Evaluation of the Apical Microleakage using Zinc Oxide Eugenol via three Different Obturation Techniques (Reamer, Tuberculin syringe and Modified Disposable Syringe) in Primary Teeth An In Vitro Study Apical Microleakage in Primary Teeth
Article Sidebar
Main Article Content
Abstract
Maintenance of primary dentition is important for a
preventing arch-length discrepancy. Therefore, successful
root canal treatment is important for keeping such teeth until
natural exfoliation occurs. This research was conducted to
quantitatively assess the sealing ability and time taken for
obturation with Zinc Oxide Eugenol via different three
obturation methods. Thirty-six extracted anterior primary
teeth samples were included in this study. Canals were
prepared by K-files (15–45) and obturated by ZOE. The
teeth were divided randomly into three experimental groups
(n=12), randomly as follows: Group I (Modified Disposable
Syringe), Group II (Reamer Technique) and Group III
(Tuberculin Syringe). The dye extraction technique was
utilized for microleakage evaluation, and obturation time
was recorded for each sample. All results were statistical
analyze, and P < 0.05 was considered to be significant. The
mean microleakage of the modified disposable syringe group
was lower than microleakage amounts in the tuberculin
syringe and reamer groups with no statistical difference (p >
0.05). In terms of obturation duration, using the modified
disposable syringe technique, the time was less than the
tuberculin group with no statistical significance difference,
and less compared to that of the reamer technique group with
a statistical significance difference (p < 0.05). In conclusion,
modified disposable syringe that used in this study was the
most acceptable obturation method when ZOE was used to
obturate the primary teeth. It has a better apical seal and
saves up on chair time, which is of high importance in
successful pediatric practice.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Journal of Medical and Oral Biosciences uses a Creative Commons Attribution (CC Attribution-ShareAlike 4.0) and its license of (CC BY-SA 4.0). This license allows the authors to hold ownership of the copyright of their articles.
Attribution-Share Alike 4.0 International License (CC BY-SA 4.0). 
Under the CC BY-SA 4.0 the authors are free to:
Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
No use, distribution or reproduction is permitted which does not comply with these terms.
https://creativecommons.org/licenses/by-sa/4.0/
References
1. Riolina A, Hartini S, Suparyati S. Dental and oral health problems in elementary school
children: A scoping review. Pediatric Dental Journal. 2020;30(2):106–14.
DOI:10.1016/j.pdj.2020.04.001
2. Ahmadi F, Triwinarto A (2019): Analysis descriptive stunting in Indonesia Health Research Basic, Ann Trop & Public Health; 22(11): S357A. DOI: http://doi.org/10.36295/ASRO.2019.221159
3. Chandrasekhar S, Prasad MG, Radhakrishna AN, Saujanya K, Raviteja NVK, Deepthi B, Ramakrishna J. A comparative In vivo efficacy of three spiral techniques versus incremental technique in obturating primary teeth. J Indian Soc Pedod Prev Dent. 2018 Jan-Mar;36(1):71-75. doi: 10.4103/JISPPD.JISPPD_365_16. PMID: 29607843.
4. Sharma K, Maria R, Durga Dutta S, Semwal M, Srija K, Pawar M, Dagli N, Niranjan Mehta D. Evaluation of obturation techniques in primary teeth among Indians. Bioinformation. 2023 Dec 31;19(13):1324-1328. doi: 10.6026/973206300191324. PMID: 38415036; PMCID: PMC10895539.
5. Achmad H, Armedina RN, Timokhina T, Goncharov V V, Sitanaya R, Riyanti E. Literature review: Problems of dental and oral health primary school children. Indian Journal of Forensic Medicine & Toxicology. 2021;15(2). 4117-4124. DOI:10.37506/ijfmt.v15i2.15019
6. Redwan AK, Alhazmi HA, Alharthi SA, Alharbi JJ. Parents' Knowledge and Awareness About the Importance of Primary Teeth and Space Maintainers in Saudi Arabia: A Cross-Sectional Study. Cureus. 2024 Jun 6;16(6):e61836. doi: 10.7759/cureus.61836. PMID: 38975367; PMCID: PMC11227340.
7. Sanusi SY, Al-Bataynehb OB. Pulp Therapy of Primary Dentition; its Relevance despite Insufficient Histological Evidence: A Review. Iran Endod J. 2023;18(1):15-40. doi: 10.22037/iej.v18i1.34931. PMID: 36751408; PMCID: PMC9900146.
8. Guimarães ME, Jorge RC, Duarte ML, Bedran NR. Pulp therapy in primary teeth with irreversible pulpitis or necrosis: a literature review. Revista, Latino americana. 2025;15:e-246692. https://doi.org/10.47990/m8j6yp38
9. Nagarathna C, Vishwanathan S, Krishnamurthy NH, Bhat PK. Primary Molar Pulpectomy Using Two Different Obturation Techniques: A Clinical Study. Contemp Clin Dent. 2018 Apr-Jun;9(2):231-236. doi: 10.4103/ccd.ccd_826_17. PMID: 29875566; PMCID: PMC5968688.
10. Jena A. Pulpectomy: A Comprehensive Review. (2020). Indian Journal of Forensic Medicine & Toxicology, 14(4), 9321- 9324. https://doi.org/10.37506/ijfmt.v14i4.13267
11. Ali A, Fadhil N, Al-Maroof A. Evaluation of technical quality and procedural errors of root canal treatment performed by undergraduate and postgraduate dental students: A retrospective radiographic analysis. Medico-Leg Update. 2020;20(3):787–92.
12. Priyadarshini P, Gurunathan D. Comparative evaluation of quality of obturation using endoflas and endoflas powder with aloevera gel as obturating materials in primary mandibular molars: a double blinded randomized controlled trial. J Complement Med Res. 2020;11(3):203–13. DOI: 10.5455/jcmr.2020.11.03.27
13. Casaña Ruiz MD, Martínez LM, Miralles EG. Update in the Diagnosis and Treatment of Root Canal Therapy in Temporary Dentition through Different Rotatory Systems: A Systematic Review. Diagnostics (Basel). 2022 Nov 13;12(11):2775. doi: 10.3390/diagnostics12112775. PMID: 36428835; PMCID: PMC9689064.
14. Coll JA, Vargas K, Marghalani AA, Chen CY, AlShamali S, Dhar V, Crystal YO. A Systematic Review and Meta-Analysis of Nonvital Pulp Therapy for Primary Teeth. Pediatr Dent. 2020 Jul 15;42(4):256-461. PMID: 32847665.
15. Silva Junior MF, Wambier LM, Gevert MV, Chibinski ACR. Effectiveness of iodoform-based filling materials in root canal treatment of deciduous teeth: a systematic review and meta-analysis. Biomater Investig Dent. 2022 May 19;9(1):52-74. doi: 10.1080/26415275.2022.2060232. PMID: 35615468; PMCID: PMC9126566.
16. Manhas, S. ., Haritwal, V. ., Chaturvedi, Y. ., Vyas, D. ., Dalsania, R. ., & Chhibber, R. . (2020). Obturating Materials in Pediatric Dentistry : Literature Review. International Journal of Contemporary Research and Review, 11(08). https://doi.org/10.15520/ijcrr.v11i08.835
17. Goit A, Srivastava M, Ayodhi S, Vannala V, Shanmugaavel AK, Sooriaprakas C. Evaluation of Three Different Obturating Techniques in Primary Molar using Cone-Beam Computed Tomography: An In vitro Study. J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1233-S1235. doi: 10.4103/jpbs.jpbs_1666_24. Epub 2025 Jun 18. PMID: 40655777; PMCID: PMC12244907.
18. Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, Gautam N. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health. 2020 Feb 3;20(1):37. doi: 10.1186/s12903-020-1025-9. PMID: 32013975; PMCID: PMC6998061.
19. Brar GS, Bajaj N, Bhola M, Brar JK. Clinical Evaluation of Root Resorption and its Correlation with Obturation Quality in Pulpectomized Deciduous Teeth with Different Obturating Materials: An In vivo Study. Contemp Clin Dent. 2019 Apr-Jun;10(2):243-248. doi: 10.4103/ccd.ccd_448_18. PMID: 32308285; PMCID: PMC7145250.
20. Bawazir OA, Salama FS. Clinical evaluation of root canal obturation methods in primary teeth. Pediatr Dent. 2006 Jan-Feb;28(1):39-47. PMID: 16615374.
21. Kale YJ, Misal S, Dadpe M, Dahake PT, Kendre SB. Comparative Evaluation of Microleakage of Zinc Oxide Eugenol and Endoflas as Obturating Materials Using Different Root Canal Irrigants in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent. 2024 Nov;17(11):1252-1257. doi: 10.5005/jp-journals-10005-2755. Epub 2024 Dec 19. PMID: 39781383; PMCID: PMC11703773.
22. Irzooqee AF, Al Haidar AHMJ, Abdul-Kareem M. The Effect of Different Obturation Techniques in Primary Teeth on the Apical Microleakage using Endoflas: A Comparative In Vitro Study. Int J Dent. 2023 Mar 31;2023:4982980. doi: 10.1155/2023/4982980. PMID: 37033128; PMCID: PMC10081900.
23. Alani, Z. K., & Abd-alla, M. H. (2025). Effect of Root Dentin Moisture on the Apical Sealing Ability of Root Canal Sealers: In vitro Study. Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ), 8(2), 122–127. https://doi.org/10.54133/ajms.v8i2.1910
24. Prabakar J, Jeevanandan G, Kengadaran S. In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants. Int J Clin Pediatr Dent. 2023 Sep-Oct;16(5):745-750. doi: 10.5005/jp-journals-10005-2684. PMID: 38162245; PMCID: PMC10753099.
25. Govindaraju L, Jeevanandan G, Veeraraghavan VP, El-Sherbiny M, Binshafi GB, Alkharji SK et al. An In-vitro Analysis of the Antimicrobial Efficacy of a Novel Obturating Material for Primary Teeth. Journal of International Dental and Medical Research. 2024;17(1):110-114.https://psau.sa.elsevierpure.com/en/publications/an-in-vitro-analysis-of-the-antimicrobial-efficacy-of-a-novel-obt/
26. Nalawade HS, Lele GS, Walimbe H. Outcome of zinc oxide eugenol paste as an obturating material in primary teeth pulpectomy: A systematic review. J Dent Res Rev 2017;4:90-6.DOI: 10.4103/jdrr.jdrr_65_17
27. Wasnik MB, Mittal R, Sajjanar A, Gahlod N, Khekade S, Shukla H. Comparative Evaluation of Antimicrobial Efficacy of Zinc Oxide Eugenol with Zinc Oxide Mixed with Three Herbal Products to be Used as Root Canal Filling Material: An In Vitro Study. Int J Clin Pediatr Dent. 2022;15(Suppl 1):S40-S46. doi: 10.5005/jp-journals-10005-2129. PMID: 35645491; PMCID: PMC9108819.
28. Hiremath MC, Srivastava P. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study. J Nat Sc Biol Med 2016;7:130-5. DOI: 10.4103/0976-9668.184698
29. Bargale S, Davangere Padmanabh SK, Kariya PB, Shah S, Dave B. Knowledge, attitude, and practice regarding standardized treatment protocol for pulp therapy in deciduous dentition among general dental practitioners of Vadodara, Gujarat, India. J Indian Soc Pedod Prev Dent. 2019 Oct-Dec;37(4):327-332. doi: 10.4103/JISPPD.JISPPD_186_19. PMID: 31710005.
30. Govindaraju L, Jeevanandan G, Emg S, Vishawanathaiah S. Assessment of Quality of Obturation, Instrumentation Time and Intensity of Pain with Pediatric Rotary File (Kedo-S) in Primary Anterior Teeth: A Randomized Controlled Clinical Trial. Int J Clin Pediatr Dent. 2018 Nov-Dec;11(6):462-467. doi: 10.5005/jp-journals-10005-1558. PMID: 31303731; PMCID: PMC6611531.
31. Naji AN, Al-Gharrawi HA. Comparison of the sealing ability of GuttaFlow bioseal with different obturation systems (an in vitro study). J Int Dent Med Res. 2020;13(4):1632–6. https://www.semanticscholar.org/paper/Comparison-of-the-Sealing-Ability-of-GuttaFlow-with-Naji-Al-Gharrawi/4f8d3f6cf84fa8977458a132279ab0dc4f32193c
32. Mahajan N, Bansal A. Various Obturation methods used in deciduous teeth. Int J Med and Dent Sci 2015; 4(1):708-713. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://scispace.com/pdf/various-obturation-methods-used-in-deciduous-teeth-sb9qub33t3.pdf
33. Dou G, Wang D, Zhang S, Ma W, Xu M, Xia B. A retrospective study on the long-term outcomes of pulpectomy and influencing factors in primary teeth. J Dent Sci. 2022 Apr;17(2):771-779. doi: 10.1016/j.jds.2021.10.007. Epub 2021 Oct 21. PMID: 35756771; PMCID: PMC9201929.
34. Ge KX, Yu-Hang Lam W, Chu CH, Yu OY. Updates on the clinical application of glass ionomer cement in restorative and preventive dentistry. J Dent Sci. 2024 Dec;19(Suppl 1):S1-S9. doi: 10.1016/j.jds.2024.07.021. Epub 2024 Jul 27. PMID: 39807434; PMCID: PMC11725089.
35. Sah S, Mangat P, Kumar A, Sah N, Shivakumar GC, Di Blasio M, Cervino G, Minervini G. Stereomicroscopic evaluation of sealing ability of four different root canal sealers: an in-vitro study. BMC Oral Health. 2024 Feb 20;24(1):258. doi: 10.1186/s12903-024-03913-7. PMID: 38378554; PMCID: PMC10877889.
36. Razmi H, Bolhari B, Karamzadeh Dashti N, Fazlyab M. The Effect of Canal Dryness on Bond Strength of Bioceramic and Epoxy-resin Sealers after Irrigation with Sodium Hypochlorite or Chlorhexidine. Iran Endod J. 2016 Spring;11(2):129-33. doi: 10.7508/iej.2016.02.011. Epub 2016 Mar 20. PMID: 27141222; PMCID: PMC4841349.
37. Negi S, Adhikari HD, Mazumder D, Lakiang RD, Bhardwaj S. Comparative evaluation of microleakage after root-end resection by erbium, chromium: Yttrium-scandium-gallium-garnet (Er, Cr:YSGG) laser and carbide bur with or without placement of mineral trioxide aggregate: An in vitro study. J Conserv Dent. 2019 Jul-Aug;22(4):391-395. doi: 10.4103/JCD.JCD_48_19. PMID: 31802826; PMCID: PMC6873605.
38. Muliyar S, Shameem KA, Thankachan RP, Francis PG, Jayapalan CS, Hafiz KA. Microleakage in endodontics. J Int Oral Health. 2014 Nov-Dec;6(6):99-104. PMID: 25628496; PMCID: PMC4295468.
39. Sahu D, Somani R, Rao BV, Nagarjuna P, Eshwara K, Lakshmi PVSD. Comparative evaluation of microleakage of various glass-ionomer cements: An: in vitro: study. International journal of preventive and clinical dental research. 2018;5(3):17–20. DOI: 10.4103/INPC.INPC_8_18
40. Öter B, Topçuog Lu N, Tank MK, Çehreli SB. Evaluation of Antibacterial Efficiency of Different Root Canal Disinfection Techniques in Primary Teeth. Photomed Laser Surg. 2018 Apr;36(4):179-184. doi: 10.1089/pho.2017.4324.
41. Yüksel BN, Demirel A, Ziya M, Kolçakoğlu K, Doğan S, Sarı Ş. The effects of various irrigation protocols on root canal wall adaptation and apical microleakage in primary teeth. Acta Odontol Scand. 2020 Jul;78(5):321-326. doi: 10.1080/00016357.2019.1709890.
42. Valizadeh M, Gheidari A, Daghestani N, Mohammadzadeh Z, Khorakian F. Evaluation of various root canal irrigation methods in primary teeth: a systematic review. BMC Oral Health. 2024 Dec 21;24(1):1535. doi: 10.1186/s12903-024-05164-y.
43. Kukreja P, Reddy PR, Hugar SM, Shigli A, Hugar SS. Comparative evaluation of efficiency of three obturation techniques for primary incisors—an in vivo study. International Journal of Oral Health and Medical Research. 2015;2(2):15–18. https://www.academia.edu/73435323/An_In_Vivo_Study
44. Monali S, Anandamoy B, Atul B. A cone-beam computed tomographic assessment of different obturation techniques in primary molars—an in vivo study. International Journal of Dental Science and Innovative Research. 2020;74(1):46–51. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ijdsir.com/uploads/pdf/16042496521009.pdf
45. Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, Pozos-Guillen AJ. Comparison between rotary and manual techniques on duration of instrumentation and obturation times in primary teeth. J Clin Pediatr Dent. 2011 Summer;35(4):359-63. doi: 10.17796/jcpd.35.4.8k013k21t39245n8.