JC Obturating Techniuques

A COMPARISON OF FOUR
GUTTA-PERCHA FILLING
TECHNIQUES IN SIMULATED C-
SHAPED CANALS
W. K. M. SOO, Y. L. THONG & J. L. GUTMANN

INTERNATIONAL ENDODONTIC JOURNAL - 2014
Presented by: ANAS.K

3rd year P.G
INTRODUCTION
• The C-shaped canal has been described as a continuous slit
connecting some or all canals in a fused rooted mandibular
second molar, consisting of a C-shaped cross-sectional
morphology (Cooke & Cox 1979).
2
INTERNATIONAL ENDODONTIC JOURNAL 2014
• The C-shaped canal has a complex system with webs or fins
connecting mesial and distal canals as well as canal configuration
changes along the root length (Melton et al. 1991, Haddad et al.
1999, Fan et al. 2004, Gao et al. 2006).
• The use of cone-beam computed tomography provides a better

understanding of this anatomical variation (Fan et al. 2004a,b, Fan
et al. 2007).
• Nevertheless, they provide a challenge with respect to preparation

and filling, even when recognized as C-shaped canals.
3
• A three-dimensional filling is of critical importance for the
ultimate success of all root canal procedures.
• In the filling of C-shaped canals, the popular cold lateral

compaction technique has been reported to have a less dense
radiographic appearance even after using a large number of
accessory gutta-percha points (Weine 1994).
• The gutta-percha does not fill the discrepancies and the narrow
connecting slit of the C-shaped canal system (Liewehr et al.
1993).
4
• In addition, the challenges of canal shaping do not always
provide a flared preparation for deep placement of a spreader
without perforating the canal wall (Jerome 1994).
• To address this problem, thermoplasticized gutta-percha

filling techniques have been advocated in filling Cshaped
canals where compaction of softened guttapercha should
predictably fill root canal aberrations (Simon 1993, Jerome
1994, Weine 1994, Gutmann & Witherspoon 2002).
5
• The efficacy of injectable thermoplasticized gutta-percha in
filling canal irregularities, such as fins, cul-desacs, internal
resorption cavities and lateral canals, is well documented.
• To prevent overfilling and apical extrusion with this filling

technique, several authors (ElDeeb 1985, Bradshaw et al. 1989,
Gatot et al. 1989, Olson et al. 1989) suggested the placement of
a master gutta-percha cone into the apical part of the root canal
prior to using the injection technique to prevent extrusion of
injected gutta-percha.
6
• The core-carrier technique, which uses heat-softened
alpha phase gutta-percha encased around a plastic carrier,
provides excellent adaptation of gutta-percha to the
prepared canal walls and irregularities (Gutmann et al.
1993).
• Ultrasonically energized spreaders that produced

frictional heat and plasticized gutta-percha were
advocated as an aid for lateral compaction of gutta-
percha cones (Moreno 1977) to produce a more
homogeneous root filling (Baumgardner & Krell 1990).
7
• Clear resin simulated canals (RSCs), with different sizes,
shapes and curvature are used.
• It allow direct visualization of the root canal procedure

being investigated including different filling techniques,
where the distribution of gutta-percha, sealer and voids can
be determined by cross-sectioning the resin block after
filling the canal space (Silver et al. 1999).
8
OBJECTIVES
Compare:
i. The ability of four gutta-percha filling techniques to three
dimensionally fill simulated C-shaped canals, based on
percentages of canal area occupied by gutta-percha, sealer
and voids at three cross-sectional levels.
1. Cold lateral compaction (LC)
2. Ultrasonic compaction (UC)
3. Single cone with injectable thermoplasticized gutta-percha (IT)
4. Core-carrier (CC)
ii. The time taken for filling.
iii. The presence of apical extrusion of gutta-percha. 9

METHODOLOGY
1. Construction of resin simulated C-shaped canals (RSCs)

• A human mandibular second molar with C-shaped root canal
was selected as the ‘master specimen’.
• The canal was prepared using the step-down technique (Goerig

et al. 1982) with circumferential filing using K-Flexofiles
(Dentsply Maillefer, Ballaigues, Switzerland) to remove
undercuts.
• A polyester casting resin (Miracon (M) Sdn Bhd, Malaysia)

was injected into the canal space.
10
• After 24 h, the tooth was demineralized in 35% aqueous nitric
acid until the total dissolution of the tooth substance.
• The resin replica of the prepared canal was cast using a semi-
precious alloy (Palliag M, Degussa AG, Hanau, Germany) into
the ‘master replica’.
11
• A vinylpolysiloxane impression material for the
monophase method (Zerosilmono, Dreve-Dentamid
GMBH, Unna, Germany) was used to prepare the mould
of the master replica.
• 80 RSCs were produced.
• Forty resin blocks were selected for the actual experiment

and the remaining 40 RSCs were practice blocks, used in
a pilot study.
• The working length for all simulated canals was

standardized to 13 mm.
12
• A size 40 K-Flexofile was used to verify the size of apical
enlargement.
• Apical canal patency was confirmed by passing a size 15

K-Flexofile through the ‘apical foramen’.
• The smallest diameter at the apical constriction allowed

unimpeded penetration by a K-Flexofile not larger than size
15 was also confirmed.
• The canals were placed in the ultrasonic cleaner for 10 min

and then dried with paper points.
13
2. Filling simulated C-shaped canals
• The forty RSCs were divided into four groups of ten samples.
• Roth Root Canal Cement, Type 801 (Roth International

Limited, Chicago, IL, USA), was used for all the four groups.
• A size 40 paper point was coated with sealer and then smeared
onto the canal wall.
14
i. Cold lateral compaction (LC)
• After a standardized gutta-percha cone, size 40 (SybronEndo,

Orange, CA, USA) was fitted to the working length, cold
lateral compaction was performed using a nickel–titanium
finger spreader (Hyflex, size medium, Hygenic Corporation,
Akron, OH, USA).
• Matching nonstandardized gutta-percha cones, size medium

(SybronEndo), beginning from the mesiolingual part of the
canal to the distolingual part of the canal.
• Continued around the canal periphery until the spreader could

only penetrate 2– 3 mm into the canal. 15
16
• Approximately 16–20 accessory gutta-percha cones were
used in each canal.
• The Narrow Posterior Touch ‘n Heat heat-carrier attached

to System B (EIE/Analytic Technology, Orange, CA,
USA) was used to sear off the extended ends of the
cones.
17
• The softened gutta-percha in the coronal portion was
vertically compacted with a size 4 Machtou’s heat-carrier
plugger (Dentsply Maillefer).
18
ii. Ultrasonic compaction (UC)
• Lateral compaction was performed, and the extended ends of

the cones were seared off.
• The ultrasonic spreader tip attached to the Suprasson PMax

Ultrasonic unit (Satelec, Merignac, France) with a power
setting of 8 was inserted into the canal without force to within
2–3 mm from the end-point of preparation.
19
• Placed into the centre of the gutta-percha mass and
activated.
• The spreader was moved in short continuous in and out

motions approximately 8–10 times with slight apical
pressure until 2–3 mm short of the working length.
• Subsequently, the ultrasonic spreader was deactivated,

slightly rotated and then withdrawn.
20
• The selected finger spreader was used to compact
laterally the softened mass of gutta-percha.
• Additionally, 2–3 accessory cones were laterally

compacted in the same manner.
• Ultrasonic compaction, followed by cold lateral

compaction, was repeated one more time.
21
iii. Single cone with an injectable thermoplasticized gutta-
percha technique (IT)
• After a size 40 standardized gutta-percha cone was fitted to the

full working length of the canal, it was partially removed with
the Narrow Posterior Touch ‘n Heat heat-carrier attached to
System B, leaving 3–4 mm of the remaining gutta-percha core
in the apical portion, as an apical barrier.
22
23
• This was followed by the injection of injectable
thermoplasticized warm guttapercha (Obtura IITM, Obtura
Corporation, Fenton, MO, USA) performed in three stages,
using a needle tip (gauge 23) and preselected root canal
plugger, size 3 and 5 (Hu-Friedy Mfg Co., Chicago, IL, USA)
and a size 4 Machtou’s heat-carrier plugger.
• Softened guttapercha was injected to 3–4 mm from the

prepared canal terminus and compacted, followed by the
second and then a third increment.
24
iv. Core-carrier technique (CC)
• Thermafil obturators, sizes 40 and 35 (Dentsply Maillefer),

were selected based on size confirmation with Verifiers
(Dentsply Maillefer) and were heated simultaneously in a
ThermaPrep Plus Oven (Dentsply Maillefer) for the
recommended time.
25
• A warm size 40 Thermafil obturator was slowly
positioned into the mesiolingual part of the canal to the
working length in a single motion without rotation or
twisting.
• Followed by the insertion of the size 35 Thermafil

obturator into the distolingual part of the canal until
resistance was felt at 1 to 1.5 mm short of the working
length.
26
27
• A preselected size 7 root canal plugger (Hu-Friedy Mfg Co.)
that could be inserted 3–4 mm into the canal without binding to
the wall was used to compact the soft gutta-percha mass
vertically around the shafts of the two carriers.
• After the guttapercha mass had cooled, the carrier shafts were
severed 1 mm above the canal orifice with the electric heat
carrier attached to the System B (SybronEndo).
• Excess gutta-percha above the canal orifice was removed.
• Finally, the whole gutta-percha mass was compacted with the

size 4 Machtou’s heat carrier plugger. 28
• The time required to fill each sample was recorded.
• Apical extrusion of gutta-percha was noted.
• To ensure complete setting of sealer, all filled resin blocks

were placed on moistened gauze in a sealed container at 37 °C
in an incubator (Mermert GmbH+Co.KG, Schwabach,
Germany), for 1 week.
29
• Cross-sectional slices of the resin blocks were made.
• Level 1 (L1), Level 3 (L3) and Level 6 (L6) represented the

apical, middle and coronal thirds of the canal, respectively.
• Images of the sections were acquired with a video camera

(Digital ½ inch CCD, JVC, Yokohama, Japan) and a zoom
microscope (VZM300, Edmunds Industrial Optics, Akita,
Japan).
30
• The percentages of area occupied by gutta-percha, sealer
and voids were determined using an image analysis
system (Leica Qwin Pro Q5501W, Leica Imaging
Systems Ltd, Cambridge, UK).
• For the CC group, areas occupied by core-carriers were

included as part of the gutta-percha areas to facilitate
comparison of groups.
• Areas representative of gutta-percha, sealer and voids

were expressed as percentages of the total area.
31
STATISTICAL ANALYSIS
• The mean time taken to fill the canals was analysed using
the analysis of variance (ANOVA) and the Bonferroni
post hoc test.
• A chi-square (v2) test was carried out to analyse the

association between extrusion of gutta-percha and the
techniques used.
32
• Univariant general linear models were performed to
explain the percentages of gutta-percha, sealer and voids
by the level of sections and obturation techniques.
• The Dunnett’s T3 post hoc test was used for pairwise

comparison between the obturation groups at each level.
• All significant levels were set at P < 0.05.
33
RESULTS
1. Time taken for filling

• Using a one-way analysis of variance (ANOVA), the
mean time taken to fill the simulated canals amongst the
groups was highly significantly different (P = 0.000).
34
• Using the Bonferroni post hoc test, the mean time for the LC
group (20.72 min) was significantly three times longer than for
the IT group (6.11 min) and CC group (6.67 min), whereas UC
(26.92 min) was significantly four times longer (P = 0.000).
35
2. Apical extrusion of gutta-percha
• There was no apical extrusion of gutta-percha in both the

LC and the UC groups.
• In both the IT and the CC groups, two of ten canals had

extrusion.
• Using the Pearson’s chi-square test, P = 4.44 (>0.05),

there was no significant association between the
extrusion and the technique used.
36
3. The percentages of canal area occupied by guttapercha,
sealer and voids
• Using univariant general linear models, the analysis on gutta-

percha and sealer revealed significant differences between the
levels (P = 0.000) and between the groups (P < 0.05).
• There was also significant interaction between levels and

groups (P = 0.000), implying that a certain group at one level
performed differently from other levels.
37
• The pairwise comparison between the levels showed
significantly less gutta-percha and more sealer at L1 compared
with L3 and L6 (P = 0.000).
• There were significantly more voids at L1 compared with L6

(P = 0.001).
38
• The CC had the highest mean percentages for gutta-percha at
L1.
39
• Using the nonparametric post hoc test of multiple comparisons
(Dunnett’s T3), significantly more gutta-percha and less sealer
were present in the canals filled by CC compared with IT at L1
(P < 0.05).
• The difference in mean percentages for gutta-percha between

LC and CC was found to be marginally significant (P = 0.049).
40
INTERNATIONAL ENDODONTIC
JOURNAL 2014
• Only the IT showed <90% of gutta-percha at this level L1.
41
• The CC was the most consistent technique with the least
variability.
42
• At L3, significantly more gutta-percha and less sealer
were present in the canals filled by the IT compared with
LC (P < 0.05).
43
• No significant difference was found in the percentages of canal
area filled with gutta-percha, sealer and voids amongst the
groups at L6.
44
Reliability test
• Based on the variance of each mean, the variation for each

repeated measurement was calculated.
• The overall variation was 2.99 and the average variation was
0.08.
• The magnitude was negligible and the reproducibility of the

evaluation method was acceptable.
45
• Most cross sections in the LC group had irregularly shaped
coalescent masses of gutta-percha with voids and areas of
sealer at the perimeter of the canals.
46
• In the UC group, most cross sections at L1 exhibited smooth
and uniform coalescent masses of gutta-percha.
• Some sections showed isolated gutta-percha cones lined with

sealer and areas of sealer within the mass of gutta-percha.
• The canal walls were not lined with sealer in most sections.
47
• There was a distinct difference between sections at L1 and
other levels in the IT group.
• Injected gutta-percha was well adapted to the master cone and

canal walls in 50% of cross sections at L1.
48
• The remaining fifty percent of the sections at L1 exhibited a
single gutta-percha cone encased in a thick layer of sealer.
• The warm gutta-percha failed to flow around the master cone,

resulting in large areas of sealer and voids at the periphery of
the cone.
49
• At L3 and L6, a smooth and uniform gutta-percha mass was
seen in the majority of cross sections.
• There was close adaptation between the gutta-percha and canal

walls.
• Sealer was observed lining the canal walls.
50
• All cross sections in the CC group had a homogenous
gutta-percha mass at the junction between the two
obturators.
• The core-carrier was completely encased in the gutta-

percha mass in the cross section at L1.
51
• In some sections, the core-carrier was directly in contact with
the canal wall.
• None of the sections showed the presence of voids between

carrier and gutta-percha mass.
52
DISCUSSION
• Simulated C-shaped canals do not represent the population of

C-shaped canals and therefore stand out as a limitation of this
investigation.
• As such, it is difficult to draw any firm conclusions on the

most effective filling technique for C-shaped canals in general.
• In addition, the surface texture of resin could influence the

flow characteristic of thermo-softened gutta-percha and sealer.
53
• Percentages of canal area occupied by guttapercha, sealer and
voids in cross sections were used as a measure of filling
quality.
• A high percentage of gutta-percha with a thin layer of sealer

area indicated good filling quality.
• Level 1 is biologically important because it determines the

apical seal.
54
• During the setting of the root canal sealer, it may shrink and/or
dissolve over time and produce leakage (Kontakiotis et al.
1997).
• Voids provide avenues for leakage and pulp tissue remnants

harbour microorganisms that may multiply to sufficient
numbers and cause or maintain disease (Kakehashi et al. 1965,
M€oller et al. 1981, Fabricius et al. 1982).
55
• The poorer quality of filling in the apical canal is
probably caused by the elongated shape and canal taper
that was greater in the mesial–distal direction than in the
buccal–lingual orientation of this simulated C-shaped
canal.
• This finding agreed with Ordinola- Zapata et al. (2009),

who found that the apical third of C-shaped canals were
less completely filled, using the MicroSeal technique
(Analytic, Glendora, CA, USA) on extracted molars.
56
• The mean percentage of gutta-percha filled area in the apical
level reported by Ordinola-Zapata et al. (2009) was 74.5%,
which was lower than the present investigation (91.75%).
• This is probably due to various anatomical types in extracted

teeth, resulting in lower filling quality.
57
• The LC served as the control technique in this study.
• The simulated canals were not sufficiently filled even

though a large number of accessory cones were used in this
technique.
• Wu et al. (2001) showed in their investigation that the

quality of filling with LC in oval canals was less reliable
and the percentage of canal area filled by gutta-percha
ranged from 70% to 100%.
58
• The inconsistency may be attributed to the irregular shape of
the canal.
• Both Kersten et al. (1986) and Wu & Wesselink (2001) found

that canals with increased flare resulted in significantly poorer
quality of fill using LC.
• For wider and irregular-shaped canals, instead of compacting

and deforming gutta-percha cones during spreader penetration,
the cones were displaced laterally.
59
• Voids and sealer were mostly found along the perimeters of the
gutta-percha mass, possibly indicating eventual loss of
integrity because of poor adaptation of gutta-percha to the
canal walls.
• Void formation was probably due to the failure of the accessory

gutta-percha cones in filling the space created by the
compacting instrument.
• With the final vertical compaction at the orifice, the percentage

of canal area occupied by gutta-percha improved coronally, as
seen at L6.
60
• Although LC was relatively easy to perform, the
simulated C-shaped canal had greater volume and
required a larger mass of gutta-percha.
• In LC, insert and compact 16 to 20 accessory gutta-

percha cones for each canal was quite a time-consuming
task, even though this technique has good apical control.
• A higher percentage of gutta-percha was observed at all

three levels in the UC group compared with the LC
group.
61
• The pilot study showed that two insertions of the ultrasonic
spreader into the canal that was initially filled by the lateral
compaction technique were sufficient to thermoplasticize the
whole guttapercha mass.
• Although not significant, this observation suggests that the UC

may result in a filling of greater density.
• This finding also supports the scanning electron microscope

investigation by Baumgardner & Krell (1990), where a more
homogeneous gutta-percha mass with fewer voids was reported
in root canals filled by UC.
62
• They found that canals filled by UC resulted in significantly
less apical leakage than canals obturated by LC.
• The warm gutta-percha should adapt more adequately to the

canal walls and irregularities.
• The lower percentage of sealer compared with LC was

probably due to the mixing of sealer and gutta-percha during
ultrasonic compaction, so the definite areas of sealer became
smaller.
63
• The findings for apical extrusion of gutta-percha in the LC and
UC groups are consistent with those of Amditis et al. (1992),
who demonstrated no apical extrusion in all specimens
obturated by LC and UC.
• In addition, a clinical study has shown that apical extrusion

occurred in only 2% of the canals obturated by UC (Zmener &
Banegas 1999).
64
• UC technique did not appear to predispose to overfilling
because adequate fitting of the master cone provided
good apical control and the depth of ultrasonic spreader
penetration was 2 to 3 mm coronal to the prepared canal
terminus.
• However, UC has a major disadvantage clinically being

the most time-consuming technique.
65
• Frictional heat generated by the ultrasonic spreader demands
further investigation to ensure that the temperature rise is not
detrimental to periodontal health.
• With the use of a master cone as an apical plug in the IT group,

the injected gutta-percha did not predictably adapt to the
master cone even after vertically compacting the injected
gutta-percha mass.
66
• Under extension of injectable gutta-percha was reported
to be a significant problem when using Ultrafil (Amditis
et al. 1992) or when a dentine plug served as an apical
barrier for the Obtura technique (Scott & Vire 1992).
• Under extension of gutta-percha was also reported in

20% of canals filled in vivo by the injection technique,
leading to apical dye leakage in these canals (Veis et al.
1994).
67
• The insignificant difference in filling quality between IT and
LC at L1 concurred with investigations that showed no
significant difference in apical dye leakage between the two
groups (ElDeeb 1985, Evans & Simon 1986).
• The improved obturation quality at L3 and L6, with less sealer

and voids, is probably due to better adaptation of thermo-
softened gutta-percha and sealer being pushed away during
vertical compaction.
68
• The current study shows that IT technique has poor apical
control but excellent adaptation in the coronal two-thirds
of the canal, reinforcing the use of warm injectable gutta-
percha strictly for backfilling only.
• Although the IT was quick to perform, the poor filling

quality at the apical third was a major deterring factor for
advocating this technique for the filling of this simulated
C-shaped canal.
69
• Warm vertical compaction using the System B was one of the
filling methods evaluated in the pilot study.
• As the apical canal has a greater taper, four to five non-

standardized gutta-percha cones were inserted into the canal
before down-packing to 3–4 mm coronal to the prepared canal
terminus.
• Cross sections at 1 mm from the obturated canal terminus

showed individual gutta-percha cones that failed to coalesce
into a single mass, indicating insufficient heat softening of the
remaining gutta-percha mass during down-packing (not
included as one of the comparison groups in this study).
70
• Two core-carrier obturators (Thermafil) were used in each
simulated canal because a single obturator did not completely
fill the canal during the pilot study.
• Our study showed that CC was the best technique compared

with LC and IT, based on the percentage of gutta-percha in the
apical canals.
• The complicated canal at the apical third was adequately filled

with satisfactory adaptation, using CC in an ex vivo study
(Stratul et al. 2011).
71
• This result also corroborated the findings of De-Deus et al.
(2006) where CC produced significantly higher gutta-percha
filled areas than the LC and System B techniques on extracted
human maxillary central incisors.
• Wolcott et al. (1997) reported significantly less void areas with

CC than LC, at the levels of 1.6 and 2.4 mm from the apex of a
resin simulated curved canal.
72
• The CC also exhibited less apical leakage using dye
penetration methods, compared with LC (Gutmann et al.
1993, Dummer et al. 1994).
• Although gutta-percha was stripped from the core-

carriers, all plastic carriers exhibited good adaptation
when in contact with the resin canal walls, possibly due
to the softening of the plastic core after heating in the
oven.
73
• This observation corresponds to the findings of De Moor &
Martens (1999), who stated that the stripping of gutta-percha
from the plastic carrier did not influence apical dye leakage.
• The incidence of apical extrusion of gutta-percha in canals

filled with Thermafil has been reported to be high in most
laboratory studies.
74
• As the simulated C-shaped canal was very wide, there
may have been a tendency for the thermo-softened gutta-
percha to flow into the area of least resistance, that is, the
canal area between the two core-carriers, instead of
flowing through the apical opening.
• Although the quality of obturation and apical extrusion in

the CC and UC were not significantly different, the filling
time for the UC was four times longer than for CC,
indicating that the CC was a more effective technique.
75
CONCLUSIONS
• The apical portion of the simulated C-shaped canal
proved to be the most difficult part of the canal to
adequately fill.
• The apical extrusion was found to be similar amongst the

four comparative groups.
• The injectable thermoplasticized gutta-percha and the

core-carrier techniques were the quickest filling
techniques, with the best quality of filling being achieved
with the use of the core-carrier technique.
76
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A COMPARISON OF FOUR

W. K. M. SOO, Y. L. THONG & J. L. GUTMANN

Presented by: ANAS.K

• The use of cone-beam computed tomography provides a better

• Nevertheless, they provide a challenge with respect to preparation

• In the filling of C-shaped canals, the popular cold lateral

• To address this problem, thermoplasticized gutta-percha

• To prevent overfilling and apical extrusion with this filling

• Ultrasonically energized spreaders that produced

• It allow direct visualization of the root canal procedure

ii. The time taken for filling.

iii. The presence of apical extrusion of gutta-percha. 9

1. Construction of resin simulated C-shaped canals (RSCs)

• The canal was prepared using the step-down technique (Goerig

• A polyester casting resin (Miracon (M) Sdn Bhd, Malaysia)

• 80 RSCs were produced.

• Forty resin blocks were selected for the actual experiment

• The working length for all simulated canals was

• Apical canal patency was confirmed by passing a size 15

• The smallest diameter at the apical constriction allowed

• The canals were placed in the ultrasonic cleaner for 10 min

• Roth Root Canal Cement, Type 801 (Roth International

• After a standardized gutta-percha cone, size 40 (SybronEndo,

• Matching nonstandardized gutta-percha cones, size medium

• Continued around the canal periphery until the spreader could

• The Narrow Posterior Touch ‘n Heat heat-carrier attached

• Lateral compaction was performed, and the extended ends of

• The ultrasonic spreader tip attached to the Suprasson PMax

• The spreader was moved in short continuous in and out

• Subsequently, the ultrasonic spreader was deactivated,

• Additionally, 2–3 accessory cones were laterally

• Ultrasonic compaction, followed by cold lateral

• After a size 40 standardized gutta-percha cone was fitted to the

• Softened guttapercha was injected to 3–4 mm from the

• Thermafil obturators, sizes 40 and 35 (Dentsply Maillefer),

• Followed by the insertion of the size 35 Thermafil

• Excess gutta-percha above the canal orifice was removed.

• Finally, the whole gutta-percha mass was compacted with the

• Apical extrusion of gutta-percha was noted.

• To ensure complete setting of sealer, all filled resin blocks

• Level 1 (L1), Level 3 (L3) and Level 6 (L6) represented the

• Images of the sections were acquired with a video camera

• For the CC group, areas occupied by core-carriers were

• Areas representative of gutta-percha, sealer and voids

• A chi-square (v2) test was carried out to analyse the

• The Dunnett’s T3 post hoc test was used for pairwise

• All significant levels were set at P < 0.05.

1. Time taken for filling

• There was no apical extrusion of gutta-percha in both the

• In both the IT and the CC groups, two of ten canals had

• Using the Pearson’s chi-square test, P = 4.44 (>0.05),

• Using univariant general linear models, the analysis on gutta-

• There was also significant interaction between levels and

• There were significantly more voids at L1 compared with L6

• The difference in mean percentages for gutta-percha between

• Based on the variance of each mean, the variation for each

• The magnitude was negligible and the reproducibility of the

• Some sections showed isolated gutta-percha cones lined with

• Injected gutta-percha was well adapted to the master cone and

• The warm gutta-percha failed to flow around the master cone,

• There was close adaptation between the gutta-percha and canal

• Sealer was observed lining the canal walls.