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
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.
16 February 2020 (online)
Thieme Medical and Scientific Publishers Private Ltd.
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- 1 Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967; 723-744
- 2 Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974; 18 (02) 269-296
- 3 Üreyen Kaya B, Erik CE, Sesli Çetin E, Köle M, Maden M. Mechanical reduction in intracanal Enterococcus faecalis when using three different single-file systems: an ex vivo comparative study. Int Endod J 2019; 52 (01) 77-85
- 4 Martinho FC, Gomes CC, Nascimento GG, Gomes APM, Leite FRM. Clinical comparison of the effectiveness of 7- and 14-day intracanal medications in root canal disinfection and inflammatory cytokines. Clin Oral Investig 2018; 22 (01) 523-530
- 5 Whitworth J. Methods of filling root canals: principles and practices. Endod Topics 2005; 12 (05) 2-24
- 6 Epley SR, Fleischman J, Hartwell G, Cicalese C. Completeness of root canal obturations: epiphany techniques versus gutta-percha techniques. J Endod 2006; 32 (06) 541-544
- 7 Libonati A, Montemurro E, Nardi R, Campanella V. Percentage of gutta-percha-filled areas in canals obturated by 3 different techniques with and without the use of endodontic sealer. J Endod 2018; 44 (03) 506-509
- 8 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 (02) 294-298
- 9 De-Deus G, Barino B, Marins J, Magalhães K, Thuanne E, Kfir A. Self-adjusting file cleaning-shaping-irrigation system optimizes the filling of oval-shaped canals with thermoplasticized gutta-percha. J Endod 2012; 38 (06) 846-849
- 10 Nhata J, Machado R, Vansan LP. et al. Micro-computed tomography and bond strength analysis of different root canal filling techniques. Indian J Dent Res 2014; 25 (06) 698-701
- 11 Strange KA, Tawil PZ, Phillips C, Walia HD, Fouad AF. Long-term outcomes of endodontic treatment performed with resilon/epiphany. J Endod 2019; 45 (05) 507-512
- 12 Piai GG, Duarte MAH, Nascimento ALD, Rosa RAD, Só MVR, Vivan RR. Penetrability of a new endodontic sealer: a confocal laser scanning microscopy evaluation. Microsc Res Tech 2018; 81 (11) 1246-1249
- 13 Xu H, Qiu XH, Zhang GD, Zhang FM. Evaluation of the filling quality of different root canal obturation techniques using micro-CT [in Chinese]. Shanghai Kou Qiang Yi Xue 2018; 27 (04) 349-353
- 14 Fragachán M, Pons M, Barriuso E, Frigola J, Ballester ML, Berástegui E. Micro-computed tomography assessment of different obturation techniques for filling lateral canals. J Clin Exp Dent 2018; 10 (07) e702-e708
- 15 Dumani A, Yilmaz S, Yoldas O, Kuden C. Evaluation of various filling techniques in distal canals of mandibular molars instrumented with different single-file nickel-titanium systems. Niger J Clin Pract 2017; 20 (03) 307-312
- 16 Soo WK, Thong YL, Gutmann JL. A comparison of four gutta-percha filling techniques in simulated C-shaped canals. Int Endod J 2015; 48 (08) 736-746
- 17 Huang Y, Orhan K, Celikten B, Orhan AI, Tufenkci P, Sevimay S. Evaluation of the sealing ability of different root canal sealers: a combined SEM and micro-CT study. J Appl Oral Sci 2018; 26: e20160584
- 18 Tedesco M, Chain MC, Bortoluzzi EA. da Fonseca Roberti Garcia L, Alves AMH, Teixeira CS. Comparison of two observational methods, scanning electron and confocal laser scanning microscopies, in the adhesive interface analysis of endodontic sealers to root dentine. Clin Oral Investig 2018; 22 (06) 2353-2361
- 19 Marciano MA, Ordinola-Zapata R, Cunha TV. et al. Analysis of four gutta-percha techniques used to fill mesial root canals of mandibular molars. Int Endod J 2011; 44 (04) 321-329
- 20 De-Deus G, Gurgel-Filho ED, Magalhães KM, Coutinho-Filho T. A laboratory analysis of gutta-percha-filled area obtained using Thermafil, System B and lateral condensation. Int Endod J 2006; 39 (05) 378-383
- 21 Leoni GB, Versiani MA, Pécora JD, Damião de Sousa-Neto M. Micro-computed tomographic analysis of the root canal morphology of mandibular incisors. J Endod 2014; 40 (05) 710-716
- 22 van der Sluis LW, Wu MK, Wesselink PR. An evaluation of the quality of root fillings in mandibular incisors and maxillary and mandibular canines using different methodologies. J Dent 2005; 33 (08) 683-688
- 23 Keçeci AD, Unal GC, Sen BH. Comparison of cold lateral compaction and continuous wave of obturation techniques following manual or rotary instrumentation. Int Endod J 2005; 38 (06) 381-388
- 24 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 (08) 719-726
- 25 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 (07) 924-928
- 26 Gound TG, Riehm RJ, Odgaard EC, Makkawy H. Effect of spreader and accessory cone size on density of obturation using conventional or mechanical lateral condensation. J Endod 2001; 27 (05) 358-361
- 27 Moule AJ, Kellaway R, Clarkson R. et al. Variability of master gutta-percha cones. Aust Endod J 2002; 28 (01) 38-43
- 28 Hartwell GR, Barbieri SJ, Gerard SE, Gunsolley JC. Evaluation of size variation between endodontic finger spreaders and accessory gutta-percha cones. J Endod 1991; 17 (01) 8-11
- 29 Cheng YA, Huang SH, Hsien HC, Chiang YC, Lin CP. Influence of cyclic heating on physical property and biocompatibility of α- and β-form gutta-percha. J Formos Med Assoc 2014; 113 (08) 498-505
- 30 Maniglia-Ferreira C, Bönecker G, Silva Jr JB, de Paula RC, Feitosa JP, Souza-Filho FJ. Degradation of trans-polyisoprene after root filling with thermoplasticized techniques. Int Endod J 2008; 41 (04) 296-302
- 31 Capurro MA, Goldberg F, Balbachan L, Macchi RL. Evaluation of the dimensional stability of different thermoplasticized gutta-percha fillings using simulated glass root canals. Endod Dent Traumatol 1993; 9 (04) 160-164
- 32 Ordinola-Zapata R, Bramante CM, Graeff MS. et al. Depth and percentage of penetration of endodontic sealers into dentinal tubules after root canal obturation using a lateral compaction technique: a confocal laser scanning microscopy study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108 (03) 450-457
- 33 D’Alpino PH, Pereira JC, Svizero NR, Rueggeberg FA, Pashley DH. Use of fluorescent compounds in assessing bonded resin-based restorations: a literature review. J Dent 2006; 34 (09) 623-634
- 34 Bitter K, Paris S, Martus P, Schartner R, Kielbassa AM. A confocal laser scanning microscope investigation of different dental adhesives bonded to root canal dentine. Int Endod J 2004; 37 (12) 840-848