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Ahmed H, Ratnayake J, Cathro P, Chandler N. The effect of an additional application of sealer prior to backfilling in the Continuous Wave of Condensation technique. AUST ENDOD J 2023; 49:344-350. [PMID: 35834235 DOI: 10.1111/aej.12658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
An additional sealer application was investigated prior to backfilling with the Continuous Wave of Condensation (CWC). 105 Palatal roots were sectioned and prepared to a file size 40, 0.06 taper with Vortex Blue® files. Groups A, B and C had a single sealer application before while groups D, E and F, received a second application of dyed sealer prior to backfilling. Roots were sectioned at 2,3,4,6,7 and 8 mm from the root apex. The percentage of sealer and dentinal tubular penetration depth was calculated at each level. At each ascending level, the sealer percentage decreased for each experimental group while the number of outer third penetration depths increased when all groups were combined. An additional sealer application prior to backfilling had minimal effect on the percentage of sealer or outer third penetration depths and can be considered a clinical preference rather than an imperative step with the CWC technique.
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Affiliation(s)
- Humza Ahmed
- Department of Oral Rehabilitation, University of Otago School of Dentistry, Dunedin, New Zealand
| | - Jithendra Ratnayake
- Department of Oral Sciences, University of Otago School of Dentistry, Dunedin, New Zealand
| | - Peter Cathro
- Department of Oral Rehabilitation, University of Otago School of Dentistry, Dunedin, New Zealand
- Department of Oral Sciences, University of Otago School of Dentistry, Dunedin, New Zealand
| | - Nick Chandler
- Department of Oral Rehabilitation, University of Otago School of Dentistry, Dunedin, New Zealand
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Ribeiro JS, Xavier SR, Cuevas Suárez CE, Pappen FG, Piva E, Lund RG, Bottino MC. Synthesis and characterization of calcium-releasing elastomeric resin-based endodontic sealers. Clin Oral Investig 2023; 27:3447-3456. [PMID: 36947264 DOI: 10.1007/s00784-023-04952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/17/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To evaluate the incorporation of halloysite nanotubes (HNTs) loaded with one of two calcium sources (i.e., calcium hydroxide/CaOH2 or beta-tricalcium phosphate/β-TCP) on the physicochemical and biological properties of an experimental resin-based dual-cured endodontic sealer. MATERIALS AND METHODS HNTs were encapsulated with CaOH2 or β-TCP at 10 wt.%. HNTs containing CaOH2 or β-TCP were added into the experimental sealers at 50 wt.%. The control sealers were the calcium-free HNT-modified resin-based experimental sealer and AH Plus™, a commercially available endodontic sealer. Degree of conversion, setting time, flow, film thickness, radiopacity, dimensional stability, and calcium ions release were determined. Antibiofilm properties and cytocompatibility of the formulated sealers and commercial control were also evaluated. One and two-way ANOVA analysis followed by Tukey's post hoc test was conducted to evaluate the effect of the independent variable on the evaluated properties. RESULTS FTIR confirmed the encapsulation of calcium sources into HNTs. Regarding flow and film thickness, the values obtained from these sealers were in accordance with the specifications provided by ISO 6876. For radiopacity, AH Plus™ achieved the highest radiopacity (p<0.05). Among the experimental formulations, all experimental HNT-containing compositions exhibited values below 3 mm Al. The experimental sealers showed greater dimensional changes when compared to the commercial (AH Plus™) control. The release of calcium ions was observed for the HNT_CaOH2 and HNT_β-TCP sealers without statistical differences. Experimental sealers containing HNT_CaOH2 and HNT_β-TCP significantly reduced the CFU/mL count and showed cell compatibility. CONCLUSIONS The findings of this study demonstrate that the incorporation of HNT_CaOH2 or HNT_β-TCP into resin-based experimental sealers promoted antimicrobial effects and gradual calcium release without impairing cytocompatibility or physicochemical properties of the sealers. Still, an adjustment to reach the minimal radiopacity established by ISO 6876 is needed. CLINICAL RELEVANCE The experimental resin-based sealers seemed to be an alternative for endodontics. The incorporation of calcium sources exerts promising antimicrobial effects while displaying low cell toxicity.
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Affiliation(s)
- Juliana S Ribeiro
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Samantha R Xavier
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Carlos E Cuevas Suárez
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, Circuito Ex Hacienda La Concepción S/N, 42160, San Agustín Tlaxiaca, Hidalgo, Mexico
| | - Fernanda G Pappen
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Evandro Piva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Rafael G Lund
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Marco C Bottino
- Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA.
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
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Single Cone Obturation versus Cold Lateral Compaction Techniques with Bioceramic and Resin Sealers: Quality of Obturation and Push-Out Bond Strength. Int J Dent 2023; 2023:3427151. [PMID: 36704662 PMCID: PMC9873427 DOI: 10.1155/2023/3427151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/26/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Objectives This study compared the obturation quality and push-out bond strength of single cone obturation (SCO) and cold lateral compaction (CLC) with AH-Plus and Sure Seal Root (SSR). Materials and Methods This in vitro experimental study was conducted on 88 single-rootedsingle-canal teeth with straight roots that were randomly divided into four groups (n = 22). All teeth were decoronated and underwent cleaning and shaping. Obturation was performed with AH-Plus and SCO technique in group 1 (SAH), AH-Plus and CLC technique in group 2 (LAH), SSR and SCO technique in group 3 (SS), and SSR and CLC technique in group 4 (LS). The roots were then sectioned into 3-mm thick slices and underwent digital photography at x25 magnification to assess the quality of obturation in the coronal, middle, and apical thirds by Image J software. The PBS was measured by a universal testing machine. The mode of failure was also determined under a stereomicroscope. Results The PBS was significantly higher in the LSS group than LAH and SAH groups, and also in the SSS group than the SAH group in all sections. The PBS in the LSS group was significantly higher than SSS in the coronal and middle thirds. Voids were significantly lower in LAH than in the SAH group in all sections. In LSS, voids in the coronal third were significantly lower than in LAH. In the middle third, voids in SSS were significantly lower than in SAH. The groups had no significant difference in the mode of failure (P > 0.05). The mean percentage of gutta-percha in the use of AH-Plus sealer was significantly higher than SSR (P < 0.05). The mean percentage of gutta-percha in the coronal third was lower than that in the middle and apical thirds (P < 0.05). Conclusion SSR showed higher PBS and less voids than AH-Plus. High PBS of the CLC/SSR group showed that CLC should still be preferred to SCO, and in the case of using SCO, SSR should be preferred to AH-Plus.
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Lyu WJ, Bai W, Wang XY, Liang YH. Physicochemical properties of a novel bioceramic silicone-based root canal sealer. J Dent Sci 2022; 17:831-835. [PMID: 35756762 PMCID: PMC9201547 DOI: 10.1016/j.jds.2021.09.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background/purpose With introduction into endodontics, bioceramic-based sealers have gained considerable popularity for excellent properties. The aim of this study was to investigate the physicochemical properties of a novel bioceramic silicone-based sealer, GuttaFlow Bioseal, and measure heat flow of setting reactions. Materials and methods Film thickness, flow, working and setting time of Bioseal were compared with other 4 kinds of sealers: iRoot SP, AH Plus, RoekoSeal and GuttaFlow2. Differential scanning calorimetry test was performed to measure heat flow. Results Bioseal demonstrated the highest film thickness of 44 μm, double to triple that of the other 4 sealers (P < 0.05). The highest flow was detected in iRoot SP and RoekoSeal, with values of 27.35 and 27.20 mm, while GuttaFlow2 and Bioseal had the lowest of 22.31 and 21.43 mm (P < 0.05). For each sealer, working time at 37 °C was shorter than that at 23 °C (P < 0.05). At 37 °C, Bioseal had the shortest working and setting time of 4.5 and 16.3 min, while iRoot SP showed the longest of 105.0 and 571.7 min (P < 0.05). Differential scanning calorimetry test revealed that setting process of all the tested sealers was exothermic. Bioseal reached an exothermic peak at 14 min, with almost 1.5 times peak intensity of GuttaFlow2 and RoekoSeal. Whereas iRoot SP and AH Plus reached an exothermic peak 5 h after mixing, with intensity 1/2 to 2/3 that of Bioseal. Conclusion The novel bioceramic silicone-based sealer Bioseal showed intense and fast exothermic reactions with characteristic physicochemical properties.
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Affiliation(s)
- Wei-Jia Lyu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wei Bai
- Dental Medical Devices Testing Center, Peking University School of Stomatology, Beijing, China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu-Hong Liang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
- Department of Stomatology, Peking University International Hospital, Beijing, China
- Corresponding author. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
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ZAN R, DEMİR AŞ. CONTEMPORARY ENDODONTIC OBTURATION TECHNIQUES: A COMPREHENSIVE LITERATURE REVIEW. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.948193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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The effect of changing apical foramen diameter on regenerative potential of mature teeth with necrotic pulp and apical periodontitis. Clin Oral Investig 2021; 26:1843-1853. [PMID: 34480644 DOI: 10.1007/s00784-021-04159-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/21/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the regenerative potential of permanent necrotic mature teeth with different apical foramen diameters in comparison to conventional endodontic treatment. METHODS Pulp necrosis and periapical pathosis were induced in premolars (144 roots) in six mongrel dogs. The infected teeth were divided into six groups; conventional root canal treatment (RCT) group prepared up to apical preparation sizes #F3 ProTaper file, regenerative endodontic therapy (RET) groups; groups RET-F3, RET-F4, and RET-F5 where regenerative endodontic procedures were applied after apical preparation up to sizes #F3, F4, and F5 ProTaper file, respectively, control groups; and positive (P) and negative (N) groups included infected and healthy teeth respectively. Each group (12 teeth with 24 roots each) was further subdivided into two subgroups (6 teeth with 12 roots each) according to the evaluation periods 1 and 3 months; each group was equally randomized in the upper and lower jaws during each evaluation period. RESULTS The inflammatory cell counts for the RCT group were statistically significantly higher than that of all RET groups at the first period and only significantly higher than RET-F5 at the second period. The enlargement of the apical foramen to #F5 showed no statistically significant difference with #F4 regarding the inflammatory cell count, tissue in-growth inside the root canal, and percentage of bone resorption. The tissue formed after RET was not true pulp tissue and is considered tissue repair with connective tissue, dilated blood vessels, and cementum-like structures. CONCLUSION: Increasing the apical size diameter was associated with less inflammatory cell count, less percentage of bone resorption, more tissue ingrowth, and more percentage of new hard tissue formation inside root canal. The minimum apical diameter that should be enlarged for RET is 0.4 mm. CLINICAL RELEVANCE RET could be used as an alternative procedure to RCT for the treatment of mature teeth with necrotic pulp and apical periodontitis.
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Machado R, Koetz R, Comparin D, Alberton LR, da Fonseca Roberti Garcia L, Xavier da Silva Neto U. Correlation among Root Canal Configuration, Quality of Filling, and Its Sealability. Eur J Dent 2021; 15:568-573. [PMID: 33622010 PMCID: PMC8382461 DOI: 10.1055/s-0041-1724158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective
This study aimed to evaluate the existence of possible correlations among root canal configuration, quality of filling, and its sealability.
Materials and Methods
Sixty human mandibular central incisors were selected for this study. The teeth were prepared with the Profile 04 system up to instrument 35/0.04 and irrigated with 2.5 mL of 2.5% sodium hypochlorite at each instrument change. Root canal filling was performed by the lateral compaction technique, using gutta-percha and an epoxy resin-based sealer (AH Plus) labeled with 0.1% Rhodamine B dye. Afterward, the specimens were submitted to fluid filtration tests to assess the sealability of the filling. Cross-sections were obtained at −3, −6, and −8 mm from the root apex and submitted to a metallographic treatment to determine the root canal configuration and the percentage of gutta-percha filled areas. The data were statistically analyzed by the Grubbs test. Pairs of correlations were analyzed by applying the Spearman test at a level of significance of 5%.
Results
No correlation was observed among the analyzed variables as follows: root canal configuration versus filling quality (Spearman’s rho = 0.031); filling quality versus sealability (Spearman’s rho = 0.219); and root canal configuration versus sealability (Spearman’s rho = 0.184).
Conclusion
The root canal configuration did not affect the quality of the filling and its sealability.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Ricardo Koetz
- Department of Endodontics, School of Dentistry, Paranaense University, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University, Francisco Beltrão, Paraná, Brazil
| | - Luiz Rômulo Alberton
- Department of Veterinary Medicine and Graduate Program in Animal Science, Paranaense University, Umuarama, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
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Hirai VHG, Machado R, Budziak MCL, Piasecki L, Kowalczuck A, Neto UXDS. Percentage of Gutta-Percha-, Sealer-, and Void-Filled Areas in Oval-Shaped Root Canals Obturated with Different Filling Techniques: A Confocal Laser Scanning Microscopy Study. Eur J Dent 2020; 14:8-12. [PMID: 32062854 PMCID: PMC7069748 DOI: 10.1055/s-0040-1701543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective
This study compared different obturation techniques, analyzing percentage of areas filled with gutta-percha, sealer, and voids (PGFA, PSFA, and PVFA, respectively) in oval-shaped root canals.
Materials and Methods
A total of 60 extracted human mandibular central incisors were decoronated, instrumented, and irrigated using the same protocol. After drying, the root canal was filled with AH Plus labeled with 0.1% rhodamine B dye using a Lentulo spiral. The filling procedure was performed by dividing the teeth into four groups according to the respective technique: G1, cold lateral condensation; G2, continuous wave of condensation; G3, modified cold lateral condensation using an F3 master cone; and G4, modified continuous wave of condensation using an ISO (International Organization for Standardization) sized 30 gutta-percha cone. Then, slices measuring 1.5 mm in thickness were obtained 3 and 6 mm from the apex and evaluated by confocal laser scanning microscopy to determine PGFA, PSFA, and PVFA.
Statistical Analysis
The data were analyzed statistically with analysis of variance and Games-Howell’s tests (
p
= 0.05).
Results
The groups showed no significant differences in the apical third (3 mm from the apex). In the middle third (6 mm from the apex), G3 and G1 showed higher PGFA and PVFA, respectively. G3 showed lower PSFA than G2 and G4. Both cold techniques (G1 and G3) promoted lower PSFA than both warm techniques (G2 and G4).
Conclusions
Notwithstanding the limitations of this
in vitro
study, PGFA, PSFA, and PVFA ranged significantly only in the middle third, as observed by the different filling techniques. Higher PGFA and PVFA values were obtained for G3 and G1, respectively. Both cold techniques promoted lower PSFA than both warm techniques.
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Affiliation(s)
- Vinicio Hidemitsu Goto Hirai
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Ricardo Machado
- Clinical Practice Limited to Endodontics, Navegantes, Santa Catarina, Brazil
| | - Maria Carolina Lucato Budziak
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, Buffalo, New York, United States
| | - Alexandre Kowalczuck
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Health and Bioscience, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
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Al-Sabawi N, Yahya M, Shehab N. Effect of four different root canal obturation techniques on marginal adaptation of bioceramic sealer: An in vitro scanning electron microscopic study. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_75_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sinhal TM, Shah RRP, Jais PS, Shah NC, Hadwani KD, Rothe T, Sinhal NN. An In vitro Comparison and Evaluation of Sealing Ability of Newly Introduced C-point System, Cold Lateral Condensation, and Thermoplasticized Gutta-Percha Obturating Technique: A Dye Extraction Study. Contemp Clin Dent 2018; 9:164-169. [PMID: 29875554 PMCID: PMC5968676 DOI: 10.4103/ccd.ccd_722_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study is to compare and to evaluate sealing ability of newly introduced C-point system, cold lateral condensation, and thermoplasticized gutta-percha obturating technique using a dye extraction method. Materials and Methodology Sixty extracted maxillary central incisors were decoronated below the cementoenamel junction. Working length was established, and biomechanical preparation was done using K3 rotary files with standard irrigation protocol. Teeth were divided into three groups according to the obturation protocol; Group I-Cold lateral condensation, Group II-Thermoplasticized gutta-percha, and Group III-C-Point obturating system. After obturation all samples were subjected to microleakage assessment using dye extraction method. Obtained scores will be statistical analyzed using ANOVA test and post hoc Tukey's test. Results One-way analysis of variance revealed that there is significant difference among the three groups with P value (0.000 < 0.05). Tukey's HSD post hoc tests for multiple comparisons test shows that the Group II and III perform significantly better than Group I. Group III performs better than Group II with no significant difference. Conclusion All the obturating technique showed some degree of microleakage. Root canals filled with C-point system showed least microleakage followed by thermoplasticized obturating technique with no significant difference among them. C-point obturation system could be an alternative to the cold lateral condensation technique.
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Affiliation(s)
- Tapati Manohar Sinhal
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Ruchi Rani Purvesh Shah
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Pratik Subhas Jais
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Nimisha Chinmay Shah
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Krupali Dhirubhai Hadwani
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Tushar Rothe
- Department of Oral and Maxillofacial Surgery, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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3D Micro-CT Analysis of Void and Gap Formation in Curved Root Canals. Eur Endod J 2017; 2:1-5. [PMID: 33403353 PMCID: PMC7757970 DOI: 10.14744/eej.2017.17004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/04/2017] [Accepted: 05/05/2017] [Indexed: 11/20/2022] Open
Abstract
Objective: This study used microcomputed tomography (micro-CT) to compare the volumes of voids and gaps in curved root canals instrumented and filled using various techniques. Methods: Twenty extracted mandibular first molars with two curved mesial root canals were used. Root canals were instrumented using a self-adjusting file (SAF) or Revo-S file system. For standardization, mesiobuccal canals were instrumented with SAF and mesiolingual canals were instrumented with Revo-S in each root. The canals were divided into four experimental groups (n=10 in each). The canals were then filled via cold lateral compaction (CLC) or a thermoplasticized injectable technique (TT) using gutta-percha and AH Plus root canal sealer. The roots were scanned with a micro-CT, and the volumes of the voids and gaps were calculated using three-dimensional (3D) micro-CT images. Data were analyzed using unpaired t- and Kruskal-Wallis tests. A value of P<0.05 was considered significant. Results: None of the tested techniques provided void- or gap-free fillings. Nevertheless, the SAF showed more gap formation than the Revo-S, and TT showed higher gap formation in all experimental groups. These differences, however, were not statistically significant (P>0.05). Conclusion: The SAF and Revo-S rotary file systems yielded comparable results. No statistically significant difference was found between the results of the various instrumentation and filling techniques.
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Schäfer E, Schrenker C, Zupanc J, Bürklein S. Percentage of Gutta-percha Filled Areas in Canals Obturated with Cross-linked Gutta-percha Core-carrier Systems, Single-Cone and Lateral Compaction Technique. J Endod 2016; 42:294-8. [DOI: 10.1016/j.joen.2015.10.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 11/30/2022]
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Kierklo A, Tabor Z, Pawińska M, Jaworska M. A microcomputed tomography-based comparison of root canal filling quality following different instrumentation and obturation techniques. Med Princ Pract 2015; 24:84-91. [PMID: 25359228 PMCID: PMC5588182 DOI: 10.1159/000368307] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 09/11/2014] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE With a microcomputed tomography (microCT) imaging device, we aimed to quantitatively evaluate root canal fillings after commonly used endodontic procedures and also tested the suitability of microCT for this purpose. MATERIALS AND METHODS Eighty single roots were instrumented and obturated with gutta-percha and Tubli-Seal. They were divided into 4 groups of 20. The Hand groups were instrumented with hand files and filled with thermoplastic (Th) compaction and cold lateral (CL) condensation, i.e. Hand-Th and Hand-CL, respectively. The Rot groups, i.e. Rot-Th and Rot-CL, were instrumented with a rotary ProFile system and filled as above. The roots were scanned and 3-dimensional (3D) visualization was obtained. The number, size, percentage of volume and distribution of voids at the filling/dentine interface (i-voids) and voids surrounded by filling material (s-voids) were measured. RESULTS Canal fillings differed significantly with regard to the size of both types of voids and the average number of i-voids. All canals presented a low volume of voids. The highest percentage (0.69%) was found for i-voids in the Hand-CL group, while the lowest volume (0.11% for s-voids and 0.14% for i-voids) was in the Hand-Th canals. Apically, in the last 3 mm, i-voids were observed mainly in the Th groups, and s-voids occurred mostly in the coronal part of the canal filling in all cases. CONCLUSION MicroCT was a useful tool for 3D quantitative evaluations of these root canal fillings. None of the root canal instrumentation and filling methods ensured void-free obturation. CL condensation produced mainly i-voids. With Th compaction, internal s-voids were particularly common, but there were mainly i-voids in the apical part.
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Affiliation(s)
- Anna Kierklo
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland
- *Assoc. Prof. Dr. Anna Kierklo, Department of Dentistry Propaedeutics, Medical University of Bialystok, ul. J. Waszyngtona 15A, PL–15-274 Bialystok (Poland), E-Mail
| | - Zbisław Tabor
- Department of Institute of Teleinformatics, Cracow University of Technology, Cracow, Poland
| | - Małgorzata Pawińska
- Department of Restorative Dentistry and Endodontics, Medical University of Bialystok, Bialystok, Poland
| | - Małgorzata Jaworska
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland
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Li GH, Niu LN, Selem LC, Eid AA, Bergeron BE, Chen JH, Pashley DH, Tay FR. Quality of obturation achieved by an endodontic core-carrier system with crosslinked gutta-percha carrier in single-rooted canals. J Dent 2014; 42:1124-34. [PMID: 24769108 DOI: 10.1016/j.jdent.2014.04.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/12/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The present study examined the quality of obturation in root canals obturated by GuttaCore, a gutta-percha-based core-carrier system with a cross-linked thermoset gutta-percha carrier, by comparing the incidence of gaps and voids identified from similar canals obturated by cold lateral compaction or warm vertical compaction. METHODS Thirty single-rooted premolars with oval-shaped canals were shaped and cleaned, and obturated with one of the three obturation techniques (N=10): GuttaCore, warm vertical compaction or cold lateral compaction. Filled canals were scanned with micro-computed tomography (micro-CT); reconstructed images were analysed for the volumetric percentage of gaps and voids at three canal levels (0-4mm, 4-8mm and 8-12mm from working length). The roots were subsequently sectioned at the 4-mm, 8-mm and 12-mm levels for analyses of the percentage of interfacial gaps, and area percentage of interfacial and intracanal voids, using scanning electron microscopy (SEM) to examine negative replicas of root sections. Data were analysed with parametric or non-parametric statistical methods at α=0.05. RESULTS Both micro-CT and SEM data indicated that canals obturated with GuttaCore core-carriers had the lowest incidence of interfacial gaps and voids, although the results were not significantly different from canals obturated by warm vertical compaction. Both the GuttaCore and the warm vertical compaction groups, in turn, had significantly lower incidences of gaps and voids than the cold lateral compaction group. CONCLUSIONS Because of the similarity in obturation quality between GuttaCore and warm vertical compaction, practitioners may find the GuttaCore core-carrier technique a valuable alternative for obturation of oval-shaped canals. CLINICAL SIGNIFICANCE The quality of obturation achieved by GuttaCore in single-rooted canals is not significantly different from that achieved by warm vertical compaction.
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Affiliation(s)
- Guo-Hua Li
- Department of Stomatology, Fuzhou Dongfang Hospital, Fuzhou, China
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Lisa C Selem
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA
| | - Ashraf A Eid
- Department of Dental and Biomedical Material Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Brian E Bergeron
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA
| | - Ji-Hua Chen
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
| | - David H Pashley
- Department of Oral Biology, Georgia Regents University, Augusta, GA, USA
| | - Franklin R Tay
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA.
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Investigation of the Effect of Sealer Use on the Heat Generated at the External Root Surface during Root Canal Obturation Using Warm Vertical Compaction Technique with System B Heat Source. J Endod 2014; 40:555-61. [DOI: 10.1016/j.joen.2013.09.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 09/20/2013] [Accepted: 09/22/2013] [Indexed: 11/23/2022]
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16
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Schäfer E, Köster M, Bürklein S. Percentage of gutta-percha-filled areas in canals instrumented with nickel-titanium systems and obturated with matching single cones. J Endod 2013; 39:924-8. [PMID: 23791265 DOI: 10.1016/j.joen.2013.04.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/05/2013] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The purpose of this study was to compare different single-cone obturation techniques in terms of the percentage of gutta-percha-filled areas (PGFA), sealer-filled areas (PSFA), and voids. METHODS Sixty extracted mandibular incisors with straight canals were allocated into 6 groups: (A) FlexMaster, (B) Mtwo, (C) ProTaper, (D) Reciproc, (E) WaveOne, and (F) control. In groups A-E, obturation was performed by using matching single-cone gutta-percha. In group F (control), manual instrumentation and obturation were performed by using cold lateral compaction with standardized gutta-percha cones. The teeth were sectioned at 2, 4, 6, and 8 mm from the apex. The total area of each canal segment was measured, and the areas were converted to PGFA, PSFA, and percentage of voids. Data were subjected to the Kruskal-Wallis and post hoc Dunn test. RESULTS At the 2-mm level, group B produced significantly higher PGFA than all other groups, whereas group B produced significantly higher PGFA than groups C, D, and E (P < .05). At the 4-mm level, groups A and B produced significantly higher PGFA than all other groups, whereas group F produced significantly higher PGFA and lower PSFA than groups C, D, and E (P < .05). At the 6-mm level, group F produced significantly higher PGFA and lower PSFA (P < .05) than all other groups, whereas groups A and B produced significantly higher PGFA and lower PSFA than groups C, D, and E (P < .05). At the 8-mm level, group F produced significantly higher PGFA and lower PSFA (P < .05) than all other groups. CONCLUSIONS Under the conditions of this study, lateral compaction and single-cone techniques that used constant tapered gutta-percha (FlexMaster, Mtwo) produced higher PGFA at the apical levels than variable tapered single-cone gutta-percha (ProTaper, Reciproc, WaveOne).
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Affiliation(s)
- Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany.
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17
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3D analyses of interface voids in root canals filled with different sealer materials in combination with warm gutta-percha technique. Clin Oral Investig 2013; 18:155-61. [PMID: 23525891 DOI: 10.1007/s00784-013-0970-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 03/04/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of the present study was to analyze the formation of voids and gaps in root canals obturated with different sealer materials in combination with warm gutta-percha vertical compaction technique by using BeeFill® 2in1. MATERIALS AND METHODS Twenty-four single-rooted teeth were collected, and root canals were prepared by using rotary files. All teeth were randomly allocated into three groups. Each group was obturated by using the BeeFill® 2in1 system in combination with Sealapex (non-eugenol, calcium hydroxide polymeric root canal sealer; Kerr Sybron, USA), RoekoSeal (polydimethylsiloxane-based sealer; Roeko, Germany), or 2Seal (epoxy-amine resin-based sealer; VDW, Germany). Following preparation, all teeth were scanned with a micro-computed tomography (CT) scanner, and a three-dimensional reconstruction of the obturated root canals was performed to analyze the volume of interface voids and gaps in the obturated teeth. RESULTS Statistical analysis demonstrated that the silicon-based sealer RoekoSeal induced significantly less voids and gaps than other tested materials. The amount of voids and gaps significantly was higher in the apical region. CONCLUSIONS These data indicate that none of the root canal-filled teeth were free of gaps. Teeth obturated with RoekoSeal demonstrated to have the highest quality in terms of voids and gaps formation in combination with the BeeFill® 2in1 obturation system. CLINICAL RELEVANCE These findings point to the potential benefit of micro-CT analyses for in vitro evaluation of root canal obturation systems and provide further information about sealer materials used in combination with a warm gutta-percha vertical compaction technique.
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Tennert C, Jungbäck IL, Wrbas KT. Comparison between two thermoplastic root canal obturation techniques regarding extrusion of root canal filling—a retrospective in vivo study. Clin Oral Investig 2012; 17:449-54. [DOI: 10.1007/s00784-012-0726-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 04/03/2012] [Indexed: 10/28/2022]
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Rodrigues A, Bonetti-Filho I, Faria G, Andolfatto C, Camargo Vilella Berbert FL, Kuga MC. Percentage of gutta-percha in mesial canals of mandibular molars obturated by lateral compaction or single cone techniques. Microsc Res Tech 2012; 75:1229-32. [PMID: 22495975 DOI: 10.1002/jemt.22053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 03/15/2012] [Indexed: 11/11/2022]
Abstract
The aim of this study was to compare the percentage of gutta-percha (PGP) in mesial root canals of mandibular molars obturated with LC (Lateral Compaction) or SC (Single Cone) ProTaper Universal System techniques at different levels of the root. Mesial root canals of 20 human permanent molars with similar anatomical characteristics were instrumented using the ProTaper Universal rotary system technique until the F2 instrument, with 20 canals filled by SC ProTaper Universal technique and 20 canals by the LC technique. The mesial roots were sectioned transversely to 3, 5, and 7 mm from the root apex. Digital images of specimens were obtained at MIC-D digital microscope in increases of 30 to 35X. The gutta-percha area was measured using ImageTool software. Data were analyzed using two-way ANOVA and Bonferroni test (α = 0.05). The SC technique provided greater PGP than the LC technique in the apical third (3 mm) (P < 0.001). In the other thirds (5 and 7 mm) there was no statistical difference between the two techniques regarding the PGP (P > 0.05). There was no statistically significant difference between thirds of the root canal for both techniques (P > 0.05). It was concluded that SC technique provided greater PGP than the LC technique in the apical third of mesial root canals of mandibular molars. There was no difference between the two techniques regarding the PGP in the cervical and middle thirds.
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Affiliation(s)
- Amanda Rodrigues
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, SP, Brazil
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Yadav RK, Chand S, Verma P, Chandra A, Tikku AP, Wadhwani KK. Clinical negligence or endodontic mishaps: A surgeons dilemma. Natl J Maxillofac Surg 2012; 3:87-90. [PMID: 23251068 PMCID: PMC3513819 DOI: 10.4103/0975-5950.102174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Complications may occur during and after endodontic treatment, which may be due to negligence of the operator. The surgical treatment of a case presenting pain and persistent pus discharge and swelling due to the extrusion of the root canal filling to the base of the nasal floor between left maxillary lateral and canine teeth is presented in this report. First, carelessness was during root canal treatment that was over obturated and second time during extraction in which overextended gutta-percha remained in the bone, caused the complications like pain, persistent pus discharge, and headache. Clinicians should be aware of the fact that endodontic instruments and filling materials (solid or liquid) can be extended in such a degree that can lead to neurological or sinus complications.
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Affiliation(s)
- Rakesh Kumar Yadav
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Sharad Chand
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Promila Verma
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Aseem Prakash Tikku
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
| | - Kulwinder Kaur Wadhwani
- Department of Conservative Dentistry and Endodontics, CSM Medical University, Lucknow, Uttar Pradesh, India
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Schäfer E, Nelius B, Bürklein S. A comparative evaluation of gutta-percha filled areas in curved root canals obturated with different techniques. Clin Oral Investig 2011; 16:225-30. [PMID: 21249509 DOI: 10.1007/s00784-011-0509-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 01/09/2011] [Indexed: 12/01/2022]
Abstract
The aim of this study was to compare different obturation techniques in severely curved canals in terms of the percentage of gutta-percha filled area and voids. The obturation times and the incidence of extrusion of filling material were also compared. Curved root canals (curvature, 25-35°) of 48 extracted human teeth were enlarged with Mtwo rotary NiTi instruments and obturated as follows: Group A: 0.04/35 matched-single-cone; Group B: cold lateral compaction with 0.04/35 gutta-percha master cone; Group C: warm vertical compaction; Group D: lateral compaction with standardized gutta-percha master cone. In all groups AHPlus was used as sealer. The teeth were sectioned horizontally at 2, 3, 4, 6 and 8 mm from the apex. The total area of each canal segment was measured and the areas of gutta-percha, sealer and voids were converted to percentages of the total area. Data were subjected to the Kruskal-Wallis and post hoc Dunn test. Obturation times were compared using ANOVA and post hoc Student-Newman-Keuls test. The matched-single-cone obturation (group A) was significantly the fastest method while warm vertical compaction (group C) required significantly more time than all other techniques (p < 0.05). No significant differences were obtained between the groups in terms of percentage of voids at any level (p > 0.05). At all levels, groups B, C, and D produced significantly higher gutta-percha filled areas (p < 0.05) and lower sealer-filled areas (p < 0.05) than group A. No significant differences were found between groups B, C, and D (p > 0.05) regarding gutta-percha and sealer-filled areas. Within the limitations of the in vitro study, it can be concluded that lateral compaction of greater taper gutta-percha cones is a fast and efficient method for obturation of curved canals.
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Affiliation(s)
- Edgar Schäfer
- Central Interdisciplinary Ambulance, School of Dentistry, University of Münster, Waldeyerstr. 30, D-48149, Münster, Germany.
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22
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Marciano MA, Ordinola-Zapata R, Cunha TVRN, Duarte MAH, Cavenago BC, Garcia RB, Bramante CM, Bernardineli N, Moraes IG. Analysis of four gutta-percha techniques used to fill mesial root canals of mandibular molars. Int Endod J 2011; 44:321-9. [DOI: 10.1111/j.1365-2591.2010.01832.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shemesh H, Wesselink PR, Wu MK. Incidence of dentinal defects after root canal filling procedures. Int Endod J 2010; 43:995-1000. [PMID: 20722755 DOI: 10.1111/j.1365-2591.2010.01740.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To compare the incidence of dentinal defects (cracks and craze lines) after root canal preparation, lateral compaction and continuous wave compaction of gutta-percha and AH26 sealer. METHODOLOGY Two hundred mandibular premolar teeth were divided into four groups with similar average canal diameters (n=50). One group was left untreated and served as the control. The other three groups were prepared with ProTaper rotary instruments up to size F4. After preparation, one group was left unfilled while two groups were filled with gutta-percha and AH26 using either lateral compaction or the continuous wave technique. Roots were then sectioned at 3, 6 and 9 mm from the apex and inspected under a microscope. The appearance of dentinal defects was noted as well as the minimum and mean remaining dentine thickness. Chi-square tests were performed to compare the incidence of dentinal defects between the groups (α=0.05), and Pearson correlation test was performed to check the correlation between defects and root level or remaining dentine thickness. RESULTS The unprepared control group had no dentinal defects. The other groups exhibited significantly more defects than the unprepared group (P<0.05). There was no difference in the incidence of defects between the two filling techniques. There was no correlation between the appearance of defects and level of the root or remaining dentine thickness. CONCLUSIONS In extracted teeth, dentinal defects were observed in roots filled with gutta-percha and AH26 using the lateral compaction and continuous wave techniques.
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Affiliation(s)
- H Shemesh
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Free University Amsterdam, Louwesweg, the Netherlands.
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24
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Kececi AD, Kaya BU, Belli S. Corono-apical leakage of various root filling materials using two different penetration modelsâA 3-month study. J Biomed Mater Res B Appl Biomater 2010; 92:261-7. [DOI: 10.1002/jbm.b.31513] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dadresanfar B, Khalilak Z, Shiekholeslami M, Afshar S. Comparative study of the sealing ability of the lateral condensation technique and the BeeFill system after canal preparation by the Mtwo NiTi rotary system. J Oral Sci 2010; 52:281-5. [DOI: 10.2334/josnusd.52.281] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Souza EM, Wu MK, van der Sluis LW, Leonardo RT, Bonetti-Filho I, Wesselink PR. Effect of filling technique and root canal area on the percentage of gutta-percha in laterally compacted root fillings. Int Endod J 2009; 42:719-26. [DOI: 10.1111/j.1365-2591.2009.01575.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Romania C, Beltes P, Boutsioukis C, Dandakis C. Ex-vivoarea-metric analysis of root canal obturation using gutta-percha cones of different taper. Int Endod J 2009; 42:491-8. [DOI: 10.1111/j.1365-2591.2008.01533.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Santoro V, Lozito P, Donno AD, Grassi FR, Introna F. [Not Available]. Open Dent J 2009; 3:68-73. [PMID: 19543544 PMCID: PMC2697057 DOI: 10.2174/1874210600903010068] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 03/17/2009] [Accepted: 03/19/2009] [Indexed: 11/25/2022] Open
Abstract
The Authors describe two cases of alleged malpractice due to overfilling. The aim of this article is to underline some medico-legal aspects regarding the quantity of extruded material which may be considered acceptable and the consequent damage to the patient. Two cases are presented here: In the first case, the dentist’s liability is clear due to excessive extrusion of endodontic material beyond the apical region combined with incomplete obturation of the canals. In the second case however, because two different dentists were involved, establishing the connection of causality between their work and the damage reported by the patient was not easy. This situation makes it difficult to establish the limits of potential responsibility, coupled with the complete absence of radiographic signs of periapical rarefaction and the small quantities of material beyond the apex. From a medico-legal point of view, a dentist may be held responsible for compensation and financial expenses of a patient for restoration of damage resulting from a dental procedure. Italian guidelines offer no indications as to when overfilling should be considered the result of a procedural error, or if it fits within the range labelled as “acceptable” and this gap offers extremely subjective interpretations of legal consultants. So, it would therefore be useful to adopt more precise qualitative/dimensional parameters, keeping in mind that the guidelines offer therapeutic recommendations and are not rigid protocols.
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Gomes-Filho JE, Hopp RN, Bernabé PFE, Nery MJ, Otoboni Filho JA, Dezan Júnior E. Evaluation of the apical infiltration after root canal disruption and obturation. J Appl Oral Sci 2009; 16:345-9. [PMID: 19089232 PMCID: PMC4327601 DOI: 10.1590/s1678-77572008000500008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 04/07/2008] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to evaluate two root canal filling techniques used in teeth that had their apical foramen disrupted and compare the apical infiltration with an ideal clinical situation. Twenty-seven freshly extracted single-rooted teeth were selected and radiographed to confirm the existence of a single and straight root canal. The crowns were removed at a mean distance of 11 mm from the apex. The teeth had the root canals instrumented and were randomly assigned to 3 groups (n=9): ND group - root canals were filled using the lateral compaction technique and no disruption was performed; DRF group - the apical constriction was disrupted by advancing a #40 K-file 1 mm beyond the original working length, the canals were reinstrumented to create an apical ledge at 1 mm from the apical foramen and were obturated with a master gutta-percha cone with same size as the last file used for reinstrumentation; DF group - the teeth had the apical constriction disrupted and the canals were obturated with a master gutta-percha cone that fit at 1 mm from the apex. The teeth were submitted to dye leakage test with Rhodamine B for 7 days, using vaccum on the initial 5 min. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown. There was no statistically significant difference (p>0.05) between the groups that had the apical foramen disrupted (DF, DRF), but significant difference was found between the disrupted groups and the non-disrupted one (p<0.01). In conclusion, none of the evaluated techniques was able to prevent apical infiltration, so working length so the working length determination has to be established and maintained carefully.
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Affiliation(s)
- João Eduardo Gomes-Filho
- Department of Endodontics, Dental School of Araçatuba, State University of São Paulo, Araçatuba, SP, Brazil
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Kaya BU, Kececi AD, Belli S. Evaluation of the sealing ability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose penetration model. ACTA ACUST UNITED AC 2007; 104:e66-73. [DOI: 10.1016/j.tripleo.2007.06.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 05/31/2007] [Accepted: 06/27/2007] [Indexed: 11/16/2022]
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