RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.

ANNEXURE –II

1. / NAME OF THE CANDIDATE AND ADDRESS / DR.RITA CHANDKI
POST GRADUATE STUDENT, DEPARTMENT OF
CONSERVATIVE DENTISTRY AND ENDODONTICS,
GOVERNMENT DENTAL COLLEGE AND RESEARCH
INSTITUTE, BANGALORE-2.
2. / NAME OF THE INSTITUTION / GOVERNMENT DENTAL COLLEGE AND RESEARCH
INSTITUTE, BANGALORE-2.
3. / COURSE OF THE STUDY AND SUBJECT / MASTER OF DENTAL SURGERY IN CONSERVATIVE
DENTISTRY AND ENDODONTICS.
4. / DATE OF ADMISSION TO COURSE / 14-05-2009
5. / TITLE OF THE TOPIC :
“COMPARISON OF MICRO-LEAKAGE ASSOCIATED WITH POST SPACE PREPARATION AT THREE DIFFERENT LENGTHS OF REMAINING GUTTA-PERCHA USING AH PLUS AND GUTTAFLOW SEALERS– AN IN VITRO STUDY.”

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

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6.2 / BRIEF RESUME OF INTENDED WORK : -
NEED FOR THE STUDY :
Successful endodontic debridement and apical sealing are essential underpinnings for the restoration of non-vital teeth.1The procedures for preparing the post space are critical, and care is required to maintain the root canal seal and the aseptic conditions achieved with endodontics.Otherwise, a pathway may be created for bacterial invasion and re-infection of the root canal system.2There has been much debate as to how, when and how much of the gutta-percha should be removed when making a post space.3
Several in vitro studies focusing on the degree of apical leakage following post space preparation have been published. Majority of the studies in this field discuss the comparison of the gutta-percha removing instruments (heat, peeso reamer, and gates glidden drills) or the timing of post space preparation (immediate or delayed). But the literature is scarce regarding the length of gutta-percha that remains in the canal while making a space for the post. There is also a relative paucity of data in the literature comparing AH Plus and Guttaflow for post space preparation.Hence, the present study is designed to compare three different lengths of remaining gutta-percha obturated using two different sealers; AH Plus and Guttaflow for establishment of apical seal after post space preparation.
REVIEW OF LITERATURE :
1. An in vitro study compared three different lengths of remaining gutta-percha for apical seal after post space preparation. The root canals were prepared and filled with gutta-percha and AH26 sealer. The post preparation was accomplished and three different lengths of gutta-percha were retained in the groups1,2 and 3 respectively. After dye penetration study, it was concluded that the best apical seal after post space preparation was associated with maximum length of remaining gutta-percha in the apical portion of the treated teeth.1
2. An in vitro microbiological study evaluated the effect of timing(immediate versus delayed)and technique of post space preparation on the ability of residual root canal obturation to prevent coronal bacterial leakage and concluded that immediate and delayed post space preparation yielded no significant difference in the canal seal. Regardless of the timing and the technique of post space preparation, coronal bacterial leakage occurred over time.2
3. An in vitro study compared apical leakage between immediate versus delayed post space preparation in canals obturated using warm vertical compaction and AH Plus sealer. After dye penetration study, it was concluded that when using warm vertical condensation and AH Plus sealer, there was significantly less leakage when the post space was prepared at the time of obturation compared to post spaces prepared one week after obturation.3
4. An in vitro study compared the flow of Guttaflow and gutta-percha into depressions and lateral grooves in the apical half of a split tooth model. It was concluded from this study that the Guttaflow flows significantly better in the apical 2mm of a split tooth model than gutta-percha placed using a warm vertical technique but also is apically extruded.4
5. An in vivo analysis compared the sealing ability of endodontic sealers AH Plus, Sealer 26 and Endofill in premolar teeth of dogs exposed to oral cavity after post- preparation. After 45 days exposure to the oral cavity, none of the sealers showed perfect sealing ability, nor did they prevent coronal dye penetration. There were statistically significant differences between the sealers studied; increasing extent and the degree of penetration were observed in the following order: AH Plus, Endofill and Sealer 26.5
6. An in vitro study was done to investigate polymerization shrinkage behavior of newly introduced root canal sealers. Three recently developed sealers; Endorez (dual cure resin-based), Realseal (dual core resin-based) and Guttaflow (silicone-based) were compared with Tubliseal (Zinc oxide-eugenol-based).Statistically significant differences were found between the tested sealers.Endorez had the highest shrinkage-strain value, followed by realseal whereas tubliseal had the lowest. Guttaflow exhibited expansion on polymerization. It was concluded that shrinkage associated with setting might jeopardize the seal of the root canal, leading to root canal failure.6
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8. / OBJECTIVES OF STUDY :
1.  To evaluate the apical sealing ability of AH Plus sealer at three different lengths of remaining gutta-percha after post space preparation.
2.  To evaluate the apical sealing ability of Guttaflow sealers at three
different lengths of remaining gutta-percha after post space
preparation.
3.  To compare the apical sealing ability of AH Plus and Guttaflow
sealers at three different lengths of remaining gutta-percha after post
space preparation.
MATERIALS AND METHODS :
Source of Data :
Freshly extracted human single rooted teeth with single root canal extracted in the Department of oral and maxillofacial surgery, Government Dental college and research institute Bangalore will be collected and stored in 0.9% Sodium chloride sterile saline solution .
SELECTION CRITERIA
Inclusion Criteria:
Single rooted teeth with single root canal
Teeth with Intact apex
Exclusion Criteria:
Teeth with Cracks
Teeth with resorption of root
Teeth with dilaceration of root
Method of Collection of Data :
Ninety teeth satisfying the selection criteria will constitute the total sample size. The selected teeth will be randomly divided into six experimental groups containing 15 teeth each. The teeth will be decoronated at the level of Cemento-enamel junction using a diamond disc. The working length will be established with a #10 K file 1mm short of the apex and the patency checked using the #10 k file. The canals will be prepared to the working length. During the preparation, the canals will be irrigated with 5.25% Sodium hypochlorite solution and 17%EDTA followed by a final saline rinse. The roots will then be aspirated and dried with absorbent paper points. The canals of the teeth in the three experimental groups(groups 1 and 2 and 3) will be obturated with Gutta percha cones and AH Plus sealer using lateral condensation technique and with Gutta-percha cones and Guttaflow in other three experimental groups.(groups 4,5 and 6) .
Experimental groups will be further treated as follows:
Group I: Gutta-percha obturated with AH Plus sealer will be removed using appropriate sized Gates Glidden drills, so as to leave 3 mm of gutta percha apically and post space prepared using peeso reamers.
Group I: Gutta-percha obturated with AH Plus sealer will be removed using appropriate sized Gates Glidden drills, so as to leave 4 mm of gutta percha apically and post space prepared using peeso reamers.
Group III: Gutta-percha obturated with AH Plus sealer will be removed using appropriate sized Gates Glidden drills, so as to leave 5 mm of gutta percha apically and post space prepared using peeso reamers.
Group IV: Gutta percha obturated with Guttaflow will be removed using appropriate sized Gates Glidden drills, so as to leave 3 mm of gutta percha apically and post space prepared using peeso reamers.
Group V: Gutta percha obturated with Guttaflow will be removed using appropriate sized Gates Glidden drills ,so as to leave 4 mm of gutta percha apically and post space prepared using peeso reamers.
Group VI: Gutta percha obturated with Guttaflow will be removed using appropriate sized Gates Glidden drills ,so as to leave 5 mm of gutta percha apically and post space prepared using peeso reamers.
The dye penetration method will be used to evaluate the apical leakage and measured in millimeter using stereomicroscope. The examiner doing the assessment of apical leakage will be blinded to the group to which the tooth belongs.Blinding will be facilitated by coding each of the samples with a number and code.
Statistical analysis: The mean and standard deviation of micro leakage in millimeters in all six study groups will be compared using ANOVA (Analysis of variance) followed by multiple comparisons using Post-hoc Tukey test. A probability value of <0.05 will be considered as statistically significant.
Does the Study require any investigations or interventions on patients or other human or other animals?
Patients consent is obtained for using their teeth for the experimental purpose.
Has ethical clearance been obtained from your institution in case of 7.3?
Yes
LIST OF REFERENCES:
1.  Rahimi S,Shahi S, Nezafati S, Reyhani M F, Shakouie S,Jalili L. In vitro comparison of three different lengths of remaining gutta-percha for establishment of apical seal after post-space preparation.J Of Oral Science 2008;50:435-43
2.  Grecca F S et al. Effect of timing and method of post space preparation on sealing ability of remaining root filling material :In vitro microbiological study.J Can Dent Assoc. 2009;75:583
3.  Solano F, Hartwell G, Applestein C. Comparison of apical leakage between Immediate versus delayed post space preparation using AH Plus sealer. Journal Of Endodontics 2005;31:752-754
4.  Zielinski T M, Baumgartner C, Marshall J G . An evaluation of Guttaflow and Gutta-percha in the filling of lateral grooves and depressions. Journal Of Endodontics 2008;34:295-298
5.  Kopper P.M.P., Figueiredo J.A.P., Della Bona A, Vanni J.R., BierC A ,Bopp S. AComparative in vivo analysis of the sealing ability of three endodontic sealers in post-prepared root canals..International Endodontic Journal 2003;36:857-863
6. Hammad M, Qualtrough A, Silicas N .Extended setting shrinkage behaviour
of Endodontic sealers.Journal Of Endodontics.2008;34:90-93
9. / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE / Approved For Submission
11. / 11.1 NAME & DESIGNATION OF THE GUIDE / DR. (Mrs.) M.KALA.
Professor & Head,
Department of Conservative Dentistry &
Endodontics,
Government Dental College & Research
Institute,Bangalore-2.
11.2 SIGNATURE OF
GUIDE
11.3  CO-GUIDE
11.4 SIGNATURE
11.5
11.6 / HEAD OF THE DEPARTMENT
SIGNATURE / DR. (Mrs.) M.KALA.
Professor & Head,
Department of Conservative Dentistry &
Endodontics,
Government Dental College & Research
Institute,
Bangalore-2.
12 / 12.1 REMARKS OF CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE

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