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Araújo LBB, Calefi PHS, Alcalde MP, Gavini G, Vivan RR, Duarte MAH. Impact of kinematics on the efficiency and safety of an engine-driven file for glide path preparation in MB2 canals of maxillary molars. Clin Oral Investig 2023; 27:1153-1158. [PMID: 36104605 DOI: 10.1007/s00784-022-04712-6] [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: 03/31/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the influence of different kinematics on the efficiency and safety of an engine-driven file for glide path preparation in second mesiobuccal canals (MB2) of maxillary molars. In addition, the torsional resistance of the file was assessed after use. METHODOLOGY Thirty-six maxillary first and second molars with two canals in the mesiobuccal root were selected and the anatomy of the canals was verified by micro-CT. The teeth were divided into 4 groups (n = 9) according to the kinematics used for glide path preparation: continuous rotation (CR), 30°/150° reciprocation (REC 30°/150°), 30°/90° reciprocation (REC 30°/90°), and 90° optimum glide path motion (OGP 90°). The duration of the procedure, number of canals in which the file reached the full working length (RFWL), canal volume before and after the procedure, rate of file fracture, and file torsional strength after use were evaluated. The ANOVA and Tukey tests or Kruskal-Wallis and Dunn tests were used for statistical analysis. RESULTS No significant differences among the groups were found for procedure duration, success at reaching the FWL, distance from the file to apex, and number of fractured files (P > 0.05). The CR group showed a significant decrease in rotation angle compared with REC 90° and OGP 90° groups (P < 0.05). There was no significant difference in canal volume among the groups (P > 0.05). CONCLUSION The type of kinematics used did not affect the efficiency, success rate, and shaping ability of the file during glide path preparation. CR seems to induce more torsional stress than the other kinematics. CLINICAL RELEVANCE The glide path preparation of narrow canals such as the MB2 is difficult and accidents such as file fracture may occur. This study showed that reciprocation with different file angulations can be safer during this challenging stage.
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Affiliation(s)
- Larissa B B Araújo
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Pedro H S Calefi
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Murilo P Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Rodrigo R Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil.
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Atav Ateş A, Arıcan B, Çiftçioğlu E, Küçükay ES. Negotiating the second mesiobuccal canal: A comparison of nickel titanium files through the experience of undergraduate dental students. J Dent Educ 2023; 87:694-701. [PMID: 36625222 DOI: 10.1002/jdd.13165] [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: 06/06/2022] [Revised: 11/23/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The aim of this study was to compare the ability of undergraduate students to reach working length (WL) in second mesiobuccal root canals (MB2) of maxillary first molars (n = 210) by using Reciproc Blue without glide path preparation, and One Curve with glide path preparation. METHODS The students (n = 105) attended theoretical and practical courses. The first group (n = 53) shaped MB2 root canals using the One Curve system and then Reciproc Blue; the second group (n = 52) shaped MB2 root canals following the reverse sequence. Participants completed a questionnaire. The chi-square and Mann-Whitney U test were used for statistical analysis using significance of p < 0.05. RESULTS The full WL was reached and shaping procedures were completed without complications in Reciproc Blue and One Curve groups at rates of 86.67% and 82.85%, respectively (p > 0.05). Treatment time was shorter in Reciproc Blue (p < 0.05). More (62.9%) students felt the One Curve system safer, while 61% felt the Reciproc Blue system faster. CONCLUSIONS Within the limitations of this study, instrument kinematics and glide path preparation did not interfere with undergraduate students' ability to achieve the WL in MB2 root canals.
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Affiliation(s)
- Ayfer Atav Ateş
- Faculty of Dentistry, Department of Endodontics, Istinye University, Istanbul, Turkey
| | - Burçin Arıcan
- School of Dental Medicine, Department of Endodontics, Bahçeşehir University, Istanbul, Turkey
| | - Elif Çiftçioğlu
- Faculty of Dentistry, Department of Endodontics, Istanbul Okan University, Istanbul, Turkey
| | - Enver Sedat Küçükay
- Faculty of Dentistry, Department of Endodontics, Istanbul Okan University, Istanbul, Turkey
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Biasillo V, Castagnola R, Colangeli M, Panzetta C, Minciacchi I, Plotino G, Staffoli S, Marigo L, Grande NM. Comparison of shaping ability of the Reciproc Blue and One Curve with or without glide path in simulated S-shaped root canals. Restor Dent Endod 2022; 47:e3. [PMID: 36578274 PMCID: PMC8891470 DOI: 10.5395/rde.2022.47.e3] [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: 03/03/2021] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 02/01/2023] Open
Abstract
Objectives This study aimed to assess the impact of a glide-path on the shaping ability of 2 single-file instruments and to compare the centering ability, maintenance of original canal curvatures and area of instrumentation in simulated S-shaped root canals. Materials and Methods Forty simulated S-shaped root canals were used and were prepared with One Curve (group OC), One G and OC (group GOC), Reciproc Blue (group RB) and R-Pilot and RB (group PRB) and scanned before and after instrumentation. The images were analyzed using AutoCAD. After superimposing the samples, 4 levels (D1, D2, D3, and D4) and 2 angles (Δ1 and Δ2) were established to evaluate the centering ability and modification of the canal curvatures. Then, the area of instrumentation (ΔA) was measured. The data were analyzed using 2-way analysis of variance and Tukey's test for multiple comparisons (p < 0.05). Results Regarding the centering ability in the apical part (D3, D4), the use of the glide-path yielded better results than the single-file groups. Among the groups at D4, OC showed the worst results (p < 0.05). The OC system removed less material (ΔA) than the RB system, and for Δ1, OC yielded a worse result than RB (p < 0.05). Conclusions The glide-path improved the centering ability in the apical part of the simulated S-shaped canals. The RB system showed a better centering ability in the apical part and major respect of the canal curvatures compared with OC system.
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Affiliation(s)
- Vincenzo Biasillo
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaella Castagnola
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Colangeli
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudia Panzetta
- Physics Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Irene Minciacchi
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Simone Staffoli
- Department of Oral and Maxillo-Facial Science, Sapienza University of Rome, Rome, Italy
| | - Luca Marigo
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Maria Grande
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
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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: 11] [Impact Index Per Article: 5.5] [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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Xu F, Zhang Y, Gu Y, Ping Y, Zhou R, Wang J. Shaping ability of four single-file systems in the instrumentation of second mesiobuccal canals of three-dimensional printed maxillary first molars. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1425. [PMID: 34733977 PMCID: PMC8506727 DOI: 10.21037/atm-21-3855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022]
Abstract
Background This study evaluated and compared the shaping ability of four advanced single-file nickel-titanium (NiTi) systems during the preparation of curved second mesiobuccal (MB2) canals in maxillary first molar replicas fabricated by three-dimensional (3D) printing via micro-computed tomography (Micro-CT) imaging. Methods A total of 60 3D-printed maxillary first molar replicas were constructed from one extracted tooth, with an angle of curvature ranging from 15° to 25°. The MB2 canals from these 60 replicas were divided into 4 groups of 15 replicas according to the canal instrumentation system used, namely, Waveone gold (WOG), Reciproc blue (RCB), XP-endo shaper (XPS) and M3-L. The specimens were scanned before and after preparation using Micro-CT. The pre- and post-instrumentation images of each specimen were superimposed, and the amount of resin removed, the change in surface area, the canal transportation, and centering ability were assessed using the Mimics software. Instrumentation time was also recorded. One-way analysis of variance and least significant difference (LSD) tests were used to statistically compare the groups. The significance level was set at 5%. Results Instrumentation time with M3-L was significantly longer than the other systems (P<0.05). The amount of resin removed and the change in surface area generated by the 4 systems were different at the apical, middle, and coronal thirds, and the total canal (P<0.05). Overall, WOG and XPS resulted in the less change than RCB and M3-L. There was no significant difference among the groups at the middle third regarding canal transportation and centering ability (P>0.05). However, a significant difference was found at the apical level (P<0.05), where RCB showed the poorest centering ability and the highest canal transportation (P<0.05). In addition, XPS resulted in the least canal transportation (P<0.05) at the coronal level, while there was no significant difference between the four groups in terms of centering ability. Conclusions The M3-L instrument required more time to prepare the curved MB2 canals compared with the other systems. Overall, WOG and XPS showed the least resin removal and surface area change. M3-L, XPS, and WOG instruments respected the original canal curvature better than RCB files.
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Affiliation(s)
- Fulu Xu
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Yuerong Zhang
- Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.,Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Yongchun Gu
- Department of Dentistry, The Ninth People's Hospital of Suzhou, China
| | - Yifan Ping
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Ruyu Zhou
- Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Juan Wang
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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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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Analysis of second mesiobuccal root canal instrumentation in maxillary first molars with three nickel-titanium rotary instruments: a micro-computed tomographic study. Odontology 2020; 109:496-505. [PMID: 33175279 DOI: 10.1007/s10266-020-00564-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to evaluate the shaping characteristics of Protaper Universal (PTU; Dentsply Tulsa Dental Specialties, Johnson City, TN), Hero Shaper (HS; MicroMega, Besacon, France) and Hyflex CM (HCM; Coltene-Whaledent, Allstetten, Switzerland) nickel-titanium systems with various apical sizes and tapers in second mesiobuccal (MB2) canal instrumentation using micro-computed tomographic imaging. A total of 27 maxillary first molars with independent patent MB2 canals were selected and randomly assigned to three groups according to the 3-dimensional morphologic aspects obtained from preoperative micro-computed tomographic scans. Canals were first negotiated with a size 8 K-file and finally prepared to F1, F2, and F3 with PTU and to sizes 20.04 taper, 25.04 taper, and 30.04 taper with HS and HCM. Postoperative scans were performed after each instrumentation with the same parameters used in the initial scan. The canal volume, canal transportation, untouched canal surface and wall thickness were measured and calculated using Mimics 10.01 software (Image Works, Materialise, Belgium). Statistical analysis was performed using one-way analysis of variance post hoc LSD tests. PTU removed more dentin than HS and HCM in all sections when instrumented to the same apical size (P < 0.05). HS and HCM presented a lower mean value of canal transportation than PTU in all measured sizes and sections. PTU presented a lower mean value of distal wall thickness than HS and HCM at the level of 1 and 2 mm below the furcation region in all measured sizes. In conclusion, for MB2 canal instrumentation, HS and HCM of 0.04 taper are safer than PTU.
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Plotino G, Nagendrababu V, Bukiet F, Grande NM, Veettil SK, De-Deus G, Aly Ahmed HM. Influence of Negotiation, Glide Path, and Preflaring Procedures on Root Canal Shaping-Terminology, Basic Concepts, and a Systematic Review. J Endod 2020; 46:707-729. [PMID: 32334856 DOI: 10.1016/j.joen.2020.01.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/24/2019] [Accepted: 01/28/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Negotiation, glide path, and preflaring are essential steps in root canal shaping procedures. This report aimed to discuss the terminology, basic concepts, and clinical considerations of negotiation, glide path, and preflaring procedures and the influence of these steps on root canal shaping. METHODS This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (number CRD42019127021). A comprehensive literature search was performed by 2 independent reviewers using a selected search strategy in 2 electronic databases (PubMed and Scopus) until January 28, 2019. A further search was performed manually in endodontic journals. Studies investigating or comparing at least 1 shaping property resulting from root canal instrumentation with a glide path or preflaring in human extracted teeth or clinical studies were included. RESULTS The literature shows that the definition of glide path and preflaring procedures remains controversial, which requires an elaboration in the American Association of Endodontists' Glossary of Endodontic Terms. After the removal of irrelevant and duplicated articles, 98 articles were included. The impact of glide path preparation and preflaring on working length determination, apical file size determination, canal transportation, separation of endodontic files, shaping time, dentinal microcrack formation, and extrusion of debris was discussed. Because of heterogeneity among the included studies, quantitative synthesis was not performed for most of the parameters. CONCLUSIONS An evidence-based guideline is needed to define and correlate the basic concepts and current applications of each step of contemporary advancements in root canal instruments. Glide path preparation reduces the risk of debris extrusion, has no influence on the incidence of dentinal crack formation, and improves the preservation of the original canal anatomy. The creation of a glide path may have no impact on Reciproc files (VDW, Munich, Germany) in reaching the full working length. Preflaring increases the accuracy of working length determination. Further randomized clinical trials are required to evaluate the effect of a glide path and preflaring on root canal treatment outcomes.
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Affiliation(s)
| | - Venkateshbabu Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Frederic Bukiet
- Aix Marseille University, CNRS, ISM, Inst Movement Sci, Marseille, France; APHM, Hôpital Timone, Service d'Odontologie, Marseille, France
| | | | - Sajesh K Veettil
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Gustavo De-Deus
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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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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Szabó B, Garoushi S, Braunitzer G, Szabó P B, Baráth Z, Fráter M. Fracture behavior of root-amputated teeth at different amount of periodontal support - a preliminary in vitro study. BMC Oral Health 2019; 19:261. [PMID: 31775721 PMCID: PMC6882155 DOI: 10.1186/s12903-019-0958-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the effect of the amount of periodontal support on the fracture resistance of root-amputated maxillary molar teeth restored with either direct class. I. restorations or class II. mesio-occluso-distal (MOD) indirect overlay restorations with cuspal coverage. Methods Sixty sound maxillary first molars were collected and randomly divided into four groups. In Groups 1 and 2, MOD cavities were prepared and all cusps were reduced by 2 mm, whereas in Group 3 and 4, only a conservative Class I. cavity was prepared. Subsequently, root canal treatment was performed and the mesio-buccal roots were amputated. Groups 1 and 2 were restored with indirect composite overlay, while Groups 3 and 4 received direct composite fillings. After restoration, teeth were embedded as follows: Groups 1 and 3: normal bone level, Groups 2 and 4: furcation involvement. The specimens were submitted to static fracture resistance testing. Fracture thresholds and fracture patterns were measured and evaluated. Results Group 1 had the highest fracture resistance (2311,6 N) among the restored groups and showed statistically significant difference compared to Group 2 (p = 0.038) and Group 4 (p = 0.011). There was no statistically significant difference in terms of fracture resistance between the rest of the groups. In terms of the fracture patterns, Group 3 was characterized by the highest percentage (60%) of mostly favorable fractures, while the rest of the groups showed predominantly unfavorable ones. Conclusions The amount of periodontal support seems to influence the fracture resistance of root-amputated and restored maxillary molars.
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Affiliation(s)
- Balázs Szabó
- Department of Periodontology Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center -TCBC Institute of Dentistry, University of Turku, Turku, Finland
| | | | - Balázs Szabó P
- Department of Food Engineering Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Zoltán Baráth
- Department of Prosthodontics Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry Faculty of Dentistry, University of Szeged, Tisza Lajos Krt., 64-66, Szeged, H-6720, Hungary.
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Soligo LT, Lodi E, Farina AP, Souza MA, Vidal CDMP, Cecchin D. Antibacterial Efficacy of Synthetic and Natural-Derived Novel Endodontic Irrigant Solutions. Braz Dent J 2019; 29:459-464. [PMID: 30517444 DOI: 10.1590/0103-6440201802172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 06/21/2018] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to compare the efficacy of grape seed extract (GSE), calcium hypochlorite [Ca(ClO)2], and sodium hypochlorite (NaOCl) irrigant solutions with rotary or reciprocating instrumentation for disinfection of root canals inoculated with Enterococcus faecalis. The mesiobuccal root canals of mandibular molars were prepared and inoculated with Enterococcus faecalis for 21 days. The roots were then randomly divided into the following eight experimental groups (n=11) according to the instrumentation technique and disinfection protocol: ProTaper Next or Reciproc R25 with sodium chloride (control group), 6% NaOCl, 6% Ca(ClO)2, or 50% GSE used for irrigation during instrumentation. The antimicrobial activity was determined on the basis of a reduction in colony-forming units (CFUs) counted on bacterial samples collected before and after root canal instrumentation and expressed as a percentage of reduction. Data were evaluated by two-way ANOVA followed by Tukey HSD post-hoc tests (p<0.05). No significant differences were observed in bacterial reduction between the ProTaper Next and Reciproc R25 systems (p>0.05), regardless of the irrigant solution used. Furthermore, all active solutions (6% NaOCl, 50% GSE, and 6% Ca(ClO)2) showed similar potential to reduce bacterial counts (p>0.05) and were significantly more effective than sodium chloride (control) (p<0.05). The results suggest that the GSE and Ca(ClO)2 have potential clinical application as irrigant solutions in endodontic therapy since they present bactericidal efficacy against Enterococcus faecalis.
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Affiliation(s)
- Larissa Tais Soligo
- Department of Restorative Dentistry, School of Dentistry, UPF - Universidade de Passo Fundo, Passo Fundo, Brazil
| | - Ediléia Lodi
- Department of Restorative Dentistry, School of Dentistry, UPF - Universidade de Passo Fundo, Passo Fundo, Brazil
| | - Ana Paula Farina
- Department of Restorative Dentistry, School of Dentistry, UPF - Universidade de Passo Fundo, Passo Fundo, Brazil
| | - Matheus Albino Souza
- Department of Restorative Dentistry, School of Dentistry, UPF - Universidade de Passo Fundo, Passo Fundo, Brazil
| | | | - Doglas Cecchin
- Department of Restorative Dentistry, School of Dentistry, UPF - Universidade de Passo Fundo, Passo Fundo, Brazil
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Performance of Reciproc Blue R25 Instruments in Shaping the Canal Space without Glide Path. J Endod 2019; 45:194-198. [PMID: 30711177 DOI: 10.1016/j.joen.2018.10.011] [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: 08/14/2018] [Revised: 10/16/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This study assessed the frequency in which Reciproc Blue R25 instruments (VDW, Munich, Germany) reached the full working length (WL) of mandibular molar canals without a glide path. The influence of the type of electric motor (ie, conventional corded or cordless) on the instrument's performance was also assessed. METHODS One hundred mandibular molars with slight to moderate root canals were selected and randomly assigned into 1 of 2 experimental groups according to the type of electric motor used: conventional corded (VDW Silver, VDW) or cordless motors (VDW.CONNECT Drive, VDW). Therefore, 50 molars and 154 root canals were selected for each motor. Reciproc Blue R25 instruments were used until reaching two thirds of the estimated WL. Then, a size 10 K-file was passively inserted to determine the full WL. No active instrumentation movement was performed with a size 10 K-file. Independently, whether a size 10 K-file reached the apex or not, Reciproc Blue R25 instruments were used to complete canal preparation. When the Reciproc Blue R25 instrument was able to reach the full WL, the case was classified as "reaching the full working length" (RFWL). If the instrument was not able to reach the full WL, the case was classified as "not reaching the full working length" (NRFWL). The chi-square test of goodness of fit was used to verify whether the observed frequencies of RFWL and NRFWL adhered to the expected ones. A 5% cutoff level of significance was considered for statistical assumptions. RESULTS Reciproc Blue R25 instruments were able to reach the full WL in 304 root canals (98.70%). The chi-square test revealed the observed frequencies of RFWL and NRFWL to be significantly different from the expected frequencies (χ2 = 292,208, P = .000). The frequency of RFWL and NRFWL was exactly the same for both types of electric motors. No instrument fractured, and a single file deformed. In 50 of 308 root canals, a size 10 K-file was unable to passively reach the full WL. From these 50 canals, Reciproc Blue R25 instruments were able to reach the full WL in 47 of them. CONCLUSIONS Reciproc Blue R25 instruments were able to reach the full WL in a high frequency of cases. The type of electric motor used did not interfere in the frequency of RFWL cases. No instrument fractured, and a single file deformed.
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Camargo EJ, Duarte MAH, Marques VAS, Só MVR, Duque JA, Alcalde MP, Vivan RR. The ability of three nickel–titanium mechanized systems to negotiate and shape
MB
2 canals in extracted maxillary first molars: a micro‐computed tomographic study. Int Endod J 2018; 52:847-856. [PMID: 30548555 DOI: 10.1111/iej.13056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Affiliation(s)
- E. J. Camargo
- Division of Endodontics College of Dentistry University Center of Várzea Grande (UNIVAG) Várzea Grande, Matogrosso Brazil
| | - M. A. H. Duarte
- Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Bauru São Paulo Brazil
| | - V. A. S. Marques
- Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Bauru São Paulo Brazil
| | - M. V. R. Só
- Department of Operative Dentistry Rio Grande do Sul Federal University Porto Alegre Rio Grande do Sul Brazil
| | - J. A. Duque
- Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Bauru São Paulo Brazil
| | - M. P. Alcalde
- Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Bauru São Paulo Brazil
| | - R. R. Vivan
- Department of Operative Dentistry Endodontics and Dental Materials Bauru School of Dentistry University of São Paulo Bauru São Paulo Brazil
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Ordinola-Zapata R, Martins JNR, Versiani MA, Bramante CM. Micro-CT analysis of danger zone thickness in the mesiobuccal roots of maxillary first molars. Int Endod J 2018; 52:524-529. [DOI: 10.1111/iej.13025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 10/03/2018] [Indexed: 12/14/2022]
Affiliation(s)
- R. Ordinola-Zapata
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
- Bender Division of Endodontics; Albert Einstein Medical Center; Philadelphia PA USA
| | - J. N. R. Martins
- Department of Endodontics; Faculdade de Medicina Dentária; Universidade de Lisboa; Lisbon Portugal
| | - M. A. Versiani
- Department of Endodontics; Ribeirão Preto Dental School; University of São Paulo; Ribeirão Preto Brazil
| | - C. M. Bramante
- Department of Endodontics; Bauru Dental School; University of São Paulo; Bauru Brazil
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15
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Coelho MS, Rios MDA, Bueno CEDS. Separation of Nickel-Titanium Rotary and Reciprocating Instruments: A Mini-Review of Clinical Studies. Open Dent J 2018; 12:864-872. [PMID: 30505367 PMCID: PMC6210497 DOI: 10.2174/1745017901814010864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/26/2018] [Accepted: 09/23/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: This review aimed to evaluate clinical studies that assessed separated NiTi rotary and reciprocating instruments. Design and Methods: This review assessed clinical studies involving treatments performed by undergraduate students, graduate students, and endodontic specialists. This review evaluated studies using rotary instruments, reciprocating instruments, and hybrid techniques. The number of uses of the different NiTi rotary and reciprocating systems was also assessed. Results: The incidence of separation for rotary instruments ranged from 0% to 23%. Rotary instruments were used from 1 to 50 times depending on the instrument and tooth type. The lowest rate of incidence separation for rotary instruments was obtained by undergraduate students, using a hybrid technique. The separation incidence for reciprocating instruments ranged from 0% to 1.71%. Reciprocating instruments were mostly single-used; one study reported their use up to 3 times. Separation rate in reciprocating instruments was similar in single-use or in multiple uses 0.2%. Conclusions: Separation of instruments has dropped recently and seems to be a minor problem in current Endodontics. Multiple uses of NiTi rotary instruments are a possibility without significantly increasing the risk of instrument separation. Single and multiple uses of NiTi reciprocating instruments are also associated with low incidence of separation. Attempting to remove separated instruments should be carefully evaluated.
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Affiliation(s)
- Marcelo Santos Coelho
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil
| | - Marcos de Azevêdo Rios
- Department of Endodontics, State University of Feira de Santana, Feira de Santana, Brazil
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Coelho MS, Lacerda MFLS, Silva MHC, Rios MDA. Locating the second mesiobuccal canal in maxillary molars: challenges and solutions. Clin Cosmet Investig Dent 2018; 10:195-202. [PMID: 30288125 PMCID: PMC6159800 DOI: 10.2147/ccide.s154641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The second mesiobuccal canal in mesiobuccal roots in maxillary molars is a common finding in root canal treatments. Failure on the location of these canals is associated with a high rate of unsuccessful treatments of maxillary molars. Its prevalence has been assessed in several in vitro and in vivo studies, presenting variations according to the methodology applied, along with the population of interest. While the anatomy of these teeth is well defined in micro-computed tomography studies, the clinical management is a great challenge for the practitioner. The use of a dental operating microscope has rendered a better clinical outcome when considering the location and treatment of this canal. On the other hand, cone-beam computed tomography use is still controversial in the efficacy of MB2 canal location. The association of a dental operating microscope with troughing performed with ultrasonic tips is an essential step in this location. Moreover, sodium fluorescein might be applied for root canal location. Due to the high rate of unsuccessful cases when the MB2 canal is not initially found, several cases are performed aiming to address the cases of missed MB2 canals. Therefore, the clinician should discuss the best possible approach, whether surgical or clinical. This article presents an overview of the importance of the MB2 canal on the outcomes of root canal treatments of maxillary molars. Solutions based in current literature will be presented accordingly.
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Bartols A, Robra BP, Walther W. The ability of Reciproc instruments to reach full working length without glide path preparation: a clinical retrospective study. PeerJ 2017; 5:e3583. [PMID: 28804693 PMCID: PMC5550015 DOI: 10.7717/peerj.3583] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 06/26/2017] [Indexed: 11/20/2022] Open
Abstract
Background Reciproc instruments are the only contemporary root canal instruments where glide path preparation is no longer strictly demanded by the manufacturer. As the complete preparation of root canals is associated with success in endodontic treatment we wanted to assess the ability and find predictors for Reciproc instruments to reach full working length (RFWL) in root canals of maxillary molars in primary root canal treatment (1°RCTx) and retreatment (2°RCTx) cases. Methods This retrospective study evaluated 255 endodontic treatment cases of maxillary molars. 180 were 1°RCTx and 75 2°RCTx. All root canals were prepared with Reciproc instruments. The groups were compared and in a binary logistic regression model predictors for RFWL were evaluated. Results A total of 926 root canals were treated with Reciproc without glide path preparation. This was possible in 885 canals (95.6%). In 1°RCTx cases 625 of 649 (96.3%) canals were RFWL and in 2°RCTx cases 260 of 277 (93.9%). In second and third mesiobuccal canals (MB2/3) 90 out of 101 (89.1%) were RFWL with Reciproc in 1°RCTx and in the 2°RCTx treatment group 49 out of 51 cases (96.1%). In mesio-buccal (MB1) canals “2°RCTx” was identified as negative predictor for RFWL (OR 0.24 (CI [0.08–0.77])). In MB2/3 canals full working length was reached less often (OR 0.04 (CI [0.01–0.31])) if the tooth was constricted and more often if MB2/3 and MB1 canals were convergent (OR 4.60 (CI [1.07–19.61])). Discussion Using Reciproc instruments, the vast majority of root canals in primary treatment and retreatment cases can be prepared without glide path preparation.
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Affiliation(s)
- Andreas Bartols
- Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany.,Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Bernt-Peter Robra
- Institute of Social Medicine and Health Economics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Winfried Walther
- Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany
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Gomes AC, Soares AJ, Souza EM, Zaia AA, Silva EJNL. Intraoperative discomfort associated with the use of a rotary or reciprocating system: a prospective randomized clinical trial. Restor Dent Endod 2017; 42:140-145. [PMID: 28503480 PMCID: PMC5426220 DOI: 10.5395/rde.2017.42.2.140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/20/2017] [Indexed: 11/24/2022] Open
Abstract
Objectives The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used. Materials and Methods Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from ‘least possible discomfort’ (1) to ‘greatest possible discomfort’ (10). The Wilcoxon signed-rank test was used to determine significant differences at p< 0.05. Results Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660). Conclusions Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.
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Affiliation(s)
- Aline Cristine Gomes
- Department of Restorative Dentistry, Campinas State University (UNICAMP) Piracicaba School of Dentistry, Piracicaba, SP, Brazil
| | - Adriana Jesus Soares
- Department of Restorative Dentistry, Campinas State University (UNICAMP) Piracicaba School of Dentistry, Piracicaba, SP, Brazil
| | - Erick M Souza
- Department of Endodontics, Federal University of Maranhão (UFMA), São Luís, MA, Brazil
| | - Alexandre Augusto Zaia
- Department of Restorative Dentistry, Campinas State University (UNICAMP) Piracicaba School of Dentistry, Piracicaba, SP, Brazil
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