Warm Obturation Technique Research Articles

In Vitro Evaluation of Root Surface Temperature Using Different Endodontic Filling Techniques

Depending on the obturation technique, the tooth and surrounding tissues may heat up during root canal filling, particularly with warm methods. This study aimed to analyze the temperature increase in the periradicular and -apical region during various warm obturation techniques with a present simulated periodontal blood flow. Seventy-five extracted human teeth were shortened to 11 mm (cut-grinder Primus diamond cutting device; Walter Messner GmbH, Oststeinbek, Germany) and prepared using the ProTaper Gold system (Dentsply Sirona Inc., Charlotte, NC, USA) ISO size 40/.06. Specimens were prepared to ensure stable fluid circulation in an artificially created periodontal space, and the procedure was recorded with a thermal infrared camera (VarioCAM HD; InfraTec GmbH Infrarotsensorik und Messtechnik, Dresden, Germany). The following obturation methods were applied: I, cold single-cone obturation (control group); II, gutta-percha-coated rigid carrier technique (GuttaFusion); III, squirting technique (injection technique); IV, continuous wave technique; and V, Schilder technique. Statistical analysis was performed using the Kruskal–Wallis test, followed by the Mann–Whitney pairwise test using the sequential Bonferroni procedure for significant differences (p < 0.05). The Schilder technique with 0 mL/min showed the lowest temperature change, with a median of 0.00 °C (max. 0.00 °C, min. 0.00 °C, IQR 0.00 °C). In contrast, the continuous wave technique at a circulation rate of 2.6 mL/min exhibited the highest temperature change, with a median of 3.76 °C (max. 5.33 °C, min. 2.42 °C, IQR 1.46 °C). Although warm obturation techniques can increase surface temperature, none of the methods produced changes that were potentially damaging to the periodontium or surrounding bone.

Effects of heating on bioceramic sealers: a scoping review of chemo-physical properties and clinical implications.

This scoping review aims to summarize current research to assess the impact of heating on the chemo-physical properties of bioceramic sealers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines, a comprehensive literature search was conducted in April 2024 across PubMed and Scopus databases. Inclusion criteria referred to all study types evaluating the effect of heating temperature on bioceramic sealers' properties, with no language or time restrictions applied. Studies were independently screened by two reviewers, and relevant data were extracted and synthesized qualitatively. Out of 91 initially identified studies, 19 met the eligibility criteria for inclusion in the qualitative synthesis. The selected studies ranged from 2014 to 2024 and comprised laboratory-based investigations. Various bioceramic sealers, including EndoSequence BC Sealer, BioRoot RCS, and TotalFill BC, were analyzed across different heating techniques. The findings revealed divergent responses of bioceramic sealers to heat, with some demonstrating stability while others exhibited alterations in properties such as flow, setting time, and chemical composition. The impact of heat on bioceramic sealers depends on the sealer's composition and laboratory setting. While some sealers are affected significantly, others remain stable. Clinicians should carefully consider these factors when bioceramic sealers are used with warm obturation techniques, but caution is needed as real-world conditions may vary. Integrating laboratory results with clinical evidence is essential for improving treatment efficacy and patient care.

Evaluation of Fracture Strength of Roots to Determine the Duration Limit of Activated Ethylene Diamine Tetraacetic Acid Irrigation for Intracanal Calcium Hydroxide Dressing Removal In Vitro

This study evaluated the effect of the use of EDTA solution at various intervals to remove intracanal calcium hydroxide medication on fracture resistance. One hundred and one extracted lower premolar teeth were randomly allocated into one control group (n = 5), two main experimental groups (CH(+), with calcium hydroxide dressing, and CH(−), without calcium hydroxide dressing), with four subgroups (EDTA intervals: 1 min, 3 min, 5 min, 10 min, n = 12). Ready-to-use injectable calcium hydroxide was used for the samples in the four CH(+) subgroups, and the samples were kept in an incubator at 37 °C and 100% humidity for seven days. All samples (CH(+), CH(−)) were irrigated with 17% EDTA, which was accompanied by activation with EndoActivator for 1, 3, 5, and 10 min, and then rinsed with 2.5% NaOCl in a standardized manner. The obturation was conducted using the warm obturation technique; experiments were conducted with a universal testing device, and their fracture strength was recorded. Compliance with the normal distribution was examined with ±2 skewness coefficients. Two-way ANOVA, Tukey’s, one-way ANOVA, and Dunnett’s tests were used for statistics (p < 0.050). A statistically significant difference was found between the mean values of the force between the groups (p = 0.009). The mean strength of the tooth at fracture that CH(−) was 401.7, CH(+) was 335.35. There was no statistically significant difference between the mean values of the forces according to time intervals (p = 0.387). While there was no significant difference among the experimental groups (p = 0.229), the mean fracture strength of the negative control group was found to be significantly higher (p < 0.001). The highest fracture resistance was observed in the nonprepared group. Irrigation with EDTA for up to 5 min showed more acceptable fracture resistance results than the other groups. Using calcium hydroxide significantly and negatively affected the root strength.

Physicochemical Changes in Root-Canal Sealers under Thermal Challenge: A Comparative Analysis of Calcium Silicate- and Epoxy-Resin-Based Sealers.

We compared the effects of heat on the physicochemical properties of recently developed calcium silicate-based sealers (CSBSs), including BioRoot Flow, BioRoot RCS, and AH Plus Bioceramic sealer, with those of the epoxy-resin-based sealer (ERBS) AH Plus. The flow, film thickness, setting time, and solubility of sealers were evaluated at 37 °C and 100 °C using ISO 6876/2012. Furthermore, pH and calcium ion release were evaluated at these temperatures. In addition, the mass change in sealers at a high temperature was assessed via thermogravimetric analysis. Then, the chemical composition and components of the sealers were analyzed using a scanning electron microscope and Fourier-transform infrared spectroscopy (FTIR). BioRoot Flow, AH Plus Bioceramic, and AH Plus complied with ISO standards in terms of flow and film thickness, both before and after heat application. However, BioRoot RCS exhibited significantly increased film thickness at 100 °C. The setting times of all sealers were significantly reduced at 100 °C. The solubility of CSBS was >3%, exceeding the ISO 6876/2012 standard, both before and after heat exposure. Conversely, the solubility of AH Plus complied with the standard, regardless of the thermal condition. For 4 weeks, CSBS showed a significantly higher pH than AH Plus at both 37 °C and 100 °C. After heat treatment, calcium release decreased in Bioroot RCS and BioRoot Flow, while AH Plus showed no significant differences before and after treatment. However, CSBS consistently exhibited significantly higher calcium release than AH Plus at both temperatures. An FTIR analysis revealed that the chemical composition of the sealers did not change at the high temperature, whereas a thermogravimetric analysis demonstrated a >5% weight reduction in CSBS and a 0.005% weight reduction in AH Plus at 100 °C. BioRoot Flow, AH Plus Bioceramic, and AH Plus possess favorable physicochemical properties, which make them suitable for application under thermal conditions. At a high temperature, BioRoot RCS did not exhibit changes in its chemical composition. However, its film thickness was increased, and pH and solubility were reduced. Therefore, caution is needed when it is applied at high temperatures, such as during the warm obturation technique.

Sealing Ability of Root Canal Sealers in Warm Obturation Techniques Compared to Cold Obturation Techniques: A Systematic Review

Introduction: Obturation is a critical step in root canal treatment of the teeth that significantly contributes to its success. Various techniques are used for obturation of root canals. Aim: To compare the sealing efficiency of sealers under warm and cold obturation techniques across parameters such as Microleakage (ML), Push-out Bond Strength (PBS), and dentinal tubule penetration, which help evaluate the sealer-dentin interface in root canal systems. Materials and Methods: The research question was designed in the Population, Intervention, Comparison, Outcome (PICO) format, and the databases searched were Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane, and Scopus following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Inclusion criteria included in-vitro studies between January 2011 and June 2021 in the English language, comparing the influence of both cold and warm obturation techniques on root canal sealers. Key parameters considered for evaluating the sealing ability of endodontic sealers were marginal adaptation, ML, and Dentinal Tubule Penetration (DTP). Two independent reviewers assessed studies for eligibility against the inclusion and exclusion criteria and conducted data extraction. Risk of bias assessment was performed using the Cochrane risk of bias assessment tool, Review Manager (v5.4). Results: A total of 19 articles were finalised for review, and methodological assessment for all parameters involved in the study was conducted using the Cochrane risk of bias assessment tool. Out of the total, five studies showed a moderate risk of bias, while the remaining 14 studies showed a low risk of bias. Conclusion: Warm and cold obturation techniques perform similarly in producing a good apical seal when used in root canal treatment with different endodontic sealer materials. Warm obturation techniques perform better than cold obturation techniques in producing homogeneous root canal fillings, while cold obturation techniques enhance push-out bond strength at the sealer-dentin interface.

Effect of Different Obturation Techniques on the Amount of Debris Extrusion During Endodontic Retreatment Using XP Endo Retreatment Set Files (In vitro Study)

Objective: This study aimed to assess the effect of the cold and warm obturation techniques on the amount of apically extruded debris (AED) and time needed for the removal of filling material during endodontic retreatment using the XP endo retreatment files.
 Methods: Sixty single-rooted lower premolars with round-shaped canals were selected for the study. The canals were prepared and obturated with one of four obturation techniques (N=15): cold lateral compaction (CLC), single-cone (SC), thermoplasticized gutta percha injection (TGP), and gutta core (GC) obturation techniques. All the root canal fillings were removed using XP endodontic retreatment files. The mean weight of the AED was estimated with an analytical balance to an accuracy of 10-4 g. AED data were subjected to Kruskal-Wallis and a one-way ANOVA, post hoc Tukey's test for the time factor, with a significance level ≤ 0.05.
 Results: AED data revealed significant differences among groups (p=0.039). The CLC technique was significant compared to TGP, with a significance level of p=0.018, and significant compared to the SC technique, with a significance level of p=0.034. Also, there were highly significant differences between groups regarding the time needed for retreatment (p=0.000).
 Conclusions: The obturation technique influences AED, and time for root canal retreatment. CLC resulted in less debris extrusion, while SC resulted in higher debris extrusion and TGP required the least time for root canal retreatment.

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.

Intratubular penetration capacity of HiFlow bioceramic sealer used with warm obturation techniques and single cone: A confocal laser scanning microscopic study

ObjectiveThe aim of this paper was to evaluate the intratubular penetration area of a bioceramic sealer, using continuous wave (CW), vertical condensation (VC) with two different types of gutta-percha (conventional (NG) and bioceramic-coated (BG)) and single cone (SC) technique with BG gutta-percha, in different root thirds. MethodsA total of 150 mature single-root human teeth (including incisors, canines and premolars) were prepared and randomly divided into five groups (n = 30). Teeth were filled using a bioceramic sealer (TotalFill BC Sealer HiFlow ®) and two different types of gutta-percha, with CW and VC techniques, the teeth in the control group were filled with SC technique and BG gutta-percha. The teeth were sectioned and evaluated as one-third portions in each case under a confocal laser microscope. The penetration area measurements were carried out with the Autocad ® programme. Data was analyzed using the one-factor ANOVA test (p < 0.05) and Post Hoc Test (p < 0.05). ResultsThe ANOVA Test showed significant differences in the penetration areas of the five obturation techniques (P < 0.05). The Post Hoc Test exhibited significant differences in multiple comparisons (P < 0.05). There was more dentinal tubule penetration in the coronal third than in the apical third in all techniques. ConclusionsThe intratubular penetration of the bioceramic sealer was influenced by the obturation techniques tested, but not by the different gutta-percha tested. There was more penetration of sealer in the warm obturation techniques than the SC, regardless of the type of gutta-percha used.

Intratubular penetration ability in the canal perimeter using HiFlow bioceramic sealer with warm obturation techniques and single cone.

BackgroundThe aim of this paper was to evaluate the intratubular penetration percentage in the perimeter of the canals of the calcium silicate-based sealer HiFlow, using three warm obturation techniques, continuous wave (CW) and vertical condensation (VC) with two different types of gutta-percha (conventional (NG) and bioceramic-coated (BG), GuttaCore (GC) and single cone (SC) with BG in different root thirds. Material and Methods180 human teeth with a single root were selected including incisors, canines and premolars were prepared and randomly divided into six groups (n=30). Teeth were filled using a bioceramic sealer TotalFill BC Sealer HiFlow (HiFlow) and two different types of gutta-percha, with CW, VC and GC techniques, the teeth in the control group were filled with SC technique and BG gutta-percha. The teeth were sectioned and evaluated as one-third portions in each case under a confocal laser microscope. The penetration ability in the canal’s perimeter was carried out with the Autocad® programme. Data was analyzed using Levene’s test (p<0,05), ANOVA test (p<0,05), Welch’s comparison test (p<0,05), Games-Howell multiple comparison test (p<0,05), Bonferroni test (p<0,05). ResultsThe percentages relative to penetration was higher in the warm obturation techniques than the SC in all thirds evaluated. Games-Howell test (p<0,05) showed up significant differences in multiple comparisons. There was greater penetration in the perimeter of the canals in the coronal third than in the apical third in all of the techniques. ConclusionsThe warm obturation techniques (CW, VC and GC) generated a greater intratubular penetration percentage in the canal perimeter of the sealer than the single cone in all thirds. Key words:HiFlow, calcium silicate-based sealer, confocal laser microscope, dentinal tubules.

“Intratubular Penetration Capacity of Hiflow Bioceramic Sealer Used with Warm Obturation Techniques and Single Cone.”

“Intratubular Penetration Capacity of Hiflow Bioceramic Sealer Used with Warm Obturation Techniques and Single Cone.”

Physico-Chemical Investigation of Endodontic Sealers Exposed to Simulated Intracanal Heat Application: Hydraulic Calcium Silicate-Based Sealers.

The aim of this study was to gain information about the effect of thermal treatment of calcium silicate-based sealers. BioRoot RCS (BR), Total Fill BC Sealer (TFBC), and Total Fill BC Sealer HiFlow (TFHF) were exposed to thermal treatment at 37 °C, 47 °C, 57 °C, 67 °C, 77 °C, 87 °C and 97 °C for 30 s. Heat treatment at 97 °C was performed for 60 and 180 s to simulate inappropriate application of warm obturation techniques. Thereafter, specimens were cooled to 37 °C and physical properties (setting time/flow/film thickness according to ISO 6876) were evaluated. Chemical properties (Fourier-transform infrared spectroscopy) were assessed after incubation of the specimens in an incubator at 37 °C and 100% humidity for 8 weeks. Statistical analysis of physical properties was performed using the Kruskal-Wallis-Test (P = 0.05). The setting time, flow, and film thickness of TFBC and TFHF were not relevantly influenced by thermal treatment. Setting time of BR decreased slightly when temperature of heat application increased from 37 °C to 77 °C (P < 0.05). Further heat treatment of BR above 77 °C led to an immediate setting. FT-IR spectroscopy did not reveal any chemical changes for either sealers. Thermal treatment did not lead to any substantial chemical changes at all temperature levels, while physical properties of BR were compromised by heating. TFBC and TFHF can be considered suitable for warm obturation techniques.

Heat Generation Changes with Electrically Heated Pluggers after Multiple Autoclave Cycles at Different Operating Temperatures

IntroductionElectrically heated pluggers are the most commonly used instruments during warm obturation techniques. This study aimed to evaluate the effect of sterilization and operating temperature settings on the heat generation of pluggers of various taper sizes. MethodsFifty pluggers were sterilized at 132°C for 25 minutes for a total of 150 cycles. One group (Autoclave200) consisted of 25 pluggers tested at an operating temperature setting of 200°C, whereas another group (Autoclave400) consisted of 25 pluggers tested at 400°C. The heat generation at their tip surface was measured with T-type thermocouples at 0, 50, 100, and 150 autoclave cycles. An unpaired t test was used to compare the time it took the pluggers to reach 60°C and the mean maximum temperature change. ResultsAfter 50 autoclave cycles, all of the 0.04 taper pluggers in Autoclave200 failed to reach 60°C. After 100 autoclave cycles, one of the 0.10 taper pluggers in Autoclave200 did not reach 60°C, and after 150 autoclave cycles, one of the 0.04 taper pluggers failed to generate any heat. The mean increase in the time to reach 60°C ranged from 1071-4004 milliseconds and 510-2074 milliseconds for Autoclave200 and Autoclave400, respectively. The mean maximum temperature change decreased by 13-29°C and 24-116°C for Autoclave200 and Autoclave400, respectively. ConclusionsAfter multiple autoclave cycles and higher operating temperature use, the electrically heated pluggers transferred less heat to the tip surface, potentially making them less effective.

The Effect of Heating Time and Temperature on Epoxy Resin and Calcium Silicate–based Endodontic Sealers

IntroductionWith the growing use of warm obturation techniques during endodontic treatment, more interest is directed toward sealers' compatibility with heat. This study aimed to evaluate the effect of heat application duration and temperature on epoxy resin– and calcium silicate–based sealers using chemical and thermogravimetric analyses. MethodsFreshly mixed samples (n = 5/group) of each sealer were heated at 200°C or 250°C for 30 or 60 seconds. Additional 2 sets of samples were examined directly after mixing or after setting without heat exposure. Raman spectroscopy was used to identify changes in the chemical structure, and a 2-way analysis of variance was performed to compare values of measurable peaks that exhibited changes. Additionally, Thermogravimetric Analysis (TGA) was used to evaluate the effect of heat on mass change where sealers were heated to 250°C at a rate of 20°C/min (11-minute duration) or maintained at 37°C for 8 hours. ResultsNo differences were detected among all the spectra of calcium silicate samples of different groups, while TGA revealed 15% and 18% weight loss upon heating at 250°C and 37°C, respectively. For the resin sealer, significant differences were detected when samples were heated for 60 seconds, involving bonds of benzene rings and aromatic amines in the uncured resin. TGA revealed minimal changes in the sealer mass (1.2% and 1.8%) on heating at 250°C and 37°C, respectively. ConclusionsHeat application duration and temperature can affect the chemical structure of epoxy resin sealers. The consideration of endodontic sealer compatibility as well as the duration of heat application is essential when warm vertical obturation is used.

Apical filling characteristics of carrier-based techniques vs. single cone technique in curved root canals.

In this in vitro study, we assessed filling characteristics (adaptation, homogeneity, sealer percentage, position of the carrier) of warm and cold obturation methods in curved root canals. A reciprocating method was used to prepare 90 curved roots (25° average curvature) to an apical size of 25.08. They were then obturated with either (A) Guttafusion (VDW, Munich, Germany), (B) Thermafil (Maillefer, Ballaigues, Switzerland) or (C) single cone technique using 25.08 gutta-percha (VDW) and sealer (2Seal easymix) (n=30 each group). Five sections in 1-mm steps were obtained from each root, beginning 1mm short of the apex. The percentage of voids in contact with root canal walls (PVO), the proportion of voids per area (PVA) and the percentage of sealer per area (PSA) were measured. Little to no differences between Guttafusion and Thermafil were seen in curved root canals with respect to adaptation and homogeneity in the apical region. Both methods showed significantly better adaptation and homogeneity than the single cone technique. The proportion of sealer was significantly greater when roots were obturated with Guttafusion than with Thermafil, but both warm obturation techniques had significantly smaller sealer areas than the single cone technique. Compared to the single cone technique, a more favourable root canal filling with less sealer could be expected from both warm obturation techniques in curved root canals. The easier-to-handle Guttafusion leads to comparable results as Thermafil in curved root canals.

Evaluación del sellado apical de tres técnicas de obturación en presencia de instrumentos rotatorios de NiTi fracturados

The purpose of the present study was to compare the sealing ability of three warm obturation techniques (thermo-plasticized gutta-percha): Schilder’s warm vertical compaction, McSpadden’s thermo-mechanical compaction and Thermafill (Dentsply-Maillefer) in teeth fractured at the apical region. 30 extracted, single-rooted teeth were prepared with Pro-Taper (Dentsply-Maillefer). At the apical third of each of these teeth, ProTaper F3 rotary instruments were deliberately fractured. Teeth were randomly divided into three groups (n=10) to be later filled with the selected technique, so that with dye penetration technique and with the aid of discoloring teeth technique, teeth could be microscopically assessed so as to determine the amount of apical microfiltration elicited in every technique. In all groups, specimens presented some degree of apical microfiltration. Teeth filled with Thermafil presented 3,134μm average microfiltration. This microfiltration was significantly higher than the one observed with McSpadden thermo-mechanical technique and Schilder’s vertical compaction technique (p<0.05). These two techniques presented 1,934μm and 2,083μm respectively. McSpadden and Schilder’s technique show no statistically significant microfiltration differences (p>0.05).

Definition and Endodontic Treatment of Dilacerated Canals: A Survey of Diplomates of the American Board of Endodontics

To gather data from Diplomates of the American Board of Endodontics regarding treatment of dilacerated canals. A questionnaire addressing definition, endodontic treatment procedures and prognosis was constructed and distributed via e-mail to 708 Diplomates of the American Board of Endodontics. Data from 150 respondents, a 21% response rate, were collected by using a Web-based interface. For statistical analysis, Chi-square tests were used. More than 25% of respondents believed that a dilacerated root should have a curvature > 40°. One-visit treatment is the best therapeutic approach and transportation is the most likely complication in preparation of these canals. A crown-down technique, watch-winding motion and a master apical file # 25 are the best choices for preparation of these canals. Any warm obturation technique is preferred over lateral compaction by most respondents. A crown-down technique for root canal preparation and a thermoplastic obturation technique are recommended for canals whose curvature is more than 40°. The prognosis of the treatment of these canals is judged not lower than normal canals. Crown-down technique and thermoplastic obturation are recommended for dilacerated canals.

Impact of smear layer on sealing property of root canal obturation using 3 different techniques and sealers. Part I

The objective of this study was to determine the influence of smear layer removal on through-and-through fluid movement along root canal fillings obturated using 3 different root canal sealers, namely AH26, Pulp Canal Sealer, and Gutta-Flow, and 3 different obturation techniques. The fluid transport model was used for detection of through-and-through fluid movement. Root canals of 230 human extracted teeth were mechanically instrumented using the step-back technique. The canals where the smear layer was not removed were irrigated with NaOCl 2.4%, whereas canals where the smear layer was removed were irrigated with EDTA 17% plus NaOCl 2.4%. The teeth were randomly divided into 10 experimental groups (n = 20) and 3 control groups (n = 10) and treated as follows. In group A, where no attempt was made for smear layer removal, the canals were obturated with lateral compaction of gutta-percha and AH26 as a sealer. In group B, the smear layer was removed, and canals were obturated as in group A. In group C (no attempt to remove the smear layer), the canals were obturated with System B plus Obtura II technique and AH26, whereas in group D, the smear layer was removed, and canals were obturated as in group C. The other 4 experimental groups were treated and obturated in the same way as in previous groups, respectively. The sealer that was used in those groups was the Pulp Canal Sealer. Finally, the latter 2 groups were obturated with Gutta-Flow technique. Fluid movement was measured at 24 hours and 30 days and 6 months. In lateral compaction groups (with and without the smear layer), no significant differences were found regarding the ability of the same materials (AH26 and Pulp Canal Sealer) to prevent the fluid movement (P > .05). In warm obturation technique, no significant difference was found between the 2 groups (with and without the smear layer) of AH26 (P > .05). On the contrary, in groups of Pulp Canal sealer, fluid transport values were significantly less when the smear layer was removed (P < .05). Finally, no significant difference was observed between the groups of Gutta-Flow (with and without the smear layer) (P > .05). Under these in vitro conditions, it seems that smear layer removal improves the ability of the filling materials to prevent the fluid movement, at least after the use of warm obturation techniques. On the contrary, smear layer removal does not seem to improve the same ability after the use of cold lateral compaction technique. Further laboratory and also clinical studies are needed in the future to compose a clear view concerning the improvement of sealing ability following smear layer removal.

A Comparison of Three Gutta-Percha Obturation Techniques to Replicate Canal Irregularities

A split-tooth model with artificially created intracanal wall defects was used to compare three gutta-percha (GP) obturation techniques, cold lateral, warm lateral, and warm vertical. The techniques were evaluated and compared based on defect replication quality as a function of defect location and size. The obturations were evaluated on an ordinal scale, 0 to 4, based on how much each defect was replicated. There was a statistically significantly better result with both warm techniques compared to cold lateral obturation, while there was no significant difference between the warm obturation techniques.

Effect of three obturation techniques on the filling of lateral canals and the main canal

The three-dimensional obturation of the root canal system is widely accepted as a key factor for successful endodontic therapy. The purpose of this study was to evaluate the obturation of lateral canals and the main canal using three gutta-percha sealer techniques: cold lateral condensation, warm lateral condensation, and warm vertical condensation. Sixty epoxied blocks with five lateral canals placed at varying angles from the main canal were used. Each experimental group was treated by a board-certified endodontist with training and clinical experience in that obturation technique. There was no statistically significant difference (p < 0.05) between the obturation techniques in the ratio of the void area to the gutta-percha-plus-sealer area for the main canal. There was significantly (p < 0.001) more sealer in the lateral canals for the two lateral condensation techniques. The warm obturation techniques had significantly (p < 0.001) more gutta-percha in the lateral canals.