Canal preparation with Hero 642 rotary Ni-Ti instruments compared with stainless steel hand K-file assessed using computed tomography

Comparison of apical and coronal sealing in canals having tapered cones prepared with a rotary NiTi system and stainless steel instruments

The purpose of this study was to compare the sealing ability of different tapered gutta percha cones that were used with lateral compaction and single cones in canals prepared with various root canal instruments. One hundred extracted maxillary incisor roots were used. In group 1, 30 roots were prepared with stainless steel instruments (SS) and then filled by the lateral compaction technique using .02 tapered master cones. In group 2, 30 roots were prepared with ProFile nickel titanium instruments (NiTi) and filled in the same way as group 1. In group 3, 30 roots were filled by the single cone technique using 0.06 tapered gutta-percha cones. The remaining 10 teeth were taken as two control groups. Apical and coronal leakage was evaluated using the fluid filtration model. Considering the effects of the instrumentation, no statistically significant differences were found between the groups prepared with SS and NiTi (P > 0.05). When the effects of obturation technique were taken into consideration, the ProFile instruments and lateral compaction resulted in significantly less coronal leakage than the SS instruments and lateral compaction (P < 0.05). There were no significant differences in apical leakage among any of the groups (P > 0.05).

Evaluation of the root dentine cutting effectiveness of the HERO 642, HERO Apical and HERO Shaper rotary systems

Different HERO rotary systems were evaluated by pre- and postoperative images of a cross-section of their mesiobuccal root thirds with a stereoscopic magnifier (45x). Fifty mesiobuccal canals of human mandibular first molars were divided into five groups: 1--HERO 642; 2--HERO 642 and HERO Apical; 3--HERO Shaper; 4--HERO Shaper and HERO Apical; 5--NitiFlex files. The perimeter of the canal was calculated using Image Tool software (UTHSCA). Final, post-instrumentation perimeters were compared by Kruskal-Wallis test (P = 0.05). The distribution of the values of the final canal perimeter for each instrumentation method was not statistically significant in any of the thirds (P = 0.174, cervical third; P = 0.874, middle third; and P = 0.631, apical third). An increase in canal perimeter was observed in all groups. In the cervical third the greatest increase was Group 5; in the middle third, Group 4, and in the apical third, Group 2.

Cone-beam computed tomography analysis of the apical third of curved roots after mechanical preparation with different automated systems

The present study evaluated by cone-beam computed tomography (CBCT) the apical canal transportation and centralizing ability of different automated systems after root canal preparation. The mesiobuccal canals of maxillary first molars (n=10 per group) were prepared with: GI - reciprocating system with K-Flexofile; GII - reciprocating system with NiTiFlex files; GIII - rotary system with K3 instruments; GIV - rotary system with RaCe instruments. CBCT scans were taken before and after biomechanical preparation up to a #40.02 diameter. Canal transportation was determined by measuring the smallest distance between the inner canal walls and the mesial and distal sides of the root. The centralization ability corresponded to the difference between the measurements from transportation evaluation, using the linear voxel to voxel method of analysis. The mean transportation was 0.06 ± 0.14 mm, with a tendency to deviate to the mesial side of the root (n=22), with no statistically significant difference among the groups (p=0.4153). The mean centralization index was 0.15 ± 0.65 also without statistically significant difference among the groups (p=0.0881). It may be concluded that apical canal transportation and centralization ability were not influenced by the type of mechanical movement and instruments used.

Shaping ability of progressive versus constant taper instruments in curved root canals of extracted teeth

AIM

To compare the shaping ability of progressive versus constant taper shaft instruments in curved root canals of extracted human teeth.

METHODOLOGY

A total of 40 root canals of mandibular molars with curvatures ranging between 20 degrees and 40 degrees were divided into two groups of 20 canals each and embedded in a muffle system. The root canals sectioned horizontally at three levels before preparation and then remounted into the mould. All root canals were prepared with ProTaper (progressive taper) or Hero Shaper (constant taper) instruments. Pre- and post-instrumentation radiographs and cross-sectional images were obtained. The parameters evaluated were: working safety (instrument failure, apical blockage and loss of working length) and shaping ability (straightening, cross-sectional area, transportation and centring ability). The data were analysed statistically using Student's t-test.

RESULTS

No instrument fractured during preparation. One Hero Shaper instrument permanently deformed. Both instrument systems maintained working length well. The canals prepared with Hero Shaper instruments were straightened to a lesser degree (P < 0.05). ProTaper instruments removed more dentine in the coronal and the middle sections of the canals. Canals prepared with Hero Shaper instruments had less transportation (P < 0.01) and better centring ability (P < 0.05) in the apical section.

CONCLUSIONS

Both instrument systems were safe to use and maintained working length well. The canals prepared with Hero Shaper had less transportation and were better centred in the apical region, possibly because their smaller taper reduced instrument stiffness.

Root canal preparation with the NiTi systems K3, Mtwo and ProTaper

The aim of this paper was to examine the result of rotary root canal preparation with the nickel-titanium (NiTi) systems K3, ProTaper and Mtwo. One hundred and fifty curved artificial root canals and 60 mesial canals of human mandibular molars were selected. In the group of curved artificial canals, all canals were prepared to size 35/0.04 taper with the three systems. In the group of human mandibular molars, the teeth with mature root canals were radiographed with silver points inserted in bucco-lingual and in mesio-distal positions. In the artificial root group, one K3 instrument separated. Mtwo (20%) showed significantly (P = 0.003) less zips than K3 (46.9%) or ProTaper (50%). There were no significant differences in ledge and elbow formation. K3 and Mtwo had the lowest percentage of canal transportation. There was no significant difference regarding the preparation length or the condition of the apical foramina following the preparation. Canals prepared with K3 (26.5%) were significantly (P < 0.001) less tapered than ProTaper (62%) and Mtwo (82%). In the human mandibular molar group, one Mtwo and one ProTaper instrument separated. No significant differences were found in the preparation length, transportation or taper. The three systems tested, K3, Mtwo and ProTaper, achieved good preparation results.

Quality of Molar Root Canal Fillings Performed With the Lateral Compaction and the Single-Cone Technique

The aim was to compare the quality of root canal fillings performed with the single-cone and lateral compaction technique. Thirty-six canals in extracted molars were filled with ISO-standardized gutta-percha points, .02 taper, by using the lateral compaction technique; 38 were filled with one gutta-percha point, .04 taper, by using the single-cone technique. Each root canal was radiographed in the bucco-oral (BO) and the mesiodistal projection (MD). A root was sufficiently filled when three of four observers had assessed it so. There was no significant impact of the filling technique on the quality (logistic regression analysis, p > 0.4). There was a significant impact of the canal type, the mandibular distal canal having a higher chance for a sufficient root filling than the mandibular mesial canal in projection BO (p = .003), but both the mandibular distal (p = 0.001) and the maxillary palatal canals (p = 0.014) had a lower chance for a sufficient filling in projection MD.

Shaping ability of progressive versus constant taper instruments in simulated root canals

AIM

To compare the shaping ability of progressive versus constant taper shaft designed instruments in simulated root canals.

METHODOLOGY

Simulated L- and S-shaped resin canals were prepared by ProTaper (progressive taper) and high elasticity in rotation 642 (Hero 642) (constant taper) instruments (n = 10 canals in each case). The pre- and post-instrumentation images were recorded and assessment of the canal shape was completed with image pro plus 5.0. The width of resin removed was measured at 9 measuring points. Incidence of canal aberrations, instrument fracture, preparation time and change of working length were recorded. In addition, the change of curvature and centring ability were also assessed. The data were analysed statistically using Student's t-test or Fisher's exact-test.

RESULTS

In both canal types, Hero 642 instruments prepared canals more rapidly (P < 0.01) and maintained working length significantly more accurately than ProTaper instruments (P < 0.05). In canals prepared with Hero 642 instruments, there was less change in curvature. Instrumentation with ProTaper results in transportation towards the outer aspect of the L-shaped curved canals in the apical part and the inner aspect of the S-shaped canals at the curve. Hero 642 instruments had a better centring ability in the apical part of the canal, but resulted in shapes with a poor taper.

CONCLUSIONS

ProTaper and Hero 642 instruments prepared curved canals rapidly, maintained working length well and were relatively safe without creating perforations and danger zones. In both canal types, Hero 642 instruments maintained the original canal curvature better, and had a better centring ability in curved canals because of its constant taper design. The taper prepared by Hero 642 instruments in the coronal part of the canal was generally poor.