Clinical and radiographic examination of the effect of different obturation techniques to the success of root canal treatment of teeth with periapical lesions

Clinical And Radiographic Examination Of The Effect Of Different Obturation Techniques To The Success Of Root Canal Treatment Of Teeth With Periapical Lesions The aim of this clinical study was to investigate and compare clinical and radiological outcome of root canal treatments with using Thermafil and cold lateral compaction methods with standardized clinical protocols, the time required for treatment, extrusion of root canal filling rates and postoperative pain levels between the groups. This study was a prospective randomized clinical trial involving 120 teeth in 100 patients aged between 18–65 years. This study involved patients who required primary, nonsurgical root canal treatmnet with either Thermafil or cold lateral compaction by one endodontist with a standard treatment protocol. A total of 56 teeth were filled with cold lateral compaction and 56 teeth with Thermafil. The time used in the entire of obturation was recorded. In a blind evaluation, the treated teeth radiographs were examined according to Orstavik et al. (1986) by two examiners who did not know their group assignment and each apical root canal filling level was examined according to Sjögren's et al. (1990). The obturation time with Thermafil technique was faster than with cold lateral compaction technique and there was statistical significance between the groups (p<0,001). The result of the present study demonstrates that, at 24 hours and 48 hours, mean pain level was higher in the TF group. At 24 hours the postoperative pain difference between the groups was not significant. At 48 hours the postoperative pain difference between the groups was significant (p= 0,002). Patient's age and gender on postoperative pain was not significant. When obturation of root canals using Thermafil, the extension of gutta-percha was more uncontrollable than cold lateral compaction group. There was statistical significance between Thermafil and cold lateral compaction groups (p= 0,027). Endodontic failures with clinical symptoms and/or radiographic radiolucency was observed in one tooth (1,8%) of the cold lateral compaction group and in two teeth (3,6%) in the Thermafil group. There was not statistically significant difference between the treatment outcomes after 24 months of observation period (p > 0.05). In conclusion, when obturating root canals using Thermafil, the extension of gutta-percha is uncontrollable than cold lateral compaction technique. Root canal treatment using with Thermafil was faster than that using cold lateral compaction for obturation time. Favorable results of the present study showed that the good sealing ability of both techniques making them appropriate to use in daily endodontic obturations. Keywords: Thermafil, cold lateral compaction, root canal treatment