Research Article
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Extrusion of Root Canal Filling Materials in Molars of a Turkish Subpopulation

Year 2023, Volume: 1 Issue: 2, 35 - 39, 31.08.2023

Abstract

Aim This research aimed to investigate the root canal filling sealer or gutta-percha extrusion in molars in a population in Turkiye.
Material and method Cone-beam computed tomography images of 831 endodontically treated molars (284 maxillary first molars, 189 maxillary second molars, 178 mandibular first molars, and 180 mandibular second molars) were examined at three planes by two endodontists. The presence of extrusion, the number of teeth, and the type of molar were determined via the chi-square test at a p-value of 0.05 in SPSS V25 (IBM, Chicago, IL).
Results 13.71 % of the molars had extrusion of root canal filling materials. In maxillary and mandibular molars, extrusion was observed in 17.5% and 8.7% of cases, respectively. Extrusion was seen in 15.8% of maxillary first molars, 20.1% of maxillary second molars, 8.4% of mandibular first molars, and 8.9% of mandibular second molars.
Conclusion Root canal filling material extrusion was statistically detected more in maxillary molars than in mandibular molars. Extrusion was more observed in maxillary second molars than in other molar categories.

References

  • Sabeti MA, Nekofar M, Motahhary P, Ghandi M, Simon JH. Healing of apical periodontitis after endodontic treatment with and without obturation in dogs. J Endod. 2006;32(7):628-33.
  • Ricucci D, Langeland K. Apical limit of root canal instrumentation and obturation, part 2. A histological study. Int Endod J. 1998;31(6):394-409.
  • Dummer PM, McGinn JH, Rees DG. The position and topography of the apical canal constriction and apical foramen. Int Endod J. 1984;17(4):192-8.
  • Ponce EH, Vilar Fernández JA. The cemento-dentino-canal junction, the apical foramen, and the apical constriction: evaluation by optical microscopy. J Endod. 2003;29(3):214-9.
  • Siqueira JF, Jr., Rôças IN, Alves FR, Campos LC. Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(3):369-74.
  • Gomes AC, Nejaim Y, Silva AI, Haiter-Neto F, Cohenca N, Zaia AA, et al. Influence of Endodontic Treatment and Coronal Restoration on Status of Periapical Tissues: A Cone-beam Computed Tomographic Study. J Endod. 2015;41(10):1614-8.
  • Ricucci D, Rôças IN, Alves FR, Loghin S, Siqueira JF, Jr. Apically Extruded Sealers: Fate and Influence on Treatment Outcome. J Endod. 2016;42(2):243-9.
  • Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297-306.
  • Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16(10):498-504.
  • Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res. 1979;87(3):217-24.
  • Siqueira JF, Jr., Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J. 2014;216(6):305-12.
  • Olsson B, Wennberg A. Early tissue reaction to endodontic filling materials. Endod Dent Traumatol. 1985;1(4):138-41.
  • Dalopoulou A, Economides N, Evangelidis V. Extrusion of root canal sealer in periapical tissues: Report of two cases with different treatment management and literature review. Balkan Journal of Dental Medicine. 2017;21(1):12-8.
  • Fristad I, Molven O, Halse A. Nonsurgically retreated root filled teeth--radiographic findings after 20-27 years. Int Endod J. 2004;37(1):12-8.
  • Santos-Junior AO, De Castro Pinto L, Mateo-Castillo JF, Pinheiro CR. Success or failure of endodontic treatments: A retrospective study. J Conserv Dent. 2019;22(2):129-32.
  • Scolozzi P, Lombardi T, Jaques B. Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(5):625-31.
  • Swartz DB, Skidmore AE, Griffin JA, Jr. Twenty years of endodontic success and failure. J Endod. 1983;9(5):198-202.
  • Pruthi PJ, Dharmani U, Roongta R, Talwar S. Management of external perforating root resorption by intentional replantation followed by Biodentine restoration. Dent Res J (Isfahan). 2015;12(5):488-93.
  • Seltzer S. Long-term radiographic and histological observations of endodontically treated teeth. J Endod. 1999;25(12):818-22.
  • Cheng L, Zhang R, Yu X, Tian Y, Wang H, Zheng G, et al. A comparative analysis of periapical radiography and cone-beam computerized tomography for the evaluation of endodontic obturation length. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):383-9.
  • Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011;44(7):610-25.
  • Moura MS, Guedes OA, De Alencar AH, Azevedo BC, Estrela C. Influence of length of root canal obturation on apical periodontitis detected by periapical radiography and cone beam computed tomography. J Endod. 2009;35(6):805-9.
  • Bergenholtz G, Lekholm U, Milthon R, Engstrom B. Influence of apical overinstrumentation and overfilling on re-treated root canals. J Endod. 1979;5(10):310-4.
  • Vier FV, Figueiredo JA. Prevalence of different periapical lesions associated with human teeth and their correlation with the presence and extension of apical external root resorption. Int Endod J. 2002;35(8):710-9.
  • ElAyouti A, Weiger R, Löst C. Frequency of overinstrumentation with an acceptable radiographic working length. J Endod. 2001;27(1):49-52.
  • Goldberg F, Cantarini C, Alfie D, Macchi RL, Arias A. Relationship between unintentional canal overfilling and the long-term outcome of primary root canal treatments and nonsurgical retreatments: a retrospective radiographic assessment. Int Endod J. 2020;53(1):19-26.
  • Tennert C, Jungbäck IL, Wrbas KT. Comparison between two thermoplastic root canal obturation techniques regarding extrusion of root canal filling--a retrospective in vivo study. Clin Oral Investig. 2013;17(2):449-54.
  • Khabbaz MG, Papadopoulos PD. Deposition of calcified tissue around an overextended gutta-percha cone: case report. Int Endod J. 1999;32(3):232-5.
  • Brooks JK, Kleinman JW. Retrieval of extensive gutta-percha extruded into the maxillary sinus: use of 3-dimensional cone-beam computed tomography. J Endod. 2013;39(9):1189-93.
  • Faria-Júnior NB, Tanomaru-Filho M, Berbert FL, Guerreiro-Tanomaru JM. Antibiofilm activity, pH and solubility of endodontic sealers. Int Endod J. 2013;46(8):755-62.
  • Lin LM, Pascon EA, Skribner J, Gängler P, Langeland K. Clinical, radiographic, and histologic study of endodontic treatment failures. Oral Surg Oral Med Oral Pathol. 1991;71(5):603-11.
  • Sari S, Duruturk L. Radiographic evaluation of periapical healing of permanent teeth with periapical lesions after extrusion of AH Plus sealer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(3):e54-9.
  • Siqueira JF, Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34(1):1-10.
  • Strindberg L. The dependence of the results of pulp therapy on certain factors. An analytic study based on radiographic and clinical follow-up examination. Actadont Scand. 1956;14.
  • Pascon EA, Spngberg LS. In vitro cytotoxicity of root canal filling materials: 1. Gutta-percha. J Endod. 1990;16(9):429-33.
  • Gutiérrez JH, Brizuela C, Villota E. Human teeth with periapical pathosis after overinstrumentation and overfilling of the root canals: a scanning electron microscopic study. Int Endod J. 1999;32(1):40-8.
  • Noiri Y, Ehara A, Kawahara T, Takemura N, Ebisu S. Participation of bacterial biofilms in refractory and chronic periapical periodontitis. J Endod. 2002;28(10):679-83.
  • Da Silva D, Endal U, Reynaud A, Portenier I, Orstavik D, Haapasalo M. A comparative study of lateral condensation, heat-softened gutta-percha, and a modified master cone heat-softened backfilling technique. Int Endod J. 2002;35(12):1005-11.
  • Gençoğlu N, Garip Y, Baş M, Samani S. Comparison of different gutta-percha root filling techniques: Thermafil, Quick-fill, System B, and lateral condensation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):333-6.
  • Saunders WP, Saunders EM, Sadiq J, Cruickshank E. Technical standard of root canal treatment in an adult Scottish sub-population. Br Dent J. 1997;182(10):382-6.
  • De Moor RJ, Hommez GM, De Boever JG, Delmé KI, Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J. 2000;33(2):113-20.
  • De Cleen MJ, Schuurs AH, Wesselink PR, Wu MK. Periapical status and prevalence of endodontic treatment in an adult Dutch population. Int Endod J. 1993;26(2):112-9.
  • Imfeld TN. Prevalence and quality of endodontic treatment in an elderly urban population of Switzerland. J Endod. 1991;17(12):604-7.
  • Yousuf W, Khan M, Mehdi H. Endodontic Procedural Errors: Frequency, Type of Error, and the Most Frequently Treated Tooth. Int J Dent. 2015;2015:673914.
  • Bürklein S, Schäfer E, Jöhren H-P, Donnermeyer D. Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis. Clinical Oral Investigations. 2020;24:1217-27.
  • Kabak Y, Abbott PV. Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population. Int Endod J. 2005;38(4):238-45.
  • Nascimento EHL, Gaêta-Araujo H, Andrade MFS, Freitas DQ. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig. 2018;22(7):2495-503.
  • Moreno JO, Alves FR, Gonçalves LS, Martinez AM, Rôças IN, Siqueira JF, Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39(5):600-4.
  • Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7.
  • Koçak B, Önay EO, Koç C, Üngör M. Taşkın kök kanal dolgu patları ve bunların çeşitli risk faktörleriyle ilişkilerinin incelenmesi: Retrospektif bir araştırma. Turkiye Klinikleri J Dental Sci.2022.
  • Ricucci D, Siqueira JF. Endodontology: an integrated biological and clinical view: Quintessence Publishing London; 2013.
  • Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature -- Part 2. Influence of clinical factors. Int Endod J. 2008;41(1):6-31.
  • Er O, Sagsen B, Maden M, Cinar S, Kahraman Y. Radiographic technical quality of root fillings performed by dental students in Turkey. Int Endod J. 2006;39(11):867-72.
  • Vukadinov T, Blažić L, Kantardžić I, Lainović T. Technical quality of root fillings performed by undergraduate students: a radiographic study Sci World J. 2014;2014:751274.
Year 2023, Volume: 1 Issue: 2, 35 - 39, 31.08.2023

Abstract

References

  • Sabeti MA, Nekofar M, Motahhary P, Ghandi M, Simon JH. Healing of apical periodontitis after endodontic treatment with and without obturation in dogs. J Endod. 2006;32(7):628-33.
  • Ricucci D, Langeland K. Apical limit of root canal instrumentation and obturation, part 2. A histological study. Int Endod J. 1998;31(6):394-409.
  • Dummer PM, McGinn JH, Rees DG. The position and topography of the apical canal constriction and apical foramen. Int Endod J. 1984;17(4):192-8.
  • Ponce EH, Vilar Fernández JA. The cemento-dentino-canal junction, the apical foramen, and the apical constriction: evaluation by optical microscopy. J Endod. 2003;29(3):214-9.
  • Siqueira JF, Jr., Rôças IN, Alves FR, Campos LC. Periradicular status related to the quality of coronal restorations and root canal fillings in a Brazilian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(3):369-74.
  • Gomes AC, Nejaim Y, Silva AI, Haiter-Neto F, Cohenca N, Zaia AA, et al. Influence of Endodontic Treatment and Coronal Restoration on Status of Periapical Tissues: A Cone-beam Computed Tomographic Study. J Endod. 2015;41(10):1614-8.
  • Ricucci D, Rôças IN, Alves FR, Loghin S, Siqueira JF, Jr. Apically Extruded Sealers: Fate and Influence on Treatment Outcome. J Endod. 2016;42(2):243-9.
  • Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297-306.
  • Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16(10):498-504.
  • Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res. 1979;87(3):217-24.
  • Siqueira JF, Jr., Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J. 2014;216(6):305-12.
  • Olsson B, Wennberg A. Early tissue reaction to endodontic filling materials. Endod Dent Traumatol. 1985;1(4):138-41.
  • Dalopoulou A, Economides N, Evangelidis V. Extrusion of root canal sealer in periapical tissues: Report of two cases with different treatment management and literature review. Balkan Journal of Dental Medicine. 2017;21(1):12-8.
  • Fristad I, Molven O, Halse A. Nonsurgically retreated root filled teeth--radiographic findings after 20-27 years. Int Endod J. 2004;37(1):12-8.
  • Santos-Junior AO, De Castro Pinto L, Mateo-Castillo JF, Pinheiro CR. Success or failure of endodontic treatments: A retrospective study. J Conserv Dent. 2019;22(2):129-32.
  • Scolozzi P, Lombardi T, Jaques B. Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(5):625-31.
  • Swartz DB, Skidmore AE, Griffin JA, Jr. Twenty years of endodontic success and failure. J Endod. 1983;9(5):198-202.
  • Pruthi PJ, Dharmani U, Roongta R, Talwar S. Management of external perforating root resorption by intentional replantation followed by Biodentine restoration. Dent Res J (Isfahan). 2015;12(5):488-93.
  • Seltzer S. Long-term radiographic and histological observations of endodontically treated teeth. J Endod. 1999;25(12):818-22.
  • Cheng L, Zhang R, Yu X, Tian Y, Wang H, Zheng G, et al. A comparative analysis of periapical radiography and cone-beam computerized tomography for the evaluation of endodontic obturation length. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(3):383-9.
  • Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011;44(7):610-25.
  • Moura MS, Guedes OA, De Alencar AH, Azevedo BC, Estrela C. Influence of length of root canal obturation on apical periodontitis detected by periapical radiography and cone beam computed tomography. J Endod. 2009;35(6):805-9.
  • Bergenholtz G, Lekholm U, Milthon R, Engstrom B. Influence of apical overinstrumentation and overfilling on re-treated root canals. J Endod. 1979;5(10):310-4.
  • Vier FV, Figueiredo JA. Prevalence of different periapical lesions associated with human teeth and their correlation with the presence and extension of apical external root resorption. Int Endod J. 2002;35(8):710-9.
  • ElAyouti A, Weiger R, Löst C. Frequency of overinstrumentation with an acceptable radiographic working length. J Endod. 2001;27(1):49-52.
  • Goldberg F, Cantarini C, Alfie D, Macchi RL, Arias A. Relationship between unintentional canal overfilling and the long-term outcome of primary root canal treatments and nonsurgical retreatments: a retrospective radiographic assessment. Int Endod J. 2020;53(1):19-26.
  • Tennert C, Jungbäck IL, Wrbas KT. Comparison between two thermoplastic root canal obturation techniques regarding extrusion of root canal filling--a retrospective in vivo study. Clin Oral Investig. 2013;17(2):449-54.
  • Khabbaz MG, Papadopoulos PD. Deposition of calcified tissue around an overextended gutta-percha cone: case report. Int Endod J. 1999;32(3):232-5.
  • Brooks JK, Kleinman JW. Retrieval of extensive gutta-percha extruded into the maxillary sinus: use of 3-dimensional cone-beam computed tomography. J Endod. 2013;39(9):1189-93.
  • Faria-Júnior NB, Tanomaru-Filho M, Berbert FL, Guerreiro-Tanomaru JM. Antibiofilm activity, pH and solubility of endodontic sealers. Int Endod J. 2013;46(8):755-62.
  • Lin LM, Pascon EA, Skribner J, Gängler P, Langeland K. Clinical, radiographic, and histologic study of endodontic treatment failures. Oral Surg Oral Med Oral Pathol. 1991;71(5):603-11.
  • Sari S, Duruturk L. Radiographic evaluation of periapical healing of permanent teeth with periapical lesions after extrusion of AH Plus sealer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(3):e54-9.
  • Siqueira JF, Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34(1):1-10.
  • Strindberg L. The dependence of the results of pulp therapy on certain factors. An analytic study based on radiographic and clinical follow-up examination. Actadont Scand. 1956;14.
  • Pascon EA, Spngberg LS. In vitro cytotoxicity of root canal filling materials: 1. Gutta-percha. J Endod. 1990;16(9):429-33.
  • Gutiérrez JH, Brizuela C, Villota E. Human teeth with periapical pathosis after overinstrumentation and overfilling of the root canals: a scanning electron microscopic study. Int Endod J. 1999;32(1):40-8.
  • Noiri Y, Ehara A, Kawahara T, Takemura N, Ebisu S. Participation of bacterial biofilms in refractory and chronic periapical periodontitis. J Endod. 2002;28(10):679-83.
  • Da Silva D, Endal U, Reynaud A, Portenier I, Orstavik D, Haapasalo M. A comparative study of lateral condensation, heat-softened gutta-percha, and a modified master cone heat-softened backfilling technique. Int Endod J. 2002;35(12):1005-11.
  • Gençoğlu N, Garip Y, Baş M, Samani S. Comparison of different gutta-percha root filling techniques: Thermafil, Quick-fill, System B, and lateral condensation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):333-6.
  • Saunders WP, Saunders EM, Sadiq J, Cruickshank E. Technical standard of root canal treatment in an adult Scottish sub-population. Br Dent J. 1997;182(10):382-6.
  • De Moor RJ, Hommez GM, De Boever JG, Delmé KI, Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J. 2000;33(2):113-20.
  • De Cleen MJ, Schuurs AH, Wesselink PR, Wu MK. Periapical status and prevalence of endodontic treatment in an adult Dutch population. Int Endod J. 1993;26(2):112-9.
  • Imfeld TN. Prevalence and quality of endodontic treatment in an elderly urban population of Switzerland. J Endod. 1991;17(12):604-7.
  • Yousuf W, Khan M, Mehdi H. Endodontic Procedural Errors: Frequency, Type of Error, and the Most Frequently Treated Tooth. Int J Dent. 2015;2015:673914.
  • Bürklein S, Schäfer E, Jöhren H-P, Donnermeyer D. Quality of root canal fillings and prevalence of apical radiolucencies in a German population: a CBCT analysis. Clinical Oral Investigations. 2020;24:1217-27.
  • Kabak Y, Abbott PV. Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population. Int Endod J. 2005;38(4):238-45.
  • Nascimento EHL, Gaêta-Araujo H, Andrade MFS, Freitas DQ. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig. 2018;22(7):2495-503.
  • Moreno JO, Alves FR, Gonçalves LS, Martinez AM, Rôças IN, Siqueira JF, Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39(5):600-4.
  • Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7.
  • Koçak B, Önay EO, Koç C, Üngör M. Taşkın kök kanal dolgu patları ve bunların çeşitli risk faktörleriyle ilişkilerinin incelenmesi: Retrospektif bir araştırma. Turkiye Klinikleri J Dental Sci.2022.
  • Ricucci D, Siqueira JF. Endodontology: an integrated biological and clinical view: Quintessence Publishing London; 2013.
  • Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature -- Part 2. Influence of clinical factors. Int Endod J. 2008;41(1):6-31.
  • Er O, Sagsen B, Maden M, Cinar S, Kahraman Y. Radiographic technical quality of root fillings performed by dental students in Turkey. Int Endod J. 2006;39(11):867-72.
  • Vukadinov T, Blažić L, Kantardžić I, Lainović T. Technical quality of root fillings performed by undergraduate students: a radiographic study Sci World J. 2014;2014:751274.
There are 54 citations in total.

Details

Primary Language English
Subjects Dental Materials and Equipment, Endodontics
Journal Section Research Articles
Authors

Emre Çulha 0000-0002-3143-2258

Fatma Tunç 0000-0003-0568-4248

Publication Date August 31, 2023
Submission Date July 9, 2023
Published in Issue Year 2023 Volume: 1 Issue: 2

Cite

Vancouver Çulha E, Tunç F. Extrusion of Root Canal Filling Materials in Molars of a Turkish Subpopulation. EDR. 2023;1(2):35-9.