Cutting ability of Heliosonic, Rispisonic, and Shaper files

Evaluation of two shaping systems and two sonic irrigation devices in removing root canal filling material from distal roots of mandibular molars assessed by micro CT

AIM

To compare two preparation systems and two sonic irrigation devices during the removal of root filling material from oval distal canals of extracted mandibular molars.

METHODOLOGY

The distal canals in 40 extracted mandibular molars were shaped using the ProTaper Next system (Dentslpy Sirona, Ballaigues, Switzerland), filled with Gutta Percha X2 (Dentsply Sirona), along with AH Plus sealer (Dentsply De Trey, Konstanz, Germany) and randomly divided into two groups (n = 20) according to volume of initial filling, preparation diameter and working length. One group was retreated using the Reciproc system (VDW, Munich, Germany), and the other using the 2Shape system (Micro-Mega, Besançon, France). A micro-CT scan was taken after the initial root filling and after retreatment to evaluate the volume of filling material remnants. The teeth were divided into four groups to test the supplementary effect of two sonic irrigation devices on removing filling material: Eddy (VDW) and MM1500 (Micro-Mega). In the first and second groups, 2Shape was followed subsequently by MM1500 and Eddy; in the third and fourth groups, Reciproc was followed by MM1500 and Eddy. A third micro-CT was taken to compare the remaining root filling material in all groups. Wilcoxon's signed rank tests, Mann-Whitney and Kruskal-Wallis tests were used for statistical analysis.

RESULTS

No significant difference was found for the volume of filling material removed between the Reciproc and 2Shape in the entire canal (P = 0.355). The volume dropped significantly from its initial value after removing the bulk of the root filling by 95.8% (from 4.71 to 0.22 mm³ ) with the 2Shape (P < 0.001) and by 94.0% (from 5.05 to 0.33 mm³ ) with the Reciproc (P < 0.001). Sonic activation significantly decreased the residual volume of filling material remnants by 3.21% (P = 0.013) in the first group, 1.38% (P = 0.012) in the second group, 1.83% (P = 0.008) in the third group and 1.83% (P = 0.012) in the fourth group. At the end, the percentage of residual material was not significantly different among the groups in the entire canal (P = 0.163).

CONCLUSION

In the distal oval canals of extracted mandibular molar teeth, there was no significant difference between the 2Shape and Reciproc systems in removing gutta-percha/sealer. Sonic activation with MM1500 and Eddy significantly improved filling material removal.

[Craniofacial approach for orbital tumors and ultrasonic bone cutting]

BACKGROUND

Removal of orbital tumors is a difficult problem. The goal of this study was to evaluate the advantages of the craniofacial approach to remove such tumors and to evaluate ultrasonic bone cutting during the procedure.

METHOD

The authors reviewed their experience with 57 tumors of the posterior cavity using lateral craniofacial and frontal transsinus approaches. Orbital osteotomies were performed with mechanical instruments or piezoelectric bone surgery as a minimally invasive surgery. For each case, the quality of bone cutting and soft tissue damage were evaluated.

RESULTS

Craniofacial approaches are simple and fast. Under the microscope, they provide a good view of the entire posterior orbital cavity. Using Piezosurgery, the functional results are good with no soft tissue damage. These advantages balance with the increased operative time required by ultrasonic bone cutting.

CONCLUSION

This study shows the advantages of craniofacial approaches for removal of posterior orbital tumor. Moreover, the present preliminary report introduces and demonstrates the utility of piezoelectric bone surgery in craniofacial approaches for orbital tumors.

Ultrasonic osteotomy as a new technique in craniomaxillofacial surgery

Ultrasound osteotomy is a new surgical technique used in dentistry to section hard tissues without damaging adjacent soft tissues. It was hypothesized that this could also be useful in craniofacial and orthognathic surgery. An ultrasonic device was employed in the following craniofacial surgical procedures: 144 Le Fort I osteotomies, 140 palatal expansions after Le Fort I osteotomies and 140 bilateral sagittal osteotomies; 2 Le Fort III osteotomies for treatment of Crouzon syndrome in two patients; 12 cases of unicortical calvarial bone grafting; removal of superior orbital roof in 25 cases of craniofaciostenosis; removal of external wall of the orbit in 10 cases of orbital cavity tumour; removal of anterior and posterior walls of the frontal sinuses in four cases of orbital cavity tumour. Integrity of soft tissues and surgical time were evaluated. Functional results were good without any soft-tissue damage being observed, but the overall operative time was increased. Ultrasound osteotomy is a new technical procedure that is advantageous for bone cutting in multiple situations, with minimal to no damage in adjacent soft tissues such as brain, palatal mucosa and the inferior alveolar nerve.

Piezoelectric osteotomy: a new technique for bone surgery-advantages in craniofacial surgery

INTRODUCTION

Ultrasonic bone cutting is a new surgical technique used in dentistry to section hard tissues without damaging adjacent soft tissues. We hypothesized that such a device could also be useful in craniofacial surgery, particularly during the removal of the superior orbital roof during craniofaciostenosis surgery.

MATERIALS AND METHODS

An ultrasonic device was employed in different craniofacial surgical procedures: 1. to remove the superior orbital roof in 30 cases of craniofaciostenosis, 2. to perform a Le Fort III osteotomy for the treatment of Crouzon syndrome in two patients, 3. to cut the parietal and frontal bone in 30 cases of craniofaciostenosis. The integrity of soft tissues and surgical time was evaluated.

RESULTS

Functional results were good without any soft tissue damage appreciated. The overall operative time, however, was increased.

CONCLUSIONS

Piezosurgery is a new technical procedure, which can be advantageous for bone cutting in multiple situations with minimal to no damage in adjacent soft tissues.

Qu’est-ce que la Piezosurgery®? Intérêten chirurgie craniomaxillofaciale. Àpropos de deux ans d'expérience

INTRODUCTION

Piezosurgery is a new surgical technique used in dentistry to section hard tissues without damaging adjacent soft tissues. We hypothesized that such a device could also be useful in craniofacial and orthognathic surgery.

MATERIAL AND METHOD

An ultrasonic device (Mectron) was employed in different craniofacial surgical procedures: a) to perform 144 Le Fort I osteotomies, 140 palatal expansions after Le Fort I osteotomies, and 134 bilateral sagittal osteotomies; b) to perform a Le Fort III osteotomy for treatment of Crouzon syndrome in 2 patients; c) to perform 5 segmental osteotomies and 3 osteotomies of the inferior edge of the mandible for facial asymmetry; d) to perform 12 cases of unicortical calvarial bone grafting; e) to remove the superior orbital roof in 20 cases of craniofaciostenosis and the frontal bone in 5 cases; f) to remove the external wall of the orbit or the anterior and posterior wall of the frontal sinuses in 10 cases of orbital cavity tumors; g) to approach the skull base through the frontal sinuses in 4 cases. Integrity of soft tissues and surgical time were evaluated.

RESULTS

Analysis of the results showed that Piezosurgery: a) allows very precise cutting; b) avoids bone cutting using an osteotome; c) spares soft tissue such as brain, dura-mater, palatal mucosa, and the inferior alveolar nerve; d) increases the time of bone cutting but not the overall operative time because of the absence of soft tissue protection.

DISCUSSION

Piezosurgery is a new technical procedure, which can be advantageous for bone cutting in many situations, sparing adjacent soft tissues such as brain, palatal mucosa, and the inferior alveolar nerve from any damage. The device's lack of power appears to be a minor problem compared with the advantages.