable time efficiency was reported in the rotary files as well. The use of rotary files resulted in better conservation of tooth structure, better canal centering, and obturation quality as well as less canal transportation and less instrumentation time compared to manual K files.

Prevalence of Teaching Apical Patency and Various Instrumentation and Obturation Techniques in United States Dental Schools: Two Decades Later

IntroductionMaintaining apical patency has been advocated to minimize canal transportation, ledge formation, and loss of working length, despite increasing debris extrusion. A previous study in 1997 by Cailleteau and Mullaney reported 50% of United States dental schools taught patency. This present study aimed to evaluate recent trends in endodontic education in United States dental schools, in relation to the prevalence of maintaining apical patency and examining the primary methods of working length determination, instrumentation, obturation, and temporization. MethodsA survey of 20 questions was distributed to 65 schools via e-mail and was available from July 2021 to September 2021. ResultsSeventy-three percent of the 46 responding schools reported that they teach patency, with 8% of this number reporting that they do so exclusively to endodontic residents. Notably, a significantly lower number of schools reported teaching patency exclusively to endodontic students compared with the Cailleteau and Mullaney study despite a significantly higher percentage of schools teaching patency overall. The most common method used to determine working length was an electronic apex locator at the 0.5 reading. Vortex Blue was the most commonly used file system used by both predoctoral and postdoctoral programs. Lateral condensation was the primary obturation technique taught in predoctoral programs, whereas warm vertical condensation was the primary obturation technique in postdoctoral programs. The study also found that 57% of schools reported using intraorifice barriers, and the most common temporary filling was glass ionomer. ConclusionsA greater portion of schools teaches patency compared with the previous study in 1997. The data collected in this survey may serve as a baseline for similar studies in the future regarding changes in endodontic education over time.

A Comparative Evaluation of Efficacy of Various Obturating Techniques for the Presence of Voids.

Evaluation of the efficacy of different obturating techniques and assessment of the presence of voids in different regions of the canal. Sixty permanent single-rooted teeth with complete, mature root apices without any anatomic variation having straight patent root canals were included in the present study. Access cavity preparation followed by biomechanical preparation was done. Samples were divided into three groups-Group A: Single cone obturation, Group B: GuttaFlow 2, and Group C: GuttaCore, and obturation was carried out. The samples after obturation were stored at 370°C and 100% humidity in an incubator for 7 days to give adequate time for obturating materials to set. Cone beam computed tomography was performed with i-cat Cb 500 machine. The voids were checked on the root canal wall. The statistical analysis was done and the data after the statistical analysis was presented. GuttaCore obturators presented a lesser volume of voids followed by GuttaFlow 2 than the single cone techniques. All the obturation techniques presented an inadequacy of obturation when the pre- and post-obturated volume of the root canal space was calculated. However, no statistically significant obturated volume differences were found between single cone and GuttaFlow 2 or between GuttaFlow 2 and GuttaCore system.

Evaluation of Retrievability of a Novel Bio-ceramic Material Using Two Different Obturation Techniques. (In Vitro Study)

Evaluation of Retrievability of a Novel Bio-ceramic Material Using Two Different Obturation Techniques. (In Vitro Study)

The role of micro-endodontics in the management of complex root canal anatomy

Micro-endodontics has emerged as a critical component in endodontics, revolutionizing the management of complex root canal anatomy. It utilizes magnification devices, such as dental operating microscopes or loupes, to enhance visualization and identify intricate anatomical details. Micro-endodontics encompasses advanced techniques and technologies that are utilized alongside the principles of conventional endodontics. While both approaches share common goals of cleaning, disinfection, and obturation of the root canal system, micro-endodontics specifically focuses on managing complex root canal anatomy by utilizing specialized tools and techniques to enhance visualization, instrumentation, disinfection, and obturation. Ultrasonic instruments aid in negotiating challenging canal configurations and removing obstructions. Nickel-titanium rotary instruments offer flexibility and durability for efficient cleaning and shaping. Advanced irrigation techniques, such as ultrasonics and laser-activated irrigation, improve disinfection. Innovative obturation techniques ensure the thorough filling of intricate canals. Despite limitations like cost, learning curve, treatment time, and access limitations, micro-endodontics has a promising future. Technological advancements, minimally invasive approaches, biomaterials, biotechnology, artificial intelligence, robotics, and interdisciplinary collaboration will further enhance micro-endodontics, improving treatment outcomes and expanding its scope in complex root canal anatomy.

Clinical applications of calcium silicate-based materials: a narrative review.

Calcium silicate-based materials are hydrophilic materials with biocompatibility and bioactivity properties. Despite many advantages, they might present some problems related to discolouration, setting time, manipulation and solubility depending on the composition of the product and the type of clinical application. Calcium silicate-based materials can be evaluated under two types according to their intended use: calcium silicate-based cements (CSCs) and calcium silicate-based sealers (CSSs). CSCs can be used in many endodontic procedures including perforation repair, resorption repair, apical barriers, guided endodontic repair, vital pulp treatment, endodontic surgery, root fractures and root canal filling as a core obturation material. CSSs are available for use with gutta-percha to obturate root canals using cold and warm techniques, including the sealer-based obturation technique. The purpose of this review is to evaluate the available literature on CSCs and CSSs and to provide up-to-date information and recommendations for their clinical applications.

Assessment of isthmus filling using two obturation techniques performed by students with different levels of clinical experience

Background/purposeRoot canal filling is a necessary skill for dental students and an important aspect of endodontic education. This study aimed to evaluate the effect of students’ clinical experiences on isthmus filling using different techniques and sealers. Materials and methodsOne hundred eight three-dimensional-printed resin replicas of isthmus were divided into six groups and either continuous wave of condensation (CWC) or single-cone obturation (SC) was performed. One of three sealers (AH Plus Jet®, GuttaFlow2, iRoot SP) was used together with a size-fitted gutta-percha master cone. All the obturations were completed by students with three different levels of clinical experience including senior postgraduate students (SPS), junior postgraduate students (JPS), and undergraduate students (US). The percentages of filled areas (PFA) at 2, 4, 6, and 8 mm from the apex were analyzed using a light microscope. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis 1-way ANOVA with Dunn's tests (α = 0.05). ResultsThe CWC group exhibited a higher PFA than the SC group (P < 0.05). The PFA was higher in the SPS group than in the JPS group or the US group with CWC (P < 0.05). The three clinical experience groups showed similar PFAs with SC (P > 0.05); however, when using SC with iRoot SP, the PFA was higher than with either of the other two sealers (P < 0.05). ConclusionCWC was found to be technique-sensitive and required clinical training. With SC, clinical experience did not improve the quality of isthmus filling without additional training. CWC was superior to SC for type IV isthmuses. When using SC, better filling quality was obtained with a bioceramic sealer.

Comparative Evaluation of Four Different Obturating Techniques in Primary Teeth Using Cone-beam Computed Tomography: An In Vivo Study.

The quality of the obturation plays a significant role in the success of endodontic treatment. To date, various technologies have been used to evaluate the quality of obturation, but all of them have their own limitations. In order to overcome those limitations, recent technological advancements like cone-beam computed tomography (CBCT) can be helpful. To compare and evaluate the efficiency of different root canal obturation techniques in primary teeth using CBCT. A total of 80 root canals in 30 children aged between 4 and 9 years were selected and divided into four groups, with 20 root canals in each. Obturation in group I was performed using the endodontic pressure syringe; group II-hand spreaders; group III-Lentulo spirals mounted on slow-speed handpiece; and group IV-insulin syringe. The quality of obturation was evaluated using a CBCT scan. Group I samples showed the most optimally filled canals followed by II and III; least in group IV. A maximum number of overfilled canals was exhibited in group III samples. Voids were minimal in all four groups and the values obtained were not statistically significant. Obturation with an endodontic pressure syringe reported the highest number of optimally filled root canals and the insulin syringe showed the least number of optimally filled canals. Ali SM, Mukthineni S, Sai Sankar AJ, et al. Comparative Evaluation of Four Different obturating Techniques in Primary Teeth using Cone-beam Computed Tomography: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):218-222.