Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University of Strasbourg, 67000, Strasbourg, France.
Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000, Strasbourg, France.
Clin Oral Investig. 2021 Jun;25(6):3757-3765. doi: 10.1007/s00784-020-03703-9. Epub 2020 Nov 26.
The aim of this study was to assess the filling quality of five obturation techniques in oval-shaped root canals.
A total of 212 mandibular first molars with one distal oval canal were selected. Distal canals, shaped with WaveOne Gold Primary, were randomly divided in five groups (n = 40) for obturation: continuous wave condensation, GuttaCore, Thermafil, single cone with AH plus, and single cone with BioRoot RCS. The proportions of gutta-percha-filled areas (GPFA), sealer-filled areas (SFA), void areas (VA), and the sealer/gutta tags into dentinal tubules at 4 mm and 2 mm from the apex were analyzed by an optical numeric microscope, SEM, and energy-dispersive X-ray (EDX). Data were then compared by Kruskal-Wallis one-way ANOVA on ranks (α = 0.05).
At 4 mm, a statistically significant higher GPFA and lower SFA were observed in the GuttaCore and Thermafil groups compared with the 3 other groups. A statistically significant lower VA was observed in the continuous wave condensation, GuttaCore, and Thermafil groups than in the two single-cone groups. At 2 mm, there were a statistically significant higher GPFA and lower SFA and VA in GuttaCore and Thermafil groups than in the 3 other groups. At the two levels investigated, the presence of gutta-percha tags was clearly demonstrated for GuttaCore and Thermafil groups; no tags were observed in the 3 other groups.
Obturation quality was overall improved in GuttaCore and Thermafil groups.
Carrier-based techniques may significantly improve the filling quality compared to continuous wave condensation and single-cone technique. The single-cone technique might have inherent limitations especially in oval root canals regardless of the sealer used.
本研究旨在评估五种根管充填技术在椭圆形根管中的充填质量。
选择 212 颗下颌第一磨牙,每个磨牙有一个远中椭圆形根管。远中根管采用 WaveOne Gold Primary 进行塑形,然后随机分为五组(每组 40 个)进行根管充填:连续波冷凝、GuttaCore、Thermafil、单尖加 AH plus、单尖加 BioRoot RCS。采用光学数字显微镜、扫描电子显微镜和能谱仪(EDX)分析距根尖 4mm 和 2mm 处牙本质小管内的牙胶充填区比例(GPFA)、密封剂充填区比例(SFA)、空隙区比例(VA)和密封剂/牙胶标签。然后采用 Kruskal-Wallis 单向方差分析(α=0.05)对数据进行比较。
在 4mm 处,与其他 3 组相比,GuttaCore 和 Thermafil 组的 GPFA 显著较高,SFA 显著较低。连续波冷凝、GuttaCore 和 Thermafil 组的 VA 显著低于两个单尖组。在 2mm 处,GuttaCore 和 Thermafil 组的 GPFA、SFA 和 VA 显著低于其他 3 组。在两个研究水平上,GuttaCore 和 Thermafil 组均清楚地显示出牙胶标签的存在;其他 3 组则没有。
GuttaCore 和 Thermafil 组的根管充填质量总体上得到了提高。
与连续波冷凝和单尖技术相比,基于载体的技术可能显著提高充填质量。无论使用何种密封剂,单尖技术在椭圆形根管中可能都存在固有局限性。