Evaluation of Extrusion and Apical Seal of Thermafil™ Obturation with and without MTA as an Apical Barrier in Comparison with Lateral Condensation Technique: An In Vitro Study.

AIM AND OBJECTIVE: This study aimed to compare the apical sealing ability and periapical extrusion in the Thermafil™ obturation technique, with and without an apical barrier of MTA, with lateral condensation technique. MATERIALS AND METHODS: Sixty freshly extracted human central incisors were instrumented with the crown down technique and divided into three experimental groups. Group I: lateral condensation technique obturation, group II: Thermafil obturation (DENTSPLY Tulsa), and group III: this group was obturated into two parts; first MTA (ProRoot) was placed in apical 3 mm and later the remaining canal was obturated with Thermafil™ obturation technique (DENTSPLY Tulsa). AH Plus sealer was used in all the groups. Specimens of all the groups were layered with nail paint excluding the apical 3 mm. Twenty-four hours later, all the teeth were suspended in Black India ink for 48 hours. Finally, all the teeth were decalcified, rendered transparent and linear dye leakage and periapical extrusion was measured using ×60 magnification of stereomicroscope with an in-built ruler. RESULTS: A Chi-square test done to evaluate periapical extrusion showed there was a significant difference found among all the groups (p < 0.05), whereas in case of linear apical dye leakage using a Student's "t" test showed there was no significant difference among all the groups (p > 0.05). CONCLUSION: Despite showing apical leakage, the thermo-plasticized gutta-percha obturation technique can be advantageous when used with MTA as an apical barrier since there is no scope for apical extrusion along with the benefit of three-dimensional obturation of the root canal system when compared with the lateral condensation technique. HOW TO CITE THIS ARTICLE: Rao AS, Mathur R, Shah NC, et al. Evaluation of Extrusion and Apical Seal of Thermafil™ Obturation with and without MTA as an Apical Barrier in Comparison with Lateral Condensation Technique: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(S-1):S40-S44.

Stereomicroscopic and Microscopic Study of Dental Structural Aspects Derived from Iatrogenic and Pathological Processes Suffered by a Second Mandibular Premolar - A Case Study.

Microscopic studies performed on extracted human teeth after their preparation in advance is helpful in a relatively good reestablishment of the treatment steps that have been applied to these teeth, as well as an evaluation of the quality of such treatments. Therefore, we have used stereo- and optical microscopy, highlighting aspects of external morphology, as well as root canal space of an extracted mandibular second premolar, subjected to prosthetic and endodontic treatment. In order to verify some technical errors that might occur during the endodontic and restorative treatment, we tried to appreciate the quality of the root canal filling and cervical defect and access cavity restoration of an extracted premolar #45.Without having the data from clinical records, we concluded that the method used for root canal filling was the warm lateral condensation technic; we also appreciated the quality of the fusion of the gutta-percha cones used, so the introduction of heated spreaders only in the central part of the bunch of cones makes it possible to clearly detect the boundaries between these cones towards the outside of the filling.

Comparative evaluation of push-out bond strength of gutta-percha using different sealers with lateral condensation and thermoplasticized obturation technique: An in vitro study.

AIM: The study aimed to evaluate and compare the push-out bond strength of gutta-percha using AH plus, Endosequence BC, and Roeko seal sealer with lateral condensation and thermoplasticized obturation technique. MATERIALS AND METHODS: Sixty single-rooted premolars were instrumented and samples were randomly assigned into three groups based on the sealer used (Group A-AH Plus, Group B-Endosequence BC, Group C-Roeko Seal) which were further divided into two subgroups-A1, B1, and C1 were obturated by the lateral condensation technique and A2, B2, and C2 using the thermoplasticized technique. Each sample was sectioned horizontally using a diamond disc, representing apical, middle, and coronal thirds, respectively. Root segments were then mounted on an acrylic block, and push-out bond strength of each sample was tested using the universal testing machine. STATISTICAL ANALYSIS: One-way ANOVA, Tukey's test, and unpaired t-test. RESULTS: For mandibular premolar teeth with a single canal using lateral condensation technique, the highest push-out bond strength was found in the A1 group (7.30 ± 0.61 MPa) at the apical level. While using the thermoplasticized technique, the highest push-out bond strength was found in the B2 group (3.71 ± 0.81 MPa) at the apical level. Overall results showed that the lateral condensation technique showed significantly higher push-out bond strength than thermoplasticized technique (P < 0.028). CONCLUSIONS: The push-out bond strength of AH Plus sealer was higher than the Endosequence BC sealer and Roeko seal sealer. Lateral condensation technique has shown higher push-out bond strength than the thermoplasticized technique.

Quality of root canal fillings using three gutta-percha obturation techniques.

OBJECTIVES: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. MATERIALS AND METHODS: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. RESULTS: The overall mean volume fraction of gutta-percha was 68.51 ± 6.75% for CL, 86.56 ± 5.00% for UL, and 88.91 ± 5.16% for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. CONCLUSIONS: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

Quality of root canal fillings using three gutta-percha obturation techniques

OBJECTIVES: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. MATERIALS AND METHODS: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. RESULTS: The overall mean volume fraction of gutta-percha was 68.51 +/- 6.75% for CL, 86.56 +/- 5.00% for UL, and 88.91 +/- 5.16% for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. CONCLUSIONS: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

Quality of root canal fillings using three gutta-percha obturation techniques

OBJECTIVES: The goal of this study was to compare the density of gutta-percha root fillings obturated with the following techniques: cold lateral (CL) compaction, ultrasonic lateral (UL) compaction, and warm vertical (WV) compaction. MATERIALS AND METHODS: Thirty-three extracted mandibular first molars, with two separate mesial canals in each, were selected. After instrumentation, the canals were stratified into three groups based on canal length and curvature, and underwent obturation with one of the techniques. No sealer was used in order to avoid masking any voids. The teeth were imaged pre- and post-obturation using micro-computed tomography. The reconstructed three-dimensional images were analyzed volumetrically to determine the amount of gutta-percha present in every 2 mm segment of the canal. P values < 0.05 were considered to indicate statistical significance. RESULTS: The overall mean volume fraction of gutta-percha was 68.51 +/- 6.75% for CL, 86.56 +/- 5.00% for UL, and 88.91 +/- 5.16% for WV. Significant differences were found between CL and UL and between CL and WV (p < 0.05), but not between UL and WV (p = 0.526). The gutta-percha density of the roots treated with WV and UL increased towards the coronal aspect, but this trend was not noted in the CL group. CONCLUSIONS: WV compaction and UL compaction produced a significantly denser gutta-percha root filling than CL compaction. The density of gutta-percha was observed to increase towards the coronal aspect when the former two techniques were used.

Evaluation of the effect of different root canal obturation techniques using two root canal sealers on the fracture resistance of endodontically treated roots.

AIM: The aim of this study was to compare the fracture resistance of teeth filled with AH Plus and MTA Fillapex root canal sealers by using different root canal obturation techniques. MATERIALS AND METHODS: One hundred and twenty pieces of single-rooted-and-canalled mandibular premolar teeth were selected. After the crowns were removed from the cemento-enamel junction, they were divided into 10 groups (n = 12). All the root canals except for the Group 1 were shaped until F4 file with ProTaper Nickel- Titanyum (Ni-Ti) rotary system. Group 1: was not instrumented. Group 2: the root canals were shaped but not filled. Group 3: roots were filled with cold lateral condensation technique (CLC) by using AH Plus. Group 4: roots were filled with CLC by using MTA Fillapex. Group 5: roots were filled with single cone technique by using AH Plus. Group 6: roots were filled with single cone technique by using MTA Fillapex. Group 7: roots were filled with AH Plus by using vertical compaction method with continuous heat. Group 8: roots were filled with MTA Fillapex by using vertical compaction method with continuous heat. Group 9: roots were filled with AH Plus by using thermoplastic core carrier method. Group 10: roots were filled with MTA Fillapex by using thermoplastic core carrier method. Before embedding the samples in acrylic resin after standing in an oven at 37°C for 2 weeks for the hardening of the root canal sealers the 5 mm apical portion of the roots were immersed in wax in order to imitate the surrounding tissues. Polyvinyl siloxane impression material was used for the samples which were embedded in acrylic resin in a way that the coronal 8 mm remained outside in order to imitate the periodontal ligament. Lateral force was applied to the samples with 1 mm/min speed in the Universal Tester. The maximum force values (F-max) which cause fractures in the examples were determined and the results were subjected to statistical evaluation by using one-way Anova and Tukey HSD tests with the significance set at (P < 0.05). RESULTS: The control group showed the maximum fracture resistance (P < 0.05). Thermafil group showed higher fracture resistance than single cone technique, cold lateral condensation technique, and system B (P < 0.05). CONCLUSIONS: It was concluded that shaping and widening of the root canals reduced the fracture resistance of teeth while Thermafil increased the resistance of roots against fracture.

Factors associated with postoperative pain in endodontic therapy.

OBJECTIVE: To assess postoperative pain in endodontic therapy and its association with clinical factors such as gender, age, tooth type, pulpal diagnosis, and preoperative pain, length of obturation and sealer extrusion. STUDY DESIGN: Cross-Sectional study. PLACE AND DURATION OF STUDY: Dental section of the Aga khan university hospital, Karachi, Pakistan from January to December 2009. METHODOLOGY: One hundred and forty patients (140) requiring endodontic therapy for molar and premolar teeth were included in this study. Local Anesthesia (2% Lidocain with 1:80,000 Epinephrine) was administered. The tooth was isolated with rubber dam. Access cavity was prepared with the help of round carbide No. 2 bur. Canal preparation was completed using crown-down technique. Access was sealed with sterile dry cotton pallet and restored temporarily with double layer of Glass ionomer cement and Cavit. After one week patients were recalled and access was re-opened, obturation was done using cold lateral condensation technique. Ca(OH)(2) based sealer was used. Postoperative radiographs were taken. Patients were recalled after 24 hours and postobturation pain was recorded using Visual analogue scale (VAS).Data was obtained on a structured Performa. χ(2) test was used for statistical analysis. RESULTS: Pain was present in 42.9% of patients. Females more frequently experienced pain (65%) than males (35%). Preoperative pain was found to be significantly associated with postoperative pain (p value < 0.001). Obturation length was not found to be significantly associated with postoperative pain (p value 1.0). Sealer extrusion was not found to be significantly associated with postoperative (P value 0.547).

Endodontic microleakage following lateral condensation or vertical condensation technique / 实用口腔医学杂志

0.05) after condensation. The difference of leakage between A and B, B and D groups was significant from 20 and 15 days on. The glucose concentration in group A and B was higher than that in group C and D during the corresponding observation period and using the corresponding sealer materia.AH Plus resulted in less leakage than Pulp Canal Sealer EWT did when using lateral condensation technique and two sealer performed the same when using vertical condensation method.Conclusions:The sealing ability of vertical condensation technique is better than that of lateral.