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9 "Canal obturation"
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Review Article
Effect of endodontic sealer on postoperative pain: a network meta-analysis
Cynthia Maria Chaves Monteiro, Ana Cristina Rodrigues Martins, Alessandra Reis, Juliana Larocca de Geus
Restor Dent Endod 2023;48(1):e5.   Published online December 29, 2022
DOI: https://doi.org/10.5395/rde.2023.48.e5
AbstractAbstract PDFPubReaderePub

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.

Trial Registration

PROSPERO Identifier: CRD42020215314

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Research Articles
Micro-computed tomographic evaluation of a new system for root canal filling using calcium silicate-based root canal sealers
Mario Tanomaru-Filho, Fernanda Ferrari Esteves Torres, Jader Camilo Pinto, Airton Oliveira Santos-Junior, Karina Ines Medina Carita Tavares, Juliane Maria Guerreiro-Tanomaru
Restor Dent Endod 2020;45(3):e34.   Published online June 9, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e34
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer).

Materials and Methods

Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05).

Results

There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer.

Conclusions

The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.

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A micro-computed tomographic study of remaining filling materials of two bioceramic sealers and epoxy resin sealer after retreatment
KyungJae Kim, Da Vin Kim, Sin-Young Kim, SungEun Yang
Restor Dent Endod 2019;44(2):e18.   Published online April 26, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e18
AbstractAbstract PDFPubReaderePub
Objective

This study evaluated the presence of residual root canal filling material after retreatment using micro-computed tomography (micro-CT).

Materials and Methods

Extracted human teeth (single- and double-rooted, n = 21/each; C-shaped, n = 15) were prepared with ProFile and randomly assigned to three subgroups for obturation with gutta-percha and three different sealers (EndoSeal MTA, EndoSequence BC sealer, and AH Plus). After 10 days, the filling material was removed and the root canals were instrumented one size up from the previous master apical file size. The teeth were scanned using micro-CT before and after retreatment. The percentage of remaining filling material after retreatment was calculated at the coronal, middle, and apical thirds. Data were analyzed using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni post hoc correction.

Results

The tested sealers showed no significant differences in the percentage of remaining filling material in single- and double-rooted teeth, although EndoSeal MTA showed the highest value in C-shaped roots (p < 0.05). The percentage of remaining filling material of AH Plus and EndoSeal MTA was significantly higher in C-shaped roots than in single- or double-roots (p < 0.05), while that of BC sealer was similar across all root types. EndoSeal MTA showed the highest values at the apical thirds of single- and double-roots (p < 0.05); otherwise, no significant differences were observed among the coronal, middle, and apical thirds.

Conclusions

Within the limitations of this study, a large amount of EndoSeal MTA remained after retreatment, especially in C-shaped root canals.

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Bacterial leakage and micro-computed tomography evaluation in round-shaped canals obturated with bioceramic cone and sealer using matched single cone technique
Kallaya Yanpiset, Danuchit Banomyong, Kanet Chotvorrarak, Ratchapin Laovanitch Srisatjaluk
Restor Dent Endod 2018;43(3):e30.   Published online July 5, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e30
AbstractAbstract PDFPubReaderePub
Objectives

To evaluate sealing ability of root canals obturated with bioceramic-impregnated gutta percha cone (BCC) or gutta percha (GP), with bioceramic sealer (BCS) or AH Plus (AH; Dentsply-Maillefer), in roundly-prepared canals using matched single-cone technique, based on bacterial leakage test, and to analyze obturation quality using micro-computed tomography (CT) analysis.

Materials and Methods

Ninety-two distobuccal roots of maxillary molars were prepared using nickel-titanium files to apical size 40/0.06. The roots were divided into 4 groups (n = 20) that were obturated with a master cone and sealer: GP/AH, BCC/AH, GP/BCS, and BCC/BCS. Bacterial leakage model using Enterococcus faecalis was used to evaluate sealing ability for 60-day period. Obturated samples from each group (n = 4) were analyzed using micro-CT.

Results

All groups showed bacterial leakage at 20%–45% of samples with mean leakage times of 42–52 days. There were no significant differences in bacterial leakage among the groups. Micro-CT showed minimal gaps and voids in all groups at less than 1%.

Conclusions

In roundly-prepared canals, the single cone obturation with BCC/BCS was comparable to GP/AH for bacterial leakage at 60 days.

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Quantification of the tug-back by measuring the pulling force and micro computed tomographic evaluation
Su-Jin Jeon, Young-Mi Moon, Min-Seock Seo
Restor Dent Endod 2017;42(4):273-281.   Published online September 4, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.273
AbstractAbstract PDFPubReaderePub
Objectives

The aims of this study were to quantify tug-back by measuring the pulling force and investigate the correlation of clinical tug-back pulling force with in vitro gutta-percha (GP) cone adaptation score using micro-computed tomography (µCT).

Materials and Methods

Twenty-eight roots from human single-rooted teeth were divided into 2 groups. In the ProTaper Next (PTN) group, root canals were prepared with PTN, and in the ProFile (PF) group, root canals were prepared using PF (n = 14). The degree of tug-back was scored after selecting taper-matched GP cones. A novel method using a spring balance was designed to quantify the tug-back by measuring the pulling force. The correlation between tug-back scores, pulling force, and percentage of the gutta-percha occupied area (pGPOA) within apical 3 mm was investigated using µCT. The data were analyzed using Pearson's correlation analysis, one-way analysis of variance (ANOVA) and Tukey's test.

Results

Specimens with a strong tug-back had a mean pulling force of 1.24 N (range, 0.15–1.70 N). This study showed a positive correlation between tug-back score, pulling force, and pGPOA. However, there was no significant difference in these factors between the PTN and PF groups. Regardless of the groups, pGPOA and pulling force were significantly higher in the specimens with a higher tug-back score (p < 0.05).

Conclusions

The degree of subjective tug-back was a definitive determinant for master cone adaptation in the root canal. The use of the tug-back scoring system and pulling force allows the interpretation of subjective tug-back in a more objective and quantitative manner.

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Review Article
Thermal irritation of teeth during dental treatment procedures
Su-Jung Kwon, Yoon-Jung Park, Sang-Ho Jun, Jin-Soo Ahn, In-Bog Lee, Byeong-Hoon Cho, Ho-Hyun Son, Deog-Gyu Seo
Restor Dent Endod 2013;38(3):105-112.   Published online August 23, 2013
DOI: https://doi.org/10.5395/rde.2013.38.3.105
AbstractAbstract PDFPubReaderePub

While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues.

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Original Articles
Influence of plugger penetration depth on the area of the canal space occupied by gutta-percha
Young Mi Lee, Ho-young So, Young Kyung Kim, Sung Kyo Kim
J Korean Acad Conserv Dent 2006;31(1):66-71.   Published online January 31, 2006
DOI: https://doi.org/10.5395/JKACD.2006.31.1.066
AbstractAbstract PDFPubReaderePub

To evaluate the ratio of gutta-percha area in the canal after canal obturation with Continuous Wave of Condensation Technique (CWCT) with varying depths of plugger penetration, forty root canals of extracted human teeth were prepared up to size 40 of 0.06 taper with ProFile®. Canals of three groups were filled with CWCT with System B™ (Analytic Tech., USA) and different plugger penetration depths of 3, 5, or 7 mm from the apex. Canals of one group were filled with lateral condensation technique as a control. The filled teeth were cross-sectioned at 1, 2, and 3 mm levels from the apical foramen. The ratio of gutta-percha area in the canal was analyzed using Auto®Cad 2000. Data were analyzed with one-way ANOVA and Duncan's multiple range test.

At all levels, higher gutta-percha area ratio was found with deeper plugger penetration depth in CWCT, and cold lateral condensation group showed higher ratio than group of plugger penetration to apical 7 mm in CWCT.

At apical 1 mm and 2 mm levels, group of plugger penetration to apical 3 mm showed significantly higher gutta-percha area ratio than those of apical 7 mm and lateral condensation (p < 0.05).

It is concluded therefore that, under the conditions of the present study, deeper plugger penetration depth results in more favorable and efficient obturation in CWCT.

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Obturation efficiency of non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments
Eun-Ah Lee, Sung-Kyo Kim
J Korean Acad Conserv Dent 2005;30(2):79-85.   Published online March 31, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.2.079
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the obturation efficiency of a non-standardized gutta-percha cone in curved root canals prepared with 0.06 taper nickel-titanium instruments.

Sixty simulated curved root canals in clear resin blocks were prepared with crown-down technique using 0.06 taper rotary ProTaper™ and ProFile (Dentsply-Maillefer) until apical canal was size 30. Root canals were randomly divided into 4 groups of 15 blocks and obturated with cold-laterally compacted gutta-percha technique by using either a non-standardized size medium gutta-percha cone or an ISO-standardized size 30 one as a master cone. Gutta-percha area ratio were calculated at apical levels of 1, 3, and 5 mm using AutoCAD 2000 after cross-sectioning, and the data were analyzed with one-way and two-way ANOVAs and Duncan's multiple range test.

Non-standardized size medium cone groups showed significantly higher gutta-percha area ratio than standardized cone groups at all apical levels (p < 0.01).

Non-standardized cone groups used significantly less accessory cones than standardized cone groups (p < 0.01).

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COMPARISON OF APICAL SEAL WITH OR WITHOUT THE USE OF DENTIN ADHESIVE SYSTEM
Min-Jo Lee, Sang-Hyuk Park, Gi-Woon Choi
J Korean Acad Conserv Dent 2005;30(1):7-15.   Published online January 14, 2005
DOI: https://doi.org/10.5395/JKACD.2005.30.1.7
AbstractAbstract PDFPubReaderePub
ABSTRACT

The purpose of this study was to compare the sealing ability of root canal obturation with or without the use of dentin adhesive system. Forty extracted human teeth with one canal were selected and decoronated. The teeth were divided into two Groups. The obturation procedure of Group 1 was the same as that of Group 2 with the exception of dentin adhesive system. Group 2 were obturated with dentin adhesive system, AH-26, and gutta-percha.

After obturation, the teeth were immersed in methylene blue solution for 84 hours. The teeth were sectioned horizontally at 1.5 mm (Level 1), 2.0 mm (Level 2), 2.5 mm (Level 3) from the root apex using a low speed microtome. Distance of dye-penetrated surface and total dentinal surface were measured using SigmaScan Pro 5.0, and the ratio of dye-penetrated distance to the total dentinal distance was analyzed statistically by Mann-Whitney U-test.

In both groups, the mean leakage ratio was decreased cervically.

At level 1, there was no significant difference between group 1 and grpup 2 (p > 0.05).

At level 2 and 3, group 1 showed significantly higher mean leakage ratio than group 2 (p < 0.05). The results suggest that using dentin adhesive system in root canal obturation procedure reduces the apical microleakage.

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