Journal of Shanghai Jiao Tong University (Medical Science) >

2025 , Vol. 45 >Issue 2: 179 - 185

DOI: https://doi.org/10.3969/j.issn.1674-8115.2025.02.006

Clinical research

Impact of residual intracanal calcium hydroxide and the root canal filling techniques on apical sealant integrity

  • SUN Haoyu ,
  • YANG Nan ,
  • SHAN Xiaoyang ,
  • WANG Yueyue ,
  • SUN Huibin
Expand
  • 1.Department of Stomatology, the Affiliated Hospital of Qingdao University, Qingdao 266003
    2.School of Stomatology, Qingdao University, Qingdao 266023, China
    3.Department of Stomatology, The 971 Hospital of the Chinese Navy, Qingdao 266071, China
SUN Huibin, E-mail: shb353.qindao@163.com.

Received date: 2024-08-15

  Accepted date: 2024-10-15

  Online published: 2025-02-28

Supported by

Key Project of Traditional Chinese Medicine Science and Technology in Shandong Province in 2023(Z-2023049);Clinical Medicine 3+X Project of Qingdao University School of Medicine(3406)

Fold

Abstract

Objective ·To compare the effects of calcium hydroxide (CH) residues in root canals and root canal filling methods on apical closure, and to provide reference for clinical selection of root canal sealing drugs and filling methods. Methods ·Seventy-five permanent mandibular premolar teeth with single root canals that were extracted due to orthodontic treatment or periodontal problems were collected from the Department of Oral and Maxillofacial Surgery of the Affiliated Hospital of Qingdao University. The crowns were removed, the root canals were prepared, and the specimens were randomly assigned into 3 groups: a water-soluble calcium hydroxide group (Group A, n=30), an oil-soluble calcium hydroxide group (Group B, n=30), and an unsealed control group (Group C, n=15). After 2 weeks of sealing, Groups A and B underwent manual preparation with a #35 K-file, followed by ultrasonic agitation and irrigation of the root canal to ensure that the calcium hydroxide residue was located roughly at the root apex and that the residue was 15% to 20%. Groups A, B, and C were randomly divided into 3 groups: the iRoot SP single-tip group (Group 1), the hot compression group (Group 2), and the cold compression group (Group 3), and root canals were filled using the iRoot SP single-tip method, the hot adhesive vertical compression filling method, and the cold adhesive lateral compression filling method, respectively. A dye penetration test was used to evaluate apical microleakage, and scanning electron microscopy was used to observe the microscopic morphology of the dentin-root canal sealer interface in each group. Statistical analysis was performed using two-way ANOVA. Results ·Both root canal sealing drugs and root canal filling methods affected the apical sealing, and there was an interaction between them. The effects of residual calcium hydroxide on apical closure were analyzed. The difference between Group B and Group C was statistically significant only in Group 1. There were statistically significant differences between Group A and Group C in Group 2 and Group 3, and statistically significant differences between Group A and Group B regardless of the root filling method. Among the three root filling methods, there was a statistically significant difference between Group 1 and Group 3 in Group C (P=0.013). In Group A and Group B, there were statistically significant differences between Group 2, Group 3 and Group 1 (P<0.001). Conclusion ·The residual water-soluble calcium hydroxide in the root canal has a negative effect on the apical closure, but the residual oil-soluble calcium hydroxide has a small negative effect on the apical closure. iRoot SP can reduce the negative effect of residual water-soluble calcium hydroxide on root canal closure.

Key words： root canal filling; calcium hydroxide; root canal sealant; apical closure; single-cone obturation; hot gutta-percha filling; cold lateral condensation

Cite this article

SUN Haoyu , YANG Nan , SHAN Xiaoyang , WANG Yueyue , SUN Huibin . Impact of residual intracanal calcium hydroxide and the root canal filling techniques on apical sealant integrity[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(2) : 179 -185 . DOI: 10.3969/j.issn.1674-8115.2025.02.006

References

1 RAI K, MANDHOTRA P, SHARMA N, et al. In vitro assessment of apical microleakage of teeth sealed with three different root canal sealers: a comparative study[J]. J Pharm Bioallied Sci, 2021, 13(Suppl 1): S375-S378.
2 DONNERMEYER D, WYRSCH H, BüRKLEIN S, et al. Removal of calcium hydroxide from artificial grooves in straight root canals: sonic activation using EDDY versus passive ultrasonic irrigation and XPendo finisher[J]. J Endod, 2019, 45(3): 322-326.
3 SOKHI R R, SUMANTHINI M V, SHENOY V U, et al. Effect of calcium hydroxide based intracanal medicaments on the apical sealing ability of resin based sealer and guttapercha obturated root canals[J]. J Clin Diagn Res, 2017, 11(1): ZC75-ZC79.
4 吕翱, 林晓新, 郭晓莉, 等. 三种根管封闭剂的根尖封闭性能体外比较研究[J]. 中国实用口腔科杂志, 2022, 15(3): 300-303.
  Lü A, LIN X X, GUO X L, et al. Study on the apical sealing ability of three root canal sealers in vitro[J]. Chinese Journal of Practical Stomatology, 2022, 15(3): 300-303.
5 孙莉青, 郭宜青, 杨爱华, 等. 3种根管充填方法对不同类型根管根尖封闭性的影响研究[J]. 国际口腔医学杂志, 2021, 48(6): 629-634.
  SUN L Q, GUO Y Q, YANG A H, et al. Study on apical sealing ability of three root canal filling techniques for different types of root canals[J]. International Journal of Stomatology, 2021, 48(6): 629-634.
6 KIRAN KUMAR N, BRIGIT B, ANNAPOORNA B S, et al. Effect of triple antibiotic paste and calcium hydroxide on the rate of healing of periapical lesions: a systematic review[J]. J Conserv Dent, 2021, 24(4): 307-313.
7 费晓磊, 彭林红. 氢氧化钙根管消毒在慢性根尖周炎行根管治疗中的应用效果观察[J]. 临床医学工程, 2024, 31(5): 555-556.
  FEI X L, PENG L H. Observation on application effect of calcium hydroxide root canal disinfection in root canal therapy of chronic periapical periodontiti[J]. Clinical Medicine & Engineering, 2024, 31(5): 555-556.
8 TURKAYDIN D, BASTURK F B, GOKER S, et al. Efficacy of Endoactivator, CanalBrush, and passive ultrasonic irrigation in the removal of calcium hydroxide paste with iodoform and p-chlorophenol from root canals[J]. Niger J Clin Pract, 2020, 23(9): 1237-1242.
9 DIAS-JUNIOR L C L, CASTRO R F, FERNANDES A D, et al. Final endodontic irrigation with 70% ethanol enhanced calcium hydroxide removal from the apical third[J]. J Endod, 2021, 47(1): 105-111.
10 TAVELLA E SILVA N C, GIBIN J T, RIVERA I C M M, et al. Calcium hydroxide paste removal strategies and bond strengths of epoxy- and silicate-based sealers[J]. Aust Endod J, 2021, 47(2): 236-244.
11 李冬雅, 李季, 李艳萍, 等. 比较不同冲洗液对根管内氢氧化钙的清除效果及根管牙本质显微硬度的影响[J]. 实用口腔医学杂志, 2021, 37(1): 90-95.
  LI D Y, LI J, LI Y P, et al. Comparison of the effects of different irrigation solutions on the removal of intracanal calcium hydroxide and the microhardness of root canal dentin[J]. Journal of Practical Stomatology, 2021, 37(1): 90-95.
12 BHANDI S, MASHYAKHY M, ABUMELHA A S, et al. Complete obturation-cold lateral condensation vs. thermoplastic techniques: a systematic review of micro-CT studies[J]. Materials (Basel), 2021, 14(14): 4013.
13 王宾. 热牙胶连续波充填与冷侧压充填技术在C型根管中应用的对比研究[J]. 内蒙古医科大学学报, 2020, 42(1): 94-95, 99.
  WANG B. A comparative study on the application of hot teether continuous wave filling and cold side pressure filling technology in C-type root canals[J]. Journal of Inner Mongolia Medical University, 2020, 42(1): 94-95, 99.
14 景然. 热牙胶垂直加压和冷侧压充填治疗急性牙髓炎合并根尖周炎效果比较[J]. 中国医疗器械信息, 2022, 28(10): 126-128.
  JING R. Comparison of the effects of vertical compression with hot gutta-percha and cold lateral compression on acute pulpitis with periapical periodontitis[J]. China Medical Device Information, 2022, 28(10): 126-128.
15 ANTUNES T M, JANINI A P, PELEPENKO L E, et al. Heating stability, physical and chemical analysis of calcium silicate-based endodontic sealers[J]. Int Endod J, 2021, 54(7): 1175-1188.
16 KANDEMIR DEMIRCI G, ??VEN F O, GüNERI P, et al. The solubility, pH value, chemical structure, radiopacity, and cytotoxicity of four different root canal sealers: an in vitro study[J]. Clin Oral Investig, 2023, 27(9): 5413-5425.
17 CACERES C, LARRAIN M R, MONSALVE M, et al. Dentinal tubule penetration and adaptation of bio-C sealer and AH-plus: a comparative SEM evaluation[J]. Eur Endod J, 2021, 6(2): 216-220.
18 AL-HIYASAT A S, YOUSEF W A. Push-out bond strength of calcium silicate-based cements in the presence or absence of a smear layer[J]. Int J Dent, 2022, 2022: 7724384.
19 AMIN S A W, SEYAM R S, EL-SAMMAN M A. The effect of prior calcium hydroxide intracanal placement on the bond strength of two calcium silicate-based and an epoxy resin-based endodontic sealer[J]. J Endod, 2012, 38(5): 696-699.
20 ESCOBAR P M, LOPES F C, CARVALHO K, et al. Influence of different calcium hydroxide removal protocols on the bond strength of epoxy resin-based sealer in long oval root canals[J]. Microsc Res Tech, 2022, 85(2): 781-788.
21 DUARTE M H, DE O DEMARCHI A C, DE MORAES I G. Determination of pH and calcium ion release provided by pure and calcium hydroxide-containing AHPlus[J]. Int Endod J, 2004, 37(1): 42-45.
22 TEOH Y Y, ATHANASSIADIS B, WALSH L J. Comparison of commercial calcium hydroxide pastes for prolonged antibacterial effect using a colourimetric assessment[J]. Materials (Basel), 2018, 11(3): 348.
23 唐芝羲, 钟苑, 钟琳, 等. 不同根管冲洗方法对Vitapex清除及根尖封闭的效果研究[J]. 中国实用口腔科杂志, 2024, 17(2): 186-191.
  TANG Z X, ZHONG Y, ZHONG L, et al. Efficacy of different root canal irrigation methods in the removal of Vitapex and apical sealing[J]. Chinese Journal of Practical Stomatology, 2024, 17(2): 186-191.
24 马昂, 王颖艺, 孙梦瑶, 等. Er: YAG激光活化冲洗技术对根管内氢氧化钙清除效果和根尖封闭性能的影响[J]. 吉林大学学报(医学版), 2022, 48(2): 462-469.
  MA A, WANG Y Y, SUN M Y, et al. Effect of Er:YAG laser activation irrigation technique on removal effect of calcium hydroxide in root canals and apical sealing ability[J]. Journal of Jilin University (Medicine Edition), 2022, 48(2): 462-469.
Options
Outlines

/

〈 〉