Research ArticleEvaluation of the Sealing Ability of Three ObturationTechniques Using a Glucose Leakage Test

Katarzyna Olczak and Halina Pawlicka

Department of Endodontics Medical University of Lodz Pomorska 251 92-213 Lodz Poland

Correspondence should be addressed to Katarzyna Olczak kolczakoppl

Received 3 February 2017 Accepted 11 May 2017 Published 19 June 2017

Academic Editor Davor Zeljezic

Copyright copy 2017 Katarzyna Olczak and Halina Pawlicka This is an open access article distributed under the Creative CommonsAttribution License which permits unrestricted use distribution and reproduction in any medium provided the original work isproperly cited

The aim of this study was to evaluate the sealing ability of three different canal filling techniques Sixty-four roots of extractedhuman maxillary anterior teeth were prepared using ProTaper rotary instruments The specimens were then randomly dividedinto 3 experimental groups (119899 = 16) and 2 control groups (119899 = 8) The root canals were filled using cold lateral compaction (CLCgroup) continuous wave condensation technique using the Elements ObturationUnit (EOU group) and ProTaper obturators (PTgroup) For the negative control group 8 roots were filled using lateral compaction as in the CLC group and the teeth were coveredtwice with a layer of nail varnish (NCG group) Another 8 roots were filled using lateral compaction but without sealer and thesewere used as the positive control (PCG group) A glucose leakage model was used for quantitative evaluation of microleakage for 24hours and 1 2 3 4 5 6 7 8 9 10 11 and 12 weeks No significant difference in the cumulative amount of leakage was found betweenthe three experimental groups at all observation times The lateral condensation of cold gutta-percha can guarantee a similar sealof canal fillings as can be achieved by using thermal methods in the round canals

1 Introduction

Adequate obturation of the root canal system constitutes oneof the most important stages of endodontic treatment whichsignificantly affects its final result [1] Even a correctly selectedsequence of irrigants the use of additional passive ultrasonicactivation and modern techniques of mechanical root canalpreparation are not capable of eliminating all oral cavitymicroorganisms When the root canal filling is not tightlysealed tissue fluids or saliva components are excellent medi-ums for bacteria [2ndash4] Nowadays root canals are mainlyfilled with gutta-percha combined with a small amount ofsealer using cold or warm gutta-percha methods [1 5ndash7]Two sets of techniques for filling root canals with gutta-percha exist solid core or ldquocold gutta-perchardquo and softenedcore or ldquowarm gutta-perchardquothermal methods The ldquocoldgutta-perchardquo techniques include the single-cone techniqueand lateral compactioncondensation The most commonlyused warm gutta-percha methods are warm vertical com-paction sometimes performed with various modificationscontinuous wave technique injection-molded gutta-percha

and core carrier (thermoplasticized obturator) technique[1 8] The contemporary single-cone obturation techniqueuses larger master cones (greater taper) that best matchthe geometry of canals prepared with nickel-titanium rotaryinstruments The use of these gutta-percha points does notrequire any accessory points or lateral condensation Lateralcompaction (condensation) techniques need onemaster coneand many additional secondary points After cementing themaster cone special instruments spreaders are placed inthe canal and the master cone is laterally compacted againstthe walls of root canals A spreader is then removed and thefirst accessory point inserted into the canal The procedure isrepeated until it is not possible to insert another gutta-perchacone further than 2mm to 3mm into the root canal [1 8]Cold lateral compaction is regarded as the benchmark againstwhich other obturation techniques are evaluated Many stud-ies have examined the quality of the fillings obtained by usinglateral condensation and the thermal method In the early1960s Dr Herbert Schilder created the warm gutta-perchavertical condensation techniqueThe purpose of this methodis to obturate the canal with a fillingmaterial softened by heat

HindawiBioMed Research InternationalVolume 2017 Article ID 2704094 8 pageshttpsdoiorg10115520172704094

2 BioMed Research International

and packed by vertical pressure from the coronal to the apicalpart of the root The master cone is plasticized with a hotinstrument of various specialized equipment systems (egSystem B) Once the down-pack is complete reverse wavesof condensation are carried out to complete the backpack[8] About twenty years later in 1996 Buchanan createdthe continuous wave of condensation obturation technique(CWT) which was a modification of Schilderrsquos warm verticalcondensation [9] The main difference between these twotechniques is that a heat plugger (in the CWT method) isinitially placed at the first introduction through the mastercone towithin 3 to 5mmof theworking length In the originalwarm vertical condensation method described by Schilderthe plugger is introduced several times until it reaches 3 to5mm from the apex In continuous wave of condensationmethod the middle and coronal thirds of the canal arethen ldquobackfilledrdquo using a gutta-percha injection techniqueIn the injection technique gutta-percha is thermoplasticallymolded and ejected from a needle into the canal [9] In orderto facilitate the filling procedure of CWTmanufacturers offerdifferent devices in which the instrument to plasticize gutta-percha in the tooth is combined with a gutta-percha injectionsyringe (eg Elements Obturation Unit BeeFill 2 in 1Calamus) A slightly different method of filling root canalsis the core carrier (thermoplasticized obturator) techniqueThis obturation techniquewas designed andpresented in 1978by Johnson Initially this system relied on metallic carrierscoated by a layer of gutta-percha intended to be heatedover an open flame Contemporary obturators are made ofradiopaque plastic or a cross-linked gutta-percha centralcarrier surrounded by a layer of gutta-percha After heatingin a special oven the obturator is placed into the canal Nextthe coronal part of the obturator is removed [10]

The sealing of the fillings has been often discussed inscientific literature However it is difficult to indicate thepredominance of one technique over the other [11ndash15] despitethe wealth of research on this subject no unequivocal con-sensus has been reached [16ndash22] A number of studies reportno differences in tightness of fillings after the applicationof different methods and little difference is noted betweencold andwarm gutta-percha techniques [16 17] Some studiesreport that fillings created using thermal methods demon-strate better tightness than those using cold gutta-percha[18 19] while others suggest the opposite [20 21]

Hence no clear consensus exists on the efficacy of rootcanal filling methods With this in mind the present studyevaluates the sealing of root canal fillings performed usingwarm and cold gutta-percha techniques Various experimen-tal models have been described to determine leakage alongroot canals filled [17 19ndash21] Although dyes radioisotopesor bacteria penetration techniques have been used to eval-uate the seal of endodontic materials the glucose leakagetestglucose leakage model (GLM) has been advocated asmore clinically relevant [22] The Discussion describes theprocess of checking the seal of the canal filling in greaterdetail

Hence the aim of the present study was to compare thesealing ability of three endodontic filling methods (cold lat-eral condensation technique continuous wave condensation

technique and thermoplasticized obturator technique) usingthe glucose leakage test The null hypothesis is that nodifference exists between the seals of root canals filled withthese three endodontic filling techniques

2 Materials and Methods

Preparation of root specimens for laboratory tests theexperiment was approved by the Bioethics Committee ofthe Medical University of Lodz (number RNN12908KE)Sixty-four roots of extracted human maxillary anterior teethwere prepared using ProTaper rotary instruments The teethwere randomly assigned to 5 groups 3 study groups (16 teetheach) and 2 control groups with 8 teeth in each The rootswere selected for the study based on the following criteria

(i) No previous root canal treatment(ii) No visible signs of root damage in the form of caries

resorption or root fracture(iii) The presence of only one straight round root canal(iv) Fully developed root apices(v) The diameter of the physiological foramen not larger

than a size 15 K file

The teeth were stored in aqueous solution of 02 sodiumazide (NaN

3) Prior to canal instrumentation the roots

were shortened to the same working length of 115mm Theroot canals were chemomechanically prepared with engine-driven ProTaper rotary 6 instruments (Dentsply MailleferBallaigues Switzerland) and irrigated with 525 NaOCl AF3 finishing file was the last instrument used in the apicalregion After preparation the root canals were flushed with15 EDTA 525 NaOCl and 09 NaCl and dried withpaper points Next the root canals were filled in the followingway

Group 1 (cold lateral condensation technique (group CLC))First the master cone was adjusted to reach the workinglength and a slight ldquotug backrdquo was felt at its withdrawalLateral condensation was performed with a 25 nickel-titanium spreader and 20 accessory gutta-percha cones

Group 2 (continuous wave condensation technique usingan Elements Obturation Unit (group EOU)) The verticalcondensation warm gutta-percha method was performedusing the System B tip of the Elements Obturation Unit anda ProTaper gutta-percha cone of F3 size The heated SystemB tip was introduced into the canal to a depth 3mm shorterthan the determined working length The remaining middleand coronal parts of the canal were filled with injected warmgutta-percha delivered from the Elements Obturation UnitExtruder

Group 3 (ProTaper obturators (group PT)) ProTaper obtu-rators F3 (Dentsply Maillefer Ballaigues Switzerland) wereused to fill the root canals of the third group

Group 4 (a negative control group (NCG)) The canals werefilledwith the cold lateral condensation technique in a similar

BioMed Research International 3

Plastic tube

Needle

Sticky wax

Glass bottle with a screw cap

Root specimen

1molL glucose

NaN31mL 02

Figure 1 Glucose penetration model

way to group 1 Prior to the commencement of glucoseleakage test the teeth in the negative control group werecovered twice with a layer of nail varnish

Group 5 (positive control group (PCG)) Root canals werefilled using the cold gutta-percha lateral condensation tech-nique without sealer After condensation was complete thegutta-percha cones were severed with a heated excavator butnot additionally condensed with a plugger

In groups 1 2 3 and 4 AH Plus material (DentsplyMaillefer Ballaigues Switzerland) was used as sealer Aftercanal obturation all the roots were stored in test tubeswrapped in sterile gauze pads saturated with of 01 NaN

3

aqueous solution The specimens were kept in an incubatorat 37∘C and 100 humidity for 3 weeks

21 Construction of the Glucose Leakage Test Device Eachroot was mounted in a leakage device as described by Xuet al [22] A separate model made of single elements wasconstructed for each tooth sample (Figure 1) The externalsurface of each tooth apart from the root apex was coatedwith wax Teeth from the negative control group were coatedwith two layers of nail varnish and then with wax before theexperiment

After tight attachment of all device elements 1molLglucose solution was added as a tracer containing 02 NaN

3

to inhibit the growth of decomposing glucose bacteria Themixture was injected into the device through a plastic tube

until the top of the solutionwas 14 cmhigher than the coronalorifice of the root which created a hydrostatic pressure of15 kPa (15 cm of H

2O) Following this 5mL of the glucose

solution containing 02 NaN3was added to each system

The glucose solution was in the plastic tube and the Eppen-dorf vial Using a pipette 1mL of 02 NaN

3was placed into

the glass bottle in which the root apex of the tooth testedwas immersed Glucose which could pass only through thecanal filling was collected in NaN

3in the glass bottle To

determine the loss of sodium azide during the experiment anadditional system without the tooth was prepared in whichthe Eppendorf vial bottom was not removed This systemwas weighed on high-precision laboratory scales (AnalyticalBalance Radwag) All the systems were stored in an incuba-tor at 37∘C and 100 humidity The specimens were storedaccording to Shemesh et al [23] with some modificationsPrior to their placement in an incubator all the systems wereinserted into a hermetically closed container housing cupswith distilledwaterThus the risk of the volume of the glucoseand sodium azide solutions being decreased by evaporationwas reduced During the experiment the system without thetooth was weighed to allow the potential evaporation of thesolutions to be accounted for Furthermore the level of theglucose solution in plastic tubes was checked

22 Glucose Concentration Measurements In order to deter-mine the glucose concentration 10 120583L of the solution wastaken from each glass bottle after 1 day and then at 7-day

4 BioMed Research International

intervals for the subsequent 12 weeks When the solutionwas collected 10 120583L of fresh 02 NaN

3was added to the

bottle to maintain a constant volume of liquid (1mL) Toevaluate the glucose concentration 1mL of Glucose-Reagentfor determining glucose concentration (BioMaxima) wasadded to the vial Upon addition the glucose contained in thetest tube was oxidized by glucose oxidase to gluconic acid andhydrogen peroxide In the presence of peroxidase the hydro-gen peroxide reacts with phenol and 4-aminoantipyrine (4-AA) to form a coloured compound quinoneimine Theintensity of its colour is directly proportional to the glucoseconcentration The reaction proceeded according to thescheme

D-glucose +H2O +O

2997888rarr gluconic acid +H

2O2

H2O2+ 4-AA + phenol 997888rarr quinoneimine + 4H

2O

(1)

After 10minutes of incubation at 25∘C a BeckmannDU-600spectrophotometer was used to read the absorbance of thestandard specimen and the tested specimens at 490 nm

23 Statistical Analysis The results were analysed to deter-mine whether any statistically significant differences existedbetween the studied techniques regarding their ability to sealthe canal fillingsTheKruskal-Wallis test was used to comparethe amount of glucose (concentration) that leaked along thecanal filling at different time points The chi-square test wasused to determine and compare the particular techniquesof the pulp cavity obturation with regard to the number ofspecimens in which glucose leakage was observed Valuesbelow 119901 = 005 were regarded as statistically significant Allcalculations were performed using Statistica 10 software

3 Results

During the experiment an increase was observed in theglucose leakage in the fillings of the teeth from three studygroups and the positive controls (Figures 2 and 3) In thenegative control group no glucose leakage was found in anyevaluated root canal filling while the highest glucose leakagewas detected in the positive controls (Figure 3) Amongthe three obturation techniques evaluated in the study thehighest glucose concentration was noticed in the group ofteeth filled with the lateral condensation technique of coldgutta-percha (Figure 2) However no statistically significantdifference was observed between the applied pulp cavityobturation methods with regard to the sealing ability ofcanal fillings (119901 gt 005) (Figures 4ndash6) Therefore the nullhypothesis was accepted Moreover in each study group thenumber of teethwith glucose leakage also increasedwith time(Figure 7) However no statistically significant difference wasobserved between the pulp cavity obturation techniques withregard to the number of unsound canal fillings (119901 lt 005)

4 Discussion

As one of the priorities of endodontic treatment is to obtainexcellent quality root canal fillings the seal of the fillings

002040608

112141618

22224

Glu

cose

conc

entr

atio

n (m

mol

L)

Time

CLCEOUPT

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Figure 2 Mean glucose concentrations in mmolL in CLC EOUandPTgroup throughout the experimental period (CLC cold lateralcondensation technique EOU continuous wave of condensationtechnique using Elements Obturation Unit PT ProTaper obtura-tors)

0255075

100125150175200225250275300

NCGPCG

Glu

cose

conc

entr

atio

n(m

mol

L)

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Time

Figure 3Mean glucose concentrations inmmolL in control groupsthroughout the experimental period (NCG negative control groupPCG positive control group)

has been evaluated by many studies most of these beingperformed in vitro However as the nature and amount ofleakage observed in in vitro penetration models cannot bedirectly applied to the clinical situation some researchersquestion the validity of their use [24 25] Neverthelessthese in vitro studies provide valuable information andwhen properly selected prepared and interpreted they cancontribute to a proper assessment of treatment methods Itis not always possible to evaluate materials under clinicalconditions using in vitro approaches even if for ethicalreasons In addition before a medical device or instrumentis tested in vivo it must be evaluated in advance underlaboratory conditions To obtain the highest value in vitroexperiments must be properly selected to reproduce theclinical situation as accurately as possible Dye penetration

BioMed Research International 5

Median

CLC EOU PTMethods

000

001

002

003

004

005

006

007

008

Glu

cose

conc

entr

atio

n (m

mol

L)

24 hours

MinndashMax

Figure 4 Glucose concentrations in mmolL in CLC EOU andPT group after 24 hours (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

6th week

CLC EOU PTMethods

00

05

10

15

20

25

30

35

40

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 5 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 6th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

tests should be avoided as better andmore accurate methodsfor assessing the seal of fillings are available [22 24 25]Since 2005 the glucose leakage test has been the mostfrequently applied method of evaluating the quality of fillingseals [22] Its key advantage is that glucose alone is usedas the tracer Glucose is a hydrophilic substance of low

12th week

CLC EOU PTMethods

0

1

2

3

4

5

6

7

8

9

10

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 6 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 12th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

0123456789

1011121314

The n

umbe

r of t

eeth

with

leak

age

CLCEOUPT

NCGPCG

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ksTime

Figure 7The number of specimens with detectable leakage in eachgroup (CLC cold lateral condensation technique EOU continuouswave of condensation technique using Elements Obturation UnitPT ProTaper obturators NCG negative control group PCG posi-tive control group)

molecular weight which allows it to penetrate the spacesavailable for toxins and bacterial enzymes As bacteria feed onglucose there is a direct relationship between the amount ofavailable sugar the number of harmful microorganisms andthe effect of endodontic treatment [22] Another advantageof the glucose test is the fact that it allows the seal of root

6 BioMed Research International

canal fillings to be traced for a long period of time withoutthe need to destroy the specimen as it happens in the dyepenetration test [22] Furthermore as the glucose solutioncannot penetrate through the root dentine test results cannotbe false positives [23] In addition no chemical reaction isinduced between the solutions used in the glucose leakagetest and the pulp cavity obturation materials applied in thepresent study [26] this is an important point because theglucose test cannot be used to assess the seal of all fillings forexample it is not advisable to use GLM to evaluate materialswith Ca(OH)

2because Ca(OH)

2-containing products react

directly with glucose [26] Furthermore the GLM is quite acomplicated test that requires extraordinary discipline andis time-consuming each tooth must be prepared with aseparate arrangement of individual elements which must bevery carefully and tightly coupled When taking the solutionfrom the glass bottle a part of GLM with a plastic tubewith glucose needs to be very carefully carried in a verticalposition and solutions in the glass bottle and in the plastictube must be maintained at a constant level throughout theentire study however it is only necessary tomake up the fluidto a predetermined amountvolume at each measurementFinally performing the test requires cooperation with achemical laboratory which uses specialized apparatus (ega spectrophotometer) and all samples must be stored underappropriate temperature and humidity conditions [22 23]The Shemesh modification was used in this study to avoidrapid evaporation of fluidglucose [23]

Despite its limitations and its labor- and time-consumingcharacter the glucose penetration test has been used bymany researchers [22 23 26 27] Its great advantage isalso that leakage measurements can be made at any timeintervals determined by the investigator Measurements ofthe glucose filtrate can be performed several times at selectedintervals during the study period or at only one point forexample several weeks or several months from the start ofthe experiment However in the opinion of the authors ofthe present study a few measurements should be taken toallow a better evaluation of filling qualityThe use of frequentmeasurements gives a better picture of the quality of the rootcanal fillings allows the investigator to accurately track theglucose leak and best realizes the potential of the method

In this study a slow gradual increase in glucose leakagewas observed over the 13 measurements performed duringthe experiment No statistically significant differences werefound in the degree of sealing ability of root canal fillings(119901 gt 005) Similar results were achieved by Kececi et al[27] who report that lateral condensation and continuouswave compaction (System B + Obtura II) are comparablesealing methods The first and the last measurement ofglucose concentration was performed three months afterthe commencement of the experiment In another studyslightly higher glucose concentration was observed in canalsfilled using the lateral condensation technique than thoseobturated with the thermal method (System B + ObturaII) during the first eight days of the experiment howeverno significant difference in the seal of canal fillings wasnoted after the second week of observations [28] Xu et al[29] found worse long-term seals when using the lateral

condensation technique than thermal methods (continuouswave compaction and the technique with thermoplasticizedThermafil obturator) No statistically significant differencewas found between the lateral condensation thermalmethodswith regard to sealing ability but only for the first twoweeks of the study From the second to the twelfth week ofthe experiment a lower glucose concentration was recordedin the group of teeth filled with thermal methods At thesame time no significant difference was found between thetwo methods regarding the number of teeth without tracerleakage [29]

Long-term evaluation of the seal of root canal fillingswas also carried out using fluid filtration and bacterial tests[16ndash18 20 30ndash33] After a 16-month specimen incubationno significant differences were observed between the lateralcondensation technique of cold gutta-percha and the verticalcompaction of warm gutta-percha (System B + Obtura II)regarding their ability to seal fillings [16] Higher valuesof fluid leakage were observed after using the Epiphanyand Resilon root canal filling materials compared to gutta-percha and AH Plus sealer [16] Similar seals were found incanals filled with the cold gutta-percha lateral condensationtechnique the thermal technique with plasticized obturator(Thermafil) andwarm vertical compaction (SystemB) duringa two-month study of bacterial penetration [30] Similarresults were obtained after one and four months of the bacte-rial test A comparable passage of bacteria was reported in thecanals filled with the cold gutta-percha lateral condensationvertical compaction of warm gutta-percha continuous wavecompaction and injection methods [19ndash21] Gencoglu et al(2007) [18] report lower fluid penetration in canals filledwith thermal methods (Thermafil Soft-Core or System B)as compared to the canals filled with the cold gutta-perchalateral condensation technique after two-year incubation ofspecimens using a zinc oxide-based sealer and eugenol (KerrPulp Canal Sealer) Because the teeth were stored for twoyears in a moist environment that is during the incubationperiod the plastic material might have partially dissolvedin the group of canals filled by lateral condensation inwhich a greater amount of sealer is usually applied than inthermal techniques [18] On the other hand some studiesindicate that a worse seal was achieved after using the thermalmethod (Touchrsquon Heat + Obtura II) than when cold gutta-percha was used [20] This difference may be due to the typeof root canal sealer used polydimethylsiloxane based rootcanal sealer which undergoes faster polymerization underthe influence of high temperatureThe impairment of siliconebonds and shortened binding time hinder the penetrationof the material into irregularities of the pulp cavity andprevent a tight connection being made with the gutta-percha[20]

5 Conclusion

The lateral condensation of cold gutta-percha can guaranteea similar seal of canal fillings as can be achieved by usingthermal methods in the round canals The glucose leakagetest is a suitable long-term method to evaluate the sealingability of root canal fillings

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International 3

Plastic tube

Needle

Sticky wax

Glass bottle with a screw cap

Root specimen

1molL glucose

NaN31mL 02

Figure 1 Glucose penetration model

way to group 1 Prior to the commencement of glucoseleakage test the teeth in the negative control group werecovered twice with a layer of nail varnish

Group 5 (positive control group (PCG)) Root canals werefilled using the cold gutta-percha lateral condensation tech-nique without sealer After condensation was complete thegutta-percha cones were severed with a heated excavator butnot additionally condensed with a plugger

In groups 1 2 3 and 4 AH Plus material (DentsplyMaillefer Ballaigues Switzerland) was used as sealer Aftercanal obturation all the roots were stored in test tubeswrapped in sterile gauze pads saturated with of 01 NaN

3

aqueous solution The specimens were kept in an incubatorat 37∘C and 100 humidity for 3 weeks

21 Construction of the Glucose Leakage Test Device Eachroot was mounted in a leakage device as described by Xuet al [22] A separate model made of single elements wasconstructed for each tooth sample (Figure 1) The externalsurface of each tooth apart from the root apex was coatedwith wax Teeth from the negative control group were coatedwith two layers of nail varnish and then with wax before theexperiment

After tight attachment of all device elements 1molLglucose solution was added as a tracer containing 02 NaN

3

to inhibit the growth of decomposing glucose bacteria Themixture was injected into the device through a plastic tube

until the top of the solutionwas 14 cmhigher than the coronalorifice of the root which created a hydrostatic pressure of15 kPa (15 cm of H

2O) Following this 5mL of the glucose

solution containing 02 NaN3was added to each system

The glucose solution was in the plastic tube and the Eppen-dorf vial Using a pipette 1mL of 02 NaN

3was placed into

the glass bottle in which the root apex of the tooth testedwas immersed Glucose which could pass only through thecanal filling was collected in NaN

3in the glass bottle To

determine the loss of sodium azide during the experiment anadditional system without the tooth was prepared in whichthe Eppendorf vial bottom was not removed This systemwas weighed on high-precision laboratory scales (AnalyticalBalance Radwag) All the systems were stored in an incuba-tor at 37∘C and 100 humidity The specimens were storedaccording to Shemesh et al [23] with some modificationsPrior to their placement in an incubator all the systems wereinserted into a hermetically closed container housing cupswith distilledwaterThus the risk of the volume of the glucoseand sodium azide solutions being decreased by evaporationwas reduced During the experiment the system without thetooth was weighed to allow the potential evaporation of thesolutions to be accounted for Furthermore the level of theglucose solution in plastic tubes was checked

22 Glucose Concentration Measurements In order to deter-mine the glucose concentration 10 120583L of the solution wastaken from each glass bottle after 1 day and then at 7-day

4 BioMed Research International

intervals for the subsequent 12 weeks When the solutionwas collected 10 120583L of fresh 02 NaN

3was added to the

bottle to maintain a constant volume of liquid (1mL) Toevaluate the glucose concentration 1mL of Glucose-Reagentfor determining glucose concentration (BioMaxima) wasadded to the vial Upon addition the glucose contained in thetest tube was oxidized by glucose oxidase to gluconic acid andhydrogen peroxide In the presence of peroxidase the hydro-gen peroxide reacts with phenol and 4-aminoantipyrine (4-AA) to form a coloured compound quinoneimine Theintensity of its colour is directly proportional to the glucoseconcentration The reaction proceeded according to thescheme

D-glucose +H2O +O

2997888rarr gluconic acid +H

2O2

H2O2+ 4-AA + phenol 997888rarr quinoneimine + 4H

2O

(1)

After 10minutes of incubation at 25∘C a BeckmannDU-600spectrophotometer was used to read the absorbance of thestandard specimen and the tested specimens at 490 nm

23 Statistical Analysis The results were analysed to deter-mine whether any statistically significant differences existedbetween the studied techniques regarding their ability to sealthe canal fillingsTheKruskal-Wallis test was used to comparethe amount of glucose (concentration) that leaked along thecanal filling at different time points The chi-square test wasused to determine and compare the particular techniquesof the pulp cavity obturation with regard to the number ofspecimens in which glucose leakage was observed Valuesbelow 119901 = 005 were regarded as statistically significant Allcalculations were performed using Statistica 10 software

3 Results

During the experiment an increase was observed in theglucose leakage in the fillings of the teeth from three studygroups and the positive controls (Figures 2 and 3) In thenegative control group no glucose leakage was found in anyevaluated root canal filling while the highest glucose leakagewas detected in the positive controls (Figure 3) Amongthe three obturation techniques evaluated in the study thehighest glucose concentration was noticed in the group ofteeth filled with the lateral condensation technique of coldgutta-percha (Figure 2) However no statistically significantdifference was observed between the applied pulp cavityobturation methods with regard to the sealing ability ofcanal fillings (119901 gt 005) (Figures 4ndash6) Therefore the nullhypothesis was accepted Moreover in each study group thenumber of teethwith glucose leakage also increasedwith time(Figure 7) However no statistically significant difference wasobserved between the pulp cavity obturation techniques withregard to the number of unsound canal fillings (119901 lt 005)

4 Discussion

As one of the priorities of endodontic treatment is to obtainexcellent quality root canal fillings the seal of the fillings

002040608

112141618

22224

Glu

cose

conc

entr

atio

n (m

mol

L)

Time

CLCEOUPT

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Figure 2 Mean glucose concentrations in mmolL in CLC EOUandPTgroup throughout the experimental period (CLC cold lateralcondensation technique EOU continuous wave of condensationtechnique using Elements Obturation Unit PT ProTaper obtura-tors)

0255075

100125150175200225250275300

NCGPCG

Glu

cose

conc

entr

atio

n(m

mol

L)

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Time

Figure 3Mean glucose concentrations inmmolL in control groupsthroughout the experimental period (NCG negative control groupPCG positive control group)

has been evaluated by many studies most of these beingperformed in vitro However as the nature and amount ofleakage observed in in vitro penetration models cannot bedirectly applied to the clinical situation some researchersquestion the validity of their use [24 25] Neverthelessthese in vitro studies provide valuable information andwhen properly selected prepared and interpreted they cancontribute to a proper assessment of treatment methods Itis not always possible to evaluate materials under clinicalconditions using in vitro approaches even if for ethicalreasons In addition before a medical device or instrumentis tested in vivo it must be evaluated in advance underlaboratory conditions To obtain the highest value in vitroexperiments must be properly selected to reproduce theclinical situation as accurately as possible Dye penetration

BioMed Research International 5

Median

CLC EOU PTMethods

000

001

002

003

004

005

006

007

008

Glu

cose

conc

entr

atio

n (m

mol

L)

24 hours

MinndashMax

Figure 4 Glucose concentrations in mmolL in CLC EOU andPT group after 24 hours (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

6th week

CLC EOU PTMethods

00

05

10

15

20

25

30

35

40

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 5 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 6th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

tests should be avoided as better andmore accurate methodsfor assessing the seal of fillings are available [22 24 25]Since 2005 the glucose leakage test has been the mostfrequently applied method of evaluating the quality of fillingseals [22] Its key advantage is that glucose alone is usedas the tracer Glucose is a hydrophilic substance of low

12th week

CLC EOU PTMethods

0

1

2

3

4

5

6

7

8

9

10

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 6 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 12th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

0123456789

1011121314

The n

umbe

r of t

eeth

with

leak

age

CLCEOUPT

NCGPCG

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ksTime

Figure 7The number of specimens with detectable leakage in eachgroup (CLC cold lateral condensation technique EOU continuouswave of condensation technique using Elements Obturation UnitPT ProTaper obturators NCG negative control group PCG posi-tive control group)

molecular weight which allows it to penetrate the spacesavailable for toxins and bacterial enzymes As bacteria feed onglucose there is a direct relationship between the amount ofavailable sugar the number of harmful microorganisms andthe effect of endodontic treatment [22] Another advantageof the glucose test is the fact that it allows the seal of root

6 BioMed Research International

canal fillings to be traced for a long period of time withoutthe need to destroy the specimen as it happens in the dyepenetration test [22] Furthermore as the glucose solutioncannot penetrate through the root dentine test results cannotbe false positives [23] In addition no chemical reaction isinduced between the solutions used in the glucose leakagetest and the pulp cavity obturation materials applied in thepresent study [26] this is an important point because theglucose test cannot be used to assess the seal of all fillings forexample it is not advisable to use GLM to evaluate materialswith Ca(OH)

2because Ca(OH)

2-containing products react

directly with glucose [26] Furthermore the GLM is quite acomplicated test that requires extraordinary discipline andis time-consuming each tooth must be prepared with aseparate arrangement of individual elements which must bevery carefully and tightly coupled When taking the solutionfrom the glass bottle a part of GLM with a plastic tubewith glucose needs to be very carefully carried in a verticalposition and solutions in the glass bottle and in the plastictube must be maintained at a constant level throughout theentire study however it is only necessary tomake up the fluidto a predetermined amountvolume at each measurementFinally performing the test requires cooperation with achemical laboratory which uses specialized apparatus (ega spectrophotometer) and all samples must be stored underappropriate temperature and humidity conditions [22 23]The Shemesh modification was used in this study to avoidrapid evaporation of fluidglucose [23]

Despite its limitations and its labor- and time-consumingcharacter the glucose penetration test has been used bymany researchers [22 23 26 27] Its great advantage isalso that leakage measurements can be made at any timeintervals determined by the investigator Measurements ofthe glucose filtrate can be performed several times at selectedintervals during the study period or at only one point forexample several weeks or several months from the start ofthe experiment However in the opinion of the authors ofthe present study a few measurements should be taken toallow a better evaluation of filling qualityThe use of frequentmeasurements gives a better picture of the quality of the rootcanal fillings allows the investigator to accurately track theglucose leak and best realizes the potential of the method

In this study a slow gradual increase in glucose leakagewas observed over the 13 measurements performed duringthe experiment No statistically significant differences werefound in the degree of sealing ability of root canal fillings(119901 gt 005) Similar results were achieved by Kececi et al[27] who report that lateral condensation and continuouswave compaction (System B + Obtura II) are comparablesealing methods The first and the last measurement ofglucose concentration was performed three months afterthe commencement of the experiment In another studyslightly higher glucose concentration was observed in canalsfilled using the lateral condensation technique than thoseobturated with the thermal method (System B + ObturaII) during the first eight days of the experiment howeverno significant difference in the seal of canal fillings wasnoted after the second week of observations [28] Xu et al[29] found worse long-term seals when using the lateral

condensation technique than thermal methods (continuouswave compaction and the technique with thermoplasticizedThermafil obturator) No statistically significant differencewas found between the lateral condensation thermalmethodswith regard to sealing ability but only for the first twoweeks of the study From the second to the twelfth week ofthe experiment a lower glucose concentration was recordedin the group of teeth filled with thermal methods At thesame time no significant difference was found between thetwo methods regarding the number of teeth without tracerleakage [29]

Long-term evaluation of the seal of root canal fillingswas also carried out using fluid filtration and bacterial tests[16ndash18 20 30ndash33] After a 16-month specimen incubationno significant differences were observed between the lateralcondensation technique of cold gutta-percha and the verticalcompaction of warm gutta-percha (System B + Obtura II)regarding their ability to seal fillings [16] Higher valuesof fluid leakage were observed after using the Epiphanyand Resilon root canal filling materials compared to gutta-percha and AH Plus sealer [16] Similar seals were found incanals filled with the cold gutta-percha lateral condensationtechnique the thermal technique with plasticized obturator(Thermafil) andwarm vertical compaction (SystemB) duringa two-month study of bacterial penetration [30] Similarresults were obtained after one and four months of the bacte-rial test A comparable passage of bacteria was reported in thecanals filled with the cold gutta-percha lateral condensationvertical compaction of warm gutta-percha continuous wavecompaction and injection methods [19ndash21] Gencoglu et al(2007) [18] report lower fluid penetration in canals filledwith thermal methods (Thermafil Soft-Core or System B)as compared to the canals filled with the cold gutta-perchalateral condensation technique after two-year incubation ofspecimens using a zinc oxide-based sealer and eugenol (KerrPulp Canal Sealer) Because the teeth were stored for twoyears in a moist environment that is during the incubationperiod the plastic material might have partially dissolvedin the group of canals filled by lateral condensation inwhich a greater amount of sealer is usually applied than inthermal techniques [18] On the other hand some studiesindicate that a worse seal was achieved after using the thermalmethod (Touchrsquon Heat + Obtura II) than when cold gutta-percha was used [20] This difference may be due to the typeof root canal sealer used polydimethylsiloxane based rootcanal sealer which undergoes faster polymerization underthe influence of high temperatureThe impairment of siliconebonds and shortened binding time hinder the penetrationof the material into irregularities of the pulp cavity andprevent a tight connection being made with the gutta-percha[20]

5 Conclusion

The lateral condensation of cold gutta-percha can guaranteea similar seal of canal fillings as can be achieved by usingthermal methods in the round canals The glucose leakagetest is a suitable long-term method to evaluate the sealingability of root canal fillings

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

4 BioMed Research International

intervals for the subsequent 12 weeks When the solutionwas collected 10 120583L of fresh 02 NaN

3was added to the

bottle to maintain a constant volume of liquid (1mL) Toevaluate the glucose concentration 1mL of Glucose-Reagentfor determining glucose concentration (BioMaxima) wasadded to the vial Upon addition the glucose contained in thetest tube was oxidized by glucose oxidase to gluconic acid andhydrogen peroxide In the presence of peroxidase the hydro-gen peroxide reacts with phenol and 4-aminoantipyrine (4-AA) to form a coloured compound quinoneimine Theintensity of its colour is directly proportional to the glucoseconcentration The reaction proceeded according to thescheme

D-glucose +H2O +O

2997888rarr gluconic acid +H

2O2

H2O2+ 4-AA + phenol 997888rarr quinoneimine + 4H

2O

(1)

After 10minutes of incubation at 25∘C a BeckmannDU-600spectrophotometer was used to read the absorbance of thestandard specimen and the tested specimens at 490 nm

23 Statistical Analysis The results were analysed to deter-mine whether any statistically significant differences existedbetween the studied techniques regarding their ability to sealthe canal fillingsTheKruskal-Wallis test was used to comparethe amount of glucose (concentration) that leaked along thecanal filling at different time points The chi-square test wasused to determine and compare the particular techniquesof the pulp cavity obturation with regard to the number ofspecimens in which glucose leakage was observed Valuesbelow 119901 = 005 were regarded as statistically significant Allcalculations were performed using Statistica 10 software

3 Results

During the experiment an increase was observed in theglucose leakage in the fillings of the teeth from three studygroups and the positive controls (Figures 2 and 3) In thenegative control group no glucose leakage was found in anyevaluated root canal filling while the highest glucose leakagewas detected in the positive controls (Figure 3) Amongthe three obturation techniques evaluated in the study thehighest glucose concentration was noticed in the group ofteeth filled with the lateral condensation technique of coldgutta-percha (Figure 2) However no statistically significantdifference was observed between the applied pulp cavityobturation methods with regard to the sealing ability ofcanal fillings (119901 gt 005) (Figures 4ndash6) Therefore the nullhypothesis was accepted Moreover in each study group thenumber of teethwith glucose leakage also increasedwith time(Figure 7) However no statistically significant difference wasobserved between the pulp cavity obturation techniques withregard to the number of unsound canal fillings (119901 lt 005)

4 Discussion

As one of the priorities of endodontic treatment is to obtainexcellent quality root canal fillings the seal of the fillings

002040608

112141618

22224

Glu

cose

conc

entr

atio

n (m

mol

L)

Time

CLCEOUPT

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Figure 2 Mean glucose concentrations in mmolL in CLC EOUandPTgroup throughout the experimental period (CLC cold lateralcondensation technique EOU continuous wave of condensationtechnique using Elements Obturation Unit PT ProTaper obtura-tors)

0255075

100125150175200225250275300

NCGPCG

Glu

cose

conc

entr

atio

n(m

mol

L)

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ks

Time

Figure 3Mean glucose concentrations inmmolL in control groupsthroughout the experimental period (NCG negative control groupPCG positive control group)

has been evaluated by many studies most of these beingperformed in vitro However as the nature and amount ofleakage observed in in vitro penetration models cannot bedirectly applied to the clinical situation some researchersquestion the validity of their use [24 25] Neverthelessthese in vitro studies provide valuable information andwhen properly selected prepared and interpreted they cancontribute to a proper assessment of treatment methods Itis not always possible to evaluate materials under clinicalconditions using in vitro approaches even if for ethicalreasons In addition before a medical device or instrumentis tested in vivo it must be evaluated in advance underlaboratory conditions To obtain the highest value in vitroexperiments must be properly selected to reproduce theclinical situation as accurately as possible Dye penetration

BioMed Research International 5

Median

CLC EOU PTMethods

000

001

002

003

004

005

006

007

008

Glu

cose

conc

entr

atio

n (m

mol

L)

24 hours

MinndashMax

Figure 4 Glucose concentrations in mmolL in CLC EOU andPT group after 24 hours (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

6th week

CLC EOU PTMethods

00

05

10

15

20

25

30

35

40

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 5 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 6th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

tests should be avoided as better andmore accurate methodsfor assessing the seal of fillings are available [22 24 25]Since 2005 the glucose leakage test has been the mostfrequently applied method of evaluating the quality of fillingseals [22] Its key advantage is that glucose alone is usedas the tracer Glucose is a hydrophilic substance of low

12th week

CLC EOU PTMethods

0

1

2

3

4

5

6

7

8

9

10

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 6 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 12th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

0123456789

1011121314

The n

umbe

r of t

eeth

with

leak

age

CLCEOUPT

NCGPCG

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ksTime

Figure 7The number of specimens with detectable leakage in eachgroup (CLC cold lateral condensation technique EOU continuouswave of condensation technique using Elements Obturation UnitPT ProTaper obturators NCG negative control group PCG posi-tive control group)

molecular weight which allows it to penetrate the spacesavailable for toxins and bacterial enzymes As bacteria feed onglucose there is a direct relationship between the amount ofavailable sugar the number of harmful microorganisms andthe effect of endodontic treatment [22] Another advantageof the glucose test is the fact that it allows the seal of root

6 BioMed Research International

canal fillings to be traced for a long period of time withoutthe need to destroy the specimen as it happens in the dyepenetration test [22] Furthermore as the glucose solutioncannot penetrate through the root dentine test results cannotbe false positives [23] In addition no chemical reaction isinduced between the solutions used in the glucose leakagetest and the pulp cavity obturation materials applied in thepresent study [26] this is an important point because theglucose test cannot be used to assess the seal of all fillings forexample it is not advisable to use GLM to evaluate materialswith Ca(OH)

2because Ca(OH)

2-containing products react

directly with glucose [26] Furthermore the GLM is quite acomplicated test that requires extraordinary discipline andis time-consuming each tooth must be prepared with aseparate arrangement of individual elements which must bevery carefully and tightly coupled When taking the solutionfrom the glass bottle a part of GLM with a plastic tubewith glucose needs to be very carefully carried in a verticalposition and solutions in the glass bottle and in the plastictube must be maintained at a constant level throughout theentire study however it is only necessary tomake up the fluidto a predetermined amountvolume at each measurementFinally performing the test requires cooperation with achemical laboratory which uses specialized apparatus (ega spectrophotometer) and all samples must be stored underappropriate temperature and humidity conditions [22 23]The Shemesh modification was used in this study to avoidrapid evaporation of fluidglucose [23]

Despite its limitations and its labor- and time-consumingcharacter the glucose penetration test has been used bymany researchers [22 23 26 27] Its great advantage isalso that leakage measurements can be made at any timeintervals determined by the investigator Measurements ofthe glucose filtrate can be performed several times at selectedintervals during the study period or at only one point forexample several weeks or several months from the start ofthe experiment However in the opinion of the authors ofthe present study a few measurements should be taken toallow a better evaluation of filling qualityThe use of frequentmeasurements gives a better picture of the quality of the rootcanal fillings allows the investigator to accurately track theglucose leak and best realizes the potential of the method

In this study a slow gradual increase in glucose leakagewas observed over the 13 measurements performed duringthe experiment No statistically significant differences werefound in the degree of sealing ability of root canal fillings(119901 gt 005) Similar results were achieved by Kececi et al[27] who report that lateral condensation and continuouswave compaction (System B + Obtura II) are comparablesealing methods The first and the last measurement ofglucose concentration was performed three months afterthe commencement of the experiment In another studyslightly higher glucose concentration was observed in canalsfilled using the lateral condensation technique than thoseobturated with the thermal method (System B + ObturaII) during the first eight days of the experiment howeverno significant difference in the seal of canal fillings wasnoted after the second week of observations [28] Xu et al[29] found worse long-term seals when using the lateral

condensation technique than thermal methods (continuouswave compaction and the technique with thermoplasticizedThermafil obturator) No statistically significant differencewas found between the lateral condensation thermalmethodswith regard to sealing ability but only for the first twoweeks of the study From the second to the twelfth week ofthe experiment a lower glucose concentration was recordedin the group of teeth filled with thermal methods At thesame time no significant difference was found between thetwo methods regarding the number of teeth without tracerleakage [29]

Long-term evaluation of the seal of root canal fillingswas also carried out using fluid filtration and bacterial tests[16ndash18 20 30ndash33] After a 16-month specimen incubationno significant differences were observed between the lateralcondensation technique of cold gutta-percha and the verticalcompaction of warm gutta-percha (System B + Obtura II)regarding their ability to seal fillings [16] Higher valuesof fluid leakage were observed after using the Epiphanyand Resilon root canal filling materials compared to gutta-percha and AH Plus sealer [16] Similar seals were found incanals filled with the cold gutta-percha lateral condensationtechnique the thermal technique with plasticized obturator(Thermafil) andwarm vertical compaction (SystemB) duringa two-month study of bacterial penetration [30] Similarresults were obtained after one and four months of the bacte-rial test A comparable passage of bacteria was reported in thecanals filled with the cold gutta-percha lateral condensationvertical compaction of warm gutta-percha continuous wavecompaction and injection methods [19ndash21] Gencoglu et al(2007) [18] report lower fluid penetration in canals filledwith thermal methods (Thermafil Soft-Core or System B)as compared to the canals filled with the cold gutta-perchalateral condensation technique after two-year incubation ofspecimens using a zinc oxide-based sealer and eugenol (KerrPulp Canal Sealer) Because the teeth were stored for twoyears in a moist environment that is during the incubationperiod the plastic material might have partially dissolvedin the group of canals filled by lateral condensation inwhich a greater amount of sealer is usually applied than inthermal techniques [18] On the other hand some studiesindicate that a worse seal was achieved after using the thermalmethod (Touchrsquon Heat + Obtura II) than when cold gutta-percha was used [20] This difference may be due to the typeof root canal sealer used polydimethylsiloxane based rootcanal sealer which undergoes faster polymerization underthe influence of high temperatureThe impairment of siliconebonds and shortened binding time hinder the penetrationof the material into irregularities of the pulp cavity andprevent a tight connection being made with the gutta-percha[20]

5 Conclusion

The lateral condensation of cold gutta-percha can guaranteea similar seal of canal fillings as can be achieved by usingthermal methods in the round canals The glucose leakagetest is a suitable long-term method to evaluate the sealingability of root canal fillings

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International 5

Median

CLC EOU PTMethods

000

001

002

003

004

005

006

007

008

Glu

cose

conc

entr

atio

n (m

mol

L)

24 hours

MinndashMax

Figure 4 Glucose concentrations in mmolL in CLC EOU andPT group after 24 hours (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

6th week

CLC EOU PTMethods

00

05

10

15

20

25

30

35

40

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 5 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 6th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

tests should be avoided as better andmore accurate methodsfor assessing the seal of fillings are available [22 24 25]Since 2005 the glucose leakage test has been the mostfrequently applied method of evaluating the quality of fillingseals [22] Its key advantage is that glucose alone is usedas the tracer Glucose is a hydrophilic substance of low

12th week

CLC EOU PTMethods

0

1

2

3

4

5

6

7

8

9

10

Glu

cose

conc

entr

atio

n (m

mol

L)

Median25ndash75MinndashMax

Figure 6 Glucose concentrations in mmolL in CLC EOU and PTgroup at the 12th week (CLC cold lateral condensation techniqueEOU continuous wave of condensation technique using ElementsObturation Unit PT ProTaper obturators)

0123456789

1011121314

The n

umbe

r of t

eeth

with

leak

age

CLCEOUPT

NCGPCG

24

hour

s

1w

eek

2w

eeks

3w

eeks

4w

eeks

5w

eeks

6w

eeks

7w

eeks

8w

eeks

9w

eeks

10

wee

ks

11

wee

ks

12

wee

ksTime

Figure 7The number of specimens with detectable leakage in eachgroup (CLC cold lateral condensation technique EOU continuouswave of condensation technique using Elements Obturation UnitPT ProTaper obturators NCG negative control group PCG posi-tive control group)

molecular weight which allows it to penetrate the spacesavailable for toxins and bacterial enzymes As bacteria feed onglucose there is a direct relationship between the amount ofavailable sugar the number of harmful microorganisms andthe effect of endodontic treatment [22] Another advantageof the glucose test is the fact that it allows the seal of root

6 BioMed Research International

canal fillings to be traced for a long period of time withoutthe need to destroy the specimen as it happens in the dyepenetration test [22] Furthermore as the glucose solutioncannot penetrate through the root dentine test results cannotbe false positives [23] In addition no chemical reaction isinduced between the solutions used in the glucose leakagetest and the pulp cavity obturation materials applied in thepresent study [26] this is an important point because theglucose test cannot be used to assess the seal of all fillings forexample it is not advisable to use GLM to evaluate materialswith Ca(OH)

2because Ca(OH)

2-containing products react

directly with glucose [26] Furthermore the GLM is quite acomplicated test that requires extraordinary discipline andis time-consuming each tooth must be prepared with aseparate arrangement of individual elements which must bevery carefully and tightly coupled When taking the solutionfrom the glass bottle a part of GLM with a plastic tubewith glucose needs to be very carefully carried in a verticalposition and solutions in the glass bottle and in the plastictube must be maintained at a constant level throughout theentire study however it is only necessary tomake up the fluidto a predetermined amountvolume at each measurementFinally performing the test requires cooperation with achemical laboratory which uses specialized apparatus (ega spectrophotometer) and all samples must be stored underappropriate temperature and humidity conditions [22 23]The Shemesh modification was used in this study to avoidrapid evaporation of fluidglucose [23]

Despite its limitations and its labor- and time-consumingcharacter the glucose penetration test has been used bymany researchers [22 23 26 27] Its great advantage isalso that leakage measurements can be made at any timeintervals determined by the investigator Measurements ofthe glucose filtrate can be performed several times at selectedintervals during the study period or at only one point forexample several weeks or several months from the start ofthe experiment However in the opinion of the authors ofthe present study a few measurements should be taken toallow a better evaluation of filling qualityThe use of frequentmeasurements gives a better picture of the quality of the rootcanal fillings allows the investigator to accurately track theglucose leak and best realizes the potential of the method

In this study a slow gradual increase in glucose leakagewas observed over the 13 measurements performed duringthe experiment No statistically significant differences werefound in the degree of sealing ability of root canal fillings(119901 gt 005) Similar results were achieved by Kececi et al[27] who report that lateral condensation and continuouswave compaction (System B + Obtura II) are comparablesealing methods The first and the last measurement ofglucose concentration was performed three months afterthe commencement of the experiment In another studyslightly higher glucose concentration was observed in canalsfilled using the lateral condensation technique than thoseobturated with the thermal method (System B + ObturaII) during the first eight days of the experiment howeverno significant difference in the seal of canal fillings wasnoted after the second week of observations [28] Xu et al[29] found worse long-term seals when using the lateral

condensation technique than thermal methods (continuouswave compaction and the technique with thermoplasticizedThermafil obturator) No statistically significant differencewas found between the lateral condensation thermalmethodswith regard to sealing ability but only for the first twoweeks of the study From the second to the twelfth week ofthe experiment a lower glucose concentration was recordedin the group of teeth filled with thermal methods At thesame time no significant difference was found between thetwo methods regarding the number of teeth without tracerleakage [29]

Long-term evaluation of the seal of root canal fillingswas also carried out using fluid filtration and bacterial tests[16ndash18 20 30ndash33] After a 16-month specimen incubationno significant differences were observed between the lateralcondensation technique of cold gutta-percha and the verticalcompaction of warm gutta-percha (System B + Obtura II)regarding their ability to seal fillings [16] Higher valuesof fluid leakage were observed after using the Epiphanyand Resilon root canal filling materials compared to gutta-percha and AH Plus sealer [16] Similar seals were found incanals filled with the cold gutta-percha lateral condensationtechnique the thermal technique with plasticized obturator(Thermafil) andwarm vertical compaction (SystemB) duringa two-month study of bacterial penetration [30] Similarresults were obtained after one and four months of the bacte-rial test A comparable passage of bacteria was reported in thecanals filled with the cold gutta-percha lateral condensationvertical compaction of warm gutta-percha continuous wavecompaction and injection methods [19ndash21] Gencoglu et al(2007) [18] report lower fluid penetration in canals filledwith thermal methods (Thermafil Soft-Core or System B)as compared to the canals filled with the cold gutta-perchalateral condensation technique after two-year incubation ofspecimens using a zinc oxide-based sealer and eugenol (KerrPulp Canal Sealer) Because the teeth were stored for twoyears in a moist environment that is during the incubationperiod the plastic material might have partially dissolvedin the group of canals filled by lateral condensation inwhich a greater amount of sealer is usually applied than inthermal techniques [18] On the other hand some studiesindicate that a worse seal was achieved after using the thermalmethod (Touchrsquon Heat + Obtura II) than when cold gutta-percha was used [20] This difference may be due to the typeof root canal sealer used polydimethylsiloxane based rootcanal sealer which undergoes faster polymerization underthe influence of high temperatureThe impairment of siliconebonds and shortened binding time hinder the penetrationof the material into irregularities of the pulp cavity andprevent a tight connection being made with the gutta-percha[20]

5 Conclusion

The lateral condensation of cold gutta-percha can guaranteea similar seal of canal fillings as can be achieved by usingthermal methods in the round canals The glucose leakagetest is a suitable long-term method to evaluate the sealingability of root canal fillings

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

6 BioMed Research International

canal fillings to be traced for a long period of time withoutthe need to destroy the specimen as it happens in the dyepenetration test [22] Furthermore as the glucose solutioncannot penetrate through the root dentine test results cannotbe false positives [23] In addition no chemical reaction isinduced between the solutions used in the glucose leakagetest and the pulp cavity obturation materials applied in thepresent study [26] this is an important point because theglucose test cannot be used to assess the seal of all fillings forexample it is not advisable to use GLM to evaluate materialswith Ca(OH)

2because Ca(OH)

2-containing products react

directly with glucose [26] Furthermore the GLM is quite acomplicated test that requires extraordinary discipline andis time-consuming each tooth must be prepared with aseparate arrangement of individual elements which must bevery carefully and tightly coupled When taking the solutionfrom the glass bottle a part of GLM with a plastic tubewith glucose needs to be very carefully carried in a verticalposition and solutions in the glass bottle and in the plastictube must be maintained at a constant level throughout theentire study however it is only necessary tomake up the fluidto a predetermined amountvolume at each measurementFinally performing the test requires cooperation with achemical laboratory which uses specialized apparatus (ega spectrophotometer) and all samples must be stored underappropriate temperature and humidity conditions [22 23]The Shemesh modification was used in this study to avoidrapid evaporation of fluidglucose [23]

Despite its limitations and its labor- and time-consumingcharacter the glucose penetration test has been used bymany researchers [22 23 26 27] Its great advantage isalso that leakage measurements can be made at any timeintervals determined by the investigator Measurements ofthe glucose filtrate can be performed several times at selectedintervals during the study period or at only one point forexample several weeks or several months from the start ofthe experiment However in the opinion of the authors ofthe present study a few measurements should be taken toallow a better evaluation of filling qualityThe use of frequentmeasurements gives a better picture of the quality of the rootcanal fillings allows the investigator to accurately track theglucose leak and best realizes the potential of the method

In this study a slow gradual increase in glucose leakagewas observed over the 13 measurements performed duringthe experiment No statistically significant differences werefound in the degree of sealing ability of root canal fillings(119901 gt 005) Similar results were achieved by Kececi et al[27] who report that lateral condensation and continuouswave compaction (System B + Obtura II) are comparablesealing methods The first and the last measurement ofglucose concentration was performed three months afterthe commencement of the experiment In another studyslightly higher glucose concentration was observed in canalsfilled using the lateral condensation technique than thoseobturated with the thermal method (System B + ObturaII) during the first eight days of the experiment howeverno significant difference in the seal of canal fillings wasnoted after the second week of observations [28] Xu et al[29] found worse long-term seals when using the lateral

condensation technique than thermal methods (continuouswave compaction and the technique with thermoplasticizedThermafil obturator) No statistically significant differencewas found between the lateral condensation thermalmethodswith regard to sealing ability but only for the first twoweeks of the study From the second to the twelfth week ofthe experiment a lower glucose concentration was recordedin the group of teeth filled with thermal methods At thesame time no significant difference was found between thetwo methods regarding the number of teeth without tracerleakage [29]

Long-term evaluation of the seal of root canal fillingswas also carried out using fluid filtration and bacterial tests[16ndash18 20 30ndash33] After a 16-month specimen incubationno significant differences were observed between the lateralcondensation technique of cold gutta-percha and the verticalcompaction of warm gutta-percha (System B + Obtura II)regarding their ability to seal fillings [16] Higher valuesof fluid leakage were observed after using the Epiphanyand Resilon root canal filling materials compared to gutta-percha and AH Plus sealer [16] Similar seals were found incanals filled with the cold gutta-percha lateral condensationtechnique the thermal technique with plasticized obturator(Thermafil) andwarm vertical compaction (SystemB) duringa two-month study of bacterial penetration [30] Similarresults were obtained after one and four months of the bacte-rial test A comparable passage of bacteria was reported in thecanals filled with the cold gutta-percha lateral condensationvertical compaction of warm gutta-percha continuous wavecompaction and injection methods [19ndash21] Gencoglu et al(2007) [18] report lower fluid penetration in canals filledwith thermal methods (Thermafil Soft-Core or System B)as compared to the canals filled with the cold gutta-perchalateral condensation technique after two-year incubation ofspecimens using a zinc oxide-based sealer and eugenol (KerrPulp Canal Sealer) Because the teeth were stored for twoyears in a moist environment that is during the incubationperiod the plastic material might have partially dissolvedin the group of canals filled by lateral condensation inwhich a greater amount of sealer is usually applied than inthermal techniques [18] On the other hand some studiesindicate that a worse seal was achieved after using the thermalmethod (Touchrsquon Heat + Obtura II) than when cold gutta-percha was used [20] This difference may be due to the typeof root canal sealer used polydimethylsiloxane based rootcanal sealer which undergoes faster polymerization underthe influence of high temperatureThe impairment of siliconebonds and shortened binding time hinder the penetrationof the material into irregularities of the pulp cavity andprevent a tight connection being made with the gutta-percha[20]

5 Conclusion

The lateral condensation of cold gutta-percha can guaranteea similar seal of canal fillings as can be achieved by usingthermal methods in the round canals The glucose leakagetest is a suitable long-term method to evaluate the sealingability of root canal fillings

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International 7

Disclosure

The content of this article is included in the doctoral disser-tation of Dr Katarzyna Olczak DDS PhD The dissertationwas supervised by Professor Halina Pawlicka DDS PhD

Conflicts of Interest

The authors declare that they have no conflicts of interest

Funding

The authors received Fund nos 502-032-044-02502-24-057and 5032-148-04503-16-001

Acknowledgments

The authors would like to thank Professor L ZylinskaHead of the Department of Molecular Neurochemistry andProfessor J Bartkowiak Head of the Department of MedicalBiochemistry for enabling them to carry out investigations

References

[1] J Whitworth ldquoMethods of filling root canals principles andpracticesrdquo Endodontic Topics vol 12 no 1 pp 2ndash24 2005

[2] S Al-Nazhan A Al-Sulaiman F Al-Rasheed F Alnajjar B Al-Abdulwahab and A Al-Badah ldquoMicroorganism penetration indentinal tubules of instrumented and retreated root canal wallsrdquoRestorative Dentistry amp Endodontics vol 39 no 2 pp 258ndash2642014

[3] M Haapasalo T Udnaes and U Endal ldquoPersistent recurrentand acquired infection of the root canal system post-treatmentrdquoEndodontic Topics vol 6 no 1 pp 29ndash56 2003

[4] A Dumani H K Guvenmez S Yilmaz O Yoldas and Z GB Kurklu ldquoAntibacterial efficacy of calcium hypochlorite withvibringe sonic irrigation system on Enterococcus faecalis an invitro studyrdquo BioMed Research International vol 2016 Article ID8076131 5 pages 2016

[5] C Lost ldquoQuality guidelines for endodontic treatment con-sensus report of the European Society of EndodontologyrdquoInternational Endodontic Journal vol 39 no 12 pp 921ndash9302006

[6] P Reszka A Nowicka M Lipski W Dura A Drozdzik andK Wozniak ldquoA comparative chemical study of calcium silicate-containing and epoxy resin-based root canal sealersrdquo BioMedResearch International vol 2016 Article ID 9808432 8 pages2016

[7] A Al-Haddad and Z A C A Aziz ldquoBioceramic-based rootcanal sealers a reviewrdquo International Journal of Biomaterialsvol 2016 Article ID 9753210 10 pages 2016

[8] P Carrotte ldquoEndodontics part 8 filling the root canal systemrdquoBritish Dental Journal vol 197 no 11 pp 667ndash672 2004

[9] L S Buchanan ldquoThe continuous wave of obturation techniquersquocenteredrsquo condensation of warm gutta percha in 12 secondsrdquoDentistry Today vol 15 no 1 pp 60ndash87 1996

[10] G Migliau A A Sofan E A Sofan S Cosma S Eramo andL Gallottini ldquoRoot canal obturation experimental study onthe thermafil system related to different irrigation protocolsrdquoAnnali di Stomatologia vol 5 no 3 pp 91ndash97 2014

[11] F Goldberg L Artaza and A De Silvo ldquoEffectiveness ofdifferent obturation techniques in the filling of simulated lateralcanalsrdquo Journal of Endodontics vol 27 no 5 pp 362ndash364 2001

[12] V Arikan H Sonmez and S Sari ldquoComparison of two basematerials regarding their effect on root canal treatment successin primary molars with furcation lesionsrdquo BioMed ResearchInternational vol 2016 Article ID 1429286 7 pages 2016

[13] B Fan M-K Wu and P R Wesselink ldquoLeakage along warmgutta-percha fillings in the apical canals of curved rootsrdquoEndodontic amp Dental Traumatology vol 16 no 1 pp 29ndash332000

[14] M Farea S Masudi and W Z W Bakar ldquoApical microleakageevaluation of system B compared with cold lateral techniqueIn vitro studyrdquo Australian Endodontic Journal vol 36 no 2 pp48ndash53 2010

[15] J Wolcott T Van Himel W Powell and J Penney ldquoEffect oftwo obturation techniques on the filling of lateral canals and themain canalrdquo Journal of Endodontics vol 23 no 10 pp 632ndash6351997

[16] F Paque and G Sirtes ldquoApical sealing ability of ResilonEpiphany versus gutta-perchaAH Plus immediate and 16-months leakagerdquo International Endodontic Journal vol 40 no9 pp 722ndash729 2007

[17] A E Williamson K L Marker D R Drake D V Dawsonand R E Walton ldquoResin-based versus gutta-percha-based rootcanal obturation influence on bacterial leakage in an in vitromodel systemrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 108 no 2 pp 292ndash2962009

[18] N Gencoglu H Orucolu and D Helvaciolu ldquoApical leakagedifferent gutta-percha techniques Thermafil JS Quick-FillSoft Core Microseal System B and lateral condensation witha computerized fluid filtaration meterrdquo European Journal ofDentistry vol 1 no 2 pp 97ndash103 2007

[19] L Pommel and J Camps ldquoIn vitro apical leakage of system Bcompared with other filling techniquesrdquo Journal of Endodonticsvol 27 no 7 pp 449ndash451 2001

[20] M-K Wu L W M Van Der Sluis C N Ardila and P RWesselink ldquoFluid movement along the coronal two-thirds ofroot fillings placed by three different gutta-percha techniquesrdquoInternational Endodontic Journal vol 36 no 8 pp 533ndash5402003

[21] K Schwarze S Stephan H Dogan and Gunay ldquoBakterien-penetrationsuntersuchung zur Dichtigkeit von Roeko Seal beiverschidenen Fulltechnikenrdquo Endodontie vol 15 no 4 pp 337ndash342 2006

[22] Q XuM-W Fan B Fan G S P Cheung andH-L Hu ldquoA newquantitative method using glucose for analysis of endodonticleakagerdquo Oral Surgery Oral Medicine Oral Pathology OralRadiology and Endodontics vol 99 no 1 pp 107ndash111 2005

[23] H Shemesh M Van Den Bos M-K Wu and P R WesselinkldquoGlucose penetration and fluid transport through coronalroot structure and filled root canalsrdquo International EndodonticJournal vol 40 no 11 pp 866ndash872 2007

[24] G DeDeus ldquoNew directions in old leakage methodsrdquo Interna-tional Endodontic Journal vol 41 no 8 pp 720-721 2008

[25] C M Oliver and P V Abbott ldquoCorrelation between clinicalsuccess and apical dye penetrationrdquo International EndodonticJournal vol 34 no 8 pp 637ndash644 2001

[26] H Shemesh E M Souza M-K Wu and P R WesselinkldquoGlucose reactivitywith fillingmaterials as a limitation for using

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

8 BioMed Research International

the glucose leakage modelrdquo International Endodontic Journalvol 41 no 10 pp 869ndash872 2008

[27] A D Kececi B U Kaya and S Belli ldquoCorono-apical leakageof various root filling materials using two different penetrationmodelsmdasha 3-month studyrdquo Journal of Biomedical MaterialsResearchmdashPart B Applied Biomaterials vol 92 no 1 pp 261ndash267 2010

[28] B U Kaya A D Kececi and S Belli ldquoEvaluation of the sealingability of gutta-percha and thermoplastic synthetic polymer-based systems along the root canals through the glucose pen-etration modelrdquo Oral Surgery Oral Medicine Oral PathologyOral Radiology and Endodontology vol 104 no 6 pp e66ndashe732007

[29] Q Xu J Ling G S P Cheung and Y Hu ldquoA quantitativeevaluation of sealing ability of 4 obturation techniques byusing a glucose leakage testrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 104 no 4 ppe109ndashe113 2007

[30] J F Siqueira Jr I N Rocas A Favieri E CAbadA J R Castroand S M Gahyva ldquoBacterial leakage in coronally unsealed rootcanals obturated with 3 different techniquesrdquoOral Surgery OralMedicine Oral Pathology Oral Radiology and Endodontics vol90 no 5 pp 647ndash650 2000

[31] G Shipper and M Trope ldquoIn vitro microbial leakage ofendodontically treated teeth using new and standard obturationtechniquesrdquo Journal of Endodontics vol 30 no 3 pp 154ndash1582004

[32] V H Brosco N Bernardineli S A Torres et al ldquoBacterialleakage in root canals obturated by different techniques Part1 microbiologic evaluationrdquo Oral Surgery Oral Medicine OralPathology Oral Radiology and Endodontology vol 105 no 1 ppe48ndashe53 2008

[33] G De Deus C F Murad C M Reis E Gurgel-Filho and TC Filho ldquoAnalysis of the sealing ability of different obturationtechniques in oval-shaped canals a study using a bacterialleakagemodelrdquoBrazilianOral Research vol 20 no 1 pp 64ndash692006

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Submit your manuscripts athttpswwwhindawicom

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CorrosionInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Polymer ScienceInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CeramicsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CompositesJournal of

NanoparticlesJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

International Journal of

Biomaterials

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

NanoscienceJournal of

TextilesHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Journal of

NanotechnologyHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

CrystallographyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

CoatingsJournal of

Advances in

Materials Science and EngineeringHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Smart Materials Research

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MetallurgyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

MaterialsJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014