Obturator Procedure Research Articles

Root canal cleanliness and debris extrusion following retreatment of thermoplastic injection technique and bioceramic-based root canal sealer.

To evaluate the amount of apically extruded debris and to determine the remaining filling material on the root canal walls by microcomputed tomography (micro-CT), following the root canal retreatment of root canals filled with different obturation techniques (single cone technique, thermoplasticised injection technique) and the different root canal sealers [bioceramic-based, epoxy resin-based root canal sealer]. 60 single rooted human premolar teeth were prepared with the ProTaper Gold system (Dentsply Maillefer) up to the F4 file and the samples were divided into 4 groups according to obturation procedures: Single cone technique + AH Plus sealer(epoxy resin-based root canal sealer, Dentsply International Inc., York, PA, USA); Single cone technique + Sure-Seal Root(bioceramic-based root canal sealer, Sure Dent Corporation, Gyeonggi-do, South Korea); thermoplastic injection technique[Calamus Dual Obturation System(Dentsply-Tulsa Dental, Tulsa, OK, USA)] + AH Plus(Dentsply International Inc.); Sure-Seal Root(Sure Dent Corporation) + Calamus Dual Obturation System (Dentsply-Tulsa Dental). The teeth were inserted into preweighed Eppendorf tubes and retreatment was performed. The tubes were kept in an incubator at 37°C for 14days to obtain the dry debris weight. Following the removal of the root canal fillings, the samples were scanned with a micro-CT device to analyse the volume of filling residues. Retreatment of samples obturated with epoxy-resin or bioceramic based root sealers combined with Calamus system resulted in higher amount of apical extrusion compared to their combination with single cone technique (p = 0.026 for Single cone technique + AH Plus sealer vs Calamus + AH Plus sealer and p = 0.005 for Single cone technique + Sure-Seal root sealer vs Calamus + Sure-Seal root sealer). The most debris was observed in the Calamus + Sure-Seal root sealer group, the least debris was observed in the Single cone technique + AH Plus sealer group. The percentage of residues was the highest in the Single cone technique + Sure-Seal root sealer and the lowest in the Calamus + AH Plus sealer group, but there were no significant differences between groups (p = 0.463). No correlation was observed among the groups in terms of extruded debris and remnants inside the root canal. When combined with bioceramic based sealer, thermoplasticised injection technique did not affect the cleanliness of root canal walls; however, it increased its apical extrusion potential during retreatment. The obturation method does not play a role in the removability of bioceramic based root canal sealer, however the use of bioceramic-based root canal sealers with cold obturation techniques may be beneficial in preventing apical extrusion.

Hydraulic (Single Cone) Versus Thermogenic (Warm Vertical Compaction) Obturation Techniques: A Systematic Review.

Root canal treatment (RCT) involves cleaning and shaping of the root canal system before filling the canals with obturating materials, often gutta-percha (GP). The two primary obturation techniques are the thermogenic (warm vertical compaction, WVC) and hydraulic (single cone, SC) techniques.The objective of this study is to compare the clinical results and effectiveness of thermogenic and hydraulic obturation procedures in endodontic therapy to provide clinicians with evidence-based recommendations. Search strategies were conducted on February 01, 2024and involved the databasesWeb of Science, PUBMED, Google Scholar, Scopus, Medline, Embase, NCBI, and Cochrane Library.The current systematic review included systematic reviews; meta-analyses; cohort studies; randomized controlled trial (RCT) studies; studies involving the comparison between single cone and warm compaction techniques; studies involving outcomes that include advantages, disadvantages, and complications associated with single cone or warm compaction techniques; and studies published within the last seven years. The selected studies were restricted to those with insufficient data, review articles without authentic references, publications in a language other than English, animal studies, and studies not involving SC or WVC. Out of 2300 studies registered, only 12 studies were included in the review. Both WVC and SC techniques showed satisfactory root canal fillings. However, five studies showed differences in the filling quality, four studies assessed the sealing ability and the dentinal tubule penetration of sealers, one study compared dentinal cracks, one study evaluated the amount of debris excluded apically, and one study compared the post-operative pain while using both techniques. The WVC andSC obturation techniques offer advantages and disadvantages in endodontic treatment. SC obturation is a simple and efficient procedure that is particularly suitable for situations with uncomplicated canal structures. The WVC obturation approach provides superior flexibility and sealing capability, especially in the complex root canal system. When choosing the method of treatment, it is important to take into account the patient's preferences, the clinician's experience, and unique considerations related to the situation. This systematic review highlights the important recommendations to healthcare professionals in selecting the most suitable obturation procedure based on the specific requirements of each clinical scenario. Research involving long-term follow-ups is required to get a better understanding of the outcomes of long-term goals. Clinical relevance: ability to educate clinicians regarding the best obturation technique between thermogenic and hydraulic. It directs the treatment decisions to maximize patient's comfort, minimize post-operative complications, and improve efficacy in endodontic practice.

Comparative evaluation of push-out bond strength and mode of failure of three different obturating materials: An in vitro study.

This research aimed to assess the push-out bond strength (PBS) to dentin of three distinct obturation materials inside the root canal and identify the failure mechanism. The research used 30 undamaged human mandibular premolars. The specimens were randomly assigned to three groups, each employing a different sealer (n = 10). Group 1 used AH Plus sealer, Group 2 used GuttaFlow-2 sealer, and Group 3 used bioceramic sealer (CeraSeal). The obturation procedure was performed utilizing the single-cone method with gutta-percha. The specimens were divided into sections and loaded using a universal testing machine. Following PBS testing, every sample underwent a stereomicroscope examination, and the specific failure mechanism was documented. The average PBS was greatest for AH Plus, followed by CeraSeal and Guttaflow-2. Notable disparities existed between the coronal and apical levels. AH Plus exhibited superior PBS qualities to root dentin compared to other sealers.

OBTURATION AND DIFFERENT OBTURATION TECHNIQUES- A REVIEW

The crucial stage of obturation completes the endodontics triad. Achieving a fluid tight seal and performing an obturation correctly and appropriately are critical to the outcome of endodontic treatment. Among the several obturation procedures available, selecting a specific technique depends on the anatomy of the root canal and attaining case-specific goals. Warm vertical compaction and lateral condensation are the two fundamental obturation techniques. Modern tools and methods have emerged, like those that use vibration and heat to cause the obturating material to condense and compact. These innovations have fundamentally changed the field of endodontics and increased the predictability of obturation success.

Challenges faced by final year dental students and house officers while performing endodontic treatment.

Objective: To identify the challenges faced by final year dental students and house officers while performing endodontic treatment. Study Design: Cross sectional study. Setting: Multicenter study. Setting: Involving Dental Colleges of Twin Cities Dental Hospitals of Islamabad and Rawalpindi including Islamabad Dental Hospital, Islamic International Dental Hospital, Pakistan Institute of Medical Sciences, Armed Forces Institute of Dentistry, Rawal Institute of Health Sciences and Margalla Institute of Health Sciences. Period: June 2023 to December 2023. Material & Methods: This cross sectional descriptive study was conducted on 263 participants. The inclusion criteria was final year dental students and house officers who had completed their mandatory rotation in endodontics department and performed root canal treatment with conventional methods. A structured questionnaire consisting of five sections containing patient management, access opening, working length determination, cleaning and shaping procedure and obturation was constructed. Google forms were sent to the participants after sample size was calculated with WHO calculator. Data was analyzed through Google forms. Results: The current study shows that majority of the participants faced difficulties in the patient management and obturation procedure. The overall most common difficulty encountered was rubber dam application (44.1%) followed by accessory GP bending during obturation (42%), apex locator use (39.4%), and canal orifice location (39.8%). Conclusion: The students and house officers are facing multiple difficulties in performing root canal treatment independently. Therefore there is a need to focus more on the training of students and house officers in their endodontic department rotation.

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

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. 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. 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. 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 Different Endodontic Access Cavity Designs with Different Burs-An in vitro Experimental Insight into the Aspect of Fracture Resistance.

In vitro fracture resistance of extracted mandibular molars treated with various access cavity designs, including traditional endodontic cavity (TradAC), conservative/contracted endodontic cavity (ConsAC), ninja endodontic cavity (UltraAC), truss endodontic cavity (TrussAC), caries-driven access cavity (CariesAC), and intact teeth, is the focus of this study. Six groups of 20 mandibular molars, totaling 120, were used in the investigation. While the other five groups underwent various access cavity preparations, chemomechanical preparation, and obturation procedures before being repaired with composite resin, Group 1 was left unaltered (the control). A 6 mm round head tip was used to apply the fracture force, which was measured in newtons, at a crosshead speed of 1 mm/min until fracture developed. According to the current study, the intact control group had the maximum fracture resistance. The access cavity groups' mean values were maximum in CariesAC followed by ConsAC, TrussAC, UltraAC, and TraditonalAC respectively. While among the four minimally invasive designs, CariesAC showed a higher fracture resistance despite the results being statistically insignificant, TradAC had a significantly lower resistance than other conservative access cavity designs.

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 < 0.001), location of dentin tubules (coronal, middle, or apical third) (p < 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.

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.

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

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

Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis

BackgroundDuring the obturation procedure, sealer extrusion occurs in some cases. iRoot SP is a kind of bioceramic sealer with superior physicochemical and biological properties. This article reports the outcome of iRoot SP extrusion in root canal treatment and the potential factors associated with the outcome.MethodsNinety-nine patients and one hundred and eighty-five teeth treated between 2014 and 2020 were included in this retrospective study. All of the cases were filled with a single-cone technique and the iRoot SP sealer. The minimum follow-up visit period was 1 year. The outcome was evaluated by clinical examination and radiographic examination at recall and was classified as healed, healing (success), or not healed (failure).ResultsThe overall success rate of all teeth was 96.8%. The success rate of adequately filled teeth was 97.3%, while that of iRoot SP extrusion was 95.8%; the difference was not statistically significant. Factors such as gender, age, tooth position, follow-up visit period, size of periapical lesion, treatment type and extruding sealer amount had no influence on the outcome of iRoot SP extruded teeth.ConclusionsThe results suggested that iRoot SP extrusion has no adverse effect on the outcome of root canal treatment, which may contribute to the endodontic treatment.

Comparative Analysis of Temperature Variation with Three Continuous Wave Obturation Systems in Endodontics: An In Vitro Study

The aim of this study was to assess temperature changes with different continuous wave obturation systems when downpacking to 2 mm and 4 mm from the apical foramen in an open system not simulating the surrounding biological structures at body temperature. Sixty single-rooted teeth were divided into three groups: (A) Dia-Duo® (DiaDent Group International, Cheongju-si, Korea), (B) Elements Free® (Kerr Corporation, Orange, CA, USA) and (C) Calamus® (Dentsply Sirona, Ballaigues, Switzerland). The root canals were instrumented with Protaper Gold (Dentsply Sirona, Ballaigues, Switzerland) to size F2 (25.08). The root canals were filled by a continuous wave using an AH Plus® sealer (Dentsply Sirona). Temperatures during the obturation procedure were measured by a thermal imaging camera (Testo 875-1®) perpendicular to a vice where the teeth were held at −2 mm and −4 mm from the apical foramen. Comparisons were made by applying Student’s t-test and ANOVA (p = 0.05). The continuous wave technique at −2 mm with the Dia-Duo system® emitted average temperatures of 37.3 °C, Elements Free® emitted 39.85 °C and Calamus® emitted 40.16 °C. At −4 mm, the Dia-Duo system® emitted average temperatures of 34.81 °C, Elements Free® emitted 33.73 °C and Calamus® emitted 32.91 °C. There were significant differences between continuous waves at −2 mm and at −4 mm (p < 0.05). Dia-Duo® was the only system that did not present significant differences between the two lengths (p = 0.197). Regarding the heat emitted, the best system was Elements Free®, since, at −2 mm, it emitted the highest temperature without going above 47 °C. The Dia-Duo® system had lower temperatures. It could be concluded that not all systems transmit the same temperature to the apex and, therefore, to the periapical tissues. The surrounding conditions, such as temperature and humidity, have not been considered in this study.

Current Trends in Root Canal Irrigation.

Chemical and mechanical root canal debridement are the primary methods used in endodontic therapy to remove all dead tissue, bacteria, and microbial byproducts from the canal. Sodium hypochlorite, a powerful organic tissue dissolver with a broad spectrum of antibacterial properties, is an excellent choice for disinfecting surfaces. Chelating agents, on the other hand, may be used to remove the inorganic components found on the smear layer. This irrigation method is capable of removing the smear layer; however, it is less effective in the apical third. While using irrigant activation devices, irrigating solutions need to be in direct contact with the whole root canal wall surfaces, especially in the apical portions of tiny root canals. The role of irrigants is extremely important because they help not only to clean the canal but also to allow the seepage of the medicaments into the canal system. Thus, the canal needs to be healthy before the obturation procedure. Nowadays, many irrigants have been studied and hence compilation of the various available sources and their effect has to be studied both in vivo and in vitro. The correlation between the irrigants and the canal cleanliness is of utmost importance, as the success of endodontic root canal treatment depends on its proper activation and characteristics. Hence, this review incorporates the current use of various irrigating solutions and their advantages and disadvantages. In the future, endodontists may employ the novel irrigants and irrigant activation devices that were discovered in this study.

Methods of obturation

After irreversible pulpal pathosis, obturation of a root canal should result in a full closure from the coronal to the apical aspect, limiting the entrance of microorganisms and fluid and therefore eliminating the root system as a source of infection and inflammation to the apical periodontium. According to current studies, the goal of obturation is to achieve not only a fluid-tight but also an airtight closure of the root canal. For obturation, semi-solid filler materials like gutta-percha have been employed in combination with sealants for many years. Poor obturation, according to Dow and Ingle, is the root cause of endodontic treatment failure. Ingle and Beveridge (1961) found that incomplete root canal obliteration accounts for roughly 58.65 percent of root canal failures in a research done at the University of Washington on the success and failures in endodontics. As a result, several obturation procedures have been developed over time. Every approach has its own set of benefits and drawbacks. As a result, the obturation procedure differs from instance to case.

Iatrogenic tooth discoloration by obturating materials: a literature review

Tooth discoloration might constitute a major problem for patients undergoing endodontic procedures, including obturation. Iatrogenic teeth discoloration might be a burden because it is time-consuming and hard to blench even if it were effective in removing the tooth stains in compared with traumatic tooth discoloration which is easy to deal with. Accordingly, clinicians must have a comprehensive understanding of the potential discoloration effects of the current sealers that are indicated for administration in many of the obturation procedures to enhance the prognosis and the relevant outcomes. In the present study, the aim to conduct a literature review about the potential iatrogenic discoloration effects of some endodontic sealers when conducting obturation procedures, based on the current evidence from the relevant studies. Among the reported agents to induce discoloration, calcium hydroxide, zinc oxide eugenol (ZOE), resin, glass ionomer, and silicon-based sealers have been reported to cause significant degrees of discoloration. Moreover, among the included studies AH-26 seems to be the least significant modality to include discoloration;however, discoloration could still be detected. With the recent technological advances, bioceramic sealers should be able to overcome this problem, especially for areas with the highest esthetic concerns. Accordingly, further investigations might be needed to enhance the quality of the current modalities and to obtain better outcomes.

GuttaFlow Bioseal as Monocone Obturation Technique in Curved Root Canals: A Scanning Electron Microscopy Study

The obturation quality of GuttaFlow Bioseal in curved root canals is not commonly investigated although there has been a current approach toward utilizing this material in extracted molars in recent years. This study assessed the obturated surface area, extrusion of root filling material beyond the apical foramen and duration of obturation procedure in curved root canals using monocone obturation technique. Access cavity was prepared in 20 human mandibular molars. Root canals with curvature of more than 10 as determined according to Schneider’s method were included. Samples were prepared using Hyflex CM rotary files and divided into two groups (n=10): Group 1 [gutta-percha cone and GuttaFlow Bioseal] and Group 2 [gutta-percha cone and RoekoSeal Automix root canal sealer]. The duration of obturation procedure was recorded and obturation radiographs were taken. Samples were bisected and the mesial roots were sectioned horizontally to obtain 3 root segments; apical, middle and coronal. All resected roots were mounted on brass stubs, sputter-coated with thin platinum coating and observed under scanning electron microscope (SEM) at 70x magnification. The SEM images were transferred to the SketchAndCalc Area Calculator software. No statistically significant differences in the obturated surface area and extrusion of root filling material were observed between Group 1 and 2, irrespective of the status of root canal curvature. Duration for obturation in severe root canal curvatures between Group 1 and 2 were statistically significant. Obturated surface area and extrusion of root filling material were not affected by the root canal curvature, however duration for obturation using GuttaFlow Bioseal in severe root canal curvatures was slightly longer.

A COMPARATIVE EVALUATION OF ANESTHETIC EFFICACY OF 4% ARTICAINE WITH 1:100000 EPINEPHRINE AND 2% LIDOCAINE WITH 1:100000 EPINEPHRINE FOR INFERIOR ALVEOLAR NERVE BLOCK AND LONG BUCCAL NERVE BLOCK DURING ROOT CANAL TREATMENT: AN IN VIVO STUDY

Background: It is important to control the pain associated with root canal treatment (RCT) in endodontic. Pain accompanying fear and anxiety due to endodontic treatment can be reduced by anesthetic techniques. The present study aims to compare the effect of articaine versus lidocaine local anesthesia for inferior alveolar nerve block (IANB) and long buccal nerve block on pain during RCT. METHODS: Twenty patients diagnosed with symptomatic irreversible pulpitis of mandibular posterior tooth were selected. The patients randomly received either cartridge of lidocaine or articaine using IANB and long buccal nerve block. The patients were randomly divided into two groups of ten. Group 1: patients received IANB and long buccal nerve block 2% lidocaine with 1:100000 epinephrine. Group 2: patients received IANB and long buccal nerve block with 4% articaine with 1:100000 epinephrine. Before the Injection, the patient received all information about the visual analysis scale (VAS). Pain was evaluated using VAS scale in numberic value 1 to 10 number. The pain was evaluated at three different stages: before administration of LA, after immediate access opening, and after immediate obturation procedure. Data were analyzed using various suitable statistical tests. RESULT: The mean value of efcacy of pain before administration of local anesthesia (LA) was 8.50 ± 0.97 for lidocaine and 8.30 ± 0.48 for articaine had no signicant difference. A signicant difference was observed at two different duration after immediate access opening and after immediate obturation where articaine has a lower mean value 3.60 ± 1.08 and 1.60 ± 0.17 respectively (P>0.05) as compared to the mean value of lidocaine 4.10 ± 1.10 and 1.60 ± 0.17 respectively Conclusion: Within the limitations of the study, in cases of symptomatic irreversible pulpitis articaine 4% did not alleviate pain much and showed better anesthetic efcacy than 2% lidocaine with IANB and long buccal nerve block.

Medium-term safety outcomes in patients undergoing tension free vaginal tape obturator for stress urinary incontinence in Murcia, Spain. Historical cohort

ABSTRACTObjective: Describe the medium-term safety of the tension free vaginal tape obturator (TVT-O) procedure in terms of complications, cure and changes in quality of life (QoL) after the surgery. Materials and methods: Descriptive historical cohort that included women over 18 years of age who underwent TVT-O due to objectively proven stress urinary incontinence, urethral hypermobility or mixed urinary incontinence in which the stress component predominated, confirmed on urodynamic testing between July 2013-April 2017, in a reference hospital located in the city of Murcia Spain. Women with previous anti-incontinence surgery, concomitant vaginal surgery and planning pregnancy were excluded. Follow-up was determined for each patient based on the time elapsed between surgery and the time when the research protocol was applied. Complications were stratified according to the modified Clavien-Dindo classification; also we evaluated subjective cure rate, quality of life using the ICIQ-SF score, before and after surgery.Results: The mean age was 52.6 (SD± 10.5) years and 80.1% of patients were at least overweight. The incidence of complications at 12 months was: 8.3% (12/144). We did not detect complications after this period in the followed patients at 24, 36 and 48 months. The subjective cure determined at 12, 24, 36 and 48 months was 62.5% (90/144), 59.09% (55/88), 50.81% (31/61) and 50% (7/14), respectively. There was a significant improvement in quality of life, as determined by the ICQ-SF mean score before and after surgery (13.76[6,34] vs 3.84[5.76]; p<0.05).Conclusions: The TVT-O surgery is a safe therapy associated with a low complication incidence at 12 months, an acceptable subjective cure rate in stress urinary incontinence, and quality-of-life improvement. Classifications of complications related to the insertion of the prosthesis and of those inherent to surgery, such as urinary tract infection, are required.

THE OROANTRAL FISTULA: A CASE REPORT

Introduction: An unnatural communication between the maxillary sinus and oral cavity is known as “oroantral communication”(OAC) and if it does not close spontaneously, it is epithelialized so that oroantral fistula develops.(2) The most common cause of oroantral fistula is the extraction of a maxillary molar or premolar.(2,11) The close relationship between the apex of these teeth and the thinness of the antral floor explains this.(11) From simple local methods like buccal advancement flap to complex distal flaps and grafts, various methods have been described in the literature for the closure of these communication.(2) To facilitate gravitational drainage and aeration via an inferior meatal antrostomy and to remove irreversibly damaged mucosa of the maxillary sinus, Caldwell Luc procedure was designed.(10) Objective: To describe a case report of oroantral fistula [OAF] and its closure. Case Report: We repot a case of 28 years old male patient who came to our attention for the presence of the OAF and presence of maxillary third molar root piece in the maxillary sinus. This patient was treated by“ OBTURATOR procedure.”

Obturation an Overview

The triad of endodontics is incomplete without the vital step of obturation. The success of an endodontically treated tooth vastly relies upon achieving a “fluid tight seal” carrying out an obturation adequately and accurately. Choosing a particular technique among several obturation techniques available is based upon the anatomy of the root canal and achieving certain objectives specific to each case. The two basic obturation procedures are lateral condensation and warm vertical compaction. There has been an advent of newer devices and techniques, such as those which employ heat and vibration for condensation and compaction of the obturating material, dramatically transforming the practice of endodontics and making success of an obturation more predictable. This article briefly covers the obturating materials and the techniques used for obturation along with their present status in today’s endodontic practice. Keywords: Guttapercha, Obturation, Obturation technique, Obturating material.