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。
