Volumetric Evaluation of Different Obturation Techniques in Primary Teeth Using Spiral Computed Tomography

Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT

AIM AND BACKGROUND

To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT).

MATERIALS AND METHODS

Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test.

RESULTS

There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation.

CONCLUSION

From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume.

CLINICAL SIGNIFICANCE

The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.

Comparative Evaluation of Four Different Obturating Techniques in Primary Teeth Using Cone-beam Computed Tomography: An In Vivo Study

Background

The quality of the obturation plays a significant role in the success of endodontic treatment. To date, various technologies have been used to evaluate the quality of obturation, but all of them have their own limitations. In order to overcome those limitations, recent technological advancements like cone-beam computed tomography (CBCT) can be helpful.

Aim

To compare and evaluate the efficiency of different root canal obturation techniques in primary teeth using CBCT.

Materials and methods

A total of 80 root canals in 30 children aged between 4 and 9 years were selected and divided into four groups, with 20 root canals in each. Obturation in group I was performed using the endodontic pressure syringe; group II-hand spreaders; group III-Lentulo spirals mounted on slow-speed handpiece; and group IV-insulin syringe. The quality of obturation was evaluated using a CBCT scan.

Results

Group I samples showed the most optimally filled canals followed by II and III; least in group IV. A maximum number of overfilled canals was exhibited in group III samples. Voids were minimal in all four groups and the values obtained were not statistically significant.

Conclusion

Obturation with an endodontic pressure syringe reported the highest number of optimally filled root canals and the insulin syringe showed the least number of optimally filled canals.

How to cite this article

Ali SM, Mukthineni S, Sai Sankar AJ, et al. Comparative Evaluation of Four Different obturating Techniques in Primary Teeth using Cone-beam Computed Tomography: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):218-222.

A critical analysis of research methods and experimental models to study root canal fillings

Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.

Cone-beam Computed Tomographic Evaluation of the Quality of Obturation Using Different Pediatric Rotary File Systems in Primary Teeth

Aim and objective

To compare and evaluate the efficacy of three different pediatric rotary file systems in primary molars using cone-beam computed tomography (CBCT).

Materials and methods

Thirty extracted mandibular primary molars were selected and divided into three groups with ten teeth each, instrumented with Kedo SG Blue rotary files, Pro AF Baby gold rotary files, and Pedo Flex rotary files, respectively. Root canal obturation was done with zinc-oxide eugenol cement and the quality of obturation was assessed using CBCT based on the extent of filling as underfilled or optimally filled and the presence or absence of voids within the filling. The data were statistically analyzed using the Chi-square test.

Results

Among the three groups, the Kedo SG Blue group showed more number of optimally filled teeth with minimal voids (p < 0.05) followed by the Pro AF Baby gold group and Pedo Flex group.

Conclusion

Within the study limitations, the Kedo SG Blue group showed ideal endodontic obturation when compared with Pro AF baby gold and Pedo Flex rotary file systems.

Clinical significance

The present study will guide the pedodontists regarding the efficacy of pediatric rotary file systems and their usage protocols.

How to cite this article

Vaishali Naidu D, Sharada Reddy J, Patloth T, et al. Cone-beam Computed Tomographic Evaluation of the Quality of Obturation Using Different Pediatric Rotary File Systems in Primary Teeth. Int J Clin Pediatr Dent 2021;14(4):542-547.

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

Aim:

The aim of this study was to compare the effectiveness of different filling materials and obturation techniques for root canal obturation in primary teeth.

Materials and Methods:

Eighty maxillary primary incisors were included in this in vitro study. After biomechanical preparation, all samples were scanned using microcomputed tomography (micro-CT) and root canal volumes were calculated. Samples were grouped according to filling materials and obturation techniques, with ten samples in each group. The samples were filled with zinc oxide eugenol (ZOE) and Vitapex using four different obturation techniques (local anesthesia syringe, lentulo spiral, pastinject, and lentulo spiral–ultrasonic activation). After filling, samples were scanned a second time using micro-CT and root canal volumes were calculated. The statistical analysis was performed using SPSS version 24.0. Data were analyzed by Kruskal–Wallis and Mann–Whitney U tests.

Results:

When the ZOE and Vitapex were compared, it was observed that there were no significant differences between their postobturated volumes, percentage obturated volume (POV), internal void (IV), and percentage of internal void volume (PIV) ( P > .05). The local anesthesia syringe group had a significantly lower postobturated volume and POV, and a significantly higher IV and PIV for both filling materials than that by the other groups ( P < .05). There was no significant difference between the other obturation techniques ( P > .05). For the local anesthesia syringe group, postobturated volume and POV were significantly higher and IV and PIV were significantly lower with Vitapex than with ZOE ( P < .05). There was no significant difference between the other obturation techniques filled either with ZOE or Vitapex ( P > .05).

Conclusion:

Except for the syringe technique, no difference was observed between the ZOE and Vitapex materials. The syringe technique used in the primary root canal filling was less effective than the other techniques, which had similar efficacy, and in this technique, more effective canal filling was achieved with Vitapex.

Comparative Evaluation of Efficacy of Obturation Techniques in Deciduous Teeth Using Cone-beam Computed Tomography: An In Vivo Study

Introduction

Pediatric dentistry has evolved from extraction acclimatized practice to prevention and preservation. Successful endodontic treatment is mandated for retention of pulpally involved primary teeth.

Aim and objective

To comparatively evaluate the obturation techniques namely lentulospiral and skini syringe with NaviTip in primary teeth using cone-beam computed tomography (CBCT).

Materials and methods

The study was carried out among children ranging between the ages of 4 years and 8 years of either sex with pulpal involvement of primary molars which were indicated for pulpectomy. The study population was divided into two groups according to the type of obturating technique used. Group I included samples obturated with lentulospirals while group II samples were obturated using skini syringes with NaviTip. Postoperatively, CBCT imaging was used to evaluate the quality of fill of both the obturation techniques by determining the presence of voids in the root canals.

Results

The total number of voids present in group I were 48, in which, 8 were in the coronal third, 16 in the middle third, and 24 in the apical third. On the other hand, the total number of voids present in group II was 21, out of which 7 were in the coronal third, 10 in the middle third, and 4 in the apical third. A statistically significant difference was noted between the two groups in terms of the overall voids present.

Conclusion

Within the limits imposed by the conditions used in the present study, both techniques can be used for obturation in the root canals of primary molars. Voids were observed with both the techniques, but minimum in group II, i.e., skini syringe with NaviTip.

How to cite this article

Nezam S, Mukherjee CG, Shukla JN, et al. Comparative Evaluation of Efficacy of Obturation Techniques in Deciduous Teeth Using Cone-beam Computed Tomography: An In Vivo Study. Int J Clin Pediatr Dent 2021;14(1):75–80.

Evaluation of Root Canal Obturation Quality in Deciduous Molars with Different Obturation Materials: An In Vitro Micro-Computed Tomography Study

Objective

To evaluate the voids in root canal treatment of deciduous molar canals using three obturating materials and two obturation systems using micro-CT. Study Design. Thirty freshly extracted deciduous molars were used in this study. The specimens were instrumented using a ProTaper Universal rotary instrument and randomly assigned into six groups (n = 5). Mesiobuccal root canals were obturated using Ca(OH)₂ and iodoform-Ca(OH)₂ and ZOE cement. The materials were applied straight from the syringe up to the 2 mm coronal level of the apex. Subsequently, the Lentulo spiral and ultrasonic activation with endoactivator were used for obturation. All samples were scanned by micro-CT with 9.1 μm isotropic voxel resolution. The voids in cross-sectional images and 3D volumes of voids were measured. Differences among materials were statically evaluated (p < 0.05).

Results

All study groups showed voids. Ca(OH)₂ and iodoform-Ca(OH)₂ with ultrasonic activation produced fewer voids whereas the ZOE groups showed higher voids with statistical significance (p < 0.05).

Conclusions

Ca(OH)₂ and iodoform-Ca(OH)₂ with ultrasonic activation decrease void formation. Further studies should be done with other obturation techniques and materials for deciduous tooth root canal management.

Root canal obturation materials and filling techniques for primary teeth: In vitro evaluation in polymer-based prototyped incisors

BACKGROUND

Achieving a void-free root canal filling is a challenge in current clinical pulpectomy practice.

AIM

To compare filling effectiveness and internal voids of root filling materials and obturation techniques in resin-prototyped primary incisors by micro-CT.

DESIGN

Fifty prototypes were instrumented and randomly divided (n = 10) according to the filling materials (Vitapex^® , ZOE, Calcicur^® , Feapex, and Calen^® -ZO) and obturation technique: lentulo or pressure syringe (n = 5). The specimens were micro-CT scanned (pixel size = 7.83 μm) and reconstructed, and the total volume of filled canal (%FC) and internal voids (%IV) of the bulk filling material was calculated. Kruskal-Wallis and Mann-Whitney tests were used to detect differences and interactions among groups.

RESULTS

Calen^® -ZO, Vitapex^® , and ZOE showed similar %FC. Calcicur^® showed lower %FC compared with Calen^® -ZO, Vitapex^® , and ZOE (P < .05) but similar to Feapex. No statistically significant differences in %FC between lentulo or pressure syringe were disclosed. Regarding %IV, Vitapex^® , and Calen^® -ZO performed better with syringe, although Calcicur^® was better with lentulo. The number of voids in the obturation bulk was similar among materials, but always lower (P < .05) in syringe filled specimens.

CONCLUSION

Vitapex^® , Calen^® -ZO, and ZOE outperformed Calcicur^® and Feapex in %FC and if the syringe technique is used, %IV of the obturation bulk and presence of defects was lower.

Comparative evaluation of three obturation techniques in primary incisors using digital intra-oral receptor and C.B.C.T-an in vitro study

OBJECTIVES

Successful pulpectomy in primary teeth depends on quality of obturation. It can be evaluated using digital intra-oral receptor (D.I.O.R) and cone beam computed tomography (C.B.C.T). The purposes of this study were to compare 3 different obturation techniques such as lentulospiral, insulin syringe, and endodontic plugger in primary incisors and to evaluate its quality of obturation using D.I.O.R and C.B.C.T technique.

MATERIALS AND METHODS

Thirty-three extracted primary incisors were biomechanically prepared and obturated with zinc oxide eugenol cement by 3 different obturation techniques. The obturation was evaluated for length of obturation and voids using D.I.O.R and C.B.C.T methods.

RESULTS

There was a statistically significant difference between all the groups in length of obturation (P = 0.02) in both D.I.O.R and C.B.C.T. Significant differences (P = 0.03) were present in number of voids among 3 obturation techniques in C.B.C.T. Statistically more voids were observed with D.I.O.R in lentulospiral (P = 0.04) group and in insulin syringe (P = 0.02) group.

CONCLUSIONS

Acceptable result was obtained with lentulospiral in length of obturation compared to insulin syringe and endodontic plugger technique. Insulin syringe technique resulted in increased underfilling with least number of voids. More number of voids were seen in middle one-third and least number of voids were observed at apical one third of the root among all the 3 techniques of obturation. The study concluded that void identification is improved with D.I.O.R compared to C.B.C.T.

CLINICAL RELEVANCE

Lentulospiral reported effective length of obturation, while insulin syringe with least number of voids. D.I.O.R (2-Dimensional) is efficient in detecting voids compared to C.B.C.T (3-Dimensional) in obturated primary teeth.

Primary Molar Pulpectomy Using Two Different Obturation Techniques: A Clinical Study

CONTEXT

A major goal in pediatric dentistry is preservation of the integrity of primary teeth and their supporting tissues until physiological process of exfoliation takes place. Pulpectomy serves such a purpose using various materials and techniques to fill the canals of primary teeth. Aims: The aim of this in vivo study was to determine the efficacy of modified disposable syringe technique in root canals of primary molars using digital radiography when obturated with endoflas.

SETTINGS AND DESIGN

A clinical study was undertaken for a period of 6 months.

SUBJECTS AND METHODS

A total of 60 primary maxillary and mandibular molars were selected in the age group of 4-8 years and randomly divided into two groups. The teeth were obturated with handheld lentulospiral and a modified disposable syringe techniques. Postoperative radiographic evaluation was done for quality of fill and voids using digital radiography. Statistical Analysis Used: Results were assessed using Chi-square test and Mann-Whitney U-test. Results: No statistically significant difference between quality of obturation using hand-held lentulospiral and modified disposable syringe (P < 0.05) was observed. Optimal obturation was achieved in both techniques; however, voids in obturation were not significant.

CONCLUSIONS

Both the hand-held lentulospiral and modified disposable syringe technique are effective in the obturation of primary molar root canals in terms of quality of fill.