The purpose of this study was to compare three methods of evaluation of the apical seal. Thirty-six teeth were prepared with a ProFile device and filled according to three filling methods: Thermafil (n = 12), warm vertical condensation (n = 12), and the single cone technique (n = 2). The apical seal was recorded with three methods, each successively used on the same teeth: a fluid filtration method, an electrochemical method, and a dye penetration study. The three methods of evaluation did not rank the apical leakage of the three filling techniques in the same order. The fluid filtration method showed that the vertical condensation was superior to Thermafil, which was in turn superior to the single cone technique (p = 0.04). The dye penetration study showed that the Thermafil was a better technique than the vertical condensation and the single cone technique (p = 0.005). The electrochemical method showed no statistical difference among the three filling techniques. No correlation was found among the results obtained with the three methods of evaluation. This study shows that several studies are necessary before comparing the apical seal obtained with various filling techniques.

The purpose of this study was to evaluate the sealing properties of four root canal sealers. Forty-eight maxillary central incisors were instrumented with Profile rotary instruments. They were randomly divided into four groups (n = 12) and filled using lateral condensation with one of the four sealers: Sealapex, Pulp Canal Sealer, AH 26, and Ketac-Endo. The apical leakage was measured with a fluid filtration method and expressed as L s(-1) KPa(-1). The teeth filled with Sealapex displayed a higher apical leakage (8.42 +/- 4.2 10(-11) L s(-1) KPa(-1)) than those filled with AH 26 (2.10 +/- 1.39 10(-11) L s(-1) KPa(-1)), Pulp Canal Sealer (0.17 +/- 0.09 10(-11) L s(-1) KPa(-1)) or Ketac-Endo (0.32 +/- 0.24 10(-1) L s(-1) KPa(-1)) (p < 0.01). No statistically significant difference was found among AH 26, Pulp Canal Sealer, and Ketac-Endo. No correlation was found between the sealing efficiency of the four sealers and their adhesive properties recorded in a previous study.

The incidence of ingestion or aspiration of endodontic instruments was low even thought most general practitioners do not routinely use rubber dam. Use of rubber dam by general practitioners for endodontic procedures should be encouraged by stressing its advantages rather than the fear factor of accidents.

A fluid filtration system was used to compare the apical microleakage of roots filled with the system B (Analytic Technology), single-cone technique, lateral condensation, vertical condensation, and Thermafil (Caulk-Dentsply). After preparation of the canal system with a Profile (Caulk-Dentsply) five groups of 10 single-rooted teeth were randomly filled according to 1 of the 5 techniques. Phosphate-buffered saline was forced under a 15 cm H2O pressure, through the apex, toward the coronal part of the root. The filtration rate in L s(-1) Kpa(-1) was recorded 24 h after filling and after 1-month storage in phosphate-buffered saline. The 24 h results showed that the single cone technique provided the highest leakage (p = 0.001). At 1-month system B, Thermafil and vertical condensation had less leakage than the two other techniques (p = 0.0001): lateral condensation produced moderate apical leakage, whereas the single cone technique showed the highest leakage. Regardless of the technique the apical leakage increased after 1-month storage (p = 0.001 or p = 0.0001, depending on the technique).

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The purpose of this study was to evaluate the influence of the measurement time and the pressure on the outcome of a fluid filtration test. Thirty-six roots were prepared with a Profile device and filled with Thermafil. The leakage along the filling material was recorded under a 15 cm H2O pressure (n = 18) or a 150 cm H2O pressure (n = 18) at 3 min, 1 h, and 24 h. The fluid flow expressed as microl min(-1) decreased with an increased measurement time (p = 0.001) and was higher in the high pressure group (p = 0.001). The fluid flow of this study, where all of the teeth were filled with the same technique, ranged from 3.8 x 10(-5) microl min(-1) cm H2O(-1) to 43 x 10(-5) microl min(-1) cm H2O(-1), depending on the pressure and measurement time. This shows the need for standardization to compare the results from various studies.

The purpose of this study was to compare two methods for evaluating periapical healing in humans: the periapical index (PAI) and a gray value correction method. Fifty human teeth with a periapical lesion were endodontically treated. Radiographs, with a special aluminum device, were taken postoperatively, after 3 months and after 6 months. The PAI was recorded at each period of time, and a Kruskall and Wallis test was performed to compare the three groups. After scanning, the size of the lesion and its gray value were recorded. The aluminum device allowed the gray values to be equalized. An analysis of variance followed by a Duncan test was performed to compare the three groups. The teeth that showed no sign of healing according to the PAI were separately analyzed by an analysis of variance and a Duncan test. The PAI (n = 50) showed signs of periapical healing over time (p < 0.01). The analysis of variance, based on gray value evaluation (n = 50), also showed signs of periapical healing over time (p < 0.002). The analysis of variance of teeth with the same PAI over time (n = 15 at 3 months, and n = 5 at 6 months), based on gray value evaluation showed statistically significant differences among the 3 groups (p < 0.02). These results show that the gray level correction method is powerful and may reduce the risks of false negative responses during assessment of treatment results or epidemiological studies.

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