In vitro evaluation of root canals obturated with four different techniques

Abstract

After cleaning and shaping of the root canal the final objective of the endodontic procedure is to obtain a three-dimensional obturation of the root canal space with a fluid-tight seal at the apical foramen. The objective of this in vitro study was to evaluate four different obturation techniques in respect of: • the radiographic quality of root canal obturation, • apical leakage and • the potential of these techniques to obdurate lateral canals One hundred and sixty canals were prepared by using RaCe nickel titanium rotary files to a size 30 with 6% taper. During preparation irrigation was done with TopClear Solution (17% EDTA and 0.2% cetremide) and ChlorXTRA (6% sodium hypochlorite). The canals were divided in four groups of forty canals each and were obturated using the Hybrid Root SEAL technique, the EndoREZ technique, the System B/Obtura technique and the Thermafil technique. The Radiographic Quality of Root Canal Obturation: Digital radiographs were taken of the four groups of obturated canals from a buccolingual and a mesiodistal direction. The quality of obturation was determined for the coronal and apical halves of each canal and scored according to radiographic appearances. The data was tabulated and statistically analyzed using the Mann- Whitney U test. The Hybrid Root SEAL technique demonstrated a statistically significant higher number of radiographic defects in the coronal aspects of the root canals when compared to the System B/Obtura and Thermafil techniques (p<0.05). There was no statistically significant difference between the radiographic defects in the coronal aspects of the root canals between Hybrid Root SEAL and EndoREZ techniques (p>0.05). The Hybrid Root SEAL technique demonstrated a statistically significantly higher number of radiographic defects in the apical aspects of the root canals compared to all the other groups (p<0.05). Apical Leakage: Twenty obturated canals of each of the four groups were processed for evaluation of apical leakage. The root surfaces were coated with nail varnish and sticky wax, leaving 4.0 mm around the apical foramen exposed. Specimens were immersed in 2% methylene blue dye for 48 hours, rinsed in distilled water and embedded in clear acrylic resin. Specimens were sectioned horizontally in 1 mm increments and the extent of dye penetration was measured to the nearest millimeter using a stereomicroscope. The data was tabulated and statistically analyzed using the Man-Whitney U test. The specimens that were obturated with the EndoREZ technique demonstrated the least apical leakage compared to all the other groups tested in this study. However, there was only a statistically significant difference when the EndoREZ technique was compared to the Hybrid Root SEAL and System B/Obtura techniques (p<0.05). The specimens that were obturated with the System B/Obtura technique demonstrated the most apical leakage compared to all the other groups tested in this study. However, there was only a statistically significant difference when the System B/Obtura technique was compared to the EndoREZ and Thermafil techniques (p<0.05). The Potential to Seal Lateral Canals: Twenty obturated canals of each of the four groups were processed for evaluation of the potential to seal lateral canals. The specimens were subjected to a clearing technique and a morphological analysis was performed using a stereomicroscope. Lateral canals were counted and graded within the coronal, middle and apical thirds of the roots. The data was tabulated and statistically analyzed using the Man-Whitney U test. The Thermafil technique demonstrated the greatest number of filled lateral canals. However, there was no statistically significant difference between the Thermafil technique and all the other techniques (p<0.05).