Thermafil Plus Research Articles

Performance of obturation techniques in anatomical irregularities located at different thirds of the root canal system.

This study aimed to compare the quality of root canal obturation (ratio of area occupied by gutta-percha (G), sealer (S), and presence of voids (V)) in different anatomical irregularities (intercanal communications, lateral irregularities, and accessory canals) located at different thirds of the root canal system of mandibular molar replicas. Sixty-seven 3D printed replicas of an accessed mandibular molar were prepared using ProGlider and ProTaper Gold rotatory systems. Three specimens were randomly selected to be used as controls and did not receive further treatment. The rest were randomly distributed in 4 experimental groups to be obturated using either cold lateral compaction (LC), continuous wave of condensation (CW), and core-carrier obturation (ThermafilPlus (TH) or GuttaCore (GC)) (n=16 per group). AHPlus® sealer was used in all groups. The three controls and a specimen from each experimental group were scanned using micro-computed tomography. The rest of the replicas were sectioned at the sites of anatomical irregularities and examined at 30× magnification. The G, S, and V ratios were calculated dividing the area occupied with each element by the total root canal area and then compared among groups using the Kruskal-Wallis test. Voids were present in all obturation techniques with ratios from 0.01 to 0.15. CW obtained a significantly higher G ratio in the irregularity located in the coronal third (0.882) than LC (0.681), TH (0.773), and GC (0.801) (p<0.05). TH and GC achieved significantly higher G ratios in those located in the apical third (p<0.05). The worst quality of obturation was observed in the loop accessory canal with all obturation techniques. Whitin the limitations of this study, it can be concluded that CW and core-carrier obturation are respectively the most effective techniques for obturating anatomical irregularities located in the coronal and the apical third.

Efficiency and effectiveness of retreatment with Thermafil Plus, Guttacore and vertical condensation.

Efficiency and effectiveness of retreatment with Thermafil Plus, Guttacore and vertical condensation.

Time Required to Remove GuttaCore, Thermafil Plus, and Thermoplasticized Gutta-percha from Moderately Curved Root Canals with ProTaper Files

IntroductionA novel carrier-based obturation system, GuttaCore, was developed to facilitate more efficient nonsurgical retreatments. This ex vivo study evaluated the time required for re-treating GuttaCore and 2 other common obturation materials in moderately curved canals with ProTaper retreatment and ProTaper files. MethodsSixty mesial roots of mandibular molars with the same mean curvature were randomly divided into 3 experimental groups: warm vertical, Thermafil Plus, and GuttaCore. Ten teeth served as positive and negative controls. The mesiobuccal canal in each sample was prepared to ISO size 30 with 0.04 taper. The warm vertical group was obturated by using a continuous-wave technique of gutta-percha compaction, and the Thermafil Plus and GuttaCore groups were obturated according to manufacturers' instructions. After allowing sealer to set, each specimen was sequentially treated with ProTaper Retreatment files D1, D2, and D3 and ProTaper Universal file F3 to the predetermined working length. The time taken to reach working length (T1) and the time required for obturation material removal (T2) were recorded. ResultsOne-way analysis of variance followed by post hoc Tukey-Kramer test indicated that the mean total time to remove filling material for the GuttaCore group was significantly shorter than those observed in the other groups (P < .05). No significant difference was observed between warm vertical and Thermafil Plus groups. ConclusionsGuttaCore is removed in less time from moderately curved canals with ProTaper files than either thermoplasticized gutta-percha or Thermafil Plus materials.

Effect of Canal Preparation on Fill Length in Straight Root Canals Obturated with RealSeal 1 and Thermafil Plus

IntroductionA common adverse effect when using thermoplasticized obturators is overextension. A canal preparation allowing for predictable obturation length would be of clinical value. This study compared straight canals instrumented to a size 40 file by evaluating the extension of 2 thermoplastic obturation systems, a 0.04 standardized taper preparation (STP) and a varied taper preparation (VTP), by evaluating the extension of 2 thermoplastic obturation systems, RealSeal 1 (RS-1) and Thermafil Plus (TP). MethodsEighty extracted mature human premolars with single straight canals were randomly divided into 4 experimental groups (n = 20). Groups 1 and 2 were instrumented to size 40/04 at working length with STP. Groups 3 and 4 were instrumented to size 40/02 at working length with VTP. Groups 1 and 3 were obturated with RS-1, and groups 2 and 4 were obturated with TP. All groups were obturated per manufacturer's instructions. Extension of material was evaluated and assessed ordinally. Statistically significant differences were determined by logistic regression with significance level set at P < .05. ResultsSignificant differences in extrusion existed between groups 2 and 4 when controlling for type of material (P = .026) and all groups for extrusion of TP compared with RS-1 when controlling for type of preparation (P < .001). ConclusionsThe results indicate that when filling with RS-1 obturators, the canal can be instrumented to an STP or VTP with a low likelihood of excessive extrusion. If the clinician prefers to use TP obturators, this study validates a VTP to decrease the occurrence of overextension.

Influence of the Diameter and Taper of Root Canals on the Removal Efficiency of Thermafil Plus Plastic Carriers Using ProTaper Retreatment Files

Introduction This study aimed to investigate the influence of canal shape on the time required for the removal of Thermafil Plus plastic carriers (Dentsply Tulsa Dental, Tulsa, OK) using ProTaper Retreatment Files (Dentsply Maillefer, Ballaigues, Switzerland). Methods Sixty simulated J-shaped canals in resin blocks were divided into six groups prepared differently in terms of apical size (25/04 or 35/06) and coronal enlargement (no coronal enlargement, using a K3 orifice opener [SybronEndo, Orange, CA] 25/08, or using Gates-Glidden drills [Mani, Tochigi, Japan] #1-4) and were filled with a Thermafil Plus of the same carrier size (size 25 or 35). The carriers were removed using ProTaper D1, D2, and D3 in a crown-down sequence, and removal time was measured. A similar experiment was performed using extracted mandibular incisors prepared to 25/04 with or without coronal enlargement using Gates-Glidden drills ( n = 10 each). Results Simulated canals coronally enlarged with Gates-Glidden drills required a significantly longer removal time than other groups of identical apical size ( p < 0.05). When groups with similar coronal enlargement were compared, those apically prepared to 35/06 required a significantly longer removal time than those prepared to 25/04 ( p < 0.05). Coronally enlarged incisors also required a significantly longer removal time than those without coronal enlargement ( p < 0.05). Conclusions Canals with a larger diameter and/or taper required more time for the removal of Thermafil Plus plastic carriers.

Apical Extrusion of Thermoplasticized Obturating Material in Canals Instrumented with Profile 0.06 or Profile GT

The purpose of this in vitro study was to compare the extrusion of thermoplacticized gutta-percha in teeth instrumented with Profile 0.06 or Profile GT, and obturated with Thermafil Plus and Thermafil GT, respectively. A total of 120, extracted, human maxillary central incisors were divided into four equal groups. Group 1 was instrumented with Profile 0.06 and obturated with Thermafil Plus. Group 2 was instrumented with Profile 0.06 and obturated using warm vertical condensation (negative control). Group 3 was instrumented with Profile GT and obturated with Thermafil GT. Group 4 was instrumented with Profile GT and obturated like Group 2 (negative control). Extrusion was graded as present or absent. Results found 9 of 30 extruded for group 1, 1 of 30 for group 2, 15 of 30 for group 3, and 2 of 30 for group 4. The results suggest that, in vitro, Thermafil GT may be more prone to extruding gutta-percha past the apical foramen than Thermafil Plus.

Effect of different rotary instrumentation techniques and thermoplastic filling on apical sealing

The aim of this study was to evaluate apical sealing after root canal treatment using two different rotary instrumentation techniques and two thermoplastic root canal filling techniques. The study was performed in 115 human extracted mandibular premolars. After coronary access the apical foramen was opened with a # 15 K file 1 mm beyond the apex. Cleaning and shaping was subsequently carried out at the working length, 1 mm from the apex, with ProFile .04/.06 system (Dentsply/Maillefer), Quantec (Analytic Endodontics/Kerr) or by the step-back technique with 1% sodium hypochlorite solution as irrigating solution. The root canals were filled with Thermafil (Dentsply/Maillefer) or Microseal (Analytic Endodontics/Kerr) or by lateral condensation technique using AH Plus sealer (epoxy type). The teeth were immersed in 2% methylene blue under vacuum. Then, they were longitudinally sectioned. The results showed that the association of Profile and Thermafil Plus provide the best results (p<0.05). In conclusion, the association of different rotary instrumentation techniques and different filling systems influenced the apical sealing.

The Effect of Insertion Rates on Fill Length and Adaptation of a Thermoplasticized Gutta-Percha Technique

The purpose of this in vivo study was to determine the effect of the insertion rate of a thermoplasticized gutta-percha obturation technique (Thermafil Plus) on the quality of the root canal obturation. A calibrated practitioner obturated the tooth in each of three groups with insertion rates of 18, 6, and 3 mm/s, respectively. The quality of the obturation was assessed by measuring the length of fill and the replication of induced canal irregularities, consisting of dimples and grooves. All measurements were made on a single tooth, with a working length of 18 mm from the canal orifice, embedded in a split mold, with 20 measurements for each insertion rate. Measurements were made under a low-power microscope, with the images recorded on videotape. The length of fill decreased with decreasing the insertion rate, from a mean overextension of +0.88 mm (SD 1.12 mm) for the 18 mm/s rate to a mean underfill of -0.13 mm (SD 1.03 mm) for the 3 mm/s rate. A trend of decreasing fill with decreasing insertion rate was observed, with the difference between the insertion rates of 18 mm/s and 3 mm/s being statistically significant at p < 0.05 using a single comparison test. Replication of dimples decreased with decreasing the insertion rate from a mean reproduction of 99% for the 18 mm/s rate to a mean reproduction of 90% for the 3 mm/s rate. The replication of grooves also decreased with decreasing the insertion rate from a mean reproduction of 100% for the 18 mm/s rate to a mean reproduction of 88% for the 12 mm/s rate. Statistical analysis of the data for both the dimples and the grooves using a paired comparison post hoc Scheffe test found these differences are significant at p < 0.05.

Comparison of a Warm Gutta-Percha Obturation Technique and Lateral Condensation

This study was designed to compare a warm gutta-percha obturation technique, Thermafil Plus (Tulsa Dental, Tulsa OK), with lateral condensation for the ability to adapt gutta-percha to the walls of a root canal system. An extracted sectioned and mounted maxillary central incisor had canal irregularities created and was subsequently subjected to multiple obturations using both techniques. Length of fill, replication to working length, number of artificial depressions replicated, quality of replications, number of voids, and general appearance of obturation were all evaluated using standardized criteria. Data evaluation consisted of a one way analysis of variance on the same type defects between obturation groups followed by a Scheffé post-hoc test. A statistically significant difference was found between the groups in each category of evaluation. Gutta-percha using Thermafil was better able to flow into lateral spaces, had fewer voids, and replicated the surface of the root better. It also, however, was extruded out the apical foramen more than in the lateral condensation group.

In Vitro Infrared Thermographic Assessment of Root Surface Temperatures Generated by the Thermafil Plus System

The purpose of this in vitro study was to investigate root surface temperatures generated by the Thermafil Plus system using infrared thermography. A total of 60 extracted human maxillary central incisors and maxillary first molars were biomechanically instrumented using ProFile 0.04 Taper Series 29 rotary instruments. The root canals were obturated using the Thermafil Plus system. An infrared thermography camera was used to measure the external root surface temperatures during and after the completion of obturation. The mean temperature rise of the external root surface from the ambient temperature was 4.26 degrees C for the mesial buccal roots, 4.58 degrees C for the distobuccal roots, 4.76 degrees C for the palatal roots, and 4.87 degrees C for the anterior roots. These temperatures were well below the critical level of 10 degrees C needed to cause damage to the attachment apparatus. From this in vitro experiment, no evidence was discovered which would indicate that the Thermafil Plus obturation system would result in damage to the periodontal ligament and the surrounding attachment apparatus as a consequence of temperature rise on the external root surface.