Porosity Distribution in Single Cone Root Canal Fillings Performed by Operators with Different Clinical Experience: A microCT Assessment

Hydraulic (Single Cone) Versus Thermogenic (Warm Vertical Compaction) Obturation Techniques: A Systematic Review

Root canal treatment (RCT) involves cleaning and shaping of the root canal system before filling the canals with obturating materials, often gutta-percha (GP). The two primary obturation techniques are the thermogenic (warm vertical compaction, WVC) and hydraulic (single cone, SC) techniques. The objective of this study is to compare the clinical results and effectiveness of thermogenic and hydraulic obturation procedures in endodontic therapy to provide clinicians with evidence-based recommendations. Search strategies were conducted on February 01, 2024 and involved the databases Web of Science, PUBMED, Google Scholar, Scopus, Medline, Embase, NCBI, and Cochrane Library. The current systematic review included systematic reviews; meta-analyses; cohort studies; randomized controlled trial (RCT) studies; studies involving the comparison between single cone and warm compaction techniques; studies involving outcomes that include advantages, disadvantages, and complications associated with single cone or warm compaction techniques; and studies published within the last seven years. The selected studies were restricted to those with insufficient data, review articles without authentic references, publications in a language other than English, animal studies, and studies not involving SC or WVC. Out of 2300 studies registered, only 12 studies were included in the review. Both WVC and SC techniques showed satisfactory root canal fillings. However, five studies showed differences in the filling quality, four studies assessed the sealing ability and the dentinal tubule penetration of sealers, one study compared dentinal cracks, one study evaluated the amount of debris excluded apically, and one study compared the post-operative pain while using both techniques. The WVC and SC obturation techniques offer advantages and disadvantages in endodontic treatment. SC obturation is a simple and efficient procedure that is particularly suitable for situations with uncomplicated canal structures. The WVC obturation approach provides superior flexibility and sealing capability, especially in the complex root canal system. When choosing the method of treatment, it is important to take into account the patient's preferences, the clinician's experience, and unique considerations related to the situation. This systematic review highlights the important recommendations to healthcare professionals in selecting the most suitable obturation procedure based on the specific requirements of each clinical scenario. Research involving long-term follow-ups is required to get a better understanding of the outcomes of long-term goals. Clinical relevance: ability to educate clinicians regarding the best obturation technique between thermogenic and hydraulic. It directs the treatment decisions to maximize patient's comfort, minimize post-operative complications, and improve efficacy in endodontic practice.

Quality of Root Canal Filling in Curved Canals Utilizing Warm Vertical Compaction and Two Different Single Cone Techniques: A Three-Dimensional Micro-Computed Tomography Study

Statement of the Problem

Successful endodontic treatment depends on three-dimensional (3D) root canal filling to prevent the leakage of residual bacteria. Different obturation techniques with different sealers should be compared by employing advanced assessment tools.

Purpose

This study compared the obturation quality of warm vertical compaction (WVC) and two different single-cone (SC) techniques using micro-computed tomography (micro-CT).

Materials and Method

Thirty-three extracted maxillary molars with mesial root canal curvature of 20‒40º were prepared in vitro with One-Curve files and randomly assigned to three groups (n=11) for root canal obturation with WVC, SC technique with AH Plus sealer (SC-AH), or SC technique with SureSeal bioceramic (BC) sealer (SC-Su). The root canals underwent micro-CT examinations before and after obturation to determine the volume percentages (VPs) of voids and gaps at different distances from the apex (coronal, middle, and apical thirds). Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests.

Results

The highest VP of voids and gaps was recorded in the SC-Su group, with no significant difference from other groups (p> 0.05). There were significant differences in VP of gaps at different distances from the apex (p<0.05). The VPs of gaps in the apical third of all the samples were significantly higher than in the coronal and middle thirds. However, the difference in VP of voids was not significant at different distances from the apex (p>0.05).

Conclusion

None of the tested techniques could provide a void-free and gap-free filling. The apical third of the canals showed the highest VP of gaps in all obturation techniques.

Advanced Materials for Clinical Endodontic Applications: Current Status and Future Directions

Endodontics has significantly evolved in recent years, with advancements in instruments, biomaterials and nanomaterials science playing a pivotal role [...].

Effect of Enhanced Recovery after Surgery (ERAS) Concept and Cluster Nursing on Psychological State and Pain of Oral Outpatients Undergoing Root Canal Therapy

Objective

The effect of the concept of enhanced recovery after surgery (ERAS) and pain of patients undergoing root canal therapy in oral clinic.

Methods

200 participants in an oral clinic from March 2020 to March 2022 were enrolled in our study. The control group (n = 100) accepted ERAS-based care and the research group (n = 100) accepted ERAS concept and cluster nursing. Nursing satisfaction, comfort, self-efficacy, subjective well-being, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores were compared.

Results

The research group had 100% satisfaction rate; the control group had 87% satisfaction rate. After nursing, the scores of comforts and self-efficacy of the two groups increased and the scores of comforts and self-efficacy of the research group were higher than those of the control group. After nursing, the scores of subjective well-being of the two groups increased. Furthermore, the higher scores of life satisfaction, interpersonal harmony, and self-efficacy in the research group were found. There was no significant difference in the scores of SAS and SDS between the two groups before nursing (P > 0.05), but after nursing, the scores of SAS and SDS in the two groups decreased, and the scores of SAS and SDS in the research group were lower than those in the control group, and there are statistically significant differences between the groups (P < 0.05). The scores of visual analogue score (VAS) and numerical rating scale (NRS) following intervention decreased, and there are statistically significant differences between the groups (P < 0.05). The less physiological, psychological, social functions, and health self-cognition in the research group were displayed, and there are statistically significant differences between groups (P < 0.05).

Conclusion

The adoption of the concept of ERAS and cluster nursing can effectively improve the psychological state and pain score of oral outpatients undergoing root canal therapy, improve comfort and self-efficacy, and enhance subjective well-being and quality of life. ERAS and cluster nursing is of great significance in relieving pain after root canal therapy in the outpatient department, reducing patients' pain and improving patients' quality of life.

A critical analysis of research methods and experimental models to study root canal fillings

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.