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VOLUME 24 , ISSUE 7 ( July, 2023 ) > List of Articles

ORIGINAL RESEARCH

External Root Surface Temperature Control with 1,1,1,2-Tetrafluoroethane Intracanal Cryotherapy during Thermoplastic Obturation: An In Vitro Study

Chakravarthy Arumugam, Rupa Ashok, Seshan Rakkesh Ramesh, Rajeswari Kalaiselvam, Karthick Soundararajan, Mathan Rajan Rajendran

Keywords : Endodontics, Intracanal cryotherapy, Periodontal ligament, Temperature reduction, Thermoplastic obturation

Citation Information : Arumugam C, Ashok R, Ramesh SR, Kalaiselvam R, Soundararajan K, Rajendran MR. External Root Surface Temperature Control with 1,1,1,2-Tetrafluoroethane Intracanal Cryotherapy during Thermoplastic Obturation: An In Vitro Study. J Contemp Dent Pract 2023; 24 (7):419-423.

DOI: 10.5005/jp-journals-10024-3528

License: CC BY-NC 4.0

Published Online: 19-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: The aim of this in vitro study was to determine the effectiveness of 1,1,1,2-tetrafluoroethane (TFE) intracanal cryotherapy for external root surface temperature control during thermoplastic obturation. Materials and methods: Thirty extracted adult single-rooted mandibular incisors were selected for this study. Endodontic shaping was performed until size X3 Protaper Next Rotary endodontic file. The teeth were divided into three groups: Group I—Control group wherein conventional irrigation was done using physiologic saline stored at room temperature, Group II—Irrigational Cryotherapy group using physiologic saline at 2.5°C, and Group III—Intracanal TFE cryotherapy group with intracanal refrigerant TFE application. Temperatures were recorded in the apical 3 mm before and after completion of each intervention and post thermoplastic obturation using a noncontact digital laser infrared thermometer. Results: Intracanal cryotherapy with TFE resulted in a mean decrease of 9.27°C compared with conventional irrigation that exhibited in a mean decrease of 2.13°C. Also, in intracanal cryotherapy group with TFE application, compared with the baseline (24.50°C), no significant differences were observed post obturation (24.61°C) with high-temperature-injectable gutta percha technique indicating good control of temperature rise on the external root surface. Conclusion: Intracanal cryotherapy with refrigerant TFE was highly effective in controlling temperature rise on the external root surface during injectable thermoplastic obturation technique. Clinical significance: Minimizing deleterious effects due to high temperatures generated during the thermoplastic obturation is critical. Clinically feasible measures to reduce the transmission of heat generated during thermoplastic obturation have been searched since long. In this regard, intracanal cryotherapy with TFE can be effectively used to control the rise of temperature on the external root surface when employing thermoplastic obturation technique.


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  1. Ingle JL, Bakland LK, editors. Endodontics. 5th edition. London: BC Decker Inc.; 2002. pp. 109–110.
  2. Brayton SM, Davis SR, Goldman M. Gutta-percha root canal fillings. An in vitro analysis. Oral Surg Oral Med Oral Pathol 1973;35(2):226–231. DOI: 10.1016/0030-4220(73)90289-2.
  3. Marciano J, Michailesco PM. Dental gutta-percha: Chemical composition, X-ray identification, enthalpic studies, and clinical implications. J Endod 1989;15(4):149–153. DOI: 10.1016/S0099-2399 (89)80251-1.
  4. Hess W, Zürcher E. The Anatomy of the Root Canals of the Teeth of the Permanent and Deciduous Dentitions. London: John Bale, Sons & Danielsson, Ltd.; 1925.
  5. Kirkham DB. The location and incidence of accessory pulpal canals in periodontal pockets. J Am Dent Assoc 1975;91(2):353–356. DOI: 10.14219/jada.archive.1975.0345.
  6. De Deus QD. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod 1975;1(11):361–366. DOI: 10.1016/s0099-2399(75)80211-1.
  7. Rubach WC, Mitchell DF. Periodontal disease, accessory canals and pulp pathosis. J Periodontol 1965;36:34–38. DOI: 10.1902/jop.1965.36.1.34.
  8. Goodman A, Schilder H, Aldrich W. The thermomechanical properties of gutta-percha. Part IV. A thermal profile of the warm gutta-percha packing procedure. Oral Surg Oral Med Oral Pathol 1981;51(5): 544–551. DOI: 10.1016/0030-4220(81)90017-7.
  9. Schilder H, Goodman A, Aldrich W. The thermomechanical properties of gutta-percha. Part V. Volume changes in bulk gutta-percha as a function of temperature and its relationship to molecular phase transformation. Oral Surg Oral Med Oral Pathol 1985;59(3): 285–296. DOI: 10.1016/0030-4220(85)90169-0.
  10. Silver GK, Love RM, Purton DG. Comparison of two vertical condensation obturation techniques: Touch ‘n heat modified and system B. Int Endod J 1999;32(4):287–295. DOI: 10.1046/j.1365-2591.1999.00215.x.
  11. Barkhordar RA, Goodis HE, Watanabe L, et al. Evaluation of temperature rise on the outer surface of teeth during root canal obturation techniques. Quintessence Int 1990;21(7):585–588. PMID: 2094859.
  12. Jurcak JJ, Weller RN, Kulild JC, et al. In vitro intracanal temperatures produced during warm lateral condensation of Gutta-percha. J Endod 1992;18(1):1–3. DOI: 10.1016/S0099-2399(06)81133-7.
  13. Gutmann JL, Rakusin H, Powe R, et al. Evaluation of heat transfer during root canal obturation with thermoplasticized gutta-percha. Part II. In vivo response to heat levels generated. J Endod 1987;13(9):441–448. DOI: 10.1016/S0099-2399(87)80062-6.
  14. Lipski M. Root surface temperature rises in vitro during root canal obturation with thermoplasticized gutta-percha on a carrier or by injection. J Endod 2004;30(6):441–443. DOI: 10.1097/00004770-200406000-00016.
  15. Eriksson AR, Albrektsson T. Temperature threshold levels for heat-induced bone tissue injury: A vital-microscopic study in the rabbit. J Prosthet Dent 1983;50(1):101–107. DOI: 10.1016/0022-3913(83) 90174-9.
  16. Fors U, Jonasson E, Berquist A, et al. Measurements of the root surface temperature during thermo-mechanical root canal filling in vitro. Int Endod J 1985;18(3):199–202. DOI: 10.1111/j.1365-2591.1985.tb00441.x.
  17. Hardie EM. Heat transmission to the outer surface of the tooth during thermomechanical compaction technique of root canal obturation. Int Endod J 2007;19(2):73–77. DOI: 10.1111/j.1365-2591.1986.tb00895.x.
  18. Romero AD, Green DB, Wucherpfennig AL. Heat transfer to the periodontal ligament during root obturation procedures using an in vitro model. J Endod 2000;26(2):85–87. DOI: 10.1097/00004770-200002000-00006.
  19. Weller RN, Koch KA. In vitro radicular temperatures produced by injectable thermoplasticized gutta-percha. Int Endod J 1995;28(2):86–90. DOI: 10.1111/j.1365-2591.1995.tb00164.x.
  20. Nicholas JV, White DR. An introduction to temperature measurement and calibration. Traceable Temperatures. Chichester, England, UK: Wiley and Sons; 1994. 239–70Dfh.
  21. McCullagh JJ, Biagioni PA, Lamey PJ, et al. Thermographic assessment of root canal obturation using thermomechanical compaction. Int Endod J 1997;30(3):191–195. DOI: 10.1046/j.1365-2591.1997.00072.x.
  22. Hussey DL, Biagioni PA, McCullagh JJ, et al. Thermographic assessment of heat generated on the root surface during post space preparation. Int Endod J 1997;30:187–190. DOI: 10.1046/j.1365-2591.1997.00071.x.
  23. Rennie S. Electrophysical agents – Contraindications and precautions: An evidence-based approach to clinical decision making in physical therapy. Physiother Can 2010;62(5):1–80. DOI: 10.3138/ptc.62.5.
  24. Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury? J Athl Train 2004;39(3):278–279. PMCID: PMC522152.
  25. Vera J, Ochoa-Rivera J, Vazquez-Carcaño M, et al. Effect of intracanal cryotherapy on reducing root surface temperature. J Endod 2015;41(11):1884–1887. DOI: 10.1016/j.joen.2015.08.009.
  26. de Gregorio C, Estevez R, Cisneros R, et al. Efficacy of different irrigation and activation systems on the penetration of sodium hypochlorite into simulated lateral canals and up to working length: An in vitro study. J Endod. 2010;36(7):1216–1221. DOI: 10.1016/j.joen.2010.02.019.
  27. de Gregorio C, Paranjpe A, Garcia A, et al. Efficacy of irrigation systems on penetration of sodium hypochlorite to working length and to simulated uninstrumented areas in oval shaped root canals. Int Endod J 2012;45(5):475–481. DOI: 10.1111/j.1365-2591.2011.01999.x.
  28. Parente JM, Loushine RJ, Susin L, et al. Root canal debridement using manual dynamic agitation or the EndoVac for final irrigation in a closed system and an open system. Int Endod J 2010;43(11):1001–1012.
  29. Miller SO, Johnson JD, Allemang JD, et al. Cold testing through full-coverage restorations. J Endod 2004;30(10):695–700. DOI: 10.1097/01.don.0000125880.11248.74.
  30. Peters DD, Lorton L, Mader CL, et al. Evaluation of the effects of carbon dioxide used as a pulpal test. 1. In vitro effect on human enamel. J Endod 1983;9(6):219–227. DOI: 10.1016/s0099-2399(86)80017-6.
  31. Fuss Z, Trowbridge H, Bender IB, et al. Assessment of reliability of electrical and thermal pulp testing agents. J Endod 1986;12(7): 301–305. DOI: 10.1016/S0099-2399(86)80112-1.
  32. Jones VR, Rivera EM, Walton RE. Comparison of carbon dioxide versus refrigerant spray to determine pulpal responsiveness. J Endod 2002;28(7):531–533. DOI: 10.1097/00004770-200207000-00011.
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