Introduction: There is a direct relationship between the quality of root canal obturation and success of endodontic therapy. The aim of the present study was to assess the quality of canal obturation performed by undergraduate dental students at the Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.Materials and Methods: Records of 200 endodontically treated teeth from patients who were visited by undergraduate students between 2009 and 2010, at the Endodontic department, Faculty of Dentistry, Mashhad University of Medical Sciences, were randomly selected for evaluation. Periapical radiographs of all treated teeth were assessed in terms of canal obturation quality (i.e. adequate density and length). Statistical analysis of data was carried out using SPSS software and chi-square test.The Statistical significance level was set at P=0.05.Results: Forty-five percent of teeth fulfilled the criteria of an acceptable root canal obturation. Adequate length and density of root filling was found in 89% and 34% of teeth, respectively. There was a significant difference between maxillary and mandibular teeth regarding the length of root canal obturation (P=0.004). A significant difference was observed between molars and other tooth types. The frequency of root canals with an acceptable filling was significantly greater in the anterior teeth compared to premolars or molars.Conclusion: The technical quality of root canal treatment performed by undergraduate dental students was found to be less than ideal.

Background: Root canal obturation length may significantly affect the development of apical periodontitis lesions. This study aimed to investigate the prevalence of periapical periodontitis and its relationship with previous root canal treatment in terms of root canal obturation length. Materials and Methods: In this cross-sectional observational study, 264 root canal-treated premolars and molars from patients referred to the Faculty of Dentistry at Azad University of Isfahan, who had undergone root canal treatment at least one year prior, were examined using CBCT radiography. A total of 630 canals with previous root canal treatments were selected. The screening protocol involved an initial selection of roots, followed by alignment in three planes (coronal, sagittal, axial) to ensure centrality. The roots were then classified based on the presence of periapical periodontitis and obturation length. Data analysis was conducted using Fisher’s exact test (α=0. 05). Results: There was no significant difference between quality of obturation length among root treated teeth in all study groups (p>0. 05). Significant difference was observed between the obturation length and the frequency of apical periodontitis. The lesions among canals with proper obturation length were significantly less than canals with under or over obturation (p<0. 001). But no significant difference was shown in pairwise comparison of each teeth type. (molars-premolars, first-second) (P>0. 05). Conclusion: There was a relationship between the length of root canal obturation and the prevalence of apical periodontitis, with a significantly lower presence of lesions in canals with appropriate obturation. However, this relationship was not observed based on the type of teeth.

Bio-obturation is an innovative approach in root canal therapy that effectively addresses complex clinical challenges using bioactive endodontic materials. This report highlights 14 diverse cases where bio-obturation was employed to manage complications such as internal and external resorption, root perforations, draining sinus tracts, mechanical obstructions, and trauma-related injuries. The outcomes demonstrate notable healing and resolution of various tooth related pathologies in failed primary root canal treatments. Root perforations and canal blockages were successfully sealed, restoring the integrity of the root canal system and ensuring continued tooth function and retention. Bio-obturation facilitated stabilization and regeneration of periradicular and supporting tissues in trauma cases, including avulsed teeth and inflammatory root resorption. Cases involving open apices, dens invaginatus, and complex root canal anatomy also showed favorable results. Overall, bio-obturation offers a transformative alternative to conventional root canal filling by promoting enhanced biological sealing and improved periradicular healing, thus increasing the probability of sustainable long-term clinical success. While calcium-enriched mixture cement served as the bioactive material in these cases, this approach may also be effectively implemented using other advanced calcium silicate-based biomaterials, broadening its applicability in challenging endodontic scenarios.

Introduction: One of the key factors in successful endodontic therapy is to adequately fill the root canals. The aim of this in vitro study was to compare the quality of four different root canal obturation techniques: cold lateral condensation (CLC), warm vertical condensation (WVC), Obtura II (OII) and Gutta Flow (GF) by using micro-computed tomography (micro CT).Materials and Methods: A total of 20 extracted maxillary first molars prepared with ProTaper files, were randomly divided into four groups. Micro CT was used to measure the internal volume of root canals. Following application of AH26 sealer to canal obturation, new micro-CT images were taken and the volume percentage (VP) of voids, gutta-percha and sealer at different levels were calculated with CT software. Data was statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests.Results: The highest percentage of filling material was observed in GF group followed by OII with no statistically significant difference (P>0.05).These two groups had a significantly more acceptable filling than WVC and CLC groups (P<0.05). Voids were detected in all samples. There was a significant difference between the highest and the lowest percentage of voids in CLC (19.6%) and GF groups (6.7%), respectively. In the apical third, CLC and OII showed the highest and the lowest percentage of voids (5.5% and 2.6%) and the lowest and highest percentage of gutta-percha (76.52% and 94.26%), respectively. These differences were statistically significant (P<0.05).Conclusion: None of the root canal filled teeth were gap-free. GF and CLC techniques showed the highest and lowest VP of obturation materials, respectively.