155]
Original Article
Abstract
Aim: To evaluate the role of rotary root canal instrumentation followed by obturation with three different techniques and two
different materials on the incidence of dentinal defects.
Materials and Methods: One hundred and sixty mandibular premolars were divided into eight groups (n = 20). Group I
was left untreated and served as control. The other seven groups were prepared with profile rotary instruments till #40.06
taper. After preparation, group II was left unfilled, groups III, IV, and V were obturated with Gutta-percha and AH Plus sealer
using passive technique, lateral compaction and warm vertical compaction, respectively. Groups VI, VII, and VIII were
obturated with Resilon and Realseal sealer using passive technique, lateral compaction, and warm vertical compaction,
respectively. Roots were then sectioned at 3, 6, and 9 mm from the apex and inspected under a stereomicroscope (50)
for dentinal defects. Chi-square test was performed to compare the incidence of dentinal defects between the groups (P
< 0.05).
Results: The unprepared control group had no dentinal defects. The instrumentation group (group II) and the obturation group
(groups III-VIII) showed significantly more defects than the uninstrumented control group (group I) (P < 0.001). There was no
significant difference between the root canal obturating techniques (group III-VIII) when compared with the instrumentation
group (group II). On inter group comparison among the obturation groups the number of defects after lateral compaction with
Gutta-percha (group IV) was significantly larger than passive Gutta-percha obturation (group III) (P < 0.05).
Conclusions: The results suggest that root canal instrumentation significantly influenced the incidence of dentinal defects or
fracture. Dentinal defects were more significantly attributed to the role of root canal instrumentation rather than the type of
obturation technique or material. Lateral compaction with Gutta-percha significantly produces more defects than passive
Gutta-percha obturation.
Key words: Dentin defects; obturation techniques; resilon; real seal; root canal instrumentation; vertical root fracture
INTRODUCTION
Vertical root fracture (VRF) is defined as a complete or
incomplete fracture initiated from the root at any level,
usually directed bucco-lingually.[1] It is a catastrophic
complication during or after root canal treatment[2]
presenting a significant clinical problem, which is difficult
to diagnose and treat.[3] It is also well known that most
vertically fractured teeth, with no history of trauma have
been root filled.[2]
It is generally accepted that the strength of an endodontically
treated tooth is directly related to the amount of remaining
Website:
www.jcd.org.in
DOI:
10.4103/0972-0707.120968
522
[Downloaded free from http://www.jcd.org.in on Monday, November 16, 2015, IP: 117.233.3.155]
Group I
It served as control where no instrumentation and
obturation procedures were done.
Group II
Shaping and cleaning was standardized for Groups II, III, IV,
V, VI, VII, and VIII.
523
[Downloaded free from http://www.jcd.org.in on Monday, November 16, 2015, IP: 117.233.3.155]
A. No defect
B. Fracture
C. All other defects
A. No defect
B. Fracture
C. Other defects
Other defects is defined as all other craze lines observed
that did not reach the canal lumen or a partial crack
extending from the canal wall into the dentine without
reaching the outer surface of the root.
Statistical analysis
Storage of specimens
Roots were stored for a period of 1 week at 37C and 100%
humidity to allow the sealer to set.[16]
Examination of roots
RESULTS
DISCUSSION
a
524
[Downloaded free from http://www.jcd.org.in on Monday, November 16, 2015, IP: 117.233.3.155]
0
0
0
Gr-II
(n=20)
Gr-III P (GP)* Gr-IV L (GP)* Gr-V WV (GP) * Gr-VI P (Res)* Gr-VII L (Res)* Gr-VIII WV
(n=20)
(n=20)
(n=20)
(n=20)
(n=20)
(Res)* (n=20)
3
3
4
17
17
16
3
4
2
17
16
18
8
7
4
12
13
16
5
3
4
15
17
16
3
4
3
17
16
17
8
6
2
12
14
18
6
6
5
14
14
15
I- Instrumentation, P (GP)- Passive (Gutta-percha), L (GP)- Lateral (Gutta-percha), WV (GP)- Warm vertical (Gutta-percha), P (Res)- Passive (Resilon), L (Res)- Lateral
(Resilon), WV (Res)- Warm Vertical (Resilon).
Control
Instrumentation group
0
4
0
3
0
3
0.887
2
4
4
4
7
3
3
8
5
0.676
0.367
0.732
3
2
5
4
6
6
3
8
6
0.887
0.092
0.921
24
33
36
0.074
Many of the defects did not connect with the pulp space, and
were located in places away from direct contact with intracanal
instruments, which is in accordance with a previous study by
Wilcox et al.,[5] who speculated that the stresses generated from
inside the root canal are transmitted through the root to the
surface where they overcome bonds holding dentine together.
525
[Downloaded free from http://www.jcd.org.in on Monday, November 16, 2015, IP: 117.233.3.155]
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
CONCLUSION
20.
21.
ACKNOWLEDGEMENTS
25.
The authors wish to thank Dr. K. Kumanan and Dr. Palanisamy, Dept
of Animal Biotechnology, Madras Veterinary College for experimental
support and Dr. Ravanan for the statistical interpretation of the results.
REFERENCES
1.
2.
3.
526
18.
19.
22.
23.
24.