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Yıldız H, Bagis N, Camgoz M, Karacaoglu F, Ocak M, Orhan K. Micro-CT evaluation of the effect of various ScRp instrumentation methods on cement loss, porosity and micro-crack formation. Int J Dent Hyg 2024; 22:588-595. [PMID: 37357382 DOI: 10.1111/idh.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/10/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the effectiveness of three different instruments on cement loss, porosity and micro-crack formation, which was not evaluated before, following scaling and root planning (SRP) using micro-computed tomography (micro-CT). METHODS In this experimental study, 30 single-rooted extracted human teeth were used and divided into three groups. All the teeth were scanned with micro-CT before and after SRP. Group 1: SRP was performed with Gracey curettes, Group 2: SRP was performed by using an ultrasonic device, and Group 3: SRP was performed by using diamond burs. Cement loss from the root surface, porosity, and micro-crack formation in the root dentine were analysed. Micro-CT is used for qualitative and quantitative analysis of samples. The obtained data were analysed statistically (p < 0.05). RESULTS Minimum cement loss following SRP was detected with ultrasonic scaler (26.98 mm3), whereas the highest was created by diamond burs (96.20 mm3) (p < 0.05). The total porosity values after SRP were 0.278%, 0.334% and 0.252% for Groups 1, 2 and 3, respectively. Although Group 3 had the least porosity values, there was no statistically significant difference between the groups. The highest micro-crack formation was seen in Group 2 and the lowest was in Group 1 with a significant difference (p < 0.05). CONCLUSIONS More cement loss was observed with diamond burs. Ultrasonic devices appear to be a viable alternative to instrumentation with curettes. However, ultrasonic devices should be used carefully because of micro-crack formation since the micro-crack resulting from instrumentation with hand instruments is the least of all.
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Affiliation(s)
- Hasan Yıldız
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Nilsun Bagis
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Melike Camgoz
- Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Fatma Karacaoglu
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Mert Ocak
- Department of Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Iosif L, Dimitriu B, Niţoi DF, Amza O. Endodontic Dentistry: Analysis of Dentinal Stress and Strain Development during Shaping of Curved Root Canals. Healthcare (Basel) 2023; 11:2918. [PMID: 37998410 PMCID: PMC10671542 DOI: 10.3390/healthcare11222918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Endodontic shaping causes stress and strain in the root canal dentin. Dentin microcracks have the potential to be later followed by root fractures occurring under the occlusal load. The aim of our research was to theoretically determine the values of such dentinal states of stress and strain during the endodontic shaping of curved root canals using finite element analysis (FEA). METHODS To highlight the stress concentrations in dentin, two geometric models were created considering the volume of the curved dental root and the contact between the endodontic file and the root canal walls. The application of forces with different values was simulated both on a uniform curved root canal and on a root canal with an apical third curvature of 25° as they would be applied during the preparation of a root canal. RESULTS In the case of the first model, which was acted upon with a force of 5 N, the deformations of the root canal appeared along the entire working length, reaching the highest values in the apical third of the root, although there were no geometric changes in the shape of the root canal. Regarding the second root model, with an apical third curvature of 25°, although the applied force was 2 N, the deformations were accompanied by geometric changes in the shape of the root, especially in the upper part of the apical third. At a higher force of 7 N exerted on the endodontic file, the geometric shape changed, and the deformation reached extreme critical values. The resulting tensile stresses appearing in the experimental structure varied similarly to the deformations. CONCLUSIONS Significant stress and strain can develop, especially in the apical third of curved root canals during their shaping, and the risk of cracks is higher for endodontically treated teeth presenting severe curvatures in the apical third of the root.
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Affiliation(s)
- Laura Iosif
- Faculty of Dentistry, University of Medicine and Pharmacy “Carol Davila” Bucharest, 17–21 Calea Plevnei Street, Sector 1, 010221 Bucharest, Romania; (L.I.); (O.A.)
| | - Bogdan Dimitriu
- Faculty of Dentistry, University of Medicine and Pharmacy “Carol Davila” Bucharest, 17–21 Calea Plevnei Street, Sector 1, 010221 Bucharest, Romania; (L.I.); (O.A.)
| | - Dan Florin Niţoi
- Faculty of Industrial Engineering and Robotics, University POLITEHNICA of Bucharest, 313 Splaiul Independenței Street, 060042 Bucharest, Romania
| | - Oana Amza
- Faculty of Dentistry, University of Medicine and Pharmacy “Carol Davila” Bucharest, 17–21 Calea Plevnei Street, Sector 1, 010221 Bucharest, Romania; (L.I.); (O.A.)
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Chanchala HP, Godhi BS, Saha S. The Use of Fiber-optic Transillumination in the Diagnosis of Fracture Line in Teeth: A Method of Standardization in Fracture Strength Studies. Int J Clin Pediatr Dent 2022; 15:475-477. [PMID: 36875983 PMCID: PMC9983586 DOI: 10.5005/jp-journals-10005-2402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The use of fiber optic transillumination (FOTI) has been witnessed in the clinical scenario for many decades but has not been used in in vitro studies. The present paper highlights the use of FOTI as a method of standardization while conducting fracture strength studies in vitro. How to cite this article Chanchala HP, Godhi BS, Saha S. The Use of Fiber-optic Transillumination in the Diagnosis of Fracture Line in Teeth: A Method of Standardization in Fracture Strength Studies. Int J Clin Pediatr Dent 2022;15(4):475-477.
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Affiliation(s)
- HP Chanchala
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Brinda S Godhi
- Department of Pediatric and Preventive Dentistry, JSS Dental College & Hospital, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
| | - Sonali Saha
- Department of Pedodontics & Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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Puleio F, Lo Giudice G, Militi A, Bellezza U, Lo Giudice R. Does Low-Taper Root Canal Shaping Decrease the Risk of Root Fracture? A Systematic Review. Dent J (Basel) 2022; 10:dj10060094. [PMID: 35735636 PMCID: PMC9222076 DOI: 10.3390/dj10060094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Minimal root-canal preparation has been suggested to reduce the risk of root fracture, but as a result, satisfactory cleaning and shaping do not take place. Large-scale taper instrumentation can contribute to removing infected tissue; however, it may weaken the tooth structure. The aim of this systematic review is to evaluate whether root-canal shaping with low-taper instruments decreases the risk of root fracture, compared to high-conicity shaping. A search was performed on Ovid MEDLINE, PubMed, and the Web of Science. The inclusion criteria were: studies comparing the root fracture resistance of endodontically treated teeth, shaped with low- and high-conicity taper instruments, in human trials, and via in vitro study. The review includes all types of endodontically treated teeth, with various instrument tapers. The scientific search engines produced 328 results. Only 20 of the results were evaluated after screening. Based on the articles analyzed, it is not clear whether a taper difference can determine differences in root fracture resistance. No randomized controlled trial (RCTs) with long follow-ups have been published to date. It must also be taken into account that the in vitro studies do not consider the numerous differences that there are between in vitro and clinical evaluation. The review was registered on the PROSPERO website, with the protocol number CRD42020151451.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
- Correspondence:
| | - Angela Militi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Ugo Bellezza
- Department of Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy;
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Silveira F, Tonelli S, de Toubes K, Brabo Pereira A, de Oliveira Miranda A, Fernandes L, Nunes E. Dentinal microcracks induced by endodontic procedures: A scientometric and bibliometric analysis. J Conserv Dent 2022; 25:78-87. [PMID: 35722065 PMCID: PMC9200181 DOI: 10.4103/jcd.jcd_469_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/18/2021] [Accepted: 12/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Due to the large number of publications relating the occurrence of dental microcracks to endodontic procedures, this bibliometric study evaluated the scientific pattern and trends in literature and provided an overview of scientific production in this context. Aim: To analyze, quantify, and characterize the scientific production and trends of published articles evaluating dentinal microcracks formation after endodontic treatment procedures between 2010 and 2020 using bibliometric indicators. Materials and Methods: Published articles were found by the search in the Medline (PubMed) and Scopus database using the combination of the following keywords: Dentinal crack OR Dentinal Microcrack OR Crack formation OR Dentin Defect AND Endodontic treatment OR Root canal preparation OR Canal Preparation OR Root canal treatment OR endodontic procedures. The search was also conducted in the Journal of Endodontics and International Endodontic Journal. After inclusion and exclusion criteria application, data from all studies included were collected. Results: Among the 556 results after the search, 45 studies were included and analyzed in this bibliometry. No trend was observed in terms of the increasing number of articles over time. Most of them used an in vitro design, compared the effect of different endodontic techniques/systems for root canal instrumentation on dentinal microcracks formation, and were conducted in Turkey, Brazil, and India. Journal of Endodontics and International Endodontic Journal were the main journals with a higher number of articles published. Interestingly, studies conducted with some funding did not lead to higher citation numbers. Moreover, a relevant proportion of studies did not consider the inclusion of control groups, baseline evaluation, or statistical analysis. Micro-CT was the main technique used to evaluate microcrack presence. Conclusion: Microcrack formation after the use of different endodontic techniques/systems has been constantly evaluated in the literature. There is a pattern of methodologies used, which may explain the concentration of these studies in specific journals and countries.
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Heberer MT, Roggendorf HC, Faber FJ, Lawrenz NA, Frankenberger R, Roggendorf MJ. Longitudinal craze line propagation in human root dentin after instrumentation with NiTi rotary files of different instrument tapers after long-term chewing simulation. Clin Oral Investig 2021; 26:2671-2679. [PMID: 34787719 PMCID: PMC8898247 DOI: 10.1007/s00784-021-04238-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/15/2021] [Indexed: 11/26/2022]
Abstract
Objectives The aim of this study was to investigate whether file design and taper significantly influence microcrack initiation during machine preparation. Materials and methods Sixty extracted teeth with straight single canals were selected. The teeth were randomly assigned to four groups based on their root canal anatomy and the corresponding NiTi rotary file system (I, Mtwo; II, ProTaper Universal; III, F6 SkyTaper; control, no preparation and filling). The root canals of the experimental groups were filled using the single-cone technique. The tested teeth were all subjected to a mechanical chewing simulation with flat lead loading over a period of 3 years (corresponding to 150,000 cycles). The teeth were checked for dentinal defects (accumulative crack growth in length) under the digital microscope (Keyence VHX-5000) at time 0 (baseline prior to chewing simulation) and after 3, 6, 12, 24, and 36 months of loading. The cumulative crack increase was statistically analyzed using the Kruskal–Wallis test, Jonckheere–Terpstra test, and the Wilcoxon rank-sum test. The significance was set at p < 0.05. Results In contrast to preparation with greater-tapered instruments, ProTaper Universal (group II) and F6 SkyTaper (group III) instrumentation with the smaller tapered Mtwo files (group I) showed less accumulative propagation of craze lines (p < 0.05) at all time points. Conclusion Instruments with greater taper for root canal instrumentation should be used with care to avoid negative long-term effects in the form of propagation of dentinal defects over time. A positive cutting-edge angle and a smaller taper have a positive effect on a lower craze line development. Clinical relevance Instruments with a positive cutting-edge angle and a smaller taper are beneficial for the long-term preservation of dentinal tooth structure.
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Affiliation(s)
- Marie-Therese Heberer
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Philipps University Marburg and University Hospital Giessen and Marburg, Campus Marburg, Georg-Voigt-Straße 3, 35039, Marburg, Germany.
| | - Hubert C Roggendorf
- Interdisciplinary Department of Oral Surgery an Implantology, University of Cologne, Kerpener Straße 32, 50931, Cologne, Germany
| | - Franz-Josef Faber
- Pre-Clinical Department, University of Cologne, Kerpener Straße 32, 50931, Cologne, Germany
| | - Nicolai-Alexander Lawrenz
- Department of Mathematics and Computer Science, Philipps University of Marburg, Hans-Meerwein-Straße 6, 35043, Marburg, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Philipps University Marburg and University Hospital Giessen and Marburg, Campus Marburg, Georg-Voigt-Straße 3, 35039, Marburg, Germany
| | - Matthias J Roggendorf
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Philipps University Marburg and University Hospital Giessen and Marburg, Campus Marburg, Georg-Voigt-Straße 3, 35039, Marburg, Germany
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7
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Versiani MA, Cavalcante DM, Belladonna FG, Silva EJNL, Souza EM, De-Deus G. A critical analysis of research methods and experimental models to study dentinal microcracks. Int Endod J 2021; 55 Suppl 1:178-226. [PMID: 34743355 DOI: 10.1111/iej.13660] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
The purpose of this narrative review was to discuss the scientific milestones that led to the current understanding of the root dentinal microcrack phenomenon based on the interplay between the usage of micro-computed tomography (micro-CT) as an analytical tool alongside a close-to-mouth experimental model. In 2009, reports on the development of dentinal microcracks in extracted teeth after root canal preparation triggered an awareness of the potential for vertical root fractures (VRFs) of endodontically treated teeth could be developed from defects created by the mechanical stress of nickel-titanium preparation systems on dentine. This assumption was taken for granted, even though no cause-effect relationship had been scientifically demonstrated. Since then, several studies using the sectioning method with extracted teeth have been published and the large discrepancy amongst their outcomes soon become evident. Moreover, the high frequency of reported dentinal microcracks largely contrasted with the clinical incidence of VRFs, raising doubts on their methodological reliability. Using micro-CT technology, it was demonstrated by several studies that, in extracted teeth, dentinal defects already existed before the endodontic procedures, indicating that the initial reports framed a non-existing cause-effect relationship between canal preparation and dentinal microcracks. Although these new findings contributed to a better comprehension of this phenomenon, the misconception that microcracks were the starting point for VRFs was only surpassed with a new in situ approach using fresh cadavers. Surprisingly, microcracks were not identified in sound teeth. As a conclusion, dentinal microcracks in extracted teeth can be considered a non-natural occurrence observed only in a laboratory set-up as a consequence of dehydration and storage conditions. Thus, dentinal microcracks shall not be considered as the starting point for VRFs as they do not manifest in non-extracted teeth. Identifying dentinal microcracks as a laboratory phenomenon highlights the impact of recent scientific developments to disclaim the clinical relevance of laboratory-obtained outcomes.
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Affiliation(s)
| | | | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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Pinto JC, Coaguila-Llerena H, Torres FFE, Lucas-Oliveira É, Bonagamba TJ, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Influence of voxel size on dentinal microcrack detection by micro-CT after root canal preparation. Braz Oral Res 2021; 35:e074. [PMID: 34644728 DOI: 10.1590/1807-3107bor-2021.vol35.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 01/04/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on dentinal microcrack detection after root canal preparation using rotary heat-treated nickel-titanium files. Curved mesial root canals (n = 24) of mandibular molars were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM). The specimens were scanned by micro-CT at 5 μm voxel size before and after root canal preparation. The percentage of microcracks was evaluated in images at 5, 10 and 20 μm voxel size, by two examiners at two moments. The Kappa and McNemar tests (α = 0.05) were used. The percentage of dentinal microcracks was similar before and after PDL and HEDM preparations, at 10 and 20 μm (p > 0.05). HEDM showed a higher percentage of dentinal microcracks in the middle third at 5 μm after preparation (p < 0.05). The detection of dentinal microcracks before and after instrumentation using PDL was more accurate at 5 μm than at 20 μm, in all thirds (p < 0.05). Within the limitations of this ex vivo study, as expected, the results showed that different resolutions influence the micro-CT analysis of microcracks. The highest accuracy in detecting microcracks was observed for analyses performed at 5 μm voxel size. HyFlex EDM caused even more microcracks to develop in the middle third, detectable only by visualization of images made at 5 μm voxel size.
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Affiliation(s)
- Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Hernán Coaguila-Llerena
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Éverton Lucas-Oliveira
- Universidade de São Paulo - USP, São Carlos Institute of Physics, Department of Physics and Interdisciplinary Science, São Carlos, SP, Brazil
| | - Tito José Bonagamba
- Universidade de São Paulo - USP, São Carlos Institute of Physics, Department of Physics and Interdisciplinary Science, São Carlos, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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Chellapilla PK, Boddeda MR, Jyothi M, Uppalapati LV, Konagala RK, Dasari L. Influence of obturating techniques on root dentin crack propagation: A micro-computed tomography assessment. J Conserv Dent 2021; 24:72-76. [PMID: 34475684 PMCID: PMC8378482 DOI: 10.4103/jcd.jcd_591_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim is to assess and compare the microcrack formation in radicular dentin after obturating the root canals with cold lateral condensation (CLC), warm vertical condensation (WVC), and injectable gutta-percha (IGP) techniques using micro-computed tomography (CT). Materials and Methods: Human extracted mandibular premolar teeth (n = 60) were haphazardly assigned based on the obturation technique into three experimental groups (n = 20 each). Root canals are cleaned and shaped with M Two rotary files and 3% sodium hypochlorite irrigant. Cross-sectional images were taken with Micro-CT to record the baseline defects present on root samples. After root canal obturation either with CLC or WVC or injectable obturation techniques, micro-CT images were captured again to analyze the increase in the number and type of dentinal defects. Statistical analysis of data was performed using the Mann–Whitney U test and the Mcnemar test at 5% significance level. Results: An increase in the number of radicular micro-cracks was identified in samples obturated with lateral condensation technique (1.66%). No change in the percentage of micro-cracks was recorded after obturation with warm vertical or injectable guttapercha (IGP) techniques (P > 0.05). The three obturation techniques were not statistically different in the occurrence of micro-cracks after obturation. Conclusion: The three obturating techniques tested showed no significant increase in radicular dentin defects' occurrence or propagation.
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Affiliation(s)
- Praveen Kumar Chellapilla
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Mohan Rao Boddeda
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Mandava Jyothi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Lakshman Varma Uppalapati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Lohita Dasari
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
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Dentinal Microcracks Induced by Endodontic Procedures: Suggested Design for Experimental Studies Using Micro-Computed Tomography and Strain Gauges. J Endod 2021; 47:1157-1165. [PMID: 33901544 DOI: 10.1016/j.joen.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/17/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The present study aimed to describe an in vitro study model to investigate root surface strain (RSS) and its correlation with the initiation/propagation of microcracks during different endodontic procedures. METHODS Four lower human incisors extracted microcrack free were selected by micro-computed tomographic imaging. Two strain gauges were bonded to the root surface of each incisor. Then, the teeth were prepared to reproduce the periodontal ligament artificially. The gauges were attached to a data acquisition system. The RSS was recorded during the entire endodontic procedure, which consisted of accessing the endodontic cavity, cleaning, shaping preparation with an Mtwo rotary system (VDW, Munich, Germany), and filling with a standardized technique. Each incisor was submitted to a different retreatment protocol and supplementary cleaning method as follows: (1) Reciproc (RC, VDW) + Flatsonic (FS; Helse, Santa Rosa de Viterbo, Brazil), (2) RC + XP-endo Finisher (XPF; FKG Dentaire, La Chaux-de-Fonds, Switzerland), (3) Mtwo retreatment (MR) + FS, and (4) MR + XPF. Finally, the teeth were rescanned to establish the postoperative microcrack formation by 2 well-trained and blinded examiners. RESULTS The maximum and minimum RSS values were -120 and 510 microstrains, respectively, for all of the files. RC showed the highest RSS values during endodontic retreatment compared with MR. FS demonstrated a higher variation between the minimum and maximum RSS than XPF. No microcracks were observed in the specimens. CONCLUSIONS This preliminary study proposed an experimental model that would combine 2 methods to evaluate the effects of endodontic systems on dentin. Although strain gauges would provide data on the stresses created, the pre- and postoperative evaluation of micro-computed tomographic images would enable microcrack formation to be determined.
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Miguéns-Vila R, Martín-Biedma B, De-Deus G, Belladonna FG, Peña-López A, Castelo-Baz P. Micro-computed Tomographic Evaluation of Dentinal Microcracks after Preparation of Curved Root Canals with ProTaper Gold, WaveOne Gold, and ProTaper Next Instruments. J Endod 2020; 47:309-314. [PMID: 33096193 DOI: 10.1016/j.joen.2020.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the influence of rotary (ProTaper Next [PTN; Dentsply Maillefer, Ballaigues, Switzerland] and ProTaper Gold [PTG, Dentsply Maillefer]) and reciprocating (WaveOne Gold [WOG, Dentsply Maillefer]) systems in dentinal microcrack generation after the preparation of curved root canals using micro-computed tomographic analysis. METHODS Twenty-four human mandibular molars with curved roots were scanned in a micro-computed tomographic device using an isotropic resolution of 6.78 μm and randomly assigned into 1 of 3 experimental groups (n = 8) according to the root canal instrumentation system used (PTN, PTG, or WOG). Then, the root canals were prepared up to PTN X2, PTG F2, and WOG Primary instruments in the PTN, PTG, and WOG groups, respectively. After canal preparation, each specimen was scanned again. Pre- and postoperative cross-sectional images of the roots (N = 35,304) were analyzed to identify the presence of dentinal microcracks. RESULTS Overall, 26% of the images presented dentinal defects (n = 9188). Dentinal microcracks were observed in 24.6%, 26%, and 27.4% of the postinstrumentation images from the PTN, PTG, and WOG groups, respectively. However, all of these dentinal microcracks were already present in the corresponding preoperative images. No new microcracks were generated after the preparation of curved root canals of mandibular molars using the aforementioned systems. CONCLUSIONS Root canal instrumentation with PTN, PTG, and WOG systems did not induce the formation of new dentinal microcracks.
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Affiliation(s)
- Ramón Miguéns-Vila
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | | | - Gustavo De-Deus
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | | | - Pablo Castelo-Baz
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Valle AD, Dotto L, Morgental RD, Pereira-Cenci T, Pereira GKDR, Sarkis-Onofre R. Influence of Root Canal Preparation on Formation of Dentinal Microcracks: A Systematic Review. Braz Dent J 2020; 31:201-220. [PMID: 32667513 DOI: 10.1590/0103-6440202002652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023] Open
Abstract
The effect of root canal preparation technique on microcrack initiation is a controversial issue. This systematic review aimed to assess the role of root canal preparation techniques with different kinematics (manual, rotary, reciprocating, adaptive, self-adjusting file) on microcrack initiation. In vitro and in situ studies comparing the influence of at least two different root canal preparation techniques on the initiation of dentin microcracks were searched in PubMed/MEDLINE and SCOPUS up to June 5, 2018 without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and the included studies were assessed for bias. Fifty-four (n=54) articles met the eligibility criteria. The results were classified according to the method used for microcrack evaluation, and most studies that used micro-computed tomography showed no formation of new cracks after root canal preparation. In general, the instrumentation techniques induced microcrack formation when the methods were destructive, irrespective of kinematics. In relation to the apex region, when the preparation working length was set as the root canal length subtracted of 1 mm, the risk of microcrack initiation reduces. The majority of the included studies had low risk of bias for all assessed domains. Our results seem to indicate that the various root canal preparation techniques considered in this study will not cause damage to the dental structure when adequately employed and the proper methodology is applied.
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Affiliation(s)
- Alânia Dalla Valle
- Graduate Program in Dentistry, Faculdade Meridional, Passo Fundo, RS, Brazil
| | - Lara Dotto
- Graduate Program in Dentistry, Faculdade Meridional, Passo Fundo, RS, Brazil
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Kfir A, Mostinsky O, Elyzur O, Hertzeanu M, Metzger Z, Pawar AM. Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study. Sci Rep 2020; 10:434. [PMID: 31949190 PMCID: PMC6965655 DOI: 10.1038/s41598-019-56957-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/09/2019] [Indexed: 11/09/2022] Open
Abstract
Anatomical features of first maxillary premolars may greatly affect endodontic and following restorative treatments. The aim of this study was to evaluate root canal configuration and root wall thickness of first maxillary premolars using a preexisting CBCT database. A CBCT database of 400 first maxillary premolar was used to study canal configuration, presence of furcation-facing groove on the buccal root and root wall thickness. Root wall thickness was measured from axial CBCT slices at three critical points of the root: The most coronal part of the furcation-facing groove in the buccal root, when present, the CEJ level of the palatal root and 5 mm apically to the CEJ level of the palatal root. Vertucci Type IV configuration was the most common among all teeth, but in single-rooted teeth, Vertucci Type II was predominant. The mean thickness of the buccal root in the area of a furcation-facing groove was 1.1 (±0.2) mm, but in 39% of the cases, it was thinner than 1 mm. The mean thickness of the palatal root at 5 mm from the CEJ was 1.1 (±0.2), but in 28% of the cases, it was thinner than 1 mm. Thickness of root dentin walls of first maxillary premolars varies and may be limited at critical points in both buccal and palatal roots. In case the patient has a previous CBCT scan it may be useful for planning treatment of first maxillary premolars, in order to recognize and avoid potential risks such as furcation-facing groove, thin dentin walls in critical areas and presence of Type II Verucci canal, all of which may dictate less invasive procedures, using smaller files.
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Affiliation(s)
- Anda Kfir
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Olga Mostinsky
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Orly Elyzur
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Moran Hertzeanu
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Metzger
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel.
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College and Hospital, Mumbai, Maharashtra, India
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Anous W, Al-Ashry S, Ali M, Kataia M. Effect of different kinematic cutting motion in multiple versus single-file concept on dentinal crack formation: An in vitro study. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_141_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alsolaihim A, Alsolaihim A, Alowais L. In vivo and in vitro diagnosis of cracked teeth: A review. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_92_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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De‐Deus G, Cavalcante DM, Belladonna FG, Carvalhal J, Souza EM, Lopes RT, Versiani MA, Silva EJNL, Dummer PMH. Root dentinal microcracks: a post‐extraction experimental phenomenon? Int Endod J 2018; 52:857-865. [DOI: 10.1111/iej.13058] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - J. Carvalhal
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís MaranhãoBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de JaneiroBrazil
| | - M. A. Versiani
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
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17
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Brosh T, Metzger Z, Pilo R. Circumferential root strains generated during lateral compaction with stainless steel vs. nickel-titanium finger spreaders. Eur J Oral Sci 2018; 126:518-525. [DOI: 10.1111/eos.12569] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Tamar Brosh
- Department of Oral Biology; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Zvi Metzger
- Department of Endodontology; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Raphael Pilo
- Department of Oral Rehabilitation; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
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Cassimiro M, Romeiro K, Gominho L, de Almeida A, Costa L, Albuquerque D. Occurence of dentinal defects after root canal preparation with R-phase, M-Wire and Gold Wire instruments: a micro-CT analysis. BMC Oral Health 2017; 17:93. [PMID: 28577367 PMCID: PMC5457538 DOI: 10.1186/s12903-017-0387-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to evaluate the frequency of dentinal defects after root canal preparation with the ProTaper NEXT, K3XF and WaveOne GOLD systems using microcomputed tomography. METHODS Sixty permanent mandibular incisors with a single canal were selected. Inspection of the teeth was performed under a stereomicroscope (15x) to observe the presence of pre-existing cracks and fractures lines. Samples were divided into three experimental groups (n = 20): ProTaper NEXT (PTN), K3XF (K3XF) and WaveOne GOLD (WOG). Specimens were scanned through high-resolution microcomputed tomography before and after the preparation of the root canal. Subsequently, all the axial images were examined by two different methods to find possible dentinal defects. Furthermore, an analysis of each millimeter of ten apical millimeters was also performed. The absence or presence of dentinal defects was screened by 3 pre-calibrated blinded examiners. RESULTS After analysing all 45,720 slices, dentinal defects were observed in 48,33% (22096 slices). PTN, K3XF and WOG groups represented 11,11% (5079 slices), 17,22% (7873 slices) and 20% (n = 9144) of the cross-sectional images, respectively. At 10 apical millimeters (600 slices), 33,33% (200 slices) presented some dentinal defects, representing 7,22% (43 slices), 13,33% (80 slices) and 12,77% (77 slices) of the cross-sectional images in the PTN, K3XF and WOG groups, respectively. All the dentinal defects presented in the postoperative images existed in the images prior to instrumentation. CONCLUSIONS There was no correlation between the preparation of a root canal using the PTN, K3XF and WOG systems and the formation of new dentinal defects.
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Affiliation(s)
- Marcely Cassimiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Camaragibe, PE, Brazil. .,, Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil.
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Camaragibe, PE, Brazil
| | - Luciana Gominho
- Department of Odontology, Biological Sciences Unit, Federal University of Campina Grande (UFCG), Campina Grande, PB, Brazil
| | - Andressa de Almeida
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Camaragibe, PE, Brazil
| | - Larissa Costa
- Nuclear Department of Energy, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Camaragibe, PE, Brazil
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19
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Zuolo ML, De-Deus G, Belladonna FG, Silva EJNLD, Lopes RT, Souza EM, Versiani MA, Zaia AA. Micro–computed Tomography Assessment of Dentinal Micro-cracks after Root Canal Preparation with TRUShape and Self-adjusting File Systems. J Endod 2017; 43:619-622. [DOI: 10.1016/j.joen.2016.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/12/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
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20
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Harandi A, Mohammadpour Maleki F, Moudi E, Ehsani M, Khafri S. CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems. IRANIAN ENDODONTIC JOURNAL 2017; 12:29-33. [PMID: 28179920 PMCID: PMC5282375 DOI: 10.22037/iej.2017.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). Methods and Materials: A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups (n=13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey’s post hoc tests were used for two-by-two comparisons. Results: Gates-Glidden drills with hand files removed significantly more (P<0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems (P>0.05). Conclusion: The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls.
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Affiliation(s)
- Azade Harandi
- Dental Material Research Center, Department of Endodontics, Dental School, Babol University of Medical Sciences, Babol, Iran
| | | | - Ehsan Moudi
- Dental Material Research Center, Department of Radiology, Dental School, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Ehsani
- Dental Material Research Center, Department of Endodontics, Dental School, Babol University of Medical Sciences, Babol, Iran
| | - Soraya Khafri
- Department of Social Medicine and Health, Dental School, Babol University of Medical Sciences, Babol, Iran
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Yilmaz A, Helvacioglu-Yigit D, Gur C, Ersev H, Kiziltas Sendur G, Avcu E, Baydemir C, Abbott PV. Evaluation of Dentin Defect Formation during Retreatment with Hand and Rotary Instruments: A Micro-CT Study. SCANNING 2017; 2017:4868603. [PMID: 29109814 PMCID: PMC5661777 DOI: 10.1155/2017/4868603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/14/2017] [Accepted: 04/26/2017] [Indexed: 05/12/2023]
Abstract
The purpose of this study was to compare the incidence and longitudinal propagation of dentin defects after gutta-percha removal with hand and rotary instruments using microcomputed tomography. Twenty mandibular incisors were prepared using the balanced-force technique and scanned in a 19.9 μm resolution. Following filling with the lateral compaction technique, gutta-percha was removed with ProTaper Universal Retreatment (PTUR) or hand instruments. After rescanning, a total of 24,120 cross-sectional images were analyzed. The numbers, types, and longitudinal length changes of defects were recorded. Defects were observed in 36.90% of the cross sections. A total of 73 defects were comprised of 87.67% craze lines, 2.73% partial cracks, and 9.58% fractures. No significant difference in terms of new defect formation was detected between the retreatment groups. The apical and middle portions of the roots had more dentin defects than the coronal portions. Defects in three roots of the PTUR instrument group increased in length. Under the conditions of this in vitro study, gutta-percha removal seemed to not increase the incidence of dentin defect formation, but the longitudinal defect propagation finding suggests possible cumulative dentinal damage due to additional endodontic procedures. Hand and rotary instrumentation techniques caused similar dentin defect formation during root canal retreatment.
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Affiliation(s)
- Ayca Yilmaz
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | | | - Cansu Gur
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Handan Ersev
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
- *Handan Ersev:
| | - Gullu Kiziltas Sendur
- Department of Mechatronics Engineering, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Egemen Avcu
- Department of Machine and Metal Technologies, Ford Otosan İhsaniye Automotive Vocational School, Kocaeli University, Kocaeli, Turkey
| | - Canan Baydemir
- Department of Biostatistics, Kocaeli University, Kocaeli, Turkey
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22
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WEI X, HU B, PENG H, TANG M, SONG J. The incidence of dentinal cracks during root canal preparations with reciprocating single-file and rotary-file systems: A meta-analysis. Dent Mater J 2017; 36:243-252. [DOI: 10.4012/dmj.2016-208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Xi WEI
- Department of Stomatology, the First Affiliated Hospital of Chongqing Medical University
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education
| | - Bo HU
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education
- College of Stomatology, Chongqing Medical University
| | - Haiyang PENG
- Department of Stomatology, the First Affiliated Hospital of Chongqing Medical University
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education
| | - Ming TANG
- Department of Stomatology, the First Affiliated Hospital of Chongqing Medical University
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education
| | - Jinlin SONG
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education
- College of Stomatology, Chongqing Medical University
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