Comparative Analysis of Temperature Variation with Three Continuous Wave Obturation Systems in Endodontics: An In Vitro Study

Abstract

The aim of this study was to assess temperature changes with different continuous wave obturation systems when downpacking to 2 mm and 4 mm from the apical foramen in an open system not simulating the surrounding biological structures at body temperature. Sixty single-rooted teeth were divided into three groups: (A) Dia-Duo® (DiaDent Group International, Cheongju-si, Korea), (B) Elements Free® (Kerr Corporation, Orange, CA, USA) and (C) Calamus® (Dentsply Sirona, Ballaigues, Switzerland). The root canals were instrumented with Protaper Gold (Dentsply Sirona, Ballaigues, Switzerland) to size F2 (25.08). The root canals were filled by a continuous wave using an AH Plus® sealer (Dentsply Sirona). Temperatures during the obturation procedure were measured by a thermal imaging camera (Testo 875-1®) perpendicular to a vice where the teeth were held at −2 mm and −4 mm from the apical foramen. Comparisons were made by applying Student’s t-test and ANOVA (p = 0.05). The continuous wave technique at −2 mm with the Dia-Duo system® emitted average temperatures of 37.3 °C, Elements Free® emitted 39.85 °C and Calamus® emitted 40.16 °C. At −4 mm, the Dia-Duo system® emitted average temperatures of 34.81 °C, Elements Free® emitted 33.73 °C and Calamus® emitted 32.91 °C. There were significant differences between continuous waves at −2 mm and at −4 mm (p < 0.05). Dia-Duo® was the only system that did not present significant differences between the two lengths (p = 0.197). Regarding the heat emitted, the best system was Elements Free®, since, at −2 mm, it emitted the highest temperature without going above 47 °C. The Dia-Duo® system had lower temperatures. It could be concluded that not all systems transmit the same temperature to the apex and, therefore, to the periapical tissues. The surrounding conditions, such as temperature and humidity, have not been considered in this study.

Root Surface Temperature Measurement During Root Canal Obturation

“…Prolonged exposure to elevated temperatures exceeding 47°C can cause damage to both dental and bone tissues. There is a suggestion that exceeding of the temperature by more than 10°C at the external root surface could potentially lead to the damage in cementum, periodontal ligament, and alveolar bone, possibly inducing resorption or ankylosis [17,23]. If the damage is short-time and the temperature does not exceed 53°C, it may be reversible; however, temperatures beyond this threshold could lead to irreversible bone damage [8].…”