Influence of root canal filling techniques on sealer penetration and gutta percha/sealer ratio: a confocal laser scanning microscopy analysis

Authors

  • Fatma Macit Ermis Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey. https://orcid.org/0000-0001-7622-8501
  • Faruk Haznedaroğlu Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey.

DOI:

https://doi.org/10.14295/bds.2020.v23i3.1957

Abstract

 

Objective: The influence of four root canal filling techniques on the penetration of an endodontic sealer into dentinal tubules and the gutta percha/ sealer ratio (GP/SR) in root canals was evaluated using confocal laser scanning microscopy (CLSM). Material and Methods: Roots of the maxillary central incisors (n=40) were prepared with ProTaper Universal files up to file F5 and assigned to five groups: continuous wave condensation, lateral condensation, single cone, Thermafill®, and negative control group. After root canal filling with gutta-percha and AH26, along with the addition of 0.01% fluorescein, the roots were cut into 2-mm slices. Using CLSM, the specimens were transversely sectioned at 3, 6, and 10 mm from the apex. Results: Sealer penetration was deeper and more frequent at 10 mm than at the 6mm and 3mm for all obturation technique. Penetration was not significantly affected by obturation techniques except single master cone tecnique. Single cone technique demonstrated the lowest sealer penetration at all levels. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone. Conclusion: In conclusion, the single cone technique resulted in lower sealer penetration than the other techniques, which did not differ significantly from each other. However, sealer thickness was strongly dependent on obturation technique. Termafill® demostrated superior GP ratio followed by continuous wave condensation, lateral condensation and single cone.

Keywords

Obturation techniques; Dentinal tubule penetration; Gutta percha, sealer ratio; Confocal laser scanning microscopy.

References

Schilder H. Filling root canals in three dimensions. Dent Clin North Am 1967 Nov;723-44.

Wennberg A, Orstavik D. Adhesion of root canal sealers to bovine dentine and gutta-percha. Int Endod J 1990 Jan;23(1):13-9. doi: 10.1111/j.1365-2591.1990.tb00797.x.

Mayo CV, Montgomery S, de Rio C. A Computerized method for evaluating root canal morphology. J Endod 1986 Jan;12(1): 2-7. doi: 10.1016/s0099-2399(86)80274-6.

Ingle JI, Bakland LK. Endodontics. 5th ed. London: BC Decker Inc; 2002.

Lea CS, Apicella MJ, Mines P, Yancich PP, Parker MH. Comparison of the obturation density of cold lateral compaction versus warm vertical compaction using the continuous wave of condensation technique. J Endod 2005 Jan;31(1): 37-9. doi: 10.1097/01.don.0000129037.75547.80.

Lipski, M. Root surface temperature rises during root canal obturation, in vitro, by the continuous wave of condensation technique using System B HeatSource. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005 Apr; 99(4): 505-10. doi: 10.1016/j.tripleo.2004.07.014.

Oguntebi BR, Shen C. Effect of different sealers on thermoplasticized Gutta-percha root canal obturations. J Endod 1992 Aug; 18(8): 363-6. doi: 10.1016/s0099-2399(06)81219-7.

Peters DD. Two-year in vitro solubility evaluation of four gutta-percha sealer obturation techniques. J Endod 1986 Apr; 12(4): 139–45. doi: 10.1016/S0099-2399(86)80051-6.

Wu MK, Wesselink PR, Boersma, J. A 1-year follow-up study on leakage of four root canal sealers at different thicknesses. Int Endod J 1995 Jul; 28(4): 185-9. doi: 10.1111/j.1365-2591.1995.tb00297.x.

Kontakiotis EG, Wu MK, Wesselink PR. Effect of sealer thickness on long-term sealing ability: a 2-year follow-up study. Int Endod J 1997 Sep;30(5):307–12. doi: 10.1046/j.1365-2591.1997.00087.x.

DuLac KA, Nielsen CJ, Tomazic TJ, Ferrillo PJ Jr, Hatton JF. Comparison of the obturation of lateral canals by six techniques. J Endod 1999 May;25(5): 376–80. doi: 10.1016/S0099-2399(06)81175-1.

Leonardo MV, Goto EH, Torres CR, Borges AB, Carvalho CA, Barcellos DC. Assessment of the apical seal of root canals using different filling techniques. J Oral Sci 2009 Dec;51(4): 593-9. doi: 10.2334/josnusd.51.593.

Dalat DM, Spångberg LS. Comparison of apical leakage in root canals obturated with various gutta percha techniques using a dye vacuum tracing method. J Endod 1994 Jul;20(7):315-9. doi: 10.1016/s0099-2399(06)80092-0.

Gordon MP, Love RM, Chandler NP. An evaluation of .06 tapered gutta-percha cones for filling of .06 taper prepared curved root canals. Int Endod J 2005 Feb;38(2):87-96. doi: 10.1111/j.1365-2591.2004.00903.x.

Romania C, Beltes P, Boutsioukis C, Dandakis C. Ex-vivo area-metric analysis of root canal obturation using gutta-percha cones of different taper. Int Endod J 2009 Jun; 42(6):491-8. doi:10.1111/j.1365-2591.2008.01533.x.

Buchanan LS The continuous wave of obturation technique: centered condensation of warm gutta-percha in 12 seconds.Dent Today 1996 Jan;15(1): 60-2, 64-7.

Kokkas AB, Boutsioukis A, Vassiliadis LP, Stavrianos CK. The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: an in vitro study. J Endod 2004 Feb; 30(2):100-2. doi: 10.1097/00004770-200402000-00009.

Mamootil K, Messer HH. Penetration of dentinal tubules by endodontic sealer cements in extracted teeth and in vivo. Int Endod J 2007 Nov; 40(11): 873–81. doi: 10.1111/j.1365-2591.2007.01307.x.

De Deus GA, Gurgel-Filho ED, Maniglia-Ferreira C, Coutinho-Filho T. The influence of filling technique on depth of tubule penetration by root canal sealer: a study using light microscopy and digital image processing. Aust Endod J 2004 Apr; 30(1): 23–8. doi: 10.1111/j.1747-4477.2004.tb00164.x.

Weis MV, Parashos P, Messer HH. Effect of obturation technique on sealer cement thickness and dentinal tubule penetration. Int Endod J 2004 Oct; 37(10): 653–63. doi: 10.1111/j.1365-2591.2004.00839.x.

Kara Tuncer A, Unal B. Comparison of sealer penetration using the EndoVac irrigation system and conventional needle root canal irrigation. J Endod 2014 May;40(5): 613-7. doi: 10.1016/j.joen.2013.11.017.

Balguerie E, Van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod 2011 Nov;37(11): 1576-9. doi: 10.1016/j.joen.2011.07.005

Balguerie E, Van der Sluis L, Vallaeys K, Gurgel-Georgelin M, Diemer F. Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study. J Endod 2011 Nov;37(11): 1576-9. doi: 10.1016/j.joen.2011.07.005.

Ravi SV, Nageswar R, Swapna H, Sreekant P, Ranjith M, Mahidhar S. Epiphany sealer penetration into dentinal tubules:Confocal laser scanning microscopic study. J Conserv Dent 2014 Mar;17(2):179-82. doi: 10.4103/0972-0707.128056.

Mjor IA, Smith MR, Ferrari M, Mannocci F. The structure of dentine in the apical region of human teeth. Int Endod J 2001 Jul; 34(5): 346-53. doi: 10.1046/j.1365-2591. 2001. 00393.x.

Kok D, Duarte M, Abreu da Rosa R, Wagner MH, Pereira JR, Só MV. Evaluation of epoxy resin sealer after three root canal filling techniques by confocal laser scanning microscopy. Microsc Res Tech 2012 Sep; 75(9): 1277-80. doi: 10.1002/jemt.22061.

Wu MK, Ozok AR, Wesselink PR. Sealer distribution in root canals obturated by three techniques. Int Endod J 2000 Jul; 33(4):340-5. doi: 10.1046/j.1365-2591. 2000. 00309.x.

Schafer E, Nelius B, Bürklein S. A comparative evaluation of gutta-percha filled areas in curved root canals obturated with different techniques. Clin Oral Invest 2012 Feb; 16(1): 225-30. doi: 10.1007/s00784-011-0509-z.

Robberecht L, Colard T, Claisse-Crinquette A. Qualitative evaluation of two endodontic obturation techniques: tapered single-cone method versus warm vertical condensation and injection system: an in vitro study. J Oral Sci 2012 Mar; 54(1): 99-104. doi: 10.2334/josnusd.54.99.

Gençoğlu N. Comparison of 6 different gutta-percha techniques (part II ) : Thermafil, JS Quick-Fill, Soft Core, Microseal, System B, and lateral condensation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003 Jul;96(1): 91-5. doi: 10.1016/s1079-2104(02)91704-x.

Liewehr FR, Kulild JC, Primack, PD. Improved density of gutta-percha after warm lateral condensation. J Endod 1993 Oct; 19(10): 489-91. doi: 10.1016/S0099-2399(06)81488-3.

Nelson EA, Liewehr FR, West LA. Increased density of gutta-percha using a controlled heat instrument with lateral condensation. J Endod 2000 Dec;26(12): 748-50. doi: 10.1097/00004770-200012000-00021.

Naseri M, Kangarlou A, Khavid A, Goodini M. Evaluation of the quality of four root canal obturation techniques using micro-computed tomography. Iran Endod J 2013 Summer; 8(3): 89-93.

De-Deus G, Maniglia-Ferreira CM, Gurgel-Filho ED, Paciornik S, Machado AC, Coutinho-Filho T. Comparison of the percentage of gutta-percha-filled area obtained by Thermafill and System B. Aust Endod J 2007 Aug; 33(2): 55-61. doi: 10.1111/j.1747-4477.2007.00047.x.

Emmanuel S, Shantaram K, Sushil KC, Manoj L. An in-vitro evaluation and comparasion of apical sealing ability of three different obturation technique-lateral condensation, Obtura II, and Thermafill. J Int Oral Health 2013 Apr; 5 (2): 35-43.

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Published

2020-06-30

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Section

Clinical or Laboratorial Research Manuscript