An in vitro investigation into the frequency of gutta percha and/or sealer in auxiliary canals using the Boston University technique
Sylva, Larry A.
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The Boston University technique of vertical compaction of warm gutta percha allows the clinician to three-dimensionally seal all portals of exit from the root canal system. Failure to adequately seal all portals of exit may ultimately lead to failure of the endodontic case. This would necessitate retreatment, surgical intervention or extraction of the involved tooth. One hundred extracted single canal anterior teeth were treated according to the Boston University technique of vertical compaction of warm gutta percha. There were five different participant groups representing various levels of skill and experience using this technique - predoctoral students, first year endodontic graduate students, second year endodontic graduate students, Boston University faculty members, and the primary investigator. Each group also used varying amounts of sealer during the obturation of the root canal systems - one-half of the teeth in each group received a normal (two Lentulo spiral hand applications) of sealer, and the other half of the teeth in each group had the canals flooded with sealer. The teeth were subsequently cleared, examined and photographed under a stereomicroscope to observe the auxiliary canals. The following results were obtained: 1) Forty-five teeth (45%) had demonstrably filled auxiliary canals. Majority of these were located in the apical one-third of the root. 2) Majority of all accessory canals were filled with sealer only. Some contained a combination of sealer and gutta percha, and a very small number contained gutta percha only. 3) The number of filled accessory canals visualized under the microscope ranged from one to thirteen and possibly as many as sixteen - it was difficult to exactly count the number of accessory canals on this particular tooth since the accessory canals projected outwards from the same area 360 degrees around the main canal. 4) Width of the accessory canals ranged between 1/16 mm and l mm. However, some apical bifidities were noted with a width greater than 1 mm. 5) The predoctoral student group obtained a 60% incidence of demonstrably filled accessory canals, while the 1st and 2nd year graduate students had a 45% incidence, the primary investigator obtained a 40% incidence, and the faculty group obtained a 35% incidence of demonstrably filled accessory canals. 6) The practice of flooding the canal with sealer proves to be of no benefit in filling accessory canals. Twenty-four of fifty teeth (48%) with the normal application of sealer revealed accessory canals, and only twenty-one of fifty teeth (42%) with the canals flooded with sealer revealed accessory canals.
Thesis (M.Sc.D.)--Boston University, Henry M. Goldman School of Graduate Dentistry, 1991 (Endodontics)Bibliography: leaves 175-183.
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