The effect of different obturation methods on sealer penetration alongside apically separated rotary nickel-titanium instruments: A confocal laser scanning microscopy study.

The effects of different obturation techniques on calcium silicate-based sealer penetration in the presence of apically separated rotary files were evaluated. Forty-eight extracted mandibular incisors were used. ProTaper F2 rotary files were separated at the apical thirds. Samples were divided into four groups (n = 12) according to obturation technique used: (a) cold lateral compaction (CLC); (b) single cone; (c) bulk-fill (BF) without a core material; and (d) thermoplastic injection (TI). Specimens were sectioned horizontally at 1 and 3 mm from the apex and studied using a confocal scanning laser microscope. The maximum tubule penetration depth and percentage of penetration were measured. Data were statistically analyzed using parametric and nonparametric tests with a significance level of 5%. Regarding penetration depth, a significant difference was found at 1 mm (p < .05), while no significant difference was found at 3 mm (p > .05). At the 3 mm level, all of the obturation techniques showed similar penetration depths. Regarding penetration percentage, the values of the CLC and TI groups were statistically less when compared with the BF group at 1 and 3 mm levels, respectively (p < .05). Under the limitations of this in vitro study, results suggest that the obturation technique may present a significant effect on sealer penetration.

A micro-computed tomography evaluation of voids using calcium silicate-based materials in teeth with simulated internal root resorption.

OBJECTIVES: The obturation quality of MTA, Biodentine, Total Fill BC root canal sealer (RCS), and warm gutta-percha (WGP) in teeth with simulated internal root resorption (IRR) was evaluated by using micro-computed tomography. MATERIALS AND METHODS: Standardized IRR cavities were created using 40 extracted maxillary central incisor teeth and randomly assigned into 4 groups (n = 10). IRR cavities were filled with MTA, Biodentine, Total Fill BC RCS (bulk-fill form) and WGP + Total Fill BC RCS. Percentage of voids between resorptive cavity walls and obturation material (external void), and inside the filling materials (internal voids) were measured. RESULTS: Total Fill BC sealer in the bulk-fill form presented significantly highest values of external and internal void percentages (p < 0.05). Biodentine showed a significantly lowest external void percentage (p < 0.05). WGP + Total Fill BC RCS presented significantly lower values of internal void percentages than all groups (p < 0.05), except Biodentine (p > 0.05). CONCLUSION: None of the filling materials were created void-free obturation in resorption cavities. Biodentine may favor its application in teeth with IRR over Angelus MTA and bulk-fill form of Total Fill BC.

Fracture Resistance of Teeth with Simulated Perforating Internal Resorption Cavities Repaired with Different Calcium Silicate-based Cements and Backfilling Materials.

INTRODUCTION: This study assessed the fracture resistance (FR) of teeth with simulated perforating internal resorption cavities repaired with different calcium silicate-based cements (CSCs) and backfilling materials. METHODS: Ninety-six mandibular premolar teeth were used. Twelve of the teeth were assigned as negative control group. Remaining roots were instrumented with rotary files, and standardized internal resorption cavities were prepared on the middle half of roots with burs. Twelve of the samples were not further interfered and were assigned as a positive control group. The apical 4 mm of the remaining 72 root canals was obturated with single-cone technique and divided into 6 groups according to CSCs used for repairing of cavities and backfilling materials as follows: MTA + MTA, MTA + gutta-percha/sealer, Biodentine + Biodentine, Biodentine + gutta-percha/sealer, MTA Plus + MTA Plus, and MTA Plus + gutta-percha/sealer. Specimens were embedded in acrylic resin and then subjected to fracture testing. The forces when the fracture occurred were analyzed with analysis of variance and Bonferroni tests at P = .05. RESULTS: No significant difference was found among CSCs irrespective of backfilling materials (P > .05). Groups MTA + gutta-percha/sealer, Biodentine + gutta-percha/sealer, and MTA Plus + gutta-percha/sealer showed significantly lower FR compared with groups MTA + MTA, Biodentine + Biodentine, and MTA Plus + MTA Plus, respectively (P < .05). The highest FR was observed in group Biodentine + Biodentine, and the lowest was in group MTA Plus + gutta-percha/sealer. FR of positive control group was statistically lower than groups completely filled with CSCs (P < .05), whereas FR of negative control group was statistically higher than the groups combined with gutta-percha and sealer (P < .05). CONCLUSIONS: The backfilling with CSCs may be a preferable material rather than gutta-percha/sealer combination for the roots with perforated internal resorptions.

Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments.

OBJECTIVES: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. MATERIALS AND METHODS: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with χ2 tests using SPSS 21.0 software. RESULTS: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. CONCLUSIONS: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.