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Kaşıkçı S, Özbek SK, Şirinoğlu E, Özdemir O. Clinicians' perspectives, inducements, preferences, and clinical experiences regarding the use of electronic apex locator and apex locator integrated engine-driven instrumentation: a cross-sectional study. BMC Oral Health 2024; 24:939. [PMID: 39143627 PMCID: PMC11323617 DOI: 10.1186/s12903-024-04710-y] [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: 04/29/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND This study aimed to investigate the perspectives, preferences, and clinical experiences regarding using electronic apex locator and apex locator integrated instrumentation of dentists and endodontists. METHODS A web-based questionnaire consisting of 3 parts and 23 closed-ended questions to achieve the objective of the study was carried out in ethical conditions between August and October 2023. The first part of survey included demographic information, while the second part was about evaluating electronic apex locator usage. In the last part, only participants' use of apex locator-integrated instrumentation was evaluated. Data were analyzed at a significance level of p < 0.05. RESULTS A total of 297 clinicians, including 59 endodontists and 34 endodontic residents/Ph.D. students participated in the questionnaire. Endodontists and endodontic residents/Ph.D. students perform statistically significantly more root canal treatments per week on average (p = 0.001). For the working length determination method (multiple option question), 78.5% of participants use an electronic apex locator and 39.7% apex locator-integrated engines. However, the preference rate for electronic apex determination technique was generally 95.6%, with the full rate confirmation of endodontists and endodontic residents/Ph.D. students (100%). A total of 21 endodontists out of 59 prefer apex locator integrated engine-driven instrumentation. Although many of these specialized clinicians use this technique, they stated that they measure electronic working length passively for confirmation of the working length before (90.5%) and after the preparation (66.7%). CONCLUSIONS Dentists, as well as endodontists, are skeptical about apex locator-integrated engine-driven instrumentation. Using this technique as a supporter rather than a primary way for preparation within safe limits may give safer results in terms of treatment outcomes.
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Affiliation(s)
- Sena Kaşıkçı
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, 41190, Türkiye.
| | - Sena Kolunsağ Özbek
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, 41190, Türkiye
| | - Ebru Şirinoğlu
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, 41190, Türkiye
| | - Olcay Özdemir
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, 78050, Türkiye
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Bhagat E, Agnihotri Y, Das A, Das S, Panda S, Hota S. Accuracy of an Electronic Apex Locator (EAL) in Measuring the Working Length of Root Canals in Comparison With Radiographs: An In Vivo Study. Cureus 2024; 16:e60283. [PMID: 38872664 PMCID: PMC11173343 DOI: 10.7759/cureus.60283] [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: 05/14/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Traditionally, radiographs were used to assess the working length of root canals. However, the use of Electronic Apex Locators (EAL) may be a non-invasive alternative. This study aimed to evaluate the accuracy of the electronic apex locator (EAL) compared to radiographic measurements in determining the working length of root canals. METHOD The study assessed the performance of EALs in different scenarios, including the presence of blood and pulp tissue, the use of ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl) as an irrigant, and post-instrumentation with normal saline. An electronic apex locator (DTE DPEX-V; Woodpecker, China) was used alongside traditional radiographs to measure the working length in 144 root canal treatments. Bland-Altman analysis was used to compare the measurements between EAL and radiographs using Jamovi software, v2.4.8 (https://www.jamovi.org/). RESULT The findings revealed strong correlations between EAL and radiographic measurements across all testing environments, with Pearson's correlation coefficients ranging from 0.944 to 0.998. The Bland-Altman analysis suggests bias; the average difference was negative and close to zero (Pulp: -0.354, EDTA: -0.0972, NaOCl: -0.0382, Saline: -0.0139) when EAL measurements were compared to radiographic measurements. CONCLUSION The working length measurement of root canals using an electronic apex locator such as DTE DPEX-V is comparable to traditional radiographic measurements. The use of irrigants improves the measurement. The EAL has the potential to be an alternative to the invasive radiograph for root canal length measurement.
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Affiliation(s)
- Esha Bhagat
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
| | - Yoshaskam Agnihotri
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
| | - Abhisek Das
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
| | - Sambarta Das
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
| | - Swagat Panda
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
| | - Sudeepta Hota
- Conservative Dentistry and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, IND
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Schimdt TF, da Fonseca Roberti Garcia L, da Silveira Teixeira C, Alcalde MP, Hungaro Duarte MA, Bortoluzzi EA. How Does Intentional Apical Foraminal Enlargement Affect the Foramen and Root Canal Morphology? J Endod 2024; 50:651-658. [PMID: 38387796 DOI: 10.1016/j.joen.2024.02.013] [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: 12/20/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION This study assessed the effect of intentional foraminal enlargement on the foramen and the apical root canal morphology. METHOD Sixty mesial roots of mandibular molars were scanned by micro-computed tomography. Their apical foramina were photographed with a stereomicroscope before and after preparation. Three groups were formed (n = 20) according to the working length (WL). G-1: foramen - 1 mm; G0: foramen; and G+1: foramen + 1 mm. Each group originated 2 subgroups (n = 10): G-1: Buchanan's patency (size 10 K-type file) and foraminal debridement (sizes 20, 25 and 30 K-type files); G0 and G+1: rotary foraminal enlargement (ProDesign S size 25/.08) or reciprocating foraminal enlargement (R25). The area, perimeter, transportation, and noninstrumented walls of the foramen were evaluated. The root canal transportation and the centering index of preparation at 1, 3 and 5 mm from the foramen were also assessed. Data were compared statistically (α = 5%). RESULTS The instruments used at the foramen and 1 mm beyond promoted foraminal enlargement and transportation. Regarding NIW, there was no difference between mechanized foraminal enlargements performed at the foramen or 1 mm beyond, similar to the manual foraminal debridement group (P > .05). There was no difference in transportation and centralization at 1-, 3-, and 5-mm apical levels, regardless of the instrumentation systems. CONCLUSION Mechanical preparation at the foramen, or 1 mm beyond, resulted in foraminal enlargement, transportation and were not able to touch all root canal walls that delimit the foramen.
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Affiliation(s)
- Tamer Ferreira Schimdt
- Endodontics Division, Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Endodontics Division, Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Cleonice da Silveira Teixeira
- Endodontics Division, Department of Dentistry, Health Sciences Center, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Eduardo Antunes Bortoluzzi
- Endodontics Division, Department of Diagnosis & Oral Health, University of Louisville, Louisville, Kentucky.
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Caviedes-Bucheli J, Muñoz-Alvear HD, Lopez-Moncayo LF, Kacharaju KR, Velasquez-Rivera AC, Carlosama-Recalde LA, Pazmiño JC, Gomez-Sosa JF, Diaz-Barrera LE, Munoz HR. Substance P/calcitonin gene-related peptide and their receptors expression in human periodontal ligament after root canal preparation with five different systems. Int Endod J 2024; 57:576-585. [PMID: 38294105 DOI: 10.1111/iej.14035] [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: 10/16/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
AIM The purpose of this study was to quantify the effect of five different root canal preparation instruments on Substance P (SP), Calcitonin gene-related peptide (CGRP) and their receptors expression in healthy human periodontal ligament. METHODOLOGY STROBE guidelines were used to design a study using 60 periodontal ligament samples obtained from healthy lower premolars where extraction was indicated for orthodontic reasons. Prior to extraction 40 of these premolars were equally divided into four groups and root canals were prepared using different systems: Mtwo, Reciproc Blue, HyFlex EDM and Plex-V. Ten premolars were prepared with hand files and served as a positive control group. The remaining 10 premolars where extracted without treatment and served as a negative control group. All periodontal ligament samples were processed to measure the expression of SP, CGRP and their receptors by radioimmunoassay. Kruskal-Wallis and Duncan tests were performed to determine statistically significant differences between the groups for each variable. RESULTS Greater expression of all the peptides measured were found in the hand-file preparation group, followed by the Reciproc Blue, Mtwo, HyFlex EDM and Plex-V groups. The lower SP, CGRP and their receptors values were for the intact teeth control group. Kruskal-Wallis test showed statistically significant differences amongst groups (p < .001). Dunn post-hoc tests showed statistically significant differences in SP, CGRP and their receptors expression between the intact teeth and the hand-file and Reciproc Blue groups. Hand-file group showed significant differences with the other groups, except with Reciproc Blue, where no differences were observed in any of the peptides measured. Finally, no differences were observed between Plex-V and HyFlex in any of the peptides measured. CONCLUSIONS Root canal preparation with hand files and Reciproc Blue generates the highest expression of SP, CGRP, NK1 and CGRP1R in human periodontal ligament, whilst Plex-V and HyFlex maintain the basal expression of neuropeptides and their receptors. Mtwo showed intermediate results between Reciproc Blue and HyFlex.
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Affiliation(s)
- Javier Caviedes-Bucheli
- Centro de Investigaciones Odontologicas, School of Dentistry, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Hernan Dario Muñoz-Alvear
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | - Luis Fernando Lopez-Moncayo
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | | | | | | | - Juan Camilo Pazmiño
- Postgraduate Endodontics Department, School of Dentistry, Universidad Cooperativa de Colombia, Pasto, Colombia
| | | | | | - Hugo Roberto Munoz
- Endodontics Department, School of Dentistry, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
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Machado R, Moreira G, Comparin D, Barroso AP, Nascimento J, Ferraz CCR, Ignácio SA, da Fonseca Roberti Garcia L, Amaral RR, Shadid D, da Silva Neto UX. Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial. BMC Oral Health 2024; 24:481. [PMID: 38643087 PMCID: PMC11032596 DOI: 10.1186/s12903-024-04225-6] [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: 12/28/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
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Affiliation(s)
- Ricardo Machado
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA.
| | - Guilherme Moreira
- Clinical Practice Limited to Endodontics, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Clinical Practice Limited to Endodontics, Cunha Porã and Francisco Beltrão, Paraná, Brazil
| | - Arthur Pimentel Barroso
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Jaqueline Nascimento
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Caio Cézar Randi Ferraz
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Sérgio Aparecido Ignácio
- School of Dentistry, Department of Statistics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Division of Endodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - David Shadid
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA
| | - Ulisses Xavier da Silva Neto
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Alshetiwi DSD, Muttlib NAA, El-Damanhoury HM, Alawi R, Rahman NA, Elsahn NA, Karobari MI. Evaluation of mechanical properties of anatomically customized fiber posts using E-glass short fiber-reinforced composite to restore weakened endodontically treated premolars. BMC Oral Health 2024; 24:323. [PMID: 38468269 PMCID: PMC10926594 DOI: 10.1186/s12903-024-04102-2] [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: 01/11/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE This study was conducted to assess the influence of combining different forms of fiber-reinforced composites (FRC) on the mechanical behavior and bond strength of compromised endodontically treated teeth (ETT). MATERIALS AND METHODS Eighty extracted human premolar teeth were randomly divided into five experimental groups according to the type of intra-radicular restoration and the canal preparation design which was either non-flared (Group 1), flared (Groups 2-5), closed-apex (Groups 1,3,5) or open-apex (Groups 2,4). Standard prefabricated fiber posts were used as intra-radicular restoration for Groups 1-3 while Groups 4-5 were restored with anatomically customized relined fiber posts. After composite core fabrication, all samples were sent for an artificial aging process. Fracture resistance and push-out bond strength tests were then carried out through a universal testing machine followed by mode of failure analysis via a stereomicroscope and scanning electron microscope. RESULTS Pairwise Log-Rank comparisons revealed that the survival rate of Group 2 and Group 3 was significantly lower than all other groups after artificial aging. The highest fracture resistance value (1796 N) was recorded in Group 5 and was significantly higher than that of the other groups (p < 0.05), while Group 2 exhibited the lowest fracture resistance (758 N), which was significantly lower compared to the other groups. Group 5 and Group 4 demonstrated a significantly higher push-out bond strength, at all root thirds, than Group 3, Group 2, and Group 1 (p < 0.05). The most frequently observed failure mode in the tested groups occurred between the resin cement and radicular dentin. CONCLUSION The use of short fiber-reinforced composite (SFRC) to reline the prefabricated FRC post has been proven to have superior fracture resistance with favorable failure patterns and increased push-out bond strength values compared to standard prefabricated FRC posts.
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Affiliation(s)
- Dawood Salman Dawood Alshetiwi
- Post-graduate Program in Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nor Aidaniza Abdul Muttlib
- Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia.
| | - Hatem M El-Damanhoury
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabihah Alawi
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Normastura Abd Rahman
- Dental Public Health Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Nesrin Aly Elsahn
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Department of Operative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global health Research, Saveetha Medical College and Hospitals, Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, Tamil Nadu, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Phnom Penh, Cambodia.
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Varatharajan V, Rahman Thazhathveedan MA, Salman Kuttikkodan M, Puzhangaraillath Mundanatayil I, Thazhe Mangool AR, Karumbil A. Effect of Coronal Flaring on Initial Apical File Size Estimation in Curved Canals Using Three Distinct Rotary Instruments: A Comparative In Vitro Study. Cureus 2024; 16:e56687. [PMID: 38646288 PMCID: PMC11032505 DOI: 10.7759/cureus.56687] [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: 02/21/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The initial size of a root canal is established by progressively introducing K-files according to the increase in the International Organization for Standardization (ISO) size in the apical region. The initial file-fit sensation is caused by coronal interferences rather than always occurring at the apex, as is commonly believed. Flaring the canal at its earliest stages enables the practitioner to accurately assess the size of the canal approaching the apex. This enables more informed judgments on the selection of the master apical file required for shaping and cleaning the apex. The aim of this in vitro study is to examine the impact of cervical flaring on the first estimation of apical file size using three distinct rotary instruments. MATERIALS AND METHODS Sixty-four extracted permanent maxillary first molars with a curvature of between 10⁰ and 20⁰ were chosen. Conventional access openings were made, and the precise length of the canal was determined, leaving it 1 mm short of the apex. The apical fit was deemed to have materialized when the largest file successfully reached the apex, and further progression beyond that depth was unattainable. An initial file that exhibited tactile resistance both before and following expansion at the designated working length (WL) was observed. The initial file that elicited a sensation of being securely attached was affixed using methacrylate into the root canal. A diamond sectioning disc was used to horizontally cut the apical 0.5 mm of the mesiobuccal root. This was done to expose the canal and the instrument at the WL. The uppermost portions were observed using a 3D optical profilometer, and digital photographs were captured for each sample. RESULTS The occurrence of coronal interferences and the choice of instruments for flaring had a notable impact on the estimation of the initial apical file (IAF) size. The file size frequency was augmented following flaring using various rotary instruments, namely ProTaper, HyFlex CM, and Endoflare. Group 1, which did not undergo preflaring, exhibited the highest disparity of 257.3 ± 54.4. The variation was substantially different (p<0.01) from all the groups that underwent flaring. The use of HyFlex CM (group 3) for preflaring resulted in the smallest average difference (124.4 ± 29.6) between the maximum diameter of the canal at the apex and the diameter of the initial file used. Endoflare (group 4) exhibited the second lowest mean disparity (178.7 ± 46) between the maximum width of the apical root canal and the diameter of the IAF, with the ProTaper group (211 ± 43.5) following closely behind. Nevertheless, there was no statistically significant discrepancy observed in the average differences between groups 2 and 4 (ProTaper and Endoflare groups, respectively). CONCLUSION Coronal preflaring significantly contributes to minimizing the variation between the IAF and the diameter of the apical canal. Prior coronal expansion using rotary files enables a more precise identification of the IAF. The choice of equipment used for flaring affects the estimation of the IAF size.
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Affiliation(s)
- Vinodhini Varatharajan
- Conservative Dentistry and Endodontics, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, IND
| | | | | | | | | | - Ashraf Karumbil
- Conservative Dentistry and Endodontics, Sree Anjaneya Institute of Dental Sciences, Kozhikode, IND
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Machado R, Pamplona GF, de Souza Júnior C, Nascimento J, Back EDEE, Comparin D, Ignácio SA, Reinke SMG, Kovalik AC, da Silva Neto UX. Clinical determination of anatomical diameter in different dental groups correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis: an observational clinical study. Sci Rep 2023; 13:16215. [PMID: 37758735 PMCID: PMC10533535 DOI: 10.1038/s41598-023-41967-9] [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: 05/17/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of this observational clinical study (OCS) was to determine the clinical anatomical diameter (CAD) in several dental groups, thus correlating them with gender, age, tooth/canal and pulpoperiradicular diagnosis. Three-hundred fifty-nine teeth/584 vital or necrotic root canals from patients of both genders and different ages composed the sample. After performing the necessary previous procedures, K-Flexofiles were used to determine the CAD. Then, the gender and age of the patients, as well as the pulpoperiradicular diagnosis of the teeth were tabulated to conduct the statistical analysis (p < 0.05). Of the 359 teeth/584 root canals evaluated, 208/342 were from women (mean age 38.85 ± 13.42 years) and 151/242 were from men (mean age 45.41 ± 14.90 years). Statistically significant differences between the CAD means of root canals from women and men were not identified (p = 0.411). The analysis of the correlation between the CAD and age also showed a total independence (p = 0.271). Teeth with pulp necrosis and asymptomatic apical periodontitis diagnosed radiographically (TPNAAPDR) had a significantly larger CAD mean than teeth with pulp necrosis and no asymptomatic apical periodontitis diagnosed radiographically (TPNNAAPDR) and teeth with vital pulp and normal apical tissues (TVPNAT) (p = 0.0297); and the last two did not differ statistically (p > 0.05). The largest CAD mean was observed in single canals of maxillary central incisors. The lowest values of this variable were identified in the mesiobuccal and mesial canals of maxillary and mandibular first molars, respectively. The CAD of the root canals was influenced only by the root canal/tooth and pulpoperiradicular diagnosis.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil.
| | - Gabriel Filipe Pamplona
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | | | - Jaqueline Nascimento
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | | | - Daniel Comparin
- Department of Endodontics, School of Dentistry, Paranaense University-UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Biostatistics, School of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Stella Maria Glaci Reinke
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
| | - Ana Cristina Kovalik
- Department of Periodontics, School of Dentistry, Regional University of Blumenau-FURB, Blumenau, Santa Catarina, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Dentistry, Regional University of Blumenau-FURB, Rua São Paulo, 2171, Itoupava Seca, Blumenau, Santa Catarina, 89030-001, Brazil
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Nam J, Piasecki L, Kwak D, Hong JH, Jung IY, Park SH, Cho SY. Variations in the morphology of apical constriction affecting electronic readings: An in vitro investigation using 3D-printed tooth models. AUST ENDOD J 2023; 49 Suppl 1:245-252. [PMID: 36448774 DOI: 10.1111/aej.12724] [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: 07/24/2022] [Revised: 11/05/2022] [Accepted: 11/21/2022] [Indexed: 09/17/2023]
Abstract
We investigated the interference of apical constriction position and diameter on the accuracy of electronic apex locators using 3D-printed tooth models. Single-rooted tooth models with the same length, canal taper and major foramen, but variation in apical constriction position or size, were designed and 3D-printed. A mounting model was custom-made for precise measurement of both marks (0.5 and APEX/0.0) of two electronic apex locators. The electronic measurements of both devices were correlated significantly to the major foramen rather than apical constriction. The mean measurements of the group with 0.45 mm in apical constriction width were significantly shorter than those of the other groups for both marks of the two devices (p < 0.05). The variations in apical constriction position and width negatively affected the precision of the 0.5 mark of the tested devices. The 0.0 or APEX mark was consistently located the major foramen.
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Affiliation(s)
- Juhee Nam
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Kyeonggi-do, South Korea
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | - Doun Kwak
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Kyeonggi-do, South Korea
| | - Jung Hwa Hong
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Kyeonggi-do, South Korea
| | - Il-Young Jung
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Sung-Ho Park
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Sin-Yeon Cho
- Department of Conservative Dentistry, National Health Insurance Service Ilsan Hospital, Goyang, Kyeonggi-do, South Korea
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Vajpayee A, Khandare PD, Dutta SD, Marathe S, Viragi P, Maria R. In vivo Study to Evaluate the Effect of Instrument Size on the Accuracy of Three Different Apex Locators when Various Irrigation Solutions are used in Vital and Non-Vital Teeth. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S1156-S1159. [PMID: 37693955 PMCID: PMC10485512 DOI: 10.4103/jpbs.jpbs_182_23] [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: 02/22/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Root canal success requires working length (WL) optimization. The current study examined how different apex locators on vital and non-vital teeth responded to instrument size. Materials and Methods Three hundred patients (180 men and 120 women) receiving root canal therapy at the department of Conservative Dentistry and Endodontics were evaluated. Therefore, we determined that 200 of the patients' teeth (100 vital and 100 non-vital teeth from the upper and lower jaws' first molars) qualified for inclusion in our study. The pulp chamber was accessed using a sterile round bur. The coronal region of the root canal was preflared with successive Gates Glidden drills (Mani Inc. Japan) and irrigated with any one of the solutions 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), or 17% ethylenediaminetetraacetic acid (EDTA) solution after checking canal patency with a size #10 K file, where (#-number). Later, the working length was established using Ingle's technique and a radiovisiograph (RVG) 0.5 mm short of the radiographic apex. Two endodontists approved this RVG. Results Overall, the #15 K file and apex locators did not differ from Ingle's method. While the #8 K file differs significantly from all apex locators, the #10 K file showed a significant difference with all apex locators except Root ZX with 2% CHX (P = 0.06). Irrigation didn't influence apex locators' accuracy. Conclusion Even in the presence of irrigating solutions, electronic apex locator (EAL) can be utilized to calculate the working length with accuracy. The apex locators #15 k files, #10 k files, and #8 k files showed the most promising results.
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Affiliation(s)
- Akhilesh Vajpayee
- Department of Conservative Dentistry and Endodontics, Daswani Dental College and Research Centre, Kota, Rajasthan, India
| | - Prachi D. Khandare
- General Dentist and Founder at Aesthetik Dentz Dental Clinic, Mumbai, Maharashtra, India
| | - Smita D. Dutta
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
| | - Seema Marathe
- Department of Prosthodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Prashant Viragi
- Department of Public Health Dentistry, Rural Dental College, Pravara Institute of Medical Sciences (Deemed to be University), Ahmednagar, Maharashtra, India
| | - Rahul Maria
- Department of Conservative Dentistry and Endodontist, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India
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11
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Pinto JC, de Faria-Vasconcelos K, Leite AF, Pedano MS, Guerreiro-Tanomaru J, Jacobs R, Tanomaru-Filho M. Effect of foraminal enlargement on microcrack formation and apical transportation: a nano-CT assessment. Sci Rep 2023; 13:4881. [PMID: 36966188 PMCID: PMC10039878 DOI: 10.1038/s41598-023-31595-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/14/2023] [Indexed: 03/27/2023] Open
Abstract
The aim of this study was to evaluate the foraminal enlargement and its influence on microcrack formation and apical transportation in root canals with apical curvature. Eighteen maxillary lateral incisors with apical curvature were selected by using micro-CT images. Root canals were randomly divided in two groups (n = 9) according to root canal preparation using two working lengths: 1 mm short of the apical foramen (control group) and 1 mm beyond the apical foramen (foraminal enlargement). For both groups Reciproc Blue R40 was used for root canal instrumentation. Specimens were scanned by nano-CT (UniTOM HR) before and after root canal preparation. Percentage, length, and width of microcracks, and apical transportation were assessed. Kappa, chi-square and McNemar tests were used for qualitative analyses while paired and unpaired t-test were used for quantitative analyses (α = 0.05). For both groups, rather similar and low percentages of microcracks were observed before root canal preparation (P > 0.05). The foraminal enlargement promoted new microcracks, not observed in the control group. An increase in microcrack length was observed when the foraminal enlargement was performed (P < 0.05). Higher apical transportation was observed when foraminal enlargement was performed (P < 0.05). Foraminal enlargement using a heat-treated reciprocating file size 40 promoted microcracks and higher apical transportation than root canal preparation up to 1 mm short of apical foramen.
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Affiliation(s)
- Jader Camilo Pinto
- Department of Restorative Dentistry, Araraquara Dental School, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria-Vasconcelos
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - André Ferreira Leite
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, 70910-900, Brazil
| | - Mariano Simón Pedano
- Department of Oral Health Sciences, Endodontology and BIOMAT-Biomaterials Research Group, KU Leuven (University of Leuven), UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Juliane Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara Dental School, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, Araraquara Dental School, São Paulo State University (UNESP), School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, CEP 14801-903, Brazil.
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12
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Lobo NS, Jacobs R, Vasconcelos KDF, Wanderley VA, Santos BCD, Marciano MA, Zaia AA. Influence of working length and anatomical complexities on the apical root canal filling: a nano-CT study. Braz Dent J 2022; 33:1-7. [PMID: 35766712 PMCID: PMC9645203 DOI: 10.1590/0103-6440202204576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/08/2021] [Indexed: 12/02/2022] Open
Abstract
The present study aimed to compare the filled volume by gutta-percha and sealer
in the apical region of the main canal and ramifications, after instrumentation
at two different working lengths using nano-computed tomography (nano-CT).
Twenty-two premolars with apical ramifications were selected after
micro-computed tomography evaluation and were randomly divided into groups for
further endodontic instrumentation at two different working lengths: G1 - Root
canals shaped 1 mm short of the apical foramen (n=11), and G2 - Root canals
shaped at the apical foramen (n=11). After completing root treatment, nano-CT
images were acquired, and the filled volume by gutta-percha and sealer in the
main canal apical 0-4 mm and 0-1 mm ranges, and apical ramifications were
objectively measured by an operator specialized in both radiology and
endodontics, blinded for both groups. The Mann-Whitney test was applied to
compare both groups regarding the filling of the main canal apical ranges and
apical ramifications with a significance level of 5% (α ≤ 0.05). It was observed
that root canals shaped at the apical foramen had a larger volume of the main
canal filled than root canals shaped 1 mm short of the apical foramen, at both
apical ranges (0-4 and 0-1 mm) (p<0.05). Regarding the filling of the apical
ramifications, there was no significant difference between groups (p>0.05).
In conclusion, the root canals shaped at apical foramen exhibited increased
filling volume of the main canal in the apical region. However, neither of both
working lengths influenced filling of the apical ramifications.
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Affiliation(s)
- Natalia Siqueira Lobo
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Reinhilde Jacobs
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla de Faria Vasconcelos
- OMFS IMPATH research group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, Leuven, Belgium
| | - Victor Aquino Wanderley
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Marina Angélica Marciano
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alexandre Augusto Zaia
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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13
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Effect of Sodium Hypochlorite Concentration on Electronic Apex Locator Reliability. MATERIALS 2022; 15:ma15030863. [PMID: 35160807 PMCID: PMC8836685 DOI: 10.3390/ma15030863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
This ex vivo study aimed to measure the performance of an electronic apex locator (EAL) in the presence of sodium hypochlorite irrigants with different concentrations. Two EALs (Root ZX Mini and Locapex 6) were used to locate the apical foramen in 10 extracted single-rooted teeth in the presence of 0.5%, 2.5% and 5% sodium hypochlorite. Visual working lengths were also determined using #10 K-file under a microscope before the electronic measurements were made. The performance of both EALs was compared for the electronic working lengths determined under the different concentrations of sodium hypochlorite. A multiple-way ANOVA and PLSD Fisher’s test with an α risk fixed at 5% were conducted. There were no statistical differences in the working lengths determined by both EALs between the three groups with different concentrations of sodium hypochlorite and their visual control measurements. When a ± 0.5 mm margin was applied, the Root ZX Mini and the Locapex 6 presented 88% and 83% accuracy, respectively. Sodium hypochlorite concentration in irrigants does not affect the accuracy and reliability of either the Root ZX Mini or the Locapex 6. Electronic apex locators are reliable with any concentration of sodium hypochlorite irrigants.
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14
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Saritha V, Raghu H, Kumar TH, Totad S, Kamatagi L, Saraf PA. The accuracy of two electronic apex locators on effect of preflaring and file size: An in vitro study. J Conserv Dent 2021; 24:46-49. [PMID: 34475679 PMCID: PMC8378484 DOI: 10.4103/jcd.jcd_4_19] [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: 02/04/2019] [Revised: 06/04/2019] [Accepted: 01/19/2021] [Indexed: 11/18/2022] Open
Abstract
Aim: This study was conducted to evaluate the effect of preflaring and file size on the accuracy of the Root ZX and E-PEX Pro electronic apex locators (EALs). Materials and Methods: The actual working length was set 1 mm short of the apical foramen in the forty extracted mandibular premolars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the “0.0” or “APEX” signals were observed on the light-emitting diode or display screens for the E-PEX Pro and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the preflaring using the S1 and SX Pro-Taper instruments. The mean differences between the actual length and electronic length values were analyzed by the Wilcoxon signed-ranked test with a significance level of P < 0.05. The factors evaluated were “Accuracy of EALs,” “size of file,” and “presence of preflaring. Results: No significant differences were observed in the accuracy of both EALs when compared with the actual lengths. On the size of the file, significant difference noticed with #20 K-file. The preflaring procedure significantly (P < 0.05) increased the accuracy of the measurements for the Root ZX and Epex Pro. Conclusions: The tested EALs showed acceptable accuracy, whereas the preflaring procedure revealed a more significant effect than the used file size.
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Affiliation(s)
- V Saritha
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - H Raghu
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Twino H Kumar
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Shrishail Totad
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Laxmikant Kamatagi
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Prahlad A Saraf
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
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15
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Machado R, Vigarani G, Macoppi T, Pawar A, Glaci Reinke SM, Kovalik Gonçalves AC. Extrusion of debris with and without intentional foraminal enlargement - A systematic review and meta-analysis. AUST ENDOD J 2021; 47:741-748. [PMID: 34146366 DOI: 10.1111/aej.12539] [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: 01/15/2021] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 01/22/2023]
Abstract
This systematic review and meta-analysis was sought to assess whether intentional foraminal enlargement (IFE) is responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes. Following the recommendations of Preferred Reporting Items for Systematic Review and Meta-Analysis - PRISMA, electronic and manual searches were performed to identify studies that evaluated the extrusion of debris, comparing different apical limits of instrumentation (with/without IFE). The quality of the studies selected was evaluated, and statistical analysis was conducted. To perform the meta-analysis, just 3 papers could be used. The heterogeneity was high, however; there was no statistically significant difference in relation to the extrusion of debris in teeth either submitted or not submitted to IFE. The general risk of bias was moderate. In conclusion, IFE is not responsible for extrusion of a larger quantity of debris from extracted human teeth with fully formed apexes.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, School of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Gislayne Vigarani
- Student of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Tainara Macoppi
- Student of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
| | - Ajinkya Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Stella Maria Glaci Reinke
- Department of Endodontics, School of Dentistry, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil
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16
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Wolf TG, Krauß-Mironjuk A, Wierichs RJ, Briseño-Marroquín B. Influence of embedding media on the accuracy of working length determination by means of apex locator: an ex vivo study. Sci Rep 2021; 11:3340. [PMID: 33558636 PMCID: PMC7870820 DOI: 10.1038/s41598-021-82942-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/27/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this research was to determine ex vivo the influence on accuracy of five different embedding media, for investigative and educational purposes, and one electronic apex locator. 110 human extracted mature roots of permanent single-rooted human teeth were used. The roots were embedded in alginate, stick sponge, 2% agar–agar and 6% and 12% gelatin. The actual working length to the physiological foramen was determined under a stereo-microscope (16 ×) and the electronic working lengths with the Elements Diagnostic Unit and a K-file ISO 10. The accuracy ranges of the accumulated measurements, when allowing a ± 0.5 mm tolerance, went from 98.2% (6% and 12% gelatin), 93.7% (alginate), 92.8% (2% agar–agar) to 91.7% (sponge). The exact measurements at the physiological foramen ranged from 80.0% (6% gelatin), 76.5% (2% agar–agar), 71.8% (12% gelatin), 68.2% (alginate) to 64.5% (sponge). Although relatively seldom (n = 24), measurements with deviations of more than ± 0.5 mm were also observed; thus, the accuracy of the working length determination results per se can be considered as clinically acceptable. The results of this research allow a recommendation of the investigated embedding media for electronic working length determination models for educational and research purposes in endodontics.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany.
| | - Anna Krauß-Mironjuk
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
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17
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Wolf TG, Willems L, Briseño-Marroquín B. An in vitro endodontic model to quantify the accessory canal filling potential of the vertical and lateral condensation techniques. AUST ENDOD J 2020; 47:245-251. [PMID: 33219588 DOI: 10.1111/aej.12465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/10/2020] [Accepted: 10/25/2020] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to determine the accessory canal filling potential of vertical and lateral condensation techniques in simulated root canals. A total of 130 prepared transparent, straight-simulated root canals with nine accessory canals (0.02 mm), prepared at different levels from the apical, were obturated with vertical (n = 100) and 30 lateral condensation (n = 30) techniques. 50.33% of the accessory canals obturated with vertical condensation were completely filled with gutta-percha; 37.78% completely filled with gutta-percha and sealer. 61.11% of the accessory canals were completely filled with sealer only using the lateral condensation technique. The vertical condensation technique filled the accessory canals more frequently than the lateral condensation techniques. The lateral condensation technique was not capable of delivering gutta-percha to any of the accessory canals. The apical third showed the lowest accessory canal filling frequency with both techniques.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Louisa Willems
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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18
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Shacham M, Levin A, Shemesh A, Lvovsky A, Ben Itzhak J, Solomonov M. Accuracy and stability of electronic apex locator length measurements in root canals with wide apical foramen: an ex vivo study. BDJ Open 2020; 6:22. [PMID: 33298851 PMCID: PMC7670426 DOI: 10.1038/s41405-020-00052-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 12/04/2022] Open
Abstract
The aim of the current study was to determine the accuracy of electronic apex locator (EAL) measurements when using files of different sizes in roots with wide apical foramina while considering a new parameter of stability of EAL reading. Ten teeth with straight roots were subjected to a sequential widening of the apical foramen to 0.6, 0.7, and 0.8 mm. The roots were embedded after each enlargement stage in an alginate mold and subjected to EAL readings. Measurements were done using sequential K-file sizes and the self-adjusting file (SAF). Measurement stability was introduced as a new additional parameter. As the difference between the file size used and the apical diameter of the canal decreases, the results obtained were more accurate and stable. The stability and accuracy of the measurements coincided with each other in a statistically significant manner. Within the limitations of the present ex vivo study, it may be concluded that in straight canals with wide apical foramina of 0.6–0.8 mm, both SS K-files which fit snugly to the walls of apical foramen and the SAF file may offer both accurate and stable EAL measurements.
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Affiliation(s)
- Maayan Shacham
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel.
| | - Avi Levin
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel
| | - Avi Shemesh
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel
| | - Alex Lvovsky
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF) Medical Corps, Tel Hashomer, Derech Sheba 2, 52621, Ramat Gan, Israel
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Lobo NS, Wanderley VA, Nejaim Y, Gomes AF, Zaia AA. Assessment of Ramifications in the Apical Region of Root Canals: A Micro-CT Study in a Brazilian Population. Braz Dent J 2020; 31:505-510. [PMID: 33146334 DOI: 10.1590/0103-6440202003430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023] Open
Abstract
The present study used microcomputed tomography (micro-CT) images to assess the prevalence, number, and location of apical ramifications (ARs) in the root canals of different dental groups in a Brazilian population. Three hundred and sixty-seven extracted human teeth, totaling 475 roots, were scanned by micro-CT at 19.6 µm spatial resolution. The obtained images were evaluated by two observers in consensus, and a descriptive analysis was performed to verify the prevalence, number, and location of ARs in each dental group. Chi-square test was used to compare the prevalence of ARs in different types of roots, and one-way analysis of variance compared the number of ARs in the apical 1 mm, 2 mm, and 3 mm of the root. Significance level was established at 5% (α=0.05). ARs were present in 253 (53.3%) of the 475 roots evaluated. A total of 607 ARs were detected, with the vast majority (530) located at one and two millimeters from the main foramen. The highest prevalence of ARs was observed in maxillary canines (65%); maxillary premolars - single-rooted (83.3%), buccal root (80%), and palatine root (73.3%); mandibular premolars (64.2%); mesiobuccal root of maxillary molars (76.6%); and mesial root of mandibular molars (66.6%). For the Brazilian population, most of the ARs are located in the apical 1 and 2 mm of the root, with greater prevalence in the posterior teeth and maxillary canines. These findings suggest the need for additional attention while planning endodontic treatments, including strategies to effectively clean and fill the apical region.
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Affiliation(s)
- Natalia Siqueira Lobo
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Victor Aquino Wanderley
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Yuri Nejaim
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Amanda Farias Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alexandre Augusto Zaia
- Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Morphologic Changes of Apical Foramen and Microcrack Formation after Foraminal Enlargement: A Scanning Electron Microscopic and Micro–computed Tomographic Analysis. J Endod 2020; 46:1726-1732. [DOI: 10.1016/j.joen.2020.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
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Radiographic and Clinical Findings of Single-Visit Root Canal Treatments with Apical Enlargement in Necrotic Teeth: A Retrospective Cohort Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7912638. [PMID: 33062699 PMCID: PMC7539075 DOI: 10.1155/2020/7912638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 08/08/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023]
Abstract
This study evaluated the long-term clinical outcomes of single-visit root canal treatments with apical enlargement on patients with necrotic pulp tissue retrospectively. A total of 137 teeth with necrotic pulp tissue which underwent single-visit root canal treatments were included. The root canals were shaped up until the apical constriction, which was determined by an apex locator. The outcomes were evaluated by two independent and calibrated endodontists clinically and radiographically. Teeth were dichotomized into healed (PAI ≤ 2, no signs or symptoms) and nonhealed (PAI > 2, with/without signs or symptoms) groups. Each patients' preoperative PAI and lesion size were recorded to evaluate the preoperative periapical status as well as several other prognostic factors. Statistical analyses were performed (p = 0.05) on ninety teeth. The mean observation time was 60 months. Out of ninety teeth, 87 (96.7%) were healed and 3 (3.3%) were nonhealed. No correlations were found between the prognostic factors and the outcomes (p > 0.05). Cohen's kappa and Gwet's agreement coefficient scores between the preoperative PAI scores and preoperative lesion sizes showed good agreements, with values of 0.834 and 0.898, respectively. Apical enlargement is a viable treatment option for single-visit root canal treatments.
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Chukka RR, Bellam MD, Marukala NR, Dinapadu S, Konda NK, Nagilla J. Efficiency of an Integrated Apex Locator in Determining Working Length in Various Irrigating Solutions: An In Vivo Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2020; 12:S410-S414. [PMID: 33149496 PMCID: PMC7595532 DOI: 10.4103/jpbs.jpbs_122_20] [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: 02/04/2020] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES The objective of this in vivo study was to compare and evaluate the accuracy of VDW Gold (VDW, Munich, Germany) integrated apex locator (IAL) and Root ZX Mini (J. Morita Corp., Kyoto, Japan) in two different irrigating solutions. MATERIALS AND METHODS Forty patients who required extraction were included in the study. Following local anesthesia, access opening was performed under rubber dam isolation. Initial negotiation of canal was performed using size 10 K-Files (M-Access, Dentsply Maillefer, Ballaigues, Switzerland). Cervical preparation was carried out using Rotary ProTaper SX files (Dentsply Maillefer, Ballaigues, Switzerland) under copious irrigation with 3% sodium hypochlorite. Patients were divided into two groups of 20 each: Group I (NaOCl) and Group II (CHX). The working length (WL) was determined in triplicates for each tooth using Root ZX apex locator and with S1 ProTaper rotary file in continuous motion in case of VDW Gold IAL in the presence of 3% sodium hypochlorite and 2% chlorhexidine. Therapeutic extraction was performed and WL was determined using size 15 K-Files under 20× magnification. RESULTS The paired sample independent t test showed that there was no significant difference between the Root ZX and VDW apex locator in determining the minor foramen in NaOCl group (P = 0.234, 0.453 respectively) and CHX group (P = 0.085, 0.087) when compared with actual working length. CONCLUSION Both the apex locators were equally effective in determining WL at 0.5 mm from the apex in presence of irrigating solutions, that is, NaOCl and chlorhexidine.
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Affiliation(s)
- Rakesh Reddy Chukka
- Department of Conservative Dentistry and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Malati Devi Bellam
- Department of Pedodontics and Preventive Dentistry, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Narender Reddy Marukala
- Department of Conservative Dentistry and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sainath Dinapadu
- Department of Conservative Dentistry and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Naresh Kumar Konda
- Department of Conservative Dentistry and Endodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Jithender Nagilla
- Department of Public Health Dentistry, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Daou C, El Hachem R, Naaman A, Zogheib C, El Osta N, Khalil I. Effect of 2 Heat-treated Nickel-Titanium Files on Enlargement and Deformation of the Apical Foramen in Curved Canals: A Scanning Electronic Microscopic Study. J Endod 2020; 46:1478-1484. [PMID: 32710894 DOI: 10.1016/j.joen.2020.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate under scanning electronic microscopy the enlargement and deformation of the apical foramen of curved mesiobuccal roots with both reciprocating and rotary single-file systems made of a newly heat-treated alloy through the use of Reciproc Blue (REC Blue; VDW, Munich, Germany) and XP-endo Shaper (XPS; FKG Dentaire, La Chaux-de-Fonds, Switzerland). METHODS Forty mesiobuccal roots of mandibular and maxillary molars presenting a curvature ranging from 20°-40° were used in this study. The apical foramens were initially scanned with a scanning electronic microscope under 200× magnification. Roots were divided into 2 groups (n = 20): the REC Blue group instrumented with the REC Blue system and the XPS group instrumented with the XPS system. Both groups were instrumented at the foramen. The apical foramens were scanned after root canal preparation. The area, circularity, and ratio of the Feret diameters were calculated from each image. The Kolmogorov-Smirnov, Mann-Whitney, and Wilcoxon tests were used for statistical analysis (P ≤ .05). RESULTS The area of the foramen increased significantly after canal shaping with REC Blue and XPS. The variation of the area was significantly greater with XPS. However, there were no significant differences in circularity and the ratio of the Feret diameters with both instruments. CONCLUSIONS No transportation was found when using REC Blue and XPS. The newly heat-treated nickel-titanium alloy did not promote deformation of the apical foramen in curved canals.
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Affiliation(s)
- Carla Daou
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Roula El Hachem
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Alfred Naaman
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nada El Osta
- Department of Prosthodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Centre de Recherche en Odontologie Clinique, Université Clermont Auvergne, Clermont-Ferrand, France; Laboratoire de Recherche Crâniofaciale, Unité de Santé Orale, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Issam Khalil
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Abdelsalam N, Hashem N. Impact of Apical Patency on Accuracy of Electronic Apex Locators: In Vitro Study. J Endod 2020; 46:509-514. [DOI: 10.1016/j.joen.2020.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022]
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García-Guerrero C, Delgado-Rodríguez CE, Molano-González N, Pineda-Velandia GA, Marín-Zuluaga DJ, Leal-Fernandez MC, Gutmann JL. Predicting the outcome of initial non-surgical endodontic procedures by periapical status and quality of root canal filling: a cohort study. Odontology 2020; 108:697-703. [DOI: 10.1007/s10266-020-00494-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 02/05/2020] [Indexed: 10/25/2022]
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26
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Meirinhos J, Martins JNR, Pereira B, Baruwa A, Gouveia J, Quaresma SA, Monroe A, Ginjeira A. Prevalence of apical periodontitis and its association with previous root canal treatment, root canal filling length and type of coronal restoration - a cross-sectional study. Int Endod J 2019; 53:573-584. [PMID: 31749154 DOI: 10.1111/iej.13256] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/17/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022]
Abstract
AIM To analyse the prevalence of periapical lesions and their association with previous root canal treatment, root canal filling length and type of coronal restoration using in vivo cone-beam computed tomographic (CBCT) assessment. METHODOLOGY A global sample of 20 836 teeth, with a combined total of 27 046 roots, from 1160 patients, was analysed via CBCT assessment in eight health centres. Each tooth was evaluated by one out of five examiners after having performed a defined calibration procedure on the basis of 319 teeth. Intra- and inter-rater reliability tests were performed. Each tooth was classified according the tooth number, presence/absence of periapical lesions, presence/absence of previous root canal treatment, length of root canal filling (short, good or overfilling) and type of coronal restoration. The z-test for proportions was used to analyse differences between tooth subgroups, and an odds ratio was determined in order to analyse the association between treatment status and periapical lesions. A P < 0.05 was considered significant. RESULTS At a tooth level, the overall prevalence of periapical lesions in the sample was 10.4%. Maxillary teeth were associated with a significantly larger percentage of lesions (13.1%), whilst maxillary first molars had the greater proportion of lesions (21.2%). The prevalence of periapical lesions was significantly larger in root filled teeth (55.5%), short root canal fillings (72.7%) and in teeth restored with crowns (46.1%). At a root level, the mesiobuccal roots of both maxillary first molars had a tendency for a larger percentage of periapical lesions. CONCLUSION History of root canal treatment, root canal filling length and type of coronal restoration influenced the presence of periapical lesions. Molars were more commonly associated with periapical lesions on root filled teeth, particularly those with short root fillings and those with crowns.
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Affiliation(s)
- J Meirinhos
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - B Pereira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - A Baruwa
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - J Gouveia
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - S A Quaresma
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - A Monroe
- Private Practice, San Diego, CA, USA
| | - A Ginjeira
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
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Golvankar K, Kader MA, Latheef AA, Ali ABM, Abullais SS, Sibagathullah M. Comparison of Accuracy in Determining the Root Canal Working Length by Using Two Generations of Apex Locators - An In Vitro Study. Open Access Maced J Med Sci 2019; 7:3276-3280. [PMID: 31949530 PMCID: PMC6953924 DOI: 10.3889/oamjms.2019.696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
AIM The present in-vitro study aims to compare the accuracy of root canal working length determination between the third generation and fourth generation electronic apex locators. MATERIAL AND METHODS Fifty extracted single-rooted single canal teeth were selected for the study, and a definite coronal plane was prepared. Actual working length (AL) was measured using a stereomicroscope under 8X magnification. Electronic working length measurements were recorded using Root ZX (EL1) and Elements Diagnostic Unit (EL2) apex locators. One-way ANOVA test was carried out to analyse the data among the experimental groups. RESULTS The results of the one-way ANOVA test showed that difference in the working length determined by either apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. The independent 't' test comparing between groups EL1 and AL; and EL2 and AL showed that working length determined by either of the apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. CONCLUSION In this in vitro study, the Root ZX and Elements Diagnostic Unit apex locators are equally accurate for determination of working length when compared to actual working length.
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El Hachem R, Wassef E, Mokbel N, Abboud R, Zogheib C, El Osta N, Naaman A. Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study. Dent J (Basel) 2019; 7:dj7010003. [PMID: 30609762 PMCID: PMC6473460 DOI: 10.3390/dj7010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022] Open
Abstract
This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus.
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Affiliation(s)
- Roula El Hachem
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Elie Wassef
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nadim Mokbel
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Richard Abboud
- Department of Maxillo-Facial Radiology, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nada El Osta
- Department of Prosthodontics, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Alfred Naaman
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
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Awawdeh L, Abu Fadaleh M, Al-Qudah A. Mandibular first premolar apical morphology: A stereomicroscopic study. AUST ENDOD J 2018; 45:233-240. [PMID: 30402906 DOI: 10.1111/aej.12313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the size, shape and position of the physiological foramen and the relationship between the age and gender to the location and size of the apical foramen of mandibular first premolars. One hundred and one extracted human mandibular first premolar teeth were examined; age and gender of the patients were recorded. Apices of teeth were examined stereomicroscopically for number, size and shape of apical foramina; frequency and deviation of accessory foramina from the apex and the relation with age and gender. Sixty-four of the premolars had one foramen and 23% had two. The distances from the foramina openings to the apices ranged from 0.07 to 2.18 mm. In younger range irregular shape was dominant (41%), whilst in older range, round shape was dominant (45%). The shape of the apical foramen changed with age and the distance from the foramen to the anatomical apex increased with age.
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Affiliation(s)
- Lama Awawdeh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Mousa Abu Fadaleh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.,Department of Restorative Dental Sciences, Majmaah University, Riyadh, Saudi Arabia
| | - Aladdin Al-Qudah
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
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Influence of foraminal enlargement on the healing of periapical lesions in rat molars. Clin Oral Investig 2018; 23:1985-1991. [DOI: 10.1007/s00784-018-2628-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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Abdulrab S, Rodrigues JC, Al-Maweri SA, Halboub E, Alqutaibi AY, Alhadainy H. Effect of Apical Patency on Postoperative Pain: A Meta-analysis. J Endod 2018; 44:1467-1473. [PMID: 30170845 DOI: 10.1016/j.joen.2018.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION This systematic review and meta-analysis assessed the available evidence regarding the effect of apical patency versus nonpatency on postendodontic pain in adult patients. METHODS The study adhered strictly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. PubMed, Scopus, MEDLINE via Ovid, Google Scholar, and the Web of Science databases were searched up to April 2018 to retrieve the most relevant studies. Two authors evaluated the studies for eligibility criteria and assessed the risk of bias using the Cochrane tool. The weighted means were calculated using a fixed effects model. When statistically significant (P < .1) heterogeneity was detected, a random effects model was used to assess the significance of treatment effects. RESULTS Five studies were identified for this systematic review; 4 were included in the meta-analyses. Two studies revealed a low risk of bias, whereas 3 studies revealed a high risk of bias. Because of the significant heterogeneity between studies, a random effects model was used. The meta-analysis showed that the apical patency resulted in less postoperative pain compared with nonpatency, but the difference was not statistically significant. Moreover, no statistically significant difference was found with regard to analgesic consumption. CONCLUSIONS Considering the limitations of this study, it was concluded that maintaining apical patency during routine endodontic treatment was not associated with an increased incidence of postoperative pain in adult patients.
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Affiliation(s)
- Saleem Abdulrab
- Department of Restorative Dental Sciences, Al Farabi Colleges, Riyadh, KSA.
| | - Jean C Rodrigues
- Department of Restorative Dental Sciences, Al Farabi Colleges, Riyadh, KSA
| | - Sadiq Ali Al-Maweri
- Department of Oral Medicine and Diagnostic Science, Al Farabi Colleges, Riyadh, KSA
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, KSA
| | | | - Hatem Alhadainy
- Department of Dentistry, College of Medicine and Dentistry, University of Alberta, Canada
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Yaylali IE, Demirci GK, Kurnaz S, Celik G, Kaya BU, Tunca YM. Does Maintaining Apical Patency during Instrumentation Increase Postoperative Pain or Flare-up Rate after Nonsurgical Root Canal Treatment? A Systematic Review of Randomized Controlled Trials. J Endod 2018; 44:1228-1236. [PMID: 29935875 DOI: 10.1016/j.joen.2018.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/25/2018] [Accepted: 05/07/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The concept of maintaining apical patency (AP) is a controversial issue in endodontics. The primary objectives of this systematic review of randomized controlled trials (RCTs) were to determine the influence of maintaining AP during instrumentation on postoperative pain severity and the prevalence of flare-ups. A second objective was to assess the effect of maintaining AP on the use of analgesics. METHODS RCTs and controlled clinical trials were searched for in MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library. Four reviewers independently screened all identified articles for eligibility. The included studies were assessed for bias using the Cochrane Risk of Bias Tool. The Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of the body of evidence. Because of the considerable heterogeneity of the studies, a meta-analysis was not possible. Therefore, the results were analyzed narratively. RESULTS Five RCTs that included a total of 848 patients were found eligible and included in the review. An assessment of the risk of bias in the included studies provided results that classified the studies as showing a low risk (n = 1), high risk (n = 1), or unclear risk (n = 3) of bias. The available evidence indicated that maintaining AP (1) did not increase postoperative pain in teeth with nonvital pulp, (2) did not increase postoperative pain in teeth with vital pulp, and (3) did not cause (0%) flare-ups. The available evidence also indicated that maintaining AP did not increase analgesic use. The available evidence indicated that maintaining AP did not increase postoperative pain when a single-visit or 2-visit root canal treatment approach was used. CONCLUSIONS In light of the current evidence, maintaining AP does not increase postoperative pain in teeth with vital/nonvital pulp when compared with nonapical patency (low to moderate quality evidence). Furthermore, maintaining AP did not cause flare-ups (low evidence) and did not increase analgesic use (moderate evidence).
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Affiliation(s)
| | | | - Safa Kurnaz
- Department of Endodontics, Dumlupinar University, Kutahya, Turkey
| | - Gul Celik
- Department of Endodontics, Suleyman Demirel University, Isparta, Turkey
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Caviedes-Bucheli J, Rios-Osorio N, Rey-Rojas M, Laguna-Rivero F, Azuero-Holguin MM, Diaz LE, Curtidor H, Castaneda-Ramirez JJ, Munoz HR. Substance P and Calcitonin gene-related peptide expression in human periodontal ligament after root canal preparation with Reciproc Blue, WaveOne Gold, XP EndoShaper and hand files. Int Endod J 2018; 51:1358-1366. [DOI: 10.1111/iej.12952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/12/2018] [Indexed: 11/27/2022]
Affiliation(s)
- J. Caviedes-Bucheli
- Centro de Investigaciones Odontologicas; Pontificia Universidad Javeriana; Bogota Colombia
| | - N. Rios-Osorio
- Postgraduate Endodontics Department; Institucion Universitaria Colegios de Colombia; Bogota Colombia
| | - M. Rey-Rojas
- Postgraduate Endodontics Department; Institucion Universitaria Colegios de Colombia; Bogota Colombia
| | - F. Laguna-Rivero
- Postgraduate Endodontics Department; Institucion Universitaria Colegios de Colombia; Bogota Colombia
| | - M. M. Azuero-Holguin
- Centro de Investigaciones Odontologicas; Pontificia Universidad Javeriana; Bogota Colombia
- Postgraduate Endodontics Department; Institucion Universitaria Colegios de Colombia; Bogota Colombia
| | - L. E. Diaz
- Engineer School; Universidad de La Sabana; Chia Colombia
| | | | | | - H. R. Munoz
- Postgraduate Endodontics Department; Universidad de San Carlos de Guatemala; Guatemala City Guatemala
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TROIANO G, PERRONE D, DIOGUARDI M, BUONAVOGLIA A, ARDITO F, LO MUZIO L. In vitro evaluation of the cytotoxic activity of three epoxy resin-based endodontic sealers. Dent Mater J 2018; 37:374-378. [DOI: 10.4012/dmj.2017-148] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Giuseppe TROIANO
- Department of Clinical and Experimental Medicine, University of Foggia
| | - Donatella PERRONE
- Department of Clinical and Experimental Medicine, University of Foggia
| | - Mario DIOGUARDI
- Department of Clinical and Experimental Medicine, University of Foggia
| | | | - Fatima ARDITO
- Department of Clinical and Experimental Medicine, University of Foggia
| | - Lorenzo LO MUZIO
- Department of Clinical and Experimental Medicine, University of Foggia
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Chaudhary S, Gharti A, Adhikari B. An in vivo comparison of accuracy of two electronic apex locators in determining working length using stainless steel and nickel titanium files. Clin Cosmet Investig Dent 2018; 10:75-82. [PMID: 29861643 PMCID: PMC5968804 DOI: 10.2147/ccide.s158882] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose A key factor affecting the success of endodontic treatment is correct determination of root canal working length (WL). The purpose of this in vivo study was to compare the accuracy of Propex II and iPex II electronic apex locator (EAL) in determining the WL under clinical conditions, to that of radiographic working length (RWL) using stainless steel (SS) and nickel–titanium (NiTi) hand files. Patients and methods Thirty-seven patients, with 60 anterior teeth (60 canals) scheduled for endodontic treatment participated in this study after ethical approval. Electronic working length (EWL) was determined by the Propex II and iPex II according to manufacturer’s instructions using SS Hand K-files and NiTi Hand files. RWL was determined after EWL determination. The results obtained with each EAL with SS and NiTi files were compared with RWL. Data was analyzed statistically at a significance level of p < 0.05. Interclass correlation coefficient was calculated. Results Statistical analysis revealed no significant difference between the EALs, indicating similar accuracies between them with respect to accuracy in determining the WL (p > 0.05). No significant difference was found between the EWL and RWL and between SS and NiTi files for WL determination (p > 0.05) as well. The result also displayed a high intraclass correlation coefficient between the RWL and EWL measurement methods. Conclusion Under the in vivo clinical conditions of this study, both Propex II and iPex II were similar to the RWL determination technique showing high correlation to RWL. Both are clinically acceptable EAL for WL determination and both SS hand K-file and NiTi file can be used interchangeably without compromising the WL during treatment.
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Affiliation(s)
- Sanjeeb Chaudhary
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Chitwan Medical College, Bharatpur, Nepal
| | - Archana Gharti
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Chitwan Medical College, Bharatpur, Nepal
| | - Bhawana Adhikari
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Chitwan Medical College, Bharatpur, Nepal
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Yammine S, Jabbour E, Diemer F, Majzoub Z. Canal Straightening Following Overinstrumentation with Three Nickel-Titanium Rotary Instruments. J Int Soc Prev Community Dent 2018; 8:245-251. [PMID: 29911063 PMCID: PMC5985682 DOI: 10.4103/jispcd.jispcd_18_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/30/2018] [Indexed: 12/22/2022] Open
Abstract
AIM The aim of the present in vitro study to compare canal straightening following shaping of curved canals with three types of new generation nickel-titanium (NiTi) rotary instruments-ProTaper Next (PTN)®, BT RaCe (BTR)®, and WaveOne Gold (WOG)®- and three different levels of protrusion beyond the major apical foramen. MATERIALS AND METHODS Forty-five extracted human maxillary and mandibular molars with at least one curved canal were distributed in three comparable groups of 15 canals each. The canals were instrumented to the major foramen and then overinstrumented with the final file 0.5 mm, 1 mm, and 1.5 mm beyond the foramen using PTN (Group PTN = 15), BTR (Group BTR = 15), and WOG (Group WOG = 15). Standardized pre- and post-instrumentation radiographs of the root canal were obtained for all groups using digital intraoral radiographs coupled with software. Differences in the degree of curvature were regarded as straightening and canal curvature was evaluated based on Schneider technique using the AmScope software for measurements and compared between groups and levels of instrumentation applying Mixed-model ANOVA. Significance was set at 0.05. RESULTS Canal curvature tended to gradually straighten out as the level of instrumentation increased in all three groups without statistically significant difference among the groups (P = 0.826). CONCLUSION Overinstrumentation in curved canals resulted in straightening of the canal curvature.
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Affiliation(s)
- Salwa Yammine
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Edgard Jabbour
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Franck Diemer
- Université Paul Sabatier, Institut Clément Ader, CHU de Toulouse, France
| | - Zeina Majzoub
- Department of Periodontology, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
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Wang Y, Liu S, Dong Y. In vitro study of dentinal tubule penetration and filling quality of bioceramic sealer. PLoS One 2018; 13:e0192248. [PMID: 29390037 PMCID: PMC5794174 DOI: 10.1371/journal.pone.0192248] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 01/18/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate the dentinal tubule penetration and filling quality of a bioceramic sealer (iRoot SP). Forty-two roots of extracted adult lower incisors were selected. After instrumentation with Protaper Universal to F3, 40 roots were chosen and randomly divided into 4 groups, as follows: iRoot SP single cone group, iRoot SP warm vertical group, AH Plus single cone group, and AH Plus warm vertical group. Before root canal filling, sealers were mixed with Rhodamine B dye for visualization under confocal laser scanning microscope. All samples were sectioned at 2, 4, and 6 mm to apex. Then, the percentages of void areas, gap regions, and segments of sealer that penetrated into dentinal tubules in each section were calculated. Non-parametric test was used for statistical analysis (α = 0.05). We found that filling techniques and types of sealer had no statistically significant effects on the occurrence of voids and gaps. The segments of iRoot SP penetrated into dentinal tubules were statistically more than that of AH Plus in both single cone and warm vertical techniques at 2 mm to apex (P < 0.05). Regardless of the filling technique used, iRoot SP can achieve comparable filling quality and better dentinal tubules penetration than AH Plus. Considering the good bioactivity of iRoot SP, it may help improve the seal of root canal system.
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Affiliation(s)
- Yahui Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
| | - Siyi Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
| | - Yanmei Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
- * E-mail:
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Silva Santos AM, Portela FMSDF, Coelho MS, Fontana CE, De Martin AS. Foraminal Deformation after Foraminal Enlargement with Rotary and Reciprocating Kinematics: A Scanning Electronic Microscopy Study. J Endod 2018; 44:145-148. [DOI: 10.1016/j.joen.2017.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 11/26/2022]
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Evaluation of Effect of Foraminal Enlargement of Necrotic Teeth on Postoperative Symptoms: A Systematic Review and Meta-analysis. J Endod 2017; 43:1969-1977. [DOI: 10.1016/j.joen.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/16/2017] [Accepted: 07/18/2017] [Indexed: 11/24/2022]
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Gurel MA, Helvacioglu Kivanc B, Ekici A. A comparative assessment of the accuracies of Raypex 5, Raypex 6, iPex and iPex II electronic apex locators: An in vitro study. J Istanb Univ Fac Dent 2017; 51:28-33. [PMID: 28955583 PMCID: PMC5573492 DOI: 10.17096/jiufd.61309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/02/2016] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The aims of this study were to examine the accuracy of iPex II and to compare it with those of Raypex 5, Raypex 6 and iPex electronic apex locators (EALs). MATERIALS AND METHODS Thirty fresh human mandibular premolar teeth were used in this study. Crown segments were cut and root canals were coronally flared. A #10 K-file was inserted until its tip can be seen within apical foramen to determine actual working length (AWL). Teeth were embedded in alginate and each multi-frequency EALs were randomly tested to determine the electronic working length (EWL). Differences between AWLs and EWLs were statistically compared. RESULTS No significant differences were found between four EALs. EWL measurements by Raypex 5 were accurate in 64.29%, Raypex 6 in 53.58%, iPex in 64.29% and iPex II in 50% of the specimens, within the range of ±0.5 mm from the AWL. CONCLUSION Within the limitations of this in vitro experiment, our findings indicate that the accuracy of working length measurements calculated with iPex II was similar to those of other multi-frequency EALs used in this study.
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Affiliation(s)
- Mugem Asli Gurel
- Gazi University, Faculty of Dentistry, Department of Endodontics Turkey
| | | | - Adil Ekici
- Gazi University, Faculty of Dentistry, Department of Endodontics Turkey
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Sübay RK, Kara Ö, Sübay MO. Comparison of four electronic root canal length measurement devices. Acta Odontol Scand 2017; 75:325-331. [PMID: 28355939 DOI: 10.1080/00016357.2017.1307447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the performance of four electronic root canal length measurement devices (ERCLMDs) [Root ZX, Raypex 6, ProPex II, and VDW Gold with ERCLMD] in wet and dry root canals with different major foramen diameters, in association with three file positions within the final 1 mm of canals. MATERIALS AND METHODS Fifty roots were divided into five groups that were instrumented apically to the terminus diameter using K-files 15, 20, 30, 40, and 60. ERCLMD measurements were made when the file tip was at major foramen, 0.5 mm and 1.0 mm short of the foramen, when the apex touched to the surface of saline or was immersed 3 mm into saline, and when the canal was dry or was irrigated with saline. The differences between the electronic lengths and the actual lengths were calculated. The data were analyzed using the three-, two-, and one-way ANOVA and the LSD test (p < .05). RESULTS Overall, the four ERCLMDs demonstrated 12.8% unstable and beyond the foramen measurements (11.3%). About 85% of the beyond the foramen measurements had foramen diameters 0.40 and 0.60. ERCLMD comparisons related to the file positions in the foramen diameters showed significant differences between ERCLMDs in each foramen diameter (p < .05). CONCLUSIONS All ERCLMDs provided highly accurate measurements within the final 1 mm of the foramen. Wet or dry canals and apex conditions did not adversely affect the accuracy of the ERCLMDs' readings. ProPex II located the file positions in the teeth with different foramen diameters more accurately than the other ERCLMDs.
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Affiliation(s)
- Rüstem Kemal Sübay
- Department of Endodontics, Faculty of Dentistry, İstanbul Aydın University, İstanbul, Turkey
| | - Özlem Kara
- Okmeydanı Dental Hospital, İstanbul, Turkey
| | - Melike Ordulu Sübay
- Department of Oral Surgery, School of Dentistry, İstanbul University, İstanbul, Turkey
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The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography–discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report. J Endod 2017; 43:1023-1027. [DOI: 10.1016/j.joen.2017.01.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/25/2017] [Accepted: 01/29/2017] [Indexed: 10/19/2022]
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Saatchi M, Iravani S, Akhavan Khaleghi M, Mortaheb A. Influence of Root Canal Curvature on the Accuracy of Root ZX Electronic Foramen Locator: An In Vitro Study. IRANIAN ENDODONTIC JOURNAL 2017; 12:173-178. [PMID: 28512481 PMCID: PMC5431720 DOI: 10.22037/iej.2017.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this in vitro study was to evaluate the correlation between accuracy of Root ZX electronic foramen locator and root canal curvature. Methods and Materials: One hundred and ten extracted mandibular molars were selected. Access cavity was prepared and coronal enlargement of mesiobuccal canal was performed. A #10 Flexofile was inserted into the mesiobuccal canal, and a radiography was taken to measure the degree of curvature by Schneider's method. The actual working length (AWL) was defined by inserting the file until its tip could be observed at a place tangential to the major apical foramen and then 0.5 mm was subtracted from this measurement. For the electronic working length (EWL) measurement, the apical 3 or 4 mm of the root was embedded in alginate as the electrolyte material. The file was inserted into the root canal to the major foramen, until the APEX reading was shown on the electronic device and then pulled back until the visual display showed the 0.5-mm mark. The AWL was subtracted from the EWL to define the distance between the file tip and the point 0.5 mm coronal to the major apical foramen. Data were analyzed using the Pearson’s correlation coefficient. Results: The accuracy of Root ZX within ±0.1 mm and ±0.5 mm was 38.2% and 94.6%, respectively. There was no correlation between the distance from the EWL to the AWL and the degree of root canal curvature (r=0.097, P=0.317). Conclusion: Root canal curvature did not influence the accuracy of Root ZX foramen locator.
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Affiliation(s)
- Masoud Saatchi
- Dental Research Center, Department of Endodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shiva Iravani
- Department of Endodontics, Dental School, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran
| | - Mehrdad Akhavan Khaleghi
- Department of Prosthodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Mortaheb
- Department of Endodontics, Dental School, Islamic Azad University of Khorasgan, Isfahan, Iran
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Tampelini FG, Coelho MS, Rios MDA, Fontana CE, Rocha DGP, Pinheiro SL, Bueno CEDS. In vivo assessment of accuracy of Propex II, Root ZX II, and radiographic measurements for location of the major foramen. Restor Dent Endod 2017; 42:200-205. [PMID: 28808636 PMCID: PMC5553019 DOI: 10.5395/rde.2017.42.3.200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 03/30/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this in vivo study was to assess the accuracy of 2 third-generation electronic apex locators (EALs), Propex II (Dentsply Maillefer) and Root ZX II (J. Morita), and radiographic technique for locating the major foramen (MF). Materials and Methods Thirty-two premolars with single canals that required extraction were included. Following anesthesia, access, and initial canal preparation with size 10 and 15 K-flex files and SX and S1 rotary ProTaper files, the canals were irrigated with 2.5% sodium hypochlorite. The length of the root canal was verified 3 times for each tooth using the 2 apex locators and once using the radiographic technique. Teeth were extracted and the actual WL was determined using size 15 K-files under a × 25 magnification. The Biostat 4.0 program (AnalystSoft Inc.) was used for comparing the direct measurements with those obtained using radiographic technique and the apex locators. Pearson's correlation analysis and analysis of variance (ANOVA) were used for statistical analyses. Results The measurements obtained using the visual method exhibited the strongest correlation with Root ZX II (r = 0.94), followed by Propex II (r = 0.90) and Ingle's technique (r = 0.81; p < 0.001). Descriptive statistics using ANOVA (Tukey's post hoc test) revealed significant differences between the radiographic measurements and both EALs measurements (p < 0.05). Conclusions Both EALs presented similar accuracy that was higher than that of the radiographic measurements obtained with Ingle's technique. Our results suggest that the use of these EALs for MF location is more accurate than the use of radiographic measurements.
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Affiliation(s)
| | - Marcelo Santos Coelho
- Department of Endodontics, Universidade Paulista School of Dentistry, Sorocaba, SP, Brazil
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Zand V, Rahimi S, Davoudi P, Afshang A. Accuracy of Working Length Determination using NovApex and Root-ZX Apex Locators: An in vitro Study. J Contemp Dent Pract 2017; 18:383-385. [PMID: 28512277 DOI: 10.5005/jp-journals-10024-2051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION This ex vivo study evaluated the accuracy of the Root-ZX electronic apex locator (EAL) (J. Morita, Tokyo, Japan) and the NovApex (Forum Technologies, Rishon Lezion, Israel) in determining the working length (WL) during endodontic treatment. MATERIALS AND METHODS Forty extracted single-rooted human teeth were selected for this study. The actual WL was measured with visual technique by a size #15 k-file under magnification. Then, the canal lengths were measured electronically with both Root-ZX and NovApex apex locators within ±0.5 and ±1 mm. Mean percentage of data was analyzed between groups using paired t-test, with a statistically significant level of p < 0.05. RESULTS The accuracy of NovApex apex locator was 85% within ±0.5 mm and 92.5% within ±1 mm. The accuracy of Root-ZX apex locator was 70% within ±0.5 mm and 97.5% within ±1 mm. There was no significant difference between the accuracy of the two EALs. CONCLUSION Both the NovApex and Root-ZX EALs are useful for measuring the WL with high accuracy. CLINICAL SIGNIFICANCE Given the importance of accurate WL determination in the success of endodontic treatments, the accuracy of different apex locators should be evaluated.
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Affiliation(s)
- Vahid Zand
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, East Azerbaijan, Islamic Republic of Iran
| | - Saeed Rahimi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, East Azerbaijan, Islamic Republic of Iran
| | - Paria Davoudi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, East Azerbaijan, Islamic Republic of Iran, Phone: +989144045938, e-mail:
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Estrela C, Pécora JD, Estrela CR, Guedes OA, Silva BS, Soares CJ, Sousa-Neto MD. Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment. Braz Dent J 2017; 28:179-190. [DOI: 10.1590/0103-6440201702451] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 01/23/2023] Open
Abstract
Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.
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BARROSO JAY, UCHIMURA JYT, ENDO MS, PAVAN NNO, QUEIROZ AF. Avaliação in vitro da influência da lima patência na manutenção do comprimento de trabalho. REVISTA DE ODONTOLOGIA DA UNESP 2017. [DOI: 10.1590/1807-2577.13416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Este trabalho teve como objetivo avaliar a influência da lima patência na manutenção do comprimento de trabalho (CT) durante o preparo coroa-ápice, utilizando o sistema oscilatório em canais artificiais de acrílico. Material e método Foram utilizados 30 cubos de acrílico: a) grupo 1 (n=10): sem a lima patência e preparo no CT (CT=16 mm); b) grupo 2 (n=10): com a lima patência K#10, comprimento de patência de 17 mm e preparo no CT; c) grupo 3 (n=10): sem a lima patência, uso de uma lima K#10 em 16 mm para recapitulação e preparo no CT. Água destilada foi utilizada como solução irrigadora. O resultado foi analisado estatisticamente pelos testes de Levene e Kruskal-Wallis (p≤0,05), pelos quais se tornou possível observar a perda do comprimento de trabalho após a instrumentação, em diferentes abordagens, em relação à lima patência. Resultado Os resultados obtidos demonstraram que houve diferença estatisticamente significante entre os grupos 1 e 3 quando comparados ao grupo 2; entretanto, ao comparar-se o grupo 1 com o grupo 3, estes apresentaram semelhanças estatísticas. O grupo 2 foi o único que conservou o CT após a instrumentação em 16 mm, enquanto os grupos 1 e 3 apresentaram uma perda de até 2 mm do CT. Conclusão Conclui-se que a lima patência em 1 mm além do CT mostrou-se eficaz na manutenção do seu comprimento durante o preparo do canal radicular.
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Jafarzadeh H, Beyrami M, Forghani M. Evaluation of Conventional Radiography and an Electronic Apex Locator in Determining the Working Length in C-shaped Canals. IRANIAN ENDODONTIC JOURNAL 2017; 12:60-63. [PMID: 28179926 PMCID: PMC5282381 DOI: 10.22037/iej.2017.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction: The purpose of this in vitro study was to compare the accuracy of working length determination using the apex locator versus conventional radiography in C-shaped canals. Methods and Materials: After confirming the actual C-shaped anatomy using cone-beam computed tomography (CBCT), 22 extracted C-shaped mandibular second molars were selected and decoronated at the cemento-enamel junction. The actual working length of these canals were determined by inserting a #15 K-file until the tip could be seen through the apical foramen and the working length was established by subtracting 0.5 mm from this length. The working length was also determined using conventional analog radiography and electronic apex locator (EAL) that were both compared with the actual working length. The data was statistically analyzed using paired t-test and marginal homogeneity test. Results: There was no significant differences between the working length obtained with apex locator and that achieved through conventional radiography in terms of measuring the mesiolingual and distal canals (P>0.05); while, significant differences were observed in measurements of the mesiobuccal canals (P=0.036). Within ±0.5 mm of tolerance margin there was no significant difference between EAL and conventional radiography. Conclusion: The apex locator was more accurate in determination of the working length of C-shaped canals compared with the conventional radiography.
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Affiliation(s)
- Hamid Jafarzadeh
- Dental Research Center and Department of Endodontics, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Forghani
- Dental Materials Research Center and Department of Endodontics, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
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Min Y, Ma JZ, Shen Y, Cheung GSP, Gao Y. A micro-computed tomography study of the negotiation and anatomical feature in apical root canal of mandibular molars. SCANNING 2016; 38:819-824. [PMID: 27296240 DOI: 10.1002/sca.21331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to investigate the clinical negotiation of various apical anatomic features of the mandibular first molars in a Chinese population using micro-computed tomography (micro-CT). A total of 152 mandibular first molars were scanned with micro-CT at 30 µm resolution. The apical 5 mm of root canal (ARC) was reconstructed three dimensionally and classified. Subsequently, the access cavity was prepared with the ARC anatomy blinded to the operator. The ARC was negotiated with a size 10 K file with or without precurve. Information on the ability to obtain a reproducible glide path was recorded. The anatomical classification of ARC was Type I with 68.45% in mandibular first molars. The negotiation result of ARC with Category i was 387 canals (74.00%). With a bent negotiating file, 96 canals were negotiated, including 88 reproducible glide paths (Category ii) and 8 irregular glide paths (Category iii). About 7.65% canals could not be negotiated with patency successfully (Category iv). The statistical analyze shown the anatomic feature of ARC had effect on the negotiation of ARC (p < 0.05). In conclusion, ARC anatomic variations had a strong potential impact on the negotiation. The category of negotiation in ARC would be helpful in the using of NiTi rotary instruments. Negotiation of ARC to the working length with patency should be careful and skillful because of the complexities of ARC. SCANNING 38:819-824, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Yi Min
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Second Clinical Branches, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ya Shen
- Division of Endodontics, Faculty of Dentistry, Department of Oral Biological and Medical Sciences, University of British Columbia, Vancouver, Canada
| | - Gary Shun-Pan Cheung
- Faculty of Dentistry, Area of Endodontics, Comprehensive Dental Care, University of Hong Kong, Hong Kong, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases, West China College and Hospital of Stomatology, Sichuan University, Chengdu, China
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An ex vivo comparison of working length determination by three electronic root canal length measurement devices integrated into endodontic rotary motors. Clin Oral Investig 2016; 20:2303-2308. [PMID: 27392613 DOI: 10.1007/s00784-016-1903-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 07/03/2016] [Indexed: 10/21/2022]
Abstract
AIM The objective of this study was to compare the accuracy of working length (WL) determination by X-Smart Dual, ENDOAce, and Gold Reciproc motor, in manual mode and mechanical preparation set to auto apical reverse (AAR) mode. MATERIALS AND METHODS Forty-five anterior teeth were included in the study. The canal length was determined by introducing #10 file into the canal until it emerged at the apical foramen. The incisal edges were adjusted to obtain 18 mm standard length. The teeth were embedded in Plexiglas tubes, filled with alginate, and measured in manual and AAR modes. RESULTS Within and between the groups, there was no significant difference in WL measurements, both in manual and AAR modes. In the X-Smart Dual group, all manual measurements were within root canal limits, while 13 % of AAR mode measurements were recorded when the file tip passed the apical foramen. In the ENDOAce group, 13 and 7 % of the measurements, in manual and AAR modes respectively, were recorded when the file tip passed the foramen. In the Gold Reciproc motor group, 27 and 33 % of the measurements, in manual and AAR modes respectively, were recorded when the file tip passed the foramen. CONCLUSION With the limitation of this ex vivo study, the tested devices presented no significant differences in length measurements and were within the clinical accepted margin of error. CLINICAL RELEVANCE Mechanical preparation must be confined to the root canal system. The adverse results of overinstrumentation emphasize the need to reconsider the ±0.50 mm margin of error that is clinically acceptable for WL measurements.
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