Effect of customization of master gutta-percha cone on apical control of root filling using different techniques: an ex vivo study

By van Zyl SP, Gulabivala K, Ng YL.

Date: 09/2006
Journal: JOE

Summary:

  •Purpose:

(i) to compare the prevalence of extrusion of root filling material and voids within the apical 5 mm when placed using different obturation techniques (cold lateral compaction (CLC), warm vertical compaction’(WVC) or continuous-wave (CW);

(ii) to investigate effects of some factors on the prevalence of root filling extrusion and voids. 

•N= A total of 180 roots from extracted human teeth

•Materials/Methods:

Selection of teeth : randomly allocated Two groups of the roots were re-used to allow all five operators to use them.

Canal preparation: by one author. Each canal was prepared 0.5 mm from the AF to a minimum apical size of 30 &.06 taper using NiTi rotary instruments.

Obturation:  5 general dental practitioners.

Assessment: BL and MD digital RG, assess root apex under magnification & presence of voids within apical 5 mm.

•Most highlighted Results: 

1.80% of the root fillings were placed within 0.5 mm of the working length, only 20% were >0.5 mm beyond WL.

2.Extrusion >0.5 mm were significantly reduced ≈50% when cold lateral compaction or customization of GP were used.

3.Operator  emerged as the most significant factor affecting the prevalence of root filling extrusion. (Operator no. 5 produced 2.5 times more extrusion) 

4.Other factors such as root canal curvature & length, apical size of canal preparation, as well as the operator’s preferred obturation technique had no significant influence on the prevalence of extrusion.

5.The use of customization of master cone could reduce the odds of prevalence of voids by approximately 50%.  

Clinical significance:

Root filling extrusion was significantly influenced by ‘operator’ and was reduced by cold lateral compaction and customization of the master cone. Customization of master cone was the only factor that reduced voids apically.