Comparative evaluation of gutta-percha adaptation in different obturation techniques using cone-beam computed...

Area of Science:

• Endodontics
• Dental Materials Science
• Radiology

Background:

• Effective three-dimensional obturation is critical for successful root canal treatment.
• Inadequate gutta-percha (GP) adaptation and voids compromise the root canal seal, potentially leading to treatment failure.
• Assessing GP adaptation quality is essential for optimizing endodontic outcomes.

Purpose of the Study:

• To compare the gutta-percha (GP) adaptation quality of four different obturation techniques.
• Techniques evaluated include cold lateral compaction (CLC), warm lateral compaction (WLC), warm vertical compaction (WVC), and thermoplasticized injection (TPI).
• Assessment was performed in permanent posterior teeth using cone-beam computed tomography (CBCT).

Main Methods:

• A double-blinded, randomized controlled trial involving 120 patients requiring root canal treatment in posterior teeth.
• Patients were randomly allocated into four groups (n=30 each): CLC, WLC, WVC, and TPI.
• Post-obturation CBCT scans were analyzed using a validated void scoring system.

Main Results:

• Thermoplasticized injection (TPI) demonstrated the highest adaptation success rate (83.33% scoring 1).
• Cold lateral compaction (CLC) showed the poorest adaptation (40% scoring 1).
• Statistically significant differences were observed between groups (P=0.012), particularly between TPI and CLC (P=0.001).

Conclusions:

• Thermoplasticized injection (TPI) technique provides significantly superior gutta-percha adaptation with minimal void formation.
• Cold lateral compaction (CLC) exhibited the highest incidence of voids.
• Warm techniques (WLC, WVC) were superior to CLC but inferior to TPI, suggesting thermoplasticized methods enhance obturation quality.