Radiografische Analyse der Position von Guttaperchapoints vor und nach Sealerapplikation in final aufbereiteten Wurzelkanälen
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Abstract
Background and objective The aim of root canal treatment is to hermetically seal the root canal system after thorough chemomechanical cleaning. The length of the root canal filling is also crucial in this regard. Overfilling the canal can cause irritation to the periradicular tissues, while underfilling leaves gaps within the tooth where bacteria can persist or re-colonize. Therefore, it is essential to strictly adhere to the previously determined working length for root canal preparation during the obturation process. During endodontic treatments, a common issue arises where the carefully determined and fixed position of the gutta-percha master points becomes difficult to reach after the insertion of a root canal sealer. It is assumed that the application of a root canal sealer may lead to a loss of the previously established working length. This study investigates the position of the gutta-percha points in fully prepared root canals both before and after sealer application, and also compares the effects of sealers from four different material classes. Material and method The experiment was conducted at the premises of Philipps University in Marburg. A total of 64 root canals from 51 teeth were mechanically prepared using the F360-system to an ISO size of 45, and the master points of the system were adapted to the same ISO size. The position of the master points within the canal was documented using twodimensional radiographs. After the insertion of a root canal sealer, the position of the master points was re-evaluated and compared with the previously recorded position. To ensure a consistent and reproducible position of the teeth during the X-ray procedure, the teeth were securely fixed in an appliance made from Lego bricks. Four different sealers, representing various material classes, were used in the experiment: • Sealergroup A: AH Plus Jet - Dentsply Sirona • Sealergroup B: Sealapex Xpress - Kerr • Sealergroup C: CeraSeal - Komet • Sealergroup D: Tubli-Seal Xpress - Kerr The X-ray images before and after sealer application were measured using ImageJ software. Results The statistical analysis revealed a loss of working length for all sealer groups compared to the previously recorded position of the master points. Isolated significant differences were observed within the sealer groups. The Games-Howell analysis identified significant differences between the AH Plus Jet and CeraSeal groups (p = 0.016*) as well as between the Tubli-Seal Xpress and CeraSeal groups (p = 0.025*). Analyzing the mean values of the groups, the use of CeraSeal resulted in the greatest deviation from the original length (-1.19). The next largest deviations were observed in the Sealapex Xpress sealer group (-0.60). Comparable losses in working length were noted for the AH Plus Jet and Tubli-Seal Xpress groups, with deviations of -0.38 and -0.36, respectively. Conclusion In this experiment, variations in the position of the master point in the final prepared root canal were observed before and after the application of the sealer. Significant differences between the sealer groups were only noted in two instances. It is likely that factors such as the initial fit of the master point, the film thickness, viscosity, and particle size of the sealers used influence the position of the master point after application. Further research on this topic could provide valuable insights and contribute to enhancing the clinical success of endodontic treatments.
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Issued: 0021-04-26
Faculty
FB20:Medizin
Language
de
Keywords
Endodontie
DFG-subjects
2.22-28 - Zahnheilkunde; Mund-, Kiefer- und Gesichtschirurgie
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Rösler, Larissa: Radiografische Analyse der Position von Guttaperchapoints vor und nach Sealerapplikation in final aufbereiteten Wurzelkanälen. : 0021-04-26. DOI: https://doi.org/10.17192/openumr/676.
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