Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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The effect of different confluence confirmation strategies on the obturation of Vertucci type II canal: micro-CT analysis

  • Seungjae Do (Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital) ;
  • Min-Seock Seo (Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital)
  • Received : 2020.04.08
  • Accepted : 2020.06.17
  • Published : 2021.02.28
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Abstract

Objectives: The present study aims to compare the obturation quality of 2 confluence confirmation techniques in artificial maxillary first premolars showing Vertucci type II root canal configuration. Materials and Methods: Thirty artificial maxillary premolars having Vertucci type II root canal configuration were made. They were divided into 3 groups according to the confluence confirmation technique as follows. Gutta-percha indentation (GPI) group (confluence confirmation using a gutta-percha cone and a K file); electronic apex locator (EAL) group (confluence confirmation using K files and EAL); and no confluence detection (NCD) group. In the GPI group and the EAL group, shaping and obturation were performed with the modified working length (WL). In the NCD group, shaping was performed without WL adjustment and obturation was carried out with an adjusted master cone. Micro-computed tomography was used before preparation and after obturation to calculate the percentage of gutta-percha occupied volume (%GPv) and the volume increase in the apical 4 mm. Data were analyzed using 1-way analysis of variance and post hoc Tukey's test. Results: Statistically significant difference was not found in terms of the %GPv from the apex to apical 4 mm. However, the NCD group showed a statistically significant volume increase compared with the EAL group (p < 0.05). Conclusions: In terms of gutta-percha occupied volume, no significant difference was observed among the 3 groups. Confluence confirmation using an EAL in teeth with Vertucci type II configuration showed less volume increase during canal shaping compared with no confluence confirmation.

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References

  1. Whitworth J. Methods of filling root canals: principles and practices. Endod Topics 2005;12:2-24. https://doi.org/10.1111/j.1601-1546.2005.00198.x
  2. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58:589-599. https://doi.org/10.1016/0030-4220(84)90085-9
  3. Gambarini G, Piasecki L, Ropini P, Miccoli G, Nardo DD, Testarelli L. Cone-beam computed tomographic analysis on root and canal morphology of mandibular first permanent molar among multiracial population in Western European population. Eur J Dent 2018;12:434-438. https://doi.org/10.4103/ejd.ejd_116_18
  4. Chaparro AJ, Segura JJ, Guerrero E, Jimenez-Rubio A, Murillo C, Feito JJ. Number of roots and canals in maxillary first premolars: study of an Andalusian population. Endod Dent Traumatol 1999;15:65-67. https://doi.org/10.1111/j.1600-9657.1999.tb00755.x
  5. Teixeira FB, Sano CL, Gomes BP, Zaia AA, Ferraz CC, Souza-Filho FJ. A preliminary in vitro study of the incidence and position of the root canal isthmus in maxillary and mandibular first molars. Int Endod J 2003;36:276-280. https://doi.org/10.1046/j.1365-2591.2003.00638.x
  6. Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Perez AR, Rocas IN, Versiani MA, Sousa-Neto MD, Provenzano JC, Siqueira JF Jr. Adjunctive steps for disinfection of the mandibular molar root canal system: a correlative bacteriologic, micro-computed tomography, and cryopulverization approach. J Endod 2016;42:1667-1672. https://doi.org/10.1016/j.joen.2016.08.003
  7. Keles A, Alcin H, Sousa-Neto MD, Versiani MA. Supplementary steps for removing hard tissue debris from isthmus-containing canal systems. J Endod 2016;42:1677-1682. https://doi.org/10.1016/j.joen.2016.07.025
  8. Versiani MA, Alves FR, Andrade-Junior CV, Marceliano-Alves MF, Provenzano JC, Rocas IN, Sousa-Neto MD, Siqueira JF Jr. Micro-CT evaluation of the efficacy of hard-tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J 2016;49:1079-1087. https://doi.org/10.1111/iej.12559
  9. Kim S, Jung H, Kim S, Shin SJ, Kim E. The influence of an isthmus on the outcomes of surgically treated molars: a retrospective study. J Endod 2016;42:1029-1034. https://doi.org/10.1016/j.joen.2016.04.013
  10. Keles A, Torabinejad M, Keskin C, Sah D, Uzun I, Alcin H. Micro-CT evaluation of voids using two root filling techniques in the placement of MTA in mesial root canals of Vertucci type II configuration. Clin Oral Investig 2018;22:1907-1913. https://doi.org/10.1007/s00784-017-2282-0
  11. Jho W, Park JW, Kim E, Song M, Seo DG, Yang DK, Shin SJ. Comparison of root canal filling quality by mineral trioxide aggregate and gutta percha cones/AH plus sealer. Dent Mater J 2016;35:644-650. https://doi.org/10.4012/dmj.2015-262
  12. Kucukkaya Eren S, Aksel H, Askerbeyli Ors S, Serper A, Kocak Y, Ocak M, Celik HH. Obturation quality of calcium silicate-based cements placed with different techniques in teeth with perforating internal root resorption: a micro-computed tomographic study. Clin Oral Investig 2019;23:805-811. https://doi.org/10.1007/s00784-018-2502-2
  13. de Pablo OV, Estevez R, Peix Sanchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 2010;36:1919-1931. https://doi.org/10.1016/j.joen.2010.08.055
  14. Kim S, Kim S, Park JW, Jung IY, Shin SJ. Comparison of the percentage of voids in the canal filling of a calcium silicate-based sealer and gutta percha cones using two obturation techniques. Materials (Basel) 2017;10:1-9.
  15. Moinzadeh AT, Zerbst W, Boutsioukis C, Shemesh H, Zaslansky P. Porosity distribution in root canals filled with gutta percha and calcium silicate cement. Dent Mater 2015;31:1100-1108. https://doi.org/10.1016/j.dental.2015.06.009
  16. Hammad M, Qualtrough A, Silikas N. Evaluation of root canal obturation: a three-dimensional in vitro study. J Endod 2009;35:541-544. https://doi.org/10.1016/j.joen.2008.12.021
  17. Kaufman AY, Keila S, Yoshpe M. Accuracy of a new apex locator: an in vitro study. Int Endod J 2002;35:186-192. https://doi.org/10.1046/j.1365-2591.2002.00468.x
  18. Jeong JW, DeGraft-Johnson A, Dorn SO, Di Fiore PM. Dentinal tubule penetration of a calcium silicate-based root canal sealer with different obturation methods. J Endod 2017;43:633-637. https://doi.org/10.1016/j.joen.2016.11.023
  19. Keles A, Alcin H, Kamalak A, Versiani MA. Micro-CT evaluation of root filling quality in oval-shaped canals. Int Endod J 2014;47:1177-1184. https://doi.org/10.1111/iej.12269
  20. Senia ES, Marshall FJ, Rosen S. The solvent action of sodium hypochlorite on pulp tissue of extracted teeth. Oral Surg Oral Med Oral Pathol 1971;31:96-103. https://doi.org/10.1016/0030-4220(71)90040-5
  21. Wu M, van der Sluis LW, Wesselink PR. A preliminary study of the percentage of gutta-percha-filled area in the apical canal filled with vertically compacted warm gutta-percha. Int Endod J 2002;35:527-535. https://doi.org/10.1046/j.1365-2591.2002.00522.x
  22. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004;30:559-567. https://doi.org/10.1097/01.DON.0000129039.59003.9D
  23. Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J 2005;38:725-734. https://doi.org/10.1111/j.1365-2591.2005.01008.x
  24. Hulsmann M, Peters OA, Dummer PM. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Topics 2005;10:30-76. https://doi.org/10.1111/j.1601-1546.2005.00152.x
  25. Schafer E, Dammaschke T. Development and sequelae of canal transportation. Endod Topics 2006;15:75-90. https://doi.org/10.1111/j.1601-1546.2009.00236.x
  26. Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? J Am Dent Assoc 2005;136:187-193. https://doi.org/10.14219/jada.archive.2005.0140
  27. Sornkul E, Stannard JG. Strength of roots before and after endodontic treatment and restoration. J Endod 1992;18:440-443. https://doi.org/10.1016/S0099-2399(06)80845-9