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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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Abdellatif D, Iandolo A, Scorziello M, Sangiovanni G, Pisano M. Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review. Bioengineering (Basel) 2024; 11:499. [PMID: 38790365 PMCID: PMC11118078 DOI: 10.3390/bioengineering11050499] [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: 04/18/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. AIM The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. RESULTS At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. CONCLUSIONS The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.
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Affiliation(s)
| | | | | | | | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy (A.I.); (M.S.); (G.S.)
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Baruwa AO, Chasqueira F, Arantes-Oliveira S, Caramês J, Marques D, Portugal J, Martins JNR. Comparative Analysis of Endodontic ISO Size 06, 08, and 10 Stainless Steel K-Files Used for Glide Path Procedures. Dent J (Basel) 2024; 12:98. [PMID: 38668010 PMCID: PMC11048936 DOI: 10.3390/dj12040098] [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: 02/23/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Small-sized stainless steel hand files are conventionally employed in root canal treatment procedures for canal scouting and for glide path establishment, owing to their superior flexibility and proficiency in navigating confined spaces. Given the diversity of brands available in the market, there exists potential variability in their physical characteristics, thereby influencing clinical performance. Consequently, this study aims to conduct a comparative analysis of the design, metallurgy, and mechanical characteristics among seven stainless steel hand file brands across ISO sizes 06, 08, and 10. A total of 315 new 25 mm length stainless steel hand files with apical sizes of 0.06, 0.08, and 0.10 from seven distinct brands were included in the study. A meticulous inspection of all instruments was undertaken to identify any structural deformations that might render them ineligible for the study. The design inspection involved the random selection of instruments from each group, which were examined under various microscopes, including a dental operating microscope, optical microscope, and scanning electron microscope. Furthermore, two instruments from each group underwent energy-dispersive X-ray spectroscopy analysis for elemental composition documentation. Mechanical tests were conducted to evaluate the instruments' resistance to lateral deformation (buckling) and their microhardness. Statistical analysis was executed using the nonparametric Mood's median test, with a predetermined significance level of 0.05. Regarding the instruments design, all files exhibited an active blade length ranging from 16 to 17 mm. However, variations were observed in the number of spirals, tip designs, and sizes, with the API K-File notably larger in sizes 0.06 and 0.08 compared to the other instruments. Despite uniform elements composition, differences in geometric features and mechanical properties were evident. Concerning buckling strength, the API K-File demonstrated superior performance across all tested sizes, while the Dentsply ReadySteel, SybronEndo, and Mani K-Files exhibited lower results (p < 0.05). In microhardness assessments, both the API and Oro K-Files displayed the lowest outcomes, with medians of 531 HVN and 532 HVN, respectively, whereas the SybronEndo K-File exhibited the highest microhardness (657 HVN). Despite similar metallurgical composition, the observed distinctions in geometric features and mechanical properties underscore the impact of the manufacturing process on the characteristics of glide path stainless steel endodontic files. These disparities may ultimately influence their clinical performance.
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Affiliation(s)
- Abayomi Omokeji Baruwa
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
| | - Filipa Chasqueira
- Instituto Universitário Egas Moniz, 2829-511 Monte da Caparica, Portugal;
| | - Sofia Arantes-Oliveira
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
- Grupo de Investigação em Materiais Dentários (BIOMAT), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
- LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), 1600-277 Lisboa, Portugal
| | - João Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
- LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), 1600-277 Lisboa, Portugal
- Instituto de Implantologia, 1070-064 Lisboa, Portugal
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
- LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), 1600-277 Lisboa, Portugal
- Instituto de Implantologia, 1070-064 Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral (GIBBO), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
- Centro de Estudos de Medicina Dentária Baseada na Evidência (CEMDBE), 1600-277 Lisboa, Portugal
| | - Jaime Portugal
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
- Grupo de Investigação em Materiais Dentários (BIOMAT), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
| | - Jorge N. R. Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal; (A.O.B.); (S.A.-O.); (J.C.); (D.M.); (J.P.)
- LIBPhys-FCT UID/FIS/04559/2013 (https://doi.org/10.54499/UIDB/04559/2020), 1600-277 Lisboa, Portugal
- Instituto de Implantologia, 1070-064 Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral (GIBBO), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
- Centro de Estudos de Medicina Dentária Baseada na Evidência (CEMDBE), 1600-277 Lisboa, Portugal
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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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Srivastava S. Root Canal Instrumentation: Current Trends and Future Perspectives. Cureus 2024; 16:e58045. [PMID: 38738101 PMCID: PMC11088362 DOI: 10.7759/cureus.58045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
The evolution of root canal instrumentation techniques has significantly impacted the field of endodontics, enhancing both the efficiency and outcomes of treatments. This review outlines the transition from manual to mechanical and rotary instruments, highlighting the role of nickel-titanium (NiTi) alloys and smart technologies in advancing procedural precision and reducing patient discomfort. Key historical developments and technological innovations, such as digital imaging and navigation systems, are explored for their contributions to improved clinical outcomes and patient satisfaction. Additionally, the review addresses the challenges presented by the complex anatomy of the root canal system and the advent of current instrumentation techniques. The potential of emerging trends, including artificial intelligence and advances in materials science, is discussed in the context of future endodontic practices. Despite the progress, challenges related to using advanced instrumentation methods, ethical considerations, and the cost factor of new technologies persist. The present review underscores the ongoing need for research and development to further refine root canal instrumentation techniques, ensuring that advancements in endodontic care remain patient-centered and accessible.
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Affiliation(s)
- Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, SAU
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Ventura BN, Gavini G, Iglecias EF, Freire LG, Caldeira CL. Using manual versus mechanized glide path instruments and ProTaper Gold versus ProTaper Next systems in curved canals: micro-CT study. Braz Oral Res 2024; 38:e006. [PMID: 38198306 DOI: 10.1590/1807-3107bor-2024.vol38.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/24/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.
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Affiliation(s)
- Breno Nappi Ventura
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Giulio Gavini
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | | | - Laila Gonzales Freire
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Celso Luiz Caldeira
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
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Özlek E, Gündüz H. The Effect of Using Different Kinematics Single File Systems with Coronal Preflaring Instruments on Postoperative Pain with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial. J Endod 2023; 49:1625-1633. [PMID: 37722449 DOI: 10.1016/j.joen.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the effect of using coronal preflaring file (One Flare; OF) with rotational (One Curve; OC) and reciprocal (WaveOne Gold; WOG) single file systems on postoperative pain in mandibular premolar teeth with symptomatic irreversible pulpitis. METHODS Eighty patients were included in this prospective, superiority, parallel, and randomized controlled clinical trial. The patients were randomly divided into four groups (n = 20) based on the use of coronal preflaring and the kinematics of the shaping instrument: WOG (without coronal preflaring), WOG with coronal preflaring (OF), OC (without coronal preflaring), and OC with coronal preflaring (OF). Patients recorded their postoperative pain intensity at 6, 24, 48, and 72 hours using a 10-cm visual analog scale. Friedman and Wilcoxon's tests were used for intragroup comparisons, and Kruskal-Wallis test was used for intergroup comparisons. The post hoc analysis was performed using Dunn's test. The Chi-square test was used to compare gender and tooth localization according to the groups, and Kruskal-Wallis test was used to compare age and preoperative pain (P < .05). RESULTS At 6 and 24 hours, WOG and OC with coronal preflaring groups showed statistically significantly lower pain scores than WOG and OC groups without coronal preflaring (P < .05). No significant difference was found between the groups in terms of analgesic medication intake. CONCLUSIONS The use of coronal preflaring with both rotational and reciprocal single file systems in root canal preparation resulted in less postoperative pain in mandibular premolar teeth diagnosed with symptomatic irreversible pulpitis.
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Affiliation(s)
- Esin Özlek
- Department of Endodontics, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey.
| | - Hüseyin Gündüz
- Department of Endodontics, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
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Yeniçeri Özata M, Falakaloğlu S, Keleş A, Adıgüzel Ö, Gündoğar M. Evaluation of shaping ability of different glide path instruments: a micro-computed tomography study. BMC Oral Health 2023; 23:780. [PMID: 37875946 PMCID: PMC10594883 DOI: 10.1186/s12903-023-03529-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND This study aimed to compare the shaping ability of different instruments, TruNatomy Glider (TRN-G), WaveOne Gold Glider (WOG-G), and ProGlider (Pro-G) using micro-computed tomography (micro-CT). METHODS The mesial canals of 27 mandibular molars with two separate mesial canals and moderate curvature were included in this study [n = 27 mesiobuccal (MB) and mesiolingual (ML) root canal]. According to the manufacturer's instructions, the glide path was created with TRN-G, WOG-G, and Pro-G glide path instruments (n = 9 MB and ML root canal in each group). Micro-CT scanning was performed before and after preparation. Mesiodistal (MD) and buccolingual (BL) transportation and the centering ratio were measured at three levels within the canal (3, 5 and 7 mm). A three-way robust ANOVA was used to compare the parameters. RESULTS TRN-G showed significantly greater transportation in the MD direction than the other instruments throughout the root canal (overall root canal) (p < 0.05). The best centering ability in the BL direction was shown by the WOG-G, regardless of level within the canal and canal distinction (MB vs. ML) (p < 0.05). There was no significant difference between groups according to the level within the canal and canal parameters (p > 0.05). Whether the root canal was MB or ML did not affect centering or transportation (p > 0.05). CONCLUSIONS Glide path instruments can be used to shape moderately curved canals with minimal apical transportation and better centering ability. All three tested glide path files can used safely before the shaping file.
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Affiliation(s)
- Merve Yeniçeri Özata
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey.
| | - Seda Falakaloğlu
- Department of Endodontics, School of Dentistry, İstanbul Health and Technology University, İstanbul, Turkey
| | - Ali Keleş
- Department of Endodontics, School of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
- Department of Endodontics, School of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Özkan Adıgüzel
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, School of Dentistry, İstanbul Medipol University, İstanbul, Turkey
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de Almeida Gardelin V, Vinholes JIAM, Grazziotin-Soares R, Pappen FG, Barletta FB. Influence of rotary and reciprocating kinematics on the accuracy of an integrated apex locator. AUST ENDOD J 2023; 49 Suppl 1:202-208. [PMID: 36401568 DOI: 10.1111/aej.12717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/03/2022] [Accepted: 11/06/2022] [Indexed: 09/17/2023]
Abstract
We evaluated in vitro the influence of nickel-titanium instruments kinematics on the accuracy and variation of root canal working length measurements, performed with an integrated apex locator, at glide path and at the end of shaping. Forty-four mandibular incisors, included in an alginate model, were allocated at random to two groups: reciprocating and rotary. Working length was determined at glide path stage and at the end of shaping. Measurements given by the integrated apex locator were matched with visual measurements. The apex locator accuracy was based on inter-group comparison. The variation in working length was based on intra-group comparison. Kinematics influenced the accuracy of measurements only after shaping (p < 0.05), and not in the glide path (p > 0.05). Rotary had values closer to the visual measurements. Diminishing of measures occurred after shaping for reciprocating (p < 0.05); and at glide-path stage for rotary (p > 0.05). The integrated apex locator was more accurate with rotary kinematics.
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Affiliation(s)
| | | | - Renata Grazziotin-Soares
- Endodontics Division, Oral Biological and Medical Sciences Department, Faculty of Dentistry, University of British Columbia, UBC, Vancouver, British Columbia, Canada
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Abbagnale R, Pagnoni F, Bhandi S, Bramucci C, Nardo DD. New Indications Regarding the Use of Endodontic Ni-Ti Rotary Instruments, How Is Shaping Changing? J Contemp Dent Pract 2023; 24:621-622. [PMID: 38152932 DOI: 10.5005/jp-journals-10024-3555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Affiliation(s)
- Rosemary Abbagnale
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesco Pagnoni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy, Phone: +393282177087, e-mail:
| | - Shilpa Bhandi
- Department of Conservative Dentistry, College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States of America
| | - Chiara Bramucci
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Dario Di Nardo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
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Laslami K, Khaldoune S, Sy A, Drouri S, Benkiran I. Apical Extrusion: Is It an Inherent Occurrence During Every Endodontic Treatment? Cureus 2023; 15:e45211. [PMID: 37720124 PMCID: PMC10504573 DOI: 10.7759/cureus.45211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
The aim of this literature review was to analyze all available scientific data on apical extrusion and to identify and associate the possible factors influencing the occurrence of apical extrusion, ranging from the choice of the canal shaping system, the irrigation technique, to the choice of diameter and the apical limit of preparation. A bibliographic search for relevant articles on apical extrusion of debris, irrigants, and bacteria was performed using the following databases: PubMed, Cochrane Library, and ScienceDirect. This search identified articles published between 2010 and 2023 in two languages (French and English). After selective sorting, 25 relevant documents were included. All the studies retained clearly agree on the inherent nature of apical extrusion during endodontic treatment. At the same time, we also understand that the amount of extrusion can be influenced by a number of parameters throughout endodontic therapy. According to this review, despite the undeniable nature of apical extrusion during endodontic therapy, studies with relatable experimental models that approach in vivo conditions are required to establish exploitable conclusions regarding apical extrusion and its prevention.
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Affiliation(s)
- Kaoutar Laslami
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Salma Khaldoune
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Aly Sy
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Sofia Drouri
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Imane Benkiran
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
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12
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Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: A narrative review. Saudi Dent J 2023; 35:468-475. [PMID: 37520597 PMCID: PMC10373078 DOI: 10.1016/j.sdentj.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This review aimed to assess the incidence, anatomical characteristics, identification, and clinical management using conventional techniques and advanced tools to manage MMCs successfully. Methods Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references. Results The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures. Conclusion The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
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Affiliation(s)
- Raghavendra Penukonda
- Department of Endodontics, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Harshada Pattar
- Department of Oral Pathology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Phrabhakaran Nambiar
- Head of the Department, Department of Oral Biology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
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Grande NM, Castagnola R, Minciacchi I, Marigo L, Plotino G. A review of the latest developments in rotary NiTi technology and root canal preparation. Aust Dent J 2023; 68 Suppl 1:S24-S38. [PMID: 37960998 DOI: 10.1111/adj.12998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
The introduction of nickel-titanium (NiTi) mechanical instruments dramatically changed clinical endodontics over the last few decades. Before NiTi, it was necessary to use more instruments to create an ideal root canal shape, and many approaches, sequences and techniques were developed over the years. Recently, NiTi endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments to improve their root canal preparation outcomes and reduce associated canal preparation risks during root canal treatment. Heat treatment is one of the most fundamental approaches to improving the fatigue resistance and flexibility of NiTi endodontic instruments. In addition, new kinematics have been developed to offer greater safety and efficiency. This narrative review describes the general properties and manufacturing of NiTi instruments, and the mechanical system evolution of NiTi instruments.
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Affiliation(s)
- N M Grande
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Castagnola
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - L Marigo
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Odontoiatria Generale e Ortodonzia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo. Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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Araújo LBB, Calefi PHS, Alcalde MP, Gavini G, Vivan RR, Duarte MAH. Impact of kinematics on the efficiency and safety of an engine-driven file for glide path preparation in MB2 canals of maxillary molars. Clin Oral Investig 2023; 27:1153-1158. [PMID: 36104605 DOI: 10.1007/s00784-022-04712-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the influence of different kinematics on the efficiency and safety of an engine-driven file for glide path preparation in second mesiobuccal canals (MB2) of maxillary molars. In addition, the torsional resistance of the file was assessed after use. METHODOLOGY Thirty-six maxillary first and second molars with two canals in the mesiobuccal root were selected and the anatomy of the canals was verified by micro-CT. The teeth were divided into 4 groups (n = 9) according to the kinematics used for glide path preparation: continuous rotation (CR), 30°/150° reciprocation (REC 30°/150°), 30°/90° reciprocation (REC 30°/90°), and 90° optimum glide path motion (OGP 90°). The duration of the procedure, number of canals in which the file reached the full working length (RFWL), canal volume before and after the procedure, rate of file fracture, and file torsional strength after use were evaluated. The ANOVA and Tukey tests or Kruskal-Wallis and Dunn tests were used for statistical analysis. RESULTS No significant differences among the groups were found for procedure duration, success at reaching the FWL, distance from the file to apex, and number of fractured files (P > 0.05). The CR group showed a significant decrease in rotation angle compared with REC 90° and OGP 90° groups (P < 0.05). There was no significant difference in canal volume among the groups (P > 0.05). CONCLUSION The type of kinematics used did not affect the efficiency, success rate, and shaping ability of the file during glide path preparation. CR seems to induce more torsional stress than the other kinematics. CLINICAL RELEVANCE The glide path preparation of narrow canals such as the MB2 is difficult and accidents such as file fracture may occur. This study showed that reciprocation with different file angulations can be safer during this challenging stage.
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Affiliation(s)
- Larissa B B Araújo
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Pedro H S Calefi
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Murilo P Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Rodrigo R Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, Bauru, São Paulo, 17012-901, Brazil.
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Influence of Coronal Flaring on the Shaping Ability of Two Heat-Treated Nickel-Titanium Endodontic Files: A Micro-Computed Tomographic Study. J Clin Med 2023; 12:jcm12010357. [PMID: 36615157 PMCID: PMC9821699 DOI: 10.3390/jcm12010357] [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: 12/11/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
Nickel-titanium (NiTi) usage is associated in endodontics with some complications including canal transportation. Centering ability of a NiTi file is the ability to stay centered in the root canal system during instrumentation. Any undesirable deviation from the natural canal path is indicated as canal transportation. A possible strategy to improve the centering ability of NiTi instruments is the pre-enlargement of the coronal third of the root canal to minimize coronal interferences. This procedure is known as coronal flaring. The aim of this study was to perform a micro-computed tomographic (micro-CT) evaluation of the effect of coronal flaring on canal transportation and centering ability of two heat treated nickel-titanium rotary instruments, 2Shape (Micro Mega, Besançon, France) and HyFlex CM (Coltène Whaledent, Altstätten, Switzerland). Thirty extracted mandibular molars with two independent mesial canals were selected and randomly instrumented (n = 15 canals) with One Flare (Micro Mega, Besançon, France) before HyFlex CM, HyFlex CM (without coronal flaring), One Flare before 2Shape and 2Shape (without coronal flaring). One Flare (Micro Mega, Besançon, France) was introduced 4 mm below the canal entrance for canals prepared with coronal flaring. HyFlex CM and 2Shape were used accordingly to manufacturers’ instructions. New files were used for each canal. During and after instrumentation, irrigation procedures were performed. Micro-CT images were obtained pre- and post-preparation to measure and record root canal transportation and centralization. They were reconstructed from root apex to canal orifices, generating approximately 1000 sections per specimen. The anatomical thirds were determined by dividing the number of cross-sectional slices by three. Root canal transportation and centralization were determined by Gambil method, and the mean values were analyzed by repeated measures analysis of variance followed by multiple comparisons of Bonferroni to compare the different instrumentations procedures and the root thirds (p < 0.05). As for root canal transportation, 2Shape reported significantly higher values compared to HyFlex CM in the cervical region independently from the coronal flaring. In the apical region, 2Shape caused significantly minor canal transportation when used with coronal flaring with compared with the absence of coronal flaring. Regarding the centralization, HyFlex CM showed higher values than 2Shape in the cervical, independently from coronal flaring. In the apical region, 2Shape with coronal flaring exhibited significant major centering ratio, compared with not. Within the limitations of this study, coronal flaring reduced canal transportation and improved centralization of the 2Shape files in the apical section while it had no significant influence on shaping ability of the HyFlex CM instruments. Coronal flaring could represent a valid strategy to improve the shaping ability of NiTi files knowing that its benefit could be influenced by the shaping file used.
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Biasillo V, Castagnola R, Colangeli M, Panzetta C, Minciacchi I, Plotino G, Staffoli S, Marigo L, Grande NM. Comparison of shaping ability of the Reciproc Blue and One Curve with or without glide path in simulated S-shaped root canals. Restor Dent Endod 2022; 47:e3. [PMID: 36578274 PMCID: PMC8891470 DOI: 10.5395/rde.2022.47.e3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 02/01/2023] Open
Abstract
Objectives This study aimed to assess the impact of a glide-path on the shaping ability of 2 single-file instruments and to compare the centering ability, maintenance of original canal curvatures and area of instrumentation in simulated S-shaped root canals. Materials and Methods Forty simulated S-shaped root canals were used and were prepared with One Curve (group OC), One G and OC (group GOC), Reciproc Blue (group RB) and R-Pilot and RB (group PRB) and scanned before and after instrumentation. The images were analyzed using AutoCAD. After superimposing the samples, 4 levels (D1, D2, D3, and D4) and 2 angles (Δ1 and Δ2) were established to evaluate the centering ability and modification of the canal curvatures. Then, the area of instrumentation (ΔA) was measured. The data were analyzed using 2-way analysis of variance and Tukey's test for multiple comparisons (p < 0.05). Results Regarding the centering ability in the apical part (D3, D4), the use of the glide-path yielded better results than the single-file groups. Among the groups at D4, OC showed the worst results (p < 0.05). The OC system removed less material (ΔA) than the RB system, and for Δ1, OC yielded a worse result than RB (p < 0.05). Conclusions The glide-path improved the centering ability in the apical part of the simulated S-shaped canals. The RB system showed a better centering ability in the apical part and major respect of the canal curvatures compared with OC system.
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Affiliation(s)
- Vincenzo Biasillo
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaella Castagnola
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Colangeli
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudia Panzetta
- Physics Department, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Irene Minciacchi
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Simone Staffoli
- Department of Oral and Maxillo-Facial Science, Sapienza University of Rome, Rome, Italy
| | - Luca Marigo
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Maria Grande
- Department of Operative Dentistry and Endodontics, Fondazione Policlinico Universitario A. Gemelli – IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
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Wang Y, Chen K, Lin X. Comparison of antibacterial effect of plantaricin 149 suspension and traditional root canal irrigation solutions in root canal infections in vitro. BMC Oral Health 2022; 22:643. [PMID: 36567353 PMCID: PMC9791718 DOI: 10.1186/s12903-022-02683-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022] Open
Abstract
Dental pulp and periapical diseases are common conditions in stomatology, caused by various pathogenic microorganisms. Antimicrobial peptides, as new antibiotics, offer promising applications in the irrigation and disinfection medicaments for root canals.One patient with chronic periapical periodontitis was selected to extract the clinical pathogenic bacteria. Porphyromonas gingivalis (Pg) (ATCC 33,277), Streptococcus mutans (Sm) (ATCC 25,175), and Prevotella intermedius (Pi) (ATCC 25,611) were used as test strains. The effects of plantaricin (Pln) 149 on the biofilm formation and growth in infected root canals were evaluated by RT-PCR, laser confocal scanning microscopy, and bacterial diversity analysis. In addition, the cytotoxicity of Pln 149 (100 µg/mL) to human dental pulp stem cells (hDPSCs) was assessed using an MTT assay. Pln 149 exhibited significant inhibitory effects on Pg Sm and Pi (P < 0.05), with significant differences in the biofilm images of the laser confocal scanning microscope (P < 0.05). There were no significant differences in hDPSCs viability or proliferation between the Pln 149 and control groups. Considering the excellent antimicrobial effects and low cytotoxicity, we suggest that Pln 149 might be a promising option for root canal irrigation solutions.
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Affiliation(s)
- Ying Wang
- grid.13402.340000 0004 1759 700XDepartment of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University,, Hangzhou, 310000 Zhejiang China
| | - Keda Chen
- grid.413073.20000 0004 1758 9341Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310000 China
| | - Xiaolong Lin
- grid.13402.340000 0004 1759 700XDepartment of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University,, Hangzhou, 310000 Zhejiang China
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Ashkar I, Sanz JL, Forner L. Cyclic Fatigue Resistance of Glide Path Rotary Files: A Systematic Review of in Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6662. [PMID: 36234003 PMCID: PMC9571085 DOI: 10.3390/ma15196662] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
The aim of the present systematic review was to perform a qualitative synthesis of in vitro studies that assess the cyclic fatigue resistance of rotary glide path (GP) files of endodontic applications. Systematic electronic searches were performed in the Medline, Embase, Scopus, SciELO, and Web of Science databases on 15 February 2022, and were last updated on 1 April In vitro studies that evaluated and compared the cyclic fatigue resistance of at least one rotary GP file system with another rotary GP file system were included. A total of 25 studies were included in the qualitative synthesis. All studies assessing the difference in the cyclic fatigue resistance between continuous and reciprocating rotation in rotary glide path files found that the latter resulted in a significantly higher cyclic fatigue resistance, as evidenced by a higher number of cycles until fracture and/or time until fracture. Within the limitations of this review and the in vitro nature of the included studies, the results indicate that the cyclic fatigue resistance of rotary GP files may be influenced by several intrinsic factors of the files, such as their taper, cross-sectional design, alloy properties, kinematics, and external factors, such as the curvature and radius at which the file is activated, the irrigation or lubricant used, and the temperature.
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Furtado JC, Feiosa APOP, Vivacqua-Gomes N, Bernardes RA, Vivan RR, Duarte MAH, Vasconcelos BCD. Root canal length changes during mechanical preparation due to different cervical enlargement patterns. Braz Oral Res 2022; 36:e080. [PMID: 35703706 DOI: 10.1590/1807-3107bor-2022.vol36.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate the root canal real length (RL) changes due to the mechanical instrumentation use with different flaring magnitudes. After access cavity, 60 mesial root canals of mandibular molars were randomly separated in three groups: Hyflex EDM (HF; #25/.12, #10/.05 e #25/~), Reciproc Blue (RB; R25), and MTwo (M2; #10/.04, #15/.05, #20/.06 e #25/.06). The RL was defined as the apical limit, and 2.5% sodium hypochlorite irrigating solution was chosen. After the access cavity (RL 1), cervical flaring (RL 2), and complete chemical-mechanical preparation (RL 3), the RL was evaluated. The RL was evaluated by a blind examiner with the aid of a microscope (16x) placing the endodontic file stop at the coronary reference. When comparing length measurements, the RL was shorter before instrumentation than that after instrumentation. A reduction of 0.65 mm (HF), 0.61 mm (RB), and 0.48 mm (M2) was observed. However, among groups, no statistical differences were found (p > 0.05). Under the conditions tested, it can be inferred that all mechanical systems provoked RL variations, which emphasizes the need for constant verification of the odontometry, mainly before root canal obturation.
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Affiliation(s)
| | | | - Nilton Vivacqua-Gomes
- São Leopoldo Mandic University , School of Dentistry of Ceará , Fortaleza , CE , Brazil
| | | | - Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru Dental School , Department of Dentistry, Endodontics and Dental Materials , Bauru , SP , Brazil
| | - Marco Antônio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School , Department of Dentistry, Endodontics and Dental Materials , Bauru , SP , Brazil
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Shi L, Yang Y, Wan J, Xie W, Yang R, Yao Y. Shaping ability of rotary and reciprocating single-file systems in combination with and without different glide path techniques in simulated curved canals. J Dent Sci 2022; 17:1520-1527. [PMID: 36299306 PMCID: PMC9588838 DOI: 10.1016/j.jds.2022.04.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/27/2022] [Indexed: 11/01/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
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21
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KÜDEN C, YOLDAŞ O, EVLİCE B, YİLMAZ S, DUMANİ A. Influence of establishing a glide path on the amount of apically extruded debris and the preservation of root canal anatomy. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1024096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Escobar PM, Lopes FC, Carvalho K, Fretes V, Hadid GG, Mazzi-Chaves JF, Sousa-Neto MD. Influence of different calcium hydroxide removal protocols on the bond strength of epoxy resin-based sealer in long oval root canals. Microsc Res Tech 2021; 85:781-788. [PMID: 34564917 DOI: 10.1002/jemt.23949] [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: 04/22/2021] [Revised: 08/25/2021] [Accepted: 09/16/2021] [Indexed: 11/06/2022]
Abstract
This study evaluated the effect of different protocols for Ca(OH)2 removal on the bond strength (BS) of epoxy resin-based sealer in long oval root canals. Forty-eight mandibular incisors with long oval root canals were selected by CBCT. Biomechanical preparation was performed, the samples were filled with Ca(OH)2 paste and distributed in four groups (n = 12): G-without Ca(OH)2 paste (C); G2-syringe/needle (SN); G3-SN + XP-Endo® Finisher (XPF); G4-SN + passive ultrasonic irrigation (PUI). After 7 days, Ca(OH)2 was removed and teeth were filled using AHPlus and guttapercha. In four samples from each group, the sealer was manipulated with 0.1% rhodamine to assess sealer penetration by fluorescent laser confocal microscopy (FLCM). Samples were sectioned in slices for BS, scanning electron microscopy, and FLCM analysis. The BS data were analyzed by ANOVA and Tukey tests (α = 0.05). The lowest BS values were found for the SN group (12.89 ± 4.36) compared to C (35.55 ± 10.05), while PUI group presented intermediate values (28.57 ± 9.35) and the XPF group (31.34 ± 9.8) showed values that were sometimes similar to C group and sometimes similar to PUI group (p > .05). The analysis of the adhesive interface showed evident gaps, with the presence of residues between the dentin and the filling material for the SN group, and for C, XPF and PUI groups juxtaposed adhesive interface. FLCM images showed sealer penetration in the dentinal tubules along the entire perimeter for C, XPF, and PUI groups. Ca(OH)2 removal with XPF and PUI from long oval root canals resulted in higher bond strength values compared to SN, besides better sealer penetration on dentinal tubules and juxtaposed adhesive interface.
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Affiliation(s)
- Patrícia Maria Escobar
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Fabiane Carneiro Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Kleber Carvalho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Vicente Fretes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Gabriela Gavilán Hadid
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, Brazil
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Comparison of Canal Transportation, Separation Rate, and Preparation Time between One Shape and Neoniti (Neolix): An In Vitro CBCT Study. Int J Dent 2021; 2021:6457071. [PMID: 34539788 PMCID: PMC8443393 DOI: 10.1155/2021/6457071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose This in vitro study compared root canal preparation in curved mesiobuccal canals of molar teeth using either the One Shape™ or the Neoniti (Neolix) rotary NiTi single-file systems, assessing canal transportation, instrument separation and time required for preparation. Methods. Extracted maxillary and mandibular human molar teeth with mesiobuccal canals having apical angles of curvature between 25 and 35o were selected and embedded in acrylic resin blocks, and an initial CBCT was taken. The teeth were divided into two equal groups (n = 20), and the canals were cleaned and shaped using either Neoniti™ or One Shape™ engine-driven NiTi rotary files. Each individual instrument was used to prepare 5 canals. The time required for the preparation of each canal was recorded. Postpreparation CBCT scans were taken and used to determine the extent of canal transportation at levels of 2, 4, 6, and 8 mm from the apex. The Kolmogorov–Smirnov test for normality was applied, and then, datasets were compared using independent t-tests, with a threshold of P < 0.05. Results Neoniti rotary files caused significantly less canal transportation of the curved canals (P=0.0001). On the other hand, the time required for canal preparation was significantly shorter for One Shape (P=0.0001). No instrument separation was recorded in both groups. Conclusion Based on these results, the Neoniti™ rotary file system is preferred because it maintains the original shape of curved root canals better than One Shape™; even though this benefit comes at the cost of an increase in preparation time in clinical practice, the better technical performance may be more important than a difference in procedural time.
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Martins JNR, Silva EJNL, Marques D, Pereira MR, Arantes-Oliveira S, Martins RF, Braz Fernandes FM, Versiani MA. Evaluation of Design, Metallurgy, Microhardness, and Mechanical Properties of Glide Path Instruments: A Multimethod Approach. J Endod 2021; 47:1917-1923. [PMID: 34537227 DOI: 10.1016/j.joen.2021.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/18/2021] [Accepted: 09/02/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION This study aims to compare the design, metallurgy, microhardness, and mechanical properties of 3 glide path nickel-titanium (NiTi) instruments. METHODS A total of 132 ProGlider (Dentsply Sirona, Ballaigues, Switzerland), Edge Glide Path (EdgeEndo, Johnson City, TN), and R-Pilot instruments (VDW, Munich, Germany) (44 per group) were selected. Design was assessed through stereomicroscopy (blades, helical angle, measuring lines, and deformation) and scanning electron microscopy (symmetry, cross section, tip, and surface finishing). NiTi ratios were measured by energy-dispersive X-ray spectroscopy and phase transformation temperatures by differential scanning calorimetry. Microhardness and mechanical performance (torsion, bending, and buckling resistance tests) were also evaluated. Statistical analyses were performed with the Mood median test with a significance set at 5%. RESULTS The Edge Glide Path had the lowest number of blades and the R-Pilot the greatest helical angle. All instruments had an almost equiatomic NiTi ratio, while showing different cross sections and tip geometries. The Edge Glide Path had a smoother surface finishing. The R-Pilot showed martensitic characteristics at room temperature, whereas mixed austenite plus R-phase was observed in the other instruments. The R-Pilot had higher results on the microhardness (436.8 hardness Vickers number), maximum torsion (0.9 Ncm), and buckling load (0.7 N) tests (P < .05), whereas the Edge Glide Path had a superior angle of rotation (683.5°) and the ProGlider was more flexible (144.1 gf) (P < .05). CONCLUSIONS Differences in the design of the instruments and the phase transformation temperatures accounted for their mechanical behavior. The R-Pilot showed the highest torque, buckling, and microhardness, whereas the ProGlider instrument was the most flexible.
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Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência, Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
| | - Emmanuel João Nogueira Leal Silva
- School of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil; Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência, Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia Arantes-Oliveira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | - Rui F Martins
- UNIDEMI, Department of Mechanical and Industrial Engineering, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Francisco Manuel Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
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25
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Oliveira LSDJ, de Bragança RMF, Sarkis-Onofre R, Faria-E-Silva AL. The effectiveness of the supplementary use of the XP-endo Finisher on bacteria content reduction: a systematic review and meta-analysis. Restor Dent Endod 2021; 46:e37. [PMID: 34513643 PMCID: PMC8411000 DOI: 10.5395/rde.2021.46.e37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/16/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives This systematic review evaluated the efficacy of the supplementary use of the XP-endo Finisher on bacteria content reduction in the root canal system. Materials and Methods In-vitro studies evaluating the use of the XP-endo Finisher on bacteria content were searched in four databases in July 2020. Two authors independently screened the studies for eligibility. Data were extracted, and risk of bias was assessed. Data were meta-analyzed by using random-effects model to compare the effect of the supplementary use (experimental) or not (control) of the XP-endo Finisher on bacteria counting reduction, and results from different endodontic protocols were combined. Four studies met the inclusion criteria while 1 study was excluded from the meta-analysis due to its high risk of bias and outlier data. The 3 studies that made it to the meta-analysis had an unclear risk of bias for at least one criterion. Results No heterogeneity was observed among the results of the studies included in the meta-analysis. The study excluded from the meta-analysis assessing the bacteria counting deep in the dentin demonstrated further bacteria reduction upon the use of the XP-endo Finisher. Conclusions This systematic review found no evidence supporting the supplementary use of the XP-endo Finisher on further bacteria counting the reduction in the root canal.
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Affiliation(s)
| | | | | | - André Luis Faria-E-Silva
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.,Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
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León-López M, Cabanillas-Balsera D, Areal-Quecuty V, Martín-González J, Jiménez-Sánchez MC, Saúco-Márquez JJ, Sánchez-Domínguez B, Segura-Egea JJ. Influence of Coronal Preflaring on the Accuracy of Electronic Working Length Determination: Systematic Review and Meta-Analysis. J Clin Med 2021; 10:2760. [PMID: 34201705 PMCID: PMC8268739 DOI: 10.3390/jcm10132760] [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: 05/24/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022] Open
Abstract
AIM To conduct a systematic review and meta-analysis according to the following PICO question: in extracted human permanent teeth, does preflaring, compared with unflared canals, influence the accuracy of WL determination with EAL? MATERIAL AND METHODS A systematic review was conducted according to the PRISMA checklist, using the following databases: PubMed, Science Direct, Scopus, and Web of Science. Studies related to WL determination using EAL both in preflared and unflared root canals of extracted human teeth were included. The outcome of interest was the accuracy of the electronic WL determination. A quality assessment of the included studies was performed, determining the risk of bias. The meta-analyses were calculated with the 5.4 RevMan software using the inverse variance method with random effects. PROSPERO registration: CRD42021243412. RESULTS Ten experimental studies fulfilled the inclusion criteria, and most of them found that preflaring increases the accuracy of the EALs in WL determination. The calculated OR was 1.98 (95% CI = 1.65-2.37; p < 0.00001; I2 = 10%), indicating that the determination of WL by EALs is almost twice as accurate in preflared canals. The accuracy of Root ZX in WL determination increases more than three times (OR = 3.25; p < 0.00001). Preflaring with Protaper files significantly increases the accuracy of EALs (OR = 1.76; p < 0.00001). The total risk of bias of the included studies was low. No obvious publication bias was observed. CONCLUSIONS The results indicate a significant increase in the accuracy of WL determination with EAL after preflaring, doubling the percentage of exact measurements. Preflaring should be recommended as an important step during mechanical enlargement of the root canal, not only because it improves the access of the files to the canal, but also because it allows one to obtain more accurate electronic determinations of WL.
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Affiliation(s)
| | - Daniel Cabanillas-Balsera
- Endodontic Section, Department of Stomatology, University of Sevilla, C/Avicena s/n, 41009 Sevilla, Spain; (M.L.-L.); (V.A.-Q.); (J.M.-G.); (M.C.J.-S.); (J.J.S.-M.); (B.S.-D.)
| | | | | | | | | | | | - Juan J. Segura-Egea
- Endodontic Section, Department of Stomatology, University of Sevilla, C/Avicena s/n, 41009 Sevilla, Spain; (M.L.-L.); (V.A.-Q.); (J.M.-G.); (M.C.J.-S.); (J.J.S.-M.); (B.S.-D.)
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27
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Fatima S, Kumar A, Andrabi SMUN, Mishra SK, Tewari RK. Effect of Apical Third Enlargement to Different Preparation Sizes and Tapers on Postoperative Pain and Outcome of Primary Endodontic Treatment: A Prospective Randomized Clinical Trial. J Endod 2021; 47:1345-1351. [PMID: 34058250 DOI: 10.1016/j.joen.2021.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/24/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the effect of apical preparation size and taper on postoperative pain and healing after primary endodontic treatment. METHODS One hundred and twenty patients with asymptomatic mandibular first molars with radiographic evidence of periapical pathology and with a periapical index (PAI) score ≥3 were randomly assigned to 2 groups, group 1 and 2, based on apical enlargement to 2 and 3 sizes larger than the initial apical binding file (IABF), respectively. Each group was further divided into subgroups A and B depending on the apical enlargement taper of 4% and 6%, respectively. Endodontic treatment was performed, and the final apical enlargement in all the groups was performed as follows: group 1A, 2 sizes larger than the IABF with a 4% taper; group 1B, 2 sizes larger than the IABF with a 6% taper; group 2A, 3 sizes larger than the IABF with a 4% taper; and group 2B, 3 sizes larger than the IABF with a 6% taper. Postoperative pain was assessed at 6, 12, 24, 48, and 72 hours. Clinical evaluation and the change in the PAI score on radiographs were assessed at the 3-, 6-, and 12-month follow-ups. RESULTS No significant difference in postoperative pain was found. The success rate was lowest (57.1%) in group 1 subgroup A as evidenced by the significant change in the PAI score between group 1 subgroup A and the rest of the groups at the 6- and 12-month follow-ups. CONCLUSIONS Apical preparation to 2 sizes larger than the IABF with a 4% taper is insufficient and results in significantly lower success rates compared with larger preparation sizes and tapers.
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Affiliation(s)
- Shazra Fatima
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
| | - Ashok Kumar
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
| | - Syed Mukhtar Un Nisar Andrabi
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India.
| | - Surendra Kumar Mishra
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
| | - Rajendra Kumar Tewari
- Department of Conservative Dentistry and Endodontics, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, India
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Shaping ability of a new heat-treated NiTi system in continuous rotation or reciprocation in artificial curved canals. Odontology 2021; 109:792-801. [PMID: 33751302 DOI: 10.1007/s10266-021-00600-9] [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: 09/24/2020] [Accepted: 03/15/2021] [Indexed: 01/15/2023]
Abstract
The purpose is to evaluate canal transportation of a new heat-treated NiTi system, the Endostar E3 Azure operated in continuous rotation or reciprocation. 40 resin blocks were divided into two groups. The first was shaped in continuous rotation while the second in reciprocation. A preoperative and two postoperative images were taken, one after the use of the 20/06 and one after the 25/06. The images were superimposed to determine canal transportation. Time required for canal shaping was recorded. One-sample and student t tests, repeated-measure analyses of variance, univariate analyses and Bonferroni multiple comparisons tests were used for statistical analysis. The significance level was set at p < 0.05. There was no significant difference between continuous and reciprocating motion with the 20/06 and 25/06, respectively, at 1 mm (p = 0.761, p = 0.559), 2 mm (p = 0.584, p = 0.810) and 3 mm (p = 0.651, p = 0.070). The reciprocating motion showed significantly less canal transportation at 5 mm (p = 0.049, p < 0.001) and 7 mm (p < 0.001, p < 0.001) for the 20/06 and 25/0.6. Continuous rotation was more time-consuming than reciprocation (p < 0.001). The Endostar E3 Azure in reciprocation respected the original canal curvature better than in continuous rotation at all levels, and required less time to prepare artificial curved canals. Endodontists should know the shaping abilities of novel heat-treated NiTi files, regarding canal transportation and its relation with the instruments' motion and apical diameter enlargement.
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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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An Arithmetic Crown-down Dynamic Tactile Instrumentation Technique: A Case Report of an S-shaped Root Canal. J Endod 2020; 47:836-843. [PMID: 33387551 DOI: 10.1016/j.joen.2020.12.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
The preparation of severely curved S-shaped double-curved root canals can be technically challenging. A novel root canal instrumentation technique is proposed, which modifies 2 techniques: the McSpadden crown-down technique and the tactile controlled activation technique. In the McSpadden crown-down technique, the root canal is divided into 2 portions: the coronal zone and the apical zone. However, rather than focusing on the length of file engagement, a formula is proposed to calculate the maximum insertion depths of higher tapered instruments to prevent overflaring of the canal and preserve pericervical dentin. Tactile-controlled activation involves activating martensitic nickel-titanium rotary files upon engagement and then immediately withdrawing the files. The proposed technique recommends 3 apical strokes after the initial engagement before withdrawal to minimize instrumentation time. This novel technique is described in a case report involving the management of an S-shaped double-curved maxillary lateral incisor. The technique presents a new method of crown-down instrumentation that prevents overflaring and avoids instrument separation.
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Analysis of second mesiobuccal root canal instrumentation in maxillary first molars with three nickel-titanium rotary instruments: a micro-computed tomographic study. Odontology 2020; 109:496-505. [PMID: 33175279 DOI: 10.1007/s10266-020-00564-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to evaluate the shaping characteristics of Protaper Universal (PTU; Dentsply Tulsa Dental Specialties, Johnson City, TN), Hero Shaper (HS; MicroMega, Besacon, France) and Hyflex CM (HCM; Coltene-Whaledent, Allstetten, Switzerland) nickel-titanium systems with various apical sizes and tapers in second mesiobuccal (MB2) canal instrumentation using micro-computed tomographic imaging. A total of 27 maxillary first molars with independent patent MB2 canals were selected and randomly assigned to three groups according to the 3-dimensional morphologic aspects obtained from preoperative micro-computed tomographic scans. Canals were first negotiated with a size 8 K-file and finally prepared to F1, F2, and F3 with PTU and to sizes 20.04 taper, 25.04 taper, and 30.04 taper with HS and HCM. Postoperative scans were performed after each instrumentation with the same parameters used in the initial scan. The canal volume, canal transportation, untouched canal surface and wall thickness were measured and calculated using Mimics 10.01 software (Image Works, Materialise, Belgium). Statistical analysis was performed using one-way analysis of variance post hoc LSD tests. PTU removed more dentin than HS and HCM in all sections when instrumented to the same apical size (P < 0.05). HS and HCM presented a lower mean value of canal transportation than PTU in all measured sizes and sections. PTU presented a lower mean value of distal wall thickness than HS and HCM at the level of 1 and 2 mm below the furcation region in all measured sizes. In conclusion, for MB2 canal instrumentation, HS and HCM of 0.04 taper are safer than PTU.
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Htun PH, Ebihara A, Maki K, Kimura S, Nishijo M, Kyaw MS, Okiji T. Comparison of Torque, Screw-in Force, and Shaping Ability of Glide Path Instruments in Continuous Rotation and Optimum Glide Path Motion. J Endod 2020; 47:94-99. [PMID: 33002538 DOI: 10.1016/j.joen.2020.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION This study aimed to analyze torque/force generation and transportation in double-curved canals instrumented with 3 types of glide path files using optimum glide path (OGP) motion in comparison with continuous rotation. METHODS Sixty simulated double-curved canals were prepared with #10/0.05 or #15/0.03 HyFlex EDM Glidepath files (Coltene/Whaledent, Altstätten, Switzerland) or a #13/0.04 prototype MANI Glidepath file (Tochigi, Japan) using OGP motion or continuous rotation (n = 10 each). Canals were sequentially prepared to 20 mm and 22 mm (full working length) using automated root canal instrumentation and a torque/force analyzing device. Transportation was calculated at 1-9 mm from the apex. Data were compared using 2-way analysis of variance followed by a post hoc simple main effect test with Bonferroni correction and a Kruskal-Wallis test (α = 5%). RESULTS All #10/0.05 instruments fractured. In the 22-mm preparation, the OGP motion resulted in lower clockwise torque and screw-in force than did continuous rotation (P < .05). In the 20-mm preparation, #15/0.03 instruments recorded a lower screw-in force for OGP motion than for continuous rotation (P < .05). Comparing the 2 preparation phases, OGP motion generated no significant differences; however, continuous rotation developed higher clockwise torque and screw-in force in the 22-mm preparation than in the 20-mm preparation (P < .05). There was no significant difference among the tested groups for transportation values. CONCLUSIONS Compared with continuous rotation, OGP motion generated less screw-in force, lower clockwise torque, and similar transportation. The #15/0.03 HyFlex EDM instrument and the #13/0.04 prototype MANI instrument performed similarly well.
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Affiliation(s)
- Pyae Hein Htun
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Keiichiro Maki
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shunsuke Kimura
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Miki Nishijo
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Moe Sandar Kyaw
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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