RESUMEN
BACKGROUND This systematic review of the literature aimed to identify published studies and evaluate them on the quality of root canal fillings (RCF) and procedural errors with rotary systems for in vivo studies prepared for different clinical settings. MATERIAL AND METHODS A full literature exploration was conducted in Clarivate Analytics' Web of Science, Elsevier's Scopus, Embase, and PubMed for studies published between January 2020 and March 2024. A manual search was also performed by reviewing the references of selected papers. The following keywords were used: quality of root canal filling(s) OR quality of root canal obturation, root canal obturation OR endodontic treatment, clinical setting (academic, private, governmental), AND/OR procedural errors and rotary instrumentation. RESULTS Sixteen clinical studies were included in this review. The acceptance percentages for obturation length, density, and taper were 76.3%, 74.7%, and 82.5%, respectively, indicating significantly high, good ratios. The overall RCF recorded showed that 68.2% of root canal obturations were considered acceptable. Acceptable rates remained higher than unacceptable rates in academic, hospital, and private settings, and percentages ranged from 65.2% to 93.0%. Only 5 studies reported procedural errors, namely, ledge formation, separated instruments, apical perforation, transportation, lateral perforation, and root/foramen perforation. CONCLUSIONS Using rotary instruments for different root canal treatment steps as instrumentation and obturations is highly recommended. Among different clinical setting and practice, these instruments resulted in a good and acceptable RCF, overall quality performed by those instruments, and few procedural errors.
Asunto(s)
Obturación del Conducto Radicular , Humanos , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/instrumentación , Preparación del Conducto Radicular/instrumentación , Preparación del Conducto Radicular/métodos , Materiales de Obturación del Conducto Radicular/normas , Tratamiento del Conducto Radicular/instrumentación , Tratamiento del Conducto Radicular/métodosRESUMEN
Introduction: the three-dimensional fluid-tight obturation of the root canal system ends the endodontic treatment process and the technical quality of obturation of the root canal (RC) is a determinant of the outcome of the treatment. This final stage of RCT is critical in the outcome of treatment, thus the need to have adequate and quality obturation. The audit of the performance of students in this aspect evaluates performances and identifies where there is a need for improvement. Therefore, we set out to evaluate the quality of root canal obturation performed by undergraduate and postgraduate clinical dental students. Methods: a cross-sectional study that evaluated the root canal obturation performed by undergraduate and postgraduate students in a teaching hospital, for 1 year. The radiographic evaluation was done by calibrated assessors. The radiographs were viewed under magnifying lenses (x3.5). The adequacy of length and homogeneity of the density of obturation were the outcome variables assessed in all the categories of teeth treated among patients who are 18 years and above, seen during the study period. Results: eighty-four maxillary and 36 mandibular teeth were root-filled in 97 patients with a mean age of 37.6 years ± 14.7 SD. A good proportion (47.5%) of the root fillings were done by the postgraduate doctors. Most of the canals (69.4%) had acceptable lengths while density was acceptable in only 37.7%. Slightly over half of canals with acceptable length (64 out of 127; 50.4%) were reported in teeth with single canals (p=0.000) likewise with density (28;40.6%). Overall acceptable length and root filling density was 28.9% and there was no statistical significance in the performances of the operators in relation to the length of root filling (p=0.109), and density (p=0.55). Conclusion: the overall acceptable length and root filling density was 28.9% among both undergraduate and postgraduate students. The adequacy of root canal filling may be dependent on experience, the complexity of the tooth, and the method of instrumentation.
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Hospitales de Enseñanza , Obturación del Conducto Radicular , Estudiantes de Odontología , Humanos , Estudios Transversales , Obturación del Conducto Radicular/normas , Nigeria , Adulto , Femenino , Masculino , Adulto Joven , Persona de Mediana Edad , Radiografía , Materiales de Obturación del Conducto RadicularRESUMEN
Background and Objectives: In teeth with open apices, performing single session apexification is a challenging treatment due to the difficulty in handling mineral trioxide aggregate (MTA). Minimally invasive approaches in dentistry have also influenced the cavity designs in endodontics. Until now, different techniques have not been investigated in addition to manual condensation during the process of placing MTA in traditional (TradACs) or conservative (ConsACs) endodontic access cavities. The aim of this in vitro study was to compare and evaluate the obturation quality of MTA apical plugs placed with different techniques in TradACs or ConsACs. Materials and Methods: Sixty upper central teeth were divided into two main groups based on cavity design, and then each main group was further divided into three subgroups according to MTA placement techniques (n = 10): TradAC-manual, TradAC-manual + indirect ultrasonic activation, TradAC-manual + XP-endo Shaper (XPS), ConsAC-manual, ConsAC-manual + indirect ultrasonic activation, and ConsAC-manual + XPS. Subsequently, the porosity percentages in the MTA apical plug were analyzed using micro-computed tomography. The statistical analysis was performed using the Kruskal-Wallis H test and Mann-Whitney U test. Statistical significance was set at p < 0.05. Results: There were differences in volume of porosity percentages (%) according to cavity designs and MTA application techniques (p < 0.05). Except for the XPS group, more porosity was observed in ConsACs compared to TradACs. In TradACs, the significantly lowest open and total porosity was observed in the manual, ultrasonic, and XPS techniques, respectively. In ConsACs, the significantly lowest porosity was observed in the manual, XPS, and ultrasonic techniques, respectively (p < 0.05). Conclusions: In MTA obturation, cavity designs and application techniques had an impact on the MTA porosity. Creating an apical plug in ConsACs may result in more porosity compared to TradACs, especially when manual or indirect ultrasonic activation is preferred. Opting for the manual technique alone may be considered sufficient for controlling porosity for both TradACs and ConsACs.
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Compuestos de Aluminio , Compuestos de Calcio , Combinación de Medicamentos , Óxidos , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular , Silicatos , Microtomografía por Rayos X , Compuestos de Calcio/administración & dosificación , Silicatos/uso terapéutico , Humanos , Microtomografía por Rayos X/métodos , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Materiales de Obturación del Conducto Radicular/uso terapéutico , Materiales de Obturación del Conducto Radicular/normas , Técnicas In VitroRESUMEN
OBJECTIVE: A systematic review and meta-analysis of the literature was carried out assessing the success rate of root canal retreatment using gutta percha. DATA SOURCES: Four of the largest databases were used to identify existing literature with no date or language restrictions. PubMed, Cochrane, ScienceDirect, Scopus and other additional sources were searched. Grey literature was also reviewed. STUDY SELECTION: Two authors, with Master's degrees in endodontics and with extensive university teaching experience, were selected to screen the databases to identify suitable studies. In case the authors were not able to agree during the study selection process, a third investigator was consulted. Specific inclusion and exclusion criteria were outlined and adhered to in the study selection. Two randomised controlled trials, seven single arm prospective studies and one single arm ambispective study published before the 10th of December 2022 were included. These studies evaluated the success of root canal re-treatment, obturated with gutta percha with at least a 1-year follow-up. Nine of the studies were published between 1998 and 2022. Seven studies were conducted in Europe, one in North America and one in Asia. DATA EXTRACTION AND SYNTHESIS: Standard Cochrane methods to assess interval validity were used. Risk of bias in individual studies was assessed using The Newcastle-Ottawa quality assessment scale (NOS) for single-arm studies, and the Cochrane risk of bias tool (RoB2) was used for randomised controlled trials. Outcome measures were standardised as either success or failure of root canal retreatment. Success was classified into 2 different criteria: Strict criteria = absence of clinical signs and symptoms and radiographically normal periodontal ligament space; and Loose criteria = absence of clinical signs and symptoms and absence or reduction of apical radiolucency in the control radiograph. Statistical analysis was undertaken using R software and the Freeman-Turkey transformation was performed. Results were visualised using forest plots. Heterogeneity between studies was measured using the Cochrane Q test and I2 values. RESULTS: Whilst following strict criteria, the success rate of non-surgical root canal retreatment obturated with gutta percha was 71% for 1-3 years follow-up (95% CI, 0.66-0.77) and 77% for 4-5 years follow-up (95% CI, 0.67-0.86). Heterogeneity was moderate (I2 = 61.4) and low (I2 = 0.0), respectively. Factors reducing the success rate of root canal re-retreatment under the strict criteria were older patients, mandibular teeth, molar teeth, the presence of a peri-apical radiolucency, teeth with a previous radiolucency, large peri-apical radiolucency's, higher initial periapical index scores and multiple visit-retreatments. Following the loose criteria, the success rate of non-surgical root canal re-treatment obturated with gutta percha was 87% for 1-3 years follow-up (95% CI, 0.79-0.93) with significant heterogeneity across the studies (I2 = 88.5%). Factors influencing the success rate under the loose criteria were large periapical lesions >5 mm and higher initial periapical index (PAI) scores. CONCLUSIONS: Non-surgical root canal retreatment results in favourable outcomes. However, there are several factors which can result in a lower success rate: the presence and size of a periapical radiolucency, a higher initial PAI score, multiple-visit retreatments, and the size and position of the tooth.
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Gutapercha , Retratamiento , Tratamiento del Conducto Radicular , Gutapercha/uso terapéutico , Humanos , Retratamiento/métodos , Tratamiento del Conducto Radicular/métodos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Resultado del TratamientoRESUMEN
BACKGROUND: Dental students are future dentists. Continuous assessment and improving of the educational curricula will ensure excellent academic performance of dental students and thus providing the community with the best treatment modalities. The aim of this study was to evaluate the root canal filling quality performed in extracted teeth by preclinical undergraduate Yemeni dental students. METHODS: Root canal treatment was performed by undergraduate preclinical dental students on 331 extracted human teeth including 741 roots. The teeth were then collected and evaluated radiographically based on three criteria of quality (length, density, and taper). Cohen's Kappa test was used to assess the agreement between the examiners and Chi-squared test was used for the association between the study variables. The level of significant was set at α < 0.05. RESULTS: The results of the study revealed that the overall quality of roots canals fillings was poor. However, more than half of the study sample (53.4%) had adequate length, 13.1% had adequate density, and 14.2% had adequate taper. Anterior as well as single-rooted teeth had significantly better quality than posterior and multi-rooted teeth, respectively. The root canal fillings quality mandibular teeth was better than of maxillary teeth with no significant difference (P > 0.05). CONCLUSION: The findings of the study emphasize the need of improving the endodontic course in the preclinical level and more advanced techniques and instruments should be incorporated.
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Endodoncia/educación , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Estudiantes de Odontología , Auditoría Clínica , Cavidad Pulpar/cirugía , Educación en Odontología , Humanos , Mandíbula/cirugía , Maxilar/cirugía , Evaluación de Procesos, Atención de Salud , Propiedades de Superficie , YemenRESUMEN
The aim of this study was to evaluate three reciprocating systems and complementary cleaning methods on filling material removal during retreatment of flattened canals. Thirty-six mandibular incisors were prepared using rotary instruments up to size 25.08 and filled using the single-cone technique. Subsequently, the teeth were divided into three groups (n = 12) according to retreatment procedures: Reciproc Blue (RB): 25/0.08 and 40/0.06; ProDesign R (PDR): 25/0.06 and 35/0.05; and WaveOne Gold (WOG): 25/0.07 and 35/0.06. The remaining filling volume materials were assessed by means of micro-CT imaging before and after retreatment. After this, the specimens were subdivided into three groups according to complementary cleaning methods: XP-Endo Shaper (30/0.01); passive ultrasonic irrigation (PUI); 60° oscillatory instrumentation with #30 H-file, and micro-CT scan was taken. Then, the roots were cut in half and the samples were analyzed by scanning electron microscope (SEM). The data were analyzed statistically using Kruskal-Wallis and Dunn's Multiple Comparison test with significance level of 5%. None of the reciprocating files promoted complete removal of filling material and there was no statistical difference between the groups, regardless instrument size (p > 0.05). Complementary cleaning methods increased remnant filling removal (p < 0.05). XP-endo Shaper significantly reduced the amount of filling material in the apical and middle thirds, compared with H-files (p < 0.05), with no difference with PUI. In the SEM, there was no statistical difference among the instruments (p > 0.05). The reciprocating systems showed similar effectiveness in removing root filling material. Complementary cleaning method with the XP-Shaper enhanced filling material removal.
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Cavidad Pulpar/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/farmacología , Obturación del Conducto Radicular/normas , Preparación del Conducto Radicular/métodos , Humanos , Microscopía Electrónica de Rastreo , Retratamiento , Preparación del Conducto Radicular/normas , Microtomografía por Rayos XRESUMEN
INTRODUCTION: Pulpectomy has been a treatment of choice in all necrotic primary teeth. Advancing technology has brought the rotary system to reduce the manual dexterity and improve the quality of treatment for pulpectomy. Advancing technology in pediatric dentistry should be used for the better treatment protocol. AIM: The aim of this study is to compare the obturation quality and instrumentation time after root canal instrumentation with rotary Kedo-S files, hand K-files, and H-files in primary molars. MATERIALS AND METHODS: A randomized control trial where pulpectomy was performed on 75 primary molars equally distributed for instrumentation with K-file, H-files rotary Kedo-S files, respectively. The instrumentation time and obturation quality were noted. RESULTS: Kedo-S files showed the least instrumentation time with better obturation quality as compared to other two groups (P < 0.001). CONCLUSION: Pediatric rotary files Kedo-S has better obturation quality in minimum instrumentation time.
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Obturación del Conducto Radicular/instrumentación , Niño , Preescolar , Método Doble Ciego , Femenino , Humanos , Masculino , Diente Molar/cirugía , Tempo Operativo , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Diente Primario/cirugíaRESUMEN
Objectives: To evaluate radiographically the technical quality of root canal fillings performed by dental students at the School of Dentistry, University of the West Indies. Methods: The dental school's database of student clinical activity between the period 2000-2004 was investigated for patients who completed root canal treatment. For each root filled tooth, at least four periapical radiographs were examined: preoperative, working length determination, try in GP point and postoperative. The final sample consisted of 198 patients with 288 root filled teeth and 460 canals. The length, presence of voids, taper, curvature of canal and fractured instruments were recorded and scored. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. Results: Sixty-three percent, 27.6% and 72.2% of root filled canals had adequate length, density and taper respectively. Fractured instruments were found in only 7 of the root canals (1.5%).The acceptability for both length and taper was found in 31.5% of canals. A significantly greater proportion of root fillings of adequate length and taper were observed in straight canals compared to curved canals (P<0.05). However no significant difference was observed for the presence of voids in straight or curved canals. The percentage of root fillings with adequate length was significantly greater in maxillary teeth than in mandibular teeth (P <0.05) and in anterior teeth compared to posterior teeth (P< 0.001).The overall acceptability of root fillings having adequate length and taper, absence of voids and no fractured instruments was found in 10.9% of canals. The mandibular incisors had the greatest level of acceptability for all observed parameters (27.3%). Conclusion: The overall acceptability of root fillings performed by dental undergraduate students was only 10.9%. Changes in teaching methods may be required to improve the quality of root canal treatment among dental students.
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Humanos , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Estudiantes de Odontología , Preparación del Conducto Radicular/normas , Trinidad y Tobago , Competencia Clínica/normas , Cavidad Pulpar/diagnóstico por imagen , Endodoncia/educaciónRESUMEN
INTRODUCTION: The aim of this study was to measure the time consumed preparing retrograde cavities in root canals of maxillary molars filled using the GuttaCore (Dentsply Tulsa Dental Specialties, Tulsa, OK) technique and the cold lateral condensation technique (CLC) and to examine the quality of the root-end cavity preparation by ultrasonic tips using micro-computed tomographic (micro-CT) scanning. METHODS: A total of 24 maxillary molars were included; distobuccal and palatal canals were instrumented to size #40 and size #50, respectively. Teeth were randomly distributed into 2 experimental groups; half of the samples were filled with CLC, and half were filled with the GuttaCore technique. After 2 months, the apical 3 mm of each root apex was resected. A retrograde cavity was then prepared 3 mm deep into the root-end-filled canals using ultrasonic tips. The quality of the preparation was first confirmed by a surgical stereomicroscope, and the time required for the root-end preparation was recorded. After root-end cavity preparation, all samples were scanned by micro-CT scanning. RESULTS: There was no significant difference between the palatal and distobuccal canals in the time required to prepare a retrograde cavity. Less time was required in the GuttaCore group to remove all root filling material and finish the cavity preparation than in the CLC group (P < .05), especially in the palatal canals. Micro-CT results confirmed that all material was removed from the root-end cavities and the absence of microcracks. CONCLUSIONS: GuttaCore was removed in less time from root-end cavities than root filling performed with the CLC technique. No damage to the surrounding dentin was detected by micro-CT scanning in the 2 groups.
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Preparación del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/métodos , Humanos , Maxilar , Diente Molar/cirugía , Calidad de la Atención de Salud , Radiografía Dental , Materiales de Obturación del Conducto Radicular/uso terapéutico , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Preparación del Conducto Radicular/normas , Tratamiento del Conducto Radicular/normas , Factores de Tiempo , Microtomografía por Rayos XRESUMEN
AIM: This systematic review was undertaken in order to develop guidelines for the European Academy of Paediatric Dentistry for the management of non-vital permanent anterior teeth with incomplete root development. METHODS: Three techniques were considered; apexification by single or multiple applications of calcium hydroxide, use of Mineral Trioxide Aggregate (MTA) for the creation of an apical plug followed by obturation of the root canal, and finally a Regenerative Endodontic Technique (RET). Scottish Intercollegiate Guideline Network (SIGN) Guidelines (2008) were used for the synthesis of evidence and grade of recommendation. RESULTS: Variable levels of evidence were found and generally evidence related to these areas was found to be weak and of low quality. It was not possible to produce evidence-based guidelines based on the strength of evidence that is currently available for the management of non-vital immature permanent incisors. CONCLUSIONS: Based on the available evidence the European Academy of Paediatric Dentistry proposes Good Clinical Practice Points as a guideline for the management of such teeth. It is proposed that the long term use of calcium hydroxide in the root canals of immature teeth should be avoided and apexification with calcium hydroxide is no longer advocated. The evidence related to the use of a Regenerative Endodontic Technique is currently extremely weak and therefore this technique should only be used in very limited situations where the prognosis with other techniques is deemed to be extremely poor. The current review supports the use of MTA followed by root canal obturation as the treatment of choice.
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Tratamiento del Conducto Radicular , Diente no Vital/terapia , Adolescente , Niño , Dentición Permanente , Odontología Basada en la Evidencia , Humanos , Guías de Práctica Clínica como Asunto , Medicina Regenerativa/métodos , Medicina Regenerativa/normas , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Tratamiento del Conducto Radicular/métodos , Tratamiento del Conducto Radicular/normasRESUMEN
Objetivo: O objetivo deste estudo foi avaliar, por microtomografia computadorizada (micro-CT), a qualidade da obturação de canais mesiais de molares inferiores utilizando os cimentos EndoSequence BC Sealer e AH Plus. Metodologia: Vinte molares inferiores foram divididos em dois grupos (n=10) de acordo com o cimento utilizado na obturação. O preparo quimico-mecânico foi realizado com as limas rotatórias K3XF. As amostras foram escaneadas por micro-CT antes e depois da intrumentação, e depois da obturação. O volume do sistema de canais radiculares (SCR) após a instrumentação e o volume da obturação foram calculados, assim, o volume percentual da obturação e dos espaços vazios pôde ser obtido. Resultados: Todas as amostras apresentaram volumes de obturação menores do que o volume pós instrumentação do SCR (p < 0,05). Não houve diferença estatística significante entre os grupos quanto ao volume da obturação e o volume de espaços vazios (p >0,05). Conclusões: Os cimentos endodônticos EndoSequence BC Sealer e AH Plus proporcionaram uma qualidade semelhante de obturação em canais mesiais de molares inferiores. Nenhum dos cimentos foi capaz de proporcionar total preenchimento do SCR. (AU)
Aim: The aim of this study was to evaluate, by computadorized microtomography (micro-CT), the root canal filling quality of mesial roots of mandibullar molars using EndoSequence BC Sealer and AH Plus sealers. Methodology: Twenty mandibular molars were divided into two groups (n=10) according to the sealer used in the obturation. Root canals were prepared using K3XF rotary files. The specimens were scanned before and after instrumentation, and after obturation by using micro-CT. The root canal system volume after instrumentation, and the filling volume were calculated, so the percentage volume of the filling, and voids and gaps could be obtained. Results: All the specimens presented the final volume smaller than the inicial volume (P < 0.05). There was no significant difference between groups with regard to the filling volume and voids and gaps volume (P > 0.05). Conclusions: EndoSequence BC Sealer and AH Plus sealer promoted a similar root filling quality in mesial root canals of madibullar molars. None of the sealers was able to fill the entire area of the root canal system. (AU)
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Humanos , Cementos Dentales/normas , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Ensayo de Materiales , Diente Molar , Microtomografía por Rayos XRESUMEN
OBJECTIVE: The aim of this study was to investigate the relationship between quality of root canal obturations and the presence/absence of periapical lesion in elderly patients. METHODOLOGY: This was a systematic conducted by means analysing studies on the quality of root canal obturations and their relationship with periapical health in elderly patients. The methodological procedures were based on Cochrane. The inclusion criteria for selection of the titles were the following: (i) studies in humans; (ii) sample consisting of individuals aged 60 years or older; (iii) intending criteria defined for the evaluation of quality of root canal obturations; (iv) intending criteria defined for the evaluation of periapical health; (v) determination of the relationship between quality of endodontic treatment and presence of periapical lesions; and (vi) articles published between 1st March 2003 and 1st March 2013. RESULTS: A total of 3161 potentially relevant studies were found in three databases chosen for the literature review, with 1669 being repeated and 395 duplicated. Therefore, the abstracts of 1097 studies were read. A total of 1022 studies were excluded, resulting in 75 articles for full analysis. However, no study could be included in the present literature review. CONCLUSION: There is no consensus on the relationship between the quality of root canal obturations and periapical health in older patients.
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Periodontitis Periapical/patología , Obturación del Conducto Radicular/normas , Anciano , Humanos , Periodontitis Periapical/etiologíaRESUMEN
PURPOSE: To assess the prevalence of apical periodontitis (AP), as determined by orthopantomograms (OPGs), and its correlation with the quality of root fillings and coronal restorations. MATERIALS AND METHODS: This cross-sectional study evaluated a random sample of 193 patients--112 (58%) females and 81 (42%) males--who presented as new patients at the Division of Endodontics. Digital OPGs were independently examined by two reliability-calibrated endodontists. The total number of teeth present, the location of the root canalfilled teeth, and the presence or absence of AP were recorded for each radiograph. The results were statistically analysed using the chi-square test followed by model building using multiple logistic regression. RESULTS: A total of 324 endodontically treated teeth from the 193 selected radiographs were analysed. The mean number of teeth per patient was 25.5 ± 4.6, with an average of 1.64 root canal treatments per subject. Radiographically detected AP was associated with 190 (58.6%) root canal-treated teeth. The logistic model shows that the quality of endodontic treatment (adjusted odds ratio [ORa] = 1.82; 95% confidence interval [CI]: 1.40-3.17), status of coronal restoration (ORa = 1.77; 95% CI: 1.20-2.61) and the type of material used for coronal restorations (ORa = 1.39; 95% CI: 1.03-1.87) were significantly related to the periapical health of the teeth. CONCLUSIONS: The quality of endodontic treatment, status of coronal restoration and the type of coronal restorative material were found to be the most important factors influencing the health of periradicular tissue.
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Periodontitis Periapical/diagnóstico por imagen , Radiografía Panorámica/métodos , Obturación del Conducto Radicular/normas , Diente no Vital/diagnóstico por imagen , Adolescente , Adulto , Anciano , Estudios Transversales , Caries Dental/diagnóstico por imagen , Adaptación Marginal Dental , Materiales Dentales/normas , Restauración Dental Permanente/normas , Femenino , Gutapercha/normas , Humanos , Masculino , Persona de Mediana Edad , Tejido Periapical/diagnóstico por imagen , Radiografía Dental Digital/métodos , Materiales de Obturación del Conducto Radicular/normas , Arabia Saudita , Adulto JovenRESUMEN
This article will discuss why a root filling that appears satisfactory on a radiograph may fail, and why one which appears unsatisfactory on a radiograph may succeed. In doing so, this article will also discuss the criteria of endodontic success and failure and its implications on the decision to retreat.
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Radiografía Dental , Tratamiento del Conducto Radicular , Cavidad Pulpar/diagnóstico por imagen , Reparación de Restauración Dental/métodos , Humanos , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular/métodos , Obturación del Conducto Radicular/normas , Tratamiento del Conducto Radicular/normas , Resultado del TratamientoRESUMEN
AIM: The aim was to assess the technical quality of root canal treatment conducted in paediatric patients. No specific data is available assessing endodontic treatment quality in children. General adult populations report satisfactory technical quality between 12.8 and 55.7 %, with higher rates by endodontists (77.4-91.0 %). METHODS: Radiographs of 100 chronological cases, conducted by staff (categorised as; junior staff, middle grades or consultants) in a UK teaching hospital, were evaluated retrospectively. Technical outcomes were compared to the European Society of Endodontology quality guideline consensus. A satisfactory root filling was defined as having: root filling material <2 mm from the radiographical apex; no canal space seen beyond the end of the obturation and an obturation of homogeneous density with no voids. In addition where MTA was used a plug of ≥3 mm was required. Any variation was considered unsatisfactory treatment. RESULTS: 61 % [95 % CI 51-70 %] of cases were deemed satisfactory. Of the remaining obturations 20.5 % were short of the apex, 28.2 % had extruded material and 56.4 % contained voids. Patients with co-operation issues, particularly anxiety, had lower technical outcomes (p = 0.001) and the use of thermoplastic obturation greatly reduced the chance of void inclusion (p = 0.004; OR 0.20 [95 % CI 0.06-0.65]). Although 'staff grade' did not show a statistically significant difference, a trend between experience and quality was suspected. CONCLUSION: Overall technical quality of treatment was comparable to the higher rates found in the general adult population. Additionally thermal obturation may be superior to cold lateral condensation in improving obturation quality, and anxiety negatively impacts on treatment provision.
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Tratamiento del Conducto Radicular/normas , Adolescente , Compuestos de Aluminio/química , Compuestos de Calcio/química , Niño , Conducta Infantil , Competencia Clínica , Conducta Cooperativa , Ansiedad al Tratamiento Odontológico/complicaciones , Cavidad Pulpar/diagnóstico por imagen , Servicio Odontológico Hospitalario , Combinación de Medicamentos , Cuerpos Extraños/diagnóstico por imagen , Humanos , Óxidos/química , Tejido Periapical/diagnóstico por imagen , Porosidad , Radiografía , Estudios Retrospectivos , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/normas , Silicatos/química , Ápice del Diente/diagnóstico por imagen , Resultado del TratamientoRESUMEN
OBJECTIVE: With a microcomputed tomography (microCT) imaging device, we aimed to quantitatively evaluate root canal fillings after commonly used endodontic procedures and also tested the suitability of microCT for this purpose. MATERIALS AND METHODS: Eighty single roots were instrumented and obturated with gutta-percha and Tubli-Seal. They were divided into 4 groups of 20. The Hand groups were instrumented with hand files and filled with thermoplastic (Th) compaction and cold lateral (CL) condensation, i.e. Hand-Th and Hand-CL, respectively. The Rot groups, i.e. Rot-Th and Rot-CL, were instrumented with a rotary ProFile system and filled as above. The roots were scanned and 3-dimensional (3D) visualization was obtained. The number, size, percentage of volume and distribution of voids at the filling/dentine interface (i-voids) and voids surrounded by filling material (s-voids) were measured. RESULTS: Canal fillings differed significantly with regard to the size of both types of voids and the average number of i-voids. All canals presented a low volume of voids. The highest percentage (0.69%) was found for i-voids in the Hand-CL group, while the lowest volume (0.11% for s-voids and 0.14% for i-voids) was in the Hand-Th canals. Apically, in the last 3 mm, i-voids were observed mainly in the Th groups, and s-voids occurred mostly in the coronal part of the canal filling in all cases. CONCLUSION: MicroCT was a useful tool for 3D quantitative evaluations of these root canal fillings. None of the root canal instrumentation and filling methods ensured void-free obturation. CL condensation produced mainly i-voids. With Th compaction, internal s-voids were particularly common, but there were mainly i-voids in the apical part.
Asunto(s)
Gutapercha , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Cemento de Óxido de Zinc-Eugenol , Análisis de Varianza , Humanos , Obturación del Conducto Radicular/métodos , Microtomografía por Rayos X/métodosRESUMEN
PURPOSE: To evaluate the frequency, distribution and quality of root canal treatment in an adult Nigerian subpopulation and to determine the prevalence of apical periodontitis. MATERIALS AND METHODS: The periapical status and length of root fillings of 756 patients attending Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria for the first time were evaluated using full mouth periapical radiographs. The length of the root canal filling was considered 'adequate' if it was ≤ 2 mm from the radiographic apex, 'under-filled' if it was > 2 mm short of the apex, and 'overfilled' if filling material extended beyond the radiographic apex. Periapical status was assessed using the periapical index (PAI) with teeth classified as having apical periodontitis if the score was over 2. RESULTS: Overall, 61.2% of the patients had root-filled teeth and 67.2% featured apical periodontitis. Of the 21,468 teeth examined, 12.2% had been root filled, and of these 41% exhibited apical periodontitis. The prevalence of root-filled teeth was higher in the younger patients, while the prevalence of apical periodontitis in root-filled teeth was similar between age groups. Root-treated teeth that were overfilled or were mandibular incisors had the highest prevalence of apical disease. Overfilled teeth were more prone to developing an apical radiolucency than were under-filled teeth (P < 0.001 and P < 0.05, respectively). CONCLUSIONS: The prevalences of endodontically treated teeth and apical periodontitis were within the range reported for other countries; however, a very large number of patients required treatment or retreatment.
Asunto(s)
Periodontitis Periapical/epidemiología , Tratamiento del Conducto Radicular/estadística & datos numéricos , Adulto , Factores de Edad , Cavidad Pulpar/diagnóstico por imagen , Femenino , Humanos , Incisivo/diagnóstico por imagen , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , Radiografía de Mordida Lateral/estadística & datos numéricos , Obturación del Conducto Radicular/normas , Tratamiento del Conducto Radicular/normas , Ápice del Diente/diagnóstico por imagen , Diente no Vital/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: The present study examined the quality of obturation in root canals filled by an experimental non-gutta-percha-based (NGP) root filling system using warm vertical or cold lateral compaction. The quality of obturation was evaluated by comparing the volumetric percentage of gaps and voids identified from similar canals obturated with gutta-percha and an epoxy resin-based sealer using the same obturation techniques. METHODS: Forty single-rooted premolars with oval-shaped canals were cleaned, shaped, and obturated with 1 of the 4 material/obturation technique combinations (n = 10). Filled canals were scanned with micro-computed tomographic imaging. Reconstructed images were analyzed for the volumetric percentage of gaps and voids at 3 canal levels (0-4, 4-8, and 8-12 mm from the working length). Roots were sectioned at the 4-mm, 8-mm, and 12-mm levels. Scanning electron microscopic images of negative replicas of root sections were examined to quantify the circumferential percentage of interfacial gaps and the area percentage of intracanal voids. Data were analyzed with parametric or nonparametric statistical methods. RESULTS: A statistically significant difference was found for the volumetric percentage distribution of gaps and voids for "obturation technique" but not for "material." Significantly higher percentages of gaps and voids were identified in canals obturated with the NGP system using cold lateral compaction. Examination of negative replicas ascribed this difference to a higher area percentage of interfacial gaps rather than more intracanal voids. CONCLUSIONS: Using warm vertical compaction, the NGP system fulfils the objective of 3-dimensional obturation of the canal space in a manner comparable with the results achieved with gutta-percha and a root canal sealer.
Asunto(s)
Resinas Epoxi/normas , Materiales de Obturación del Conducto Radicular/normas , Obturación del Conducto Radicular/normas , Cavidad Pulpar/diagnóstico por imagen , Resinas Epoxi/química , Gutapercha/química , Gutapercha/normas , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Preparación del Conducto Radicular/métodos , Propiedades de Superficie , Temperatura , Microtomografía por Rayos X/métodosRESUMEN
OBJECTIVE: To study the periapical status of root-filled permanent teeth of 9-17-year-olds in Møre & Romsdal county, Norway. MATERIALS AND METHODS: All permanent teeth with endodontic treatment in patients born in 1994-2001 were identified in the dental records of the Public Dental Service. The data collected consisted of chart entries and radiographs. Of 1182 teeth, 174 teeth in 155 patients met further inclusion criteria, i.e. completed endodontic treatment and a follow-up with a readable radiograph of at least 1 year. Periapical status was assessed with the Periapical Index (PAI) and the technical quality of the root fillings was also quantified on a 4-grade visual scale. RESULTS: Apical periodontitis was found on follow-up radiographs in 25% of all teeth and in 48% of the teeth with pre-operative apical periodontitis. Forty-two per cent of root fillings were of adequate technical quality. Adequate technical quality of the root filling was significantly correlated with radiographic success. CONCLUSIONS: About one fourth of all root-filled teeth and almost half of the teeth with pre-operative apical periodontitis showed clear signs of the disease at recall.
Asunto(s)
Periodontitis Periapical/clasificación , Tratamiento del Conducto Radicular/normas , Diente no Vital/terapia , Adolescente , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Noruega , Periodontitis Periapical/diagnóstico por imagen , Radiografía de Mordida Lateral , Estudios Retrospectivos , Obturación del Conducto Radicular/normas , Raíz del Diente/diagnóstico por imagen , Diente no Vital/diagnóstico por imagen , Resultado del TratamientoRESUMEN
OBJECTIVES: The present study examined the quality of obturation in root canals obturated by GuttaCore, a gutta-percha-based core-carrier system with a cross-linked thermoset gutta-percha carrier, by comparing the incidence of gaps and voids identified from similar canals obturated by cold lateral compaction or warm vertical compaction. METHODS: Thirty single-rooted premolars with oval-shaped canals were shaped and cleaned, and obturated with one of the three obturation techniques (N=10): GuttaCore, warm vertical compaction or cold lateral compaction. Filled canals were scanned with micro-computed tomography (micro-CT); reconstructed images were analysed for the volumetric percentage of gaps and voids at three canal levels (0-4mm, 4-8mm and 8-12mm from working length). The roots were subsequently sectioned at the 4-mm, 8-mm and 12-mm levels for analyses of the percentage of interfacial gaps, and area percentage of interfacial and intracanal voids, using scanning electron microscopy (SEM) to examine negative replicas of root sections. Data were analysed with parametric or non-parametric statistical methods at α=0.05. RESULTS: Both micro-CT and SEM data indicated that canals obturated with GuttaCore core-carriers had the lowest incidence of interfacial gaps and voids, although the results were not significantly different from canals obturated by warm vertical compaction. Both the GuttaCore and the warm vertical compaction groups, in turn, had significantly lower incidences of gaps and voids than the cold lateral compaction group. CONCLUSIONS: Because of the similarity in obturation quality between GuttaCore and warm vertical compaction, practitioners may find the GuttaCore core-carrier technique a valuable alternative for obturation of oval-shaped canals. CLINICAL SIGNIFICANCE: The quality of obturation achieved by GuttaCore in single-rooted canals is not significantly different from that achieved by warm vertical compaction.