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 »  Home  »  Endodontic Articles 7  »  A preliminary study of the percentage of gutta-percha-filled area in the apical canal filled with vertically compacted warm gutta-percha
A preliminary study of the percentage of gutta-percha-filled area in the apical canal filled with vertically compacted warm gutta-percha
Introduction.



M.-K.Wu, L.W. M. van der Sluis & P. R.Wesselink
Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands.

Introduction.
Both gutta-percha and sealer are used to ¢fill root canals, and each makes its own contribution to the seal achieved. Gutta-percha is dimensionally stable (Wu et al. 2000a), whereas most sealers dissolve over time (Orstavi k 1983, Peters 1986,Tronstad et al. 1988, Kazemi et al. 1993). The dissolution of the sealer is probably responsible for the increase in leakage along the root ¢fillings over time (Kontakiotis et al.1997). A good adaptation of gutta-percha to the canal wall promotes the complete obturation of the root-canal space. With such intimate adaptation of gutta-percha, the space between the gutta-percha and the canal wall to be ¢filled with sealer is greatly reduced (Wu et al.1997, Wu et al.2000b).Reducing the amount of sealer and the ratio of sealer to gutta-percha in the root ¢filling promotes the long-term seal provided by the root ¢filling.
The technique of vertically compacting warm gutta-percha in the root canal was popularized by Schilder (1967) and was recently described in detail by Ruddle (1994). After heating gutta-percha in the root canal using an electronic device, Touch ’n Heat (Analytic Technology, Redmond,WA, USA), the thermoplasticized gutta-percha is vertically compacted by means of pre-fitted pluggers. The adaptation of gutta-percha achieved by this technique has been found to be superior to that provided by cold lateral compaction (Smith et al. 2000, Wu et al. 2001a). More recently, System B (EIE/Analytic) was developed, which is used to obturate the root-canal system with a single continuous wave of thermoplasticized gutta-percha (Buchanan1996).
Silver et al. (1999) after performaning warm vertical compaction measured the percentage of gutta-percha- ¢filled canal area (PGFA) in root canals. At 6 mm from the apex, the PGFA reached 97-98% using either Touch’n Heat or System B. At 2 mm from the apex, however, this percentage dropped to 94.5% using Touch ’n Heat and to 84.5%using System B. This suggests that the quality of gutta-percha adaptation is compromised in the apical root canal. In another study using Touch ’n Heat (Wu et al.2001a), PGFA was measured 2 and 4 mm from the apex. The average PGFA reached 99.6% at 4 mm, whilst it was only 94.1%at 2 mm. It was found that some cross-sections of warm vertical compaction root ¢fillings cutat 2 mm from the apex appeared to be similar to those of a single cone ¢filling; the gutta-percha cone was encased in a thick layer of sealer (Wuet al.2001a), indicating that the gutta-percha at this level had not been heated before the vertical compaction.
The above ¢findings indicate that the PGFA achieved during warm vertical compaction was almost 100% in the coronal and middle portions of root canal, but lower in the apical root canals under the influence of other factors.
Heating conditions, including the depth of heat application, heating time and temperature may influence the PGFA. Smith et al. (2000) studied the effect of varying the depth of heat application on the adaptation of gutta-percha. They applied heat at 3, 5 and 7 mm from the apex, respectively, and found that the deeper the heat was applied, the better the adaptation achieved.
On the other hand, the width of root canals varies greatly (Kerekes & Tronstad 1977a,b,c, Dummer et al. 1984). At 2 mm from the apex of maxillary canines, for instance, the buccal/lingual diameters varied from 0.28 to 0.71mm and the mesial/distal diameters from 0.28 to 0.63 mm (Wu et al. 2000c). Usually, a medium sized, nonstandardized gutta-percha cone is used for the canine during warm vertical compaction. The amount of gutta-percha is similar in each individual canal, despite the differences in diameter. It will be clear that it is more difficult to achieve a good adaptation of gutta-percha in a wide root canal.
The purpose of this study was to investigate the influence of the canal width and the depth of heat application on the PGFA achieved by warm vertical compaction in the apical root canal.