Influence of different obturation techniques in coronal bacterial infiltration: study in dogs
Keywords:Dental leakage; Dental Pulp Cavity; Endodontics; Root canal obturation.
The objective of this study was to evaluate, in vivo, coronal bacterial infiltration after endodontic treatment with different obturation technique. Forty-five dogs’ root canals, originated from incisors and premolars, were used. The animals were intubated after general anesthesia. After local antisepsis and placement of rubber dam isolation, teeth were opened and instrumented up to a Kerr handfile #40, followed by three obturation protocols with Endofill®: Lateral condensation, Lateral condensation with a coronal plug of set Endofill® and Tagger hybrid technique. Access openings were not sealed and root fillings remained exposed to oral environment for 90 days. After this period, animals were euthanized and specimens were histologically processed and stained with Brown and Brenn. Dentinal tubules were evaluated with presence or absence of bacteria descriptive analysis. Bacterial infiltration was identified on root canal walls in six out of 14 root canals filled with the lateral condensation technique (42,8%), two out of 15 canals filled with Lateral condensation with a plug of set Endofill® (13,3%) and in two out 13 root canals filled with the Tagger hybrid technique (15,3%). Although the use of a coronal plug or a thermomechanical compaction technique showed less bacterial infiltration than conventional lateral condensation, none of the obturation techniques prevented bacterial infiltration to periapical area, evidencing the importance of a proper coronal seal or final restoration.
Barbosa, H.G., Holland, R., de Souza V., et al. (2003). Healing process of dog teeth after post space preparation and exposition of the filling material to the oral environment. Braz Dent J, 14:103-108.
Borlina, S.C., Souza, V., Holland, R., & Murata, S. S., et al. (2010). Influence of apical foramen widening and sealer on the healing of chronic periapical lesions induced in dogs’ teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 109:932-940.
Braz Junior, R., Albuquerque, M.S. de., Sena, K.X. da F.R. de., et al. (2021). Evaluation of cervical microleakage by Enterococcus faecalis in endodontically treated teeth sealed with composite resins. Res Soc Dev, 9: e3599108356.
Brown, J. H. & Brenn, L. (1931). A method for the differential staining of Gram-positive and Gram-negative bacteria in tissue sections. Bull Johns Hopkins Hosp, 48:69-73.
Bueno, C. R. E., Cury, M. T. S., Vasques, A. M. V., et al. (2019). Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study. Braz Oral Res, 33: e017.
Carratù, P., Amato, M., Riccitiello, F., & Rengo, S. (2002). Evaluation of leakage of bacteria and endotoxins in teeth treated endodontically by two different techniques. J Endod, 28:272-5.
Chailertvanitkul, P., Saunders, W. P., & Mackenzie, D. (1997a). Coronal leakage in teeth root-filled with two different sealers after long-term storage. Endod Dent Traumatol, 13: 82-7.
Chailertvanitkul, P., Saunders, W. P., & Mackenzie, D. (1997b). Coronal leakage of obturated root canals after long-term storage using a polimicrobial marker. J Endod, 23: 610-13.
Chow, E., Trope, M., & Nissan, R. (1993). In vitro endotoxin penetration of coronally unsealed endodontically treated teeth. J Endod, Abstract 8; 19:187.
Clarkson, R. M., Podlich, H. M., Savage, N. W., & Moule, A. J. (2003). A survey of sodium hypochlorite use by general dental practitioners and endodontists in Australia. Aust Dent J, 48:20–6.
Dalmia, S., Gaikwad, A., Samuel, R., Aher, G., Gulve, M., & Kolhe, S. (2018). Antimicrobial Efficacy of Different Endodontic Sealers against Enterococcus faecalis: An In vitro Study. J Int Soc Prev Community Dent, 8:104-109.
Dragland, I. S., Wellendorf, H., Kopperud, H., et al. (2019). Investigation on the antimicrobial activity of chitosan-modified zinc oxide-eugenol cement. Biomater Investig Dent, 6(1), 99–106.
Fonseca, L. de A., Cangussu, R. A., Oliveira, A. S. de, et al. (2020). Comparison of endodontic disinfection of primary teeth root canals using rotary and reciprocating system: An in vitro study. Res Soc Dev, 9(8): e457985882.
Fracassi, L. D., Ferraz, E. G., Albergaria, S. J., Veeck, E. B., Costa, N. P., Sarmento, V. A. (2013). Evaluation of the quality of different endodontic obturation techniques by digital radiography. Clin Oral Invest, 17:97–103.
Friedman, S., Torneck, C. D., Komorowski, R., Ouzounian, Z., Syrtash, P., & Kaufman, A. (1997). In vivo model for assessing the functional efficacy of endodontic filling materials and techniques. J Endod, 23:557-561.
Gillen, B. M., Looney, S. W., Gu, L. S., et al. (2011). Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod, 37:895–902.
Gomes-Filho, J. E., Watanabe, S., Cintra, L. T. A., Nery, M. J., Dezan-Junior, E., Queiroz, I. O. A., Lodi, C. S., & Basso, M. D. (2013). Effect of MTA-based sealer on the healing of periapical lesions. J App Oral Sci, 21:235-242.
Hatton, J. F., Ferrillo, P. J., Wagner, G., & Stewart, P. (1988). The effect of condensation pressure on the apical seal. J Endod, 14:305-308.
Holland, R., Mazuqueli, L., Souza, V., Murata, S. S., Dezan-Júnior, E., & Suzuki, P. (2007b). Influence of the Type of Vehicle and Limit of Obturation on Apical and Periapical Tissue Response in Dogs’ Teeth After Root Canal Filling with Mineral Trioxide Aggregate. J Endod, 33:693–697.
Holland, R., Souza, V., Nery, M. J., Otoboni Filho, J. A., Bernabé, P. F. E., & Dezan Junior, E. (1999). Reaction of dog’s teeth to root canal filling with mineral trioxide aggregate or a glass ionomer sealer. J Endod, 25:728 –30.
Holland, R., Souza, V., Tagliavini, R. L., & Milanezi, L. A. (1971). Healing process of teeth with open apices: histological study. Bull Tokyo dent Coll, 12:333-38.
Holland, R., Manne, L. N., Souza, V., Murata, S. S., & Dezan-Junior, E. (2007a). Periapical Tissue Healing after Post Space Preparation with or without Use of a Protection Plug and Root Canal Exposure to the Oral Environment. Study in Dogs. Braz Dent J, 18:281-8.
Holland, R., Cruz, A. C., Souza, V., Nery, M. J., Bernabé, P. F. E., Otoboni-Filho, J. A., & Dezan-Júnior, E. (2000). Comportamiento de los tejidos periapicales frente a la exposición de la obturación endodôntica el medio oral. Estudio histológico en dientes de peros. Endodoncia, 18:99-108.
Khayat, A., Lee, S. J., & Torabinejad, M. (1993). Human Saliva Penetration of Coronally Unsealed Obturated Root Canals. J Endod, 19:458-61.
Koche, J. C. (2011). Fundamentos de metodologia científica: teoria da ciência e iniciação à pesquisa. Vozes:182 p.
Leduc, J., & Fishelberg, G. (2003). Endodontic obturation: a review. Gen Dent, 51:232-233.
Libonati, A., Di Taranto V., D`Agostini, C., Santoro, M. M., Di Carlo, D., Ombres, D., Gallusi, G., Favalli, C., Marzo, G., & Campanella, V. (2018). Comparison of Coronal Leakage of Different Root Canal Filling Techniques: An Ex Vivo Study. J Biol Regul Homeost Agents, 32:397-405.
Lone, M. M., Khan, F. R., & Lone, M. A. (2018). Evaluation of Microleakage in Single-Rooted Teeth Obturated with Thermoplasticized Gutta-Percha Using Various Endodontic Sealers: An In-Vitro Study. J Coll Physicians Surg Pak, 28(5): 339–343.
Macedo, L. M. D., Silva-Sousa, Y., Silva, S. R. C., Baratto, S. S. P., Baratto-Filho, F., Rached-Júnior, F. J. A. (2017). Influence of Root Canal Filling Techniques on Sealer Penetration and Bond Strength to Dentin. Braz Dent J, 28:380-4.
Mohajerfar, M., Nadizadeh, K., Hooshmand, T., et al. (2019). Coronal Microleakage of Teeth Restored with Cast Posts and Cores Cemented with Four Different Luting Agents after Thermocycling. J Prosthodont, 28(1): e332–e336.
Monajemzadeh, A., Ahmadi Asoor, S., Aslani, S., & Sadeghi-Nejad, B. (2017). In vitro antimicrobial effect of different root canal sealers against oral pathogens. Curr Med Mycol, 3:7-12.
Muliyar, S., Shameem, K. A., Thankachan, R. P., Francis, P. G., Jayapalan, C. S., & Hafiz, K. A. (2014). Microleakage in endodontics. J Int Oral Health, 6:99-104.
Nakamura, D. H., Garcia, R. B., Bramante, C. M., Moraes, I. G., & Bernadineli, N. (2006). Sealing Ability of Cements In Root Canals Prepared For Intraradicular Posts. J Appl Oral Sci, 14:224-7.
Nascimento, W. M., Limoeiro, A. G. da S., Moraes, M. M., et al. (2021). Reduction in Enteroccocus faecalis counts produced by three file systems in severely curved canals. Res Soc Dev, 10(2): e58910212956.
Oliveira, S. G. D., Gomes, D. J., Costa, M. H. N., Sousa, E. R., & Lund, R. G. (2013). Coronal microleakage of endodontically treated teeth with intracanal post exposed to fresh human saliva. J Appl Oral Sci, 21:403-8.
Prithviraj, K. J., Sreegowri, Manjunatha, R. K., Horatti, P., Rao, N., & Gokul, S. (2020). In Vitro comparison of the microbial leakage of obturation systems: Epiphany with resilon, guttaflow, and ah plus with gutta percha. Indian J Dent Res, 31(1): 37–41.
Ray, H. A., & Trope, M. (1995). Periapical Status of Endodontically Treated Teeth In Relation To The Technical Quality Of The Root Filling And The Coronal Restoration. Int Endod J, 28:12– 8.
Savioli, R. N., Pecora, J. D., Mian, H., & Ito, I. Y. (2006). Evaluation of the antimicrobial activity of each component in Grossman’s sealer. Braz Oral Res, 20:127-131.
Shanmugam, S., PradeepKumar, A. R., Abbott, P. V., et al. (2020). Coronal Bacterial Penetration after 7 days in class II endodontic access cavities restored with two temporary restorations: A Randomised Clinical Trial. Aust Endod J, 46(3): 358–364.
Shipper, G., Teixeira, F. B., Arnold, R. R., & Trope, M. (2005). Periapical inflammation after coronal microbial inoculation of dog roots filled with gutta-percha or resilon. J Endod, 31:91– 6.
Singh, G., Gupta, I., Elshamy, F. M. M., Boreak, N., & Homeida, H. E. (2016). In vitro comparison of antibacterial properties of bioceramic-based sealer, resin-based sealer and zinc oxide eugenol based sealer and two mineral trioxide aggregates. Eur J Dent, 10:366-369.
Slaus, G., Bottenberg, P. (2002). A survey of endodontic practice amongst Flemish dentists. Int Endod J, 35:759–67.
Song, M., Kim, H. C., Lee, W., & Kim, E. (2011). Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod, 37:1516-1519.
Souza, R. S., Gandini-Junior, L. G., Souza, V., Holland, R., & Dezan-Junior, E. (2006). Influence of Orthodontic Dental Movement on the Healing Process of Teeth with Periapical Lesions. J Endod, 32:115–119.
Torabinejad, M., Ung, B., & Kettering, J. D. (1990). In Vitro Bacterial Penetration of Coronally Unsealed Endodontically Treated Teeth. J Endod, 16:566-9.
Tronstad, L., Asbjornsen, K., Doving, L., Pedersen, I., & Eriksen, H. M. (2000). Influence of Coronal Restorations on The Periapical Health of Endodontically Treated Teeth. Endod Dent Traumatol, 16:218 –21.
Trope, M., Chow, E., & Nissan, R. (1995). In vitro endotoxin penetration of coronally unsealed endodontically treated teeth. Endod Dent Traumatol, 11:90-4.
Wang, Z., Shen, Y., & Haapasalo, M. (2014). Dentin extends the antibacterial effect of endodontic sealers against Enterococcus faecalis biofilms. J Endod, 40:505-508.
Wijnbergen, M., & Van Mullem, P. J. (1987). Effect of histological decalcifying agents on number and stainability of gram-positive bacteria. J Dent Res, 66:1029-1031.
Yamauchi, S., Shipper, G., Buttke, T., Yamauchi, M., & Trope, M. (2006). Effect of Orifice Plugs On Periapical Inflammation in Dogs. J Endod, 32:524 –526.
Zmener, O., Pameijer, C. H., Kokubu, G. A., & Grana, D. R. (2010). Subcutaneous Connective Tissue Reaction to Methacrylate Resin–based and Zinc Oxide and Eugenol Sealers. J Endod, 36:1574–1579.
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Copyright (c) 2021 Eloi Dezan-Júnior; Carlos Roberto Emerenciano Bueno; Ana Maria Veiga Vasques; Valdir de Souza; Mauro Juvenal Nery; José Arlindo Otoboni Filho; Pedro Felício Estrada Bernabé; João Eduardo Gomes-Filho; Luciano Tavares Ângelo Cintra; Rogério de Castilho Jacinto; Gustavo Sivieri-Araújo; Roberto Holland
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