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Alfadley A, Jamleh A. Assessment of Vertical Force Generated with Single File Systems during Shaping of Constricted Root Canals. Eur J Dent 2024. [PMID: 39013443 DOI: 10.1055/s-0044-1786840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate the shaping force generated with OneShape (OS) and HyFlex EDM (HEDM) systems designed for single file shaping, in comparison with ProTaper Next (PTN). MATERIALS AND METHODS Maxillary premolar teeth received access cavity preparation and their canals were shaped with OS, HEDM, or PTN to size 25 according to manufacturer's instructions with consistent pressure on the files to give a gentle "in-and-out" movements of 2 mm amplitude. The canal shaping was completed with a total of three insertions. After each insertion, 1% NaOCl irrigation and recapitulation with K-file size 15 were performed. The vertical shaping force was measured using a force gauge (M5-20 Advanced Digital Force Gauge; Mark-10 Corporation, NY). STATISTICAL ANALYSIS The shaping time was analyzed by using a one-way analysis of variance (ANOVA) test and differences between the mean apical and coronal maximum force values were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. The level of significance was set as 0.05. RESULTS The magnitude of the vertical forces increased with successive advancements of the instruments within the canal. During canal shaping procedures in all groups, the apical and coronal maximum force values of the OS and HEDM ranged from 2.5 to 7.2 N and 1.3 to 2.9 N, respectively. PTN generated the lowest maximum apical forces during the second and third insertions (p < 0.05). HEDM generated significantly less maximum coronal forces than both OS and PTN during the first insertion while the use of OS was associated with the highest amount of force values in the second and third insertions (p < 0.05). In terms of shaping time, no significant differences were detected among the three tested systems (p = 0.606). CONCLUSION The tested single file systems were associated with higher shaping forces in the apical direction that were significant in the second and third insertions.
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Affiliation(s)
- Abdulmohsen Alfadley
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Jamleh
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Medina-Torres L, Cochran C, Bauer PA, Valcanaia AJ, Sindu D, Cavalcanti B, McDonald N. Effect of different instrumentation techniques on students' performance and outcomes of nonsurgical root canal treatment. J Dent Educ 2024; 88:940-948. [PMID: 38557969 DOI: 10.1002/jdd.13523] [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: 08/03/2023] [Revised: 01/18/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study compared, retrospectively, the incidence of clinical errors and effects on treatment outcomes, when students were exposed to two different instrumentation techniques: a hybrid rotary technique (HYB), consisting of both hand instrumentation with hand stainless steel and Ni-Ti files plus the use of a rotary system (Vortex Blue, Dentsply Sirona), versus a full reciprocation instrumentation technique (WaveOne Gold [WOG], Dentsply Sirona). METHODS A total of 368 endodontic cases (n = 184) in anterior and premolar teeth, completed by dental students at the University of Michigan School of Dentistry from 2013 to 2022, were used for the study. The groups were evaluated by two calibrated clinicians, observing the incidence of clinical errors: file separations, over-instrumentation, ledges and transportations. Treatment outcomes were also observed. Data were analyzed statistically by Fisher's exact test and Mann-Whitney U test (p < 0.05). RESULTS No significant difference in file separations, ledges, and transportation was observed between the two groups. However, the WOG Group experienced significantly more over-instrumentation than HYB group, although this did not significantly affect tooth survival or periapical index (PAI). Cases with PAI scores of 5 were found to have significantly less tooth survival compared to the other PAI scores. CONCLUSIONS It can be concluded that both techniques in our study are well suited to advancing the endodontic dental education of students and novice operators, anticipating relatively successful outcomes of tooth survival, as long as the cases selected are less severe in progression preoperatively.
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Affiliation(s)
- Luis Medina-Torres
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Clarence Cochran
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Patricia Ann Bauer
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Andre Joao Valcanaia
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Devika Sindu
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Bruno Cavalcanti
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Neville McDonald
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Laajala A, Nuutinen M, Luttinen A, Vähänikkilä H, Tanner T, Laitala ML, Karki S. Survival of endodontically treated teeth in public dental service in Northern Finland: a practise-based register study. Acta Odontol Scand 2024; 83:190-196. [PMID: 38660831 PMCID: PMC11302629 DOI: 10.2340/aos.v83.40491] [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: 02/20/2023] [Accepted: 01/06/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The aim of this study was to explore the factors associated with the survival of root canal treated teeth in a practise-based study setting in a 5-year period. MATERIAL AND METHODS This retrospective study used data from the electronic patient registration system of the public dental services of the City of Oulu, Finland. The inclusion criteria for this study were patients aged ≥ 20 years who had root canal treatment (RCT) that was initiated in 2014. One RCT per patient was included in the study. A total of 713 patients met the inclusion criteria. The outcome variable for this study was the extraction of the RCT tooth during the 5-year period. Explanatory variables included age, diagnosis, tooth type (incisive, canine, premolar, molar), RCT technique (manual, motorized), time from RCT initiation to final restoration and type of final restoration (composite, glass ionomer, fixed dental prosthesis). To evaluate the association between the outcome variable and explanatory variables, Cox regression analyses were performed. RESULTS The overall survival rate was 91%. The middle-aged (40-59-years-old) and the oldest (60 and older) patients had a two-fold risk of extraction compared to younger (20-40-years-old) patients. Similarly, a short length of time from RCT initiation to final restoration (0-14 days) resulted in a nearly three times higher risk of extraction compared to a longer period (≥ 90 days). CONCLUSIONS The 5-year survival rate of RCTs seems high. Extractions were more common among patients over 40 years of age and if the RCT was completed shortly after its initiation.
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Affiliation(s)
- Anne Laajala
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; Medical Research Center and Oulu University Hospital, City of Oulu, Finland.
| | - Matti Nuutinen
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
| | - Atso Luttinen
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tarja Tanner
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; The Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - Marja-Liisa Laitala
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; Medical Research Center and Oulu University Hospital, City of Oulu, Finland
| | - Saujanya Karki
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
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Odgerel Z, Kwak SW, Ha JH, Gambarini G, Shen Y, Kim HC. Effect of MT Technology of Heat Treatment on Reciproc: Comparison of Reciproc, Reciproc Blue, and Reciproc MT. J Endod 2024; 50:520-526. [PMID: 38311116 DOI: 10.1016/j.joen.2024.01.020] [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: 10/09/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION This study aimed to evaluate the effects from the memory-triple (MT) heat treatment on the fatigue resistance of the Reciproc by comparison with the file systems of same geometry. METHODS Reciproc files subjected to MT heat treatment technology were designated as Group RMT and were compared with the original Reciproc (Group REC) and Reciproc Blue (Group REB). Each NiTi file from 3 groups (n = 15) was operated reciprocally with a repetitive up-and-down movement in the curved canal with 4 mm of pecking distance inside of the simulated canal at body temperature. When each file fractured, the time until fracture was recorded. The length of the fractured fragment was measured. Fractured fragments were observed under scanning electron microscope (SEM) to evaluate the topographic features of the surface. Differential scanning calorimetry (DSC) analysis was performed to estimate phase transformation temperatures. One-way analysis of variance and Duncan post hoc comparison were applied to compare among the groups at a significance level of 95%. RESULTS RMT showed significantly higher fracture resistance (P < .05), whereas there was no difference in fatigue resistance between REC and REB. SEM examination showed the files from the 3 groups had similar topographic features. RMT showed a peak of austenite peak (Ap) at a temperature (52°C) higher than body temperature, whereas REC and REB showed Ap at 37 and 32°C, respectively. CONCLUSIONS Under the condition of this study, the new heat treatment technique of MT technology could enhance the fatigue fracture resistance of the reciprocating files made of M-wire and Blue-wire.
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Affiliation(s)
- Zunduijamts Odgerel
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Republic of Korea
| | - Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Republic of Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, College of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Gianluca Gambarini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Yangsan, Republic of Korea.
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De Pedro-Muñoz A, Rico-Romano C, Sánchez-Llobet P, Montiel-Company JM, Mena-Álvarez J. Cyclic Fatigue Resistance of Rotary versus Reciprocating Endodontic Files: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:882. [PMID: 38337577 PMCID: PMC10856014 DOI: 10.3390/jcm13030882] [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: 01/03/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: The failure of nickel-titanium (NiTi) rotary files is a complication related to endodontic instruments. The aim of this study was to compare the resistance to cyclic fatigue between rotary and reciprocating file systems. (2) Methods: Specific PICO: Population (P): artificial root canals; Interventions (I): instrumentation with NiTi rotary and reciprocating files; Comparison (C): rotary versus reciprocating files; Outcome (O): cyclic fatigue resistance. Studies were identified through bibliographic research using electronic databases (Medline, Embase, Scopus, SciELO, and WOS). The studies were combined using a random effects model by the inverse variance method. The effect size was the mean of the time to fracture (TTF) and number of cycles to fracture (NCF). Heterogeneity was assessed using the p value of the Q test for heterogeneity and the I2. (3) Results: TTF for rotary files was determined in 474.5 s and 839.1 for reciprocating without statistically significant differences. NCF for rotary systems was determined in 1444.2 and for reciprocating file systems in 4155.9 with statistically significant differences (p = 0.035), making reciprocating files more resistant. (4) Conclusions: Reciprocating files have better resistance to cyclic fatigue than rotary files. When tested in double curvature canals, reciprocating files also showed higher resistance.
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Affiliation(s)
- Ana De Pedro-Muñoz
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - Cristina Rico-Romano
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - Patricia Sánchez-Llobet
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Jesús Mena-Álvarez
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
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Keskin C, Pirimoğlu B, Çiftçioğlu E, Dinger E, Kömeç O, Keleş A. Shaping outcomes of Reciproc Blue and Rotate in roots canals with band-shaped isthmuses: micro-CT study. Clin Oral Investig 2023; 27:7337-7344. [PMID: 37861748 DOI: 10.1007/s00784-023-05324-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE This study assessed the outcome of shaping the mesial roots of mandibular first molars containing band-shaped isthmuses with an isthmus floor located at the apical third with Reciproc Blue and Rotate instruments in terms of canal transportation, canal aberrations and unprepared apical canals. MATERIALS AND METHODS Pair-matched mesial roots of mandibular first molars according to their isthmus location (distance from apical foramina) and size were constructed based on quantitative measurements (length, major and minor diameter at isthmus roof and floor) on preoperative micro-CT scanning (n = 10). The pair-matched specimens were prepared either using Reciproc Blue R25 (25.08v) or Rotate (15.04, 20.05, 25.06) instruments and then subjected to a second micro-CT scanning. Micro-CT scans were analysed to evaluate the canal transportation at the apical foramen and isthmus floor levels and the frequency of procedural errors (separated instruments, artificial canal preparation, cross shaping and unprepared apical canals). Canal transportation values were compared using Mann-Whitney U, and the distribution of procedural errors was compared with chi-square tests with a 5% significance threshold. RESULTS Greater transportation values were detected in the apical foramen level compared to the isthmus floor in both groups. No significant difference was detected between Rotate and Reciproc Blue groups in terms of absolute transportation values and the incidence of procedural errors (p > .05). CONCLUSION Preparation of mesial root canals containing a band-shaped isthmus at the apical portion with Reciproc Blue and Rotate instruments caused transportation of the original canal position at the isthmus floor and the apical foramen levels and resulted in procedural errors. CLINICAL RELEVANCE This ex vivo micro-CT study using controlled pair-matched specimens showed that presence of a band-shaped isthmus complicates canal preparation procedure irrespective of the preparation systems.
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Affiliation(s)
- Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
| | - Burcu Pirimoğlu
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Elif Çiftçioğlu
- Department of Endodontics, Faculty of Dentistry, Okan University, Istanbul, Turkey
| | - Esma Dinger
- Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | | | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
- Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Bürklein S, Arias A. Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta-analysis. Int Endod J 2023; 56 Suppl 3:395-421. [PMID: 35670625 DOI: 10.1111/iej.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The development of endodontic instruments has rapidly advanced, but their impact on endodontic outcome parameters remains unclear. OBJECTIVES This systematic review aimed to answer the following PICOT questions: In patients with apical periodontitis (P) what is the effectiveness of root canal instrumentation ([Q1] performed with contemporary techniques [I] in comparison with 'traditional' techniques [C]] and ([Q2] performed with contemporary engine-driven NiTi instruments [I] compared with other types of contemporary engine-driven NiTi instruments [with different design and/or technology] [C]) in terms of clinical and patient-related outcomes (O)? METHODS After PROSPERO protocol registration, a literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. Grey literature and major journal contents were examined. Two independent reviewers performed the study selection, data extraction and appraisal of included studies. A quantitative meta-analysis was considered, and statistical heterogeneity and overall quality of evidence were assessed. RESULTS Nine studies were identified showing substantial methodological differences. Five studies addressed PICOT 1 and three PICOT 2, whereas one study aimed both. A random-effects meta-analysis model was considered for the outcome 'radiographic evidence of normal periodontal ligament space or reduction of apical lesion size' (PICOT 1) based on three studies with 332 evaluable participants and showed that contemporary instrumentation was associated with a more favourable outcome (p = .005) compared with root canal preparation with stainless steel instruments (odds ratio = 2.07 [95%-confidence interval = 1.25-3.44]) with no evidence of statistical heterogeneity (I2 = 0%) but low quality of evidence. DISCUSSION Albeit a few studies fulfilled eligible criteria, no study had a low risk of bias. Compelling evidence indicating significantly different outcome rates using different endodontic instruments when treating teeth with apical periodontitis is lacking. CONCLUSIONS In terms of healing, the results of the meta-analysis determined the higher effectiveness of root canal instrumentation performed with contemporary techniques in comparison with conventional stainless steel instruments in patients with apical periodontitis followed for a minimum of 1 year with low quality of evidence. No differences could be demonstrated between preparations with traditional stainless steel and contemporary NiTi instruments for other clinical and patient-related outcomes. REGISTRATION PROSPERO (CRD42021274642).
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Affiliation(s)
| | - Ana Arias
- School of Dentistry, Complutense University, Madrid, Spain
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Duncan HF, Kirkevang LL, Peters OA, El-Karim I, Krastl G, Del Fabbro M, Chong BS, Galler KM, Segura-Egea JJ, Kebschull M. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3:238-295. [PMID: 37772327 DOI: 10.1111/iej.13974] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. AIM To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. METHODS This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. RESULTS The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. CONCLUSION The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bun San Chong
- Faculty of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Juan J Segura-Egea
- Department of Stomatology, Endodontics Section, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Karim MH, Faraj BM. Comparative Evaluation of a Dynamic Navigation System versus a Three-dimensional Microscope in Retrieving Separated Endodontic Files: An In Vitro Study. J Endod 2023; 49:1191-1198. [PMID: 37393950 DOI: 10.1016/j.joen.2023.06.014] [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: 05/14/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION This study aimed to compare the effectiveness of a dynamic navigation system and a three-dimensional microscope in retrieving broken rotary Nickel-Titanium files when using trepan burs and the extractor system. MATERIALS AND METHODS Thirty maxillary first bicuspids with 60 separate roots were split into 2 comparable groups based on a comprehensive cone beam computed tomography analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated Nickel-Titanium rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time, and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. RESULTS The microscope-guided group had a higher success rate than the dynamic navigation system guidance, but the difference was insignificant (P > .05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, shorter time to retrieve the fragments and less change in the root canal volume (P < .05). CONCLUSION Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.
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Affiliation(s)
- Mohammed H Karim
- Conservative Department, University of Sulaimani, College of Dentistry, Iraq.
| | - Bestoon M Faraj
- Conservative Department, University of Sulaimani, College of Dentistry, Iraq
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [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] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Vashisht R, Kumar U, Jhamb S, Singla R. Comparative evaluation of cleaning efficiency of single file NiTi rotary system during root canal treatment procedure - A scanning electron microscope study. J Conserv Dent 2023; 26:316-320. [PMID: 37398853 PMCID: PMC10309122 DOI: 10.4103/jcd.jcd_52_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 07/04/2023] Open
Abstract
Background Optimal biomechanical preparation, thorough irrigation, proper disinfection, and finally, well-sealed obturation is a must to attain definitive success in root canal procedure. Proper preparation of the root canal is all the more imperative to establish a hermetic apical seal with adequately placed filling materials. The present study was conducted for comparing the Cleaning Efficiency of F360 system and the WaveOne Gold (WOG) system of rotary NiTi instrumentation for a root canal. Materials and Methods One hundred freshly extracted noncarious mandibular canines were obtained. Access cavity of standard size was made followed by the establishment of working length. Afterward, random division of all the specimens was done into two study groups: group A: the group in which F360 system was used for instrumentation and group B: the group in which the WOG system was used for instrumentation. Irrigations of all the specimens of both the study groups were done followed by root canal shaping by the instrument system of their respective study groups. Scanning electron microscope (SEM) was used for assessment after specimens were cut buccolingually. Debris score and residual smear layer score were used for assessment. Results Among group A specimens, the mean smear layer score at the coronal third, middle third, and apical third was 1.76, 2.39, and 2.65, respectively. Among group B specimens, the mean smear layer score at the coronal third, middle third, and apical third was 1.34, 1.59, and 1.92, respectively. While analyzing statistically, it was seen that the mean smear layer score was significantly higher among specimens of group A in comparison to group B. While analyzing statistically, it was seen that the mean debris score was significantly higher among specimens of group A in comparison to group B. Conclusion The cleaning effectiveness of WOG instruments was significantly enhanced in comparison to F360 equipment.
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Affiliation(s)
- Ruchi Vashisht
- Department of Oral Health Science Centre, Unit of Conservative and Endodontics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Umesh Kumar
- Department of Oral Health Science Centre, Unit of Conservative and Endodontics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Swaty Jhamb
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, PGIMER, Chandigarh, India
| | - Ruchi Singla
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, PGIMER, Chandigarh, India
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Chan WS, Gulati K, Peters OA. Advancing Nitinol: From heat treatment to surface functionalization for nickel–titanium (NiTi) instruments in endodontics. Bioact Mater 2023; 22:91-111. [PMID: 36203965 PMCID: PMC9520078 DOI: 10.1016/j.bioactmat.2022.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Nickel-titanium (NiTi) alloy has been extensively researched in endodontics, particularly in cleaning and shaping the root canal system. Research advances have primarily focused on the design, shape, and geometry of the NiTi files as well as metallurgy and mechanical properties. So far, extensive investigations have been made surrounding surface and thermomechanical treatments, however, limited work has been done in the realm of surface functionalization to augment its performance in endodontics. This review summarizes the unique characteristics, current use, and latest developments in thermomechanically treated NiTi endodontic files. It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization. Whilst clinical translation of this technology has yet to be fully realized, future research direction will lie in the use of nanotechnology. Nitinol (Nickel Titanium alloy) is widely used to clean/shape root canal system in endodontics. To enhance its performance, various thermo-mechanical and nano-engineering modifications have been performed. This comprehensive review summarizes the latest advances and future trends relating to functionalized NiTi endodontic files.
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Kumagai H, Sugaya T, Tominaga T. Cauterization of Narrow Root Canals Untouched by Instruments by High-Frequency Current. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2542. [PMID: 37048836 PMCID: PMC10095201 DOI: 10.3390/ma16072542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/06/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
The mechanical removal of bacteria is fundamental to the treatment of infected root canals, but complete sterilization of biofilms tends not to extend to uninstrumented areas. However, during electrical conduction to a root canal filled with a conductor, the higher impedance where the root canal is narrower generates Joule heat that may result in a large temperature increase and sterilization. The effect of a high-frequency electric current on the wall of a simulated narrow root canal was investigated by scanning electron microscopy (SEM) and energy dispersive X-ray spectrometry (EDS). Simulated root canals, 0.1 mm in diameter, were prepared in dentine blocks. The root canal wall was treated with Plank-Rychlo solution for 5 min to create a decalcified layer. The simulated root canal was filled with either saline or NaClO, and 150 or 225 V at 520 kHz was applied for 0 s, 1 s, or 5 s. As the conduction time increased, and when the saline was replaced with NaClO, the proportion with a flat decalcified surface decreased, dentinal tubules and a lava-like morphology were significantly more evident on SEM (p < 0.01), and EDS showed significant decreases in carbon and oxygen and increases in calcium (p < 0.01). It was concluded that filling uninstrumented root canals with NaClO and using electrical conduction for 5 s could incinerate and eliminate the organic material of the root canal wall. The application of high-frequency electric current may lead to the cure of many cases of persistent apical periodontitis.
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Affiliation(s)
- Hiromichi Kumagai
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13W7, Kita-ku, Sapporo 060-8586, Hokkaido, Japan
| | - Tsutomu Sugaya
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13W7, Kita-ku, Sapporo 060-8586, Hokkaido, Japan
| | - Toshihiko Tominaga
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13W7, Kita-ku, Sapporo 060-8586, Hokkaido, Japan
- Tominaga Dental Clinic, Setotyomyoujinshitahonjo 197-3, Naruto 771-0360, Tokushima, Japan
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Elbahary S, Rosen E, Haj-Yahya S, Elias MG, Talmi S, Tsesis I, Slutzky H. The Effect of General Anesthesia on the Outcome of Root Canal Treatment in Pediatric Patients—A Retrospective Cohort Study. CHILDREN 2023; 10:children10030520. [PMID: 36980078 PMCID: PMC10047262 DOI: 10.3390/children10030520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023]
Abstract
This study aimed to evaluate the effect of general anesthesia (GA) on the 1-year outcome of Root Canal Treatment (RCT) performed in pediatric patients and to compare it to the outcome of RCT in pediatric patients without GA. Patients admitted for RCT in permanent dentition in a public hospital, dated 2015 to 2020, age 8–15 with a minimum of one year follow-up period, were included in the study. The sample consisted of 326 teeth from 269 patients treated by a single operator, with a recall rate of 81%. Overall, 124 teeth were treated under GA and 142 teeth were without GA. The mean follow-up time was 31.5 months. Data underwent statistical analysis and the significance threshold was set for p < 0.05. Of the total cases, 90% showed favorable outcomes. A significantly higher favorable outcome was seen in the GA group than in the non-GA group (98% and 85%, respectively, p < 0.001). The outcome was significantly affected by the type and quality of the coronal restoration, degree of root development, and lesion size (p < 0.05). According to the current study, in uncooperative pediatric patients, a more favorable outcome of root canal treatment can be obtained under GA than LA if the procedure is carried out with immediate restoration.
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Affiliation(s)
- Shlomo Elbahary
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
- Correspondence:
| | - Eyal Rosen
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Sohad Haj-Yahya
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Maysa Ghrayeb Elias
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Shany Talmi
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Igor Tsesis
- Department of Endodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Hagay Slutzky
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
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Algahtani FN, Barakat RM, Alqarni LM, Alqabbani AF, Alkadi MF, Almohareb RA. Undergraduate Endodontic Training and Its Relation to Contemporary Practice: Multicenter Cross-Sectional Study in Saudi Arabia. Int J Clin Pract 2023; 2023:7484570. [PMID: 36704246 PMCID: PMC9833919 DOI: 10.1155/2023/7484570] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/05/2023] Open
Abstract
Materials and Methods An online questionnaire was developed and emailed to all dental schools in Saudi Arabia. This questionnaire was answered by the endodontic undergraduate program director. The data collected were analysed using descriptive statistics. Results The response rate was 96.15%, which means twenty-five out of twenty-six dental schools participated in the study. The majority of the academic supervisors was endodontists (92%). The use of magnification and ultrasonic tips was not required by 84% and 76% of the dental schools, respectively. The main endodontic treatment techniques were the step-back technique and gates glidden for cleaning and shaping (76%) and cold lateral compaction for obturation (92%). Conclusions The dental students were supervised by endodontic specialists and trained to use traditional endodontic methods. Encouraging dental educators to train students to use modern technology and equipment would probably improve their graduate clinical skills and performance.
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Affiliation(s)
- Fahda N. Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Reem M. Barakat
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Lujain M. Alqarni
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Alanoud F. Alqabbani
- Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Manal F. Alkadi
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Rahaf A. Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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Thu M, Ebihara A, Maki K, Nishijo M, Kimura S, Nakatsukasa T, Kyaw MS, Okiji T. Effect of different axial speed patterns on cyclic fatigue resistance of rotary nickel-titanium instruments. BMC Oral Health 2022; 22:617. [PMID: 36529721 PMCID: PMC9761994 DOI: 10.1186/s12903-022-02639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To evaluate the effect of pecking motions with faster upward speed on the dynamic cyclic fatigue resistance of nickel-titanium rotary instruments with different metallurgy. METHODS Forty each of ProTaper Universal F3 (PTU) and ProTaper Gold F3 (PTG) instruments (size #30/.09) were equally divided into four groups. The test was performed using an 18-mm-long stainless steel artificial canal with a 5-mm radius of curvature, a 45° canal curvature and a 2-mm canal diameter. A downward speed of 100 mm/min was employed, while the upward speed was set at 100, 150, 200 or 300 mm/min. Time to failure (Tf), number of cycles to failure (Nf) and number of pecking motions to failure (Np) were recorded. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests for Tf, Nf, and Np (α = 0.05). RESULTS The 100/300 mm/min group showed significantly higher Np values than the 100/100 mm/min group (p < 0.05), whereas there were no significant differences in Tf and Nf among the tested speed groups (p < 0.05) in either PTU or PTG. PTG exhibited significantly higher Tf, Nf, and Np than PTU (p < 0.05). CONCLUSIONS Under the tested conditions, the fastest upward speed group showed significantly higher cyclic fatigue resistance, as demonstrated by larger Np, than the same speed group. PTG had significantly higher cyclic fatigue resistance than PTU in all groups.
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Affiliation(s)
- Myint Thu
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Arata Ebihara
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Keiichiro Maki
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Miki Nishijo
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Shunsuke Kimura
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Taro Nakatsukasa
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Moe Sandar Kyaw
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Takashi Okiji
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
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Miçooğulları Kurt S, Kandemir Demirci G, Serefoglu B, Kaval ME, Güneri P, Çalışkan MK. Quality of root canal treatment performed by undergraduate students using nickel-titanium reciprocating versus hand instruments. J Dent Educ 2022; 86:1662-1670. [PMID: 35830253 DOI: 10.1002/jdd.13038] [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: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare the technical quality of root canal treatment (RCT) depending on the incidence of procedural errors performed by undergraduate students using nickel-titanium reciprocating and conventional hand instrumentation techniques, and to assess the impact of case difficulty and localization of the teeth (maxillary or mandibular molars). METHODS Dental records and periapical radiographs of molars that were treated with either hand or reciprocating WaveOne (WO) instruments were evaluated retrospectively. The technical quality of RCTs, the incidence of ledge formation, perforation, instrument fracture, overinstrumentation, underfilling, overfilling, inadequate root canal filling, and the effects of case difficulty and tooth localization were compared using the chi-square test with a significance of 5% (α = 0.05). RESULTS While overinstrumentation was more frequent in the WO group (247 teeth), the incidence of inadequate root canal fillings was higher in the hand instrumentation group (245 teeth) (p < 0.01). No significant difference was observed in the incidence of other procedural errors (p > 0.05). The number of teeth with acceptable technical quality in preparation and obturation was 172 (69.6%) in the WO group, whereas it was 142 (58%) in the hand instrumentation group, presenting a significant difference between the instrumentation techniques (p < 0.01). Higher technical quality rates were observed with WO instrumentation in the high difficulty category and in maxillary teeth (p < 0.01). CONCLUSION Higher technical quality in preparation and obturation can be achieved with WO reciprocating instruments and file-matched greater tapered gutta-percha cones. No significant difference was observed between the groups in the incidence of procedural errors except for overinstrumentation and insufficient root canal filling. WO instrumentation and obturation with file-matched greater tapered gutta-percha cones provided better technical quality in the high difficulty category and in maxillary teeth.
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Affiliation(s)
| | | | - Burcu Serefoglu
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, Turkey
| | - Mehmet Emin Kaval
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Bornova, Turkey
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Treatment Outcome and Root Canal Preparation Techniques: 5-Year Follow-Up. Int Dent J 2022; 72:811-818. [PMID: 36153168 DOI: 10.1016/j.identj.2022.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aims at comparing treatment outcome and tooth survival of root canal-filled teeth following manual vs rotary instrumentation techniques over a 5-year period. METHODS This was a single-centre study conducted as a follow-up to a short-term parallel-arm randomised controlled noninferiority trial in which root canal treatment was performed on teeth using either rotary or manual instrumentation. Patients were monitored at post 6-month, 1-year, 4-year, and 5-year review periods by blinded evaluators. Treatment outcome was categorised as favourable, uncertain, and unfavourable (employing European Society of Endodontology categorisation based on strict clinical and radiographic criteria), and 5-year tooth survival was determined by assessing whether tooth was in situ in the oral cavity or extracted. The Kaplan-Meier method and log rank test evaluated tooth survival. P value <.05 was considered statistically significant. RESULTS Ninety of 120 treated teeth were assessed in 37 men and 40 women with mean age of 30.6 ± 10.99 years. Treatment outcome was significantly more favourable in the rotary group compared to the manual group at post 6-month (P = .021) and 1-year (P = .043) review periods. The differences in favourable outcome (P = .498) and tooth survival (P = .296) between the 2 groups were, however, not significant at the 5-year review period. CONCLUSIONS The rotary instrumentation technique was shown to be more effective in resolving clinical symptoms and promoting periapical healing after the post 6-month and 1-year review compared to the manual instrumentation technique; however, both groups had similar favourable outcomes and survival rates after an extended 5-year review period.
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El Abed R, Alshehhi A, Kang YJ, Al Raeesi D, Khamis AH, Jamal M, Kim HC. Fracture Resistance of Heat-Treated Nickel-Titanium Rotary Files After Usage and Autoclave Sterilization: an in vitro study. J Endod 2022; 48:1428-1433. [PMID: 35987385 DOI: 10.1016/j.joen.2022.08.004] [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: 04/23/2022] [Revised: 07/21/2022] [Accepted: 08/10/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION This study aimed to evaluate the dynamic cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) files after usage and autoclaving. METHODS Two heat-treated NiTi file systems with the tip sizes of #25 of ProTaper Gold F2 (PG) and TruNatomy Prime (TN) were selected. Files in each system was divided into three experimental subgroups (n=10). For subgroup-1, new files were tested to establish baseline number of cycles to failure (NCF). For subgroup-2, files underwent canal instrumentation in a simulated J-shaped canal block with the 35-degree of curvature with 16.5-mm of length. The simulated canals were pre-enlarged using stainless-steel files, #10K and #15K. After instrumentation, the files were tested. For subgroup-3, files underwent canal instrumentation as in subgroup-2 and followed by autoclave sterilization then were tested for cyclic failure. Cyclic fatigue test was performed in dynamic pecking motion under body temperature. The time to fracture was recorded and calculated into NCF. Fracture fragments lengths were measured using digital microcaliper. Statistical analysis was conducted using independent t-test and multi-factorial analysis of variance with 95% significance. Scanning electron microscopy was used to examine the topographic characteristics after cyclic fatigue tests. RESULTS There were no significant differences between file systems in subgroup-1 using new files (P<.05). While PG reduced the NCF after use, TN showed significantly increased NCF (P<.05). However, after sterilization, TN showed reduced NCF than the used one (P<.05). CONCLUSIONS Cyclic loading by usage and heat treatment during sterilization may result in different cyclic fatigue resistance according to the geometry and alloy characteristics.
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Affiliation(s)
- Rashid El Abed
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Aisha Alshehhi
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Yoo Jung Kang
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Dana Al Raeesi
- Endodontic Department, Emirates Health Services Establishment, Dubai, United Arab Emirates
| | - Amar H Khamis
- Biostatistics Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mohamed Jamal
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea.
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Matoug-Elwerfelli M, Abdou A, Almutairi W, Alhuthayli M, Aloyaynaa S, Almohareb R. Radiographic assessment of endodontic mishaps in an undergraduate student clinic: a 2-year retrospective study. PeerJ 2022; 10:e13858. [PMID: 35945941 PMCID: PMC9357366 DOI: 10.7717/peerj.13858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/17/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives The aim of this study was to compare the occurrence of instrumentation and obturation related endodontic procedural mishaps following the use of either, stainless steel hand or engine-driven rotary instrumentation techniques. Methods From a computerized hospital database, a total of 730 dental patient records who had received endodontic treatment by undergraduate dental students between August 2018 to September 2020 were retrieved. The inclusion criteria were primary (non-surgical) endodontic treatment on permanent teeth with complete radiographic records. Following record screening, a final sample of n = 475 dental records were included. Radiographic records were evaluated for both instrumentation and obturation related mishaps. The data was analysed using multiple logistic regression analysis (α = 0.05). Results Engine-driven rotary instrumentation resulted in a significant decrease in the overall occurrence of instrumentation related endodontic mishaps by 40% compared to hand instrumentation (Odds Ratio = 0.59 [0.36-0.97], p = 0.04). In particular, rotary instrumentation decreased ledge formation, perforation and obturation related mishaps, with minimal effect on the limitation of zipping. Conclusion The use of rotary instrumentation techniques may reduce the incidence of instrumentation and obturation endodontic mishaps in the undergraduate dental clinic.
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Affiliation(s)
| | - Ahmed Abdou
- Prosthetic Dentistry Department, Division of Biomaterials, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
| | - Wejdan Almutairi
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Malak Alhuthayli
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shaikhah Aloyaynaa
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rahaf Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Factors affecting the quality of endodontic treatment in general dental practice in Scotland: a qualitative focus group study. Br Dent J 2022; 233:129-133. [PMID: 35869214 PMCID: PMC9305044 DOI: 10.1038/s41415-022-4475-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/08/2022] [Indexed: 12/02/2022]
Abstract
Introduction The quality of endodontic treatment worldwide is variable despite clear clinical guidelines being available. Aims Identify the factors that affect the quality of endodontic treatment in general dental practice in Scotland and how to overcome the barriers identified. Methods Four online focus group interview sessions were conducted in which a total of 16 participants were recruited, including general dental practitioners, endodontic specialists and educationalists. Topics for facilitated discussion were based on healthcare system theory and included education/training, patient factors, resources and equipment factors; themes were identified via template analysis. Results A number of themes and subthemes affecting the quality of care are reported, including aspects to do with remuneration, time, education, training, support from secondary care and the impact of COVID-19. Conclusion Findings support: increase practical experience for undergraduates; access to postgraduate mentoring and training; development of a managed clinical network to facilitate access to appropriately trained specialists; and increased remuneration to allow sufficient time and adequate equipment to achieve clinical standards. Despite available clinical guidelines, the quality of root canal treatment in NHS general dental practices is suboptimal. A variety of factors influence the quality of treatment in general dental practices, such as cost of treatment and equipment, a lack of training or education, inadequate support from secondary care and the impact of COVID-19. Adequate funding and support for clinicians could allow them to invest appropriately in treatment and equipment to improve the quality of care in NHS. Continuing professional education is frequently seen as a tool to improve the quality of care.
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Guillory M, Vall P. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. J Vet Dent 2022; 39:257-268. [PMID: 35585702 DOI: 10.1177/08987564221098566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews the historical development, properties, and trends of nickel titanium rotary instrumentation use for the veterinary endodontist.
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Affiliation(s)
| | - Patrick Vall
- Animal Dental Care and Oral Surgery, Colorado Springs, CO
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23
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Effect of Different Downward Loads on Canal Centering Ability, Vertical Force, and Torque Generation during Nickel-Titanium Rotary Instrumentation. MATERIALS 2022; 15:ma15082724. [PMID: 35454413 PMCID: PMC9031471 DOI: 10.3390/ma15082724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to examine how downward loads influence the torque/force and shaping outcome of ProTaper NEXT (PTN) rotary instrumentation. PTN X1, X2, and X3 were used to prepare J-shaped resin canals employing a load-controlled automated instrumentation and torque/force measuring device. Depending on the torque values, the handpiece was programmed to move as follows: up and down; downward at a preset downward load of 1 N, 2 N or 3 N (Group 1N, 2N, and 3N, respectively; each n = 10); or upward. The torque/force values and instrumentation time were recorded, and the canal centering ratio was calculated. The results were analyzed using a two-way or one-way analysis of variance and the Tukey test (α = 0.05). At the apex level, Group 3N exhibited the least canal deviation among the three groups (p < 0.05). The downward force was Group 3N > Group 2N > Group 1N (p < 0.05). The upward force, representing the screw-in force, was Group 3N > Group 1N (p < 0.05). The total instrumentation time was Group 1N > Group 3N (p < 0.05). In conclusion, increasing the downward load during PTN rotary instrumentation improved the canal centering ability, reduced the instrumentation time, and increased the upward force.
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24
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Wolf E, Leonard K, Vidigsson M, Tegelberg Å, Koch M. Adoption of change in endodontic practice after an educational program: A qualitative study. Clin Exp Dent Res 2022; 8:781-792. [PMID: 35179317 PMCID: PMC9209795 DOI: 10.1002/cre2.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim was to define the characteristics of successful implementation of new clinical endodontic routines within a public dental health organization, following an educational program. Materials and Methods Fifteen staff members were strategically selected for the interview. All had completed a theoretical educational intervention including a complementary endodontic treatment strategy and, for the dentists, comprising training in the nickel‐titanium‐rotary‐technique. All experienced the successful acceptance of new clinical routines. Two thematic in‐depth audiotaped interviews were conducted, wherein the informants described the implementation process in their own words. The interviews were transcribed verbatim and analyzed according to Qualitative Content Analysis. Results A theme was identified: A multiple flexible process with governance support and gradual reinforcement of motivation, with the following main categories: Firstly, contextual facilitation, with two subcategories (i) a multifaceted organizational foundation and (ii) a tolerance of flexibility. Secondly, emotional facilitation, with two subcategories (i) an experience of simplification and (ii) an experience of improvement. Conclusion The results improve the understanding of a multifaceted process underlying the acceptance of changes to clinical endodontic procedures by dentists in a public dental health organization. Important contributing factors identified were governance support, a committed resource person with contextual knowledge, tolerance of flexibility in implementation, and permissive informal communication channels within the local workplace. These findings might be a valuable contribution to an evidence base, facilitating the selection of the most appropriate educational strategy and structure for a specified purpose.
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Affiliation(s)
- Eva Wolf
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Kerstin Leonard
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - My Vidigsson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Åke Tegelberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Margaretha Koch
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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25
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Arias A, Peters OA. Present Status and Future Directions - Canal Shaping. Int Endod J 2022; 55 Suppl 3:637-655. [PMID: 35118683 PMCID: PMC9303733 DOI: 10.1111/iej.13698] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.
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Affiliation(s)
- A Arias
- School of Dentistry, Complutense University, Madrid, Spain
| | - O A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
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26
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Chaniotis A, Ordinola Zapata R. Present status and future directions -Management of curved and calcified root canals. Int Endod J 2022; 55 Suppl 3:656-684. [PMID: 35106792 DOI: 10.1111/iej.13685] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge. This narrative review seeks to provide and consolidate the principles necessary for understanding the dynamics of curved and constricted canal management and to improve the understanding for future developments in this field.
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Affiliation(s)
- Antonis Chaniotis
- Private practice, National and Kapodistrian University of Athens, Dental School, Athens, Greece
| | - Ronald Ordinola Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
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27
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Gavini G, Candeiro GTDM, Potgornik Ferreira F, Rubino GA, Aun CA, Bezerra AG, Malavasi M, Lemos ÉM, Caldeira CL, Akisue E. Retrospective study of endodontic treatment performed by undergraduate students using reciprocating instrumentation and single‐cone obturation. J Dent Educ 2022; 86:751-758. [DOI: 10.1002/jdd.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Giulio Gavini
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | | | | | - Gustavo Alberto Rubino
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | - Carmo Antônio Aun
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Alexandre Gomes Bezerra
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Maurílio Malavasi
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Érico Melo Lemos
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Celso Luiz Caldeira
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | - Eduardo Akisue
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
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28
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Kwak SW, Shen Y, Liu H, Kim HC, Haapasalo M. Torque Generation of the Endodontic Instruments: A Narrative Review. MATERIALS 2022; 15:ma15020664. [PMID: 35057383 PMCID: PMC8778851 DOI: 10.3390/ma15020664] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022]
Abstract
As the use of nickel-titanium (NiTi) file systems for root canal therapy has become popular; hence, knowledge and understanding of the characteristics of NiTi files is essential for dentists. Unintended sudden fracture can occur during root canal shaping, and it is important to understand the conditions that may cause instrument fractures. Torque is defined as the force required to rotate the NiTi file and can be considered of as a parameter for the stress generated. The endodontic engine maintains a constant rotational speed by adjusting torque regardless of the root canal conditions. The process of root canal shaping by rotary instruments is a series of actions that requires torque and generates stress to both the teeth and the NiTi instruments. The generated stress may induce the strain accumulation on NiTi instrument and the canal wall and lead to the development of microcrack in the instrument and dentinal wall. Therefore, understanding of torque and stress generated is important to prevent the fractures to the instrument and the teeth. This stress has been measured using various experimental approaches, including microcrack observation by using a microscope or computed tomography, attaching strain gauges to the teeth, and finite element analysis. This review focuses on the stress generated to the teeth and the instrument during instrumentation under various experimental conditions. The factors related to torque generation are also discussed.
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Affiliation(s)
- Sang Won Kwak
- Department of Conservative Dentistry, Dental and Life Science Institute, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea;
- Department of Oral Biological and Medical Sciences, Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Y.S.); (H.L.)
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Y.S.); (H.L.)
| | - He Liu
- Department of Oral Biological and Medical Sciences, Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Y.S.); (H.L.)
- Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining 272000, China
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Dental and Life Science Institute, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea;
- Correspondence: (H.-C.K.); (M.H.)
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Division of Endodontics, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (Y.S.); (H.L.)
- Correspondence: (H.-C.K.); (M.H.)
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29
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Metallurgical Tests in Endodontics: A Narrative Review. Bioengineering (Basel) 2022; 9:bioengineering9010030. [PMID: 35049739 PMCID: PMC8773015 DOI: 10.3390/bioengineering9010030] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/17/2022] Open
Abstract
Since there are no reviews of the literature on this theme, the aim of this narrative review is to summarize the metallurgical tests used in endodontics, pointing out their functional use and their pros and cons and giving readers a user-friendly guide to serve as an orientation aid in the plethora of metallurgical tests. With this purpose, a literature search for articles published between January 2001 and December 2021 was conducted, using the electronic database PubMed to collect all published articles regarding the metallurgical tests used in endodontics for the evaluation of NiTi rotary instruments. The search was conducted using the following keywords: “metallurgy”, “differential scanning calorimetry” (DSC), “X-ray diffraction” (XRD), “atomic force microscopy” (AFM), “energy-dispersive X-ray spectroscopy” (EDS), “focused ion beam analysis” (FIB) and “Auger electron spectroscopy” (AES) combined with the term “endodontics” or “NiTi rotary instruments”. Considering the inclusion and exclusion criteria, of the 248 articles found, only 81 were included in the narrative review. According to the results, more than 50% of the selected articles were published in one of the two most relevant journals in endodontics: International Endodontic Journal (22.2%) and Journal of Endodontics (29.6%). The most popular metallurgical test was DSC, with 43 related articles, followed by EDS (33 articles), AFM (22 articles) and XRD (21 articles). Few studies were conducted using other tests such as FIB (2 articles), micro-Raman spectroscopy (4 articles), metallographic analysis (7 articles) and Auger electron spectroscopy (2 articles).
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30
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Bhat R, Kini A, Shetty P, Kansara P, Penugonda B. Cyclic Fatigue Resistance and Surface Roughness of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals – An Atomic Force Microscopy Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
| | - Arjun Kini
- New York University College of Dentistry, USA
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31
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Zanza A, D’Angelo M, Reda R, Gambarini G, Testarelli L, Di Nardo D. An Update on Nickel-Titanium Rotary Instruments in Endodontics: Mechanical Characteristics, Testing and Future Perspective-An Overview. Bioengineering (Basel) 2021; 8:bioengineering8120218. [PMID: 34940371 PMCID: PMC8698980 DOI: 10.3390/bioengineering8120218] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Since the introduction of Nickel-Titanium alloy as the material of choice for the manufacturing of endodontic rotary instruments, the success rate of the root canal therapies has been significantly increased. This success mainly arises from the properties of the Nickel-Titanium alloy: the biocompatibility, the superelasticity and the shape memory effect. Those characteristics have led to a reduction in time of endodontic treatments, a simplification of instrumentation procedures and an increase of predictability and effectiveness of endodontic treatments. Nevertheless, the intracanal separation of Nickel-Titanium rotary instruments is still a major concern of endodontists, with a consequent possible reduction in the outcome rate. As thoroughly demonstrated, the two main causes of intracanal separation of endodontic instruments are the cyclic fatigue and the torsional loads. As results, in order to reduce the percentage of intracanal separation research and manufacturers have been focused on the parameters that directly or indirectly influence mechanical properties of endodontic rotary instruments. This review describes the current state of the art regarding the Nickel-Titanium alloy in endodontics, the mechanical behavior of endodontic rotary instruments and the relative stresses acting on them during intracanal instrumentation, highlighting the limitation of the current literature.
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Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
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Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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33
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Yon MJY, Tang MHY, Cheung GSP. Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.747071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify articles that reported on the defects and/or fracture of NiTi instrument used clinically (Jan 1980 till Aug 2021), with additional search manually by going through the list of references of the initially screened articles. Those satisfying the inclusion and exclusion criteria were entered into the analysis.Study Eligibility Criteria, Participants, and Interventions: All studies from the said databases reporting on NiTi root canal instruments that were deformed or separated during normal clinical use.Study Appraisal and Synthesis Methods: Studies with data available and suitable for meta-analysis were grouped according to the general design of the NiTi instruments for comparison. Safety quotient value was calculated based on the rate of instrument distortion and fracture.Results: Various instrument designs exhibited different incidences of distortion and fracture, hence a different “safety quotient” (ratio of the amount of deformed instruments to that of fractures in use). Heat-treated files showed the highest safety quotient value. All brands of NiTi file demonstrated a statistically significantly lower incidence of fracture, if treated as disposable instruments after clinical use in a patient.Limitations: Inclusion of articles written in English only, and grouping of file systems into general design types in the analysis.Conclusions and Implications of Key Findings: NiTi endodontic files should be scrutinized for defects before being used in the root canal. Disposing the NiTi instruments after clinical use in a patient (so-called “single use”) is recommended for minimizing fracture clinically. Certain instrument designs tend to show discernible deformation before they should fracture in the next use.
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Experimental Study of the Effects of Torsional Loading on Three Types of Nickel-Titanium Endodontic Instruments. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In modern endodontics, nickel-titanium (NiTi) rotary instruments are used on a large scale for root canal shaping. Nevertheless, the separation of an instrument is a serious concern during shaping. The aim of this study is to determine and compare the torsional fracture characteristics of three types of NiTi endodontic instruments, each with different cross-section designs and movements performed during root canal shaping: Endostar E3 (Endostar, Poldent Co. Ltd., Warsaw, Poland); Reciproc R25 (VDW, Munich, Germany); and Protaper Next X2 (Dentsply Maillefer, Ballaigues, Switzerland). Fifteen instruments are used in this study, divided in three groups (n = 5): Group Endostar, Group Reciproc and Group Protaper. For testing, each instrument is used to shape five simulated root canals, following which its torsional stress to failure is measured. The fracture lengths of all three groups are roughly between 2 and 3 mm from the tip. Higher values of the moment of torsion in fracture, and smaller values of the maximum twisting angle are observed for Group Endostar, as well as closer to circular cross-sections. However, the values of the shear tension are similar for all three groups, because the disadvantage given by the fracture section shape for Groups Reciproc and Protaper is compensated either by size or by intrinsic properties of the instrument material. For the shear tension the Endostar values are insignificantly increased (Kruskal–Wallis test, p = 0.207), and in the case of the maximum twist angle the Protaper values are insignificantly increased (Kruskal–Wallis test, p = 0.287). Because of the instruments shape and conicity, the analysis had to be carried out separately with regard to the length of the fractured tip. Rules-of-thumb are extracted from the study for current practice: if a blockage of the first 2 to 3 mm part of the tip can be anticipated (by the excessive curving of the instrument), the handpiece must be adjusted to torque values that do not exceed 1.5 to 2.5 N · cm for Endostar and 1 to 2 N · cm for Reciproc and Protaper instruments.
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Kwak SW, Ha JH, Shen Y, Haapasalo M, Kim HC. Effects of Root Canal Curvature and Mechanical Properties of Nickel-Titanium Files on Torque Generation. J Endod 2021; 47:1501-1506. [PMID: 34237386 DOI: 10.1016/j.joen.2021.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aimed to compare the torque generated by 4 different files in root canals with 4 different curvature angles. METHODS Four brands of nickel-titanium (NiTi) endodontic files were selected: WaveOne Primary (Dentsply Sirona, Ballaigues, Switzerland), WaveOne Gold Primary (Dentsply Sirona), ProTaper Universal F2 (Dentsply Sirona), and ProTaper Next X2 (Dentsply Sirona). A tempered steel block containing artificial canals with 4 different canal curvatures (15°, 25°, 35°, and 45°) was constructed. Each file was used according to the manufacturer's instructions in the dynamic model, with an added 15 axial up-and-down movements of 4 mm at the end of the canal. The generated torque was recorded, and the total and maximum torque values were measured. Two-way analysis of variance and the Duncan post hoc comparison test were performed at a significance level of 95%. RESULTS A significant correlation between the curvature angle and the type of file system was observed (P < .05). As the degree of canal curvature increased, the generated total and maximum torque increased. At 15° and 25°, the NiTi files with reciprocating motion generated a higher total and maximum torque than files with continuous rotation. ProTaper Universal of conventional NiTi alloy showed the steepest increase in the generated total and maximum torque with the increasing curvature angle. The ProTaper Next file had the lowest torque values at the higher canal angles of 35° and 45° (P < .05). CONCLUSIONS Despite the study limitations, it can be concluded that root canal curvature, design, and heat treatment of NiTi files and file kinematics affect the generated torque during instrumentation.
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Affiliation(s)
- Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental and Life Science Institute, Dental Research Institute, Pusan National University, Yangsan, South Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental and Life Science Institute, Dental Research Institute, Pusan National University, Yangsan, South Korea.
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Sivas Yilmaz Ö, Keskin C, Aydemir H. Comparison of the Torsional Resistance of 4 Different Glide Path Instruments. J Endod 2021; 47:970-975. [PMID: 33640424 DOI: 10.1016/j.joen.2021.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The present study aimed to compare the torsional strength of the initial files of the Mtwo (VDW, Munich, Germany) and novel Rotate systems (VDW, Munich, Germany) with the ProGlider (Dentsply Sirona, Ballaigues, Switzerland) and R-Pilot (VDW) glide path instruments. METHODS The Mtwo (10/.04), ProGlider (16/.02), R-Pilot (12.5/.04), and Rotate (15/.04) glide path files were compared regarding their torsional strength, which was tested using a specially designed test device (N = 20). The data obtained were statistically analyzed at 5% significance level using 1-way analysis of variance and the post hoc Tukey test. The fragment surfaces and separated instruments were examined with ×50, ×100, and ×1000 magnification under a scanning electron microscope. RESULTS The R-Pilot group showed the highest torsional strength value among all groups (P < .05), whereas there was no significant difference between the torsional strength values of the Mtwo and ProGlider groups (P > .05). The Rotate group had the lowest torsional strength among all groups (P < .05). The Mtwo group showed the lowest angle of rotation among all groups (P < .05). CONCLUSIONS Although the R-Pilot glide path file exhibited the highest torsional strength in all groups, Rotate showed the highest angle of rotation. Differences in torsional resistance of the instruments may be associated with their manufacturing methods and design features.
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Affiliation(s)
- Özlem Sivas Yilmaz
- Department of Endodontics, Faculty of Dentistry, Karabuk University, Karabuk, Turkey.
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Hikmet Aydemir
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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37
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Gomes MS, Vieira RM, Böttcher DE, Plotino G, Celeste RK, Rossi-Fedele G. Clinical fracture incidence of rotary and reciprocating NiTi files: A systematic review and meta-regression. AUST ENDOD J 2021; 47:372-385. [PMID: 33410578 DOI: 10.1111/aej.12484] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 12/01/2022]
Abstract
This systematic review was registered in PROSPERO (CRD42017075917) and aimed to investigate whether the available clinical evidence supports the hypothesis that reciprocating motion results in a lower incidence of nickel-titanium files fracture compared to continuous rotation. Clinical studies that reported the incidence of fracture of engine-driven nickel-titanium files were included. The main exposure was the kinematics, and the primary outcome was the incidence of files fracture. The overall incidence of files fracture was 2.27%, with a trend for higher incidence with rotary motion (2.43%) than with reciprocating (1.0%), though without significant differences. Multiple meta-regression models revealed that the use of nickel-titanium files in more than four teeth and less proficient operators were associated with a higher incidence of file fracture. There was no difference in the clinical incidence of fracture of nickel-titanium instruments between reciprocating and rotary motions; however, other factors were identified.
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Affiliation(s)
- Maximiliano Schünke Gomes
- Pontifícia Universidade Católica do Rio Grande do Sul, School of Health and Life Sciences, Graduate Program in Dentistry, Porto Alegre, Brazil
| | - Rosângela Mello Vieira
- Pontifícia Universidade Católica do Rio Grande do Sul, School of Health and Life Sciences, Graduate Program in Dentistry, Porto Alegre, Brazil
| | - Daiana Elisabeth Böttcher
- Pontifícia Universidade Católica do Rio Grande do Sul, School of Health and Life Sciences, Graduate Program in Dentistry, Porto Alegre, Brazil
| | - Gianluca Plotino
- Private Practice, Grande, Plotino & Torsello - Studio di Odontoiatria, Rome, Italy
| | - Roger Keller Celeste
- Department of Preventive and Social Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Shape Memory Biomaterials and Their Clinical Applications. Biomed Mater 2021. [DOI: 10.1007/978-3-030-49206-9_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kim NY, Kwak SW, Yoon TH, Ha JH, Versluis A, Kim HC. Numeric Evaluation of Innovate Spring Machined Nickel-Titanium Rotary Instruments: A 3-dimensional Finite Element Study. J Endod 2020; 47:303-308. [PMID: 33091452 DOI: 10.1016/j.joen.2020.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/30/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate if machined springs in nickel-titanium (NiTi) rotary instruments can improve their mechanical properties. The bending and torsion properties were assessed using finite element (FE) model analysis. METHODS A basic 3-dimensional file model without a spring was created with apical size #25, 25-mm full length, and 16-mm cutting flutes. Three other models were created with a spring machined into their shaft portion with different numbers of spring coils: standard (STspr), 10% more (INspr), and 10% less (DEspr). To compare the mechanical responses among the 4 FE models, file bending and torsion were simulated using FE analysis. RESULTS Spring machined NiTi rotary instruments showed higher torsional resistance and less bending stiffness than the same instrument without. The spring machined models required more torque to bend or rotate the DEspr model than was required for the STspr and INspr models; however, the STSpr and INSpr models were similar. CONCLUSIONS Within the limitations of this study, the FE analysis indicated that machining a spring into the shaft of NiTi rotary instruments improved torsional resistance and bending flexibility. Therefore, spring machining has the potential to increase the durability of the NiTi rotary instruments.
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Affiliation(s)
- Na Yoon Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, South Korea
| | - Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, South Korea
| | - Tae Ho Yoon
- Korea Institute of Science and Technology Information, Daejeon, South Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Antheunis Versluis
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, South Korea.
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Lam MSH, Chang JWW, Cheung GSP. Ex vivo shaping ability of reciprocating instruments operated by new users: Reciproc versus WaveOne. Clin Oral Investig 2020; 25:2791-2799. [PMID: 33033922 DOI: 10.1007/s00784-020-03593-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare two reciprocating NiTi systems operated by novices for use in curved root canals. METHODS Fifty mesial roots of extracted mandibular first molars, with 2-2 canal configuration, were scanned with micro-CT and divided into 2 groups according to canal length and curvature: Reciproc and WaveOne. Each system was used to prepare one of the two canals by fourth-year dental students, who were new to reciprocating files and were blinded to the system being used. After another scanning, the pre- and post-instrumentation images were compared 3-dimensionally in software. RESULTS Some 43 to 46% of the canal wall area remained un-instrumented. Significantly higher proportions of canals were transported towards the isthmus or furcation aspect than the mesial or external aspect. Mean transported distance was the greatest in the coronal one-third. Remaining dentine wall was the thinnest at the furcal aspect near the middle root region. No significant difference was noted between the two brands in the parameters examined. CONCLUSIONS Both brands of reciprocating file left similar amounts of un-instrumented canal wall, and resulted in similar extent of canal transportation. CLINICAL RELEVANCE NiTi reciprocating files can safely be used by new users to prepare curved root canals into a predictable shape.
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Affiliation(s)
- Mary S H Lam
- Department of Health, The Government of Hong Kong SAR, Hong Kong, Hong Kong
| | - Jeffrey W W Chang
- Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, PPDH, 34 Hospital Road, Pokfulam, Hong Kong, SAR
| | - Gary S P Cheung
- Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, PPDH, 34 Hospital Road, Pokfulam, Hong Kong, SAR.
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Torsional Resistance of WaveOne Gold and Reciproc Blue according to the Loading Methods. J Endod 2020; 47:88-93. [PMID: 32961213 DOI: 10.1016/j.joen.2020.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/12/2020] [Accepted: 09/14/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study aimed to compare the torsional resistances and fracture modes of WaveOne Gold (Dentsply Sirona, Ballaigues, Switzerland) and Reciproc Blue (VDW, Munich, Germany) using the repetitive torsional loading (RTL) method and the conventional single-rotation (STL) method. METHODS A 3-mm file tip was fixed with a brass plate, and a torsional load was applied using a custom device. In the RTL method, the file was driven counterclockwise at 50 rpm until it achieved the preset torque of 0.5 Ncm; thereafter, it was returned to its original position. This recovery of the file to its original position was defined as 1 torsional loading cycle; the number of repetitive load cycles until fracture was counted. In the STL method, the files were rotated at a constant rate of 2 rpm in a counterclockwise direction until file fracture. The fragments fractured by the 2 methods were compared under a scanning electron microscope to examine the topographic features of the fractured surfaces and longitudinal aspects. RESULTS With the RTL method, Reciproc Blue showed a higher number of repetitive load cycles until fracture than WaveOne Gold (P < .05). With the STL method, Reciproc Blue also had a higher ultimate strength than WaveOne Gold (P < .05). Scanning electron microscopic findings of the fractured specimens from the 2 test methods showed different features of torsional failure. CONCLUSIONS Within the study limitations, both the RTL and STL methods conferred similar torsional resistance. Therefore, the clinically relevant RTL method with repetitive and reciprocation motion can be used for testing torsional resistance.
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Analysis of Force and Torque with XP Shaper and OneCurve Systems During Shaping of Narrow Canals. Eur Endod J 2020; 5:123-127. [PMID: 32766522 PMCID: PMC7398991 DOI: 10.14744/eej.2020.96967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/08/2020] [Indexed: 11/20/2022] Open
Abstract
Objective: The purpose of this laboratory-based study was to compare the shaping forces and torques developed by the XP Shaper (FKG Dentaire SA, La Chaux-de-fonds, Switzerland) and OneCurve (Micro-Mega, Besancon, France) systems during shaping of narrow canals. Methods: Mandibular premolars with a single canal were divided equally into two groups; XP Shaper and OneCurve (n=16 each). In both groups, the canals were shaped with XP Shaper file (30/01) or OneCurve file (25/O6) that was inserted three times until it reached the canal length. The tooth was surrounded by water under controlled simulated intracanal temperature throughout the experiment. The inward and outward peak forces and the peak torques were recorded and analyzed statistically using the Mann-Whitney test. The shaping times were analyzed using Student’s t-test. The significance level was set at 5%. Results: In both groups, the developed forces in both directions and the torques increased with the successive insertions of the file. In the two groups, the inward peak forces ranged from 0.33 to 3.12 N, while the outward peak forces ranged from 0.09 to 1.96 N. In the three insertions, the XP Shaper showed significantly lower peak forces in both directions. The peak torque developed in both groups ranged from 0.12 to 1.52 N.cm. XP Shaper had significantly lower torque values in all the insertions than OneCurve. The XP Shaper system was able to completely shape the canals in 33.4 seconds while the OneCurve system was able to completely shape the canals in 32.8 seconds. Conclusion: The XP Shaper system showed favorably lower force and torque values during canal shaping compared with the OneCurve system.
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Ha JH, Kwak SW, Versluis A, Kim HC. Buckling Resistance of Various Nickel-Titanium Glide Path Preparation Instruments in Dynamic or Static Mode. J Endod 2020; 46:1125-1129. [PMID: 32497655 DOI: 10.1016/j.joen.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to compare the buckling resistance of nickel-titanium (NiTi) instruments for glide path preparation depending on the test mode (static vs dynamic). METHODS The conventional PathFile (PF; Dentsply Sirona, Ballaigues, Switzerland) and heat-treated ProGlider (PG, Dentsply Sirona) and WaveOne Gold Glider (WG, Dentsply Sirona) were evaluated. The instrument tips were placed in a small dimple prepared in an aluminum cube in a customized device. The file was then pushed in the axial direction at a 1.0-mm/s crosshead speed with rotation (dynamic mode) or without rotation (static mode). The dynamic mode of WG used its dedicated reciprocating rotation, whereas the others were rotated continuously at 300 rpm. The axial load and lateral buckling displacement were simultaneously measured. Data were analyzed statistically using 2-way analysis of variance (P = .05). RESULTS The buckling resistance in the dynamic mode was higher than in the static mode for PG and WG (P < .05), whereas PF was not influenced by test modes (P > .05). In the dynamic mode, the PG required the highest buckling load followed by PF and WG (P < .05). In the static mode, the WG showed the lowest load (P < .05). The dynamic mode showed significantly more upper level lateral buckling displacement than in the static mode (P < .05). CONCLUSIONS When the glide path preparation instruments moved in the dynamic mode as in clinical situations, the buckling resistance of the heat-treated NiTi glide path instruments was higher than in the static condition. The heat-treated instruments may have better buckling resistance than the conventional NiTi instrument in clinical situations.
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Affiliation(s)
- Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Antheunis Versluis
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea.
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Spatial Cleaning Action of Ultrasonic Irrigation on Enterococcus faecalis Biofilm. Dent J (Basel) 2020; 8:dj8020042. [PMID: 32392720 PMCID: PMC7344959 DOI: 10.3390/dj8020042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the spatial cleaning effect of ultrasonic irrigation in simulated root canal with oblong cross section in the absence of antimicrobial agent. A 7-day E. faecalis biofilm was cultivated in a rectangular, simulated canal model and subjected to passive ultrasonic irrigation (PUI) with sterile saline for 5 minutes. After that, the biofilm was examined by confocal microscopy after bacterial viability staining at 58 sites around and beyond the endosonic file. Results showed that, at the vicinity of the file, the amount of viable bacteria ranged from 13.1% (2.75 mm from the tip) to 40.5% (4.5 mm level). Lesser amounts of live bacteria were observed within 1 mm from the vibrating file, which amount increased for sites farther away. At 3 mm distance, the amount of bacteria (35.5 to 64.4%) was significantly greater than areas situated close to the vibrating file (P < 0.01). Sites next to the anti-nodes of file had less bacteria remaining than sites near the nodes (P = 0.050). Apically (0.5 mm or more), the amount of bacteria was significantly greater than that at the file tip (16.4%) (P < 0.05). It was concluded that PUI is able to dislodge a single-species biofilm, provided that they are situated in close vicinity to the vibrating file.
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Lee JY, Kwak SW, Ha JH, Kim HC. Ex-Vivo Comparison of Torsional Stress on Nickel-Titanium Instruments Activated by Continuous Rotation or Adaptive Motion. MATERIALS 2020; 13:ma13081900. [PMID: 32316559 PMCID: PMC7215760 DOI: 10.3390/ma13081900] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to evaluate the effect of adaptive motion applied to conventional nickel-titanium (NiTi) rotary instruments on torsional stress generation during shaping procedure. One hundred and twenty mesio-buccal canals of molars were randomly assigned to two groups according to the kinetics; adaptive motion (AD) and continuous rotation (CR). Each group was divided into four subgroups (n = 15) according to the NiTi instrument systems: HyFlex EDM, One Curve, Twisted File Adaptive, and ProTaper Next. A glide path was established with PathFile #1, for each file group being used with either of the kinetic movements. During the instrumentation with the designated motion and file system, the generated torque was measured via the control unit and acquisition module. Based on the acquired data, the maximum and total torque were calculated. The data were statistically analyzed using Kruskal–Wallis and Mann–Whitney tests at a significance level of 95%. The maximum and total torque generated by all instruments were significantly reduced by the adaptive motion (p < 0.05). In the CR group, HyFlex EDM generated the highest maximum and total stress. In the AD group, HyFlex EDM showed the highest maximum torsional stress, and One Curve showed the highest total torsional stress (p < 0.05). The TF Adaptive instrument with adaptive movement produced the lowest maximum and total torsional stress (p < 0.05). Under the conditions of this study, the use of adaptive motion would be useful to reduce the torsional stress of instrument and root dentin. The reduction of torsional stress through adaptive motion may enhance the durability of instruments and reduce the potential risk of dentinal cracks.
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Affiliation(s)
- Joo Yeong Lee
- Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (J.Y.L.); (S.W.K.)
| | - Sang Won Kwak
- Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (J.Y.L.); (S.W.K.)
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Korea;
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (J.Y.L.); (S.W.K.)
- Correspondence: ; Tel.: +82-55-360-5222
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Bartols A, Bormann C, Werner L, Schienle M, Walther W, Dörfer CE. A retrospective assessment of different endodontic treatment protocols. PeerJ 2020; 8:e8495. [PMID: 32030328 PMCID: PMC6995660 DOI: 10.7717/peerj.8495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/31/2019] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to assess the clinical impact of non-surgical root canal treatments (NSRCT) performed with different treatment protocols on the probability of tooth survival without untoward events and to identify predictors influencing the outcome. Methods During the period from July 1999 to October 2016, 5,858 patients were identified in which 9,967 NSRCTs were performed. The treatments were followed up and divided into three groups. In Group 1 root canal treatment was performed with hand instruments, in Group 2 with multiple file rotary instruments and passive ultrasonic irrigation (PUI), and Group 3 was treated with Reciproc instruments and PUI. Untoward events were defined as orthograde retreatment, apicoectomy or extraction of the tooth after initial treatment. Weibull regression was used to analyse the data. Results A total of 9,938 cases could be included into the analyses. The results showed 5-years predicted survival rates without untoward events of 73.9% (95% CI [71.7%–76.1%]), 75.1% (95% CI [71.7%–78.0%]) and 78.4% (95% CI [75.1%–81.4%]) for study group 1 (N = 5,580), 2 (N = 1,700) and 3 (N = 2,658), respectively. The differences between Group 1 and 3 were statistically significant (p < 0.006). Higher age of the patient (per year increase) and number of earlier NSRCTs (per unit increase) reduce the survival without untoward events statistically significant (both p < 0.02), while treatment of premolars had a statistically significant lower hazard ratio [0.89 (95% CI [0.79–0.99]; p = 0.030)] compared to treatment of molars and anterior teeth. A higher number of supportive periodontal treatments (per unit increase) improved tooth survival without untoward events highly significant (p < 0.0001). Discussion More recent endodontic treatment protocols involving reciprocating instruments and PUI appear to be associated with higher tooth survival rates without untoward events compared to hand instruments.
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Affiliation(s)
- Andreas Bartols
- Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany.,Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University, Kiel, Germany
| | - Carsten Bormann
- Chair of Econometrics and Statistics, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Luisa Werner
- Chair of Econometrics and Statistics, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Melanie Schienle
- Chair of Econometrics and Statistics, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Winfried Walther
- Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University, Kiel, Germany
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47
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Isik V, Kwak SW, Abu-Tahun IH, Ha JH, Kayahan MB, Kim HC. Effect of Shaft Length on the Torsional Resistance of Rotary Nickel-titanium Instruments. J Endod 2019; 46:295-300. [PMID: 31812358 DOI: 10.1016/j.joen.2019.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/20/2019] [Accepted: 10/25/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study was conducted to evaluate the effect of file length on the torsional resistance of nickel-titanium rotary files. METHODS Forty-five new files with a #25 tip size and variable taper for ProTaper Next (PTN; Dentsply Sirona, York PA), ProTaper Gold (PTG, Dentsply Sirona), and HyFlex CM (HCM; Coltene-Whaledent, Allstetten, Switzerland) were divided into 3 subgroups (n = 15) according to the file length (21, 25, and 31 mm). Torsional tests were performed using a custom-made device (AEndoS; DMJ System, Busan, Korea). The maximum torsional load and distortion angle were measured until file fracture occurred. The toughness was calculated using these data. All data were statistically analyzed using 2-way analysis of variance at a confidence level of 95%. One-way analysis of variance and Duncan post hoc comparison were also conducted to assess the difference among the independent variables, shaft length, and file system. RESULTS A statistically significant interaction was observed between the file system and instrument length with respect to the maximum torsional load (P < .05). The 31-mm shaft length of HCM showed higher maximum torsional load than that of the 25- and 21-mm shaft length in the HCM groups (P < .05). Among the instrument systems, PTG showed the significantly highest maximum torsional load followed by PTN and HCM (P < .05). The 31-mm shaft length of PTG showed significantly higher toughness than that of the 21- and 25-mm shaft lengths (P < .05), whereas PTN and HCM did not show any difference in relation to the shaft length. CONCLUSIONS Within the limitations of this study, the instrument with a longer shaft may have higher maximum torsional load or toughness than that with a shorter shaft.
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Affiliation(s)
- Vasfiye Isik
- Department of Endodontics, Division of Clinical Sciences, Faculty of Dentistry, Okan University, Istanbul, Turkey
| | - Sang Won Kwak
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea
| | - Ibrahim H Abu-Tahun
- Department of Conservative Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Mehmet Baybora Kayahan
- Department of Endodontics, Division of Clinical Sciences, Faculty of Dentistry, Okan University, Istanbul, Turkey.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea.
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48
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Manchanda S, Sardana D, Yiu CKY. A systematic review and meta‐analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. Int Endod J 2019; 53:333-353. [DOI: 10.1111/iej.13233] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 01/23/2023]
Affiliation(s)
- S. Manchanda
- Paediatric Dentistry and Orthodontics Faculty of Dentistry The University of Hong Kong Hong Kong S.A.R
| | - D. Sardana
- Paediatric Dentistry and Orthodontics Faculty of Dentistry The University of Hong Kong Hong Kong S.A.R
| | - C. K. Y. Yiu
- Paediatric Dentistry and Orthodontics Faculty of Dentistry The University of Hong Kong Hong Kong S.A.R
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Effectiveness of a reciprocating single file, single cone endodontic treatment approach: a randomized controlled pragmatic clinical trial. Clin Oral Investig 2019; 24:2247-2257. [PMID: 31650315 DOI: 10.1007/s00784-019-03077-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/13/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare the root filling quality, the sealer extrusion, and the healing rates of apical lesions addressed via two endodontic treatment approaches. The hypothesis tested was that both techniques present similar apical periodontitis healing results. MATERIALS AND METHODS This study was a parallel-design, pragmatic, and randomized clinical trial. One hundred twenty anterior teeth with necrotic pulps and apical periodontitis were randomly allocated to be either instrumented with hand files and obturated with the lateral compaction technique or instrumented with a single file in a reciprocating movement and obturated with a single-cone technique. The root canal filling quality, the occurrence of sealer extrusion, and apical periodontitis healing were the outcomes of interest. Data were analyzed through chi-square analysis, and the odds ratio for healing was adjusted using a logistic regression model (α = 0.05). RESULTS No significant differences were observed between the endodontic techniques regarding the root filling quality or sealer extrusion. Six months after treatment, both endodontic techniques presented equivalent results regarding apical periodontitis healing. The healing rate was affected only by the periapical status at baseline. CONCLUSIONS The obturation of the root canal of the anterior teeth using reciprocating file-matched single cones presented a similar quality to that obtained with manual instrumentation followed by the lateral condensation technique. Similar healing rates of apical lesions were also observed. CLINICAL RELEVANCE For treating anterior teeth with apical periodontitis, a reciprocating single-file, single-treatment protocol was as effective as a traditional protocol combining hand instrumentation and the lateral compaction obturation technique.
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50
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Nayak A, Kankar PK, Jain PK, Jain N. Force and vibration generated in apical direction by three endodontic files of different kinematics during simulated canal preparation: An in vitro analytical study. Proc Inst Mech Eng H 2019; 233:839-848. [PMID: 31165678 DOI: 10.1177/0954411919854574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
During root canal shaping, pain could result from the high level of force or vibration generated. This could be related to file kinematics or geometry. In the present study, a comparison is made between forces and vibrations generated by endodontic files having three different kinematics. Square pillar resin blocks were used as simulated root canals to study forces and vibrations generated by the file having reciprocating motion (WaveOne Gold), transline motion (Self-Adjusting File), and rotary motion (2Shape). The forces and vibrations were measured using the dynamometer and accelerometer, respectively. Recorded time domain signals were processed in MATLAB to calculate the root mean square value. A one-way analysis of variance and Tukey's test for post hoc comparison at 95% confidence interval were applied over the root mean square data of different files. From a statistical analysis of the file systems, the null hypotheses could not be accepted (P < 0.05) as 95% of the confidence interval. Differences between the means were statistically significant. The root mean square values of force and vibration for WaveOne Gold significantly exceeded those of Self-Adjusting File, 2Shape1, and 2Shape2 while the root mean square values of vibration for 2Shape1 and 2Shape2 were significantly less than the Self-Adjusting File; however, the root mean square value of force for the 2Shape2 was significantly more than for the Self-Adjusting File. Under the present experimental conditions, significant differences in the root mean square values of force and vibration of the three endodontic files of different kinematics have been observed. The WaveOne Gold file system generated higher apical force and vibration than the transline and rotary file system.
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Affiliation(s)
| | - P K Kankar
- 2 Indian Institute of Technology Indore, Indore, India
| | | | - Niharika Jain
- 3 Department of Conservative Dentistry & Endodontics, Triveni Institute of Dental Science, Hospital & Research Centre, Bilaspur, India
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