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Özlek E, Gündüz H. The Effect of Using Different Kinematics Single File Systems with Coronal Preflaring Instruments on Postoperative Pain with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial. J Endod 2023; 49:1625-1633. [PMID: 37722449 DOI: 10.1016/j.joen.2023.09.003] [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: 05/14/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the effect of using coronal preflaring file (One Flare; OF) with rotational (One Curve; OC) and reciprocal (WaveOne Gold; WOG) single file systems on postoperative pain in mandibular premolar teeth with symptomatic irreversible pulpitis. METHODS Eighty patients were included in this prospective, superiority, parallel, and randomized controlled clinical trial. The patients were randomly divided into four groups (n = 20) based on the use of coronal preflaring and the kinematics of the shaping instrument: WOG (without coronal preflaring), WOG with coronal preflaring (OF), OC (without coronal preflaring), and OC with coronal preflaring (OF). Patients recorded their postoperative pain intensity at 6, 24, 48, and 72 hours using a 10-cm visual analog scale. Friedman and Wilcoxon's tests were used for intragroup comparisons, and Kruskal-Wallis test was used for intergroup comparisons. The post hoc analysis was performed using Dunn's test. The Chi-square test was used to compare gender and tooth localization according to the groups, and Kruskal-Wallis test was used to compare age and preoperative pain (P < .05). RESULTS At 6 and 24 hours, WOG and OC with coronal preflaring groups showed statistically significantly lower pain scores than WOG and OC groups without coronal preflaring (P < .05). No significant difference was found between the groups in terms of analgesic medication intake. CONCLUSIONS The use of coronal preflaring with both rotational and reciprocal single file systems in root canal preparation resulted in less postoperative pain in mandibular premolar teeth diagnosed with symptomatic irreversible pulpitis.
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Affiliation(s)
- Esin Özlek
- Department of Endodontics, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey.
| | - Hüseyin Gündüz
- Department of Endodontics, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
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Yu D, Guo L, Gao J, Liu J, Yang D. Evaluation of apical extrusion of debris and centering ability in different nickel-titanium files during curved root canal preparation. BMC Oral Health 2023; 23:395. [PMID: 37322508 PMCID: PMC10273756 DOI: 10.1186/s12903-023-03070-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/22/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Curved root canals lead to difficulties in cleaning, shaping and filling the root canal system. Apical extrusion of debris and root canal transportation are important factors causing postoperative complications. In clinical practice, commonly selected instruments include multifile NiTi systems, such as M3-Pro PLUS (M3-PRO), Orodeka Plex 2.0 (ODP), Rotate (ROT), and Protaper Gold (PTG), as well as single-file NiTi systems, such as M3-L Platinum 2019 (M3L), Waveone Gold (WOG), and Reciproc Blue (RCB). This study aimed to comprehensively evaluate the differences in the apical extrusion of debris and centering ability of the above NiTi files. METHODS Seventy 3D-printed resin teeth were used (n = 10). The apically extruded debris was collected in a preweighed centrifuge tube. The resin teeth with or without root canal preparation were cut into separate cross sections at 1 mm, 3 mm, 5 mm, and 7 mm away from the root apex, and then the root canal transportation and centering ratio of each cross section were calculated. RESULTS Apical extrusion of debris was highest in RCB but lowest in OD-P (P < 0.05). Root call deviation was lowest in ROT at the 3 mm level, in PTG at the 5 mm level, and in PTG and ROT at the 7 mm level (P < 0.05). The centering ratio of NiTi files was highest in the RCB group at the 3 mm level, in the PTG group at the 5 mm level, in the ROT group at the 7 mm level (P < 0.05). CONCLUSIONS For NiTi files with the same system, the cross-sectional design is the greatest factor affecting the extrusion of debris, and motion mode is the second. In addition, the multifile system could reduce the degree of root canal transportation.
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Affiliation(s)
- Dongsheng Yu
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Li Guo
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Jing Gao
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Jie Liu
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Deqin Yang
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China.
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Gayatri S, Mathew S, Kumaravadivel K, Thangavel B, Thangaraj DN, Shaji A. Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth With Simulated Apical Root Resorption: An In Vitro Study. Cureus 2023; 15:e40904. [PMID: 37492825 PMCID: PMC10365891 DOI: 10.7759/cureus.40904] [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: 06/24/2023] [Indexed: 07/27/2023] Open
Abstract
Aim The aim of this study was to compare the amount of debris produced apically during the removal of root canal obturating material by using various files in extracted teeth with simulated apical root resorption. Materials and methods An in vitro study was conducted in the root canals of 90 extracted mandibular premolar teeth that were prepared with a ProTaper Gold rotary file (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and an AH Plus sealer (Dentsply Maillefer, Ballaigues, Switzerland) using a cold lateral compaction technique. A total of 45 mandibular premolar teeth were randomly assigned to three control groups (i.e., the ProTaper Universal retreatment file (Dentsply Maillefer), the Reciproc Blue file (VDW, Munich, Germany), and the HyFlex Remover file (Coltene/Whaledent, Altstatten, Switzerland) for the removal of root canal filling material, whereas the remaining 45 teeth were treated as the experimental group and their apical portion was modified to simulate apical root resorption. The teeth of this experimental group were randomly divided into three subgroups according to the same three techniques used with the control groups for the removal of root canal filling materials. The apically extruded debris was collected into pre-weighed borosilicate glass tubes and then dried. The mean weight of the apically extruded debris was assessed using an analytical balance to an accuracy of 10-4 g. Further, the data were analyzed using the Kruskal-Wallis test and Tukey's post hoc test. Results In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion than the groups without simulated root resorption (a < 0.05). In both the control groups and experimental groups, the ProTaper Universal retreatment file was associated with the least weight of the apically extruded debris (a < 0.05), followed by the Reciproc Blue file and the HyFlex Remover file. Conclusion The amount of debris extruded apically was significantly greater in the teeth with simulated apical root resorption than in those without it. Further, during the removal of the root canal filling materials, HyFlex Remover was associated with significantly more apically extruded debris in all groups.
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Affiliation(s)
- Sasti Gayatri
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Sebeena Mathew
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Karthick Kumaravadivel
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Boopathi Thangavel
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Deepa N Thangaraj
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Athira Shaji
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
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Quantitative Assessment of Apically Extruded Debris after Single-Files Supplemental Retreatment considering Apical Patency Influence: In Vitro Study. Int J Biomater 2022; 2022:7544813. [PMID: 36589768 PMCID: PMC9797296 DOI: 10.1155/2022/7544813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study aims to assess the impact of re-establishing apical patency on the quantity of debris extruded through the apex after three supplementary retreatment files (TruNatomy (TRN), WaveOne Gold (WOG), and XP endo Finisher R (XPFR)). Materials and Methods Eighty single-rooted mandibular premolars were prepared with ProTaper Universal rotary systems (PTU) up to F3 and obturated. The samples were divided into two main groups according to the presence or absence of the apical patency (n = 40), GI with apical patency and GII without apical patency. Based on the file system, which was adopted to eliminate the previous filling, each group had four subgroups (n = 10). In GI PTUR and GII PTUR, ProTaper Universal retreatment files (PTUR) were utilized only to remove the most primary filling material (control groups). In the other groups (PTUR) used, it was first followed by supplementary files. The quantity of debris extruded by different retreatment file systems was determined and compared to the corresponding control group with or without apical patency. Data were analyzed using a two-way ANOVA with a post hoc Tukey's multiple comparison test at a 5% significance level. Results There was a statistically significant difference among the control and experimental groups. XPFR had the least quantity of extruded debris. Apical patency did not affect the debris extrusion. Conclusion All tested files led to a significant apical debris extrusion regardless of apical patency.
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SERÇE FİKİRLİ B, ALTUNKAYNAK B, KAYAOĞLU G. Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.945129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method: Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.
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Affiliation(s)
| | | | - Güven KAYAOĞLU
- Department of Endodontics, Faculty of Dentistry, Gazi University
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Furtado JC, Feiosa APOP, Vivacqua-Gomes N, Bernardes RA, Vivan RR, Duarte MAH, Vasconcelos BCD. Root canal length changes during mechanical preparation due to different cervical enlargement patterns. Braz Oral Res 2022; 36:e080. [PMID: 35703706 DOI: 10.1590/1807-3107bor-2022.vol36.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the root canal real length (RL) changes due to the mechanical instrumentation use with different flaring magnitudes. After access cavity, 60 mesial root canals of mandibular molars were randomly separated in three groups: Hyflex EDM (HF; #25/.12, #10/.05 e #25/~), Reciproc Blue (RB; R25), and MTwo (M2; #10/.04, #15/.05, #20/.06 e #25/.06). The RL was defined as the apical limit, and 2.5% sodium hypochlorite irrigating solution was chosen. After the access cavity (RL 1), cervical flaring (RL 2), and complete chemical-mechanical preparation (RL 3), the RL was evaluated. The RL was evaluated by a blind examiner with the aid of a microscope (16x) placing the endodontic file stop at the coronary reference. When comparing length measurements, the RL was shorter before instrumentation than that after instrumentation. A reduction of 0.65 mm (HF), 0.61 mm (RB), and 0.48 mm (M2) was observed. However, among groups, no statistical differences were found (p > 0.05). Under the conditions tested, it can be inferred that all mechanical systems provoked RL variations, which emphasizes the need for constant verification of the odontometry, mainly before root canal obturation.
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Affiliation(s)
| | | | - Nilton Vivacqua-Gomes
- São Leopoldo Mandic University , School of Dentistry of Ceará , Fortaleza , CE , Brazil
| | | | - Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru Dental School , Department of Dentistry, Endodontics and Dental Materials , Bauru , SP , Brazil
| | - Marco Antônio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School , Department of Dentistry, Endodontics and Dental Materials , Bauru , SP , Brazil
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Comparative Evaluation of Apically Extruded Debris during Pulpectomy Procedure in Primary Molar Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study. Int J Dent 2022; 2022:9433225. [PMID: 35706458 PMCID: PMC9192212 DOI: 10.1155/2022/9433225] [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: 03/27/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Successful outcome of endodontic treatment depends on chemomechanical preparation of the tooth. However, during canal preparation, debris may extrude through the apical foramen causing postoperative complications. The aim of this study is to evaluate and compare the amount of apically extruded debris during the pulpectomy procedure in primary molar teeth using two different rotary files and hand files. Materials and Methods Distal roots of sixty extracted primary molars were divided into three groups: group A: Prime Pedo™ pediatric rotary files, group B: DXL-Pro Pedo™ pediatric rotary files, and group C: hand files. Myers and Montgomery experimental model was used. Preweighed Eppendorf tubes were used to collect apically extruded debris. The tubes were then placed in an incubator at 70°C for 5 days. The weight of the debris attained was determined. The data were analyzed using ANOVA and post hoc Bonferroni test. Results Hand files produced more apical debris extrusion (P < 0.05). Prime Pedo™ pediatric rotary files produced the least debris (P < 0.05). Conclusion Prime Pedo™ and DXL-Pro Pedo™ pediatric rotary files extruded significantly lower amount of debris apically during pulpectomy as compared to hand files. Rotary files can be considered an alternative to hand files in pediatric endodontics.
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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10
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Gurawa A, Mohana P, Abraham D, Gupta A, Chauhan P, Singh A, Jala S. Quantitative evaluation of apically extruded debris during root canal preparation with reciprocating single file system, continuous rotary multiple file system and manual technique: An in vitro study. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_167_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An in vitro study. J Conserv Dent 2022; 25:547-554. [PMID: 36506635 PMCID: PMC9733558 DOI: 10.4103/jcd.jcd_273_22] [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: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
Background Guided conservative endodontic access is a novel technique and the influence of such access cavities on apical debris extrusion (ADE) can have a significant effect on postoperative pain. Objective This study compared ADE and preparation time (PT) in the mesial canals of the mandibular first permanent molars in different access cavity designs and the amount of sodium hypochlorite in the extruded debris using attenuated total reflection-Fourier transform infrared spectrometer (ATR-FTIR). Materials and Methods Human mandibular first permanent molars (N = 72) were selected and randomly divided into six groups (n = 12) based on type of cavity design and files used: Group 1, Conservative Access Cavity [ConsAC])-WaveOne Gold; Group 2, ConsAC-Mtwo; Group 3, ConsAC-XP-endo shaper; Group 4, Traditional Access Cavity [TradAC])-WaveOne; Group 5, TradAC-Mtwo; and Group 6, TradAC-XP-endo shaper. All the ConsAC were prepared with a customized template fabricated using cone beam computed tomography. ADE evaluation was done using the Myers and Montgomery set up. All the instruments were used according to the manufacturers' instructions, followed by a final irrigation using Endoactivator. The time taken for preparation was calculated using a digital watch. Five samples in each group was taken and subjected to ATR-FTIR analysis. Results There was no significant difference between the groups with respect to ADE (P > 0.05). Whereas, a statistically significant difference was seen in PT between the TradAC and ConsAC (P < 0.05). Using ATR-FTIR, it was found that all the samples of extruded debris had the presence of sodium hypochlorite. Conclusions All instrumentation systems produced ADE irrespective of access cavity design. The time taken for preparation of canals in ConsAC was significantly longer compared to TradAC. Clinical Relevance ADE can translate clinically as postoperative pain. Assessing the ADE in ConsAC could shed light on the type of file systems that can be used in such cavities in order to minimize postoperative pain clinically.
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Affiliation(s)
- Sathish Sundar
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Sathish Sundar, Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, No. 1, Alapakkam Main Road, Maduravoyal, Chennai - 600 095, Tamil Nadu, India. E-mail:
| | - Aswathi Varghese
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
| | - Krithika J. Datta
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
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Filho GS, Guedes OA, Pereira TM, Miranda-Pedro FL, Aranha AMF, de Oliveira HF, Pécora JD, Borges ÁH. Residual Dentin Thickness in Bifurcated Maxillary Premolars after Cervical Preflaring Preparation: A CBCT Analysis. Open Dent J 2021. [DOI: 10.2174/1874210602115010495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
This study evaluated the residual dentin thickness (RDT) of maxillary premolars after the use of different cervical preflaring (PF) drills by using cone-beam computed tomography (CBCT).
Methods:
Eighty bifurcated maxillary premolars were accessed and randomly divided into 5 groups (n=16). PF was performed with Gates-Glidden #1, #2, and #3 (group 1), Largo #1 and #2 (group 2), and LA Axxess #20/.06 (group 3), #35/.06 (group 4), and #45/.06 (group 5). CBCT images were acquired before (preoperative) and after (postoperative) PF. Initial and final cervical dentin thickness was measured at the buccal, palatal, mesial, and distal aspects, 0.5 mm coronally to the furcation, on both buccal and palatal roots, using CBCT’s image analysis software. The percentage of removed dentin after PF preparation was also calculated. Data were analyzed using ANOVA followed by Tukey’s test at a significance level of P < 0.05.
Results:
No statistically significant differences were found among the groups for preoperative or postoperative RDT (P > 0.05). LA Axxess #20/.06 (group 3) removed significantly less cervical dentin at all root canal aspects on both buccal and palatal roots. The mesial aspect of the buccal root and distal aspect of the palatal root were significantly reduced after the use of LA Axxess #45/.06 (group 5) and Largo #1 and #2 drills (group 2), respectively (P < 0.05).
Conclusion:
PF in bifurcated maxillary premolars should be performed with LA Axxess instrument #20/.06. The use of Gates-Glidden #1, #2, and #3, Largo #1 and #2, and LA Axxess #45/.06 drills should be done with caution.
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Evaluation of Cyclic Fatigue and Bending Resistance of Coronal Preflaring NiTi File Manufactured with Different Heat Treatments. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Coronal preflaring NiTi files should possess proper hardness, resistance to fracture and flexibility. This study compared the bending resistance and cyclic fatigue resistance of three orifice preflaring NiTi files. HyFlex EDM Orifice opener (#25/12), HyFlex CM (#25/08) and One Flare (#25/09) were tested (n = 46/instrument). Bending resistance was assessed with the stress when perpendicular displacement was applied to a 3 mm point from the file tip, and was performed at either room temperature (RT, n = 10) or body temperature (BT, n = 10). Cyclic fatigue resistance was tested with an artificial ceramic root canal at RT (n = 10) and BT (n = 10), and the number of cycles to failure (NCF) was obtained. The bending resistance and the NCF results were analyzed by two-way ANOVA and Tukey’s test. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analyses were performed (n = 3, respectively). HyFlex EDM exhibited the highest bending resistance, followed by One Flare and HyFlex CM (p < 0.05), irrespective of the tested temperature. At RT, HyFlex CM demonstrated the highest NCF (p = 0.001), while HyFlex EDM had the highest NCF at BT (p < 0.001). The tested NiTi files were composed of austenite and martensite according to the DSC and XRD results. HyFlex EDM had the highest bending resistance and NCF measured at BT.
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Kırıcı D, Koç S, Kuştarcı A. Effects of different glide path techniques on the amount of extruded debris and preparation times during root canal preparation. J Dent Res Dent Clin Dent Prospects 2021; 14:187-190. [PMID: 33408825 PMCID: PMC7770400 DOI: 10.34172/joddd.2020.031] [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: 03/01/2020] [Accepted: 04/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background. This study purposed to compare the effect of new single glide path files on extruded apical debris and total preparation times during root canal preparation with the WaveOne Gold system.
Methods. Thirty-six extracted human lower molar teeth with mesiobuccal canal curvature angles of 25‒35° were randomly splited to three groups. In group 1, the glide path was created with WaveOne Gold Glider (WGG) file at working length (WL); in group 2, the glide path was created with ProGlider file (PG); in group 3, the glide path was not performed. In all the groups, the root canals were shaped with WaveOne Gold Primary (WOG) reciprocating files at WL. Apically extruded debris during instrumentation was picked up into pre-weighed Eppendorf tubes. The weight of the dry extruded debris was calculated by subtracting the pre- and post-instrumentation weights of the tubes in each group. The total time elapsed during the canal preparation was calculated with a chronometer. The data were analyzed using one-way ANOVA and post hoc Tukey tests.
Results. The WGG/WOG group extruded significantly fewer debris than the WOG and PG/WOG groups (P<0.05). There was no significant difference between the WOG and PG/WOG groups (P>0.05). The WGG/WOG and PG/WOG groups were significantly faster than the WOG group.
Conclusion. The amount of debris extruded apically significantly diminished when conventional WGG was implemented before using WOG. The total preparation time significantly diminished when the WOG file was used in combination with reciprocating and rotary glide path preparation techniques.
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Affiliation(s)
- Damla Kırıcı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Simay Koç
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Kuştarcı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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15
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Hazar E, Özdemir O, Koçak M, Sağlam B, Koçak S. Apical debris extrusion of single-file systems in curved canals. ENDODONTOLOGY 2021. [DOI: 10.4103/endo.endo_105_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Ates AA, Arıcan B, Testarelli L, Gambarini G, Zanza A, Seracchiani M. Influence of Clinical Operative Technique on Debris Extrusion of Two Reciprocating Files. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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17
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Düzgün S, Topçuoğlu HS, Kahraman Ö. Evaluation of apically extruded debris during the canal preparation using new heat-treated nickel-titanium files in curved canals. AUST ENDOD J 2020; 47:54-58. [PMID: 33159482 DOI: 10.1111/aej.12459] [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: 07/16/2020] [Revised: 10/01/2020] [Accepted: 10/21/2020] [Indexed: 11/29/2022]
Abstract
This study compared the amount of apically extruded debris associated with different heat-treated Ni-Ti rotary systems during the preparation of curved root canals of mandibular molars. Sixty extracted human mandibular molars were selected. EdgeFile, K3XF, OneCurve (OC) and ROTATE files were used to prepare both mesial canals of teeth. The initial weight of each Eppendorf tube to be used was calculated using an analytical balance prior to instrumentation. After instrumentation, the tubes were then stored for 5 days in an incubator at 70°C. Each tube was reweighed, and the weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. All files caused apical extrusion of debris. There was no statistical difference between the ROTATE, EdgeFile, OC and K3XF systems (P > 0.05). All the heat-treated Ni-Ti rotary systems led to similar apical debris extrusion during the canal preparation.
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Affiliation(s)
- Salih Düzgün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Ömür Kahraman
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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18
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Melo AM, Vivacqua-Gomes N, Bernardes RA, Vivan RR, Duarte MAH, Vasconcelos BCD. Influence of Different Coronal Preflaring Protocols on Electronic Foramen Locators Precision. Braz Dent J 2020; 31:404-408. [PMID: 32901717 DOI: 10.1590/0103-6440202003282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/04/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the influence of different coronal preflaring protocols (absent, conservative and conventional) on the accuracy of Root ZX II, Raypex 6, and RomiApex A-15 electronic foramen locators (EFLs). Twenty mandibular molars with Vertucci's type IV mesial roots were subjected to endodontic exploration and foraminal patency confirmation. Under 16x magnification, its real lengths (RL) were measured and registered (RL1). The canals were then irrigated with 2.5% sodium hypochlorite and electronically measured (EM1) employing the alginate model; all measurements were performed in triplicate by a blind operator using adjusted endodontic hand-files introduced until the apex foramen. Coronal preflaring procedures were sequentially performed with #25/.06 (conservative) and #25/.12 (conventional) instruments; new RLs extents were performed after each coronal preparation protocol (RL2/RL3), as same as electronic measurements (EM2/EM3). The devices error (mm) was evaluated considering the difference between RLs and EMs at each preparation stage; their precision was stablished adopting ±0.5 mm as tolerance margin. The EFLs error significantly reduced after conventional coronal preflaring protocol (p<0.05), which not occur after the conservative one. The best precisions values were noted after conventional preparation as 90% (Root ZX II), 97.5% (Raypex 6), and 92.5% (RomiApex A-15). No significant differences were found in EFLs comparisons, regardless of the coronal protocol tested (p>0.05). Under the conditions tested it can be concluded that the EFLs evaluated were precise. Moreover, the preflaring protocols influences its accuracy's, where the less conservative one produced the best results.
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Affiliation(s)
- Andrélia Maciel Melo
- School of Dentistry of Ceará, Faculdade São Leopoldo Mandic, Fortaleza, CE, Brazil
| | | | | | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, USP - Universidade de São Paulo, Bauru, SP, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, USP - Universidade de São Paulo, Bauru, SP, Brazil
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Keskin C, Sivas Yilmaz Ö, Inan U. Apically extruded debris produced during glide path preparation using R-Pilot, WaveOne Gold Glider and ProGlider in curved root canals. AUST ENDOD J 2020; 46:439-444. [PMID: 32820600 DOI: 10.1111/aej.12428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022]
Abstract
The present study aimed to compare the apically extruded debris produced during glide path preparation using R-Pilot (RP), WaveOne Gold Glider (WGG) and ProGlider (PG) with the subsequent preparation using Reciproc Blue in curved root canals. Mesial roots of mandibular molars with angle of curvature between 25° and 35° were selected (n = 20). The Myers and Montgomery method was used to collect and assess apically extruded debris. The glide path was prepared either manually with K-file, ProGlider, R-Pilot or WaveOne Gold Glider. Manual preparation group produced the highest amount of apically extruded debris (P < 0.05), while all groups caused debris extrusion. There were no significant differences among the extruded debris caused by RP, PG and WGG groups (P > 0.05). Apically extruded debris produced by engine-driven reciprocational or continuous rotational single file glide path instruments was similar, whereas manual glide path preparation was associated with the greatest amount of extruded debris.
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Affiliation(s)
- Cangül Keskin
- Faculty of Dentistry, Department of Endodontics, Ondokuz Mayis University, Samsun, Turkey
| | - Özlem Sivas Yilmaz
- Faculty of Dentistry, Department of Endodontics, Ondokuz Mayis University, Samsun, Turkey
| | - Uğur Inan
- Faculty of Dentistry, Department of Endodontics, Ondokuz Mayis University, Samsun, Turkey
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20
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ALTUNBAŞ D, TOYOĞLU M. THE INFLUENCE OF DIFFERENT TORQUE SETTINGS ON THE AMOUNT OF APICALLY EXTRUDED DEBRIS DURING ROTARY INSTRUMENTATION. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.691090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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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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22
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da Silva PB, Duarte SF, Alcalde MP, Duarte MAH, Vivan RR, da Rosa RA, Só MVR, do Nascimento AL. Influence of cervical preflaring and root canal preparation on the fracture resistance of endodontically treated teeth. BMC Oral Health 2020; 20:111. [PMID: 32299409 PMCID: PMC7161170 DOI: 10.1186/s12903-020-1050-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 02/24/2020] [Indexed: 11/16/2022] Open
Abstract
Background Evaluate the fracture resistance of endodontically treated teeth after cervical preflaring and root canal preparation and to assess the volume of the root canal and the amount of remaining root dentin before and after cervical preflaring. Methods Forty-four mandibular incisors were selected using micro-CT scanning and distributed into 4 groups (n = 11) according to the instrument used for cervical preflaring: control group - no cervical preflaring; Gates Glidden – burs size #2 and #3; WXN – 25.07 Navigator instrument; and Easy – 25.08 ProDesign S instrument. Coronal opening was performed, and the canals were prepared with Wave One Gold Primary and filled with an epoxy-resin based sealer and gutta-percha cones. Micro-CT scans were performed before and after root canal instrumentation. All images were reconstructed and assessed for the thickness of mesial and distal root dentin at 3 mm and 5 mm from the cement -enamel junction and for the volume of cervical portion of the canal after preparation. Fracture resistance test was performed applying compressive loads at a crosshead speed of 0.5 mm/min, applied on the palatal aspect of specimens at 135° along the long axis of the tooth. The data were analyzed using ANOVA and Tukey’s test (P = .05). Results Cervical preflaring and canal preparation reduced the dentin thickness (P < .05) and increased the canal volume (P < .05) in all groups at 3 mm an 5 mm. Cervical preflaring with Gates Gliden burs reduced the fracture resistance of endodontically treated teeth (P < .05). Conclusions All instruments reduced the dentin thickness and increased the canal volume in the cervical at 3 mm and 5 mm. Gates Glidden reduced fracture resistance of mandibular incisors submitted to cervical preflaring, whereas NiTi instruments did not. Clinical relevance Cervical preflaring assumes particular importance previously to the root canal preparation because it minimizes the occurrence of operative accidents, and permits more accurate determination of working length and the apical diameter.
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Affiliation(s)
- Paula Barcellos da Silva
- Departamento de Odontologia Conservadora, Universidade Federal do Rio Grande do Sul, 2492 Ramiro Barcelos Street, Porto Alegre, RS, 90035-003, Brazil
| | - Simone Ferreti Duarte
- Departamento de Odontologia Conservadora, Universidade Federal do Rio Grande do Sul, 2492 Ramiro Barcelos Street, Porto Alegre, RS, 90035-003, Brazil
| | | | | | | | - Ricardo Abreu da Rosa
- Departamento de Odontologia Conservadora, Universidade Federal do Rio Grande do Sul, 2492 Ramiro Barcelos Street, Porto Alegre, RS, 90035-003, Brazil
| | - Marcus Vinícius Reis Só
- Departamento de Odontologia Conservadora, Universidade Federal do Rio Grande do Sul, 2492 Ramiro Barcelos Street, Porto Alegre, RS, 90035-003, Brazil.
| | - Angela Longo do Nascimento
- Departamento de Odontologia Conservadora, Universidade Federal do Rio Grande do Sul, 2492 Ramiro Barcelos Street, Porto Alegre, RS, 90035-003, Brazil
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23
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Topçuoğlu HS, Demirbuga S, Topçuoğlu G. Evaluation of apically extruded debris during the removal of canal filling material using three different Ni-Ti systems and hand files in teeth with simulated apical root resorption. Int Endod J 2019; 53:403-409. [PMID: 31605377 DOI: 10.1111/iej.13234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 01/23/2023]
Abstract
AIM To compare the weight of apically extruded debris produced during the removal of root canal filling material using various files in extracted teeth with simulated apical root resorption. METHODOLOGY The root canals of one hundred and twenty extracted mandibular premolar teeth were prepared with Revo-S files and filled using a cold lateral compaction technique with gutta-percha and a resin-based sealer (AdSeal; Meta-Biomed, Cheongwon, Korea). Sixty teeth were randomly assigned to four control groups (hand file, ProTaper Universal retreatment file, D-RaCe retreatment file, and Reciproc file) for the removal of root canal filling material. The apical portion of the remaining 60 teeth was modified to simulate apical root resoption, and the teeth were then randomly divided into 4 experimental groups (using the same techniques as in the control groups) for the removal of root canal filling material. Apically extruded debris was collected into pre-weighed Eppendorf tubes and then dried. The mean weight of the apically extruded debris was assessed with an analytical balance to an accuracy of 10-4 g. Data were analysed using two-way analysis of variance and a Tukey's post hoc test. RESULTS In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion compared to the groups without simulated resorption (P < 0.05). The amount of apically extruded debris was greatest in the hand file groups compared with the other groups (P < 0.05). In the groups with simulated apical root resorption, the Reciproc system was associated with the least weight of apically extruded debris (P < 0.05), whereas there was no significant difference between the ProTaper Universal retreatment and D-RaCe files (P > 0.05). In the groups without simulated apical root resorption, there was no significant difference between Reciproc, ProTaper Universal retreatment and D-RaCe retreatment files (P> 0.05). The time required to remove the root canal filling material was as follows: hand file > ProTaper Universal retreatment = D-RaCe retreatment > Reciproc (P < 0.05). CONCLUSIONS The weight of apically extruded debris was significantly greater in teeth with simulated apical root resorption than in those teeth without simulated apical root resorption. Hand files were associated with significantly more apically extruded debris in all groups during removal of root canal filling material.
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Affiliation(s)
- H S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - S Demirbuga
- Department of Restorative Dentistry, Erciyes University, Kayseri, Turkey
| | - G Topçuoğlu
- Private Practice in Pedodontics, Kayseri, Turkey
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24
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Pappen FG, Xavier SR, Pilownic KJ, Santos LGP, Gomes APN, Felix AC, Demarco FF, Souza EM. Impact of infected and noninfected human dentine debris on bone healing in rats. Int Endod J 2019; 52:1679-1690. [DOI: 10.1111/iej.13178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- F. G. Pappen
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - S. R. Xavier
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - K. J. Pilownic
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - L. G. P. Santos
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - A. P. N. Gomes
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - A. C. Felix
- Central Vivarium Federal University of Pelotas PelotasBrazil
| | - F. F. Demarco
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luis Brazil
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Doğanay Yıldız E, Arslan H. The effect of blue thermal treatment on endodontic instruments and apical debris extrusion during retreatment procedures. Int Endod J 2019; 52:1629-1634. [PMID: 31131904 DOI: 10.1111/iej.13161] [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] [Received: 01/08/2019] [Accepted: 05/22/2019] [Indexed: 01/03/2023]
Abstract
AIM To determine the effect of blue thermal treatment on Reciproc (VDW, Munich, Germany) endodontic instruments and the amount of apically extruded debris during retreatment procedures. METHODOLOGY Thirty extracted mandibular molar teeth having mesial roots with a degree of curvature less than 20° and having an initial apical size equivalent to a size 10 K-file were selected. The mesial roots of the teeth were removed from the cementoenamel junction to obtain a 15-mm root length. The mesiobuccal canals were prepared to size F2 using the ProTaper Universal system (Dentsply Sirona, Ballaigues, Switzerland), filled with gutta-percha and 2Seal (VDW) using the lateral compaction technique and then randomly divided into two groups (n = 15). The root fillings were removed with one of the following instruments using a crown-down preparation technique: M-Wire Reciproc or Reciproc Blue (both VDW). Apically extruded debris was collected in pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70 °C for five days to evaporate the distilled water. The data were analysed using the Mann-Whitney U test (P = 0.05). RESULTS Reciproc Blue (1.42 ± 0.4491 mg) extruded significantly less debris apically than M-Wire Reciproc (2.56 ± 1.0232 mg) (P < 0.05). CONCLUSIONS Blue thermal treatment of Reciproc instruments was associated with less debris extrusion during retreatment procedures.
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Affiliation(s)
- E Doğanay Yıldız
- Department of Endodontics, Faculty of Dentistry, Kırıkkale University, Kırıkkale, Turkey
| | - H Arslan
- Department of Endodontics, Faculty of Dentistry, Health Sciences University, İstanbul, Turkey
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26
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Mendonça de Moura JD, Bueno CEDS, Fontana CE, Pelegrine RA. Extrusion of Debris from Curved Root Canals Instrumented up to Different Working Lengths Using Different Reciprocating Systems. J Endod 2019; 45:930-934. [PMID: 31109752 DOI: 10.1016/j.joen.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the extrusion of debris associated with the use of the Reciproc (VDW GmbH, Munich, Germany) and WaveOne Gold (Dentsply Maillefer, Ballaigues, Switzerland) reciprocating systems in curved canals instrumented up to different working lengths (WLs). METHODS Sixty mesial roots of extracted mandibular first molars with mesiobuccal canals having curvatures between 10° and 20° and independent foramina were randomly distributed into 4 experimental groups (n = 15) according to WL and the instrumentation system used: RC0, Reciproc and WL at the apical foramen; RC1, Reciproc and WL at 1 mm short of the apical foramen; WOG0, WaveOne Gold and WL at the apical foramen; and WOG1, WaveOne Gold and WL at 1 mm short of the apical foramen. The canals were irrigated with double-distilled water throughout the preparation. Each root was fit into an Eppendorf tube to collect the debris extruded through the foramen during instrumentation. After instrumentation, the roots were removed from the tubes, and the weight of the debris was obtained by subtracting the initial weight of the tubes from their final weight. The data were submitted to the analysis of variance parametric test complemented by the Tukey test. RESULTS No statistically significant difference was observed between the 4 experimental groups regarding the amount of debris extruded (P > .05). CONCLUSIONS The 2 reciprocating systems tested were associated with similar amounts of apically extruded debris, regardless of the working length used in the instrumentation.
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Affiliation(s)
| | | | - Carlos Eduardo Fontana
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
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27
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Effects of Different Glide Path Files on Apical Debris Extrusion in Curved Root Canals. J Endod 2018; 44:1191-1194. [DOI: 10.1016/j.joen.2018.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/20/2022]
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28
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Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files. J Endod 2018; 44:856-859. [DOI: 10.1016/j.joen.2018.01.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 11/21/2022]
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29
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Topçuoğlu HS, Ulusan Ö, Topçuoğlu G, Biricik E. Apically extruded debris during the removal of canal filling material from root canals using three techniques. ACTA ACUST UNITED AC 2018; 9:e12337. [PMID: 29603889 DOI: 10.1111/jicd.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/01/2018] [Indexed: 01/13/2023]
Abstract
AIM In the present study, we evaluated the effect of the single-cone technique (SCT), cold lateral compaction (CLC), and wave vertical compaction (WVC) technique performed using two different sealers on the amount of apically extruded debris (AED) produced during the removal of canal filling material. METHODS Ninety extracted mandibular premolars were prepared with ProTaper instruments. The teeth were then randomly assigned to six groups (N = 15) for root canal filling: (a) group 1, CLC+AH Plus; (b) group 2, SCT+AH Plus; (c) group 3, WVC+AH Plus; (d) group 4, CLC+MTA Fillapex; (e) group 5, SCT+MTA Fillapex; and (f) group 6, WVC+MTA Fillapex. In all groups, the removal of canal filling material was performed with ProTaper retreatment instruments. The mean weight of the AED was assessed with an analytical balance. RESULTS The amount of AED was lowest in groups 2 and 5 (P < .05), with no difference between these groups (P > .05). Groups 3 and 6 produced the greatest amount of extruded debris (P < .05); there was no difference between these groups (P > .05). Additionally, there was no difference between groups 1 and 4 (P > .05). There was no significant difference among the groups regarding sealer type (P > .05). CONCLUSIONS The canal filling technique used affected the amount of AED produced during the removal of canal filling material, but not sealer type.
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Affiliation(s)
- Hüseyin S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Özge Ulusan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Eda Biricik
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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30
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Borges ÁH, Damião MS, Pereira TM, Filho GS, Miranda-Pedro FL, Luiz de Oliveira da Rosa W, Piva E, Guedes OA. Influence of Cervical Preflaring on the Incidence of Root Dentin Defects. J Endod 2018; 44:286-291. [DOI: 10.1016/j.joen.2017.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/19/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
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Zhang C, Liu J, Liu L. The influence of ProTaper and WaveOne on apically extruded debris: A systematic review and meta-analysis. J Conserv Dent 2018; 21:474-480. [PMID: 30294105 PMCID: PMC6161523 DOI: 10.4103/jcd.jcd_82_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Apically extruded debris produced during root canal preparation can induce postoperative inflammation and subsequent failure of root canal treatment. Therefore, debris production must be reduced to improve the outcome of root canal treatment. Aim: This study aimed to provide a theoretical basis for the improvement of root canal treatment by comparing the difference in the amount of apically extruded debris produced during the root canal preparation of extracted human teeth with ProTaper Universal (PTU), ProTaper Next (PTN), and WaveOne (WO). Materials and Methods: On March 30, 2017, three researchers searched five electronic databases (PubMed/Medline, Cochrane, Science Direct Online, Embase, and Web of Science) with no time limitations. Only articles written in English were retrieved, and 150 articles were obtained. Then, the three researchers independently selected articles in accordance with previously established inclusion and exclusion criteria, and inconsistent results were discussed. Data were analyzed through meta-analysis for standardized mean difference (SMD). Results: Eight studies met the inclusion criteria and were subjected to qualitative analysis. Four articles showed that PTU produced higher amounts of apical debris than WO; two articles showed that PTU produced lower amounts of apical debris than WO; and three articles showed that PTN produced lower amounts of apical debris than WO. Moreover, one article demonstrated that PTU produced higher amounts of apical debris than PTN. A meta-analysis showed that PTU and WO did not produce significantly different amounts of apically extruded debris: SMD = −0.26, Z = 0.50 (P > 0.05). PTU produced lower amounts of apically extruded debris than WO: SMD = −4.98, Z = 2.79 (P < 0.05). However, results were significantly heterogeneous among all the included studies (I2= 97%). No significant difference was found between PTU and WO in the amounts of apically extruded debris: SMD = 0.47, Z = 1.06 (P > 0.05). Conclusion: Currently available evidence shows that PTN can produce lower amounts of apical debris than WO (P < 0.05). Moreover, the amounts of apically extruded debris produced by PTU and WO are not significantly different (P > 0.05). Nevertheless, given the limited number of studies reviewed, a definitive conclusion cannot be reached.
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Affiliation(s)
- Chen Zhang
- Department of Oral Medical, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Jun Liu
- Department of Orthodontics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingshuang Liu
- Department of Endodontics, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Oral Medical, Qingdao University, Qingdao, China
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Arslan D, Kustarci A. Efficacy of photon-initiated photoacoustic streaming on apically extruded debris with different preparation systems in curved canals. Int Endod J 2017; 51 Suppl 1:e65-e72. [PMID: 28708251 DOI: 10.1111/iej.12816] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 07/10/2017] [Indexed: 11/28/2022]
Abstract
AIM To determine the effect of photon-initiated photoacoustic streaming (PIPS) on the extrusion of debris using multiple-file (ProTaper Next-PTN) and single-file (One Shape-OS) continuous rotary systems in curved canals in human molar teeth. METHODOLOGY Sixty extracted maxillary first molar teeth with curved mesial roots, mature apices and of similar lengths were selected. Teeth having canals with apical diameters larger than size 15 were discarded. The teeth were randomly divided into four experimental groups (n = 15 teeth per group) according to the file used and irrigation systems: (i) OS with PIPS with a 2940 nm Er:YAG laser (0.3 W, 15 Hz, and 20 mJ), (ii) OS with conventional needle irrigation (CNI) with a 27-G needle, (iii) PTN with PIPS and (iv) PTN with CNI. The PIPS and CNI was applied during each file change for 20 s. Total irrigation and activation time was 1 min, and a total volume of 7.5 mL of bidistilled water was used as the irrigant. The apically extruded debris was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of dry extruded debris was assessed by subtracting the initial weight of the tube from the final weight. The results were analysed statistically using one-way analysis of variance and Tukey's post hoc tests. Bonferroni correction was used to compare the groups. RESULTS The PIPS irrigation technique was associated with significantly more debris extrusion than the CNI system (P < 0.05). The single-file (One Shape-OS) rotary system was associated with more debris than the multiple-file (ProTaper Next-PTN) rotary systems when the same irrigation system was used (P > 0.05). The total amount of debris extruded apically by PIPS activation was significantly greater than that by CNI (P < 0.05). CONCLUSIONS All file and irrigation systems extruded debris apically. PIPS activation was associated with significantly more extrusion debris in curved canals compared with no activation.
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Affiliation(s)
- D Arslan
- Department of Endodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul
| | - A Kustarci
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Topçuoğlu HS, Topçuoğlu G. Postoperative pain after the removal of root canal filling material using different techniques in teeth with failed root canal therapy: a randomized clinical trial. Acta Odontol Scand 2017; 75:249-254. [PMID: 28162017 DOI: 10.1080/00016357.2017.1283707] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study evaluated the intensity and duration of postoperative pain after the removal of root canal filling material in retreatment procedures of upper incisor teeth with chronic apical periodontitis, using different techniques. MATERIALS AND METHODS One hundred and thirty-five patients requiring retreatment of upper incisor teeth with chronic apical periodontitis were included in the study. The patients were assigned to three groups of 45 patients, according to the method used to remove old canal filling material. In group 1, canal filling material was removed using hand files. In group 2, the canal filling material was removed with ProTaper universal retreatment (PTUR) instruments. In group 3, Reciproc instruments were used to remove canal filling material. Teeth were then medicated with calcium hydroxide and sealed using temporary filling material. The presence of postoperative pain was assessed after 6, 12, 24, 48 and 72 h, 7 days, and finally after 10 days. RESULTS In all time intervals, except for 72 h, 7 days and 10 days, group 1 participants reported more intense postoperative pain than those in groups 2 and 3 (p = 0.02). In all time intervals, there was no difference in the pain scores between groups 2 and 3 (p = 0.08). In all groups, the intensity of postoperative pain decreased over time. The required time to remove canal filling material was less for the Reciproc group compared to the hand and ProTaper retreatment groups (p = 0.032). CONCLUSIONS Hand files caused greater postoperative pain after non-surgical endodontic retreatment (NSER) of upper incisor teeth with chronic apical periodontitis compared to the ProTaper retreatment and Reciproc files.
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Affiliation(s)
| | - Gamze Topçuoğlu
- Department of Pedodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Western JS, Dicksit DD. Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis. J Conserv Dent 2017; 20:30-36. [PMID: 28761250 PMCID: PMC5514807 DOI: 10.4103/0972-0707.209066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing. OBJECTIVES Of this meta-analysis was to collect and analyze in vitro studies quantifying apically extruded debris while using Hand ProTaper (manual), ProTaper Universal (rotary), Wave One (reciprocating), and self-adjusting file (SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically. METHODOLOGY An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms "Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems." A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris. RESULTS Statistically significant difference was seen in the following comparisons: SAF < Wave One, SAF < Rotary ProTaper. CONCLUSIONS Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.
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Affiliation(s)
- J Sylvia Western
- Faculty of Dentistry, SEGi University, No. 9, Jalan Teknologi, Kota Damansara, PJU5, Selangor, Malaysia
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Vasconcelos BC, Bastos LM, Oliveira AS, Bernardes RA, Duarte MAH, Vivacqua-Gomes N, Vivan RR. Changes in Root Canal Length Determined during Mechanical Preparation Stages and Their Relationship with the Accuracy of Root ZX II. J Endod 2016; 42:1683-1686. [PMID: 27616540 DOI: 10.1016/j.joen.2016.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 07/28/2016] [Accepted: 07/30/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to determine the variations in root canal length (RCL) occurring during endodontic treatment stages (initial, preflared, and concluded) and correlate them with the accuracy of Root ZX II (RZX). METHODS After coronal access, 26 mandibular molars had the apical foramen of the 52 mesial canals standardized (250 μm) and their respective initial RCL was recorded (RCL1 = initial) by using a clinical microscope (×16) and manual K-file instruments. By using the alginate model, sequential electronic measurements were taken with the RZX. After the initial measurement (EM1), WaveOne Primary instruments were used to prepare the cervical and middle thirds of the root canals, and then the second RCL and EM measurements (RCL2/EM2 = preflared) were obtained. Finally, mechanical preparation was concluded, and the measurement procedures were repeated to obtain the final RCL and EM measurements (RCL3/EM3 = concluded). RESULTS Statistically significant differences were observed in all comparisons in the RCL (P < .05). The RCL1 - RCL3 showed the highest variation (0.6 mm), with the extent of specimens reduced by up to 1.75 mm. No statistically significant differences were found in the accuracy of the RZX (P > .05); 100% precision (± 0.5 mm) was found in all stages. CONCLUSIONS Under the conditions of this study, the authors concluded that during endodontic treatment, the extent of the RCL was reduced, thereby jeopardizing control of the apical limit during instrumentation and/or obturation. The RZX was extremely accurate in all evaluated stages.
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Affiliation(s)
| | - Luzia Mesquista Bastos
- School of Dentistry of Sobral, Federal University of Ceará, Campus Sobral, Sobral, Ceará, Brazil
| | - Ariany Souza Oliveira
- School of Dentistry of Sobral, Federal University of Ceará, Campus Sobral, Sobral, Ceará, Brazil
| | | | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nilton Vivacqua-Gomes
- School of Dentistry of Ceará, São Leopoldo Mandic University, Campus Fortaleza, Fortaleza, Ceará, Brazil
| | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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