1
|
Tanomaru-Filho M, Lucchesi MB, Santos-Junior AO, Tavares KIMC, Pinto JC, Guerreiro-Tanomaru JM. Filling ability of ready-to-use or powder-liquid calcium silicate-based sealers after ultrasonic agitation. Braz Dent J 2024; 35:5802. [PMID: 39045989 PMCID: PMC11262770 DOI: 10.1590/0103-6440202405802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/23/2024] [Indexed: 07/25/2024] Open
Abstract
This study evaluated the effect of ultrasonic agitation on the filling capacity of ready-to-use calcium silicate-based sealer Bio-C Sealer (BCS, Angelus, Paraná, Brazil) or powder-liquid BioRoot RCS (BR, Septodont, Saint-Maur-des-Fossés, France) using curved artificial canals by micro-computed tomography (micro-CT). Additionally, flow (mm) and flow area (mm2) were evaluated for both materials. Acrylic resin main canal (60° curvature and 5 mm radius, with 3 lateral canals in the cervical, middle, and apical thirds) were prepared up to size 40/.05 (Prodesign Logic, Brazil). The agitation method was used with ultrasonic tip (US, Irrisonic, Helse, Brazil): BCS, BCS/US, BR, and BR/US. All specimens were filled using the single-cone technique. The samples were scanned by micro-CT (8,74 µm) after obturation. The percentage of filling material and voids were calculated. Flow was evaluated based on ISO 6876/2012 standards (mm) and area (mm2). The data were statistically analyzed using ANOVA and Tukey tests (α = 0.05). BR/US showed lower percentage of filling material in the lateral canals than and, BCS/US (p<0.05). BR/US resulted in a higher percentage of voids than BR in the lateral apical third (p<0.05). BCS showed higher flow than BR (p<0.05). BCS and BR presented proper filling capacity in the simulated curved canals regardless of the use of ultrasonic agitation. However, BR/US showed more voids in the apical third. BCS demonstrates higher filling ability.
Collapse
Affiliation(s)
- Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Maíra Bonassi Lucchesi
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
| | | |
Collapse
|
2
|
Santos-Junior AO, Tavares KIMC, Pinto JC, Torres FFE, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Flatsonic Ultrasonic Tip Optimizes the Removal of Remaining Filling Material in Flattened Root Canals: A Micro-computed Tomographic Analysis. J Endod 2024; 50:612-618. [PMID: 38278319 DOI: 10.1016/j.joen.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION The aim of this study was to evaluate the effectiveness of the XP-endo Finisher R (XPFR; FKG Dentaire, La Chaux-de-Fonds, Switzerland) or the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) in removing remaining filling material after the retreatment of flattened root canals using micro-computed tomographic imaging. METHODS Twenty-four flattened distal root canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were prepared with Reciproc Blue (RB) R40 (VDW GmbH, Munich, Germany) and filled using the Tagger hybrid technique. All canals were retreated with RB R40, and apical enlargement was performed with RB R50 (VDW GmbH). The specimens were randomly distributed into 2 groups: XPFR or Flatsonic (n = 12). The percentage of remaining filling material after retreatment and centralization ability was evaluated. Data were submitted to Mann-Whitney, Wilcoxon, and unpaired t tests (α = 5%). RESULTS Greater capacity to remove remaining filling material in the entire canal and the cervical and middle thirds was observed for the Flatsonic compared with the XPFR (P < .05). However, both supplementary cleaning techniques showed a similar percentage of residual filling material in the apical third (P > .05). No difference was observed in the centralization ability between the techniques (P > .05). CONCLUSIONS The Flatsonic promotes greater removal of remaining filling material than the XPFR in the retreatment of flattened root canals. However, both supplementary cleaning approaches were similar in the apical third. The XPFR and Flatsonic were able to maintain root canal centralization.
Collapse
Affiliation(s)
| | | | - Jáder Camilo Pinto
- Departament of Dentistry, Centro Universitário Presidente Antônio Carlos, Barbacena, Minas Gerais, Brazil; Department of Dentistry, Centro Universitário Presidente Tancredo de Almeida Neves, São João del Rei, Minas Gerais, Brazil
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University, School of Dentistry, Araraquara, São Paulo, Brazil.
| |
Collapse
|
3
|
Yu Y, Yuan CY, Yin XZ, Wang XY. Assessment of isthmus filling using two obturation techniques performed by students with different levels of clinical experience. J Dent Sci 2024; 19:169-176. [PMID: 38303796 PMCID: PMC10829546 DOI: 10.1016/j.jds.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/07/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Root canal filling is a necessary skill for dental students and an important aspect of endodontic education. This study aimed to evaluate the effect of students' clinical experiences on isthmus filling using different techniques and sealers. Materials and methods One hundred eight three-dimensional-printed resin replicas of isthmus were divided into six groups and either continuous wave of condensation (CWC) or single-cone obturation (SC) was performed. One of three sealers (AH Plus Jet®, GuttaFlow2, iRoot SP) was used together with a size-fitted gutta-percha master cone. All the obturations were completed by students with three different levels of clinical experience including senior postgraduate students (SPS), junior postgraduate students (JPS), and undergraduate students (US). The percentages of filled areas (PFA) at 2, 4, 6, and 8 mm from the apex were analyzed using a light microscope. Data were analyzed using the Mann-Whitney U test or Kruskal-Wallis 1-way ANOVA with Dunn's tests (α = 0.05). Results The CWC group exhibited a higher PFA than the SC group (P < 0.05). The PFA was higher in the SPS group than in the JPS group or the US group with CWC (P < 0.05). The three clinical experience groups showed similar PFAs with SC (P > 0.05); however, when using SC with iRoot SP, the PFA was higher than with either of the other two sealers (P < 0.05). Conclusion CWC was found to be technique-sensitive and required clinical training. With SC, clinical experience did not improve the quality of isthmus filling without additional training. CWC was superior to SC for type IV isthmuses. When using SC, better filling quality was obtained with a bioceramic sealer.
Collapse
Affiliation(s)
- Yang Yu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Chong-Yang Yuan
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xing-Zhe Yin
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
4
|
Souza PHFD, Oliveira Santos-Junior A, Pinto JC, Tavares KIMC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study. Braz Dent J 2023; 34:29-35. [PMID: 38133470 PMCID: PMC10759957 DOI: 10.1590/0103-6440202305474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to evaluate the effect of apicoectomy performed with a bur or an ultrasonic tip on the adaptation of the filling material to root canal dentin. Twenty human mandibular incisors were selected and prepared with a ProDesign Logic system up to diameter 40/.05. The root canals were filled with Bio-C Sealer (Angelus, PR, Brazil) using the single cone technique and were stored at 37ºC and 95% relative humidity for 7 days. After this period, the apicoectomy of the 3 millimeters of the root apex was performed using Endo-Z bur (Dentsply Sirona) or Bladesonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, Brazil) (n=10). The specimens were scanned by micro-computed tomography (micro-CT; SkyScan 1176) with a voxel size of 8.74 µm after obturation and after apicoectomy. The percentage of voids at the interface between the filling material and the root canal wall was evaluated in the apical 4 mm of the root after apicoectomy, besides the time cutting to both devices. The data obtained were submitted to paired and unpaired t-tests (α = 0.05). Endo-Z and Bladesonic increased the percentage of voids between the filling material and the dentin after apicectomy (p<0.05), and they were similar (p>0.05). Endo-Z has a shorter time to perform apicoectomy compared to Bladesonic (p<0.05). Apicectomies with Endo-Z or Bladesonic could harm the material/dentin interface, while the Endo-Z bur was faster than the Bladesonic ultrasonic tip.
Collapse
Affiliation(s)
- Pedro Henrique Fiorin de Souza
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| | - Jáder Camilo Pinto
- Departament of Dentistry - Centro Universitário Presidente Antônio Carlos - UNIPAC, Barbacena, MG, Brazil and Department of Dentistry - Centro Universitário Presidente Tancredo de Almeida Neves - UNIPTAN, São João del Rei, MG, Brazil
| | | | | | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, UNESP - Universidade Estadual Paulista, Araraquara, SP, Brazil
| |
Collapse
|
5
|
Girelli CFM, de Lima CO, Silveira FF, Lacerda MFLS, Nunes E. Marginal gaps and voids using two warm compaction techniques and different sealers: a micro-CT study. Clin Oral Investig 2023:10.1007/s00784-023-04866-x. [PMID: 36695972 DOI: 10.1007/s00784-023-04866-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the percentage of marginal gaps and voids in oval-shaped canals obturated by using two warm compaction techniques with a Bio-C sealer and AH Plus Jet. MATERIALS AND METHODS Forty canines with oval canals were scanned by microcomputed tomography (micro-CT), and root canal preparation was performed with an XP-endo Shaper system and irrigated with 5.25% sodium hypochlorite. Then, the specimens were paired into four groups (n=10) according to the root canal filling technique and endodontic sealer: Bio-C sealer and continuous wave of condensation, Bio-C sealer and Tagger's hybrid, AH Plus Jet and continuous wave of condensation, and AH Plus Jet and Tagger's hybrid. After root canal filling, a new scan was performed. The percentage of marginal gaps and voids was calculated with the ImageJ software, and the data were analyzed statistically using two-way ANOVA and Tukey tests, with a significance level of 5%. RESULTS The percentage of marginal gaps was significantly lower in the Bio-C sealer than in AH Plus Jet (p=0.021) regardless of the technique. However, no difference was found in the percentage of voids between root canal filling techniques and the endodontic sealer (p>0.05). CONCLUSION Both sealers and techniques demonstrated good quality of root canal filling. However, the use of the Bio-C sealer enhanced the filling ability by reducing marginal gaps, regardless of the root canal filling technique. CLINICAL RELEVANCE This study highlights the better performance of the Bio-C sealer in the quality of the root canal filling, reducing marginal gaps when compared to AH Plus Jet independent of the technique.
Collapse
Affiliation(s)
| | - Carolina Oliveira de Lima
- Department of Dentistry, Federal University of Juiz de Fora, R. São Paulo, 745 - Centro, Governador Valadares, Minas Gerais, 35010-180, Brazil
| | - Frank Ferreira Silveira
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
| | | | - Eduardo Nunes
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
6
|
De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
Collapse
Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | | |
Collapse
|
7
|
Cho YS, Kwak Y, Shin SJ. Comparison of Root Filling Quality of Two Types of Single Cone-Based Canal Filling Methods in Complex Root Canal Anatomies: The Ultrasonic Vibration and Thermo-Hydrodynamic Obturation versus Single-Cone Technique. MATERIALS 2021; 14:ma14206036. [PMID: 34683625 PMCID: PMC8539525 DOI: 10.3390/ma14206036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/20/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the effectiveness of ultrasonic vibration and thermo-hydrodynamic obturation (VibraTHO) using two types of root canal sealers, in comparison to the single-cone (SC) technique and a calcium silicate-based root canal sealer in complex root canal anatomies. Thirty single-rooted human maxillary premolars with two canals that had a complex root canal anatomy of transverse anastomoses or ramifications were prepared and assigned to the following three experimental groups, according to the filling method: SE group, SC technique with Endoseal TCS; VE group, VibraTHO with Endoseal TCS; and VG group, VibraTHO with GuttaFlow 2. Each tooth was scanned using micro-computed tomography, and the volume percentages of the filling material were calculated. The analysis of variance was used to analyze the statistical differences between the three groups (p < 0.05). The mean volume of the filling material was higher in the VG and VE groups than that in the SE group (p < 0.05) along the apical to middle-to-coronal thirds, and significant differences were observed between each root canal area (p < 0.05), with the only exception being at the apical thirds between the VE and SE groups. The VibraTHO technique using GuttaFlow 2 can be a more effective root canal filling method for anatomically complex root canal systems than the SC technique with Endoseal TCS. On the other hand, the VibraTHO technique using Endoseal TCS has a limited effect on improving the quality of the root filling at the apical portion of anatomically complex root canal systems, compared to the SC technique with Endoseal TCS.
Collapse
Affiliation(s)
- Yong-Sik Cho
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul 03722, Korea;
- Private Practice—Yonsei Doctors’ Dental Clinic, 201, 28 Daesan-ro, Ilsandong-gu, Goyang-si 10359, Korea
| | - Youngjun Kwak
- Private Practice—Yonsei Nature Dental Clinic, 2F, 281 Yangnyeong-ro, Dongjak-gu, Seoul 06919, Korea;
| | - Su-Jung Shin
- Gangnam Severance Hospital, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, 211 Eonjuro, Gangnam-gu, Seoul 06273, Korea
- Correspondence: ; Tel.: +82-2-2019-3572; Fax: +82-2-3463-4052
| |
Collapse
|
8
|
Cho YS. Ultrasonic vibration and thermo-hydrodynamic technique for filling root canals: Technical overview and a case series. Int Endod J 2021; 54:1668-1676. [PMID: 33987851 DOI: 10.1111/iej.13566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/19/2022]
Abstract
AIM To present a novel root canal filling technique: Ultrasonic Vibration & Thermo-Hydrodynamic Obturation (VibraTHO), and its rationale with a series of cases. SUMMARY The VibraTHO technique was used to fill the root canals of three clinically challenging cases: A C-shaped mandibular molar with complex anatomy, a C-shaped mandibular molar with an infected root canal system and a periapical lesion that required retreatment, and apically bifurcating mesiobuccal canals with a common orifice in a maxillary second molar. The cases were followed up for 15, 7 and 37 months, respectively. After follow-up, normal periapical status was observed without any noticeable radiographic change in the root canal fillings in each case. Periapical radiographs revealed complete healing of the periapical area in cases with pre-operative periapical lesions.
Collapse
Affiliation(s)
- Yong-Sik Cho
- Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Korea.,Private Practice, Goyang-si, Korea
| |
Collapse
|