The Effect of the Design of Endodontic Access Cavity on the Apical Seal of Root Canal Filling with Warm Vertical Compaction Technique (An In Vitro Study)

Abstract

Background & Aim: Establishing an endodontic access cavity is the first key step in endodontic treatment. Recently, several conservative endodontic access cavity designs have been introduced, which increased the challenges for the practitioner in the following stages of endodontic treatment, including root canal filling. Therefore, the aim of this in-vitro study was to investigate the effect of conservative endodontic access cavity design in upper premolars on the quality of apical sealing of the root canal filling with warm vertical compaction technique

Materials and Methods: The study sample, which consisted of 20 upper premolars, was randomly distributed into two equal groups according to the design of the endodontic access cavity, the first group: traditional endodontic access cavity group (TEC), the second group: conservative endodontic access cavity group (CEC). After preparing the access cavity for each group separately, the canals were prepared, then obturated with warm vertical compaction technique then the teeth were restored using glass ionomer cement. Teeth were then kept in the incubator at a temperature of 37 ° C for a week. The outer surface of the teeth was completely coated with nail polish except for 2 mm of the apical area, the teeth were left to dry, then were immersed in red row wax and the roots of the teeth were immersed in a 2% methylene blue (PH 7) solution. All samples were kept in the incubator (37°C and 100% humidity for 24 hours.). Longitudinal sections of the teeth were performed in the buccolingual direction, then all sections were examined using a stereomicroscope and the amount of linear dye penetration was recorded in the interface area (filling material - tooth) using a digital measuring instrument (Vernier Caliper). Data were analyzed using a T-student test for independent samples at the level of significance (P ≤ 0.05).

Results: The mean of dye penetration and the standard deviation, respectively, for the traditional and conservative access groups were (0.485 ±0.282 mm, 0.519 ±0.295 mm) and it was (P-value = 0.795 > 0.05). This indicates that there is no statistically significant difference in the amount of dye penetration between the traditional and the conservative access cavity groups used in the study.

Conclusions: Conservative endodontic access cavity design in upper premolars did not affect the quality of the apical sealing of root canal filling compared with the traditional access cavity when using warm vertical compaction technique.