Complete Obturation—Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies

Abstract

To prevent re-infection and provide a hermetic seal of the root canal system, an endodontist must aim to produce a void-free obturation. This review aimed to compare the completeness of root canal obturation between the two most prevalent methods—cold lateral condensation and warm gutta-percha techniques—using micro-CT (PROSPERO reg no. 249815). Materials and Methods: A search of Scopus, Embase, PubMed (Medline via PubMed), and Web of Science databases was done without any time restriction according to the PRISMA protocol. Articles that compared both techniques and were published in English were included. Data was extracted and the risk of bias was assessed using an adapted tool based on previous studies. Results: A total of 141 studies were identified by the search. Following the screening and selection of articles, 9 studies were included for review. Data was extracted manually and tabulated. Most studies had a moderate risk of bias. None determined operator skill in both methods before comparison. The data extracted from the included studies suggests that both techniques produce voids in the obturation. The thermoplasticized gutta-percha techniques may result in fewer voids compared to cold lateral condensation. Conclusion: Considering the limitations of the included studies, it was concluded that neither technique could completely obturate the root canal. Thermoplasticized gutta-percha techniques showed better outcomes despite a possible learning bias in favor of cold lateral condensation. Establishing operator skills before comparison may help reduce this bias.

Deficiencies in Root Canal Fillings Subsequent to Adaptive Instrumentation of Oval Canals

“…This might be owing to the file’s exceptional adaptability to the root canal cross-section and continuous irrigation, both of which provide increased cleaning and shaping possibilities. When compared to other files, these are more effective in addressing the perimeter of the root canal, resulting in better cleaning of irregularly shaped root canals [ 21 , 22 , 23 , 24 ]. Due to debris accumulation in the canal irregularities, the root canal filling material cannot flow and establish close contact with the radicular dentine.…”

Does Multi-Fiber-Reinforced Composite-Post Influence the Filling Ability and the Bond Strength in Root Canal?

“…After a successful endodontic treatment, which includes a proper access cavity, shaping, irrigation, and tridimensional filling of the root canal space, clinicians need to select the most appropriate restoration for each endodontically treated tooth (ETT) [ 1 , 2 , 3 , 4 ]. Such restorations may often represent a real challenge, especially in teeth that are structurally compromised; several studies have well established that restorative complications represent the main reason for failure, which may likely lead to tooth extraction [ 5 , 6 ].…”

Successful root canal therapy during COVID-19 pandemic

“…The result of a recenct systematic review by Bhandi et al demonstrated that thermoplasticized techniques had fewer voids in the root canal filling. 9 Moreover, another study evaluated the effect of obturation techniques on root dentinal crack propagation. The results showed no change in the percentage of micro-cracks by using warm vertical or injectable Gutta-Percha techniques.…”