Next Article in Journal
Light Beam Scattering from the Metal Surface with a Complex Mono- and Two-Periodic Microstructure Formed with Femtosecond Laser Radiation
Previous Article in Journal
Study on Sliding Friction Coefficient in Block Element Method Based on Experimental Method
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Applied Sciences
Volume 14
Issue 19
10.3390/app14198661
applsci-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Evaluation of Gutta-Percha-Filled Areas in Curved and Straight Root Canals Using Three Reciprocating Single-File Systems Followed by Matching Single-Cone Obturation

by
Shakiba Arvaneh
1,
Shahpar Haghighat
2,
René Schwesig
3 and
Christian Ralf Gernhardt
1,*
1
University Outpatient Clinic for Conservative Dentistry and Periodontology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 16, 06112 Halle, Germany
2
ACECR Academic Center for Education, Culture and Research, Breast Cancer Research Center, Motamed Cancer Institute, No 146, South Gandi, Haghani St., Vanak Sq., Teheran P.O. Box 1517964311, Iran
3
Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle, Germany
*
Author to whom correspondence should be addressed.
Appl. Sci. 2024, 14(19), 8661; https://doi.org/10.3390/app14198661
Submission received: 12 August 2024 / Revised: 14 September 2024 / Accepted: 23 September 2024 / Published: 25 September 2024
(This article belongs to the Section Applied Dentistry and Oral Sciences)
Browse Figure
Versions Notes

Abstract

:
This study aimed to evaluate and compare the quality of matching single-cone obturation using three different single-file systems—WaveOne® Gold (Dentsply Sirona, Bensheim, Germany), Reciproc® blue (VDW GmbH, Munich, Germany), and Procodile® (Komet Medical, Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany). The evaluation focused on the percentage of gutta-percha-filled areas (PGFAs), sealer-filled areas (PSFAs), and unfilled areas (PUAs) across three different sections of curved and straight root canals. Sixty extracted human teeth were categorized into six groups. Based on radiographically determined root canal curvature, thirty curved and thirty straight root canals were prepared using the single-file systems according to the manufacturers’ instructions and obturated with matching gutta-percha cones using AH-Plus sealer. A total of 180 sections were evaluated digitally under the microscope and the results were statistically analyzed. The mean gutta-percha percentages for Reciproc® blue, Procodile®, and WaveOne® Gold were 83%, 82%, and 80%, respectively. No significant (p > 0.05) and relevant (ηp2 < 0.10) differences were found in the proportion of form-fitting gutta-percha cones between the systems in all sections. Similarly, canal anatomy showed no significant influence (p > 0.05). Ex vivo, all three systems showed comparable filling quality in all sections of curved and straight canals. Therefore, it can be concluded that all three file systems, in combination with their corresponding gutta-percha points, might be reliable methods for root canal obturation. Reciproc® Blue, Procodile®, and WaveOne® Gold consistently achieved comparable obturation results across various root configurations and levels of the root canal.

1. Introduction

Rotary and reciprocating instruments have revolutionized endodontic instrumentation by allowing a more efficient and faster root canal preparation [1]. Single-file systems maintain canal curvature, are associated with less instrument fractures, and allow a safe, fast, and more efficient root canal preparation than manual techniques [2,3]. Used in a carefully performed crown-down approach, both rotary and reciprocating single-file Ni-Ti instruments allow root canal preparations to be achieved with less straightening and acceptable apical debris extrusion [2]. Despite its benefits due to the increased flexibility of rotary Ni-Ti systems, fracture due to torsional and cyclic fatigue is still a concern with NiTi files [4,5].
Yared [3] introduced the concept of reciprocating motion of a motorized NiTi system based on a balanced force technique. These instruments cut dentin in a counter-clockwise (CCW) direction and are immediately released in a clockwise (CW) reciprocating motion, rather than a rotating motion. Since the CW rotation is smaller than the CCW rotation, the instrument can advance into the root canal, reducing the risk of procedural errors (e.g., instrument fracture and canal transportation), preserving the original canal curvature effectively, and allowing the preparation of the majority of root canals without glide path preparation [6,7]. Nevertheless, the use of a glide path in a curved canal before the reciprocating single-file system is recommended due to the reduction in apical canal transportation [8,9]. There are several reciprocating single-file systems on the market, including WaveOne® Gold (Dentsply Sirona Deutschland GmbH, Bensheim, Germany), Reciproc® blue (VDW GmbH, Munich, Germany), and Procodile® (Komet Medical Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany), which demonstrate promising results in terms of reduced preparation time and a lower incidence of procedural errors [10,11,12,13,14]. Root canal preparation, coupled with a matching-taper single-cone obturation technique, offers a dependable means of shaping the root canal, resulting in fewer procedural errors and more satisfactory filling quality in terms of length and homogeneity, particularly in the apical third [15]. Obturated root canals using reciprocating file-matched single cones demonstrate comparable quality to other obturation techniques like lateral condensation, along with similar healing rates for apical lesions [16,17]. They also prove to be faster than traditional lateral condensation [18,19,20].
Therefore, the aim of this study was to compare three different single-cone obturation techniques regarding the portion of gutta-percha-filled areas (PGFAs), sealer-filled areas (PSFAs), and unfilled areas (PUAs) across three different sections of curved and straight canals using the three different reciprocating single-file systems—Reciproc® blue, Procodile®, and WaveOne®—for root canal preparation and their corresponding matching gutta-percha cones for single-cone obturation. The hypothesis to be evaluated was that the performance of the three different files systems differs significantly, resulting in variations in the percentage of gutta-percha, sealer, and unfilled areas across different sections and configurations of the root canals. The null hypothesis to be tested was that all three companies perform well and that the percentage of gutta-percha, sealer, and unfilled areas is the same in all groups.

2. Materials and Methods

2.1. General Study Design

In this ex vivo study, we included 60 root canals from single- and multi-rooted permanent teeth extracted from humans that did not undergo previous endodontic treatment and had completed root growth. Before the experimental procedure and over the entire experimental period, the teeth and prepared samples were stored in sterile, physiological 0.9% saline solution (Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany) at room temperature. The study protocol and the use of extracted teeth received approval from the Ethics Committee of Martin-Luther-University Halle-Wittenberg, Halle, Germany (protocol number: 2024-023). All patients received verbal and written information on the study and signed consent forms prior to extraction.

2.2. Sample Selection

Teeth with root caries or root fractures as well as teeth that had undergone endodontic treatment or root apex resection were excluded. Single-rooted teeth were decoronated, while the roots of multi-rooted teeth were separated using diamond burs (Komet Dental Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany). This allows for an initial visual inspection of the root canal form. Subsequently, the initial apical file, working length, and root curvature were determined and illustrated radiographically using sterile size 10 and 15 K- and Hedstroem-Files (VDW GmbH, Munich, Germany). Furthermore, in order to minimize the influence of anatomical variations and root canal configurations, roots with an initial apical file greater than size 15 were excluded. The root curvature was determined using Schneider’s method [21]. Canals with 0° to 5° and canals with 10° to 20° were classified as straight and curved, respectively. Teeth with a root curvature exceeding 20° and those that presented two canals as well as oval or irregularly formed canals were also excluded from this study.

2.3. Sample Population

In this study, the obturation quality of three single-file systems and their corresponding gutta-percha points were compared using a single-cone obturation technique. Therefore, the sixty included roots were randomly classified into six groups based on root canal curvature and file system. Root canals were prepared with file size 25, since this size was available in all three reciprocating single-file systems. Accordingly, 20 roots (10 curved, 10 straight) were prepared per single-file system according to the manufacturers’ instructions and filled with their prefabricated matching gutta-percha point and AH-Plus sealer (Dentsply Sirona Deutschland GmbH, Bensheim, Germany). Subsequently, these roots were examined in the apical, middle, and coronal section. This resulted in 30 samples per file system and configuration, and a total of 180 samples in the population.

2.4. Root Canal Preparation and Obturation

In each of the six groups, the canals were prepared with a reciprocating technique and a slow in-and-out pecking motion according to the manufacturers’ instructions using a calibrated endodontic motor (VDW GmbH, Munich, Germany) with the variably tapered nickel–titanium Procodile®, WaveOne® Gold, and Reciproc® blue. Following a standardized protocol, a new single-file system from the respective groups was used for each canal, ensuring that the same conditions were present in all specimens. This involved alternating storage and irrigation using sterile 0.9% sodium chloride (NaCl) solution (Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany), 3% sodium hypochlorite (NaOCl) solution (Aug. Hedinger GmbH & Co. KG, Stuttgart, Germany), and 20% Ethylendiamintetraacetat (EDTA) solution (Speiko—Dr. Speier GmbH, Bielefeld, Germany). Finally, a sonic-activated flush using EDDY™ (VDW GmbH, Munich, Germany) was performed [22]. During the root canal preparation, 15 mL of sodium hypochlorite and 5 mL of EDTA were used for each root canal simulating the clinical situation. The canals were then dried using paper points (Coltène/Whaledent GmbH, Altstätten, Switzerland).
Subsequently, the fully prepared canals were filled using the corresponding shape-congruent, prefabricated gutta-percha points and AH-Plus sealer (Dentsply Sirona Deutschland GmbH, Bensheim, Germany) using the single-cone obturation technique. The sealer was placed using a Lentulo spiral (VDW Root Filler, VDW GmbH, Munich, Germany). After the canal orifices were covered with Tetric Evo Flow® (Ivoclar Vivadent GmbH, Ellwangen, Germany) composites, the samples were stored in sodium chloride for at least 24 h before further processing to ensure the complete curing of the root filling.

2.5. Evaluation and Statistical Analysis

After hardening, the samples were embedded in Technovit® (Kulzer GmbH, Hanau, Germany) resin. In the next step, three slices (each 1 mm thin) were taken from each root canal at intervals of 3 mm starting from the apex (i.e., 3 mm, 6 mm, and 9 mm) using a diamond band saw (EXAKT Advanced Technologies GmbH, Norderstedt, Germany).
All the sections were analyzed and digitally measured with a fluorescence microscope (Compact, Model series BZ-X, KEYENCE Deutschland GmbH, Neu-Isenburg, Germany) to assess the proportion of areas filled with gutta-percha, sealer, and unfilled areas (Figure 1). Thereafter, the data were statistically analyzed using SPSS program Version 28.0. (IBM®, Ehningen, Germany). The normality of outcomes was evaluated by the Kolmogorov–Smirnov test. Two-way ANOVA at a 5% significance level was used to evaluate differences between the results of all groups. Since the frequency of filling quality did not have a normal distribution, we compared the quantitative outcomes by the Kruskal–Wallis and Mann–Whitney tests between three and two groups of study at a 5% significance level, respectively. The filling quality had normal distribution in straight or curved shaped channels; thus, we compared this outcome between three companies by one-way ANOVA analysis at a 5% significance level.

3. Results

3.1. General Result per File System

The examination (Figure 1) showed that the canals after single-cone obturation using the matching gutta-percha points were, in total, 82%, 17%, and 1% filled with gutta-percha, sealer, and voids, respectively, regardless of the file system, canal configuration, and canal area. According to the Kruskal–Wallis test, there was no significant difference in the portion of gutta-percha-filled areas (PGFAs, p = 0.158), sealer-filled areas (PSFAs, p = 0.056), and unfilled areas (PUAs, p = 0.148) between the three systems (Table 1).

3.2. Results by Curvature

Regardless of the three different single-file and matching gutta-percha point systems and different root sections, the Mann–Whitney test shows no significant difference regarding PGFAs (p = 0.358), PSFAs (p = 0.345), and PUAs (p = 0.309) between the curved and straight canals processed with single-file systems size 25. However, straight canals have a slightly higher percentage of gutta-percha-filled areas, with 83% compared to curved canals with 81% (Table 2).
Regarding the three different systems, the root canal filling composition (PGFA, PSFA, PUA) showed no significant differences between curved and straight root canals (p > 0.05, Table 3).

3.3. Results per Canal Section

The results show that the coronal section is best filled with 85% gutta-percha, followed by the middle section with 82%, and the apical section with 79%. The middle section had the highest percentage of voids with 1.46%. Statistical analysis of the results shows no significant differences between the three systems with regard to PGFAs, PSFAs, and PUAs, neither in the apical section (p = 0.193, p = 0.091, and p = 0.133, respectively), nor in the middle section (p = 0.400, p = 0.85, and p = 0.223, respectively), nor coronally (p = 0.758, p = 0.840, and p = 0.513, respectively, Table 4).

4. Discussion

In the present study, the performance of three reciprocating single-file systems was investigated ex vivo based on their obturation quality with a matching single-cone gutta-percha point. The stated hypothesis, that the obturation performance of the three different systems differs significantly, resulting in variations in the percentage of gutta-percha, sealer, and unfilled areas across different sections and configurations of the root canals, had to be rejected. The results of the present investigation revealed no significant impact of the used system, the standardized root canal curvature, or the examined root canal section. Therefore, the null hypothesis, that all three systems showed no significant differences in the composition, could be confirmed. This means that single-cone obturation using matching gutta-percha points after root canal preparation with reciprocating single-file systems might help to achieve favorable results when focusing on the obturation composition.
The treatment steps for sample preparation, application of all materials, and the subsequent evaluation of the slices under the microscope were performed by one researcher, avoiding any influence by other persons. The endodontic treatment of the specimens followed a clinical recommended protocol including all clinical steps.
Prior studies suggest that root canal preparation followed by a matching-taper single-cone filling technique offers better shaping and root canal filling quality in the apical third compared to different cold and warm obturation methods, although results are less optimal in the central and cervical portions of the root canals [15,23]. The result of this study shows that the proportion of gutta-percha is highest in the coronal region at 85% and decreases apically (79%), while the proportion of sealer increases from coronal (14%) to apical (21%) regions.
This study shows that the middle area of the canal has the highest proportion of unfilled areas with 1.5%, which can be caused by irregular shapes of the canals or due to the sawing process under water cooling [24]. Additionally, these unfilled areas might be mainly created due the presence of debris after the instrumentation and irrigation of the root canal. The curved canals also have a larger proportion of cavities than the straight canals, although the difference is not significant. In this context, previous studies have shown that the AH-Plus exhibited higher leakage values than other gutta-percha containingand bioceramic sealers [25,26]. To improve the filling quality of the matching-taper single-cone technique in irregular canals, additional use of vertical and lateral condensation was recommended [15]. In our opinion, a combination of a shape-matched single-cone and isonormal gutta-percha points can also be an option for filling irregularly shaped canals. The bond strength of root canal fillings technique also appears to depend on the sealer [27]. The effect of irrigants on sealer bond strength was also investigated in prior studies. The epoxy resin-based AH-Plus sealer showed no impact in this context, whereas a methacrylate resin-based (RealSeal SE, SybronEndo, Orange, CA, United States) exhibited limitations [28]. Future studies may explore the influence of bioceramic sealers in this regard.
Although numerous studies regarding the composition of root canal fillings are available [29,30], the influence of obturation on clinical success is still discussed controversially and difficult to determine [17,31]. However, in terms of healing rates of periapical lesions, studies on single-cone obturation methods, using reciprocating file-matched single cones compared to other techniques for obturation, showed equivalent results regarding apical periodontitis healing after treatment [16,18]. So, regarding the clinical outcome, single-cone obturation might be comparable and seems to have no disadvantages compared to other techniques [17]. Future studies should compare the long-term outcomes of using reciprocating single-file systems in combination with matching gutta-percha points for obturation with regard to the healing rate of periapical lesions compared to other preparation and obturation techniques. The appropriate irrigation protocol, along with ultrasonic activation, can significantly impact these outcomes and should be carefully considered in this context [22,32]. The size of the periapical lesion is also highlighted as a crucial factor, as its growth significantly reduces the success of endodontic therapy [33].
A previous study, which compares variable- and constant-tapered single-cone gutta-percha obturation systems, shows that the area filled with gutta-percha is larger with the lateral condensation and single-cone technique with constant-tapered gutta-percha than with variable single-cone gutta-percha (ProTaper®, Reciproc®, WaveOne®) [34]. In another study that compares WaveOne Gold and Reciproc® Blue, it was found that Reciproc® Blue demonstrated superior adaptation and achieved ideal filling conditions more frequently, especially at 1 mm from the root apex and in the lingual wall. Despite observing larger spaces in the WaveOne® Gold group, these variances did not reach statistical significance [35]. In our study, no significant differences were found between WaveOne® Gold, Reciproc® Blue, and Procodile in terms of PGFA, PSFA, and PUA in different areas of the root canal. Reciproc® Blue shows a slightly better percentage of gutta-percha filling in all areas and in both curved and straight canals. Among these three products, Wave One® Gold has the lowest PGFA apically (3 mm from the root apex) with 76%, but the greatest proportion of sealer with zero voids.
A previous study indicated that Reciproc® Blue is more resistant to cyclic fatigue than WaveOne® [36,37,38]. In our study, no instrument fractures were detected in any of the single-file systems across all study periods. All three single-file systems demonstrated reliable methods for root canal preparation.
This study adds to the understanding of single-file root canal preparations combined with single-cone obturation techniques, affirming their safety and efficacy in root canal treatment across all three manufacturers, although the limitations of an ex vivo study compared to a clinical study should be considered. Despite attempts at standardization, the diameter, the configuration of root canals, the anatomical variations, and the different tapers of the used single-file instrumentation systems and their corresponding gutta-percha cones can influence the results [39]. In order to minimize the influence of these anatomical variations and root canal configurations, roots with an initial apical file greater than size 15 were excluded in the present study.
Furthermore, differences in dimensions between the file instruments and the cones should be taken into account [40]. Since in this study samples had to be discarded and replaced after evaluation under the microscope due to the canal configuration or anatomical variations like oval- or c-shaped canals, possible impacts on the results should be considered [41]. Despite the results of the present study, the clinical impact of the observed composition of single-cone root canal obturation on the outcome and healing of pulpal and periapical disease remains uncertain. Therefore, we propose clinical studies in prospective or at least retrospective design to evaluate different single-file systems in future studies [42]. The fact that the teeth were collected at different times, from various dentists, and without consistent consideration of the patients’ ages may introduce uncontrolled variability that could affect the consistency and reproducibility of the results.

5. Conclusions

Despite the limitations of an ex vivo study, it could be concluded that when focusing on the composition of the root canal fillings, the three reciprocating single-file systems used in combination with the corresponding gutta-percha points for single-cone obturation showed a high amount of gutta-percha-filled areas and similar results in all sections of curved and straight root canals.

Author Contributions

Conceptualization, C.R.G.; methodology, S.A. and C.R.G.; software, S.A., R.S. and C.R.G.; formal analysis, S.A., S.H. and C.R.G.; investigation, S.A.; resources, R.S. and C.R.G.; data curation, S.A., S.H. and C.R.G.; writing—original draft preparation, S.A. and C.R.G.; writing—review and editing, S.H., R.S. and C.R.G.; visualization, S.A. and S.H.; supervision, R.S. and C.R.G.; project administration, C.R.G.; funding acquisition, C.R.G. All authors have read and agreed to the published version of the manuscript.

Funding

This study was funded by Komet Dental, Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany (No.: KZE 31113578).

Institutional Review Board Statement

This study was conducted in accordance with the Declaration of Helsinki, and the use of extracted human teeth was approved by the Ethics Committee of Martin-Luther-University Halle-Wittenberg, Halle, Germany (protocol number: 2024-023, approved on 9 February 2024).

Informed Consent Statement

Informed consent was obtained from all subjects to use their teeth for dental laboratory research prior to extraction.

Data Availability Statement

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

Acknowledgments

We would like to extend our sincere gratitude to Angela Rosemeier (Medical Technical Assistant, Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg) for her invaluable support in sample preparation and the operation of the equipment. Her dedication and expertise greatly contributed to the success of our research.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Burklein, S.; Fluch, S.; Schafer, E. Shaping ability of reciprocating single-file systems in severely curved canals: WaveOne and Reciproc versus WaveOne Gold and Reciproc blue. Odontology 2019, 107, 96–102. [Google Scholar] [CrossRef]
  2. Burklein, S.; Donnermeyer, D.; Hentschel, T.J.; Schafer, E. Shaping Ability and Debris Extrusion of New Rotary Nickel-Titanium Root Canal Instruments. Materials 2021, 14, 1063. [Google Scholar] [CrossRef] [PubMed]
  3. Burklein, S.; Benten, S.; Schafer, E. Shaping ability of different single-file systems in severely curved root canals of extracted teeth. Int. Endod. J. 2013, 46, 590–597. [Google Scholar] [CrossRef] [PubMed]
  4. Bergmans, L.; Van Cleynenbreugel, J.; Wevers, M.; Lambrechts, P. Mechanical root canal preparation with NiTi rotary instruments: Rationale, performance and safety. Am. J. Dent. 2001, 14, 324–333. [Google Scholar] [PubMed]
  5. Guelzow, A.; Stamm, O.; Martus, P.; Kielbassa, A. Comparative study of six rotary nickel–titanium systems and hand instrumentation for root canal preparation. Int. Endod. J. 2005, 38, 743–752. [Google Scholar] [CrossRef]
  6. Bürklein, S.; Hinschitza, K.; Dammaschke, T.; Schäfer, E. Shaping ability and cleaning effectiveness of two single-file systems in severely curved root canals of extracted teeth: Reciproc and WaveOne versus Mtwo and ProTaper. Int. Endod. J. 2012, 45, 449–461. [Google Scholar] [CrossRef]
  7. Dhingra, A.; Ruhal, N.; Miglani, A. Evaluation of single file systems Reciproc, Oneshape, and WaveOne using cone beam computed tomography–an in vitro study. J. Clin. Diagn. Res. 2015, 9, ZC30. [Google Scholar] [CrossRef] [PubMed]
  8. Aydin, U.; Karataslioglu, E. Evaluation of canal transportation after preparation with Reciproc single-file systems with or without glide path files. J. Conserv. Dent. Endod. 2017, 20, 230–233. [Google Scholar] [CrossRef]
  9. Shi, L.; Yang, Y.; Wan, J.; Xie, W.; Yang, R.; Yao, Y. Shaping ability of rotary and reciprocating single-file systems in combination with and without different glide path techniques in simulated curved canals. J. Dent. Sci. 2022, 17, 1520–1527. [Google Scholar] [CrossRef]
  10. Bartols, A.; Robra, B.-P.; Walther, W. The ability of Reciproc instruments to reach full working length without glide path preparation: A clinical retrospective study. PeerJ 2017, 5, e3583. [Google Scholar] [CrossRef]
  11. Liang, Y.; Yue, L. Evolution and development: Engine-driven endodontic rotary nickel-titanium instruments. Int. J. Oral Sci. 2022, 14, 12. [Google Scholar] [CrossRef] [PubMed]
  12. Yared, G. Canal preparation using only one Ni-Ti rotary instrument: Preliminary observations. Int. Endod. J. 2008, 41, 339–344. [Google Scholar] [CrossRef] [PubMed]
  13. Yared, G. Canal preparation using one reciprocating instrument without prior hand filing: A new concept. Int. Dent. SA 2011, 2, 78–87. [Google Scholar]
  14. Yuan, G.; Yang, G. Comparative evaluation of the shaping ability of single-file system versus multi-file system in severely curved root canals. J. Dent. Sci. 2018, 13, 37–42. [Google Scholar] [CrossRef]
  15. Krug, R.; Krastl, G.; Jahreis, M. Technical quality of a matching-taper single-cone filling technique following rotary instrumentation compared with lateral compaction after manual preparation: A retrospective study. Clin. Oral Investig. 2017, 21, 643–652. [Google Scholar] [CrossRef]
  16. Winkler, A.; Adler, P.; Ludwig, J.; Hofmann, N.; Soliman, S.; Krastl, G.; Krug, R. Endodontic Outcome of Root Canal Treatment Using Different Obturation Techniques: A Clinical Study. Dent. J. 2023, 11, 200. [Google Scholar] [CrossRef]
  17. Radwanski, M.; Pietrzycka, K.; Eyuboglu, T.F.; Ozcan, M.; Lukomska-Szymanska, M. Clinical outcome of non-surgical root canal treatment using different sealers and techniques of obturation in 237 patients: A retrospective study. Clin. Oral Investig. 2024, 28, 479. [Google Scholar] [CrossRef]
  18. de Figueiredo, F.E.D.; Lima, L.F.; Oliveira, L.S.; Ribeiro, M.A.; Correa, M.B.; Brito-Junior, M.; Faria-e-Silva, A.L. Effectiveness of a reciprocating single file, single cone endodontic treatment approach: A randomized controlled pragmatic clinical trial. Clin. Oral Investig. 2020, 24, 2247–2257. [Google Scholar] [CrossRef] [PubMed]
  19. Gordon, M.; Love, R.; Chandler, N. An evaluation of. 06 tapered gutta-percha cones for filling of. 06 taper prepared curved root canals. Int. Endod. J. 2005, 38, 87–96. [Google Scholar] [CrossRef]
  20. Talabani, R.M. Management of apical periodontitis using WaveOne gold reciprocating files, single-cone endodontic approach: A case series. Ann. Med. Surg. 2021, 66, 102385. [Google Scholar] [CrossRef]
  21. Schneider, S.W. A comparison of canal preparations in straight and curved root canals. Oral Surg. Oral Med. Oral Pathol. 1971, 32, 271–275. [Google Scholar] [CrossRef]
  22. Plotino, G.; Cortese, T.; Grande, N.M.; Leonardi, D.P.; Di Giorgio, G.; Testarelli, L.; Gambarini, G. New technologies to improve root canal disinfection. Braz. Dent. J. 2016, 27, 3–8. [Google Scholar] [CrossRef] [PubMed]
  23. Rodrigues, A.; Bonetti-Filho, I.; Faria, G.; Andolfatto, C.; Camargo Vilella Berbert, F.L.; Kuga, M.C. Percentage of gutta-percha in mesial canals of mandibular molars obturated by lateral compaction or single cone techniques. Microsc. Res. Tech. 2012, 75, 1229–1232. [Google Scholar] [CrossRef]
  24. Nagy, C.; Bartha, K.; Bernath, M.; Verdes, E.; Szabo, J. The effect of root canal morphology on canal shape following instrumentation using different techniques. Int. Endod. J. 1997, 30, 133–140. [Google Scholar] [CrossRef]
  25. El Sayed, M.A.A.M.; Taleb, A.A.A.; Balbahaith, M.S.M. Sealing ability of three single-cone obturation systems: An: In-Vitro: Glucose leakage study. J. Conserv. Dent. Endod. 2013, 16, 489–493. [Google Scholar] [CrossRef] [PubMed]
  26. Kaul, S.; Kumar, A.; Badiyani, B.K.; Sukhtankar, L.; Madhumitha, M.; Kumar, A. Comparison of sealing ability of bioceramic sealer, AH Plus, and guttaflow in conservatively prepared curved root canals obturated with single-cone technique: An in vitro study. J. Pharm. Bioallied Sci. 2021, 13, S857–S860. [Google Scholar] [CrossRef] [PubMed]
  27. Araújo, C.C.C.; Brito-Júnior, M.; Faria-E-Silva, A.L.; Pereira, R.D.; Silva-Sousa, Y.T.; Cruz-Filho, A.M.; Sousa-Neto, M.D. Root filling bond strength using reciprocating file-matched single-cones with different sealers. Braz. Oral Res. 2016, 30, e53. [Google Scholar] [CrossRef]
  28. Stelzer, R.; Schaller, H.-G.; Gernhardt, C.R. Push-out bond strength of RealSeal SE and AH Plus after using different irrigation solutions. J. Endod. 2014, 40, 1654–1657. [Google Scholar] [CrossRef]
  29. Gernhardt, C.R.; Kruger, T.; Bekes, K.; Schaller, H.G. Apical sealing ability of 2 epoxy resin-based sealers used with root canal obturation techniques based on warm gutta-percha compared to cold lateral condensation. Quintessence Int. 2007, 38, 229–234. [Google Scholar]
  30. Barcelos So, G.; Abrahao, N.B.; Weissheimer, T.; Lenzi, T.L.; Reis So, M.V.; da Rosa, R.A. Effect of Obturation Techniques on the Quality of Root Canal Fillings: A Systematic Review and Meta-analysis of In Vitro Studies. Iran. Endod. J. 2024, 19, 61–74. [Google Scholar] [CrossRef]
  31. Pirani, C.; Camilleri, J. Effectiveness of root canal filling materials and techniques for treatment of apical periodontitis: A systematic review. Int. Endod. J. 2023, 56 (Suppl. 3), 436–454. [Google Scholar] [CrossRef] [PubMed]
  32. Ruddle, C.J. Endodontic disinfection: Tsunami irrigation. Saudi Endod. J. 2015, 5, 1–12. [Google Scholar] [CrossRef]
  33. Vučetić, J.; Ilić, J. Root canal treatment of an extensive periapical lesion. Stomatol. Glas. Srb. 2022, 69, 183–189. [Google Scholar] [CrossRef]
  34. Schäfer, E.; Köster, M.; Bürklein, S. Percentage of gutta-percha–filled areas in canals instrumented with nickel-titanium systems and obturated with matching single cones. J. Endod. 2013, 39, 924–928. [Google Scholar] [CrossRef] [PubMed]
  35. Ariza, J.E.F.; Elejalde, D.A.; Cardenas, Y.A.R.; Del Castillo, A.A.; Mora, G.A.R.; Guillén, L.E.A. Adaptation of a Single-Cone in Prepared Teeth with Two Reciprocating Systems. Iran. Endod. J. 2022, 17, 27. [Google Scholar]
  36. Alsilani, R.; Jadu, F.; Bogari, D.F.; Jan, A.M.; Alhazzazi, T.Y. Single file reciprocating systems: A systematic review and meta-analysis of the literature: Comparison of reciproc and WaveOne. J. Int. Soc. Prev. Community Dent. 2016, 6, 402–409. [Google Scholar]
  37. Dagna, A.; Poggio, C.; Beltrami, R.; Colombo, M.; Chiesa, M.; Bianchi, S. Cyclic fatigue resistance of OneShape, Reciproc, and WaveOne: An: In Vitro: Comparative study. J. Conserv. Dent. Endod. 2014, 17, 250–254. [Google Scholar]
  38. Pedullà, E.; Grande, N.; Plotino, G.; Palermo, F.; Gambarini, G.; Rapisarda, E. Cyclic fatigue resistance of two reciprocating nickel–titanium instruments after immersion in sodium hypochlorite. Int. Endod. J. 2013, 46, 155–159. [Google Scholar] [CrossRef]
  39. Holderrieth, S.; Gernhardt, C.R. Maxillary molars with morphologic variations of the palatal root canals: A report of four cases. J. Endod. 2009, 35, 1060–1065. [Google Scholar] [CrossRef]
  40. Haupt, F.; Seidel, M.; Rizk, M.; Sydow, H.-G.; Wiegand, A.; Rödig, T. Diameter and taper variability of single-file instrumentation systems and their corresponding gutta-percha cones. J. Endod. 2018, 44, 1436–1441. [Google Scholar] [CrossRef]
  41. Gazzaneo, I.; Amoroso-Silva, P.; Pacheco-Yanes, J.; Alves, F.R.F.; Marceliano-Alves, M.; Olivares, P.; Meto, A.; Mdala, I.; Siqueira, J.F., Jr.; Rocas, I.N. Disinfecting and Shaping Type I C-shaped Root Canals: A Correlative Micro-computed Tomographic and Molecular Microbiology Study. J. Endod. 2021, 47, 621–630. [Google Scholar] [CrossRef] [PubMed]
  42. De-Deus, G.; Reis, C.; Beznos, D.; de Abranches, A.M.G.; Coutinho-Filho, T.; Paciornik, S. Limited ability of three commonly used thermoplasticized gutta-percha techniques in filling oval-shaped canals. J. Endod. 2008, 34, 1401–1405. [Google Scholar] [CrossRef] [PubMed]
Applsci 14 08661 g001
Figure 1. An apical section of a straight canal to visualize the performed evaluation technique. Gutta-percha-filled areas (1), sealer-filled areas (2), and unfilled areas (3) are visible. The calculation of the area size was performed using digital measurements under the microscope.
Figure 1. An apical section of a straight canal to visualize the performed evaluation technique. Gutta-percha-filled areas (1), sealer-filled areas (2), and unfilled areas (3) are visible. The calculation of the area size was performed using digital measurements under the microscope.
Applsci 14 08661 g001
Table 1. Evaluation of the filling quality between the three systems: SD = Standard Deviation (* Kruskal–Wallis Test).
Table 1. Evaluation of the filling quality between the three systems: SD = Standard Deviation (* Kruskal–Wallis Test).
nMean (%)SDVariance Analysis (p) *
PGFAWaveOne® Gold6080.39.030.158
Procodile®6082.29.57
Reciproc® blue6083.45.65
Total18082.08.32
PSFAWaveOne® Gold6018.98.360.056
Procodile®6016.88.96
Reciproc® blue6015.14.88
Total18017.07.73
PUAWaveOne® Gold600.772.390.148
Procodile®600.932.05
Reciproc® blue601.462.87
Total1801.052.46
Table 2. Pooled results and comparison of PGFA, PSFA, and PUA between curved and straight canals (* Mann–Whitney U-Test).
Table 2. Pooled results and comparison of PGFA, PSFA, and PUA between curved and straight canals (* Mann–Whitney U-Test).
nMean (%)SDVariance Analysis (p) *
PGFAcurved9081.19.230.358
straight9082.97.24
Total18082.08.32
PSFAcurved9017.78.370.345
straight9016.27.00
Total18017.07.73
PUAcurved901.193.010.309
straight900.921.77
Total1801.052.46
Table 3. One-way ANOVA to compare the three systems in straight and curved channels (* Kruskal–Wallis Test).
Table 3. One-way ANOVA to compare the three systems in straight and curved channels (* Kruskal–Wallis Test).
ConfigurationAreaFile SystemnMean (%)SDVariance Analysis (p) *
curvedPGFAWaveOne® Gold3078.910.60.404
Procodile®3081.89.69
Reciproc® blue3082.66.90
Total9081.19.23
PSFAWaveOne® Gold3020.19.280.218
Procodile®3017.69.34
Reciproc® blue3015.45.50
Total9017.78.37
PUAWaveOne® Gold300.983.230.170
Procodile®300.561.53
Reciproc® blue302.013.72
Total901.193.00
straightPGFAWaveOne® Gold3081.77.030.334
Procodile®3082.69.61
Reciproc® blue3084.33.98
Total9082.97.24
PSFAWaveOne® Gold3017.87.290.189
Procodile®3016.18.65
Reciproc® blue3014.94.23
Total9016.27.00
PUAWaveOne® Gold300.551.080.477
Procodile®301.312.43
Reciproc® blue300.901.50
Total900.921.77
Table 4. Comparison of the three single-file systems in each section with one-way ANOVA, p < 0.001 (* Kruskal–Wallis Test).
Table 4. Comparison of the three single-file systems in each section with one-way ANOVA, p < 0.001 (* Kruskal–Wallis Test).
ConfigurationAreaFile SystemnMean (%)SDVariance Analysis (p) *
apicalPGFAWaveOne® Gold2076.38.060.193
Procodile®2079.410.6
Reciproc® blue2080.66.41
Total6078.88.59
PSFAWaveOne® Gold2023.78.060.091
Procodile®2019.69.44
Reciproc® blue2018.34.70
Total6020.57.87
PUAWaveOne® Gold200.000.000.133
Procodile®200.992.46
Reciproc® blue201.132.87
Total600.712.20
middlePGFAWaveOne® Gold2079.210.50.400
Procodile®2082.36.63
Reciproc® blue2083.94.74
Total6081.87.79
PSFAWaveOne® Gold2019.78.400.085
Procodile®2016.66.44
Reciproc® blue2014.04.17
Total6016.76.87
PUAWaveOne® Gold201.153.380.223
Procodile®201.102.02
Reciproc® blue202.113.56
Total601.463.05
coronalPGFAWaveOne® Gold2085.45.750.758
Procodile®2085.010.5
Reciproc® blue2085.84.57
Total6085.47.29
PSFAWaveOne® Gold2013.55.090.840
Procodile®2014.310.2
Reciproc® blue2013.14.24
Total6013.66.90
PUAWaveOne® Gold201.152.330.513
Procodile®200.711.68
Reciproc® blue201.122.00
Total600.992.00
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Arvaneh, S.; Haghighat, S.; Schwesig, R.; Gernhardt, C.R. Evaluation of Gutta-Percha-Filled Areas in Curved and Straight Root Canals Using Three Reciprocating Single-File Systems Followed by Matching Single-Cone Obturation. Appl. Sci. 2024, 14, 8661. https://doi.org/10.3390/app14198661

AMA Style

Arvaneh S, Haghighat S, Schwesig R, Gernhardt CR. Evaluation of Gutta-Percha-Filled Areas in Curved and Straight Root Canals Using Three Reciprocating Single-File Systems Followed by Matching Single-Cone Obturation. Applied Sciences. 2024; 14(19):8661. https://doi.org/10.3390/app14198661

Chicago/Turabian Style

Arvaneh, Shakiba, Shahpar Haghighat, René Schwesig, and Christian Ralf Gernhardt. 2024. "Evaluation of Gutta-Percha-Filled Areas in Curved and Straight Root Canals Using Three Reciprocating Single-File Systems Followed by Matching Single-Cone Obturation" Applied Sciences 14, no. 19: 8661. https://doi.org/10.3390/app14198661

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop