Comparative Three-Dimensional Analysis of Three Different Root Canal Obturation Techniques: An In Vitro Study

Background The outcome of a successful root canal treatment depends on effective debridement, shaping, and obturation of the root canal system. The process of obturation is a requisite for ensuring to provide a hermetic seal in order to prevent microbial re-infection. Among the various existing techniques, the single-cone technique, warm vertical compaction, and thermoplasticized gutta-percha are notably the most popular techniques used in endodontic procedures. While assessment of obturating techniques has hugely relied on 2D radio-imaging in the past, it has its limitations, such as distortion of image, superimposition. Therefore, this study was conducted to assess the efficacy of the three different obturating techniques using three 3D techniques of cone beam computed tomography (CBCT). The findings will aid clinicians for long-term, successful outcomes for root canal therapies. Method The current in vitro study evaluated the efficacy of three obturation techniques - single-cone, warm vertical compaction, and thermoplasticized gutta-percha - in 72 extracted human premolars with single canals. The teeth samples were disinfected, decoronated, and instrumented using Neo Endo rotary files. After random allocation (n=24 per group), canals were obturated using one of the three techniques. Specimens were scanned via CBCT and analyzed for adaptation, voids, and density in apical, middle, and coronal thirds by two blinded observers. Data were analyzed using one-way ANOVA and Bonferroni post hoc tests (α=0.05). Results The thermoplasticized technique showed significantly superior performance with 100%, 75%, and 75% void-free cases at apical, middle, and coronal levels, respectively (mean values: 0.10-0.20). Warm vertical compaction demonstrated moderate results (75% to 62.5% void-free), while the single-cone technique showed the highest void formation (50% to 37.5% void-free). Statistical analysis revealed highly significant differences between techniques (p=0.00). Conclusion The thermoplasticized gutta-percha technique produced the most consistent results with minimal voids, making it the most effective obturation method as compared to single-cone and warm vertical compaction.