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Kim JH, Cho BH, Lee JH, Kwon SJ, Yi YA, Shin Y, Roh BD, Seo DG. Influence of preparation design on fit and ceramic thickness of CEREC 3 partial ceramic crowns after cementation. Acta Odontol Scand 2015; 73:107-13. [PMID: 25299600 DOI: 10.3109/00016357.2014.956145] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigated the influence of preparation design on the marginal and internal gap and ceramic thickness of partial ceramic crowns (PCCs) fabricated with the CEREC 3 system. MATERIALS AND METHODS Sixteen extracted human mandibular molars were prepared according to two different preparation designs (n = 8): a retentive preparation design with traditional cusp capping (Group I) and a non-retentive preparation design with horizontal reduction of cusps (Group II). PCCs were fabricated from IPS Empress CAD with the CEREC 3 system. The parameters for luting space and minimum occlusal ceramic thickness were set to 30 μm and 1.5 mm, respectively. The fabricated PCCs were cemented to their corresponding teeth with self-adhesive resin cement and were then scanned by micro-computed tomography. The marginal and internal gaps were measured at pre-determined measuring points in five bucco-lingual and three mesio-distal cross-sectional images. The ceramic thicknesses of the PCCs were measured at the measuring points for cusp capping areas. RESULTS Group II (167.4 ± 76.4 μm) had a smaller overall mean gap, which included the marginal and internal gap measurements, than that of Group I (184.8 ± 89.0 μm). The internal gaps were larger than the marginal gaps, regardless of preparation design. Group I presented a thinner ceramic thickness in the cusp capping areas than the minimum occlusal ceramic thickness parameter of 1.5 mm. CONCLUSION. Preparation design had an influence on fit, particularly the internal gap of the PCCs. Ceramic thickness could be thinner than the minimum ceramic thickness parameter.
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Affiliation(s)
- Jae-Hoon Kim
- Department of Conservative Dentistry and Dental Research Institute, School of Dentistry, Seoul National University , Seoul , Republic of Korea
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Kierklo A, Tabor Z, Pawińska M, Jaworska M. A microcomputed tomography-based comparison of root canal filling quality following different instrumentation and obturation techniques. Med Princ Pract 2015; 24:84-91. [PMID: 25359228 PMCID: PMC5588182 DOI: 10.1159/000368307] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 09/11/2014] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE With a microcomputed tomography (microCT) imaging device, we aimed to quantitatively evaluate root canal fillings after commonly used endodontic procedures and also tested the suitability of microCT for this purpose. MATERIALS AND METHODS Eighty single roots were instrumented and obturated with gutta-percha and Tubli-Seal. They were divided into 4 groups of 20. The Hand groups were instrumented with hand files and filled with thermoplastic (Th) compaction and cold lateral (CL) condensation, i.e. Hand-Th and Hand-CL, respectively. The Rot groups, i.e. Rot-Th and Rot-CL, were instrumented with a rotary ProFile system and filled as above. The roots were scanned and 3-dimensional (3D) visualization was obtained. The number, size, percentage of volume and distribution of voids at the filling/dentine interface (i-voids) and voids surrounded by filling material (s-voids) were measured. RESULTS Canal fillings differed significantly with regard to the size of both types of voids and the average number of i-voids. All canals presented a low volume of voids. The highest percentage (0.69%) was found for i-voids in the Hand-CL group, while the lowest volume (0.11% for s-voids and 0.14% for i-voids) was in the Hand-Th canals. Apically, in the last 3 mm, i-voids were observed mainly in the Th groups, and s-voids occurred mostly in the coronal part of the canal filling in all cases. CONCLUSION MicroCT was a useful tool for 3D quantitative evaluations of these root canal fillings. None of the root canal instrumentation and filling methods ensured void-free obturation. CL condensation produced mainly i-voids. With Th compaction, internal s-voids were particularly common, but there were mainly i-voids in the apical part.
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Affiliation(s)
- Anna Kierklo
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland
- *Assoc. Prof. Dr. Anna Kierklo, Department of Dentistry Propaedeutics, Medical University of Bialystok, ul. J. Waszyngtona 15A, PL–15-274 Bialystok (Poland), E-Mail
| | - Zbisław Tabor
- Department of Institute of Teleinformatics, Cracow University of Technology, Cracow, Poland
| | - Małgorzata Pawińska
- Department of Restorative Dentistry and Endodontics, Medical University of Bialystok, Bialystok, Poland
| | - Małgorzata Jaworska
- Department of Dentistry Propaedeutics, Medical University of Bialystok, Bialystok, Poland
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MOURA-NETTO C, PALO RM, PINTO LF, MELLO-MOURA ACV, DALTOÉ G, WILHELMSEN NSW. CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas. Braz Oral Res 2014; 29:1-6. [DOI: 10.1590/1807-3107bor-2015.vol29.0006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 08/13/2014] [Indexed: 11/22/2022] Open
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Metzger Z. The self-adjusting file (SAF) system: An evidence-based update. J Conserv Dent 2014; 17:401-19. [PMID: 25298639 PMCID: PMC4174698 DOI: 10.4103/0972-0707.139820] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 11/04/2022] Open
Abstract
Current rotary file systems are effective tools. Nevertheless, they have two main shortcomings: They are unable to effectively clean and shape oval canals and depend too much on the irrigant to do the cleaning, which is an unrealistic illusionThey may jeopardize the long-term survival of the tooth via unnecessary, excessive removal of sound dentin and creation of micro-cracks in the remaining root dentin. The new Self-adjusting File (SAF) technology uses a hollow, compressible NiTi file, with no central metal core, through which a continuous flow of irrigant is provided throughout the procedure. The SAF technology allows for effective cleaning of all root canals including oval canals, thus allowing for the effective disinfection and obturation of all canal morphologies. This technology uses a new concept of cleaning and shaping in which a uniform layer of dentin is removed from around the entire perimeter of the root canal, thus avoiding unnecessary excessive removal of sound dentin. Furthermore, the mode of action used by this file system does not apply the machining of all root canals to a circular bore, as do all other rotary file systems, and does not cause micro-cracks in the remaining root dentin. The new SAF technology allows for a new concept in cleaning and shaping root canals: Minimally Invasive 3D Endodontics.
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Affiliation(s)
- Zvi Metzger
- Department of Endodontology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Quality of obturation achieved by a non-gutta-percha-based root filling system in single-rooted canals. J Endod 2014; 40:2003-8. [PMID: 25262034 DOI: 10.1016/j.joen.2014.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/19/2014] [Accepted: 07/21/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The present study examined the quality of obturation in root canals filled by an experimental non-gutta-percha-based (NGP) root filling system using warm vertical or cold lateral compaction. The quality of obturation was evaluated by comparing the volumetric percentage of gaps and voids identified from similar canals obturated with gutta-percha and an epoxy resin-based sealer using the same obturation techniques. METHODS Forty single-rooted premolars with oval-shaped canals were cleaned, shaped, and obturated with 1 of the 4 material/obturation technique combinations (n = 10). Filled canals were scanned with micro-computed tomographic imaging. Reconstructed images were analyzed for the volumetric percentage of gaps and voids at 3 canal levels (0-4, 4-8, and 8-12 mm from the working length). Roots were sectioned at the 4-mm, 8-mm, and 12-mm levels. Scanning electron microscopic images of negative replicas of root sections were examined to quantify the circumferential percentage of interfacial gaps and the area percentage of intracanal voids. Data were analyzed with parametric or nonparametric statistical methods. RESULTS A statistically significant difference was found for the volumetric percentage distribution of gaps and voids for "obturation technique" but not for "material." Significantly higher percentages of gaps and voids were identified in canals obturated with the NGP system using cold lateral compaction. Examination of negative replicas ascribed this difference to a higher area percentage of interfacial gaps rather than more intracanal voids. CONCLUSIONS Using warm vertical compaction, the NGP system fulfils the objective of 3-dimensional obturation of the canal space in a manner comparable with the results achieved with gutta-percha and a root canal sealer.
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Topcu KM, Karatas E, Ozsu D, Ersoy I. Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement. Eur J Dent 2014; 8:326-329. [PMID: 25202211 PMCID: PMC4144129 DOI: 10.4103/1305-7456.137636] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Materials and Methods: Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. Results: An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P < 0.001). The ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). Conclusions: None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups.
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Affiliation(s)
- K Meltem Topcu
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkiye
| | - Ertugrul Karatas
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkiye
| | - Damla Ozsu
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Ataturk University, Erzurum, Turkiye
| | - Ibrahim Ersoy
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Sifa University, Izmir, Turkiye
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Li H, Zhang C, Li Q, Wang C, Song Y. Comparison of cleaning efficiency and deformation characteristics of Twisted File and ProTaper rotary instruments. Eur J Dent 2014; 8:191-196. [PMID: 24966769 PMCID: PMC4054049 DOI: 10.4103/1305-7456.130598] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: The objective of the following study is to compare the cleaning efficiency and deformation characteristics of Twisted File (TF) and ProTaper (PT) nickel-titanium rotary instruments in root canal preparation. Materials and Methods: A total of 52 canals from 26 extracted maxillary first molars were randomly assigned into two groups of each including 13 mesiobuccal and 12 distobuccal (DB) canals. Two DB canals were as blank controls. After preparation with TF and PT, we recorded the preparation time and evaluate the amounts of debris and smear layer at apical, middle and coronal canals under scanning electron microscopy (SEM). Three cross-sections of canals at 3 mm, 5 mm and 7 mm from the apex foramens were scanned before and after preparation under micro-computed tomography. Changes of the cross-section area (CSA) at the three levels were calculated with Photoshop CS4. File deformation was also investigated under SEM. Two groups were statistically compared with Mann-Whitney test and independent sample t-test. Results: Less debris and smear layer were found in coronal regions of canals prepared with TF (P = 0.006, P = 0.001, respectively). TF group displayed more CSA change than PT group (P = 0.045) at cross-sections of 5 mm from the apex foramens and took significantly less preparation time than PT group did (P = 9.06 × 10−28). All five TF files without obvious micro-cracks and two out of 25 PT files with many micro-cracks showed visible unwound deformation. Conclusion: Neither TF nor PT achieves complete cleanliness of canal walls. Their deformation features might indicate different fracture resistance. TF single-file technique would substantially shorten the time of root canal preparation.
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Affiliation(s)
- Hang Li
- Department of Endodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chenzheng Zhang
- Department of Endodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Li
- Department of Endodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Changning Wang
- Department of Periodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yaling Song
- Department of Endodontics, The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory for Oral Biomedicine, Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Holliday R, Alani A. Traditional and contemporary techniques for optimizing root canal irrigation. ACTA ACUST UNITED AC 2014; 41:51-2, 54, 56-8 passim. [PMID: 24640478 DOI: 10.12968/denu.2014.41.1.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Canal irrigation during root canal treatment is an important component of chemo-mechanical debridement of the root canal system. Traditional syringe irrigation can be enhanced by activating the irrigant to provide superior cleaning properties. This activation can be achieved by simple modifications in current technique or by contemporary automated devices. Novel techniques are also being developed, such as the Self-adjusting File (Re-Dent-Nova, Ra'anana, Israel), Ozone (Healozone, Dental Ozone, London, UK), Photoactivated Disinfection and Ultraviolet Light Disinfection. This paper reviews the techniques available to enhance traditional syringe irrigation, contemporary irrigation devices and novel techniques, citing their evidence base, advantages and disadvantages. CLINICAL RELEVANCE Recent advances in irrigation techniques and canal disinfection and debridement are relevant to practitioners carrying out root canal treatment.
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Li GH, Niu LN, Selem LC, Eid AA, Bergeron BE, Chen JH, Pashley DH, Tay FR. Quality of obturation achieved by an endodontic core-carrier system with crosslinked gutta-percha carrier in single-rooted canals. J Dent 2014; 42:1124-34. [PMID: 24769108 DOI: 10.1016/j.jdent.2014.04.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/12/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The present study examined the quality of obturation in root canals obturated by GuttaCore, a gutta-percha-based core-carrier system with a cross-linked thermoset gutta-percha carrier, by comparing the incidence of gaps and voids identified from similar canals obturated by cold lateral compaction or warm vertical compaction. METHODS Thirty single-rooted premolars with oval-shaped canals were shaped and cleaned, and obturated with one of the three obturation techniques (N=10): GuttaCore, warm vertical compaction or cold lateral compaction. Filled canals were scanned with micro-computed tomography (micro-CT); reconstructed images were analysed for the volumetric percentage of gaps and voids at three canal levels (0-4mm, 4-8mm and 8-12mm from working length). The roots were subsequently sectioned at the 4-mm, 8-mm and 12-mm levels for analyses of the percentage of interfacial gaps, and area percentage of interfacial and intracanal voids, using scanning electron microscopy (SEM) to examine negative replicas of root sections. Data were analysed with parametric or non-parametric statistical methods at α=0.05. RESULTS Both micro-CT and SEM data indicated that canals obturated with GuttaCore core-carriers had the lowest incidence of interfacial gaps and voids, although the results were not significantly different from canals obturated by warm vertical compaction. Both the GuttaCore and the warm vertical compaction groups, in turn, had significantly lower incidences of gaps and voids than the cold lateral compaction group. CONCLUSIONS Because of the similarity in obturation quality between GuttaCore and warm vertical compaction, practitioners may find the GuttaCore core-carrier technique a valuable alternative for obturation of oval-shaped canals. CLINICAL SIGNIFICANCE The quality of obturation achieved by GuttaCore in single-rooted canals is not significantly different from that achieved by warm vertical compaction.
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Affiliation(s)
- Guo-Hua Li
- Department of Stomatology, Fuzhou Dongfang Hospital, Fuzhou, China
| | - Li-Na Niu
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Lisa C Selem
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA
| | - Ashraf A Eid
- Department of Dental and Biomedical Material Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Brian E Bergeron
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA
| | - Ji-Hua Chen
- State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
| | - David H Pashley
- Department of Oral Biology, Georgia Regents University, Augusta, GA, USA
| | - Franklin R Tay
- Department of Endodontics, Georgia Regents University, Augusta, GA, USA.
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Keleş A, Alcin H, Kamalak A, Versiani MA. Micro-CT evaluation of root filling quality in oval-shaped canals. Int Endod J 2014; 47:1177-84. [PMID: 24527697 DOI: 10.1111/iej.12269] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 02/08/2014] [Indexed: 12/01/2022]
Abstract
AIM To assess the percentage volumes of filling materials and voids in oval-shaped canals filled with either cold lateral compaction or warm compaction techniques, using micro-computed tomography (micro-CT). METHODOLOGY Twenty-four single-rooted maxillary premolar teeth with oval-shaped canals were selected and the root canals prepared and assigned to two groups (n = 12), according to the filling technique: cold lateral compaction (CLC) or warm vertical compaction (WVC). Each specimen was scanned using a micro-CT device at an isotropic resolution of 12.5 μm. Percentage volumes of root filling materials and voids were calculated, and data were statistically analysed using Student's t-test and Friedman's test, with a significance level of 5%. RESULTS Overall, mean percentage volumes of gutta-percha, sealer and voids were 82.33 ± 3.14, 13.42 ± 2.91 and 4.26 ± 0.74 in the CLC group and 91.73 ± 4.48, 7.70 ± 4.44 and 0.57 ± 0.44 in the WVC group, respectively, with a statistically significant difference between groups (P < 0.05). At the apical level, differences in the percentage volumes of filling materials and voids between groups were not significant (P > 0.05). CONCLUSIONS No root fillings were void free. Warm vertical compaction produced a significantly greater volume of gutta-percha and a significantly lower percentage of voids than those achieved with cold lateral compaction. Distribution of sealer and voids within the root canal space after root filling was unpredictable, irrespective of the technique used.
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Affiliation(s)
- A Keleş
- Department of Endodontics, Faculty of Dentistry, İnönü University, Malatya, Turkey
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KELEŞ A, ŞIMŞEK N, ALÇIN H, AHMETOGLU F, YOLOGLU S. Retreatment of flat-oval root canals with a self-adjusting file: An SEM study. Dent Mater J 2014; 33:786-91. [DOI: 10.4012/dmj.2014-054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Metzger Z, Solomonov M, Kfir A. The role of mechanical instrumentation in the cleaning of root canals. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12048] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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63
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Bürklein S, Schäfer E. Critical evaluation of root canal transportation by instrumentation. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12043] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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64
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Versiani MA, Leoni GB, Steier L, De-Deus G, Tassani S, Pécora JD, de Sousa-Neto MD. Micro–computed Tomography Study of Oval-shaped Canals Prepared with the Self-adjusting File, Reciproc, WaveOne, and ProTaper Universal Systems. J Endod 2013; 39:1060-6. [DOI: 10.1016/j.joen.2013.04.009] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/07/2013] [Accepted: 04/03/2013] [Indexed: 11/25/2022]
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Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse JM, Peyre A, Kahn JL, Sixou M. Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol 2013; 41:649-55. [PMID: 23166362 DOI: 10.1259/dmf/81804525] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The various types of cone beam CT (CBCT) differ in several technical characteristics, notably their spatial resolution, which is defined by the acquisition voxel size. However, data are still lacking on the effects of voxel size on the metric accuracy of three-dimensional (3D) reconstructions. This study was designed to assess the effect of isotropic voxel size on the 3D reconstruction accuracy and reproducibility of CBCT data. METHODS The study sample comprised 70 teeth (from the Institut d'Anatomie Normale, Strasbourg, France). The teeth were scanned with a KODAK 9500 3D® CBCT (Carestream Health, Inc., Marne-la-Vallée, France), which has two voxel sizes: 200 µm (CBCT 200 µm group) and 300 µm (CBCT 300 µm group). These teeth had also been scanned with the KODAK 9000 3D® CBCT (Carestream Health, Inc.) (CBCT 76 µm group) and the SCANCO Medical micro-CT XtremeCT (SCANCO Medical, Brüttisellen, Switzerland) (micro-CT 41 µm group) considered as references. After semi-automatic segmentation with AMIRA® software (Visualization Sciences Group, Burlington, MA), tooth volumetric measurements were obtained. RESULTS The Bland-Altman method showed no difference in tooth volumes despite a slight underestimation for the CBCT 200 µm and 300 µm groups compared with the two reference groups. The underestimation was statistically significant for the volumetric measurements of the CBCT 300 µm group relative to the two reference groups (Passing-Bablok method). CONCLUSIONS CBCT is not only a tool that helps in diagnosis and detection but it has the complementary advantage of being a measuring instrument, the accuracy of which appears connected to the size of the voxels. Future applications of such measurements with CBCT are discussed.
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Affiliation(s)
- D Maret
- Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Service de Médecine Légale, Hôpital de Rangueil, 37 allées J Guesde, 31000 Toulouse, France.
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Ruckman JE, Whitten B, Sedgley CM, Svec T. Comparison of the Self-Adjusting File with Rotary and Hand Instrumentation in Long-oval–shaped Root Canals. J Endod 2013; 39:92-5. [DOI: 10.1016/j.joen.2012.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 07/11/2012] [Accepted: 07/26/2012] [Indexed: 11/28/2022]
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68
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Lin J, Shen Y, Haapasalo M. A comparative study of biofilm removal with hand, rotary nickel-titanium, and self-adjusting file instrumentation using a novel in vitro biofilm model. J Endod 2012; 39:658-63. [PMID: 23611386 DOI: 10.1016/j.joen.2012.11.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/03/2012] [Accepted: 11/06/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study sought to present a standardized biofilm model in extracted teeth with an artificial apical groove to quantify the efficacy of hand, rotary nickel-titanium, and self-adjusting file (SAF) instrumentation in biofilm bacteria removal. METHODS Thirty-six extracted single-rooted teeth with oblong canals were selected. Each tooth was split longitudinally, and a 0.2-mm-wide groove was placed in the apical 2 to 5 mm of the canal. After growing mixed bacteria biofilm inside the canal under an anaerobic condition, the split halves were reassembled in a custom block, creating an apical vapor lock. Teeth were randomly divided into 3 treatment groups (n = 10 per group) using the K-file, ProFile (Dentsply Tulsa Dental Products, Tulsa, OK), and the SAF (ReDent-Nova, Ra'anana, Israel). Irrigation consisted of 10 mL 3% NaOCl and 4 mL 17% EDTA. Six teeth received no treatment. Areas inside and outside the groove were examined using a scanning electron microscope. RESULTS The scanning electron microscope showed a consistently thick layer of biofilm grown in the canals of the control group after 4 weeks. Within the groove, a smaller area remained occupied by bacteria after the use of the SAF compared with the ProFile and the K-file (3.25%, 19.25%, and 26.98%, respectively; P < .05). For all groups, significantly more bacteria were removed outside the groove than inside (P < .05). No statistical differences were found outside the groove (P > .05). CONCLUSIONS Although all techniques equally removed bacteria outside the groove, the SAF reduced significantly more bacteria within the apical groove. No technique was able to remove all bacteria. This biofilm model represents a potentially useful tool for the future study of root canal disinfection.
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Affiliation(s)
- James Lin
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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Maret D, Telmon N, Peters OA, Lepage B, Treil J, Inglèse JM, Peyre A, Kahn JL, Sixou M. Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol 2012. [DOI: 10.1259/dmfr/81804525] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Kfir A, Telishevsky-Strauss Y, Leitner A, Metzger Z. The diagnosis and conservative treatment of a complex type 3 dens invaginatus using cone beam computed tomography (CBCT) and 3D plastic models. Int Endod J 2012; 46:275-88. [PMID: 23137215 DOI: 10.1111/iej.12013] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 08/24/2012] [Indexed: 12/15/2022]
Abstract
AIM To investigate the use of 3D plastic models, printed from cone beam computed tomography (CBCT) data, for accurate diagnosis and conservative treatment of a complex case of dens invaginatus. SUMMARY A chronic apical abscess with a draining sinus tract was diagnosed during the treatment planning stage of orthodontic therapy. Radiographic examination revealed a large radiolucent area associated with an invaginated right maxillary central incisor, which was found to contain a vital pulp. The affected tooth was strategic in the dental arch. Conventional periapical radiographs provided only partial information about the invagination and its relationship with the main root canal and with the periapical tissues. A limited-volume CBCT scan of the maxilla did not show evidence of communication between the infected invagination and the pulp in the main root canal, which could explain the pulp vitality. A novel method was adopted to allow for instrumentation, disinfection and filling of the invagination, without compromising the vitality of the pulp in the complex root canal system. The CBCT data were used to produce precise 3D plastic models of the tooth. These models facilitated the treatment planning process and the trial of treatment approaches. This approach allowed the vitality of the pulp to be maintained in the complex root canal space of the main root canal whilst enabling the healing of the periapical tissues. KEY LEARNING POINTS Even when extensive periapical pathosis is associated with a tooth with type III dens invaginatus, pulp sensibility tests should be performed. CBCT is a diagnostic tool that may allow for the management of such teeth with complex anatomy. 3D printed plastic models may be a valuable aid in the process of assessing and planning effective treatment modalities and practicing them ex vivo before actually performing the clinical procedure. Unconventional technological approaches may be required for detailed treatment planning of complex cases of dens invaginatus.
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Affiliation(s)
- A Kfir
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel.
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71
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Leonardi DP, Haragushiku GA, Tomazinho FSF, Furuse AY, Volpato L, Baratto-Filho F. Undergraduate students introduction to manual and rotary root canal instrumentation. THE BULLETIN OF TOKYO DENTAL COLLEGE 2012; 53:155-9. [PMID: 23124306 DOI: 10.2209/tdcpublication.53.155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to evaluate the performance of undergraduates in their first contact with manual and rotary root canal instrumentation. Forty-two students who had never worked on a root canal before instrumented 42 extracted lower-incisors. Participants were assigned to one of two groups: Rotary instrumentation or manual instrumentation. Pre- and post-operative computed tomography scans were obtained with a 3-dimensional dental imaging system. Starting and finishing times of preparation were recorded. The cross-sectional area of the root canal was analyzed with 2-mm-below-the-apex initial and final transverse images recorded through a digital imaging system and analyzed with software to measure the initial and final area of the root canal in mm(2). Data from the cross-sectional area of the root canal and time spent were subjected to the Mann-Whitney's U-test (p<0.05). The rotary instrumentation group showed smaller time for preparation (p=0.0204). No differences between rotary and manual instrumentation regarding the cross-sectional area of the root canal were observed (p=0.25). No accidents occurred. Undergraduate students showed good performance in their first contact with the manual and rotary instrumentation with regard to time spent and cross-sectional area of the root canal, with no operative accidents.
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Affiliation(s)
- Denise Piotto Leonardi
- Master Program in Clinical Dentistry, School of Dentistry, Positivo University, Curitiba, PR, Brazil.
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72
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Gandolfi MG, Parrilli AP, Fini M, Prati C, Dummer PMH. 3D micro-CT analysis of the interface voids associated with Thermafil root fillings used with AH Plus or a flowable MTA sealer. Int Endod J 2012; 46:253-63. [DOI: 10.1111/j.1365-2591.2012.02124.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/23/2012] [Indexed: 11/30/2022]
Affiliation(s)
- M. G. Gandolfi
- Laboratory of Biomaterials and Oral Pathology, Department of Odontostomatological Science; University of Bologna; Bologna; Italy; Italy
| | - A. P. Parrilli
- Laboratory of Preclinical and Surgical Studies; Rizzoli Orthopaedic Institute; Bologna; Italy
| | - M. Fini
- Laboratory of Preclinical and Surgical Studies; Rizzoli Orthopaedic Institute; Bologna; Italy
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73
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Solomonov M, Paqué F, Kaya S, Adıgüzel Ö, Kfir A, Yiğit-Özer S. Self-Adjusting Files in Retreatment: A High-resolution Micro–Computed Tomography Study. J Endod 2012; 38:1283-7. [DOI: 10.1016/j.joen.2012.06.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 06/10/2012] [Accepted: 06/11/2012] [Indexed: 11/24/2022]
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74
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Dietrich MA, Kirkpatrick TC, Yaccino JM. In Vitro Canal and Isthmus Debris Removal of the Self-Adjusting File, K3, and WaveOne Files in the Mesial Root of Human Mandibular Molars. J Endod 2012; 38:1140-4. [DOI: 10.1016/j.joen.2012.05.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 05/10/2012] [Accepted: 05/17/2012] [Indexed: 10/28/2022]
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75
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De-Deus G, Barino B, Marins J, Magalhães K, Thuanne E, Kfir A. Self-Adjusting File Cleaning-Shaping-Irrigation System Optimizes the Filling of Oval-shaped Canals with Thermoplasticized Gutta-percha. J Endod 2012; 38:846-9. [DOI: 10.1016/j.joen.2012.02.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 02/24/2012] [Accepted: 02/24/2012] [Indexed: 11/27/2022]
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76
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Zogheib C, Naaman A, Medioni E, Bourbouze G, Chirani RA. The quality of Thermafil obturations with different final apical tapers: a three-dimensional microcomputed tomographic comparative study. J Contemp Dent Pract 2012; 13:322-6. [PMID: 22918004 DOI: 10.5005/jp-journals-10024-1145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study is to evaluate the influence of final canal taper on the sealing ability of Thermafil by using microcomputed tomography (micro-CT). MATERIALS AND METHODS Fifty-four single-rooted teeth were instrumented to apical size 40 taper 4, 6 and 8%. Teeth were divided into three groups. All teeth were filled with Thermafil (Dentsply,Tulsa Dental Products). Using micro-CT, roots were scanned and volume measurements of voids at 1, 3 and 5 mm from the apex were calculated using specialized CT software. Measurements were analyzed statistically with ANOVA followed by Bonferroni multiple comparison correction. RESULTS Data analysis showed that 0.08 preparations provided better results than 0.06 and 0.04% tapered samples especially at 1 mm from the apex. Mean percentage of voids were significantly higher with Thermafil taper 0.06% (p = 0.05). None of the root canals filled teeth were gap free. Root canal preparations with bigger taper exhibited less voids than smaller tapered preparations. CLINICAL SIGNIFICANCE In our daily practice, enlarging the apical third (last 3 mm) of root canals to an 8% taper gives a better sealing ability and thus long-term success for our root canal obturations.
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Affiliation(s)
- Carla Zogheib
- Department of Endodontics, School of Dentistry Saint-Joseph University, 1104 2020 Beirut, Libanon.
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77
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Markvart M, Bjørndal L, Darvann TA, Larsen P, Dalstra M, Kreiborg S. Three-dimensional analysis of the pulp cavity on surface models of molar teeth, using X-ray micro-computed tomography. Acta Odontol Scand 2012; 70:133-9. [PMID: 21780969 DOI: 10.3109/00016357.2011.600707] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The purpose of this study was to investigate the scanning and segmentation precision of surface models of molars for the detection of small volumes, such as the reduced pulp cavity; formation of mineral deposits; detection of narrow root canals and to improve the clinical and morphological understanding of the number of root canals and their configuration. METHODS Eighteen human molars were scanned using X-ray micro-computed tomography. The reconstruction of the surface models had a precision of <1 voxel, using three-dimensional software and quantitative color mapping. In order to relate the measurements to changes over time the size of the pulp chambers was classified in two well-defined groups. RESULTS The mineral deposits were more evenly distributed in small pulp chambers than in large, but complete root canal calcification was never observed. No difference was observed in the material with respect to the presence of intra-radicular connections. In upper molars, a second mesiobuccal canal (mb(2)) frequency of 91% was found. The difference in length between the first mesiobuccal canal (mb(1)) and mb(2) was <1 mm. The number of root canals could be related to the number of root cones. CONCLUSION In summary, three-dimensional surface models were made with a high precision; an increased accumulation of mineral deposits was noted in molars with small pulp chambers and combined with the consistent pattern of intra-radicular connections, the potential endodontic treatment complexity is underlined in such cases. Finally, an improved understanding of root canal prevalence was reached, when merging well-defined definitions on root morphology and clinical classification systems.
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Affiliation(s)
- Merete Markvart
- Department of Cariology and Endodontics, School of Dentistry, University of Copenhagen, Copenhagen, Denmark.
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78
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Solomonov M, Paqué F, Fan B, Eilat Y, Berman LH. The Challenge of C-shaped Canal Systems: A Comparative Study of the Self-Adjusting File and ProTaper. J Endod 2012; 38:209-14. [DOI: 10.1016/j.joen.2011.10.022] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Revised: 10/26/2011] [Accepted: 10/26/2011] [Indexed: 11/28/2022]
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79
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Paqué F, Al-Jadaa A, Kfir A. Hard-tissue debris accumulation created by conventional rotary versus self-adjusting file instrumentation in mesial root canal systems of mandibular molars. Int Endod J 2011; 45:413-8. [PMID: 22188277 DOI: 10.1111/j.1365-2591.2011.01991.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F Paqué
- Division of Preventive Dentistry, Periodontology, and Cariology, University of Zürich Center of Dental Medicine, Zürich, Switzerland.
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Influence of apical taper on the quality of thermoplasticized root fillings assessed by micro-computed tomography. Clin Oral Investig 2011; 16:1493-8. [DOI: 10.1007/s00784-011-0638-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 11/08/2011] [Indexed: 10/15/2022]
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81
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Evaluation of radicular dentin erosion and smear layer removal capacity of Self-Adjusting File using different concentrations of sodium hypochlorite as an initial irrigant. ACTA ACUST UNITED AC 2011; 112:524-30. [DOI: 10.1016/j.tripleo.2011.02.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 02/14/2011] [Accepted: 02/15/2011] [Indexed: 11/20/2022]
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82
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Versiani MA, Pécora JD, de Sousa-Neto MD. Flat-Oval Root Canal Preparation with Self-Adjusting File Instrument: A Micro–Computed Tomography Study. J Endod 2011; 37:1002-7. [PMID: 21689560 DOI: 10.1016/j.joen.2011.03.017] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/24/2011] [Accepted: 03/25/2011] [Indexed: 10/18/2022]
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83
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De-Deus G, Souza EM, Barino B, Maia J, Zamolyi RQ, Reis C, Kfir A. The Self-Adjusting File Optimizes Debridement Quality in Oval-shaped Root Canals. J Endod 2011; 37:701-5. [PMID: 21496675 DOI: 10.1016/j.joen.2011.02.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 01/25/2011] [Accepted: 02/03/2011] [Indexed: 11/16/2022]
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84
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Micro–computed Tomography Evaluation of the Preparation of Long Oval Root Canals in Mandibular Molars with the Self-adjusting File. J Endod 2011; 37:517-21. [PMID: 21419301 DOI: 10.1016/j.joen.2010.12.011] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 12/13/2010] [Accepted: 12/20/2010] [Indexed: 11/20/2022]
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85
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Root canal preparation of maxillary molars with the self-adjusting file: a micro-computed tomography study. J Endod 2010; 37:53-7. [PMID: 21146077 DOI: 10.1016/j.joen.2010.08.047] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2010] [Revised: 08/21/2010] [Accepted: 08/25/2010] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this study was to describe the canal shaping properties of a novel nickel-titanium instrument, the self-adjusting file (SAF), in maxillary molars. METHODS Twenty maxillary molars were scanned by using micro-computed tomography at 20-μm resolution. Canals were shaped with the SAF, which was operated with continuous irrigation in a handpiece that provided an in-and-out vibrating movement. Changes in canal volumes, surface areas, and cross-sectional geometry were compared with preoperative values. Canal transportation and the fraction of unprepared canal surface area were also determined. Data were normally distributed and compared by analyses of variance. RESULTS Preoperatively, mean canal volumes were 2.88 ± 1.32, 1.50 ± 0.99, and 4.30 ± 1.89 μm(3) [corrected] for mesiobuccal (MB), distobuccal (DB), and palatal (P) canals, respectively; these values were statistically similar to earlier studies with the same protocol. Volumes and surface areas increased significantly in MB, DB, and P canals; mean canal transportation scores in the apical and middle root canal thirds ranged between 31 and 89 μm. Mean unprepared surfaces were 25.8% ± 12.4%, 22.1% ± 12.0%, and 25.2% ± 11.3% in MB, DB, and P canals, respectively (P > .05) when assessed at high resolution. CONCLUSIONS By using SAF instruments in vitro, canals in maxillary molars were homogenously and circumferentially prepared with little canal transportation.
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