Department of Endodontics, Fluminense Federal University, Niterói, Brazil.
Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil.
Int Endod J. 2022 Apr;55 Suppl 2:384-445. doi: 10.1111/iej.13713. Epub 2022 Mar 13.
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11 000 articles, an impressive number that is much higher than "root canal disinfection" (5544 articles) or even the popular "root canal preparation" (8527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. As filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
根管充填材料和技术一直是牙髓学中研究最多的课题之一。在 PubMed 中使用主题词“根管充填”进行简单搜索，就发现了超过 11000 篇文章，这个令人印象深刻的数字远高于“根管消毒”（5544 篇文章），甚至高于热门的“根管预备”（8527 篇文章）。根管充填术之所以被如此重视，不仅仅是因为直观的原因。这是因为根据回顾性临床数据中常见射线照片上的白线出现，根管充填的质量被认为是治疗失败（愈合不良）的主要原因之一。自华盛顿研究发表以来，人们已经做出了令人印象深刻的努力，以开发新材料和技术，并开发了大量的实验室方法来评估根管充填的质量。本文旨在讨论和评估根管充填的最相关的实验室方法。由于纵向临床研究报告称，根管充填质量的提高并未转化为更高的成功率，因此，本文不仅仅是基于方法的简单综述，还旨在对用于研究充填材料和技术的实验室方法进行深入的批判性评估。最近的数据表明，根管封闭剂在长期的尺寸稳定性/随时间降解方面在治疗效果中起着核心作用。在这种情况下，实验室方法的开发应侧重于至少在一定程度上预测根管充填的长期临床行为，而不仅仅是对不同材料或技术进行排序。
