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Uzunoğlu Özyürek E, Küçükkaya Eren S, Karahan S. Effect of treatment variables on apical extrusion of debris during root canal retreatment: A systematic review and meta-analysis of laboratory studies. J Dent Res Dent Clin Dent Prospects 2024; 18:1-16. [PMID: 38881644 PMCID: PMC11179139 DOI: 10.34172/joddd.40501] [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: 07/07/2023] [Accepted: 12/06/2023] [Indexed: 06/18/2024] Open
Abstract
Background This study aimed to systematically and comprehensively review the effect of various treatment variables on apically extruded debris (AED) during non-surgical root canal retreatment (NSRCRT). Methods The study protocol is shared in the Open Science Framework database (https://osf.io/kjtdg/?view_only=17060180705745ec9dae9a01614f3880). An electronic search was conducted up to July 2022 to reveal related studies. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and data extraction. Quantitative data synthesis was performed, and the risk of bias in the studies was also evaluated. Results Forty-six studies were included in the systematic review and 14 in the meta-analysis. Conflicting or limited evidence was found for the effect of sealer type, obturation technique, and solvent use. The manual instrumentation increased the amount of AED compared to rotary instrumentation during the removal of filling materials (P<0.001). There was no significant difference in the amount of AED between the use of rotary and reciprocating files during the removal of filling materials (P=0.181). Conclusion Rotary instruments can be recommended instead of manual instruments during the removal of filling materials to control the amount of AED. Further studies with a low risk of bias are needed to clarify the effect of other treatment variables on AED during NSRCRT.
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Affiliation(s)
- Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Abdelnaby P, Ibrahim M, ElBackly R. In vitro evaluation of filling material removal and apical debris extrusion after retreatment using Reciproc blue, Hyflex EDM and ProTaper retreatment files. BMC Oral Health 2023; 23:902. [PMID: 37990209 PMCID: PMC10664678 DOI: 10.1186/s12903-023-03579-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES To evaluate the amount of remaining filing material and apical debris extrusion after retreatment using Reciproc Blue, Hyflex EDM and ProTaper Retreatment Files. MATERIALS AND METHODS Thirty-six extracted permanent mandibular first molars with moderately curved mesial roots were selected. Mesiobuccal canals were prepared using the ProTaper Next system up to size X2 and filled using gutta-percha and Adseal sealer via cold lateral compaction. Teeth were randomly divided into three equal groups (n = 12): Group 1: Reciproc Blue (RB)(VDW, Germany), Group 2: Hyflex EDM (HEDM)(Coltene/Whaledent, Switzerland), Group 3: ProTaper Universal Retreatment file system + ProTaper Next file system (PTUR + PTN)( Dentsply Maillefer, Switzerland). Eppendorf tubes were used to collect the apically extruded debris. Cone-beam computed tomographic scans were taken prior to and after retreatment and the volume of remaining filling material was assessed at the coronal, middle and apical levels. Statistical analysis was performed using the Kruskal-Wallis test, Friedman's test and Wilcoxon Sign Rank test. Significance level was set at p value 0.05. RESULTS There were no statistically significant differences among the three groups in the reduction of the volume of the filling material or in the amount of apically extruded debris. CONCLUSION All the tested filing systems showed similar efficacy in removing the filling material, however, none of them could achieve its complete removal. Apical extrusion of debris occurred with all the systems used with no significant difference between the three groups.
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Affiliation(s)
- Passent Abdelnaby
- Conservative Dentistry Department, MS Student, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Ibrahim
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania ElBackly
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
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Tavares KIMC, Pinto JC, Santos-Junior AO, Duarte MAH, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of Additional Apical Preparation on Retreatment of Curved Root Canals Filled with Different Sealers. Eur J Dent 2023; 17:636-641. [PMID: 36075266 PMCID: PMC10569835 DOI: 10.1055/s-0042-1750693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE This study assessed the influence of additional apical preparation on material removal during retreatment of curved root canals filled with different sealers. MATERIALS AND METHODS Twelve mesial roots of mandibular molars with two separate canals and curvature between 25 and 35 degrees were selected. The working length was established 1-mm short of the apical foramen, and all the root canals were prepared using ProDesign R (PDR) 25/0.06. After preparation, the root canals were divided in two groups (n = 12) and filled by continuous wave condensation technique with NeoMTA Plus or AH Plus. All the root canals were retreated using rotary ProDesign Logic RT 25/0.08, reciprocating PDR 25/0.06 and apical preparation with PDR 35/0.05. Additional apical preparation was performed with ProDesign Logic (PDL) 50/0.01. The samples were scanned using a Skycan 1176 micro-computed tomography (micro-CT), voxel size 8.74 µm, before and after the retreatment procedures. Percentages of remaining filling material were evaluated. STATISTICAL ANALYSIS The data were submitted to paired and unpaired t-tests (α = 0.05). RESULTS Percentage of remaining filling material was similar between the root canals filled with NeoMTA Plus or AH Plus sealer after retreatment using PDR 35/0.05, and after additional apical preparation using PDL 50/0.01 (p > 0.05). However, PDL 50/0.01 significantly decreased the percentage of remaining filling material in the apical third after the additional apical preparation for both sealers (p < 0.05). CONCLUSION NeoMTA Plus or AH Plus did not influence the retreatment of curved root canals. ProDesign Logic 50/0.01 promoted greater filling material removal in the apical third.
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Affiliation(s)
- Karina I. M. C. Tavares
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Jader C. Pinto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Airton O. Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Marco A. H. Duarte
- Department of Dentistry, Endodontics and Dental Materials, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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Kaşıkçı S, Türker SA, Güven B. Effect of different retreatment files using different kinematics on the release of inflammatory mediators in root canal retreatment of single-rooted teeth: a randomized clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04930-6. [PMID: 36856848 DOI: 10.1007/s00784-023-04930-6] [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: 08/12/2022] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVES This randomized clinical trial aimed to evaluate the effect of two rotaries (ProTaper Universal Retreatment (PTUR)), D-Race (DR) + XP-Endo Finisher R (XPFR) and one reciprocating (Reciproc Blue (RB) retreatment techniques on the release of neuropeptides (Substance P, calcitonin gene-related peptide (CGRP)), and cytokines (IL-6 and IL-10) in periapical fluid in root canal retreatment of single-rooted teeth. MATERIALS AND METHODS In this randomized clinical trial (ClinicalTrials.gov ID: NCT05039502), seventy-five patients scheduled for retreatment were randomly divided into 3 groups according to the file system used to remove root canal filling materials (n = 25): PTUR, RB, and DR + XPFR. After reshaping and disinfection of the root canals, periapical fluid samples were taken, and the levels of Substance P, CGRP, IL-6, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed using the Kruskal-Wallis and chi-square tests. The level of significance was set as p = 0. 05. RESULTS All the allocated participants received the intervention and were analyzed. There was no statistically significant difference among groups in terms of gender, age, tooth localization, and the distribution of analgesic use after treatment (p values 0.799, 0.095, 0.637, 1.000, respectively). No statistically significant difference was found in terms of the levels of Substance P, CGRP, and IL-10 among groups (p > .05), except IL-6. CONCLUSIONS PTUR, RB, and DR + XPFR files have comparable results in the expression of inflammatory mediators. CLINICAL RELEVANCE Retreatment files powered with rotary or reciprocating motion produced similar neuropeptide and cytokine levels in patients.
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Affiliation(s)
- Sena Kaşıkçı
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Sevinç Aktemur Türker
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
| | - Berrak Güven
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Oliveira PS, Ferreira MC, Paula NGN, Loguercio AD, Grazziotin-Soares R, da Silva GR, da Mata HCS, Bauer J, Carvalho CN. Postoperative Pain Following Root Canal Instrumentation Using ProTaper Next or Reciproc in Asymptomatic Molars: A Randomized Controlled Single-Blind Clinical Trial. J Clin Med 2022; 11:jcm11133816. [PMID: 35807101 PMCID: PMC9267392 DOI: 10.3390/jcm11133816] [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: 05/22/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Aim: The development of postoperative pain following root canal instrumentation may impair patient’s comfort and undermine their trust in the dentist. This study assessed the effect of root canal instrumentation techniques (rotary (PTN; ProTaper Next®) and reciprocating (R; Reciproc®)) on the postoperative pain intensity (primary outcome) and tenderness on biting (secondary outcome) of patients’ asymptomatic molars. Methodology: This study protocol was registered with ReBec-WHO (U1111-1182-2800). From a pool of 112 patients evaluated for eligibility (healthy adults (≤18 years old)), with a single asymptomatic molar (maxillary or mandibular) indicated for root canal treatment, diagnosed with asymptomatic irreversible pulpitis (including chronic hyperplastic pulpitis), 75 were randomly allocated in similar proportions to receive the intervention (two-appointment root canal therapy) in either the PTN or R group. The allocated procedures were performed using standardized protocols. Participants (blinded to the instrumentation technique) rated their pain intensity at 6, 12 and 24 h and from day 2 to day 7 following the root canal instrumentation appointment using a VAS and an NRS; the ibuprofen tablets taken and the presence of tenderness on biting were recorded. The instrumentation time was registered. Univariate and multivariate statistics measured the effect of independent variables on the outcomes. Results: From the 75 patients allocated, 8 patients (4 from each group) were lost; in total, 33 patients were analyzed in the PTN group and 34 in the R group. The frequencies of postoperative pain (p > 0.05) and tenderness on biting (p > 0.05) were similar between groups. The medication intake (mean of 1.31 tablets) and the time of instrumentation (approximately 11 min) were similar between groups. Conclusion: ProTaper Next and Reciproc® caused a slight risk of tenderness on biting and contributed to similar self-reported postoperative pain (low intensity) up to 7 days following root canal shaping.
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Affiliation(s)
- Patrícia Santos Oliveira
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
| | - Meire Coelho Ferreira
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
| | | | - Alessandro Dourado Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa 84010-330, Brazil;
| | | | - Gisele Rodrigues da Silva
- Department of Operative Dentistry, Federal University of Uberlândia (UFU), Uberlândia 38408-100, Brazil;
| | | | - José Bauer
- Dentistry Biomaterials Laboratory (Biomma), School of Dentistry, Federal University of Maranhão, São Luís 65080-805, Brazil;
| | - Ceci Nunes Carvalho
- Postgraduate Program of Dentistry, CEUMA University, São Luís 65065-470, Brazil; (P.S.O.); (M.C.F.); (N.G.N.P.)
- Correspondence: ; Tel.: +55-98-98117-0078
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Simões LP, dos Reis-Prado AH, Bueno CRE, Viana ACD, Duarte MAH, Cintra LTA, Lemos CAA, Benetti F. Effectiveness and safety of rotary and reciprocating kinematics for retreatment of curved root canals: a systematic review of in vitro studies. Restor Dent Endod 2022; 47:e22. [PMID: 35692221 PMCID: PMC9160764 DOI: 10.5395/rde.2022.47.e22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and Methods Only in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. Results The search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. Conclusions This review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.
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Affiliation(s)
- Lucas Pinho Simões
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, University of São Paulo (USP), School of Dentistry, Bauru, SP, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), School of Dentistry, Governador Valadares, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Belo Horizonte, MG, Brazil
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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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8
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Ajina MA, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J 2021; 55 Suppl 1:119-152. [PMID: 34674279 DOI: 10.1111/iej.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Despite enjoying high favourable outcome rates, root canal treatment is not always successful. Root canal retreatment is a widely practised option for managing a non-healing root treated tooth. A basic distinction between retreatment and initial treatment is the requirement to remove the existing root filling material occupying the root canal space. Only then, can the technical deficiencies and possible causes of failure be addressed. Hence, the successful removal of the root filling material is critical to achieving the objectives of retreatment. Many different materials and techniques have been used for root canal filling, which have been documented in a plethora of studies; these are mainly laboratory studies investigating the removal of root filling materials. To help guide future research, which may then better inform clinical practice in relation to retreatment procedures, the focus of this narrative review is on the research methods and experimental models employed to study the removal of root filling materials. The current available literature demonstrates great variation in the research methodologies used to study the removal of root filling material, including direct visualization by splitting tooth samples or clearing, three-dimensional radiographic imaging including using microcomputed tomography or cone-beam computed tomography, and a combination of these techniques. Depending on the research method employed, variation also exists in quantification of root filling material removal; these include measurements of surface area, volume or weight, and criteria-based (semi-quantitative) assessment. Experimental models, using human teeth or resin models, differ with respect to standardization techniques and replication of the clinical scenario including initial sample preparation, canal filling, allocation and technical aspects of retreatment procedures. Future models should replicate, as closely as possible, the clinical scenario. Currently, microcomputed tomography provides a highly detailed, non-invasive and non-destructive method of objectively assessing and quantifying root filling removal.
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Affiliation(s)
- Mahdi A Ajina
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Shah
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Bun San Chong
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Çanakçi BC, Er Ö, Genç Şen Ö, Süt N. The effect of two rotary and two reciprocating NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth: A randomized controlled trial. Int Endod J 2021; 54:2016-2024. [PMID: 34383324 DOI: 10.1111/iej.13609] [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: 03/03/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 01/07/2023]
Abstract
AIM This randomized clinical trial aimed to assess the effect of two rotary (ProTaper Retreatment + ProTaper Gold and Hyflex EDM) and two reciprocating (Reciproc Blue and WaveOne Gold) NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth. METHODOLOGY One hundred and eighty patients scheduled for root canal retreatment were randomly assigned to one of the four groups according to the NiTi system (ProTaper Retreatment + ProTaper Gold, Hyflex EDM, Reciproc Blue or WaveOne Gold) used for the removal of root canal fillings and further canal preparation. The working length was determined to be 1 mm shorter than the '0.0' mark of the apex locator. Root canals were filled with gutta-percha and an epoxy resin-based root canal sealer using a lateral compaction technique. The teeth were restored using a resin composite material. A single operator performed the retreatments in a single visit. The incidence and intensity of postoperative pain were rated on a numeric rating scale by patients 24, 48 and 72 h after retreatment. The number of analgesic tablets (400 mg Ibuprofen) taken by patients was also recorded. Data were analysed using the Mann-Whitney U, Wilcoxon and chi-square tests. RESULTS For the intensity of postoperative pain, the difference between the four groups was not significantly different (p > .05). No significant difference was found between the groups in terms of analgesic medication intake (p > .05). CONCLUSIONS The rotary and reciprocating NiTi systems tested in this study were associated with similar intensity of postoperative pain and intake of analgesics following root canal retreatment on single-rooted incisor teeth completed in one visit.
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Affiliation(s)
- Burhan Can Çanakçi
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Er
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Genç Şen
- Department of Endodontics, Faculty of Dentistry, Yüzüncü Yıl University, Van, Turkey
| | - Necdet Süt
- Department of Biostatistics, Medical Faculty, Trakya University, Edirne, Turkey
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Uğur Aydın Z, Erdönmez D, Ateş MO, Doğan T. Efficacy of different irrigation activation systems on bacterial extrusion. AUST ENDOD J 2021; 47:137-142. [PMID: 32820601 DOI: 10.1111/aej.12432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 06/21/2020] [Accepted: 07/26/2020] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to evaluate the quantity of extruded bacteria following with EndoVac, EDDY, EndoActivator (EA) and standard needle irrigation (SNI). Ninety teeth with a single root and canal were included in this study. Fifteen teeth were selected as the negative control group to confirm sterilization. Seventy-five teeth were contaminated with Enterococcus faecalis (E. faecalis) for 4 weeks. Teeth were prepared and divided into five groups (n:15): EndoVac, EDDY, EA, SNI and positive control groups. The extruded bacteria were cultured for bacterial quantification. The counts of extruded bacteria were lower in the EndoVac group compared to the EDDY group (P˂ 0.05). The counts of extrusion bacteria were not different in EA and SNI groups compared to EDDY and EndoVac groups (P > 0.05). Within the limits of this study, EndoVac was found to be more reliable irrigation systems than EDDY in terms of the bacterial extrusion.
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Affiliation(s)
- Zeliha Uğur Aydın
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Demet Erdönmez
- Department of Biology, Faculty of Arts and Science, Aksaray University, Aksaray, Turkey
| | - Melis Oya Ateş
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tülin Doğan
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Debris Extrusion Using Reciproc Blue and XP Endo Shaper Systems in Root Canal Retreatment. Int J Dent 2021; 2021:6697587. [PMID: 33833804 PMCID: PMC8012141 DOI: 10.1155/2021/6697587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022] Open
Abstract
This study aimed at assessing the performance of Reciproc Blue (RB) and XP Endo Shaper (XPS), used for canal retreatment on extracted teeth, in terms of debris extrusion and obturating materials removal. Thirty mandibular premolars were prepared to ProTaper X2 file, obturated using warm vertical compaction, and then incubated for 28 days at 100% humidity at 37°C. Teeth were randomly assigned into two groups, according to the system used for retreatment (RB and XPS). During retreatment, debris extruded beyond the apex was collected in preweighed Eppendorf tubes, and the retreatment time was measured. Afterward, the teeth were longitudinally sectioned to assess the remaining obturating materials. Data were statistically analyzed using the Mann-Whitney test and chi-square test at a 95% confidence level. All the samples had extruded debris at varying weights ranging from 0.125 mg to 3.680 mg. XPS extruded less debris than RB, but no difference was detected (Mann-Whitney test; P > 0.05). RB and XPS required 54.9 ± 17.9 and 22.3 ± 9.3 seconds to perform retreatment procedures, respectively (Mann-Whitney test; P < 0.05). The sealer was found in all the samples. Compared to the RB group, fewer samples with remaining gutta-percha were found in the XPS group (Chi-square test; P < 0.05). None of the files fractured during the retreatment procedure. The tested files appear to extrude debris beyond the apex. Although XPS was able to remove the gutta-percha completely from the majority of the canals, it was unable to remove the sealer.
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Serefoglu B, Kandemir Demirci G, Miçooğulları Kurt S, Kaşıkçı Bilgi İ, Çalışkan MK. Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment. Restor Dent Endod 2021; 46:e5. [PMID: 33680894 PMCID: PMC7906842 DOI: 10.5395/rde.2021.46.e5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/03/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated. Materials and Methods Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level. Results Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05). Conclusions All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.
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Affiliation(s)
- Burcu Serefoglu
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | | | | | | | - Mehmet Kemal Çalışkan
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
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13
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Effect of Rotary and Reciprocating Instrumentation Motions on Postoperative Pain Incidence in Non-Surgical Endodontic Treatments: A Systematic Review and Meta-Analysis. Eur Endod J 2021; 6:3-14. [PMID: 33609019 PMCID: PMC8056811 DOI: 10.14744/eej.2020.51523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours. METHODS Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity. RESULTS At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis. CONCLUSION There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.
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Postoperative pain in endodontic retreatment of one visit versus multiple visits: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig 2021; 25:455-468. [PMID: 33399930 DOI: 10.1007/s00784-020-03767-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?" MATERIALS AND METHODS This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p < 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. RESULTS Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30 days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p > 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low. CONCLUSION Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results. CLINICAL RELEVANCE Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.
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Reciproc and Reciproc Blue in the removal of bioceramic and resin-based sealers in retreatment procedures. Clin Oral Investig 2019; 24:405-416. [DOI: 10.1007/s00784-019-02956-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/07/2019] [Indexed: 12/12/2022]
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Aboud LRDL, Santos BCD, Lopes RT, Viana LAC, Scelza MFZ. Effect of Aging on Dentinal Crack Formation after Treatment and Retreatment Procedures: a Micro-CT Study. Braz Dent J 2018; 29:530-535. [DOI: 10.1590/0103-6440201802134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract In order to evaluate the volume of dentinal cracks taking into account the age of the dentin and the type of file system used for endodontic procedures, forty freshly extracted single-rooted lower incisive teeth presenting similar root volume, were divided into two groups according to the age of the patient: Group Young (18 - 30 years old) and Group Old (60 years old or more). Each specimen was scanned by microcomputed tomography (micro-CT) in three stages: (i) before any treatment, (ii) after endodontic treatment with Reciproc files (REC), and (iii) after subsequent endodontic retreatment. Each group was subdivided into two subgroups, according to the retreatment technique used: retreatment with REC or with ProTaper Universal Retreatment (PUR) files. For each subgroup, the images were analyzed for differences in the volume of dentinal cracks in the middle and apical thirds of the teeth , according to the dentin age. In both stages (before and after instrumentation), the micro-CT images of the old root dentin presented with higher volume of cracks than those of the young root dentin, statistical significance notwithstanding (p>0.01). The use of REC files appeared to have no statistically significant differences in the generation of cracks in any type of root dentin when compared with PUR files (p>0.01). When retreated with PUR, the old root dentin presented with a significantly higher volume of cracks (p<0.01) when compared with the old root dentin initially.
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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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Postoperative pain after removal of gutta-percha from root canals in endodontic retreatment using rotary or reciprocating instruments: a prospective clinical study. Clin Oral Investig 2018; 22:2623-2631. [DOI: 10.1007/s00784-018-2361-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/24/2018] [Indexed: 11/28/2022]
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Delai D, Boijink D, Hoppe CB, Grecca AS, Kopper PMP. Apically extruded debris in filling removal of curved canals using 3 NiTi systems and hand files. Braz Dent J 2018; 29:54-59. [PMID: 29267525 DOI: 10.1590/0103-6440201801760] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/19/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to assess the amount of apically extruded debris during filling removal with WaveOne Gold (WOG), ProTaper Universal Retreatment (PTR), D-RaCe Retreatment (DRR) or hand files (HF), to compare the working time during filling removal, and to describe failures of NiTi instruments. Forty mesiobuccal roots of maxillary first molars were prepared with WOG Primary, obturated and divided into 4 groups (n=10), according to the instruments used: WOG, PTR, DRR or HF. Distilled water was used as irrigant and the extruded debris were collected in Eppendorf tubes and dried. The amount of extruded debris was determined by subtracting the final from the initial weight. The time of filling removal for each canal was recorded and the instruments used were analyzed pre and post-operatively by SEM. Kruskal-Wallis and Dunn’s test analyzed extruded debris data and ANOVA, followed by Tukey’s test, compared the working time data (a=0.05). Instrument deformation and fracture were described. WOG produced significantly less debris compared with HF and DRR (p<0.05), and similar to PTR (p>0.05). HF, PTR and DRR showed no significant difference (p>0.05). Working time in HF group was significantly higher than others (p<0.05). SEM analyses showed, from the 18 instruments evaluated, 3 fractures and 10 deformations. All instruments tested caused debris extrusion. WOG was associated with less extrusion than DRR and HF. Filling removal with HF was slower than with the other instruments. All NiTi systems presented fracture and deformation.
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Nevares G, Romeiro K, Albuquerque D, Xavier F, Fogel H, Freire L, Cunha R. Evaluation of Apically Extruded Debris during Root Canal Retreatment Using ProTaper Next and Reciproc in Severely Curved Canals. IRANIAN ENDODONTIC JOURNAL 2017; 12:323-328. [PMID: 28808459 PMCID: PMC5527208 DOI: 10.22037/iej.v12i3.15850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To compare the apical extrusion of debris produced during root obturating material removal from severely curved root canals using either Reciproc (REC) or ProTaper Next (PTN) systems. METHODS AND MATERIALS Twenty-six mesial canals of lower molars were instrumented, filled and allocated into two groups (n=13). Micro-computed tomographic images were performed to determine the root canal configuration (Vertucci's type IV) and initial volume of obturation. One Eppendorf tube was assigned per canal and weighed (10-4g) before and after removal of the obturating material. The difference between the initial and final weights was calculated and statistically evaluated. RESULTS Apical extrusion of debris was confirmed in all samples, and the mean amount of apical extrusion was similar between both groups (0.061±0.014 g in PTN vs. 0.065±0.016 g in REC samples) (P<0.05). CONCLUSION Both systems caused apical extrusion of debris with no differences between PTN and REC systems.
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Affiliation(s)
- Giselle Nevares
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Felipe Xavier
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Camaragibe, PE, Brazil
| | - Howard Fogel
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
| | - Laila Freire
- School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Cunha
- Division of Endodontics, College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
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Comparin D, Moreira EJL, Souza EM, De-Deus G, Arias A, Silva EJNL. Postoperative Pain after Endodontic Retreatment Using Rotary or Reciprocating Instruments: A Randomized Clinical Trial. J Endod 2017; 43:1084-1088. [DOI: 10.1016/j.joen.2017.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/16/2017] [Accepted: 02/16/2017] [Indexed: 10/19/2022]
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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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Yılmaz K, Özyürek T. Apically Extruded Debris after Retreatment Procedure with Reciproc, ProTaper Next, and Twisted File Adaptive Instruments. J Endod 2017; 43:648-651. [DOI: 10.1016/j.joen.2016.12.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/29/2016] [Accepted: 12/04/2016] [Indexed: 11/28/2022]
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