Effectiveness of different obturation techniques in surpassing the ledge formed in simulated curved canals

Abstract

AIM: To compare the effectiveness of different obturation techniques in surpassing the ledge formed in simulated curved root canals. METHODS: Eighty acrylic-resin blocks with curved canals were instrumented with Gates-Glidden drills to simulate a ledge formation. Then, a K-File #10 was used for trying to surpass the deviation, and the blocks that permitted surpassing were rejected. The remaining blocks were divided into 4 groups according to the obturation technique: lateral condensation, Tagger's Hybrid technique, Thermafil and System B. The blocks had their images digitalized using a scanner before and after the obturation procedures. The images were analyzed with Image Tool 3.0 software. Statistical analysis was performed by one-way ANOVA at a significant level of 5%. RESULTS: The System B resulted in the highest obturated area (p<0.001). There were no significant differences between the Tagger's Hybrid technique and Thermafil system regarding the effectiveness in surpassing ledge (p>0.05). The lateral condensation resulted in the worst ability in filling the ledge space (p<0.001). CONCLUSIONS: Within the limitations of this study, it was possible to conclude that techniques using heat condensation or gutta-percha thermoplastification were more effective in surpassing the ledge formed in curved canals than the lateral condensation.

endodontics; root canal therapy; root canal obturation; root canal filling materials

• ¹
  Schafer E, Nelius B, Burklein S. A comparative evaluation of gutta-percha filled areas in curved root canals obturated with different techniques. Clin Oral Investig. 2012; 16: 225-30.
• ²
  Goldberg F, Artaza LP, De Silvio A. Effectiveness of different obturation techniques in the filling of simulated lateral canals. J Endod. 2001; 27: 362-4.
• ³
  Burklein S, Benten S, Schafer E. Shaping ability of different single-file systems in severely curved root canals of extracted teeth. Int Endod J. 2013; 46: 590-7.
• ⁴
  Jafarzadeh H, Abbott PV. Ledge formation: review of a great challenge in endodontics. J Endod. 2007; 33: 1155-62.
• ⁵
  Kapalas A, Lambrianidis T. Factors associated with root canal ledging during instrumentation. Endod Dent Traumatol. 2000; 16: 229-31.
• ⁶
  Terauchi Y. Correction of ledged canals with ultrasonic tips. Dent Today. 2008; 27: 140: 2-5.
• ⁷
  Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J Endod. 1997; 23: 533-4.
• ⁸
  Vire DE. Failure of endodontically treated teeth: classification and evaluation. J Endod. 1991; 17: 338-42.
• ⁹
  Peters LB, Wesselink PR, Moorer WR. The fate and the role of bacteria left in root dentinal tubules. Int Endod J. 1995; 28: 95-9.
• ¹⁰
  De Deus G, Murad CF, Reis CM, Gurgel-Filho E, Coutinho Filho T. Analysis of the sealing ability of different obturation techniques in oval-shaped canals: a study using a bacterial leakage model. Braz Oral Res. 2006; 20: 64-9.
• ¹¹
  Bernardineli N. Accidents and complicantions in instrumentation. In: Bramante CM, Berbert A, Bernardineli N, Moraes IG, editors. Accidents and complications in endodontic treatment - clinical solutions. São Paulo: Santos Publishing; 2003: p.50-106.
• ¹²
  Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J. 2005; 38: 725-34.
• ¹³
  Greene KJ, Krell KV. Clinical factors associated with ledged canals in maxillary and mandibular molars. Oral Surg Oral Med Oral Pathol. 1990; 70: 490-7.
• ¹⁴
  Santos SMC, Soares JA, César CAS, Brito-Júnior M, Moreira AN, Magalhães CS. Radiographic quality of root canal fillings performed in a postgraduate program in Endodontics. Braz Dent J. 2010; 21: 315-21.
• ¹⁵
  Goerig AC, Michelich RJ, Schultz HH. Instrumentation of root canals in molar using the step-down technique. J Endod. 1982; 8: 550-4.
• ¹⁶
  Torabinejad M. Passive step-back technique. Oral Surg Oral Med Oral Pathol. 1994; 77: 398-401.
• ¹⁷
  Burroughs JR, Bergeron BE, Roberts MD, Hagan JL, Himel VT. Shaping ability of three nickel-titanium endodontic file systems in simulated S-shaped root canals. J Endod. 2012; 38: 1618-21.
• ¹⁸
  Goldberg M, Dahan S, Machtou P. Centering ability and influence of experience when using WaveOne single-file technique in simulated canals. Int J Dent. 2012; 2012: 206-321.
• ¹⁹
  Hamze F, Honardar K, Nazarimoghadam K. Comparison of two canal preparation techniques using mtwo rotary instruments. Iran Endod J. 2011; 6: 150-4.
• ²⁰
  Lam TV, Lewis DJ, Atkins DR, Macfarlane RH, Clarkson RM, Whitehead MG, et al. Changes in root canal morphology in simulated curved canals over-instrumented with a variety of stainless steel and nickel titanium files. Aust Dent J. 1999; 44: 12-9.
• ²¹
  Marciano MA, Bramante CM, Duarte MA, Delgado RJ, Ordinola-Zapata R, Garcia RB. Evaluation of single root canals filled using the lateral compaction, tagger's hybrid, microseal and guttaflow techniques. Braz Dent J. 2010; 21: 411-5.
• ²²
  Dummer PM. Comparison of undergraduate endodontic teaching programmes in the United Kingdom and in some dental schools in Europe and the United States. Int Endod J. 1991; 24: 169-77.
• ²³
  Dummer PM, Kelly T, Meghji A, Sheikh I, Vanitchai JT. An in vitro study of the quality of root fillings in teeth obturated by lateral condensation of gutta-percha or Thermafil obturators. Int Endod J. 1993; 26: 99-105.
• ²⁴
  Gulabivala K, Holt R, Long B. An in vitro comparison of thermoplasticised gutta-percha obturation techniques with cold lateral condensation. Endod Dent Traumatol. 1998; 14: 262-9.
• ²⁵
  Luccy CT, Weller RN, Kulild JC. An evaluation of the apical seal produced by lateral and warm lateral condensation techniques. J Endod. 1990; 16: 170-2.
• ²⁶
  Brosco VH, Bernardineli N, Moraes IG. "In vitro" evaluation of the apical sealing of root canals obturated with different techniques. J Appl Oral Sci. 2003; 11: 181-5.
• ²⁷
  Mann SR, McWalter GM. Evaluation of apical seal and placement control in straight and curved canals obturated by laterally condensed and thermoplasticized gutta-percha. J Endod. 1987; 13: 10-7.
• ²⁸
  Clinton K, Van Himel T. Comparison of a warm gutta-percha obturation technique and lateral condensation. J Endod. 2001; 27: 692-5.
• ²⁹
  Peng L, Ye L, Tan H, Zhou X. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis. J Endod. 2007; 33: 106-9.
• ³⁰
  Beasley RT, Williamson AE, Justman BC, Qian F. Time required to remove guttacore, thermafil plus, and thermoplasticized gutta-percha from moderately curved root canals with protaper files. J Endod. 2013; 39: 125-8.
• ³¹
  Buchanan LS. The continuous wave of obturation technique: 'centered' condensation of warm gutta-percha in 12 seconds. Dent Today. 1996; 15: 60-2, 64-7.
• ³²
  Zhang W, Suguro H, Kobayashi Y, Tsurumachi T, Ogiso B. Effect of canal taper and plugger size on warm gutta-percha obturation of lateral depressions. J Oral Sci. 2011; 53: 219-24.
• ³³
  Guess GM, Edwards KR, Yang ML, Iqbal MK, Kim S. Analysis of continuous-wave obturation using a single-cone and hybrid technique. J Endod. 2003; 29: 509-12.
• ³⁴
  Jung IY, Lee SB, Kim ES, Lee CY, Lee SJ. Effect of different temperatures and penetration depths of a System B plugger in the filling of artificially created oval canals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 453-7.

Publication Dates

• Publication in this collection
  19 July 2013
• Date of issue
  June 2013

History

• Received
  10 Apr 2013
• Accepted
  25 June 2013