Yang Ruiqi, Tian Jun, Huang Xiangya, Lei Shuxiang, Cai Yanling, Xu Zhezhen, Wei Xi
Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Hospital of Stomatology Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou, 510055, Guangdong, China.
Guangdong Province Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
Clin Oral Investig. 2021 Jun;25(6):4163-4173. doi: 10.1007/s00784-020-03747-x. Epub 2021 Feb 26.
This study aimed to evaluate dentinal tubule penetration and the retreatability of EndoSequence BC Sealer HiFlow (HiFlow), iRoot SP, and AH Plus when using the single-cone (SC) or continuous wave condensation (CWC) technique.
Sixty-five single-rooted teeth were instrumented and randomly divided into 5 groups: group 1, AH Plus/CWC; group 2, iRoot SP/CWC; group 3, iRoot SP/SC; group 4, HiFlow/CWC; and group 5, HiFlow/SC. The ability to re-establish patency during endodontic retreatment was recorded, as was the time taken to reach the working length. Dentinal tubule penetration and remaining debris after retreatment were evaluated by confocal microscopy and scanning electron microscopy. Data were analyzed by Kruskal-Wallis test and Dunn's multiple comparisons test (α = 0.05).
The HiFlow/CWC and iRoot SP/CWC groups required more time to reach the working length than groups that underwent the SC technique regardless of the sealer used (P < .05). The HiFlow/CWC group showed a significantly higher percentage of sealer penetration area than that of the iRoot SP/SC at 4 mm from the apex (P < .05) and penetrated deeper into dentinal tubules than iRoot SP/SC at both 8-mm and 12-mm levels (P < .05). Moreover, the HiFlow/CWC and HiFlow/SC groups demonstrated less remaining sealer along the canal wall than AH Plus/CWC group at 4-mm level (P < .05).
HiFlow/CWC technique showed better performance in dentinal tubule penetration than that of iRoot SP/SC. Both HiFlow and iRoot SP combined with CWC technique groups required more retreatment time than the other groups. Furthermore, using HiFlow with either the CWC or SC technique left less remaining sealer at 4-mm level than using AH Plus with the CWC technique during retreatment.
With favorable performance in dentinal tubule penetration and retreatability in endodontic retreatment, the combined use of EndoSequence BC Sealer HiFlow with the recommended continuous wave condensation technique may be a worthwhile choice in root canal treatment.
本研究旨在评估使用单锥法(SC)或连续波热凝牙胶技术(CWC)时,EndoSequence BC Sealer HiFlow(HiFlow)、iRoot SP和AH Plus对牙本质小管的渗透情况以及再治疗的可行性。
选取65颗单根牙进行预备,随机分为5组:第1组,AH Plus/CWC;第2组,iRoot SP/CWC;第3组,iRoot SP/SC;第4组,HiFlow/CWC;第5组,HiFlow/SC。记录根管再治疗期间重新建立通畅的能力以及达到工作长度所需的时间。通过共聚焦显微镜和扫描电子显微镜评估再治疗后牙本质小管的渗透情况和残留碎屑。数据采用Kruskal-Wallis检验和Dunn多重比较检验进行分析(α = 0.05)。
无论使用何种封闭剂,HiFlow/CWC组和iRoot SP/CWC组达到工作长度所需的时间均比采用SC技术的组更长(P < 0.05)。HiFlow/CWC组在距根尖4 mm处的封闭剂渗透面积百分比显著高于iRoot SP/SC组(P < 0.05),在8 mm和12 mm水平处,其牙本质小管的渗透深度均大于iRoot SP/SC组(P < 0.05)。此外,在4 mm水平处,HiFlow/CWC组和HiFlow/SC组根管壁上的残留封闭剂少于AH Plus/CWC组(P < 0.05)。
HiFlow/CWC技术在牙本质小管渗透方面的表现优于iRoot SP/SC。HiFlow和iRoot SP与CWC技术联合使用的两组再治疗时间均比其他组更长。此外,在根管再治疗期间,HiFlow采用CWC或SC技术在4 mm水平处的残留封闭剂均少于AH Plus采用CWC技术。
EndoSequence BC Sealer HiFlow与推荐的连续波热凝牙胶技术联合使用,在根管再治疗中具有良好的牙本质小管渗透性能和再治疗可行性,可能是根管治疗中一个值得选择的方法。