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Kyaw MS, Ebihara A, Iino Y, Thu M, Maki K, Kimura S, Htun PH, Okiji T. Effect of repetitive up-and-down movements on torque/force generation, surface defects and shaping ability of nickel-titanium rotary instruments: an ex vivo study. BMC Oral Health 2024; 24:986. [PMID: 39180005 PMCID: PMC11344434 DOI: 10.1186/s12903-024-04689-6] [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: 05/08/2024] [Accepted: 07/30/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND The screw-in effect is a tendency of a nickel-titanium (NiTi) rotary endodontic file to be pulled into the canal, which can result in a sudden increase in stress leading to instrument fracture, and over-instrumentation beyond the apex. To reduce screw-in force, repeated up-and-down movements are recommended to distribute flexural stress during instrumentation, especially in curved and constricted canals. However, there is no consensus on the optimal number of repetitions. Therefore, this study aimed to examine how repeated up-and-down movements at the working length affect torque/force generation, surface defects, and canal shaping ability of JIZAI and TruNatomy instruments. METHODS An original automated root canal instrumentation device was used to prepare canals and to record torque/force changes. The mesial roots of human mandibular molars with approximately 30˚ of canal curvature were selected through geometric matching using micro-computed tomography. The samples were divided into three groups according to the number of up-and-down movements at the working length (1, 3, and 6 times; n = 24 each) and subdivided according to the instruments: JIZAI (#13/0.04 taper, #25/0.04 taper, and #35/0.04 taper) or TruNatomy (#17/0.02 taper, #26/0.04 taper, and #36/0.03 tape) (n = 12 each). The design, surface defects, phase transformation temperatures, nickel-titanium ratios, torque, force, shaping ability, and surface deformation were evaluated. Data were analyzed with the Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS The instruments had different designs and phase transformation temperatures. The 3 and 6 up-and-down movements resulted in a smaller upward force compared to 1 movement (p < 0.05). TruNatomy generated significantly less maximum torque, force, and surface wear than JIZAI (p < 0.05). However, TruNatomy exhibited a larger canal deviation (p < 0.05). No statistical differences in shaping ability were detected between different up-and-down movements. CONCLUSIONS Under laboratory conditions with JIZAI and TruNatomy, a single up-and-down movement at the working length increased the screw-in force of subsequent instruments in severely curved canals in the single-length instrumentation technique. A single up-and-down movement generated more surface defects on the file when using JIZAI. TruNatomy resulted in less stress generation during instrumentation, while JIZAI better maintained the curvature of root canals.
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Affiliation(s)
- 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Yoshiko Iino
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Myint Thu
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, 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), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Călin C, Focșăneanu AM, Paulsen F, Didilescu AC, Niță T. Shaping Efficiency of Rotary and Reciprocating Kinematics of Engine-driven Nickel-Titanium Instruments in Moderate and Severely curved Root Canals Using Microcomputed Tomography: A Systematic Review of Ex Vivo Studies. J Endod 2024; 50:907-924. [PMID: 38537784 DOI: 10.1016/j.joen.2024.03.009] [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: 12/29/2023] [Revised: 02/29/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION This systematic review aimed to compare reciprocating with continuous rotary instrumentation kinematics, by means of microcomputed tomography evaluations, in extracted human permanent teeth with moderate and severe canal curvatures. METHODS The research protocol was registered in the International Prospective Register of Systematic Reviews and given the reference number CRD42023404035. An electronic search was undertaken in MEDLINE (PubMed), EBSCO, Scopus, Web of Science databases until December 2021. Manual screening of issues in endodontic journals and references of relevant articles were assessed individually. The risk of bias (RoB) of the included articles was evaluated with the QUIN tool (Quality Assessment Tool for In Vitro Studies). RESULTS Among 1640 retrieved articles, 49 were included in the qualitative synthesis. Fifteen articles had low RoB, 33 articles had medium RoB, and only 1 study was at high RoB. Continuous rotary systems had better centering ability in both moderate and severe canal curvatures and resulted in less apical transportation in severely curved root canals. None of the kinematic systems was capable of instrumenting the entire canal surface area. Reciprocating kinematics systems tended to provide higher increase in surface area of severely curved canals and produced fewer dentinal microcracks in moderately curved canals. CONCLUSIONS The evidence presented in this review suggests that continuous rotary system seems to be better than reciprocating system in solving the major issues encountered during root canal instrumentation of extracted teeth with moderate and severe curvatures.
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Affiliation(s)
- Claudiu Călin
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreea C Didilescu
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Tiberiu Niță
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery "Dan Theodorescu Hospital", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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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: 0] [Impact Index Per Article: 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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Belladonna FG, Guimarães TDM, Silva EJNL, Vieira EDO, Lee JK, Rodrigues EDA, Souza EM, Versiani MA. Exploring the Efficacy of 6 Preparation Systems for Achieving Minimal Root Canal Transportation: A Micro-CT Investigation. J Endod 2023; 49:1722-1732. [PMID: 37717910 DOI: 10.1016/j.joen.2023.09.004] [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: 05/31/2023] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION This study aimed to assess the canal transportation with 6 preparation systems. METHODS Sixty curved mesial roots of mandibular molars were scanned, and their root canals (n = 20 per group) were prepared with XP-endo Shaper, BioRace, ProTaper Next, Twisted File Adaptive, Reciproc, or Reciproc Blue systems. After preparation, a new scan was conducted, and transportation was determined by comparing the geometric center of the canal in 13,542 cross-sectional slices. The transport direction frequencies were recorded, and linear transport were compared using a Univariate GLM model and Tukey honestly significant difference tests (α = 5 %). RESULTS Transportation was affected by the preparation system and root third (P < .05), with no significant effect observed for the root canal (P > .05). The Twisted File Adaptive had the highest transport (P < .05), and the lowest transports were observed with XP-endo Shaper, ProTaper Next, and BioRace (P < .05). Reciproc Blue and Reciproc showed intermediate results (P < .05). The apical and coronal third exhibited the lowest and highest transportation, respectively (P < .05). A significant interaction was observed between the preparation system and root third (P < .05). In the coronal third, transportation was mostly toward the disto-inside direction, whereas in the middle and apical thirds, transportation was predominantly toward the mesio-outside direction. CONCLUSIONS XP-endo Shaper had the lowest mean linear transportation followed by the ProTaper Next, BioRace, Reciproc Blue, and Reciproc systems. The Twisted File Adaptive system had the worst performance. The direction of transportation was generally toward the inner aspect of the canal at the coronal third and toward the outer aspect of the curve at the middle and apical thirds.
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Affiliation(s)
| | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Rio de Janeiro, Brazil; Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Jong-Ki Lee
- Private Practice, Changwon, Republic of Korea
| | | | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
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Bueno CRE, Sarmiento JL, Vasques AMV, da Silva ACR, Cintra LTA, Santos JMM, Dezan-Júnior E. Biocompatibility, Biomineralization and Induction of Collagen Maturation with the Use of Calcium Hydroxide and Iodoform Intracanal Dressing. J Funct Biomater 2023; 14:507. [PMID: 37888171 PMCID: PMC10607429 DOI: 10.3390/jfb14100507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Biocompatibility and biomineralization of root canal dressings are important requirements for periapical healing. This study evaluated the inflammatory response, biomineralization and tissue repair by collagen fiber maturation in the subcutaneous tissue of rats. Eighteen Wistar rats (n = 6) received subcutaneous implants: calcium hydroxide + propylene glycol [CH+P], calcium hydroxide + propylene glycol + iodoform [CH+P+I], iodoform + carbowax [I+Cwax] and carbowax [Cwax]. Extra empty tubes were used as a control [C]. After 7, 15 and 30 days, the implants were removed with surrounding tissue for staining of hematoxylin-eosin, Von Kossa, picrosirius red and without staining for analysis under polarized light. Results were analyzed via Kruskal-Wallis followed by Dunn testing for nonparametric data and ANOVA followed by a Tukey post hoc test for parametric data (p < 5%). At 7 days, all groups showed a moderate inflammatory reaction and thick fibrous capsule, except the [Cwax] group, with a severe inflammatory infiltrate (p < 0.05). After 15 days, all groups but control had a decrease in inflammatory response. At 30 days, all groups presented a mild reaction and thin fibrous capsule (p > 0.05). Only groups containing calcium hydroxide were found to be positive using Von Kossa staining and polarized light in all periods. At 7 days, all groups showed a higher proportion of immature fibers. At 15 days, the [CH+P] and [Cwax] groups increased their proportion of mature/immature fibers. At 30 days, only the [CH+P] group presented a significant prevalence of mature collagen fibers (p < 0.05). All groups showed biocompatibility, but only groups containing calcium hydroxide induced biomineralization. The addition of iodoform delayed tissue healing.
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Affiliation(s)
- Carlos Roberto Emerenciano Bueno
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Jimena Lama Sarmiento
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Ana Maria Veiga Vasques
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Ana Cláudia Rodrigues da Silva
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | - Luciano Tavares Angelo Cintra
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
| | | | - Eloi Dezan-Júnior
- Endodontic Section, Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry (FOA), São Paulo State University (Unesp), Araçatuba 16015-050, SP, Brazil (A.M.V.V.)
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Chan CW, Romeo VR, Lee A, Zhang C, Neelakantan P, Pedullà E. Accumulated Hard Tissue Debris and Root Canal Shaping Profiles Following Instrumentation with Gentlefile, One Curve, and Reciproc Blue. J Endod 2023; 49:1344-1351. [PMID: 37516238 DOI: 10.1016/j.joen.2023.07.019] [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: 05/19/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION This laboratory study aimed to evaluate the accumulated hard tissue debris (AHTD) and shaping performance following root canal instrumentation with a novel stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with two single-file nickel-titanium instruments of different kinematics through micro-computed tomography (micro-CT) analysis. METHODS Thirty isthmus-containing mesial roots of human mandibular molars with a curvature of 15°-35° were scanned with micro-CT at an isotropic resolution of 12 μm and randomly assigned to three groups (n = 10) according to the instruments used for canal preparation: Gentlefile (GF; #23/.04), One Curve (OC; #25/.06; Micro-Mega, Besancon, France), and Reciproc Blue R25 (RB; #25/.08; VDW, Munich, Germany). The AHTD, unprepared canal surface area, volume changes, surface area changes, and transportation were evaluated by comparing preoperative and postoperative micro-CT images. In addition, the time required for canal preparation was recorded. Data were statistically analyzed using the one-way analysis of variance (ANOVA) test or the Kruskal-Wallis test at a significance level of 5%. RESULTS No significant differences were observed in the percentage of AHTD or in the unprepared canal surface area between the three groups (P > .05). The RB group demonstrated a significantly greater percentage increase in volume and surface area than the GF group (P < .05). The GF and OC groups showed significantly less transportation at 3 mm from the apex than the RB group (P < .001). The OC group required significantly less time for instrumentation than the RB and GF groups (P < .05). CONCLUSIONS Instrumentation with GF (#23/.04), OC, and RB yielded similar levels of AHTD and unprepared surface area in isthmus-containing curved canals. GF achieved this with less dentin removal and apical transportation, at the expense of a longer preparation time.
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Affiliation(s)
- Chi Wai Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Virginia Rosy Romeo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Angeline Lee
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Prasanna Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA.
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Jose J, Teja KV, Silva EJNL, Janani K, Siddique R, Rossi-Fedele G. Centric versus eccentric engine-driven endodontic instrument design for microbial load reduction-A systematic review and meta-analysis of randomised clinical trials. AUST ENDOD J 2023; 49 Suppl 1:515-527. [PMID: 36514265 DOI: 10.1111/aej.12726] [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: 07/28/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments.
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Affiliation(s)
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Chennai, India
| | - Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Lui K, Liu H, Wang H, Yang X, Huang D, Zhou X, Gao Y, Shen Y. An application framework of 3D assessment image registration accuracy and untouched surface area in canal instrumentation laboratory research with micro-computed tomography. Clin Oral Investig 2023; 27:715-725. [PMID: 36482105 DOI: 10.1007/s00784-022-04819-w] [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: 04/08/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The purpose of this study was to develop a customized framework for evaluating the registration accuracy of four registration techniques and measuring the untouched surface area of canal instrumentation by visually inspecting and calculating the overlapping area of the surfaces. METHODS Twenty-one mandibular incisors were scanned by micro-computed tomography before and after instrumentation. Elastix registration, surface registration, manual registration, and DataViewer registration techniques were used to align the pre- and post-operative datasets. The customized MeVisLab framework was created to investigate the registration accuracy by visual inspection and calculating overlapping areas. The canal surfaces were imported into the same framework to measure the untouched surface area and the consistence test was validated. The correlation between registration accuracy and untouched surface area was analyzed. RESULTS There is a statistically significant difference between manual registration and automatic registration (P < 0.05). There is no statistical difference between the two untouched surface measure methods (P > 0.05). The partial correlation coefficients for the untouched surface area and registration accuracy were 0.45 (P < 0.05). CONCLUSIONS This application framework based on free customizable software, allows a new method to measure registration accuracy and untouched surface area in an efficient and sensitive way. The application of a precise registration method would improve the quality of micro-CT canal instrumentation studies. CLINICAL RELEVANCE This study developed a customized framework based on free software for evaluating the registration accuracy of different registration techniques and measuring the untouched surface area of canal instrumentation could help researchers to improve the quality of micro-CT studies of canal instrumentation.
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Affiliation(s)
- Kayi Lui
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Hao Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China
| | - Xueqin Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, 14#, 3rd Section of RenMin South Road, Chengdu, 610041, China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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3D-Printed Teeth in Endodontics: Why, How, Problems and Future-A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137966. [PMID: 35805624 PMCID: PMC9265401 DOI: 10.3390/ijerph19137966] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023]
Abstract
Three-dimensional printing offers possibilities for the development of new models in endodontics. Numerous studies have used 3D-printed teeth; however, protocols for the standardization of studies still need to be developed. Another problem with 3D-printed teeth is the different areas of literature requested to understand the processes. This review aims to gather evidence about 3D-printed teeth on the following aspects: (1) why they are advantageous; (2) how they are manufactured; (3) problems they present; and (4) future research topics. Natural teeth are still the standard practice in ex vivo studies and pre-clinical courses, but they have several drawbacks. Printed teeth may overcome all limitations of natural teeth. Printing technology relies on 3D data and post-processing tools to form a 3D model, ultimately generating a prototype using 3D printers. The major concerns with 3D-printed teeth are the resin hardness and printing accuracy of the canal anatomy. Guidance is presented for future studies to solve the problems of 3D-printed teeth and develop well-established protocols, for the standardization of methods to be achieved. In the future, 3D-printed teeth have the possibility to become the gold standard in ex vivo studies and endodontic training.
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Vivan RR, Costa VASM, Conti LC, Duque JA, Bramante CM, Só MVR, Alcalde MP, Duarte MAH. Effect of nickel-titanium alloys on root canal preparation and on mechanical properties of rotary instruments. Braz Oral Res 2022; 36:e085. [PMID: 35703710 DOI: 10.1590/1807-3107bor-2022.vol36.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/24/2022] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the quality of curved root canal preparation, torsional fatigue, and cyclic fatigue of rotary systems manufactured with different NiTi alloys. Ninety single-rooted canals with curvatures of 15° to 30o were scanned and divided into three groups according to the rotary system used: BT-Race (BTR) - 10.06, 35.00, 35.04; SequenceRotaryFile (SRF) - 15.04, 25.06, 35.04; and ProDesignLogic (PDL) - 25.01, 25.06, 35.05. Each system was used on three specimens. The teeth were prepared, scanned, and analyzed to assess increase in volume, transportation, and centering ability of the root canal. Torsional fatigue of glide path instruments (BTR 10.06, SRF 15.04 and PDL 25.01) and cyclic fatigue of the finishing instrument (BTR 35.04, SRF 35.04 and PDL 35.05) were obtained by analyzing completely new instruments (n = 10) and instruments after they had been used three times (n = 10). After the torsional and cyclic fatigue tests, the fractured surface of the new and used instruments were examined by scanning electron microscopy. Increase in volume, canal transportation, and centering ability showed no significant differences among the groups (p > 0.05). The torsional test showed that SRF 15.04 produced the highest torque values for both new and used instruments, followed by PDL 25.01 and BTR 10.06 (p < 0.05). PDL 25.01, both new and used, exhibited higher values of angular deflection followed by SRF 15.04 and BTR 10.06 (p < 0.05). As regards cyclic fatigue, use of PDL 35.05, both new and used, required a longer time and larger number of cycles than did SRF 35.04 and BTR 35.04 (p < 0.05). Clinical use affected the torsional fatigue of BTR; however, cyclic fatigue was not significantly affected (p < 0.05). All rotary systems were able to prepare the curved canals satisfactorily and were used safely on the three specimens. Relative to torsional fatigue, SRF 15.04 exhibited a higher torque, and PDL 25.01, higher angular deflection. BTR 10.06 was the most affected by clinical use. PDL 35.05 showed greater resistance to cyclic fatigue.
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Affiliation(s)
- Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Vanessa Abreu Sanches Marques Costa
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Leticia Citelli Conti
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Jussaro Alves Duque
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Clovis Monteiro Bramante
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Marcus Vinicius Reis Só
- Universidade Federal do Rio Grande do Sul - UFRS, Department of Endodontics , Porto Alegre , RS , Brazil
| | - Murilo Priori Alcalde
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
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Impact of agitation/activation strategies on the antibiofilm potential of sodium hypochlorite/etidronate mixture in vitro. BMC Oral Health 2022; 22:201. [PMID: 35606751 PMCID: PMC9125931 DOI: 10.1186/s12903-022-02222-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background To investigate the effect of a rotary agitation method or ultrasonically activated irrigation on the antibiofilm effect of a mixture of sodium hypochlorite (NaOCl) and etidronate (1-hydroxyethylidene-1,1-bisphosphonate, HEBP) using a dual-species biofilm model in root canal system. Methods Mature dual-species biofilms of Enterococcus faecalis and Streptococcus gordonii were formed in root canals of mandibular premolars. Teeth were randomly allotted (n = 12) to group 1, XP-endo Finisher (XPF); group 2, ultrasonically activated irrigation (UAI); group 3, syringe-and-needle irrigation (SNI). In all groups, canals were instrumented with a rotary instrument (XP-endo Shaper) prior to irrigant agitation/activation. A mixture containing 2.5% NaOCl and 9% HEBP was used throughout the experiment. Bacterial counts from the canal were determined using qPCR before preparation (S1), after preparation (S2), and after final irrigation agitation/activation (S3). Bacterial viability within the dentinal tubules in the coronal, middle and apical root-thirds was quantified using confocal microscopy after Live/Dead staining. The bacterial counts and viability were compared between groups using one-way ANOVA and post-hoc Tukey’s tests. Paired t-test was used to compare the bacterial counts within groups. Results Instrumentation alone could significantly reduce the microbial counts in all the groups (P < 0.0001). Subsequent agitation/activation resulted in significant microbial reduction only in XPF and UAI (P < 0.05), both of which reduced significantly more microbial counts than SNI (P < 0.05). Live/Dead staining revealed that XPF and UAI showed significantly greater percentage of dead bacteria within the dentinal tubules than SNI in the coronal third (P < 0.05); UAI resulted in the significantly highest percentage of dead bacteria in the middle third (P < 0.05); while there was no significant difference between the groups in the apical third (P > 0.05). Conclusions When using the sodium hypochlorite/etidronate mixture for irrigation, final irrigant agitation/activation with XP-endo Finisher or ultrasonic can improve disinfection of the main root canal space and the dentinal tubules in the coronal third, while ultrasonically activated irrigation appears to exhibit better disinfection within dentinal tubules in the middle third. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02222-1.
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Drukteinis S, Peciuliene V, Bendinskaite R, Brukiene V, Maneliene R, Rutkunas V. Shaping and Centering Ability, Cyclic Fatigue Resistance and Fractographic Analysis of Three Thermally Treated NiTi Endodontic Instrument Systems. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E5823. [PMID: 33371244 PMCID: PMC7766619 DOI: 10.3390/ma13245823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 11/26/2022]
Abstract
The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel-titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey's test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.
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Affiliation(s)
- Saulius Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, LT-08217 Vilnius, Lithuania; (V.P.); (R.B.); (V.B.); (R.M.); (V.R.)
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