• Restorative Dentistry and Endodontics
• /
• v.46 no.2
• /
• pp.27.1-27.10
• /
• 2021

This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients' teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.

• Proceedings of the KACD Conference
• /
• 2001.11a
• /
• pp.572-572
• /
• 2001

The meaning of obturating root canal is to substitute an inert filling materials in the prepared canal space in order to eliminate all avenues of leakage from the oral cavity or periradicular tissue into root canal system. Inadequate obturation induce the infiltration of periapical tissue fluids, which provide materials for growth of microorganisms or localization of bacteria, into dead space of loosely filled canal. Most parts of endodontic failure is attributed to inadequate obturation of root canal system.(omitted)

• Restorative Dentistry and Endodontics
• /
• v.47 no.4
• /
• pp.40.1-40.18
• /
• 2022

Objectives: This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Materials and Methods: Systematic searches were performed for studies published up to May 17^th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Results: Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. Conclusions: This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

• Restorative Dentistry and Endodontics
• /
• v.21 no.2
• /
• pp.517-529
• /
• 1996

The purpose of this study was to evaluate the apical sealing ability of the Thermafil endodontic obturation technique and to compare it with lateral condensation technique. 42 straight canals from extracted human anterior teeth and 42 curved canals(> $25^{\circ}$) from maxillary and mandibular molar teeth were selected. And 80 of them were divided into four groups, 20 canals respectively. The teeth in prior two groups had straight canals and the other two groups had curved canals. The rest of four canals served as positive and negative controls. After resecting anatomical crowns, all canals were prepared using a standard step-back technique. Lateral condensation was used to obturate two groups, one group of straight ones the other curved. And Thermafil obturators were also used in the same two groups. Obturated teeth were infiltrated by India ink for a week, decalcified and cleared with 5% nitric acid and methyl salicylate. The apical leakage and the frequency of filled lateral and accessory canals were measured with stereomicroscope and also apical extrusion of sealer and gutta-percha and obturation time were checked and the data were analyzed statistically(one-way ANOVA, t-test, Chi-square test). The results were as follows : 1. There was no significant difference in the degree of dye penetration between Thermafil and lateral condensation groups(p>0.05). 2. Apical extrusion of sealer and gutta-percha occurred significantly more often with Thermafil obturators in straight canals(p<0.05), but not significantly different in curved canals(p>0.05). 3. Canal obturation time with Thermafil obturators was significantly faster than lateral condensation (p<0.05). 4. The Thermafil groups showed a higher frequency of filled lateral and accessory canals than in the lateral condensation groups. But the difference was not statistically significant (p>0.05).

• The Journal of the Korean dental association
• /
• v.38 no.3 s.370
• /
• pp.288-292
• /
• 2000

Perhaps the most frustrating scenario in dentistry lies in the apparently well-instrumented and well-obturated tooth that, becomes symptomatic after treatment of shows a periapical lesion on recall examination. Conventional root canal treatment demands stringent adherence to asepsis, awareness of canal morphology, and mastery of a variety of clinical techniques. But the risk of endodontic failure does not end with canal obturation. The quality of the coronal restoration may have a greater bearing on the ultimate success of a case than the quality of the root canal treatment itself. This review of the endodontic literature will define coronal leakage, describe its influence on endodontic treatment failures, and make specific recommendations on prevention.

• The Journal of Advanced Prosthodontics
• /
• v.5 no.1
• /
• pp.16-20
• /
• 2013

PURPOSE. To assess the retention of glass fiber post cemented with self-adhesive resin cement into optimum and over-prepared root canals following obturation in the presence of either eugenol (EB) or calcium hydroxide (CB)-based sealers. MATERIALS AND METHODS. Roots of extracted premolars were endodontically-treated in 5 groups (n = 10). Roots of Group 1 (control) were left with no obturation and then optimally prepared to receive endodontic dowels. Other root canals were obturated with gutta-percha in the presence of either eugenol-based (Groups 2 and 4) or calcium hydroxide-based (Groups 3 and 5) sealer. Dowel spaces were prepared with optimal diameter in Groups 2 and 3, one size larger in Groups 4 and 5. Standardized fiber posts were luted to the prepared spaces using self-adhesive resin cement and its retention was then tested on an universal testing machine. Both one-way ANOVA and Tukey's HSD comparisons (${\alpha}$=0.05) were used to identify the significance of inter-group retention differences. Scanning electron microscopy (SEM) of both optimally and over-prepared dowel spaces was also considered to figure the nature of their interior out. RESULTS. The post retention was significantly higher to the non-obturated, optimally-prepared dowel spaces of Group 1 compared to the obturated, optimally-prepared ones of Groups 2 and 3. For each dowel space diameter, root canals obturated using CB of Groups 3 and 5 showed significantly higher dowel retention compared to those obturated using EB of Groups 2 and 4. Post retention to the over-prepared dowel spaces of Groups 4 and 5 was significantly higher than that recorded for the optimally-prepared ones of Groups 1-3. SEM images revealed traces of endodontic sealer and gutta-percha on the walls of the optimally-prepared dowel spaces. CONCLUSION. Despite the adverse effect of endodontic sealers on the retention of fiber posts, the over-preparation of dowel spaces helps to improve the retention.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.3
• /
• pp.575-580
• /
• 1997

It has been reported that the operative treatment for the preservation of tooth having periapical lesion has shown over ninety percent of success whereas in the case where calcified canal is severe, canal is perforated, ledge is formed, tooth restored by post and core and cases where symptoms still exist after treatment, endodontic treatment may not all be the solution in attaining a successful treatment. Thus Apicoectomy would generally be used to prevent the loss of tooth having periapical lesion where treatment prognosis is poorly evaluated by endodontic treatment. In case 1 and 2, endodontic treatment was applied due to unilocular radiolucent lesion in periapical area but the symptoms somehow did not show improvement and therefore operated apicoectomy, and as in case 1, favorable results were attained but as in case 2, yet more observation has to be done. The followings are the results we have concluded : 1. In the process of endodontic treatment, absolute canal obturation has great effect on attaining successful treatment. 2. In cases where endodontic treatment is not highly recommended, for example, tooth having dental pulp and periapical lesion, favorable results can be attained by applying apicoectomy.

• Restorative Dentistry and Endodontics
• /
• v.48 no.1
• /
• pp.5.1-5.22
• /
• 2023

This systematic review and network meta-analysis aimed to answer the following focused research question: "Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?" Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration's tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I² = 0%; p > 0.05 and 8 studies: I² = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

• Restorative Dentistry and Endodontics
• /
• v.49 no.3
• /
• pp.28.1-28.12
• /
• 2024

Objectives: This study aimed to investigate the endodontic characteristics of mandibular premolars with dens evaginatus (DE) that require endodontic treatment. Materials and Methods: Patients who underwent endodontic treatment were enrolled. The inclusion criteria were patients who underwent root canal treatment in the lower permanent teeth with DE and were followed up for at least 1 year. Preoperative clinical and radiographic variables were obtained. The frequency distribution of the preoperative variables was compared using the χ² or Fisher's exact tests. The significance of the change in periapical health index (PAI) and root development stages before and after treatment was examined using the Wilcoxon signed-rank test. Results: A total of 150 teeth of 134 patients with an average age of 15.3 years were included. The percentage distribution comparison of the preoperative variables and obturation techniques revealed significant differences in pulpal and periapical diagnosis, and percussion, and especially regarding age, root development stage, and PAI. Age was the only statistically significant preoperative variable associated with root growth (p < 0.05). Conclusions: Approximately, 60% of DEs requiring endodontic treatment had immature roots. Age being the most significant predisposing factor, early treatment provides the greatest opportunity for full root development.

• Restorative Dentistry and Endodontics
• /
• v.47 no.1
• /
• pp.11.1-11.11
• /
• 2022

This study aimed to describe the outcomes of the GentleWave system (GW) (Sonendo) on root canal treatment. Published articles were collected from scientific databases (MEDLINE/PubMed platform, Web of Science, Scopus, Science Direct and Embase). A total of 24 studies were collected from August/2014 to July/2021, 20 in vitro and 4 clinical. GW System was not associated with extrusion of the irrigant, promoted faster organic dissolution than conventional syringe irrigation (CSI), passive ultrasonic irrigation (PUI) continuous ultrasonic irrigation (CUI) and EndoVac, reduced more bacterial DNA and biofilm than PUI and CUI, promoted higher penetration of sodium hypochlorite into dentinal tubules than PUI and CUI in vitro, and removed more intracanal medication than CSI and PUI. GW was able to remove pulp tissue and calcifications. Moreover, its ability to remove hard-tissue debris and smear layer was better than that of CSI, and its ability to remove root canal obturation residues was lower or similar to that of PUI, and similar to that of CSI and EndoVac. Regarding root canal obturation of minimally instrumented molar canals, GW was associated with high-quality obturation. Clinically, the success rate of endodontic treatment using GW was 97.3%, and the short-term postoperative pain in the GW group was not different from CSI. Further research, mainly clinical, is needed to establish whether GW has any advantages over other available irrigation methods.