Abstract
Introduction: This in vitro study used cone-beam computed tomography (CBCT) to evaluate four obturation techniques (Navitip, plugger, lentulo spiral, and Metapex) and two materials (ZOE and Metapex) in primary second molars. The goal was to perform a 3D volumetric analysis of obturation quality, overcoming the limitations of traditional 2D radiography, to identify techniques that ensure a hermetic seal in complex root canal systems and optimize clinical outcomes.
Methods: Eighty-four root canals from human second primary molars were selected. Following access cavity preparation and root canal instrumentation, all the specimens were scanned via CBCT to determine initial canal volume. They were then divided into four experimental groups based on obturation technique and material: group 1: ZOE (creamy) injected with a Navitip; group 2: ZOE (firmer) placed with an Endo Plugger; group 3: ZOE (creamy) delivered with a lentulo spiral; group 4: Metapex. After obturation, a second CBCT scan was performed to calculate the filled volume percentage for each root canal. Data were analyzed using SPSS 26, employing ANOVA and independent t-tests with a significance level of P<0.05 after confirming normal distribution.
Results: A statistically significant difference was found in the percentage of filled volume between the groups. The Metapex group exhibited the highest mean filling volume (94.63%), significantly outperforming all ZOE groups. Among the ZOE techniques, the Navitip injection method was the most effective, followed by the lentulo spiral and plugger techniques, which showed the lowest mean volume (86.41%). Although no significant difference was observed between maxillary and mandibular teeth overall, significant differences appeared when comparing techniques within each jaw.
Conclusion: Metapex achieved a significantly higher percentage of root canal filling volume than ZOE. For ZOE obturation, the Navitip injection technique was most effective, followed by the lentulo spiral and plugger techniques.