Quality Of Obturation Research Articles

Comparative evaluation of different obturation techniques in primary molars: An in vivo study

Abstract Aim: The study was undertaken to compare the filling quality of a 30 gauge cannula (NaviTip™, Ultradent Inc., South Jordan, UT, USA) used on a pressure syringe with a lentulospiral in primary molars. Materials and Methods: Thirty mandibular first and second primary molars in 28 healthy children of both sexes in the age group of 4-8 years were included in the study. All pulpectomy procedures were performed by one investigator. Before obturation, the subjects were randomly selected for the two obturation techniques. Effectiveness of the two obturation techniques was assessed by three independent evaluators using postoperative radiographs taken immediately after each obturation. Filling quality was determined by analyzing presence or absence of voids, extent of fill and apical seal. Results: The results of the obturation quality of the tested techniques were collected and statistically analyzed using chi-square test. There was a significant difference for the presence of voids between the two groups. NaviTip group showed the best results for the number of voids (mesial χ2 = 3.567, P = 0.0497) (distal χ2 = 5.058, P = 0.0269). The lentulospiral group showed more number of optimal fillings. When results were compared in terms of apical seal, NaviTip showed better apical seal but statistically no difference (P >.05). Conclusion: Lentulospiral produced the best results in terms of length of obturation, while NaviTip syringe was efficient enough in controlling voids and produced the best results for apical seal.

Radiographic Quality of root fillings performed by dentists in Jammu and Kashmir, North India

The present study aimed at assessing the quality of root canal obturations being performed in the state of Jammu and Kashmir. Records of 1056 endodontically treated teeth from patients who visited the department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College, Jammu were obtained. Intra-oral periapical radiographs of all treated teeth were assessed in terms of canal obturation quality (adequate length and density). Fifty-one percent of the teeth fulfilled the criteria of an acceptable root canal filling. Adequate length and density was found in 78% and 24% of teeth, respectively. Our findings underline the need to improve the quality of endodontic health care being provided to the average patient in the state of Jammu and Kashmir. Keywords: Endodontics; Radiograph; Root Canal Filling; Root Canal Treatment; Technical Quality

Technical quality assessment of root canal treatment performed by preclinical dental students at Taibah University, KSA.

ObjectivesThe aim of this study was to evaluate the technical quality of root canal treatment (RCT) performed by preclinical undergraduate dental students at the Dental College of Taibah University KSA.MethodsIn this study, 259 extracted teeth were treated endodontically by preclinical students of the College of Dentistry, Taibah University, KSA, from 2013 to 2015. The evaluation criteria were root canal obturation length, root canal obturation density (homogeneity), and root canal obturation taper. A specific score (0, 1, or 2) was assigned to each parameter.ResultsOf 259 endodontically extracted teeth, 138 (53.3%) had RCT of unacceptable technical quality, 42 (16.2%) had treatment of slightly acceptable technical quality, 50 (19.3%) had treatment of acceptable technical quality, and 29 (11.2%) teeth had RCT of perfectly acceptable technical quality. There were no significant differences (p > 0.05) in the technical quality of root canal obturation among types of teeth.ConclusionThe results of this study showed that there were varied levels of technical quality of root canal treatment performed by preclinical undergraduate dental students, and the outcome varied between unacceptable, slightly acceptable, acceptable, and perfectly acceptable. The unacceptable cases were the most common, representing more than half of all cases, and the perfectly acceptable cases were the least common. There is an urgent need to improve the endodontics teaching programmes in the College of Dentistry of Taibah University. This research should be repeated in the future to evaluate improvement in the performance of RCT by undergraduate dental students in Taibah University.

CONE BEAM COMPUTED TOMOGRAPHY EVALUATION OF TWO OBTURATION TECHNIQUES AFTER PREPARATION WITH TWO NOVEL ROTARY SYSTEMS (IN VITRO STUDY)

INTRODUCTION: Three dimensional obturation is an essential factor for the success of root canal treatment which is achieved by the adaptation of the root filling to the canal walls to create a homogenous mass of filling.OBJECTIVES: To compare the obturation quality of different obturation techniques in curved canals using two rotary systems by CBCT.MATERIALS AND METHODS: Forty mesial roots of mandibular first molars were selected, decoronated to 12mm length and divided into two groups (n=20). Group I: instrumented with Protaper Next file system; Group II: instrumented with Wave One primary file, then they were subdivided into subgroups (A1, A2 and B1 ,B2) according to the obturation technique used . Subgroups (A1, A2) were obturated with single cone technique while subgroups (B1 , B2) were obturated using cold lateral compaction technique. Pre and post obturation CBCT images were used to assess the volume of voids in the filled canals. Data were analyzed using Kruskal–Wallis and Mann-Whitney tests.RESULTS: Subgroup B1 showed the least amount of voids with percentage (14.82%), while subgroup B2showed the highest amount of voids with percentage (40.16%) when compared to the other subgroups. At the coronal level, subgroup B1 showed less volume of voids with mean percentage (13.41±9.11), while subgroup B2 showed higher amount of voids with mean percentage (23.17±5.27) than subgroups (A1and A2). At the middle third, there was no significant difference between the four subgroups. Apically, single cone subgroups (A1 and A2) produced significantly less volume of voids than lateral compaction subgroups.CONCLUSIONS: Protaper Next group obturated with lateral compaction technique provided the least amount of voids followed by the two single cone subgroups, while Wave one group obturated with lateral compaction technique provided the highest amount of voids.

Comparative Study Regarding Two Obturation Methods with Thermoplasticized Gutta-Percha for the Root Canals

AIM: This study draws a comparison, through the transparentization method, focusing on the quality of the canal obturation made with thermoplasticized gutta-percha, between two different systems: GuttaMaster VDW (München, Germany), based on obturators made of a plastic core, covered in alpha gutta-percha, and a system of vertical warm condensation.MATERIALS AND METHODS: The study focused on twenty teeth extracted for various reasons which underwent the endodontic treatment realized through a hybrid technique, using the rotary files system of NiTi MTWO (VDW, München, Germany), and the manual files k-file type (Kendo, VDW, München, Germany). The teeth were distributed into two groups of ten. The teeth in the first group underwent obturation using the CWC technique of vertical warm obturation, and the teeth in the second group underwent root obturation using the GuttaMaster system (VDW, München, Germany). The teeth were decalcified in nitric acid. Using the method of transparentization with methyl salicylate, there were emphasized aspects regarding the abilities of each method to seal three-dimensionally the endodontic space.RESULTS: The teeth which underwent vertical obturation presented many more holes in the obturation material, holes situated mainly in the medial and coronary third. However, these teeth presented the highest degree of insertion in the lateral canals, as compared to the other obturation technique employed. The homogeneity of the root obturation had not had any statistical significant differences between the two techniques. However, the technique of injecting thermoplasticized gutta-percha was superior to the other one regarding the tightness on the edge and the degree of penetration in the lateral canals.CONCLUSIONS: The knowledge of both the qualities and the limits of the obturation material chosen, as well as the correctness of performing the two techniques, determines a definite improvement of the quality of the canal treatment, which ends with a three-dimensional canal obturation.

QUALITY OF SINGLE CONE AND GUTTA CORE OBTURATION IN CURVED ROOT CANALS AFTER NEEDLE OR DIODE LASER IRRIGANT ACTIVATION USING CONE BEAM COMPUTED TOMOGRAPHY AND STEREOMICROSCOPE

Objective: The purpose of this study was to assess the quality of single cone and gutta core obturation in curved root canals of the mandibular molars after needle and diode laser activation of both ethylenediaminetetraacidic acid (EDTA) and sodium hypochlorite (NaOCl) irrigation using cone beam computed tomography (CBCT) and stereomicroscope. Methods: A total of twenty –four extracted human mandibular molars with root canal curvature more than 20 degrees and type IV anatomic configuration in the mesial roots were selected for this study. Canals in mesial roots were prepared with ProTaper next instruments up to x3 and equally divided into two experimental groups (n=12) according to final one minute activation for each of 5 ml 2.5% NaOCl and 5 ml 15% EDTA using; side-vented needle (group1) or 980 nm diode laser (group2). After preparation, the mesial canals were randomly obturated with either single-cone gutta-percha (sub group A) or gutta core Obturator (subgroup B). Obturated canals were scanned with cone beam computed tomography; images were used to assess the quality of obturation at different canals levels. The roots were subsequently sectioned at 2, 4, 6, 8 and 12 mm levels from the apex for analyses of the percentage of gutta percha filled area (PGFA) and percentage of sealer filled area (PSFA) using stereomicroscope to examine the root sections. The areas of gutta percha and sealer for each segment of the root were measured using Image J software. Kruskal-Wallis test was used to analyze data. Results: Both cone beam and digital stereomicroscopic data indicated that canals obturated with gutta core after irrigant activation had the highest PGFA. The Gutta core and diode laser acti- vation group produced significantly higher PGFA and lower PSFA at different root canal levels 4,6 and 8 mm levels of the root canal (P < .05) than all other groups at the same levels (P < .05). Single cone and EDTA has the lowest PGFA and highest PSFA (P < .05). Conclusions: The results reinforced that 980-nm Diode activated irrigation improved the qual- ity of obturation of the mesial root canals in mandibular molars by using gutta core or single cone. Variation in root canal obturation technique and irrigation activation influenced the percentage of gutta percha filled area and percentage of sealer filled area.

Sealing ability and obturation quality of root canals filled with gutta-percha and two different sealers

Aim To evaluate sealing ability and quality of obturation when canal filled with gutta-percha and either mineral trioxide aggregate (MTA), or AH Plus sealer with detection of any possible correlation between microleakage and voids. Materials and methods Human freshly extracted 30 maxillary one-rooted teeth were prepared and assigned to experimental groups (n = 10), designated as group I: gutta-percha/AH Plus, group II: gutta-percha/MTA sealer, group III positive control group (n = 5) teeth unobturated, group IV: negative control group (n = 5) teeth obturated with gutta-percha, AH Plus sealer. After obturation, each tooth was prepared for fluid filtration assessment. Voids detection was performed through cross-sectional analysis at three root levels. Data were analyzed using one-way analysis of variance at a level of confidence of 95%. Results None of the tested obturation systems was able to provide leak proof filling. The sealing ability of MTA FillApex sealer showed higher parameters than AH Plus sealer even if it was not significant. The lowest percent of voids was recorded at the apical third for both tested sealers. The correlation between leakage and voids percentage was nonsignificant. Conclusion Calcium silicate root canal sealer (MTA FillApex) and AH Plus sealer can provide adequate seal with low voids percent. None of the root canal filled teeth were gap-free. Voids percentage cannot be used as an indicator for sealing ability.

Effect of Different Obturation Techniques on the Prognosis of Endodontic Therapy: A Retrospective Comparative Analysis

Success of root canal therapy (RCT) is largely dependent upon the quality of biomechanical preparation and obturation of the pulp canal. Improperly cleaned or shaped root canal, regardless of the type of obturation method and obturating material, cannot lead to the success of endodontic therapy. Hence, we conducted a clinical comparative analysis of two obturating techniques. A total of 140 patients receiving RCT at the department of Endodontic were included in the present study. The average follow-up time for the patients was 29 months (18-38 months). Patients were grouped into two depending on the type of obturating technique used. Evaluation of the clinical and radiographic follow-up records of the patients was done and analysis was made. One-way analysis of variance (ANOVA) was used for assessing the level of significance. The average age of the patients undergoing obturation with carrier-based obturation (CO) technique and lateral compaction (LC) technique was 43 and 48 years respectively. While comparing failure and success of the teeth at the time of follow-up, nonsignificant results were obtained. Significant difference was seen, while comparing the presence of voids and type of teeth in which endodontic therapy was performed using different obturating techniques. Endodontic therapy done with LC obturating technique or with CO technique shows prognostic difference on the outcome or quality of treatment therapy. Quality of obturation is more important rather than type while performing endodontic therapy for better prognosis.

Evaluation of the Quality of Obturation with Obtura at Different Sizes of Apical Preparation Through Microleakage Testing.

Obturation of the root canal system is required to prevent recontamination of the root canal after cleaning and shaping procedures and to seal the root canal completely, both the apical and coronal avenues of potential leakage and to maintain the disinfected status. The aim of this study was to determine the microleakage by dye leakage method at 1mm, 3mm and 5mm short of the apex with different sizes of apical preparation, obturated by Obtura. Sixty freshly extracted human single rooted teeth were randomly distributed into six equal groups. Group I (control group) was obturated by lateral compaction technique. Group II to VI were experimental groups (apical preparations done upto ISO sizes 20, 30, 40, 50 and 60 respectively), obturated by Obtura technique. After storing the samples at 100% humidity for seven days and one day in 2% methylene blue, the roots of the teeth were sectioned at 3mm short of the apex. They were observed under stereomicroscope at 20X magnification and the images were analysed for microleakage using the scoring criteria. The data obtained were analysed by One-way ANOVA followed by Tukey pair-wise multiple comparison test and p ≤ 0.05 was considered as the level of significance. The lowest mean microleakage score was seen in Group VI (0) and the highest mean leakage score was seen in Group II (1.5). There was statistically significant difference between Group II and Group V (p = 0.044), Group II and Group VI (p = 0.013). There was no significant difference between all the other groups (p> 0.05). Comparison of microleakage between different groups from ISO sizes 20-60 recommends a minimum apical preparation of ISO size 30.

Failure of endodontic treatment: The usual suspects.

Inappropriate mechanical debridement, persistence of bacteria in the canals and apex, poor obturation quality, over and under extension of the root canal filling, and coronal leakage are some of the commonly attributable causes of failure. Despite the high success rate of endodontic treatment, failures do occur in a large number of cases and most of the times can be attributed to the already stated causes. With an ever increasing number of endodontic treatments being done each day, it has become imperative to avoid or minimize the most fundamental of reasons leading to endodontic failure. This paper reviews the most common causes of endodontic failure along with radiographic examples.

Micro‐computed tomographic assessment of quality of obturation in the apical third with continuous wave vertical compaction and single match taper sized cone obturation techniques

The aim of the present micro-computed tomography (Micro-CT) analysis was to compare the quality of obturation in the apical third of the root with the warm vertical compaction (WVC) and single matching taper sized cone (SMTSC) techniques. Mesial roots of 16 freshly extracted mandibular first molar teeth (with a total of 32 canals) were used. Canals in each mesial root were shaped to a size F3 Protaper and were randomly assigned to either continuous wave vertical compaction or single match tapered size cone technique. Volume of voids and gaps in the obturated roots were measured using micro-CT scanning at 1, 3, and 5 mm from the apex of the root. There was no statistically significant difference in the volume of voids measured at 1 mm (p > 0.05), 3 mm (p > 0.05) and 5 mm (p > 0.05) filled with either WVC and SMTSC techniques. The quality of obturation in the apical third of the root with the WVC and SMTSC techniques is comparable. SCANNING 38:352-356, 2016. © 2015 Wiley Periodicals, Inc.

Quality of Root Canal Obturation Performed by Senior Undergraduate Dental Students

The aim of the present study was to assess the quality of canal obturation performed by undergraduate denal students at Saveetha Dental College and Hospitals, Chennai. Records of 200 endodontically treated teeth from patients who were visited by undergraduate students between month of November 2014 to May 2015. Periapical radiographs of all treated teeth were assessed in terms of canal obturation quality (adequate density and length). Forty-five percent of teeth fulfilled the criteria of an acceptable root canal obturation. Adequate length and density of root filling was found in 89% and 34% of teeth, respectively. There was a significant difference between maxillary and mandibular teeth regarding the length of root canal obturation. A significant difference was observed between molars and other tooth types. The frequency of root canals with an acceptable filling was significantly greater in the anterior teeth compared to premolars or molars. The technical quality of root canal treatment performed by undergraduate dental students was found to be less than ideal.

Quality of Root Canal Obturation Performed by Senior Undergraduate Dental Students

The aim of the present study was to assess the quality of canal obturation performed by undergraduate denal students at Saveetha Dental College and Hospitals, Chennai. Records of 200 endodontically treated teeth from patients who were visited by undergraduate students between month of November 2014 to May 2015. Periapical radiographs of all treated teeth were assessed in terms of canal obturation quality (adequate density and length). Forty-five percent of teeth fulfilled the criteria of an acceptable root canal obturation. Adequate length and density of root filling was found in 89% and 34% of teeth, respectively. There was a significant difference between maxillary and mandibular teeth regarding the length of root canal obturation. A significant difference was observed between molars and other tooth types. The frequency of root canals with an acceptable filling was significantly greater in the anterior teeth compared to premolars or molars. The technical quality of root canal treatment performed by undergraduate dental students was found to be less than ideal.

Guidelines to enhance the interpretation of two-dimensional periapical radiographic images in endodontics

AbstractRadiology is an indispensable tool in the clinical practice of endodontics because most structures that harbor diseases are invisible to the naked eye. As a result, the use of periapical radiographs before, during, and after root canal treatment is essential in order that anatomical details, canal length, obturation quality, and tooth and bone pathology can be identified and monitored. The purpose of this article is to discuss the guidelines that should be followed to enhance the interpretation of periapical radiographic images in endodontics and to facilitate the identification of root and root morphology, relationship of the teeth to the surrounding anatomical structures and pathological changes in the radicular and peri-radicular areas.

English

The aim of this study was to evaluate the outcomes of teaching endodontics to undergraduate students at Riyadh Colleges. This study was undertaken by assessing the technical quality of root canal obturation and the presence of procedural errors in root canal treatment cases performed by the final year dental students in clinics. All of the root canal treatment cases performed by the final year dental students in the 2nd semester of 2012 to 2013 were examined, with a total of 450 root canals from 241 teeth. The quality of root canal obturation was examined in relation to the length of the root filling based on the radiographic apex, the density of the obturation according to the presence of voids, and the taper of root canal fillings. The overall acceptable quality of the evaluated root canals was 36%. Of these canals, acceptable length, density, and taper were reported in 76.6, 46.4, and 73.8%, respectively. Overall, 9.3% of the treated root canals had procedural errors, and majority of these errors were found in canals of posterior mandibular teeth. Apical transportation was the most encountered error; it was found in 3.1% of the treated canals. The technical quality of the root canal treatments conducted by the students in this study was comparable to other studies. However, introducing new techniques and armamentaria might improve this quality. Key words: Technical quality of obturation, undergraduate education, evaluation, education development.

Comparative Evaluation of Obturating Techniques in Primary Teeth: An in vivo Study.

ABSTRACTAim: The present study was undertaken to compare two methods of obturation in primary teeth by using lentulospirals and pressure syringe, radiographically.Materials and methods: Sixty teeth in subjects with mean age of 5.88 ± 1.58 years were obturated randomly using two different obturating techniques, i.e. group I: Thirty teeth obturated with pressure syringe, and group II: Thirty teeth obturated with lentulospiral. Quality of obturation and presence or absence of voids were assessed by taking radiographs after obturation was done using both the techniques. Results of quality of obturation were statistically analyzed using Chi-square test and Mann-Whitney’s test, whereas voids were analyzed using Chi-square test.Results: No statistically significant difference between the quality of obturation using pressure syringe or lentulospiral (p > 0.05) was observed. However, significantly higher number of voids were found for lentulospiral technique as compared to pressure syringe (p < 0.01).Conclusion: Both the techniques were found to be equally efficient statistically, though lentulospiral produced more voids.How to cite this article: Vashista K, Sandhu M, Sachdev V. Comparative Evaluation of Obturating Techniques in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2015;8(3): 176-180.

Quality of Obturation Achieved by a Non–gutta-percha–based Root Filling System in Single-rooted Canals

IntroductionThe present study examined the quality of obturation in root canals filled by an experimental non–gutta-percha–based (NGP) root filling system using warm vertical or cold lateral compaction. The quality of obturation was evaluated by comparing the volumetric percentage of gaps and voids identified from similar canals obturated with gutta-percha and an epoxy resin–based sealer using the same obturation techniques. MethodsForty single-rooted premolars with oval-shaped canals were cleaned, shaped, and obturated with 1 of the 4 material/obturation technique combinations (n = 10). Filled canals were scanned with micro–computed tomographic imaging. Reconstructed images were analyzed for the volumetric percentage of gaps and voids at 3 canal levels (0–4, 4–8, and 8–12 mm from the working length). Roots were sectioned at the 4-mm, 8-mm, and 12-mm levels. Scanning electron microscopic images of negative replicas of root sections were examined to quantify the circumferential percentage of interfacial gaps and the area percentage of intracanal voids. Data were analyzed with parametric or nonparametric statistical methods. ResultsA statistically significant difference was found for the volumetric percentage distribution of gaps and voids for “obturation technique” but not for “material.” Significantly higher percentages of gaps and voids were identified in canals obturated with the NGP system using cold lateral compaction. Examination of negative replicas ascribed this difference to a higher area percentage of interfacial gaps rather than more intracanal voids. ConclusionsUsing warm vertical compaction, the NGP system fulfils the objective of 3-dimensional obturation of the canal space in a manner comparable with the results achieved with gutta-percha and a root canal sealer.

Microscopic analysis of the quality of obturation and physical properties of MTA Fillapex.

This study analyzed the quality of obturation and physical properties of MTA Fillapex and AH Plus sealer. A sample of 30 human maxillary central incisors were instrumented with Protaper until a F5 (50/05) file. Both sealers were mixed with Rhodamine-B dye to allow visualization on a confocal laser-scanning microscope (CLSM). Next, the canals were filled using the single cone technique. After setting, all samples were sectioned at 2, 4, and 6 mm from the apex. CLSM was used to analyze the gaps and sealer penetration into the dentinal tubules. All samples were scanned 10 µm below the dentin surface and images were recorded at 100× magnification using the fluorescent mode. Additionally, the solubility, flowability and setting time of the sealers were evaluated. All the measured quantities of the examined materials were evaluated for significant differences by means of statistical analysis. The CLSM analysis of the MTA Fillapex showed the highest percentage of gaps at all sections (P = 0.0001). Physical tests revealed adequate properties for both sealers except for a higher solubility of the MTA Fillapex (P = 0.0001). The MTA Fillapex presented flowability and intratubular penetration similar to the AH Plus. Nevertheless, the MTA Fillapex sealer presented a higher solubility and considerable quantity of gaps between the sealer/dentin interface in relation to the AH Plus sealer. Clinicians must take into consideration, the quality of endodontic sealers as it is essential in the outcome of the root canal filling.

Relationship between quality of root canal obturation and periapical lesion in elderly patients: a systematic review.

The aim of this study was to investigate the relationship between quality of root canal obturations and the presence/absence of periapical lesion in elderly patients. This was a systematic conducted by means analysing studies on the quality of root canal obturations and their relationship with periapical health in elderly patients. The methodological procedures were based on Cochrane. The inclusion criteria for selection of the titles were the following: (i) studies in humans; (ii) sample consisting of individuals aged 60years or older; (iii) intending criteria defined for the evaluation of quality of root canal obturations; (iv) intending criteria defined for the evaluation of periapical health; (v) determination of the relationship between quality of endodontic treatment and presence of periapical lesions; and (vi) articles published between 1st March 2003 and 1st March 2013. A total of 3161 potentially relevant studies were found in three databases chosen for the literature review, with 1669 being repeated and 395 duplicated. Therefore, the abstracts of 1097 studies were read. A total of 1022 studies were excluded, resulting in 75 articles for full analysis. However, no study could be included in the present literature review. There is no consensus on the relationship between the quality of root canal obturations and periapical health in older patients.

Comparative Radiographic Assessment of Root Canal Obturation Quality: Manual Verses Rotary Canal Preparation Technique

Objective: To compare the technical quality of root canal obturation in relation to rotary and manual root canal preparation techniques. Study Design: Cross sectional, analytical study. Place and Duration of Study: The Aga Khan University Hospital Karachi from January till December 2011. Methodology: Data was retrospectively retrieved by periapical radiographs of 60 root canal treated molars for assessment of obturation quality. Data was divided into two groups, 30 radiographs in each group. Group 1 and 2 teeth were prepared with rotary and manual canal preparation technique respectively followed by obturartion with cold lateral condensation technique. Postobturation radiographs were assessed to evaluate technical quality of obturation in term of length, density and taper of root filling. Mann Whitney-U and Chi- square test was applied to compare the difference in technical quality of obturation between two canal preparation techniques. Results: Amongst Thirty molar prepared with rotary instruments, 27 had achieved acceptable length, 25 had adequate density and 27 had achieved adequate taper. Amongst 30 molars prepared manually, 18 had achieved acceptable length, 14 had adequate density and 12 had adequate taper. Conclusion: Radiographic technical quality of the obturation (length, density and taper) was better with rotary technique as compared to manual canal preparation technique.