Evaluation of the root canal tridimensional filling with warm vertical condensation, carrier-based technique and single cone with bioceramic sealer: a micro-CT study

Aim: To compare the quality of the tridimensional (3D) filling and the presence of radiographic translucencies after root canal obturation with three different techniques: warm vertical condensation, carrier-based and single cone with bioceramic sealer.

Methodology: Thirty single-rooted human teeth extracted for periodontal reasons were selected. Glide path was performed with ProGlider and shaping with ProTaper Next (PTN) X1, X2 and X3 up to working length (WL). The specimens were randomly divided into three groups (N=10) for the final 3D filling step: Buchanan’s continuous wave of condensation (Group 1, G1), Thermafil® (Group 2, G2) or TotalFill® BC Points™ combined with  TotalFill® BC Sealer (Group 3, G3).

Micro-CT scans were performed after the obturation step and the slices were 3D reconstructed with standardized parameters. Afterwards, the filled area and the associated radiographic translucencies were computer-isolated, and their volumes were calculated. The statistical analysis was performed using one-way ANOVA and the post-hoc Student-Newmann-Keuls (P<0,05).  

Results: The mean percentage of translucency areas in the warm vertical condensation group was 1,23%, whereas in the carrier-based group was 4,22% and in the single cone with bioceramic sealer group was 10,44%. The differences between the groups were statistically significant (P=0,029).

Conclusion: All the obturation techniques provided an adequate 3D root canal filling. However, the null hypothesis of a superimposable 3D filling quality between groups was refused. The single cone technique with bioceramic sealer represented a viable clinical alternative, although it seemed more operator-dependent than the others.

Key Words: bioceramic sealer, micro-CT, root canal obturation, root canal sealers volumetric distortion