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Chiramel David E, H A, Santhosh Mani E, George S, Semwal I, Raj R A. Fracture Strength of Tooth Roots Following Canal Preparation by Three Rotary File Systems: An In Vitro Study. Cureus 2024; 16:e57302. [PMID: 38690448 PMCID: PMC11059113 DOI: 10.7759/cureus.57302] [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] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Since the beginning of modern endodontics, there have been many concepts, strategies, and techniques for root canal preparation. A mind-boggling variety of files have developed for negotiating and shaping them throughout the years. Today's most secure, most effective, and simplest file system combines the most reliable design elements of the past with the latest technological advances to create the most effective file system. So, the need for the study is to evaluate the fracture strength of tooth roots following canal preparation by three rotary file systems: ProTaper Universal file system (Dentsply, USA), ProTaper Next file system (Dentsply Sirona USA), and Neolix A1 nickel-titanium (NiTi) file system (Orikam Healthcare India Pvt Ltd., New Delhi, India). METHOD Ninety human mandibular molars were selected for the study. Inclusion criteria include human mandibular first and second molars and teeth removed for routine clinical reasons, and intact apices were selected, excluding cases with root surface caries, root surface fissures, teeth with immature root apex, mesial canal fusion, extremely short roots, thin roots, or curved roots. All teeth were preserved in a solution of 10% neutral buffered formalin for two weeks and then transferred to distilled water for examination. The teeth were randomly divided into three groups. Access cavities were created, and working lengths were determined. Groups 1, 2, and 3 underwent shaping using ProTaper Universal, ProTaper Next, and Neolix A1 (NiTi) file systems, respectively, following guidelines. Canals were irrigated with sodium hypochlorite and ethylenediaminetetraacetic acid (EDTA) and were obturated up to the mid-root region with AH Plus sealer. To facilitate fracture testing, obturation was performed to distribute the load from the spreader to the canal wall. The EndoSequence and Quick-Fill obturation system were utilized to fill the apical half of the canal with gutta-percha material. After obturation, the distal root of each tooth was cut, while the mesial root was securely positioned in a putty material. A universal testing machine was employed for the fracture tests, operating at a cross-head speed of 1 mm/min. The machine was equipped with a D11 hand spreader tip, which was inserted into the root canal to make contact with the gutta-percha. Gradual force was applied to the root canal until a fracture occurred, at which point the force application was stopped. The amount of force required to cause the fracture was measured in newtons. Data were collected and recorded using IBM SPSS Statistics for Windows, Version 17.0 (Released 2008; IBM Corp., Armonk, New York, United States) and then transferred to Microsoft Excel for analysis. Descriptive statistics, mean, and standard deviation were used for continuous data. The fracture resistance of dental roots treated with three types of files was compared using a one-way ANOVA. Graphs were generated using Excel and Word. A significance level of p<0.01 was chosen. RESULT ANOVA indicated significant differences in mean fracture resistance: Neolix A1 (NiTi) (95.3 N) > NEXT (91.0 N) > universal (86.6 N), with a p-value of 0.004 (<0.001), confirming statistical significance. CONCLUSION The study concludes that the canal instrumented with Neolix A1 (NiTi) exhibits higher fracture resistance after canal instrumentation compared to ProTaper Next and ProTaper Universal.
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Affiliation(s)
- Elvis Chiramel David
- Department of Conservative Dentistry and Endodontics, MES Dental College, Perinthalmanna, IND
| | - Azeem H
- Department of Conservative Dentistry and Endodontics, MES Dental College, Perinthalmanna, IND
| | - Emil Santhosh Mani
- Department of Conservative Dentistry and Endodontics, MES Dental College, Perinthalmanna, IND
| | - Sibin George
- Department of Conservative Dentistry and Endodontics, MES Dental College, Perinthalmanna, IND
| | - Indra Semwal
- Department of Conservative Dentistry and Endodontics, Uttaranchal Dental and Medical Research Institute, Dehradun, IND
| | - Akhila Raj R
- Department of Conservative Dentistry and Endodontics, Amrita School of Dentistry, Amrita Institute of Medical Sciences (AIMS), Amrita Vishwa Vidyapeetham, Kochi, IND
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Usta SN, Silva EJNL, Falakaloğlu S, Gündoğar M. Does minimally invasive canal preparation provide higher fracture resistance of endodontically treated teeth? A systematic review of in vitro studies. Restor Dent Endod 2023; 48:e34. [PMID: 38053776 PMCID: PMC10695733 DOI: 10.5395/rde.2023.48.e34] [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: 07/24/2023] [Revised: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 12/07/2023] Open
Abstract
This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the "PubMed, Web of Science, and Scopus" databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
| | | | - Seda Falakaloğlu
- Department of Endodontics, Faculty of Dentistry, Istanbul Health and Technology University, Istanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, University of Medipol, İstanbul, Turkey
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Muacevic A, Adler JR, Makandar SD, Nik Abdul Ghani NR, Metgud S. Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Instrumented With K3XF Rotary Files Using Different Tapers. Cureus 2023; 15:e34247. [PMID: 36843773 PMCID: PMC9957576 DOI: 10.7759/cureus.34247] [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] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
AIM To compare the effect of different tapers of the K3XF file system on the fracture resistance of endodontically treated mandibular premolars obturated with a three-dimensional (3-D) obturation system. METHODOLOGY For the study, 80 freshly extracted human mandibular premolars with single well-developed roots without any curvatures were taken and the tooth roots were wrapped in a single layer of aluminum foil, and they were placed vertically in a plastic mold filled with self-curing acrylic resin. The access was opened, and working lengths were determined. The canals were instrumented keeping an apical size of #30 by different taper rotary files: Group 1: un-instrumented (control group), Group 2: 30/.04, Group 3: 30/.06, Group 4: 30/.08 K3XF file system, and teeth were obturated using a 3-D obturation system, and access cavities were filled using composite. Both experimental and control groups were subjected to fracture load using a conical steel tip (0.5mm) attached to a universal testing machine to record force applied in newton until root fracture. RESULTS Root canal instrumented groups showed lower fracture resistance than the uninstrumented group. CONCLUSION Hence it could be concluded that endodontic instrumentation with increased taper rotary instruments caused a decrease in fracture resistance of the teeth, and biomechanical preparation of root canal system with rotary or reciprocating instruments caused a significant decrease in fracture resistance of endodontically treated teeth (ETT), thereby decreasing their prognosis and long-term survival.
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Puleio F, Lo Giudice G, Militi A, Bellezza U, Lo Giudice R. Does Low-Taper Root Canal Shaping Decrease the Risk of Root Fracture? A Systematic Review. Dent J (Basel) 2022; 10:dj10060094. [PMID: 35735636 PMCID: PMC9222076 DOI: 10.3390/dj10060094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Minimal root-canal preparation has been suggested to reduce the risk of root fracture, but as a result, satisfactory cleaning and shaping do not take place. Large-scale taper instrumentation can contribute to removing infected tissue; however, it may weaken the tooth structure. The aim of this systematic review is to evaluate whether root-canal shaping with low-taper instruments decreases the risk of root fracture, compared to high-conicity shaping. A search was performed on Ovid MEDLINE, PubMed, and the Web of Science. The inclusion criteria were: studies comparing the root fracture resistance of endodontically treated teeth, shaped with low- and high-conicity taper instruments, in human trials, and via in vitro study. The review includes all types of endodontically treated teeth, with various instrument tapers. The scientific search engines produced 328 results. Only 20 of the results were evaluated after screening. Based on the articles analyzed, it is not clear whether a taper difference can determine differences in root fracture resistance. No randomized controlled trial (RCTs) with long follow-ups have been published to date. It must also be taken into account that the in vitro studies do not consider the numerous differences that there are between in vitro and clinical evaluation. The review was registered on the PROSPERO website, with the protocol number CRD42020151451.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
- Correspondence:
| | - Angela Militi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Ugo Bellezza
- Department of Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy;
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Bagheri R, Abbaszadegan A, Nabavizadeh MR, Ferooz M, Parashos P. Mathematical validation of measurement of root fracture resistance: an in vitro study. BMC Oral Health 2021; 21:503. [PMID: 34620146 PMCID: PMC8499452 DOI: 10.1186/s12903-021-01873-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to develop a mathematically valid method of assessing fracture resistance of roots. The model developed used mesial roots of lower molars instrumented using stainless steel hand files (SS) and two rotary nickel-titanium (NiTi) systems. Methods Eighty human lower molars were selected and randomly divided into four groups (n = 20). After instrumentation, the root canals were obturated using thermoplasticized gutta percha. The roots were covered with a simulated periodontal ligament and mounted vertically in autopolymerizing acrylic in PVC tubes. Using a universal testing machine, the force to fracture (N) was applied and the maximum load (FL) was recorded. Remaining dentine volume was calculated and the fracture resistance (FR) was recorded. The data were analyzed using SPSS version 22 with P < .05.
Results There were no significant differences among the instrumentation methods for FL but in FR the roots instrumented using rotary NiTi showed significantly lower values than control groups and SS files (P < 0.001). Conclusions Considering the effect of root length, volume of the root, and volume of the instrumented canal as well as the maximum failure load may be a more objective method of reporting fracture resistance of roots.
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Affiliation(s)
- Rafat Bagheri
- Dental Materials Department and Biomaterials Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad R Nabavizadeh
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ferooz
- Royal Australian Air Force, RAAF Base Williamtown, Williamtown, NSW, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, 720 Swanston St, Melbourne, VIC, 3010, Australia.
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Kılıç Y, Karataşlıoğlu E, Kaval ME. The Effect of Root Canal Preparation Size and Taper of Middle Mesial Canals on Fracture Resistance of the Mandibular Molar Teeth: An In Vitro Study. J Endod 2021; 47:1467-1471. [PMID: 34118255 DOI: 10.1016/j.joen.2021.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate the influence of root canal preparation size and taper of middle mesial (MM) canals on fracture resistance of mandibular molars. METHODS Fifty-five mandibular molar teeth having an MM canal were selected based on the cone-beam computed tomographic analysis. After the decoronation and distal root separation procedure, the lengths of the mesial roots were standardized to 13 mm. The specimens were randomly distributed into 5 groups (n = 11). Mesiobuccal and mesiolingual canals were prepared up to size 30.06 using VDW.ROTATE rotary files (VDW, Munich, Germany). The MM canal was prepared up to size 25.04, 25.06, 30.04, and 30.06, respectively. No preparation was done in the MM canal in the control group. After the irrigation protocol, the canals were obturated with the single-cone technique. A thin layer of silicone-coated specimens was embedded in acrylic resin and subjected to a fracture strength test by a universal testing machine. A vertical force was applied to the roots until they fracture. Statistical analysis was performed with 1-way analysis of variance and post hoc Duncan tests (P = .05). RESULTS There was no significant difference between group 25.04 and the control group, but the fracture strengths of these groups were found to be significantly higher than that of groups 25.06, 30.04, and 30.06 (P < .05). CONCLUSIONS Within the limitations of this study, we concluded that increasing the apical diameter and taper in the MM canal reduces the fracture strength of mandibular molar teeth. Among the tested instrumentation sizes, fracture strength decreased significantly when greater than 25.04 instrumentation sizes were chosen.
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Affiliation(s)
- Yağmur Kılıç
- Department of Endodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Emrah Karataşlıoğlu
- Department of Endodontology, Faculty of Dentistry, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mehmet Emin Kaval
- Department of Endodontology, Faculty of Dentistry, Ege University, Izmir, Turkey.
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Wright PP, Scott S, Shetty S, Kahler B, Walsh LJ. Resistance to compressive force in continuous chelation. AUST ENDOD J 2020; 47:150-156. [PMID: 32902070 DOI: 10.1111/aej.12440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
Continuous chelation involves the simultaneous use of sodium hypochlorite and a chelating agent. Given the combination of a proteolytic agent and a demineralising chelator, this study aimed to investigate whether mixtures containing the weak chelators etidronate or clodronate and sodium hypochlorite could adversely affect the mechanical strength of teeth compared to the sequence sodium hypochlorite/EDTA/sodium hypochlorite. Matching pairs of bovine teeth were tested on a universal testing machine, and the compressive load at fracture was recorded. One root from each pair was prepared with the sequence, and the matching tooth was prepared with either water, the clodronate mixture or the etidronate mixture. No differences in load at fracture were seen between either mixture and the sequence. However, loads were higher in the teeth irrigated with water compared to the sequence. The results indicated that the continuous chelation mixtures did not alter tooth mechanical properties compared to the standard sequence.
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Affiliation(s)
- Patricia P Wright
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Suzanne Scott
- Australian e-Health Research Centre, CSIRO, North Ryde, NSW, Australia
| | - Sowmya Shetty
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Bill Kahler
- School of Dentistry, University of Queensland, Herston, QLD, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Herston, QLD, Australia
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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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Krikeli E, Mikrogeorgis G, Lyroudia K. In Vitro Comparative Study of the Influence of Instrument Taper on the Fracture Resistance of Endodontically Treated Teeth: An Integrative Approach–based Analysis. J Endod 2018; 44:1407-1411. [DOI: 10.1016/j.joen.2018.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/01/2018] [Accepted: 05/06/2018] [Indexed: 10/28/2022]
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Impact of Access Cavity Design and Root Canal Taper on Fracture Resistance of Endodontically Treated Teeth: An Ex Vivo Investigation. J Endod 2018; 44:1402-1406. [PMID: 30049471 DOI: 10.1016/j.joen.2018.05.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/14/2018] [Accepted: 05/06/2018] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The susceptibility of endodontically treated teeth (ETT) to fracture is mainly associated with the loss of tooth structure. This study evaluated the effect of the access cavity design and taper preparation of root canals on ETT fracture resistance of maxillary molars. METHODS For tapering assessment, 30 sound distobuccal roots of maxillary molars were randomly assigned to 1 of 3 groups (n = 10): a .04 taper, a .06 taper, or a .08 taper. Endodontic canal preparations were performed using the Twisted Files rotary system (Kerr Co, Glendora, CA). In addition, 48 intact maxillary first and second molars were randomly assigned to 1 of 3 groups (n = 16) for cavity preparation approaches: intact teeth, traditional access cavity (TAC), or conservative access cavity (CAC). Fracture resistance was tested using a universal testing machine. For statistical analysis, the level of significance was P ≤ .05. RESULTS The .04 taper instrumentation had the highest fracture resistance (259.61 ± 52.06), and the .08 taper had the lowest (168.43 ± 59.63). The .04 and .06 groups did not differ significantly (P > .05); however, these groups differed significantly from the .08 group (P ≤ .05). Regarding the cavity preparation approaches, the 3 groups of intact teeth, CAC, and TAC showed fracture resistance mean values of 2118.85 ± 336.97, 1705.69 ± 591.51, and 1471.11 ± 435.34, respectively, with no significant difference between the CAC and TAC groups (P > .05). CONCLUSIONS Increasing the taper of the root canal preparation can reduce fracture resistance. Moreover, access cavity preparation can reduce resistance; however, CAC in comparison with TAC had no significant impact.
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Khoshbin E, Donyavi Z, Abbasi Atibeh E, Roshanaei G, Amani F. The Effect of Canal Preparation with Four Different Rotary Systems on Formation of Dentinal Cracks: An In Vitro Evaluation. IRANIAN ENDODONTIC JOURNAL 2018; 13:163-168. [PMID: 29707009 PMCID: PMC5911288 DOI: 10.22037/iej.v13i2.16416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Endodontic rotary systems may result in dentinal cracks. They may propagate to vertical root fracture that compromises the outcome of endodontic treatment. This study aimed to compare Neolix and Reciproc (single-file systems), Mtwo and ProTaper (conventional rotary systems) in terms of dentinal crack formation in root canal walls. Methods and Materials: This in vitro study was conducted on 110 extracted human single-rooted teeth. The teeth were randomly divided into four experimental groups (n=25) for root canal preparation with Neolix, Reciproc, Mtwo and ProTaper systems and two control groups (n=5). The first control group underwent root canal instrumentation with hand files while the second control group received no preparation and was only irrigated. After instrumentation, root canals were horizontally sectioned at 3, 6 and 9 mm from the apex and inspected under a stereomicroscope under 12× magnification for detection of cracks. The data were analyzed using Chi-square, GEE test and Bonferroni tests (P<0.05). Results: No crack was found in the control groups. All rotary systems caused dentinal cracks. ProTaper, Reciproc, Mtwo and Neolix caused cracks in 92%, 80%, 68% and 48% of samples. ProTaper caused significantly more cracks than Neolix and Mtwo (P<0.05). No significant differences were noted between other groups (P>0.05). Conclusion: All rotary systems cause dentinal cracks and it is significantly different in apical, middle and coronal third of the root. Neolix appears to be a suitable alternative to other rotary systems since use of this single-file system saves time and cost and minimizes trauma to dentinal walls.
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Affiliation(s)
- Elham Khoshbin
- Department of Endodontic Dentistry, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zakiyeh Donyavi
- Department of Endodontic Dentistry, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Abbasi Atibeh
- Department of Periodontology Dentistry, Dental School, Urmia University of Medical Sciences, Urmia, Iran
| | - Ghodratollah Roshanaei
- Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics and Epidemiology, Public Health School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faranak Amani
- Dental Center, Urmia Seyedoshohada Hospital, Urmia University of Medical Sciences, Urmia, Iran
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Pilo R, Metzger Z, Brosh T. Effect of root morphology on the susceptibility of endodontically treated teeth to vertical root fracture: An ex-vivo model. J Mech Behav Biomed Mater 2017; 69:267-274. [PMID: 28113131 DOI: 10.1016/j.jmbbm.2017.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/25/2016] [Accepted: 01/11/2017] [Indexed: 10/20/2022]
Abstract
Vertical root fracture (VRF) of endodontically treated teeth is relatively common, and the involved teeth have a poor prognosis. Previous destructive methodologies applied force to the root in an uneven manner; thus, the associated experiments could not truly assess the mechanical behavior of VRF. This problem was resolved in the current study via the novel application of a bursting pressure methodology to endodontically treated maxillary central incisors and premolars. Hydrostatic pressure was applied inside the root canal through a cannula bonded to the coronal access cavity, and the apical foramen was sealed. VRFs were observed as water burst from the fractured root surface. Morphometric parameters were measured by staining and serially sectioning the roots. The bursting pressure was significantly lower in the premolars compared with that in the incisors (19.1±3.3MPa and 25.5. ±4.5MPa, respectively, p=0.001). Cracks in the roots appeared from the apex to the cement enamel junction (CEJ) (61%), apex to mid-root (26%) and mid-root to CEJ (13%), and they involved either two root surfaces (52%) or one root surface (48%) and closely resembled clinical VRF cases. Positive correlations were found between the bursting pressure and the proximal root wall thickness, whereas correlations were not observed between the bursting pressure and the buccal or lingual wall thicknesses. Statistical Analyses of Covariance (ANCOVA) models showed that the proximal wall thickness and an elliptically shaped root cross section were the variables that indicated the differences in strength between premolars, which are more prone to VRF, and maxillary central incisors, which are less prone to VRF.
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Affiliation(s)
- Raphael Pilo
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Zvi Metzger
- Department of Endodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Tamar Brosh
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
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Pawar AM, Barfiwala D, Pawar M, Metzger Z, Kfir A, Jain N. Assessment of the fracture resistance of teeth instrumented using 2 rotary and 2 reciprocating files versus the Self-Adjusting File (SAF): An ex vivo comparative study on mandibular premolars. J Conserv Dent 2016; 19:138-42. [PMID: 27099419 PMCID: PMC4815541 DOI: 10.4103/0972-0707.178692] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Aim: Current ex vivo study compared fracture resistance of teeth instrumented using 5 endodontic files, filled with Gutta-percha and AH Plus. Materials and Methods: Sixty freshly extracted, single-rooted mandibular premolars were acquired and decoronated to obtain 15 mm segments. These samples were randomly divided into six groups (n = 10). Group 1 served as the control containing untreated samples (without instrumentation or filling). In Groups 2-6, samples were instrumented using rotary (Universal ProTaper and Revo-S), reciprocating (WaveOne and RECIPROC®), and self-adjusting file (SAF), respectively. Following instrumentation, the samples were filled by lateral compaction with Gutta-percha and AH Plus. A week later, after the sealer was completely set, a vertical load was applied to the specimen's canal in each group until fracture. The loads required for fracture were recorded, and statistical analysis was performed. Results: The mean fracture load differed significantly among the groups (P < 0.01; one-way ANOVA). Tukey's post-hoc tests revealed that the fracture resistance was similar in the control and SAF groups (P > 0.05) and was significantly higher than that of the 2 rotary and reciprocating groups (P < 0.01). Conclusion: The samples instrumented by the SAF exhibited a better fracture resistance.
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Affiliation(s)
- Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, D. Y. Patil Dental School and Hospital, Pune, Maharashtra, India
| | - Digesh Barfiwala
- Department of Conservative Dentistry and Endodontics, D. Y. Patil Dental School and Hospital, Pune, Maharashtra, India
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Zvi Metzger
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Anda Kfir
- Department of Endodontology, Tel Aviv University, Tel Aviv, Israel
| | - Niharika Jain
- Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
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14
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Çiçek E, Aslan MA, Akkoçan O. Comparison of the Resistance of Teeth Instrumented with Different Nickel-Titanium Systems to Vertical Root Fracture: An In Vitro Study. J Endod 2015. [PMID: 26211563 DOI: 10.1016/j.joen.2015.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study compared the fracture resistance of teeth instrumented with ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Next (PTN, Dentsply Maillefer), WaveOne (Dentsply Maillefer), Twisted File (SybronEndo, Orange, CA), Mtwo (MT; VDW, München, Germany), and Revo-S (MicroMega, Besançon, France) nickel-titanium systems and obturated with compatible gutta-percha cones of finishing files using the single-cone technique and a resin sealer. METHODS The study included 72 mandibular premolar teeth. The roots were covered with additive silicone and placed in Eppendorf tubes, which were filled with a self-curing acrylic. The tubes were separated into 6 groups: prepared with the ProTaper Universal (F4 40/.06) (group 1), prepared with the PTN (X4 40/.06) (group 2), prepared with the WaveOne reciprocating file (40/.08) (group 3), prepared with the Twisted File (40/.04) (group 4), prepared with the MT (40/.06) (group 5), and prepared with the Revo-S (AS 40/.06) (group 6). After the preparations were completed, all the teeth were filled with the appropriate gutta-percha systems. The force (N) was applied at a 1-mm/min crosshead speed until the roots fractured. Differences among the groups were analyzed by Tukey and analysis of variance tests. RESULTS Group 2 was the most resistant to fracture, and group 5 was the least resistant. The difference in the fracture resistance between the 2 groups was statistically significant (P = .019). The resistance of group 3 and group 6 to vertical root fracture was similar, and the resistance of group 4 was slightly lower than that of the other groups (P = .058). CONCLUSIONS The roots instrumented with the MT were the least resistant, and the roots instrumented with the PTN were the most resistant to VRF.
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Affiliation(s)
- Ersan Çiçek
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey.
| | - M Ali Aslan
- Department of Prosthodontics, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey
| | - Oğuzhan Akkoçan
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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15
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Nur BG, Ok E, Altunsoy M, Tanriver M, Capar ID. Fracture strength of roots instrumented with three different single file systems in curved root canals. Eur J Dent 2015; 9:189-193. [PMID: 26038648 PMCID: PMC4439844 DOI: 10.4103/1305-7456.156804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: The aim of this study was to compare the fracture strength of roots instrumented with three different single file rotary systems in curved mesial root canals of maxillary molars. Materials and Methods: Curvatures of 25°–35° on mesial roots of 60 maxillary molar teeth were sectioned below the cementoenamel junction to obtain roots 11 mm in length. The roots were balanced with respect to buccolingual and mesiodistal diameter and weight. They were distributed into three experimental groups and one control group (no instrumentation) (n = 15): Reciproc rotary file (R25, VDW, Munich, Germany), WaveOne Primary rotary file (Dentsply Tulsa Dental Specialties, Tulsa, UK) and OneShape (Micro-Mega, Besancon, France) rotary file. Vertical load was applied until fracture occurred. Data were statistically analyzed using one-way analysis of variance test (P < 0.05). Results: The mean fracture load was 412 ± 72 Newton (N) for the control group, 395 ± 69 N for the Reciproc group, 373 ± 63 N for the WaveOne group and 332 ± 68 N for the OneShape group. The fracture load differences among three experimental groups were not statistically significant (P > 0.05.) Whereas, the fracture loads of control and OneShape groups were significantly different (P = 0.012). Conclusions: Fracture resistance of the roots instrumented with WaveOne and Reciproc file systems were similar to the control group whereas it was observed that OneShape rotary file systems enhance the fracture strength of standardized curved roots when compared with the control group.
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Affiliation(s)
- Bilge Gulsum Nur
- Departments of Pedodontics, Faculty of Dentistry, Sifa University, Izmir, Turkiye
| | - Evren Ok
- Department of Endodontics, Faculty of Dentistry, Sifa University, Izmir, Turkiye
| | - Mustafa Altunsoy
- Departments of Pedodontics, Faculty of Dentistry, Sifa University, Izmir, Turkiye
| | - Mehmet Tanriver
- Departments of Pedodontics, Faculty of Dentistry, Sifa University, Izmir, Turkiye
| | - Ismail Davut Capar
- Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, Izmir, Turkiye
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16
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Grande NM, Plotino G, Sinibaldi R, Gambarini G, Somma F. The impact of endodontic anatomy on clinical practice: a micro-CT study and tribute to Prof. Francesco Riitano. GIORNALE ITALIANO DI ENDODONZIA 2015. [DOI: 10.1016/j.gien.2015.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Effect of the Size of the Apical Enlargement with Rotary Instruments, Single-cone Filling, Post Space Preparation with Drills, Fiber Post Removal, and Root Canal Filling Removal on Apical Crack Initiation and Propagation. J Endod 2015; 41:253-6. [DOI: 10.1016/j.joen.2014.10.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/15/2014] [Accepted: 10/18/2014] [Indexed: 11/20/2022]
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18
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Aydin U, Aksoy F, Karataslioglu E, Yildirim C. Effect of ethylenediaminetetraacetic acid gel on the incidence of dentinal cracks caused by three novel nickel-titanium systems. AUST ENDOD J 2014; 41:104-10. [DOI: 10.1111/aej.12097] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ugur Aydin
- Dentistry Faculty, Department of Endodontics; Gaziantep University; Gaziantep Turkey
| | - Fatih Aksoy
- Dentistry Faculty, Department of Endodontics; Gaziantep University; Gaziantep Turkey
| | - Emrah Karataslioglu
- Dentistry Faculty, Department of Endodontics; Gaziantep University; Gaziantep Turkey
| | - Cihan Yildirim
- Dentistry Faculty, Department of Endodontics; Gaziantep University; Gaziantep Turkey
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