Rajivgandhi University of Health Sciences,Bangalore
RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES,BANGALORE
KARNATAKA
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. /NAME OF THE CANDIDATEAND ADDRESS
( IN BLOCK LETTERS) / DR.KAVITHA.GPOST GRADUATE STUDENT,
DEPARTMENT OF CONSERVATIVE
DENTISTRY AND ENDODONTICS,
COLLEGE OF DENTAL SCIENCES,
DAVANGERE-577004,
KARNATAKA.
2. /
NAME OF THE INSTITUTION
/ COLLEGE OF DENTAL SCIENCES,DAVANGERE-577004
KARNATAKA.
3. / COURSE OF THE STUDY AND SUBJECT / MASTER OF DENTAL SURGERY IN
CONSERVATIVE DENTISTRY AND
ENDODONTICS.
4. / DATE OF ADMISSION TO COURSE / 19-05-2010
5. /
TITLE OF THE TOPIC
/ “AN IN-VITRO COMPARISON OF APICAL MICROLEAKAGE AFTER IMMEDIATE VERSUS DELAYED POST SPACE PREPARATION USING RESILON AS AN OBTURATION MATERIAL”-A FLUID FILTRATION STUDY.
6. / Brief resume of the intended work:
6.1 Need for the Study:
Endodontically treated teeth with insufficient coronal tooth structure generally require radicular posts to assist in restoring the tooth to function.
To place the post, the post space might be prepared immediately after obturation or at a later stage when the sealer is set completely.But during the preparation of the post space it is important not to disrupt the integrity of the apical seal.1
The current widely accepted concept is that a 5mm remaining root canal filling provides an apical seal that does not differ from that of an intact root canal filling.2
Resilon is a recent resin based root canal filling material which has demonstrated formation of monoblock with root canal dentin and numerous studies have shown decreased microleakage due to monoblock formation.
The aim of this study is to evaluate the integrity of the apical seal of the teeth obturated with Resilon and the post spacethat is prepared either immediately or after 1 week with 5mm or 3mm of apical filling material left in the canal.
6.2 Review of Literature:
A study was done to evaluate the effect of immediate and delayed post space preparation on the apical sealing ability of EndoREZ, a methacrylate based dual cured resin sealer, with or without accelerator.Fifty extracted human teeth were endodontically prepared and divided in to six groups.Groups 1,2,3 and 4 (n=10) were filled with resin coated gutta percha and either EndoREZ with accelerator or EndoREZ without accelerator.Groups 5 and 6 were positive and negative control groups. Microleakage was assessed by computerized fluid filtration device. It was concluded that the EndoREZ accelerator did not provide any advantage.The microleakage was less in immediate preparation than delayed post space preparation.1
A study was done to evaluate the unpredictability of seal after post space preparation.Coronal leakage of 30 endodontically treated teeth were assessed before post space preparation using a fluid transport assay. In 10 teeth post space was prepared using a two step procedure, first to a remaining filling of 6mm and then to 3mm.In other 10 teeth the removal was done in one step to a remaining length of 3mm and other 10 teeth with intact root canal fillings served as control.The results showed that 3-6mm fillings provided a seal inferior to that of intact root canal fillings.3mm apical filling showed more variation than the 6mm apical filling.2
A study was done to evaluate the correlation between remaining length of root canal fillings after immediate post space preparation and coronal leakage was assessed by pressure driven radioactive tracer assay.After obturation with gutta percha and AH plus, the coronal part of root canal fillings were immediately removed using hot plugger to a remaining length of either 3, 5, 7 or 9 mm.Intact root canal fillings served as a control.The coronal microleakage was assessed by pressure driven radioactive tracer at the pressure of 130mm Hg.Result showed that the leakage gradually increased for 28 days.It was concluded that root canal fillings of 3, 5 and 7mm have an inferior seal and the 9mm group was equally good to the control group.This study concludedthatthe sealing is proportional to the length of the remaining filling.3
An ex-vivo study was done to analyse the integrity of the apical seal of resilon root fillings following immediate post space preparation or after one week by leaving either 5mm or 3mm of apical filling.150 freshly extracted and sterilized mandibular premolars were decoronated at 16mm length and prepared using K3 rotary to apical file size 45, 0.04 taper and they are divided into 5 groups.Group1: control group in which the root canals were not fillesd.Except for the control the rest of the teeth were obturated with Resilon and the post space prepared as mentioned.Group 2: immediate preparation by leaving 5mm apical filling.Group 3:delayed preparation after 1 week with 5mm apical filling.Group 4:immediate preparation with 3 mm apical filling.Group 5:delayed preparation after 1 week with 3 mm apical filling.It was concluded that immediate post preparation was associated with less microleakage than delayed preparation and 5mm apical filling of Resilon provided a significantly better seal compared to 3mm apical filling.4
A study was done to compare the effect of immediate versus delayed post space preparation on the apical seal using AH plus sealer.The root canals of teeth in group 1 and 2 were obturated using warm, vertical compaction of gutta percha and AH plus sealer.In group 1, the post space was made immediately at the time of obturation.In group 2 the post space was made after placing the teeth in saline at 370C for 1 week. Group 3 and 4 served as positive and negative control.The teeth were placed in India ink for 72 hours.Then the roots were sectioned vertically and microleakage was assessed under stereomicroscope.It was concluded that immediate post space preparation was better than delayed preparation.5
6.3 Aims and Objectives of the study:
The aim of this ex vivo study was to analyse the integrity of the apical seal of Resilon root fillings following immediate versus delayed post space preparation after 1 week by leaving either 5mm or 3mm of apical filling material.
7. / Material and methods:
7.1 Source of Data :
Fifty mandibular premolars will be collected for the study from Department of Oral Maxillofacial surgery, College of Dental Sciences, Davangere.
7.2 Method of Collection of Data:
50 caries free single root mandibular premolars with straight canals will be selected.The teeth are washed in water and then autoclaved at 1210C, 15 PSI pressure for 40minutes.
Teeth will then be debrided of soft tissue, calculus and bone and then placed in sterile physiologic saline solution at room temperature until used.The teeth will be decoronated at CEJ to leave 16 mm of root length.A size 10K file will be placed into the canal until it is just visible at the apical foramen and working length will be determined by subtracting 1mm of length.
Root canals are prepared by crown down technique using size 45, 0.04 taper, K3 rotary instruments (Sybron Endo). Apical patency will be maintained with a size of 10K file.After each instrumentation the root canals are irrigated using 5ml of 1% sodium hypochlorite.Finally each canal is flushed with 5ml of 17% EDTA and 5ml of distilled water.The teeth were divided in to 5 groups of 10 each.
Group-1:Control Group:The instrumented canals are left empty.The canals of the remaining 40 teeth were dried with paper points and obturated with bondable Resilon System (Real Seal).Resilon master cone size 45, 0.04 taper are coated with Real Seal sealer and placed into the canal to working length.Lateral condensation with fine and medium fine accessory Resilon points is performed until root canal is filled.To create a coronal seal, coronal surface of the Resilon filling is light cured for 40 seconds with LED curing light.These teeth will be divided in to four groups of10 teeth each.
Group-2:Immediate post space preparation with 5mm of remaining apical filling. The post space preparation is initiated using peeso reamers size 2, 3, 4 leaving 5mm filling material apically.
Group-3:Delayed post space preparation with 5mm apical filling.After obturation,the root canal orifices are restored temporarily with Cavit G and stored in gauze dampened with sterile saline and enclosed in sealed containers for 7 days to allow the sealer to set.The post space preparation is carried out 1 week later using the same technique as in group-2.
Group-4:Immediate post space preparation with 3mm apical filling.The post space preparation is carried out immediately after light curing using peeso reamers size 2, 3, 4 leaving 3mm filling material apically.
Group-5: Delayed post space preparation with 3mm of remaining apical filling.After obturation, the root canal orifices are restored temporarily with Cavit G and stored in gauze dampened with sterile saline and enclosed in sealed container for 7 days to allow the sealer to set.The post space preparation is initiated 1 week later using the same technique as in group-4.
Microleakage Evaluation:
The roots are mounted in a fluid transport device with head space pressure of 1.2 atmosphere applied using an O2 cylinder, distilled water is forced through a plastic tube that is attached to the coronal end of the prepared sample.The apical end of the root is attached to another plastic tube that is connected to a 100 microlitre glass capillary tube.An air bubble is introduced through the open end or the capillary.All the connections are sealed tightly using cyanoacrylate resin and the whole apparatus is immersed in a water bath.
The head space pressure forced the fluid to pass along any through and through voids that might exist along the root filling displacing the air bubble in the capillary tube by connective transport of water.The volume of transported fluid is measured by observing the movement of the air bubble over a period of 10 minutes.
A camera is mounted on a tripod stand and focused on the bubble in the pipette. The pictures at the start of experiment and at 10 minutes are transferred to the computer.The bubble position in each picture is determined by professional software (AutoCAD 2007).The results will be expressed as microlitre per minute per cm of water pressure.
Statistical Analysis:
The results will be analysed by using one way ANOVA and Post hoc test.
7.3Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
Not applicable
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Not required
8. / List of References:
1)Cobankara.F, Orucoglu.H, Ozlan.H, Yildirim.C. Effect Of Immediate And Delayed Post Preparation On Apical Microleakage By Using MethacrylateBased EndoREZ Sealer With Or Without Accelerator.J Endod 2008;34(12): 1504-1507.
2)Abramovitz. I, Lev.R, Fuss. Z, Metzger. Z, The Unpredictability Of Seal After Post Space Preparation: A Fluid Transport Study.J Endod 2001;27(4):292-295.
3)Metzger. Z, Abramovitz. R, Abramovitz. R, Tagger. M. Correlation Between Remaining Length Of Root Canal Fillings After Immediate Post Space Preparation and Coronal Leakage.J Endod 2000;26(12):724-726.
4)Attamk, Talwar. S. A Laboratory Comparison Of Apical Leakage Between Immediate Versus Delayed Post Space Preparation In Root Canals Filled With Resilon.Int Endod J 2010;43 (9):775-781.
5)Solano.F, Hartwell. G, Appelstein. C. Comparison Of Apical Leakage Between Immediate Versus Delayed Post Space Preparation Using AH Plus Sealer.J Endod 2005;31(10):752-754.
9. / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE
11.2 SIGNATURE / Dr. LAKSHMI AMARA M.D.S
PROFESSOR,
DEPARTMENT OF CONSERVATIVE
DENTISTRY AND ENDODONTICS
COLLEGE OF DENTAL SCIENCES,
DAVANGERE – 577 004.
KARANTAKA
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE
DEPARTMENT
11.6 SIGNATURE / Dr. VASUNDHARA SHIVANNA M.D.S PROFESSOR AND HEAD,
DEPARTMENT OF CONSERVATIVE
DENTISTRY AND ENDODONTICS
COLLEGE OF DENTAL SCIENCES,
DAVANGERE – 577 004
KARNATAKA
12. / 12.1 REMARKS OF THE
CHAIRMAN AND
PRINCIPAL
12.2 SIGNATURE