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Herrera Á, Azabal M, Jimenez-Octavio JR, del Real-Romero JC, López de Armentia S, Asensio-Gil JM, Arias A. Comparative Analysis of Surface Roughness and Plastic Deformation of Reciprocating Instruments after Clinical Use. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3978. [PMID: 39203156 PMCID: PMC11356323 DOI: 10.3390/ma17163978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/24/2024] [Accepted: 08/03/2024] [Indexed: 09/03/2024]
Abstract
This study assessed the surface topography and plastic deformation (PD) of new and used contemporary reciprocating instruments. Twenty-six WaveOne Gold (WOG) and EdgeOne Fire (EO) instruments were photographed under magnification. The instruments were randomly assigned to a control group of new instruments preserved for surface roughness analysis (n = 6 each), or to an experimental group to shape the root canal system of a single molar (n = 20 each), making a total of four groups (WOGnew, EOnew, WOGused, EOused). Used instruments were also photographed after instrumentation. The presence of fractures was registered. Preoperative and postoperative images were randomly ordered for evaluation. Two blinded calibrated examiners evaluated the presence of PD. Inter-observer agreement was calculated with the Kappa coefficient (K = 0.89). 3D profilometry was also used for the surface roughness analysis of six randomly selected instruments from the WOGused and EOused groups. Chi-square and two-way ANOVA tests were used to, respectively, compare PD and changes in surface roughness among the groups. No instruments fractured; however, a significantly greater percentage of EO instruments suffered plastic deformation than WOG instruments (p < 0.001), (OR = 11.09 (CI 95% 2.6-56.3)). The overall surface roughness was higher for most parameters in the EO instruments (p < 0.05). Single uses of EO instruments produced significantly higher chances of PD and increased surface roughness values compared to WOG.
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Affiliation(s)
- Ángel Herrera
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain;
| | - Magdalena Azabal
- Department of Dentistry, School of Medicine, San Pablo CEU University, 28003 Madrid, Spain;
| | - Jesús R. Jimenez-Octavio
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Juan C. del Real-Romero
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Sara López de Armentia
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Juan M. Asensio-Gil
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain;
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Immich F, de Araújo LP, da Gama RR, da Rosa WLDO, Piva E, Rossi-Fedele G. Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review. AUST ENDOD J 2024; 50:409-463. [PMID: 38923176 DOI: 10.1111/aej.12870] [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: 05/20/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.
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Affiliation(s)
- Felipe Immich
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Lucas Peixoto de Araújo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
- School of Dentistry, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Evandro Piva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Ragozzini G, Abu Hasna A, dos Reis FAS, de Moura FB, Campos TMB, Bueno CES, Carvalho CAT, de Martin AS. Effect of Autoclave Sterilization on the Number of Uses and Resistance to Cyclic Fatigue of WaveOne Gold and Four Replica-Like Endodontic Instruments. Int J Dent 2024; 2024:6628146. [PMID: 38938694 PMCID: PMC11208808 DOI: 10.1155/2024/6628146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/31/2024] [Accepted: 05/22/2024] [Indexed: 06/29/2024] Open
Abstract
This study aimed to evaluate the effect of autoclave sterilization on the integrity and instruments' fracture number after multiple uses and cyclic fatigue of the original WaveOne Gold (Dentsply Sirona Endodontics) compared to four replica-like instruments (TF4-Gold, Roll-Wave-Gold, W-File, and Micro-Gold). The instruments were analyzed by scanning electron microscope (SEM) before being used in root canal instrumentation (baseline). One hundred and fifty human molars, freshly extracted for orthodontic reasons or periodontal disease and with severe curvature (between 30° and 60°), were used. Fifty teeth were instrumented with 10 instruments from each group and were evaluated for integrity. After sterilization in an autoclave, the instruments were analyzed by SEM. This procedure was repeated twice more, totaling three rounds of instrumentation, sterilization, and SEM analysis. Ten unused instruments from each group were evaluated for resistance to cyclic fatigue in a static test using a motor and a device simulating a canal with a 60° curvature angle. The instruments were driven by the motor until separation, visually verified, and the time measured in seconds. Data were analyzed by Chi-square, one-way ANOVA, and Tukey analysis, considering a significance level of 5%. It was found that there was no statistically significant difference between the groups tested in the effect of sterilization on the number of uses. The SEM analysis showed distortions in the instruments after the 3rd use. There was a statistically significant difference in the cyclic fatigue test between the results of WaveOne Gold, TF4 Gold, and Roll Wave Gold compared to W File and Micro Gold (P < 0.0001) and a statistically significant difference between the W File and Micro Gold groups (P < 0.0001). In conclusion, this study affirmed that WaveOne Gold, TF4-Gold, and Roll-Wave-Gold instruments exhibit comparable cyclic fatigue resistance. Besides, all examined instruments can be reliably employed for up to two cases.
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Affiliation(s)
- Gustavo Ragozzini
- Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Amjad Abu Hasna
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
- School of DentistryUniversidad Espíritu Santo, Samborondón, Ecuador
| | | | - Felipe Bernardo de Moura
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
| | | | | | - Cláudio Antonio Talge Carvalho
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
| | - Alexandre Sigrist de Martin
- Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
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AbuMostafa A, Alrefaie MM, Abu-Mostafa N, Algahtani FN. Microcomputed tomography analysis of curved root canal preparation when coronal flaring and glide path files used with heat-treated nickel titanium rotary files. PLoS One 2024; 19:e0299896. [PMID: 38568900 PMCID: PMC10990200 DOI: 10.1371/journal.pone.0299896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/17/2024] [Indexed: 04/05/2024] Open
Abstract
The objective was to evaluate the effect of glide path and coronal flaring on the dentin volume removal and percentage of touched walls in curved canals using two heat-treated rotary files. The mesiobuccal canal of forty-eight, randomly selected, extracted mandibular molars was divided into two groups of 24 each, according to the type of instrument used (RACE EVO and EdgeSequel rotary files). Each group was further divided into three subgroups; Group (A): Control using one file shaped to 04/30, Group (B) with a glide path (EdgeGlidePath (EGP)), and Group (C): with a glide path and coronal flaring (EGP and EdgeTaper Platinum (ETP) SX file respectively). The root canals were then instrumented using the assigned instruments. The assessment was carried out using micro-CT. The comparison of the mean values of the tested groups about dentin volume removal and percentage of untouched walls did not reach statistical significance (p<0.05). Glide path and coronal flaring had an insignificant effect on the dentin volume removal and percentage of untouched walls in curved canals.
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Affiliation(s)
- Ammar AbuMostafa
- Department of Restorative Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed M. Alrefaie
- Department of Restorative Dentistry, Ministry of Health, Riyadh Third Cluster, Riyadh, Kingdom of Saudi Arabia
| | - Nedal Abu-Mostafa
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Fahda N. Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Almalki M, Khayat W. The Use and Reprocessing of Endodontic Files in Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e54427. [PMID: 38510902 PMCID: PMC10951433 DOI: 10.7759/cureus.54427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2024] [Indexed: 03/22/2024] Open
Abstract
Objectives This study aimed to assess the awareness, implementation, and compliance with the infection control policy recommended by the Saudi Ministry of Health (MOH) for the use and reprocessing of endodontic files and to examine the association between compliance and gender, experience, clinical ranks, and workplace sector. Methods This was a cross-sectional study conducted using a validated self-administered electronic questionnaire created and distributed to dentists who perform endodontic treatment in Saudi Arabia. Data were collected between June and July 2023. Descriptive statistics were reported as counts and percentages. Comparisons among the demographic groups were done using the Kruskal-Wallis and Mann-Whitney tests. Results A total of 402 dentists completed the survey. The results showed that 76.1% (n=306) of respondents claimed that they were aware of the infection control policy recommended by the Saudi MOH for the use and reprocessing of endodontic files in dental clinics. Only 13.2% (n=53) of dentists used single-use endodontic files, and 36.6% (n=147) did not use an endodontic box in their dental clinics. The most commonly reported method of tracing the number of uses of endodontic files was to write the ID of the patient or the number of uses on the sterilization pouch as reported by 37.6% of participants (n=151). The average compliance score percentage was 63.5 ± 16.7. Most of the respondents showed moderate to high levels of compliance (51.7% (n=208) and 42.0% (n=169) of dentists, respectively). Dentists with less than 5 years of experience showed significantly less compliance than dentists with more than 10 years of experience (p = 0.005). Gender, clinical rank, and workplace sector were not significantly associated with the extent of adhering to the evaluated infection control policy. Conclusions Our findings indicate a relatively high level of compliance with the Saudi MOH policy of using and reprocessing endodontic files. However, critical measures such as the single-use of endodontic files, sterilizing new endodontic files, and using the sterilized endodontic box for each patient need improvement. Hence, this study recommends enhancing awareness through continuous education and training.
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Affiliation(s)
- Majed Almalki
- Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, SAU
| | - Waad Khayat
- Department of Restorative Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, SAU
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Yavaş E, Yekeler A, İlgen S, Uzunoğlu Özyürek E. In vitro assessment of the roles of initial preparation size and solvent application on apically extruded debris in endodontically treated teeth. J Dent Res Dent Clin Dent Prospects 2023; 17:250-255. [PMID: 38584998 PMCID: PMC10998170 DOI: 10.34172/joddd.2023.40665] [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: 09/15/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study investigated the effects of solvent use and initial canal enlargement size on apically extruded debris (AED). Methods The palatal roots of 60 upper molars were assigned to two groups based on the initial preparation size: F3 or F4 ProTaper Universal files. The roots were obturated using the single-cone technique. Each group was subdivided based on the retreatment procedures: with or without solvent. After evaporation, the Eppendorf tubes were weighed using an electronic balance. The data were statistically analyzed (P=0.05). Results Using a solvent enhanced the amount of AED in samples initially prepared up to F3 or F4 files (P<0.05). When the solvent was used, the AED was greater in samples initially prepared up to the F4 file (P<0.05); however, when the solvent was omitted, the results were reversed (P<0.05). Conclusion Both parameters had a role in AED. Solvents should be used cautiously during root canal retreatment because of the potential for apical extrusion of filling materials. Using files with smaller tapers during initial preparation might be beneficial when considering the amount of AED compared to those with larger tapers.
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Affiliation(s)
| | | | | | - Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Cheung MC, Peters OA, Parashos P. Global survey of endodontic practice and adoption of newer technologies. Int Endod J 2023; 56:1517-1533. [PMID: 37800848 DOI: 10.1111/iej.13982] [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: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
AIM To investigate current endodontic practices, adoption of technologies and continuing education attendance within specialist endodontic practice globally and to identify geographic trends. METHODOLOGY A web-based survey of endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA on routine treatment preferences, armamentarium and education attendance was conducted. Chi-squared, independent sample t-tests, Cochran's Q test and McNemar's test were performed. RESULTS The survey was completed by 543 endodontists or endodontic post-graduate students. Almost all respondents used the dental operating microscope (DOM, 91.3%), engine-driven nickel-titanium instruments (NiTi, 97.6%), electronic apex locators (EAL, 93.0%), cone-beam computed tomography (CBCT, 91.2%) and calcium silicate-based materials (CSBMs, 93.7%). Dental dam was always used by 99.1%. Over half used irrigation adjuncts (81.8%), warm vertical compaction (74.6%) and heat-treated NiTi (60.2%). Geographic comparison between AP (Asia-Pacific, n = 78), AM (Americas, n = 402) and EM (Europe and Middle East, n = 63) was performed. AM and EM preferred single-visit treatment more (p < .001) and used higher sodium hypochlorite concentrations than AP. AM had more access to CBCT in the workplace (86.6%) than AP (65.4%, p < .001) and used CBCT for routine preoperative assessment (39.6%) more than EM (7.3%, p < .001). Almost all of EM used irrigation adjuncts (95.2%), more than AM (78.1%, p = .001). AP used steroid/antibiotic medicaments most (p < .001) and had the highest attendance at continuing education programmes. CONCLUSION Several endodontic-specific armamentaria have reached almost complete adoption within global specialist endodontic practice, whilst the continued uptake of newer technologies should be followed over time. Some practising philosophies varied significantly across different geographic regions.
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Affiliation(s)
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Bürklein S, Arias A. Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta-analysis. Int Endod J 2023; 56 Suppl 3:395-421. [PMID: 35670625 DOI: 10.1111/iej.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The development of endodontic instruments has rapidly advanced, but their impact on endodontic outcome parameters remains unclear. OBJECTIVES This systematic review aimed to answer the following PICOT questions: In patients with apical periodontitis (P) what is the effectiveness of root canal instrumentation ([Q1] performed with contemporary techniques [I] in comparison with 'traditional' techniques [C]] and ([Q2] performed with contemporary engine-driven NiTi instruments [I] compared with other types of contemporary engine-driven NiTi instruments [with different design and/or technology] [C]) in terms of clinical and patient-related outcomes (O)? METHODS After PROSPERO protocol registration, a literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials. Grey literature and major journal contents were examined. Two independent reviewers performed the study selection, data extraction and appraisal of included studies. A quantitative meta-analysis was considered, and statistical heterogeneity and overall quality of evidence were assessed. RESULTS Nine studies were identified showing substantial methodological differences. Five studies addressed PICOT 1 and three PICOT 2, whereas one study aimed both. A random-effects meta-analysis model was considered for the outcome 'radiographic evidence of normal periodontal ligament space or reduction of apical lesion size' (PICOT 1) based on three studies with 332 evaluable participants and showed that contemporary instrumentation was associated with a more favourable outcome (p = .005) compared with root canal preparation with stainless steel instruments (odds ratio = 2.07 [95%-confidence interval = 1.25-3.44]) with no evidence of statistical heterogeneity (I2 = 0%) but low quality of evidence. DISCUSSION Albeit a few studies fulfilled eligible criteria, no study had a low risk of bias. Compelling evidence indicating significantly different outcome rates using different endodontic instruments when treating teeth with apical periodontitis is lacking. CONCLUSIONS In terms of healing, the results of the meta-analysis determined the higher effectiveness of root canal instrumentation performed with contemporary techniques in comparison with conventional stainless steel instruments in patients with apical periodontitis followed for a minimum of 1 year with low quality of evidence. No differences could be demonstrated between preparations with traditional stainless steel and contemporary NiTi instruments for other clinical and patient-related outcomes. REGISTRATION PROSPERO (CRD42021274642).
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Affiliation(s)
| | - Ana Arias
- School of Dentistry, Complutense University, Madrid, Spain
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Cheung MC, Parashos P. Current endodontic practice and use of newer technologies in Australia and New Zealand. Aust Dent J 2023; 68:186-196. [PMID: 37382301 DOI: 10.1111/adj.12967] [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] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. METHODS Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. RESULTS Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone-beam computed tomography (CBCT; 98.6%) and calcium silicate-based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine-driven nickel-titanium (NiTi) instruments (91.4%); Group E had more experience with engine-driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands-on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). CONCLUSION Dental dam, EAL and engine-driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association.
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Affiliation(s)
- M C Cheung
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - P Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
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Scherer AS, Bier CAS, Vanni JR. Effect of glide path instruments in cyclic fatigue resistance of reciprocating instruments after three uses. Braz Dent J 2023; 34:27-34. [PMID: 37194854 PMCID: PMC10208288 DOI: 10.1590/0103-6440202305226] [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: 09/24/2022] [Accepted: 03/07/2023] [Indexed: 05/18/2023] Open
Abstract
The present study aims to evaluate the effect of different glide path instruments on the cyclic fatigue resistance of reciprocating endodontic instruments after three uses in mandibular molars. Eighteen Wave One Gold Primary reciprocating instruments were selected and randomly divided into three groups according to the glide path instrument: G1 - manual file K #15, G2 - Wave One Glider reciprocating instrument, and G3 (control group) - glide path was not performed. The reciprocating instruments were tested on mandibular molars and subdivided into three other groups: a new instrument, an instrument with a previous single-use, and an instrument with two previous uses. After the endodontic instrumentation, the instruments were subjected to the cyclic fatigue resistance test using an appropriate tool. The data were submitted to the Shapiro-Wilk test, and subsequently the Kruskal-Wallis test with a significance level of 5%. The results showed no statistical difference between the groups. Thus, it was concluded that the creation of a glide path did not affect the cyclic fatigue resistance of the reciprocating instrument. In addition, the reuse of final preparation instruments up to two times proved to be safe since no fractures were observed in the tested instruments.
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Affiliation(s)
- André Schroder Scherer
- Graduate program in Dental Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | | | - José Roberto Vanni
- Graduate program in Dental Science, Dental Specialty Center Meridional, Passo Fundo, Rio Grande do Sul, Brazil
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Arias A, Peters OA. Present Status and Future Directions - Canal Shaping. Int Endod J 2022; 55 Suppl 3:637-655. [PMID: 35118683 PMCID: PMC9303733 DOI: 10.1111/iej.13698] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.
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Affiliation(s)
- A Arias
- School of Dentistry, Complutense University, Madrid, Spain
| | - O A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
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Dablanca-Blanco AB, Arias A, Ginzo-Villamayor MJ, Pérez MC, Castelo-Baz P, Martín-Biedma B. Influence of operator expertise on glide path and root canal preparation of curved root canals with rotary and reciprocating motions. AUST ENDOD J 2021; 48:37-43. [PMID: 34699669 DOI: 10.1111/aej.12585] [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: 07/02/2021] [Revised: 09/25/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022]
Abstract
This study intended to help practitioners selecting the appropriate motion according to their level of expertise for glide path and complete root canal preparation of curved canals in terms of instrument fracture and preparation time. A total of 160 curved root canals (angle >30°, radius <6 mm) were allocated randomly to 4 groups: A/B for expert operators and C/D for nonexpert operators. A/C were shaped with rotary and B/D with reciprocating instruments. Preparation time was registered and compared with Kruskal-Wallis non-parametric test and Dunn's post hoc test. Instrument separation was also registered and compared with chi-square test. A fractographic analysis was performed with scanning electron microscopy. The use of reciprocation motions allowed nonexpert operators to avoid instrument breakage during glide path and to prepare root canals faster. Experts were equally effective in rotary/reciprocating root canal shaping and faster with rotary motions than nonexpert operators, who also fractured significantly more rotary instruments.
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Affiliation(s)
- Ana Belén Dablanca-Blanco
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - María José Ginzo-Villamayor
- Department of Statistics, Mathematical Analysis and Optimization, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Pablo Castelo-Baz
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Benjamín Martín-Biedma
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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ARICAN B, ATAV ATEŞ A. Effect of number of uses on the cyclic fatigue resistance of single-file rotary instruments. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.862248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Perez-Villalba D, Macorra JC, Perez-Higueras JJ, Peters OA, Arias A. Body temperature fatigue behaviour of reciprocating and rotary glide path instruments in sodium hypochlorite solutions alone or combined with etidronate. AUST ENDOD J 2021; 47:450-456. [PMID: 33720489 DOI: 10.1111/aej.12504] [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: 12/08/2020] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
The aim of the study was to compare cyclic fatigue (CF) resistance of reciprocating and rotary glide path instruments in the presence of irrigation solutions at body temperature. CF resistance of 100 instruments (50 ProGlider and 50 WaveOne Gold Glider) was tested in sodium hypochlorite solutions alone (NaOCl) or in combination with etidronate (NaOCl/HEBP). The CF platform with a simulated canal (curvature = 60°/radius = 3 mm) was submerged in a temperature-controlled bath with the solutions kept at 37 ± 1°C controlled by a precision mercury glass thermometer. Instruments were actioned following manufacturer guidelines, and time to failure was recorded and compared among groups with Weibull analysis. Reciprocating glide path preparation instruments were more resistant to CF than rotary instruments in both irrigation solutions. The irrigation solution did not affect the mean life of ProGlider, but reciprocating instruments lasted significantly longer used in presence of NaOCl compared to NaOCl/HEBP.
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Affiliation(s)
- Dario Perez-Villalba
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - José C Macorra
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - Juan J Perez-Higueras
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - Ove A Peters
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, Madrid, Spain
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15
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Iacono F, Pirani C, Gatto MR, Prati C, Peters OA. Combining apical torsional load and cyclic fatigue resistance of NiTi instruments: New approach to determine the effective lifespan of rotary instruments. AUST ENDOD J 2021; 47:429-434. [PMID: 33650137 DOI: 10.1111/aej.12495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
In the described proof-of-principle experiments, we introduced a novel testing device to investigate how different concurrent torsional loads influence the cyclic fatigue (CF) resistance of a nickel-titanium (NiTi) instrument. The device was designed to test CF resistance of NiTi files with a standardized load on the apical 5 mm; a movable cylinder controlled by a lever provided a uniform real-time load. Thirty-three NiTi instruments 25.04 (F360, Komet, Lemgo, Germany) were rotated until fracture at 30° curvature under three different torsional loads (n = 11 each); Group A: 2.5 Ncm; Group B: 5 Ncm; Group C: 10 Ncm. anova, multiple comparisons Tamhane tests, regression and Kaplan-Meyer analysis were performed to contrast means. Resistance to cyclic fatigue differed significantly among groups (P = 0.0001). Increased torsional loads led to a decrease in time to failure. An inverse correlation (r = -0.721, P = 0.001) was observed between time and torsional load, with higher torsional loads correlated to shorter times to fracture.
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Affiliation(s)
- Francesco Iacono
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Chiara Pirani
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Rosaria Gatto
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Ove A Peters
- School of Dentistry, University of Queensland, Herston, Queensland, Australia.,University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
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Stošić N, Popović J, Anđelković-Apostolović M, Mitić A, Nikolić M, Barac R. Ultrastructural analysis of the surface changes on the nickel-titanium endodontic instruments after multiple use. ACTA FACULTATIS MEDICAE NAISSENSIS 2021. [DOI: 10.5937/afmnai38-29386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
One of the primary goals in endodontics is efficient cleaning and shaping of the root canal while maintaining its original configuration. Numerous studies highlight the advantage of using nickel-titanium instruments and the most important is their high flexibility and the ability to penetrate the curved canals. The aim of this study was to analyze the ultrastructure of the surface of nickel-titanium endodontic files before and after use. Eighty-four instruments were included in this study. The instruments were used one, three and six times for root canal preparation on extracted upper premolars. The analysis was performed based on the number of uses and the size of the instruments. Changes on flat surfaces in the grooves of the instruments, defects of the cutting edges and fractures were evaluated. The surface ultrastructure was analyzed on a scanning electron microscope (SEM). SEM analysis showed irregularities on the surfaces of the new instruments. Surface defects and damage of the cutting edges were present after the first use. After three uses, the damage was more evident in instruments of all sizes. After six uses, all instruments showed damage of the cutting edges, and a significant number of fractures were observed. Irregularities on the working parts are already noticed on the new endodontic instruments and originate from the production process. The first signs of damage appear after the first use. In order to prevent errors in clinical work during root canal preparation, it is recommended that the number of instruments uses should be limited.
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17
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Martins JN, Silva EJ, Marques D, Pereira MR, Ginjeira A, Silva RJ, Braz Fernandes FM, Versiani MA. Mechanical Performance and Metallurgical Features of ProTaper Universal and 6 Replicalike Systems. J Endod 2020; 46:1884-1893. [DOI: 10.1016/j.joen.2020.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 11/29/2022]
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18
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Tsotsis P, Dunlap C, Scott R, Arias A, Peters OA. A survey of current trends in root canal treatment: access cavity design and cleaning and shaping practices. AUST ENDOD J 2020; 47:27-33. [PMID: 33030288 DOI: 10.1111/aej.12449] [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: 08/12/2020] [Accepted: 09/16/2020] [Indexed: 01/26/2023]
Abstract
The purpose of this study was to evaluate current trends in access cavity design and cleaning and shaping among endodontists. A survey was e-mailed to active members of the American Association of Endodontists. Data showed that most respondents used traditional (57%) or conservative (43%) access cavities; less than 1% reported using ultraconservative access cavities. A glide path was created by 93% of respondents; NaOCl was used as lubricant by 51% of respondents, while 28% used RC Prep, 9% used liquid EDTA, 7% used Glyde, and 2% did not use any lubricant. Most respondents used NaOCl at 5.25% or higher concentration. Smear layer was removed by 92% of endodontists. Apical gauging was mostly accomplished with hand files. Clinical preferences varied among surveyed endodontists and among different age groups. Currently, very few endodontists use ultraconservative access preparations. There was large variation among the respondents suggesting a possible need for quality guidelines.
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Affiliation(s)
- Polymnia Tsotsis
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Craig Dunlap
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Raymond Scott
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Ana Arias
- Department of Conservative Dentistry, School of Dentistry, Complutense University, Madrid, Spain
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA.,School of Dentistry, University of Queensland, Herston, Queensland, Australia
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