Tuesday, October 12, 2010

Clinical Evaluation of Root Canal Obturation Methods in Primary Teeth

Resident: Roberts

Date: 10/13/10

Article title: Clinical Evaluation of Root Canal Obturation Methods in Primary Teeth

Journal: Pediatric Dentistry

Volume: 28:1 Pages 39-47

Year: 2006


Purpose:


To evaluate two differing obturation techniques, their effectiveness and success rates in primary molars


Methods:


50 pulpectomies and their respective filling materials were performed on 24 children( ages 4.5 to 9). Two varying methods were used to obturate the cleaned canals: one in which a lentulo spiral was attached to a slow speed handpiece and the other which consisted of a lentulo spiral that was hand held to perform the same task.


Criteria for this study:


Teeth were include if they:


  1. History of spontaneous pain
  2. Presence of a sinus tract
  3. Periapical bone swelling
  4. Continuous bleeding after amputation of coronal pulp tissue
  5. No pulp tissue remaining when the pulp chamber was accessed
  6. Pus discharge from the canal
  7. Evidence of a radicular pathologic lesion with or without caries involvement
  8. Periapical or inter-radicular radiolucency


Teeth were excluded if they:


  1. Were unrestorable
  2. Had pathologic lesion that extended to the tooth germ of the succedaneous tooth
  3. Showed signs of extensive internal/ external pathological root resorption


Success rates and results at 6 month follow up


Teeth obturated by lentulo in slow speed handpiece: clinical 96%, radiographic 91%


Teeth obturated by lentulo but performed manually by hand: clinical 92%, radiographic 72%


Combined total of 94% clinical and 81% radiographical success rate

The success were also analyzed by the quality of the obturation


56% (28) were optimally filled, 32% (16)were underfilled, and 12% (6)were overfilled.


Optimal: clinical 92%, radiographic 92%

Underfilled: clinical 94%, radiographic 56%

Overfilled: clinical 100%, radiographic 100%



Conclusion:


There was no statistical significance between the hand held or the handpiece mounted lentulo spiral. Optimally and over filled root canals showed a statistically higher success rate compared to underfilled root canals.


Assessment: His conclusions based on quality of fill and success rates differed from those he quoted, but he didn’t offer up a reason as to why and I would have liked to have had an insight to perhaps why his conclusion was different than others who have performed similar research.


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