Influence of selected obturation techniques on the status of periapical tissue


Kustra, Przemysław


CWC ; obturation ; later condensation ; endodontic


Study objective The objective of the study was as follows: 1) present a clinical and radiological comparative assessment of two root canal obturation techniques, the Gutta-Percha lateral condensation method versus the CWC technique, five years after the conclusion of the treatment 2) provide an analysis of intraoperative and early complications of root canal treatment in the case of both the assessed techniques 3) provide a radiological assessment of the quality of obturation taking into account the degree of canal obturation and the homogeneity of the obturation material Material and methods The records of 171 patients were analysed. Personally I performed endodontic treatment at these patients. The study presents the early results obtained after 14 days and the long-term results 5 years after the completion of the treatment. A total of 310 teeth (116 teeth from men and 194 from women) were analysed, including 174 multi-rooted and 136 single-rooted teeth. This represented a combined total of 548 roots. The average age of the patients was 42 years and 11 months. The patients selected for the study had been scheduled for primary root canal treatment or retreatment with or without periapical lesions. For a patient’s records to be included in the analysis, a standardised endodontic treatment protocol was necessary. Primary treatment refers to those situations where the den ; tist has treated a tooth endodontically for the first time. On the other hand, retreatment concerns those cases where a tooth had been treated endodontically earlier but with no positive result. The reasons for retreatment were as follows: incomplete obturation of the root canal, inflammation of the periapical tissue, insufficient sealing of obturation or toothache (chronic pain occurring after a certain period following root canal treatment). Excluded from the study were patients who did not consent to the treatment, patients undergoing oncological treatment, patients with diseases of the immune system and patients requiring surgical intervention, e.g. resection or radectomy. Consent for the study was obtained from the Bioethics Committee of the Jagiellonian University No. KBET/236/B/2010. Breakdown of groups The study material was divided into two main groups. Group I - the root canal system was filled using the cold lateral condensation method. The treatment was carried out on 163 teeth, including 98 multi-rooted and 65 single-rooted. The average age in the group was 41 years and 6 months, with the average for the 42 women being 39 years and 3 months and the average for the 25 men being 45 years and 1 month. Group II - root canal system obturated using the thermal continuous wave condensation (CWC) system. The treatment was carried out on 147 teeth, including 76 multi ; ­ rooted and 71 single-rooted. The average age in the group was 44 years and 7 months. The average age of the 36 women was 42 years and 1 month and the average age of the 18 men was 49 years and 3 months.The groups were randomised according to time criteria. In the first 6 months the Gutta-Percha lateral condensation method was utilised and in the following six months the CWC technique was employed. The study material was also divided according to the presence or absence of periapical lesions and type of treatment applied. On this basis the following subgroups were formed: subgroup A - teeth with healthy periapical periodontium (164 teeth, group I - 86, group II - 78).subgroup B - teeth with periapical lesions (146 teeth, group I - 77, group II - 69).The study material as a whole was also divided into teeth undergoing primary treatment and undergoing retreatment. Class I - primary endodontic treatment (128 teeth) Class II - teeth retreated endodontically (182 teeth) Conclusions The following conclusions were drawn from the results: 1. A lower percentage of positive treatment results for the lateral condensation method compared with the CWC technique suggests the superiority of the thermal technique. 2. The similar treatment results registered for both primary and secondary endodontic treatment regardless of the obturation method used indicate the benefits of secondary root ; canal treatment of teeth. 3. An analysis of the complications following canal obturation revealed no major differences between the two techniques. On the other hand, obturation tetnded to be heterogeneous in the case of the lateral condensation technique, while more numerous instances of sealer puffing into the periapical tissue was evident when the CWC technique was used. 4. The negative effect of hetereogeneous obturation in the form of air bubbles caused by the treatment suggests the need for secondary endodontic treatment for teeth with such obturations. 5. Root canal obliteration leads to worse treatment results. 6. The results obtained in the study confirmed the commonly held view that the treatment prognosis is far worse for teeth with inflammed periapical tissue than in the case of teeth with a healthy periapical periodontium.

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2 - studia doktoranckie

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Wydział Lekarski


Zarzecka, Joanna



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Praca doktorska

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