Beş Farklı Obturasyon Tekniği ile Doldurulmuş Oval Şekilli Kök Kanallarının in Vitro Hacimsel Değerlendirilmesi

Year 2023, , 1 - 7, 30.04.2023

Gizem Çolakoğlu , Işıl Kaya Büyükbayram , Sana Al-shammari

https://doi.org/10.29228/erd.36

Abstract

Amaç: Bu in vitro çalışma, minimal invaziv kök kanal şekillendirilmesi sonrası beş farklı obturasyon tekniği ile doldurulmuş oval şekilli kök kanallarındaki doldurulmamış alanların hacimlerini konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak karşılaştırmayı amaçlamıştır.
Gereç ve Yöntemler: Oval şekilli kanala sahip 50 adet çekilmiş alt küçük azı dişi kullanılmıştır. Kök kanalları 30.04’e kadar K3 eğeler (Kerr, USA) ile şekillendirilmiştir. Daha sonra örnekler rastgele 5 gruba dağıtılmış ve beş farklı teknikle doldurulmuştur; AH Plus ile tek kon tekniği (Grup A), BIO-C® SEALER ile tek kon tekniği (Grup B), AH Plus ile modifiye lateral kondansasyon tekniği 0.4 taper master güta kulanılarak (Grup C), AH Plus ile lateral kondansasyon tekniği (Grup D) ve AH Plus ile devamlı ısı ile kompaksiyon tekniği (Grup E). Obturasyon öncesi ve sonrası tüm dişler KIBT ile görüntülenmiştir. 3D Doctors yazılımı ile kanalın her bir üçlüsündeki boşlukların hacmi hesaplanmıştır. Kruskal-Wallis ve post hoc Dunn testleri istatistik için kullanılmıştır (p<0.05).
Bulgular: Koronal üçlü, orta üçlü ve toplam olmak üzere, Grup E en az ortalama boşluk hacmi yüzdesini gösterirken Grup A ise en yüksek ortalama boşluk hacmi yüzdesini göstermiştir. Ancak, orta ve apikal üçlüde gruplar arasında ortalama boşluk hacmi yüzdesi açısından istatistiksel olarak anlamlı bir faklılık yoktur (p>0.05).
Sonuç: Obturasyon tekniği, oval şekilli kök kanallarının orta ve apikal üçlüsündeki obturasyon kalitesini minimum etkilemiştir. Tek kon teknikleri, devamlı ısı ile kompaksiyon tekniğine göre daha fazla boşluk hacim yüzdesine sahiptir.

Keywords

Obturasyon teknikleri, Oval şekilli, Konik ışınlı bilgisayarlı tomografi, Hacimsel değerlendirme

In Vitro Volumetric Evaluation of Oval-Shaped Root Canals Filled With Five Different Obturation Techniques

Abstract

Objectives: This in vitro study aimed to compare the volumes of unfilled areas in oval-shaped root canals filled with five different obturation techniques after minimally invasive root canal shaping using cone beam computed tomography (CBCT).
Materials and Methods: 50 extracted mandibular premolars with oval-shaped root canals were used. Root canals were instrumented with K3 files (Kerr, USA) to size #30.04. Then, the samples were randomly distributed into five groups and obturated with different techniques; single cone technique with AH plus (Group A), single cone technique with BIO-C® SEALER (Group B), modified lateral condensation technique with AH Plus using 0.04 GP (Group C), conventional lateral condensation technique with AH Plus (Group D) and continuous warm compaction with AH plus (Group E). All teeth were scanned using CBCT before and after obturation. Volume of voids was calculated in each third of the root canal using 3D Doctors software. Kruskal-Wallis and post hoc Dunn tests were used for statistics (p<0.05).
Results: Group E showed the least mean volume percentage of voids, whereas Group A showed the highest mean volume percentage of voids in the coronal third, the middle third and overall. However, in the middle and apical thirds, there was no statistically significant difference between the groups regarding the mean volume percentage of voids (p>0.05).
Conclusion: The obturation technique effected the quality of obturation minimally in the middle and apical thirds of oval-shaped root canals. The single cone techniques had a higher percentage volume of voids than the continuous wave compaction technique.

Keywords

Obturation techniques, Oval-shaped, Cone-beam computed tomography, Volumetric evaluation

References

• 1. Al-Ashou WMO, Al-Shamaa RM, Hassan SS. Sealing Ability of Various Types of Root Canal Sealers at Different Levels of Remaining Gutta Percha After Post Space Preparation at Two Time Intervals. J. Int. Soc. Prev. Community Dent. 2021; 11(6):721-728.
• 2. Bhandi S, Mashyakhy M, Abumelha AS, Alkahtany MF, Jamal M, Chohan H, Raj AT, Testarelli L, Reda R, Patil S. Complete Obturation-Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies. Materials (Basel). 2021;14(14):4013.
• 3. Celikten B, Jacobs R, De Faria Vasconcelos K, Huang Y, Shaheen E, Nicolielo LFP, Orhan K. Comparative evaluation of cone beam CT and micro-CT on blooming artifacts in human teeth filled with bioceramic sealers. Clin. Oral Investig. 2019;23(8):3267-3273.
• 4. Clinton K, Van Himel T. Comparison of a warm gutta-percha obturation technique and lateral condensation. J. Endod. 2001;27(11):692-695.
• 5. Collins J, Walker MP, Kulild J, Lee C. A comparison of three gutta-percha obturation techniques to replicate canal irregularities. J. Endod. 2006;32(8):762-765.
• 6. De-Deus G, Reis C, Beznos D, de Abranches AM, Coutinho-Filho T, Paciornik S. Limited ability of three commonly used thermoplasticized gutta-percha techniques in filling oval-shaped canals. J. Endod. 2008;34(11):1401-1405.
• 7. De-Deus G, Santos GO, Monteiro IZ, Cavalcante DM, Simões-Carvalho M, Belladonna FG, Silva E, Souza EM, Licha R, Zogheib C, Versiani MA. Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals. Int. Endod. J. 2022;55(7):795-807.
• 8. Deus GD, Murad CF, Reis CM, Gurgel-Filho E, Coutinho Filho T. Analysis of the sealing ability of different obturation techniques in oval-shaped canals: a study using a bacterial leakage model. Braz. Oral Res. 2006;20(1):64-69.
• 9. Dhangar K, Shetty P, Makandar SD, Bapna PA, Ghani N, Bakar WZW, Metgud S. Comparative Evaluation of the Percentage of Gutta-percha Filled Areas in Canals Obturated with Different Obturation Techniques. J. Contemp. Dent. Pract. 2022;23(2): 176-180.
• 10. Gluskin AH, Peters CI, Peters OA. Minimally invasive endodontics: challenging prevailing paradigms. Br. Dent. l. 2014;216(6):347-353.
• 11. Hammad M, Qualtrough A, Silikas N. Evaluation of root canal obturation: a three-dimensional in vitro study. J Endod. 2009;35(4):541-544.
• 12. Jou YT, Karabucak B, Levin J, Liu D. Endodontic working width: current concepts and techniques. Dent Clin North Am. 2004;48(1):323-335.
• 13. Kalantar Motamedi MR, Mortaheb A, Zare Jahromi M, Gilbert BE. Micro-CT Evaluation of Four Root Canal Obturation Techniques. Scanning. 2021;6632822.
• 14. Keles A, Alcin H, Kamalak A, Versiani MA. Micro-CT evaluation of root filling quality in oval-shaped canals. Int. Endod. J. 2014;47(12):1177-1184.
• 15. Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I, Nakagaki H, Nakamura H. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2004;97(1):95-99.
• 16. Metzger Z, Teperovich E, Zary R, Cohen R, Hof R. The self-adjusting file (SAF). Part 1: respecting the root canal anatomy-a new concept of endodontic files and its implementation. J Endod. 2010;36(4):679-690.
• 17. Miyashita H, Asaumi R, Sakamoto A, Kawai T, Igarashi M. Root canal sealers affect artifacts on cone-beam computed tomography images. Odontol. 2021;109(3):679-686.
• 18. Olczak K, Pawlicka H, Szymański W. Root and canal morphology of the maxillary second premolars as indicated by cone beam computed tomography. Aust. Endod. J. 2022.
• 19. Ozawa T, Taha N, Messer HH. A comparison of techniques for obturating oval-shaped root canals. Dent. Mater. J. 2009;28(3):290-294.
• 20. Penha da Silva PJ, Marceliano-Alves MF, Provenzano JC, Dellazari RLA, Gonçalves LS, Alves FRF. Quality of Root Canal Filling Using a Bioceramic Sealer in Oval Canals: A Three-Dimensional Analysis. Eur. J. Dent. 2021;15(3):475-480.
• 21. Plotino G, Grande NM, Mercade M, Cortese T, Staffoli S, Gambarini G, Testarelli L. Efficacy of sonic and ultrasonic irrigation devices in the removal of debris from canal irregularities in artificial root canals. J. Appl. Oral Sci. 2019;27:e20180045.
• 22. Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac. Radiol. 2021;50(5):20200503.
• 23. Rundquist BD, Versluis A. How does canal taper affect root stresses? Int. Endod. J. 2006;39(3):226-237.
• 24. Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod. 2005;31(4):271-274.
• 25. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-275.
• 26. Schilder H. Filling root canals in three dimensions. 1967. J. Endod. 2006;32(4):281-290.
• 27. Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J. Endod. 2010;36(4):609-617.
• 28. Viapiana R, Moinzadeh AT, Camilleri L, Wesselink PR, Tanomaru Filho M, Camilleri J. Porosity and sealing ability of root fillings with gutta-percha and BioRoot RCS or AH Plus sealers. Evaluation by three ex vivo methods. Int. Endod. J. 2016;49(8):774-782.
• 29. Whitworth J. Methods of filling root canals: principles and practices. Endodontic Topics. 2005;12(1):2-24.
• 30. Wu MK, Kast'áková A, Wesselink PR. Quality of cold and warm gutta-percha fillings in oval canals in mandibular premolars. Int. Endod. J. 2001;34(6):485-491.
• 31. Wu MK, Wesselink PR. A primary observation on the preparation and obturation of oval canals. Int. Endod. J. 2001;34(2):137-141.
• 32. Zan R, Demi̇r AŞ. Contemporary Endodontic Obturation Techniques: A Comprehensive Literature Review. Cumhuriyet Dental Journal. 2021;24(3):310-317.
• 33. Zare S, Shen I, Zhu Q, Ahn C, Primus C, Komabayashi T. Micro-computed tomographic evaluation of single-cone obturation with three sealers. Restor. Dent. Endod. 2021;46(2): e25.