Mathur Rachit, Sharma Medhavi, Sharma Deepak, Raisingani Deepak, Vishnoi Suchita, Singhal Deepika, Grover Shekhar
Senior Lecturer, Department of Endodontics, Mahatma Gandhi Dental College , Jaipur, Rajasthan, India .
Reader, Department of Endodontics, Mahatma Gandhi Dental College , Jaipur, Rajasthan, India .
J Clin Diagn Res. 2015 Dec;9(12):ZC13-7. doi: 10.7860/JCDR/2015/15796.6931. Epub 2015 Dec 1.
Coronal and apical leakage still remains one of the most important cause for endodontic failure in spite of the presence of advanced endodontic materials. The cause may attribute to different filling techniques, physical and chemical properties of sealers and presence or absence of smear layer assessment of coronal or apical leakage is used as a research method to compare the sealing ability of different techniques and endodontic materials.
To compare the coronal bacterial leakage using methylene blue in four different obturation techniques after protaper hand instrumentation.
Ninety extracted single-rooted teeth were instrumented to an apical preparation size F3 Protaper hand files. Twenty teeth were randomly obturated with lateral compaction, 20 with vertical compaction, 20 with combination of vertical and lateral compaction and 20 with Thermafil. Ten teeth were used for positive and negative controls (five teeth in each group). Teeth were kept in 100% humidity for 90 days, and then subjected coronally to Proteus vulgaris for 21 days to assess bacterial leakage. After bacterial challenge, methylene blue was placed coronally for another 21 days, and then scoring was done according to depth of dye leakage. Chi-square test was done for statistical analysis.
Leakage as observed with combination of vertical and lateral compaction was significantly less than vertical compaction, lateral compaction and thermafil carriers during bacterial challenge. However, when dye was used it also showed statistically significant results with thermafil carriers showing the least leakage in comparison to vertical condensation, lateral condensation and combined groups.
The study concludes that two different methods i.e. bacterial and dye leakage revealed considerable variation on the same substrate Thus, due to the presence of variability among the results obtained by two different analytical methods used in the present study, the study emphasizes the need for standardization of methods as the lack of standardization hinders the comparison of different endodontic filling techniques.
尽管有先进的牙髓治疗材料,但冠部和根尖部渗漏仍是牙髓治疗失败的最重要原因之一。其原因可能归因于不同的充填技术、封闭剂的物理和化学性质以及玷污层的有无。冠部或根尖部渗漏的评估被用作一种研究方法,以比较不同技术和牙髓治疗材料的封闭能力。
在使用Protaper手动器械预备后,比较四种不同充填技术下使用亚甲蓝检测的冠部细菌渗漏情况。
90颗拔除的单根牙用Protaper手动锉预备至根尖F3尺寸。20颗牙随机采用侧方加压充填,20颗采用垂直加压充填,20颗采用垂直和侧方加压联合充填,20颗采用热牙胶充填。10颗牙用作阳性和阴性对照(每组5颗牙)。将牙齿置于100%湿度环境中90天,然后冠部接种普通变形杆菌21天以评估细菌渗漏。细菌攻击后,再在冠部放置亚甲蓝21天,然后根据染料渗漏深度进行评分。采用卡方检验进行统计分析。
在细菌攻击期间,垂直和侧方加压联合充填观察到的渗漏明显少于垂直加压、侧方加压和热牙胶充填。然而,当使用染料时,热牙胶充填组与垂直加压、侧方加压及联合组相比渗漏最少,也显示出统计学显著结果。
该研究得出结论,即细菌渗漏和染料渗漏这两种不同方法在同一底物上显示出相当大的差异。因此,由于本研究中使用的两种不同分析方法所获得的结果存在变异性,该研究强调方法标准化的必要性,因为缺乏标准化会阻碍不同牙髓充填技术的比较。