Root Canal Obturation Methods Research Articles

Trends and Patterns of Endodontic Therapy in Primary Teeth: A Visualized Bibliometric Analysis of Research Output in Saudi Arabia

Abstract Aim: To analyze research trends and collaboration patterns in endodontic therapy of primary teeth in Saudi Arabia using bibliometric analysis. Materials and Methods: A search was conducted in the Web of Science database on March 1, 2024, to identify relevant publications. A total of 54 articles were retrieved and ranked according to citation counts. The key indices contain total citation counts, h-index, and publication counts. The analysis used Biblioshiny (Bibliometrix R package) and VOSViewer to show the collaboration networks and publication trends. Two reviewers were used for extraction to ensure validity and reliability. Results: The bibliometric analysis showed an increase in research output and citations, with peaks in 2020 and 2023. King Abdulaziz University and King Saud University were the leading institutions in this field, with the most publications and extensive collaboration networks. The most highly cited article was published by Bawazir OA in 2006, which was about root canal obturation methods in primary teeth. The keyword used most was “Mineral trioxide aggregate.” The key journals in this field were Pediatric Dentistry and the Saudi Dental Journal. Conclusion: This study confirms the emergence of Saudi Arabia as a significant contributor to research in primary tooth endodontics, demonstrating increasing scholarly impact and academic interest in this field. The results highlight the country’s growing role on the global research stage. Collaboration patterns suggest that this positive trend is likely to enhance impactful collaborative research in the future.

ANALYSIS OF THE ROOT CANAL APICAL THIRD OBTURATION QUALITY DEPENDING ON THE TOOTH ROOT INDIVIDUAL ANATOMY

Background: Up-to-date methods of root canal obturation applying gutta-percha do not provide an accurate and predictable result. The different anatomy of the root canal apical third requires the selection of an optimal method that avoids voids and high sealer content. This study compared standard and modified lateral compaction techniques in root canals with different morphologies using computed tomography. Objective: To come up with an optimal method for filling the apical third of the root canal, considering its anatomical structure and to evaluate the quality of obturation using the computed tomography method. Materials and methods: The research was performed on 46 root canals of extracted teeth. All teeth were divided into two groups depending in the obturation technique used. The study included a lateral compaction technique with modification in oval-shaped root canals, followed by control using computed tomography. Results: Basing on the study, it has been revealed that even at the stage of computed tomography it is possible to plan the most appropriate method of root canal obturation, depending on their shape. Conclusion: To increase the endodontic treatment efficiency it is necessary to take into account the individual anatomical and morphological structure of the root canals. Root canals that have an oval shape in the apical third may require an obturation technique different from a standard one.

ANALYSIS OF THE ROOT CANAL APICAL THIRD OBTURATION QUALITY DEPENDING ON THE TOOTH ROOT INDIVIDUAL ANATOMY

Background: Up-to-date methods of root canal obturation applying gutta-percha do not provide an accurate and predictable result. The different anatomy of the root canal apical third requires the selection of an optimal method that avoids voids and high sealer content. This study compared standard and modified lateral compaction techniques in root canals with different morphologies using computed tomography. Objective: To come up with an optimal method for filling the apical third of the root canal, considering its anatomical structure and to evaluate the quality of obturation using the computed tomography method. Materials and methods: The research was performed on 46 root canals of extracted teeth. All teeth were divided into two groups depending in the obturation technique used. The study included a lateral compaction technique with modification in oval-shaped root canals, followed by control using computed tomography. Results: Basing on the study, it has been revealed that even at the stage of computed tomography it is possible to plan the most appropriate method of root canal obturation, depending on their shape. Conclusion: To increase the endodontic treatment efficiency it is necessary to take into account the individual anatomical and morphological structure of the root canals. Root canals that have an oval shape in the apical third may require an obturation technique different from a standard one.

Volumetric Evaluation of 5 Root Canal Obturation Methods in TrueTooth 3-dimensional–Printed Tooth Replicas Using Nano–computed Tomography

IntroductionThe aim of this study was to evaluate the volumes of total obturation and voids in different obturation techniques using nano–computed tomographic imaging. The null hypothesis was that the obturation technique and the materials used have no effect on the total volume of obturation or the total volume of voids. MethodsFifty maxillary left central incisor 3-dimensional–printed replicas (TrueTooth; Dental Engineering Laboratories, Santa Barbara, CA) were instrumented and randomly assigned to 5 different obturation groups (n = 10): single cone with EndoSequence Gutta-Percha Points (Brasseler USA, Savannah, GA) and Ribbon Sealer (Dentsply Sirona, Tulsa, OK) (SC1), single cone with BC 150 Series Gutta-Percha Points (Brasseler USA) and EndoSequence BC Sealer (Brasseler USA) (SC2), continuous wave with EndoSequence Gutta-Percha Points and Ribbon Sealer (CW), GuttaCore carrier obturation (Dentsply Sirona) and Ribbon Sealer (GC), and cold lateral condensation with EndoSequence Gutta-Percha Points and Ribbon Sealer (CL). After obturation, nano–computed tomographic images were obtained, and volumetric analysis was performed. Statistical analysis using 1-way analysis of variance (ANOVA). The level of significance was set at 5% (P < .05). ResultsThe 1-way ANOVA for total obturation indicated a statistically significant effect of group on obturation. Post hoc tests revealed a significant difference between the SC2, CW, and CL groups compared with the SC1 and GC groups. The 1-way ANOVA for calculated voids indicated a statistically significant effect of group on voids. Post hoc tests revealed significant differences between the SC1 group and the GC and CL groups. ConclusionsThis study concluded that obturation technique and the materials used significantly affect the total volume of obturation material and potential for voids.

The effects of pressure in vitro on three methods of root canal obturation.

The seal of root canal fillings depends on the anatomy of the root canal system and on the properties of filling materials and their bond to the walls of the root canal. Alterations in pressure may influence these properties. The current study investigated and compared microleakage in a tapered single-cone method versus lateral and vertical condensation after diving simulation. One hundred and thirty five extracted single-rooted teeth were used. Following instrumentation and irrigation to #30.06 Mtwo rotary system, obturations were performed in three groups of 45 teeth: Group 1, tapered single-cone with Endoseal MTA sealer; Group 2, lateral condensation with AH26 sealer; Group 3, vertical condensation with AH26 sealer. Then all specimens were divided into three groups and incubated at ambient room pressure (101.3 kPa), 203 kPa or 304 kPa for 120 minutes respectively 20 times over one month to simulate diving conditions. Microleakage quantitative analysis was recorded by using a 2% Methylene blue dye for 24 hours. The amounts of microleakage increased with increasing pressure in all obturation groups; however, the differences were not statistically significant (P > 0.05). At all three pressures, the least microleakage was recorded in Group 3, vertical condensation. Although the differences between vertical condensation, lateral condensation, and tapered single-cone methods were statistically significant (P < 0.001), the vertical condensation and lateral condensation groups did not differ from each other (P > 0.05). Vertical condensation may be the best technique, based on sealing ability, for people who frequently experience pressure alterations.

Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

Purpose:The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography.Materials and Methods:A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test.Results:The results showed significant differences between the four groups for the length of obturation (P < 0.05). The endodontic pressure syringe showed the best results (98.5% optimal fillings) and jiffy tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used.Conclusions:Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

Ex Vivo Area-Metric Analysis of Root Canal Obturation Using Cold and Warm Gutta-Percha

Purpose. To evaluate the percentage content of gutta-percha, sealer, and voids in a filled canal area following three different filling techniques, using microphotographs and Nis Elements® software. Material and Methods. After completing chemomechanical preparation, the teeth (n=48) were randomly divided into three groups (n=16) and filled by either cold lateral condensation (CLC group), the continuous wave technique (EOU group), and the ProTaper® thermoplasticized obturator (PT group). The roots were then sectioned horizontally 2.5, 6.5 and 8.5 mm from the tooth apical foramen. The surface areas of the sealer, voids, and gutta-percha (PGFA percentage of gutta-percha-filled area) were calculated and the results subjected to statistical analysis (Kruskal-Wallis test). Results. The percentage of gutta-percha (PGFA) was lower in the apical third of the canal for the CLC and EOU groups than the PT group. In the middle and the coronal third of the canal, the PGFA value was higher after using thermal techniques (EOU and PT) than cold lateral condensation (CLC). The presence of voids was comparable in the fillings performed using warm and cold gutta-percha obturation at all levels. Conclusion. Although thermal methods of root canal obturation allow higher PGFA values to be obtained than cold lateral condensation, the content of voids is comparable.

Ultramicroscopic study of the interface and sealing ability of four root canal obturation methods: Resilon versus gutta‐percha

Recently, filling materials have been introduced based on the dentine adhesion technologies used in conservative dentistry in an attempt to seal the root canal more effectively. The purpose of this study was to investigate the interface between the canal and root-filling material. Sealing ability of four root canal obturation methods was analysed by means of scanning electron microscopy. Extracted single-rooted teeth were endodontically treated and filled with gutta-percha/Pulp Canal Sealer using the Thermafil (TH) technique, gutta-percha/Pulp Canal Sealer using the System B (SB) technique, Resilon points/RealSeal (RS) and RealSeal 1/RealSeal (RS1). Specimen interfaces were analysed using field-emission scanning electron microscopy. The adhesive groups RS and RS1, formed hybrid layers but showed areas of separation (gaps) similar to those in the conventional obturation groups. The RS and RS1 groups showed less separation in the coronal third, but the separation was similar to that in the TH and SB groups in the middle and apical thirds. The sealing ability of Resilon is not superior to that of existing materials.

Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts

The purpose of this study was to compare the fracture resistances of immature teeth treated with MTA along with root canal obturation methods using AH Plus, MetaSEAL, MTA Fillapex sealers + lateral compaction technique, and Unicore quartz fiber posts. Fifty single-rooted maxillary anterior teeth were divided into five groups. The crowns were dissected and root canals were enlarged. #6 Peeso reamers were allowed to protrude 1 mm. beyond the apex to simulate immature teeth. The apical 4-5 mm of each tooth was filled using Angelus white MTA. The remaining portions of canals were obturated as follows: Group 1: No backfilling (control), Group 2: AH Plus + gutta-percha, lateral compaction, Group 3: MetaSEAL + gutta-percha, lateral compaction, Group 4: MTA Fillapex + gutta-percha, lateral compaction, Group 5: UniCore Fiber posts luted using PermaFlo DC. The specimens were embedded into self-curing acrylic poured into identical cylinders which were mounted on a jig providing a 45° angle. A compressive load increasing at 1 mm min(-1) was applied and the maximum load at which fracture occurred was recorded. Statistical analysis was performed using Kruskal-Wallis and Dunn's multiple tests. The highest fracture resistance was obtained with Group 5 (Fiber posts) whereas Group 4 (MTA Fillapex) yielded the lowest values. The mean fracture resistance value of Group 2 (AH Plus) was significantly higher than Group 4 (MTA Fillapex) (P = 0.001). The mean fracture value of Group 5 (Fiber posts) was significantly higher than Group 2 (AH Plus), Group 3 (MetaSEAL), and Group 4 (MTA Fillapex) (P = 0.02, 0.004, and 0.0001, respectively). Within the limitations of this study, UniCore quartz fiber posts provided the highest resistance. This methodology may specifically be advantageous for teeth with arrest of development at early stages, as these teeth are more susceptible to fracture owing to their excessively weak dentinal walls.

Influence of smear layer on the coronal leakage of thermafil and laterally condensed gutta-percha root fillings with a glass ionomer sealer

The effect that two methods of root canal obturation, combined with removal of the smear layer, had on coronal leakage was studied in vitro. Single-rooted teeth with mature apices were prepared chemomechanically and divided into two groups of 72 teeth each. One of the groups was treated with 40% citric acid and 2% sodium hypochlorite to remove the smear layer. The teeth were then subdivided and obturated using the glass ionomer sealer, Ketac Endo and either lateral condensation or Thermafil. After storage for 7 days or 4 months, the specimens were evaluated for coronal leakage using Indian ink. After 90 h, each root was split longitudinally and the maximum extent of leakage was measured using a stereomicroscope at x6 magnification. After 7 days, there was significantly less leakage in those teeth obturated with Thermafil without smear layer compared with the other groups (p < 0.05). After 4 months, there was no significant difference in leakage between the groups (p > 0.05).