Root Canal Obturation Techniques Research Articles

Evaluation of the incidence of apical crack formation after different root canal obturation techniques using a stereomicroscope. (An In vitro study)

Evaluation of the incidence of apical crack formation after different root canal obturation techniques using a stereomicroscope. (An In vitro study)

Evaluation of the Sealing Ability of Various Root Canal Obturation Techniques in Permanent Molars: An In vitro Study.

Achieving a reliable seal in root canal obturation is essential for the success of endodontic treatment. Despite the availability of multiple techniques, the comparative sealing abilities of these methods remain a topic of investigation, particularly in permanent molars. This in vitro study involved 60 extracted permanent molars, divided randomly into three groups: Group A (lateral compaction), Group B (thermoplasticized gutta-percha), and Group C (single cone). After instrumentation and obturation, the sealing ability was assessed using a dye penetration method. Arbitrary values were assigned to quantify the extent of dye penetration. The mean dye penetration values were as follows: Group B (thermoplasticized gutta-percha) had the lowest penetration (2.1 ± 0.3 mm), followed by Group A (lateral compaction) (3.5 ± 0.4 mm), and Group C (single cone) exhibited the highest penetration (5.2 ± 0.6 mm). In this study, thermoplasticized gutta-percha demonstrated superior sealing ability compared to lateral compaction and single cone techniques in permanent molars. These findings underscore the importance of selecting an effective obturation technique to ensure optimal seal integrity in root canal therapy.

Evaluation of Density and Homogeneity of Three Different Root Canal Obturation Techniques: A Three –Dimensional Computed Tomography In Vitro Study

The aim of this in vitro study was to compare three dimensionally the density and homogeneity of cold lateral compaction, warm vertical compacti on and guttaflow root canal obturation techniques using computed tomography. Thirty canals of 12 mm from extracted lower single canal premolars were selected then instrumented and divided randomly into 3 groups with 10 roots in each group. Group I was obturation with cold lateral compaction technique, group II was obturated with warm vertical compaction technique and group III was obturated with guttaflow system. The specimens were then analyzed for the density and homogeneity in both vertical and hor i zontalsections in apical, middle and coronal third with 1 mm section thickness using computed tomography. The data obtained in hounsefield units were subjected to statistical analysis. In conclusionguttaflow was superior in the apical part and none of the tested obturation techniques can achieve three dimensional dense and homogenous obturation from apical to coronal parts of root.

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.

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.

Endodontic flare-up incidence in pulp necrosis in Universitas Airlangga Dental Hospital (RSKGMP Universitas Airlangga)

Background : Dental caries occurs as a result of demineralization of the hard tissues of the teeth followed by the destruction of the organic matter, resulting in bacterial invasion and death of the pulp which can lead to pulp necrosis. One of the treatments for pulp necrosis is endodontic treatment. Endodontic treatment includes root canal preparation techniques, root canal irrigation materials, root canal dressing materials, and also root canal obturation techniques. In endodontic treatment can experience flare-ups. An endodontic flare-up is a pain or swelling after endodontic treatment that occurs in a relatively short time. Purpose : To describe the incidence of endodontic flare-ups in pulp necrosis at RSMKGP Universitas Airlangga. Methods : Conducted descriptive observasional research on patients who had endodontic treatment at UPF Dental Conservation, Dental and Oral Hospital, Faculty of Dental Medicine, Airlangga University in 2018, 2019, and 2020. Results : A total of 28 patients (30,1%) from 93 patients were experience pain or flare-ups after root canal treatment. Conclusion : From the result of this study, it can be concluded that there is still an incidence of endodontic flare-ups in pulp necrosis at RSKGMP Universitas Airlangga which is 30,1%.

Endodontic Flare-up Incidense in Irreversible Pulpitis in Universitas Airlangga Dental Hospital (RSKGMP Universitas Airlangga)

Background: Carious lesions that do not be treated, becomes infected and inflamed, leading to irreversible pulpitis. One of the treatments for irreversible pulpitis is root canal treatment. In root canal treatment can cause flare-ups. Purpose: Obtaining a data base on flare-ups with a diagnosis of irreversible pulpitis at RSKGMP and obtaining a picture of flare-ups in irreversible pulpitis based on root canal preparation techniques, root canal irrigation materials, root canal dressing materials, and root canal obturation techniques. Methods: The study used was a descriptive observational study with a study design cross sectional in patients with a diagnosis of irreversible pulpitis who had received root canal treatment at the UPF Dental Conservation RSKGMP University of Airlangga in 2018, 2019, and 2020. Results: A total of 14 patients (28%) of 50 patients experienced (flare-up). Conclusion: The incidence flare-ups of root canal treatment in irreversible pulpitis at RSKGMP University of Airlangga is 28%.

Effect of a heat-based root canal obturation technique on push-out bond strength of the classical bioceramic and new HiFlow sealer.

This study aimed to investigate the effect of the heat-based obturation technique on the push-out bond strength of the classical bioceramic and new HiFlow sealer. Fifty single-rooted human mandibular premolars were obturated using one of the following techniques: (1) BC-SC; (2) BC-W; (3) HiFlow-SC; (4) HiFlow-W; and (5) AH Plus-W. Following obturation, specimens were sectioned into 1-mm-thick root slices 4 and 8 mm from the working length and were subjected to a push-out bond test using a universal testing machine and examined for their modes of failure under an inverted phase-contrast microscope. At both distances tested, there was no difference in the push-out bond strength among the four bioceramic groups (P > 0.05). The AH Plus-W group had lower bond strength than every other group at both distances from the working length. The most common failure mode was mixed failure.

Correction to: Root canal obturation techniques with hydraulic calcium silicate-based materials

Correction to: Root canal obturation techniques with hydraulic calcium silicate-based materials

Root canal obturation techniques with hydraulic calcium silicate-based materials

Root canal obturation techniques with hydraulic calcium silicate-based materials

Light and shade of Single Cone Technique in root canal obturation

The conventional principle of root canal obturation is to make the gutta percha(GP) ratio high and the sealer ratio low. Many studies suggested that continuous wave technique(CWT) was superior to cold lateral compaction(CLC) in teeth with complex anatomical structures, but CWT also has many disadvantages. With the recent development of the calcium silicate based sealer(CSS), single cone technique(SCT) is back in the spotlight as a root canal obturation technique. Due to the advantages of clinical convenience, many dentists obturate root canal by SCT. When obturating the root canal by SCT, it is likely that the quality of the root canal obturation will decrease as compared to CLC or CWT depending on tooth anatomic complexities, and it is dif-ficult to remove the CSS from root canals in the cases of retreatment. Therefore, it is recommended to be carefulin selecting case when obturating the root canal by SCT.

Comparison of Various Root Canal Filling Materials and Obturation Techniques for Primary Teeth Using Microcomputed Tomography

Aim: The aim of this study was to compare the effectiveness of different filling materials and obturation techniques for root canal obturation in primary teeth. Materials and Methods: Eighty maxillary primary incisors were included in this in vitro study. After biomechanical preparation, all samples were scanned using microcomputed tomography (micro-CT) and root canal volumes were calculated. Samples were grouped according to filling materials and obturation techniques, with ten samples in each group. The samples were filled with zinc oxide eugenol (ZOE) and Vitapex using four different obturation techniques (local anesthesia syringe, lentulo spiral, pastinject, and lentulo spiral–ultrasonic activation). After filling, samples were scanned a second time using micro-CT and root canal volumes were calculated. The statistical analysis was performed using SPSS version 24.0. Data were analyzed by Kruskal–Wallis and Mann–Whitney U tests. Results: When the ZOE and Vitapex were compared, it was observed that there were no significant differences between their postobturated volumes, percentage obturated volume (POV), internal void (IV), and percentage of internal void volume (PIV) ( P > .05). The local anesthesia syringe group had a significantly lower postobturated volume and POV, and a significantly higher IV and PIV for both filling materials than that by the other groups ( P < .05). There was no significant difference between the other obturation techniques ( P > .05). For the local anesthesia syringe group, postobturated volume and POV were significantly higher and IV and PIV were significantly lower with Vitapex than with ZOE ( P < .05). There was no significant difference between the other obturation techniques filled either with ZOE or Vitapex ( P > .05). Conclusion: Except for the syringe technique, no difference was observed between the ZOE and Vitapex materials. The syringe technique used in the primary root canal filling was less effective than the other techniques, which had similar efficacy, and in this technique, more effective canal filling was achieved with Vitapex.

Evaluation of Different Root Canal Obturation Techniques in Internal Root Resorption of Three-Dimensional Printed Teeth Manufactured Using Computer Software.

The objective of this study was to evaluate and compare the filling ability of various root canal obturation techniques on the internal root resorption (IRR) cavities of replicated tooth samples manufactured using computer software and a three-dimensional (3D) printer. Orthographic images and root structures of a healthy upper maxilla central incisor in determined volumes and sizes were drawn as a prototype with the aid of computer software. Using the same software, an IRR defect was also modeled. These two images were then transferred to the AutoDesk Fusion 360 3D modeling program (AutoDesk, San Rafael, CA) for meshing. Afterward, the tooth model was transferred to a 3D modeling and prototyping program (RhinoCeros 3D; Robert McNells & Assoc., New York) and printed on a 3D printer. Eighty replicas with IRR were manufactured and divided into four groups (n = 20 per group) according to the obturating techniques as follows: Group 1: Cold lateral compaction (CLC), Group 2: Core Carrier System (GuttaCore), Group 3: Injectable Cold Filling (GuttaFlow® BioSeal), and Group 4: Continuous Wave Obturation System (Elements Free). After root canal filling, replicas were scanned with a high-resolution micro-computed tomography system (SkyScan 1172; Bruker-microCT, Kontich, Belgium), data regarding voids (unobturated areas) inside the IRR defects were statistically analyzed using nonparametric Kruskal-Wallis tests. A pairwise comparison between the tested groups showed that Groups 3 and 4 had significantly fewer voids compared with Groups 1 and 2 in IRR defects (p < 0.05). Group 1/Group 2 and Group 3/Group 4 had similar results in terms of voids and there were no statistically significant differences (p > 0.05). The injectable cold filling system (GuttaFlow BioSeal) and the injectable continuous wave obturation system (Elements Free) successfully obturated the pathological IRR irregularities when compared with CLC and core carrier (GuttaCore) systems.

Micro-CT Evaluation of Four Root Canal Obturation Techniques.

Purpose The aim of this in vitro study was to evaluate the quality of four root canal obturation techniques using microcomputed tomography (micro-CT). Materials and Methods A total of 36 mandibular first premolars with mostly round canals were decoronated, then instrumented up to a size F3 rotary file, and dressed with an epoxy resin-based sealer. Subsequently, they were divided into 4 different groups (n = 9) based on the method of obturation: lateral condensation using 0.02 tapered master cone (LC2), lateral condensation using 0.04 tapered master cone (LC4), matched single-cone technique (MS), and matched single cone-mediated ultrasonic activation (MSUA). All the teeth were scanned using micro-CT (resolution of 19 μm), and the percentage volume of voids was calculated. One-way analysis of variance and Tukey test were used to analyze the data (α = 0.05). Results The total percentage volume of voids was significantly lower in the MSUA group compared to all other groups (P < 0.05). The total percentage volume of voids was significantly lower in the MS group compared to the LC4 (P < 0.001) and LC2 (P < 0.001) groups. However, there was no significant difference between the LC2 and LC4 groups (P < 0.65). Conclusions MSUA, significantly, showed the least root canal filling voids amongst all the obturation techniques studied. MSUA can be considered an effective method for the filling of the round root canals. In general, lateral condensation using either 0.02 or 0.04 tapered master cones had significantly the highest volume percentage of voids amongst the experimental groups.

Efficacy of prototype endodontic obturators for novel root canal obturation techniques using a resin-based sealer in various powder-liquid ratios

This study aimed to examine novel techniques using prototype endodontic obturators to obturate a resin-based sealer. Powder-liquid ratios of MetaSEAL Soft were changed to obtain suitable root canal sealing, and the physical properties for various powder-liquid ratios were analyzed according to ISO-6876. Tensile bond strength was also examined. Prototype endodontic obturators with a combination of thread numbers and pitch angles were analyzed for sealing ability after MetaSEAL Soft was obturated in simulated root canals. Powder-liquid ratios of 1.0:1, 1.1:1, 1.2:1, and 1.3:1 showed suitable physical properties; however, flow for 1.4:1 was below a standard value. Tensile bond strength increased gradually when the powder-liquid ratio changed from 1.0:1 to 1.3:1, and 1.3:1 and 1.4:1 showed the highest and lowest bond strengths, respectively. Sealing ability increased when pitch angles of the obturators were 5°, 8°, and 11°; 11° showed the best results. Similarly, sealing ability increased when the thread number was 12, 17, and 22 pitches; 22 showed the best results. These findings suggest that the prototype endodontic obturator can be useful for obturating MetaSEAL Soft, and a powder-liquid ratio of 1.3:1 MetaSEAL Soft may be the most suitable for achieving excellent sealing.

Microscopic and chemical evaluation of the filling quality of five obturation techniques in oval-shaped root canals.

The aim of this study was to assess the filling quality of five obturation techniques in oval-shaped root canals. A total of 212 mandibular first molars with one distal oval canal were selected. Distal canals, shaped with WaveOne Gold Primary, were randomly divided in five groups (n = 40) for obturation: continuous wave condensation, GuttaCore, Thermafil, single cone with AH plus, and single cone with BioRoot RCS. The proportions of gutta-percha-filled areas (GPFA), sealer-filled areas (SFA), void areas (VA), and the sealer/gutta tags into dentinal tubules at 4mm and 2mm from the apex were analyzed by an optical numeric microscope, SEM, and energy-dispersive X-ray (EDX). Data were then compared by Kruskal-Wallis one-way ANOVA on ranks (α = 0.05). At 4mm, a statistically significant higher GPFA and lower SFA were observed in the GuttaCore and Thermafil groups compared with the 3 other groups. A statistically significant lower VA was observed in the continuous wave condensation, GuttaCore, and Thermafil groups than in the two single-cone groups. At 2mm, there were a statistically significant higher GPFA and lower SFA and VA in GuttaCore and Thermafil groups than in the 3 other groups. At the two levels investigated, the presence of gutta-percha tags was clearly demonstrated for GuttaCore and Thermafil groups; no tags were observed in the 3 other groups. Obturation quality was overall improved in GuttaCore and Thermafil groups. Carrier-based techniques may significantly improve the filling quality compared to continuous wave condensation and single-cone technique. The single-cone technique might have inherent limitations especially in oval root canals regardless of the sealer used.

Micro-computed tomography evaluation of root canal filling quality with apical negative pressure

ObjectivesThe objective of the present study was to compare, using micro-computed tomography (micro-CT), the location and volume percentage of voids in root canals that were obturated with a premixed tricalcium silicate sealer and a single gutta-percha master cone, in the presence or absence of apical negative pressure. MethodsTwenty extracted human mandibular premolars were cleaned and shaped. The teeth were assigned to 2 groups (n = 10) according to the filling technique: apical negative pressure sealer application combined with the single-cone technique (NPS) or syringe-assisted sealer application combined with the single-cone technique (SS). Each specimen was scanned using micro-CT at 10 μm resolution. The percentages of voids were calculated from segmental regions of interest. Data were analysed using nonparametric statistical methods, with statistical significance pre-set at α = 0.05. ResultsSignificant difference was identified (p < 0.05) in the overall percentage of voids between the NPS group (0.33 %; interquartile range 0.25 %) and the SS group (6.29 %; interquartile range 5.57 %). In the NPS group, the percentages of voids in the coronal-third or middle-third of the canal space were statistically lower than that in apical-third (p < 0.0167, Bonferroni adjustment), with no significant difference between the former two groups. In the SS group, no significant difference in the percentages of voids was identified among the coronal-third, middle-third and apical-third of the canal space. ConclusionsApical negative pressure sealer application combined with the single-cone technique produces fewer voids in root canal fillings than the conventional single-cone technique. Clinical significanceThe apical negative pressure sealer application technique combined with single-cone filling constitutes a novel root canal obturation technique that improves the quality of root canal filling by minimising the volume of voids within the three-dimensional canal space.

Effect of four different root canal obturation techniques on marginal adaptation of bioceramic sealer: An in vitro scanning electron microscopic study

Aim: Successful endodontic treatment can be achieved with techniques and materials that have the ability to seal root canal space. The aim of this study was to investigate the effect of four techniques of obturation (single cone [SC], cold lateral [CL], continuous wave [CW], and carrier based [CB]) on the marginal adaptation of bioceramic sealer to the root canal walls using scanning electron microscope (SEM). Materials and Methods: Forty, single-rooted lower premolars were included in this study. The teeth were segmented at the level of cementoenamel junction (CEJ). Then, root canals were shaped with rotary ProTaper nickel–titanium (NiTi) files to F3. Instrumented teeth were assigned randomly into four experimental groups (n = 10/group) as follows: (1) SC, (2) CL, (3) CW, and (4) CB. EndoSequence BC sealer was used for the four groups. After root canal obturation, the roots were horizontally cut into three levels and the interface was examined under SEM in the apical, middle, and cervical thirds of each group. The data collected were analyzed using one-way analysis of variance (ANOVA) and Tukey’s post hoc multiple range tests at P ≤ 0.05. Results: CW of obturation technique showed the best marginal adaptation and the least mean of gaps along the interface between the obturating material and the root canal dentine at all sections of the root (apical, middle, and coronal), followed by the CL technique. Also, results found that CW and CL were significantly different from SC and CB techniques. Conclusion: Techniques of obturation had an effect on the marginal adaptation of bioceramic sealer to the root canal walls. CW technique showed the best marginal adaptation for bioceramic sealer followed by the CL technique. Less marginal adaptation was observed in the SC and CB techniques.

Digital Radiographic Evaluation of the Quality of Different Root Canal Obturation Techniques in Deciduous Mandibular Molars after Preparation with Rotary Technique.

Statement of the Problem: Several factors affect the success of pulp therapy of primary teeth, including cleaning and shaping of the root canals and the quality of obturation as the most important steps. Purpose: The aim of the present study was to compare the quality of different root canal obturation techniques in deciduous mandibular molars subsequent to preparation of the root canals with the rotary technique, using the photo stimulated phosphor (PSP) digital radiographic technique. Materials and Method: In this in vitro study, 221 root canals were selected in 80 extracted deciduous mandibular second molars. The root canals were prepared with a modified protocol for ProTaper NiTi rotary files and with only two instruments (SX and S2) and obturated using a lentulo spiral, condensation technique, an anesthetic syringe, and tuberculin syringe techniques with ZOE paste. The quality of the root canal obturation (obturation length and the number and sizes of the voids) was evaluated using PSP radiographic technique. Data were analyzed with SPSS 21, using chi-squared, Kruskal-Wallis and Mann-Whitney tests. Results:There were no significant differences in the obturation length (p= 0.285) and the number of voids (p= 0.061) between the study groups; however, there were significant differences in void sizes between the study groups (p= 0.001). The condensation and tuberculin syringe groups exhibited the best and worst results considering the obturation length, respectively. Lentulo and anesthetic syringe techniques have also exhibited acceptable results. The condensation and anesthetic syringe groups exhibited the minimum and maximum number of voids, respectively. The condensation and lentulo groups exhibited the maximum and minimum void sizes, respectively. Conclusion:If implemented correctly, there will be no significant difference among the experienced root canal obturation techniques considering obturation length and the number of voids.

A Comparative Mircoleakage Assessment in Root Canals Obturated by Three Obturation Techniques using Fluid Filtration System

The aim of this study was to assess the micro leakage in three root canal obturation techniques viz. Warm vertical condensation, Cold lateral condensation and Thermafil using fluid filtration system. In this study the fluid filtration method is fabricated and used to assess the micro leakage in gutta-percha material obturated using three obturation techniques viz. Warm vertical condensation, Cold lateral condensation and Thermafil. The assessment system which can quantify the micro leakage present into the obturated root canal cavity is today's vital need to improve the further progress in endodontics and conservative dentistry. 45 No's of samples were taken for study and categorized into three, Category I: 15 No's of samples obturated using warm vertical condensation, Category II: 15 No's of samples obturated using cold lateral condensation and Category III: 15 No's of samples obturated using Thermafil. All obturated samples were tested using the fluid filtration system. The DSLR 1200D Canon and Auto CAD by Auto Desk were used to record the bubble displacement in the micropipette. The micro leakage reading are shown in Table 2 and tabulated values showed that Category II: 15 No's of samples obturated using cold lateral condensation, showed highest micro leakage value highest micro leakage followed by Category III: 15 No's of samples obturated using Thermafil and Category I: 15 No's of samples obturated using warm vertical condensation. Category III shown moderate leakage value. The study indicated that micro leakage evaluation using the fabricated fluid filtration system is most reliable quantitative method. On the basis of comparison of micro leakage assessment of three obturation techniques it is found that warm vertical condensed sample having least leakage over the Thermafil and Cold lateral condensation. The reason for micro leakage is shrinkage of gutta-percha during solidification to cause gap in between obturation material and canal wall which can be avoided by providing shrinkage allowance.