Date of Award

2020

Department

Department of Endodontics

First Advisor

Ove A. Peters

First Committee Member

Ove A. Peters

Second Committee Member

Christine I. Peters

Third Committee Member

Alan H. Gluskin

Abstract

Introduction: The aim of this study was to evaluate the frequency and amount of Ca(OH)2 extrusion in relation to the intracanal delivery technique, apical foramen size, and depth of placement. Methods: Standardized training blocks with j-shaped canals were used (n=64); half of the simulated canals were shaped to apical size #35(.06 taper) and the remaining 32 to #45(.06). The frequency and extent of Ca(OH)2 extrusion were measured relative to apical taper, the depth of insertion, and whether syringe or spiral filler was used. Blocks were immersed in pH-sensitive gel and observed for color change. The visible extent of extrusion, indicated by color change, was determined as area and expressed in mm2. Results: Extrusion of Ca(OH)2 occurred in 48/64 of the samples. At 3mm from the canal terminus, the device type had a significant effect on the frequency of extrusion, with syringe placement causing extrusion significantly (p<0.01) more frequently, irrespective of device size. Amounts of extrusion were significantly larger at 2mm short of the canal terminus (median 27.44mm2, IQR 10.02), compared to 3mm distance (median 19.69mm2, IQR 25.07; p<0.0001). Analyzed separately at 2 and 3mm distance, respectively, there was significantly more extrusion with placement using a syringe size #35 compared to spiral filler size #45. Conclusions: Considering the limits of the in vitro experimental design, a spiral filler at 500rpm, placed 3mm short of the apex found to minimize extrusion of Ca(OH)2 placed in root canals.

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