root canal obturation

The objective of this study was to assess the presence of voids in mesial root canals of mandibular molar teeth obturated by using the single-cone (SC) and continuous wave of condensation (CWC) obturation techniques, and results were analyzed by using micro-computed tomography. Twenty-four mandibular molars with fully developed roots and mesial root curvature ranging from 25° to 35° were instrumented by using Reciproc R25 files, and then they were obturated by using the SC and CWC techniques. Specimens were scanned before and after obturation for micro-computed tomography analysis (voxel size, 17.42 μm). After volumetric analysis and tridimensional reconstruction of the root canals, data were analyzed by using analysis of variance and the Tukey test. No significant differences were observed between the 2 techniques in terms of total percentage volume of voids: CWC = 3.91% ± 0.72%; SC = 6.52% ± 1.16% (P > .05). Only in the cervical third, CWC showed a significantly lower percentag...

Aim Our objective was to perform an in vitro evaluation of root fracture in endodontically treated teeth using two cone beam computed tomography (CBCT) machines. Materials and methods The sample comprised 86 singlerooted human premolars that had been fractured by a universal testing machine. The tomographic images were acquired using an Orthopantomograph OP300® and an Orthophos XG 3D® and evaluated by three examiners, by means of specific software. The teeth were classified into presence or absence of root fracture, then the root third where the fracture occurred, was determined. With regard to the detection of the fracture, the Kappa statistic was used for intra and interexaminer reproducibility at two distinct points in time. Chi-squared test was employed to analyze the sensitivity and specificity of the two tomographs (p < 0.05). Results The results showed a good or excellent Kappa index between examiners. As for the absolute frequency, the sensitivity (0.6) of the Orthophos X...

Aim  To evaluate the fracture resistance of teeth filled with various canal filling materials.Methodology  The crowns of 100 single‐rooted teeth were removed leaving 12 mm of the roots. The canals were shaped using Endo‐Sequence files. Following instrumentation, 80 teeth were divided into four groups. The remaining 20 teeth were divided into two groups. The teeth in each group were filled as follows: Group 1: AH‐Plus + Gutta‐percha (Cold lateral compaction), Group 2: Resilon + Epiphany (Cold lateral compaction), Group 3: ActiV GP cone + ActiV GP sealer, Group 4: ActiV GP sealer + Gutta‐percha (Cold lateral compaction), Group 5: No instrumentation or filling, Group 6: Instrumentation but no filling. After the sealers had set, the roots were embedded in acrylic moulds and subjected to a compressive loading at a rate of 1 mm min−1. The load at which fracture occurred was recorded and statistically analysed using Kruskal–Wallis one‐way analysis of variance and Z‐tests.Results  The fract...

This study evaluated in vivo 2 different obturation techniques (lentulo spiral mounted in a slow-speed handpiece and hand-held) in primary teeth. The study was carried out on 24 children (mean age = 6.71 years) who had received 50 single-visit zinc oxide and eugenol (ZOE) pulpectomies in primary molars. The root canal filling materials were deposited into the canals either by a lentulo spiral mounted in a slow-speed handpiece or by a hand-held lentulo spiral. Evaluation of pulpectomized molars was performed by both authors immediately and 6 months following treatment using specific clinical and radiographic criteria. In cases of disagreement, the lower rank was selected. The study found 64% (16/25) optimal filling (if 1 or more of the canals having ZOE ended at the radiographic apex or up to 2 mm short of the apex) when the lentulo spiral mounted in the slow-speed handpiece was used. It also found a 96% (21/22) clinical success rate in the group obturated by the lentulo spiral mount...

Aim: To compare the apical sealing in mesio-buccal canals of extracted molars obturated with low-temperature thermoplasticized gutta-percha or cold lateral condensation techniques using a .06 or a .02 mm/mm tapered gutta-percha master cone. The secondary aim was to evaluate the depth of spreader penetration in root canals using a .06 or a .02 mm/mm tapered gutta-percha master cone. Methodology: Forty-four mesio-buccal curved canals (25-40 degree) were instrumented with .06 nickel-titanium rotary instruments and randomly distributed into two control groups (n=4) and three experimental groups (n=12) for obturation by the Ultrafil 3D system or by cold lateral condensation with .06 or .02 tapered master cone. Canal sealer AH-Plus was used. The depth of spreader penetration was recorded in millimetres. Roots were covered with two layers of nail polish, immersed in India ink for 7 days, transversally sectioned and examined with a stereomicroscope. Student s t test was used to determine whether there was a difference in spreader penetration between groups. Kruskal-Wallis test was used to determine whether there was a difference in leakage. Results: There were no differences among the three groups (p=0.396), which showed a very similar mean microleakage (0.42, 0.75 and 0.42). The difference in spreader penetration between the groups filled by cold lateral condensation was significant (p=0.001) Conclusion: The Ultrafil 3D system and cold lateral condensation techniques with .06 or .02 tapered master cones were equally effective in the apical sealing of curved canals. The spreader penetrated deeper using a .02 mm/mm tapered gutta-percha master cone.

To compare the apical sealing in mesio-buccal canals of extracted molars obturated with low-temperature thermoplasticized gutta-percha or cold lateral condensation techniques using a .06 or a .02 mm/mm tapered gutta-percha master cone. The secondary aim was to evaluate the depth of spreader penetration in root canals using a .06 or a .02 mm/mm tapered gutta-percha master cone. Forty-four mesio-buccal curved canals (25-40 degree) were instrumented with .06 nickel-titanium rotary instruments and randomly distributed into two control groups (n=4) and three experimental groups (n=12) for obturation by the Ultrafil 3D system or by cold lateral condensation with .06 or .02 tapered master cone. Canal sealer AH-Plus was used. The depth of spreader penetration was recorded in millimetres. Roots were covered with two layers of nail polish, immersed in India ink for 7 days, transversally sectioned and examined with a stereomicroscope. Student s t test was used to determine whether there was a ...

Success of non-surgical root canal treatment is predicted by meticulous cleaning and shaping of the root canal system, three-dimensional obturation and a well-fitting "leakage-free" coronal restoration. The techniques of obturation that are available have their own relative position in the historical development of filling techniques. Over the years, pitfalls with one technique have often led to the development of newer methods of obturation, along with the recognition that no one method of obturation may satisfy all clinical cases. A total of 120 extracted human permanent anterior maxillary and mandibular single rooted teeth were selected for the present study and divided into 3 groups based on the method of obturation technique. Following the preparation the patency at the apical foramen was confirmed by passing a file #15. After obturation of all three groups, teeth were immersed in 1% of aqueous methylene blue dye for a period of two weeks and then samples were subject...

Placement of orifice plugs has been suggested to augment the seal of conventional root canal fillings. This study assessed in vivo the efficacy of white mineral trioxide aggregate (MTA) plugs in preventing periapical inflammation subsequent to coronal inoculation of root-filled teeth. The two-rooted mandibular premolars of six beagle dogs were conventionally prepared and filled with gutta-percha and sealer. A white MTA orifice plug was placed into one canal in each tooth. Pulp chambers were inoculated with plaque except for 12 teeth (negative control), and restored. Radiographs were taken at regular intervals. At 10 months, dogs were killed and jaw blocks processed for histology. None of the roots revealed radiographic or histologic evidence of severe inflammation. Mild inflammation was observed in 17% and 39% of the roots with and without an orifice plug, respectively (McNemar, p > 0.05). Without development of severe inflammation, the seal augmentation efficacy of MTA orifice p...

Separated instruments represent one of the procedural mishaps during endodontic treatment. Left unadressed, this complex situation may jeopardize the long term prognosis of root canal treatment. Clinical management depends on multiple factors. The options for approaching these situations are: removal of the fractured segment, bypassing and sealing the fragment within the root canal space. The aim of our study is to demonstrates the value of endodontic treatment in the successful management of these conditions and its contribution to complex oral rehabilitation.

Purpose The objective of this study was to compare postobturation flare-ups following single and two-visit endodontic treatment of molar teeth with periapical radiolucency. Materials and methods A total of 100 patients with asymptomatic molar teeth with periapical radiolucency were selected. They were randomly allocated into two groups. Fifty patients received complete endodontic treatment in one-visit. Fifty patients received treatment by debridement and instrumentation at the first visit followed by obturation at the second visit. Results 10% of patients had flare-ups in the single visit group and 8% of patients had flare-ups in the two-visit group. Number of visits did not affect the success of endodontic treatment (p > 0.05). Age, gender and tooth type had no effects on the occurrence of flare-ups regardless the number of visits (p > 0.05). Conclusion One-visit endodontic treatment was as successful as two-visit endodontic treatment as evaluated by rate of flareups in asym...

Aim  To evaluate bacterial leakage of Apexit Plus, a new root canal sealer, in comparison with AH Plus.Methodology  A total of 56 single‐rooted human teeth were randomly divided into two experimental groups of 16 roots and two control groups. Roots were filled by lateral condensation with Gutta‐percha and AH Plus or with Gutta‐percha and Apexit Plus. A split chamber microbial leakage model was used in which Streptococcus mutans placed in the upper chamber could reach the lower chamber only through the filled canal. Positive controls were filled only with Gutta‐percha and tested with bacteria, whereas negative controls were sealed with wax to test the seal between chambers. Additionally, film thickness, solubility and dimensional change were determined.Results  All positive controls leaked within 24 h, whereas none of the negative controls leaked after 30 days. Apexit Plus had significant less bacterial leakage (log‐rank test, P < 0.0001) than AH Plus. AH Plus (0.3% solubility) sh...

Background To determine the prevalence of periapical lesions in root canal-treated teeth in a rural, male adult, Turkish population and to investigate the influence of the quality of root canal fillings on prevalence of periapical lesions. Methods The sample for this cross-sectional study consisted of 552 adult male patients, 18-32 years of age, presenting consecutively as new patients seeking routine dental care at the Dental Sciences of Gulhane Military Medicine, Ankara. The radiographs of the 1014 root canal-treated teeth were evaluated. The teeth were grouped according to the radiographic quality of the root canal filling and the coronal restoration. The criteria used for the examination were slightly modified from those described by De Moor. Periapical status was assessed by the Periapical Index scores (PAI) proposed by Orstavik. Results The overall success rate of root canal treatment was 32.1%. The success rates of adequately root canal treatment were significantly higher tha...

Some techniques and instruments like stereomicroscopy and confocal microscopy used for observing neural cells are too complicated and dependent on preparation and cell fixation methods. This may question the results of these methods. Though, we have used scanning electron microscopy on replicated specimens to observe p19 neural cells and their cellular extensions. This manuscript has shown the feasibility of using replica (indirect) method instead of direct methods for observing morphological characteristics of this high sensitive cell line. As neural cells are very sensitive to fixation solutions and processes, we have used replica mode and observed neural cells with a novel indirect method. We have used replica mode in this study to indirectly and noninvasively evaluate the state of p19 neural cells and their cellular extensions. SCANNING 32: 369–374, 2010. © 2010 Wiley Periodicals, Inc.

The prime objective of this case report is to obtain access cavity designs that is strategic dentin preservation (ie, leaving a truss of dentin between the 2 cavities thus prepared). Three permanent teeth with an indication for endodontic treatment were treated via the truss access cavity design rather than traditional access cavity protocol using copious irrigation. The teeth were then given post-endodontic restorations. Endodontically treated teeth did not show any post-operative symptoms or any presence of post-operative periapical radiolucency or flare-up. Truss access approach mainly emphasizes on the preservation of the healthy tooth structure with the minimally invasive approach. This minimal invasive approach in access opening avoids the need for conventionally placed crowns.

The aim of this study was to assess the prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. A total of 1,372 periapical radiographs of endodontically treated teeth were analyzed based on the quality of root filling, status of coronal restoration and presence of posts associated with apical periodontitis (AP). Data were analyzed statistically using odds ratio, confidence intervals and chi-square test. The prevalence of AP with adequate endodontic treatment was low (16.5%). This percentage dropped to 12.1% in cases with adequate root filling and adequate coronal restoration. Teeth with adequate endodontic treatment and poor coronal restoration had an AP prevalence of 27.9%. AP increased to 71.7% in teeth with poor endodontic treatment associated with poor coronal restoration. When poor endodontic treatment was combined with adequate coronal restoration, AP prevalence was 61.8%. The prevalence of AP was low w...

Aim  To assess the effect of spreader size used during cold lateral compaction of gutta‐percha on fracture resistance of roots in maxillary incisor teeth.Methodology  The crowns of 50 human maxillary incisor teeth having no carious lesions, no fracture or crazing were resected 2 mm coronal to the cemento‐enamel junction. The root canals of the teeth were prepared as follows: Group 1: No canal preparation. Group 2: Preparation using the stepback technique to a size 40 master apical file. Group 3: Canal preparation to size 40 and filling with laterally compacted gutta‐percha; the first spreader used was equal to size 40. Group 4: Same as group 3 except the first spreader was equal to size 35. Group 5: Same as group 3 except the first spreader was equal to size 25.For each root, a simulated periodontal ligament was prepared. The roots were than mounted in polyester resin and fractured vertically on a universal testing machine (Shimadzu, Tokyo, Japan). The fracture values of teeth were ...

To investigate the apical sealing ability of glass ionomer and resin-based root canal obturation systems in comparison to a conventional vertical compaction of warm guttapercha. Forty-five extracted human teeth were randomly assigned into 3 groups of 15 each: a resin-based (EndoRez), a glass ionomer-based (Activ GP), and a conventional gutta-percha plus pulp sealer obturation system (GP/EWT). Apical and root canal space sealing abilities were assessed on five cross-sections 1.0 mm apart starting from the apex. Cross-section images were analysed using a focus-variation 3D scanning microscope and unsealed space was calculated as the percentage of total root canal space occupied by voids and debris. EndoRez had significantly higher rate of apical leakage and deeper dye penetration as compared to GP/EWT and Activ GP. EndoRez group had also more voids and debris (22.5%) in the root canal spaces as compared to GP/EWT (10.5%) and Activ GP (10.8%). Apical leakages occurred not only along th...

To compare in vitro differences in the apical filling regarding working length (WL) change and presence of voids and to validate OCT in comparison to µCT for the detection of failures in the apical filling. Forty-five uniradicular teeth with round canals, divided into groups (n=15) following the obturation protocols: CL (Lateral condensation), TMC (thermomechanical compaction) and SC (single cone). Samples were scanned using µCT (parameters: 80 kV, 222 µA, and resolution of 11µm), OCT (parameters: SSOCT, 1300nm and axial resolution of 12µm), and periapical digital radiography. The images were analyzed by two blind and calibrated observers using ImageJ software to measure the boundary of the obturation work length (WL) and voids presence. Categorical and metric data were submitted to inferential analysis, and the validity of the OCT as a diagnostic test was assessed with performance and reliability tests. The WL average remained constant for all obturation techniques and image method...

Aim This cross-sectional study aimed to investigate the prevalence of apical periodontitis (AP) and root-filled teeth in a 65-year-old population in Oslo, Norway, and to investigate associations of pathosis and endodontic treatment with selected individual risk indicators and technical quality of root fillings. Material and methods A random sample of 450 65-year-olds in Oslo answered a questionnaire and underwent a clinical and radiological examination (52% men and 48% women). Periapical radiographs were taken of all root-filled teeth and of teeth with apical radiolucency, and periapical status was evaluated using the Periapical Index. Apex-to-filling distance and homogeneity were assessed for all root fillings. Analyses on individual level and tooth level were performed. The outcome variables were ‘non-root-filled tooth with AP’ (‘untreated AP’), ‘root-filled tooth’, and 'root-filled tooth with AP’. The explanatory variables were gender, education, dental attendance pattern, sm...

Introduction: The present study compared the ability of the endodontic sealers AH Plus, Pulp Canal Sealer and EndoREZ to fill the root canal system in association with gutta-percha. Methods: Ninety mandibular premolars were accessed, prepared and divided into three groups of 30 teeth each, according to the sealer used to fill the canals: AH Plus, Pulp Canal Sealer and EndoREZ. All the teeth were filled using the continuous wave of condensation technique. The specimens were then decalcified, dehydrated, rendered transparent, and analyzed by three independent evaluators with 8x magnification. Chi-squared test (χ2, p < 0.05) was used to compare the groups in relation to the totally filled, the partially filled and the non filled ramifications. The same test was used to compare the directions of filled ramifications and the number of ramifications among the three thirds of the roots. Results: EndoREZ filled a significantly higher number of ramifications than AH Plus and Pulp Canal Se...