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Dianat O, Naseri M, Safi Y, Modaberi A, Zargar N, Peters OA, Farajollahi M. Accuracy comparison of single- and double-sleeve endodontic guides for fiber post removal. BMC Oral Health 2024; 24:497. [PMID: 38678244 PMCID: PMC11055251 DOI: 10.1186/s12903-024-04283-w] [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: 01/17/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND This study aimed to assess the accuracy of two different endodontic guides for fiber post removal. METHODS In this in vitro study, 54 maxillary canine fiber posts were mounted on 36 maxillary stone casts; 18 teeth were mounted unilaterally, and 36 teeth were mounted bilaterally. Static endodontic guides were fabricated according to baseline cone-beam computed tomography (CBCT) and intraoral optical scans using Blue Sky software. In the single-sleeve endodontic guides group (SSG), two anterior and two posterior teeth were included in a 5-unit guide. In the double-sleeve endodontic guides group (DSG) group, the guide was passed through the midline to include both canine teeth and extended by 2 teeth posterior to the canine teeth bilaterally (a 10-unit guide). After drilling, postoperative CBCT scans were taken and superimposed on the virtually designed path, and the maximum coronal deviation (MCD) at the marginal entry point of the tooth, maximum apical deviation (MAD) at 10 mm apical to the tooth margin, and maximum angular deflection (MAnD) of the drill were calculated. RESULTS The mean MCD, MAD, and MAnD were 0.34 mm, 0.6 mm, and 2.32 degrees, respectively, in the SSG and 0.31 mm, 0.7 mm, and 2.37 degrees, respectively, in the DSG. The two groups were not significantly different from each other in terms of MCD (P = 0.573), MAD (P = 0.290), or MAnD (P = 0.896). CONCLUSIONS The accuracies of the two techniques, the extended double sleeve guide and the single sleeve guide, were comparable and thus DSG may be used for removal of fiber posts in adjacent or distant teeth.
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Affiliation(s)
- Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Mandana Naseri
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Modaberi
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Zargar
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Mehran Farajollahi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Özdayi K, Yilmaz S, Dumani A, Yoldas O. Effects of ultrasonics and trephine burs on dentinal microcrack formation during broken instrument removal procedures: A micro-CT analysis. AUST ENDOD J 2024; 50:123-130. [PMID: 37997642 DOI: 10.1111/aej.12820] [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: 03/27/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
The objective of this study was to compare the effects of ultrasonic and trephine burs on microcrack formation during the removal of broken instruments, utilising micro-computed tomography (Micro-CT). Twenty-five extracted human mandibular molars were used for this study. The hand files were fractured into the mesiobuccal canal, except in the control group. In the ultrasonic group (n = 10), ultrasonic tips were used to retrieve the instrument, while in the trephine group (n = 10), trephine burs (Meitrac, Meisinger) and an extractor device were utilised. For the control group (n = 5), only staging platform was prepared. After the removal procedures, micro-CT images were obtained from the specimens. The chi-squared test was used to analyse the data, and significance was considered to be p < 0.05. Overall, 15 736 cross sections were analysed. No significant differences were found between control and experimental groups. Removal of broken instruments with trephine burs caused significantly more dentinal microcracks compared with ultrasonics (p = 0.016).
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Affiliation(s)
| | - Sehnaz Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Aysin Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Oguz Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Elzanaty TK, Elashiry MM, Mahran AH. Retreatability of NeoSEALER Flo obturated with warm vertical compaction versus single-cone technique using two different retreatment systems. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:286-292. [PMID: 38634031 PMCID: PMC11019814 DOI: 10.4103/jcde.jcde_314_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 04/19/2024]
Abstract
Aim The aim of this study was to compare the retreatability of NeoSEALER Flo obturated with warm vertical compaction (WVC) and single-cone (SC) techniques using two different retreatment systems. Materials and Methods Thirty-two root canals were shaped and obturated with NeoSEALER Flo either in an SC obturation technique or a WVC technique. Samples were retreated using ProTaper retreatment or EdgeFile XR retreatment system. The percentage of remaining debris after retreatment was analyzed under a scanning electron microscope using ImageJ software. The time taken to reach full working length (WL) and induce patency was recorded. Statistical Analysis Statistical analysis was performed using an unpaired t-test and a one-way analysis of variance test. Results The percentage of remaining debris after retreatment was significantly higher in the SC technique than in the WVC technique, regardless of the retreatment system used. EdgeFile XR system removed more filling material than the ProTaper retreatment system, regardless of the obturation technique. The apical region showed significantly higher remaining debris than other regions in all groups. The WL and patency were achieved faster in the SC group, while in the WVC group, the EdgeFile XR system was faster. Conclusions The WVC technique showed better retrieval of the filling material; however, a longer time was taken for retreatment. EdgeFile XR system performed better in removing filling materials from inside the canals.
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Affiliation(s)
| | - Mohamed M. Elashiry
- Department of Endodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Abeer Hashem Mahran
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Alamoudi RA, Alfarran A, Alnamnakani B, Howait M, Alghamdi NS, Ain TS. Assessment of Incidence, Management and Contributory Factors of Root Canal Instrument Separation in an Endodontics Post- Graduate Program: A Retrospective Clinical Study. Niger J Clin Pract 2024; 27:16-21. [PMID: 38317030 DOI: 10.4103/njcp.njcp_833_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 11/08/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The successful outcome of nonsurgical root canal treatment (NS-RCT) is largely dependent on the technical quality of the procedure. OBJECTIVE To investigate the incidence of separated instruments in endodontic postgraduate clinics between January 2018 and December 2021, and to determine the potential contributory factors that increase the risk of instrument separation. MATERIALS AND METHODS A retrospective observational study was conducted in the Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. Data was collected to determine the incidence of separated instruments and their associated variables. Seven variables were analyzed separately: nonsurgical initial or retreatment case, tooth type, tooth arch, tooth location, canal type, root curvature, level of fracture, and file type. RESULTS A total of 3150 cases were treated, of which 108 cases had separated instruments. The overall incidence of instrument separation was 3.4% while 53.7% of separated instruments occurred in the mandibular molars, followed by 42.6% in the maxillary molars. The highest frequency of instrument separation was recorded in the mesiobuccal canal (35.2%). The level of separation was found to be statistically significant in relation to the management (P < .001). CONCLUSION Nickel-titanium instruments tend to separate more inside the root canal system than stainless steel instruments. However, under the limitation of this study, the incidence of instrument separation is still quite low, even with postgraduate endodontic residents with limited experience.
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Affiliation(s)
- R A Alamoudi
- Department of Endodontic, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - A Alfarran
- Faculty of Dentistry, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - B Alnamnakani
- Faculty of Dentistry, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - M Howait
- Department of Endodontic, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - N S Alghamdi
- Department of Restorative Dental Sciences, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia
| | - T S Ain
- Pediatric Dentistry and Orthodontic Sciences (Division of Preventive Dentistry), College of Dentistry King Khalid University, Abha, Saudi Arabia
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Xie K, Li Y, Wang X. Evaluation of a broken instrument removal training course for general dentistry residents. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:784-792. [PMID: 36271668 DOI: 10.1111/eje.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION To help general dentistry residents better manage the intracanal broken instrument situation, we introduced a hands-on training course into the endodontic curriculum of a general dentistry residency programme. MATERIALS AND METHODS Thirty general dentistry residents and 30 residents with endodontic specialty training background in a general hospital served as the experimental group and reference group, respectively. The experimental group underwent a training course including a 30-min lecture and two hands-on sessions (2 h each). After the course, residents from both groups were asked to perform the instrument removal procedure on simulated root canals. Success rate, procedure time and canal volume change were compared between groups. Questionnaire results were also analysed. RESULTS All residents successfully managed to remove the broken instruments in the test. Procedure time was significantly longer for general dentistry residents (15.8 ± 5.7 min vs 13.7 ± 4.5 min, Mann-Whitney U test, p = .038). Canal volume change was significantly greater for general dentistry residents (8.53 ± 3.82 μl vs 5.94 ± 2.73 μl, independent-samples t-test, p = .004). In the questionnaires, trainees gave overall positive ratings for the course. The marginal homogeneity test on before and after scores of the questionnaire items showed the training helped the trainees to reduce the stress level associated with instrument breakage (p < .001). It also motivated the trainees to remove the broken instrument in some straightforward cases (p < .001). CONCLUSION The broken instrument removal training course could help the general dentistry residents better manage the intracanal broken instrument situation.
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Affiliation(s)
- Kexian Xie
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Yuangao Li
- Department of Stomatology, Peking University Third Hospital, Beijing, China
| | - Xiao Wang
- Department of Stomatology, Peking University Third Hospital, Beijing, China
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Priyadarshni P, Nagpal A, Arif A, Sharma A, Rahman M, Sinha S. Comparative Evaluation of Dentinal Crack After Root Canal Preparation Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid Files: An In Vitro Study. Cureus 2023; 15:e49593. [PMID: 38161952 PMCID: PMC10754683 DOI: 10.7759/cureus.49593] [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: 10/13/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
AIM The objective of the study was to assess and compare the dentinal microcracks produced by TruNatomy, Neoendo Flex, and Neoendo Neohybrid files during root canal preparation. MATERIAL AND METHODS In this in vitro investigation, four groups of 25 samples each were assembled from 100 mandibular premolar teeth. Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid files, or leaving the teeth unprepared (control), the teeth underwent root canal preparation. Horizontal sections were taken at different distances from the apex to analyze dentinal cracks. A stereomicroscope was used to assess the existence or lack of cracks, and chi-square tests were performed on the data. RESULTS In the control group, there were no cracks. TruNatomy files created fewer cracks compared to Neoendo Flex and Neoendo Neohybrid files. CONCLUSIONS This in vitro investigation demonstrates that the root surface might acquire dentinal cracks as a result of nickel-titanium instruments. Compared to Neoendo Flex and Neoendo Neohybrid files, TruNatomy showed a decreased incidence of cracks. However, it is important to note that these conclusions are limited to the scope of this study.
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Affiliation(s)
- Priyanka Priyadarshni
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
| | - Ajay Nagpal
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
| | - Arina Arif
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
| | - Abhishek Sharma
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
| | - Mutiur Rahman
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
| | - Shreyasi Sinha
- Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, IND
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Jamleh A, Nassar M, Alfadley A, Alanazi A, Alotiabi H, Alghilan M, Alfouzan K. Retreatment of oval-shaped root canals filled with TotalFill bioceramic or AH plus sealer. Sci Rep 2023; 13:9357. [PMID: 37291272 PMCID: PMC10250336 DOI: 10.1038/s41598-023-36608-0] [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: 02/16/2023] [Accepted: 06/07/2023] [Indexed: 06/10/2023] Open
Abstract
This study investigated retreatment of oval canals filled with gutta-percha and different sealers using WaveOne Gold (WOG). Single oval canals were prepared to size 30, 0.04 and obturated with gutta percha and AH Plus (AHP) or TotalFill bioceramic (TFBC) sealer. After 6-month incubation, the canals were retreated with WOG Primary (25, 0.07) under simulated body temperature, and the developed load and torque were simultaneously measured. The time and regaining the apical patency were checked. Micro-computed tomography scanning was performed to calculate the remaining obturating materials. An independent t-test and chi-square test were performed at a 95% confidence level. A shorter retreatment time was needed in TFBC than in AHP (P = 0.003). However, a higher maximum apical load was reported with AHP (P = 0.000). Meanwhile, comparable maximum coronal load and maximum torque values were observed. Apical patency was regained in all TFBC roots and only 75% of the AHP samples (P = 0.217). The remaining obturating materials were comparable in TFBC (13.02 ± 8.12%) and AHP (10.11 ± 8.46%) (P = 0.398). WOG was able to remove 89.89% and 86.98% of obturating materials in TFBC and AHP, respectively. The TFBC presented lower apical loads and faster retreatment compared to AHP.
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Affiliation(s)
- Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia.
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Abdulmohsen Alfadley
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Azhar Alanazi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- Endodontic Division, Dental Services, Central Region, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hadeel Alotiabi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Maryam Alghilan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Alfouzan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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Hülsmann M, Klinger M, Dullin C, Baxter S. Removal of Thermafil obturators using two different techniques: A comparative Ex Vivo study. J Endod 2023:S0099-2399(23)00242-X. [PMID: 37164168 DOI: 10.1016/j.joen.2023.04.014] [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: 02/10/2023] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION The aim of this ex vivo study was to compare two techniques for removal of Thermafil obturators from curved root canals in mandibular molars. METHODS Sixty mesial root canals in extracted mandibular molars were distributed into matched pairs according to degree and radius of curvature and were prepared to size 35/.04 and obturated with Thermafil obturators size 35. Each tooth was embedded in resin, mounted in a mannequin head and isolated with rubber dam to simulate clinical conditions. Removal of obturators was undertaken under a dental operating microscope by an experienced endodontist using either the FragRemover loop device, or reciprocating NiTi instruments. Pre- and postoperative micro-CT scans were taken to compare the amount of remaining filling material and of removed dentin. Eventual problems during removal attempts were recorded. RESULTS Using Reciproc 24 carriers (80%) were removed, 16 in one piece, 8 in small pieces, in 6 cases removal failed. The FragRemover removed 12 carriers (40%), all of these completely, but in 18 cases removal failed (P < 0.05). Reciproc left less remaining filling material than the FragRemover (P < 0.05) but removed significantly more dentin in the apical part of the root canal (P < 0.01). There was no significant difference concerning the total amount of removed dentin (P > 0.05) between both groups. Seven complications occurred in the Reciproc group. In five teeth working length could not be reached, in two teeth a Reciproc file R25 fractured. With the FragRemover 64 complications occurred, in 36 cases, including second removal attempts, the loop slipped over the carrier, in 24 cases the top of the carrier was sheared off. In nine cases separation of the core occurred too far apically, not allowing further use of the FragRemover. In four cases the wire loop tore. CONCLUSIONS Reciproc was more effective in removal of Thermafil carriers, whereas using the FragRemover less dentin was removed in the apical part of the root canal and more obturation material was left.
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Affiliation(s)
- Michael Hülsmann
- Center of Dental Medicine, Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zürich, Zürich, Switzerland.
| | | | - Christian Dullin
- Dept. of Diagnostic Radiology, University of Göttingen, Göttingen, Germany
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Mustafa M, Attur K, Bagda KK, Singh S, Oak A, Kathiria N. An Appraisal on Newer Endodontic File Systems: A Narrative Review. J Contemp Dent Pract 2022; 23:944-952. [PMID: 37283003 DOI: 10.5005/jp-journals-10024-3398] [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] [Indexed: 06/08/2023]
Abstract
AIM This narrative review aims to explore and elicit the newer endodontic file systems used for root canal treatments. BACKGROUND The primary goals of endodontic therapy continue to be the mechanical enlargement and shaping of the intricate endodontic root canal systems to aid in disinfection. Nowadays endodontists have access to a wide range of endodontic file systems for root canal preparations with various design characteristics and benefits. REVIEW RESULTS ProTaper Ultimate (PTU) files' tip have a triangular convex cross-section, an offset mass of rotating design, a maximum flute diameter of 1.0 mm, and are constructed of gold wire, hence, commonly applied in conditions with restricted accessibility or an extremely curved canal. TruNatomyhas advantages over other cutting-edge file systems like maximum flute diameter of the corona, reduced distance between active cutting flutes, and shorter handles in comparison to SX instruments. In comparison to PTU files, ProTaper Gold (PTG) files are noticeably more elastic and fatigue-resistant. Compared to files in the F1-F3 range, size S1 and S2 files have a significantly longer fatigue life. MicroMega One RECI is more resistant to cyclic fatigue because of its heat treatment and reciprocating action and the C-wire heat treatment of the former gives it flexibility and controlled memory, enabling the prebending of the file. The RECIPROC blue demonstrated enhanced flexibility, increased fatigue resistance, and lower microhardness while maintaining the same surface qualities. CONCLUSION As per the necessity and requirement on case to case basis, every endodontic file system has advantages and disadvantages as mentioned in this narrative review. According to the need, an endodontist can select the file system which is required specifically. Although several studies are comparing these various systems in the literature, this narrative review aims to give the clinician a summary of some recently launched endodontic rotary file systems available in the market and their clinical uses. CLINICAL SIGNIFICANCE As per the priority and need of the case, whether removal and extrusion of debris, reduction of micro-organisms, keeping canal anatomy, and cutting efficiency, a specific required file system can be utilized.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat, India; Center for Transdisciplinary Research, Saveetha Dental College, Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9987697896; e-mail:
| | - Kailash Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Kamal Kumar Bagda
- Department of Conservative Dentistry and Endodontics, Goenka Research Institute of Dental Sciences, Gandhinagar, Gujarat, India
| | - Shalini Singh
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Anjali Oak
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Nishtha Kathiria
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
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Dulundu M, Helvacioglu-Yigit D. The Efficiency of the BTR-Pen System in Removing Different Types of Broken Instruments from Root Canals and Its Effect on the Fracture Resistance of Roots. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5816. [PMID: 36079199 PMCID: PMC9457077 DOI: 10.3390/ma15175816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
The study aimed to evaluate the efficiency of the BTR-Pen system in removing different types of instrument fragments from root canals and to assess its effect on fracture resistance of the roots after the removal of the instruments. One hundred thirty human teeth were divided into 10 groups (2 control groups and 8 study groups) according to the localization and type of the fractured fragment as well as the retrieval techniques. Broken instruments were extracted either with BTR-Pen system loops or removed using solely ultrasonic tips. The success rate of instrument removal and consumed time were recorded. All the teeth were subjected to a load at a 1 mm/min rate in a universal testing machine for mechanical testing. The success of removing broken instruments using the BTR-Pen and ultrasonic was 86.7% and 83.3%, respectively (p > 0.05). When the time is compared, the BTR-Pen system (23.97 ± 8.35 min) showed similar results to that of the ultrasonic technique (24.1 ± 8.28 min) (p > 0.05). The BTR-Pen group required less force to fracture than the ultrasonic group (p = 0.024). In conclusion, the BTR-Pen and ultrasonic groups showed no significant difference in terms of the success rate and removal time. The roots that underwent instrument removal using the BTR-Pen system had less fracture resistance.
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Affiliation(s)
- Merve Dulundu
- Faculty of Dentistry, Kocaeli University, Kocaeli 41190, Turkey
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Bordone A, Ciaschetti M, Perez C, Couvrechel C. Guided Endodontics in the Management of Intracanal Separated Instruments: A Case Report. J Contemp Dent Pract 2022; 23:853-856. [PMID: 37283022 DOI: 10.5005/jp-journals-10024-3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The aim of this case report is to describe the removal of a fractured file in mandibular right first premolar through the application of an endodontic template to guide a trephine until the file. BACKGROUND The fracture of an endodontic instrument is a rare complication that requires therapeutic management. Removal procedures often cause excessive dentine loss. To limit this inconvenience, several techniques describing the removal of fractured files in the coronal third of the canal have been proposed. The guide facilitates the use of the Zumax removal kit (Zumax Medical Co. Ltd., Suzhou, China). CASE DESCRIPTION A 30-year-old patient was referred to dental office for the endodontic retreatment of his mandibular right first premolar. The tooth was painful to percussion and buccal palpation. The periapical radiograph showed a periapical lesion, a defective root canal treatment, and the presence of a fractured file. It was decided to use the Zumax kit in order to remove the instrument. By using digital implantology software, a guide was constructed with a tube to guide a trephine and achieve straight-line access. The trephine was later driven by the resin guide. After completing the drilling, the instrument was removed with the Zumax extractor and the canal was then prepared, disinfected, and filled. CONCLUSION The current case describes the removal of a separated instrument by use of a new approach that is planned on computer software and guided by a resin guide. CLINICAL SIGNIFICANCE The guided endodontic technique avoids excessive loss of dental structure and simplifies the procedure by reducing chair time and increasing the operator's confidence.
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Affiliation(s)
| | | | - Cyril Perez
- Private Practice, 14 Rue des Capucines, Paris, France, Phone: +33 627717742, e-mail:
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Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique. Case Rep Dent 2022; 2022:3752466. [PMID: 35909436 PMCID: PMC9337978 DOI: 10.1155/2022/3752466] [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: 04/12/2022] [Accepted: 07/02/2022] [Indexed: 11/17/2022] Open
Abstract
This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.
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13
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Assessment of Bioceramic Sealer Retreatability and Its Influence on Force and Torque Generation. MATERIALS 2022; 15:ma15093316. [PMID: 35591647 PMCID: PMC9101237 DOI: 10.3390/ma15093316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023]
Abstract
This study assesses the retreatability of TotalFill bioceramic (TFBC) and AH Plus (AHP) sealers and their impact on retreatment force and torque. Twenty-six premolar teeth with single oval canals were instrumented, obturated using the matched gutta-percha cone technique with one of the tested sealers, and then temporized. After a 6-month incubation at 37 °C and 100% humidity, the canals were retreated with the XP Shaper system. During retreatment, the generated force and torque were measured. Micro-CT scanning was run before and after the retreatment procedure to analyze the remaining obturating materials in the canals. The apically directed maximum force in AHP was higher than that in TFBC. The coronally directed maximum force and the maximum torque were comparable between the groups. A higher amount of remaining obturating materials was found in the AHP compared to that in the TFBC. Based on these findings, endodontic sealer had an influence on retreatability, and the TFBC showed less remaining obturating materials and lower retreatment forces in the apical direction compared to the AHP in extracted teeth with oval canals.
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14
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Terauchi Y, Ali WT, Abielhassan MM. Present status and future directions - Removal of fractured instruments. Int Endod J 2022; 55 Suppl 3:685-709. [PMID: 35377473 DOI: 10.1111/iej.13743] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
Success rate of fractured instrument retrieval varies because it is dependent mainly on several factors including the visibility of the fractured instrument, the length of the fractured instrument in relation to the curvature of the canal, and the techniques applied to each case. This review aims to update the present status on removal of fractured instruments to identify factors and variables that could affect the success of fractured instrument retrieval based on both the preparation techniques and the instrument retrieval techniques. On the other hand, future directions of fractured instrument retrieval should focus on management of non-visible fractured instruments since the removal of those instruments are deemed unpredictable with the current techniques, whereas the removal of visible fractured instruments are considered predictable now. Another possible direction of it is there might be no more instrument fracture due to possible significant changes in the root canal preparation technique which may dispense with the use of rotary instruments.
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Affiliation(s)
- Yoshi Terauchi
- CT & MicroEndodontic center, 3-3-1 Chuorinkan, Yamato-Shi, KANAGAWA, 242-0001, Japan.,Yoshitsugu Terauchi, 9-8-14 Chuorinkan, Yamato City, KANAGAWA, 2420007, Japan
| | - Wagih Tarek Ali
- Endodontic Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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15
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Faus-Matoses V, Burgos Ibáñez E, Faus-Llácer V, Ruiz-Sánchez C, Zubizarreta-Macho Á, Faus-Matoses I. Comparative Analysis of Ease of Removal of Fractured NiTi Endodontic Rotary Files from the Root Canal System-An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020718. [PMID: 35055540 PMCID: PMC8775915 DOI: 10.3390/ijerph19020718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
This study aimed at analyzing and comparing the ease of removal of fractured nickel-titanium (NiTi) endodontic rotary files from the root canal system between the ultrasonic tips and the Endo Rescue appliance removal systems, as well as comparing the volume of dentin removed between ultrasonic tips and the Endo Rescue appliance using a micro-computed tomography (micro-CT) scan. MATERIAL AND METHODS Forty NiTi endodontic rotary files were intentionally fractured in 40 root canal systems of 20 lower first molar teeth and distributed into the following study groups: A: Ultrasonic tips (n = 20) (US) and B: Endo Rescue device (n = 20) (ER). Preoperative and postoperative micro-CT scans were uploaded into image processing software to analyze the volumetric variations of dentin using an algorithm that enables progressive differentiation between neighboring pixels after defining and segmenting the fractured NiTi endodontic rotary files and the root canal systems in both micro-CT scans. A non-parametric Mann-Whitney-Wilcoxon test or t-test for independent samples was used to analyze the results. RESULTS The US and ES study groups saw 8 (1 mesiobuccal and 7 distal root canal system) and 3 (distal root canal system) fractured NiTi endodontic rotary files removed, respectively. No statistically significant differences were found in the amount of dentin removed between the US and ER study groups at the mesiobuccal (p = 0.9109) and distal root canal system (p = 0.8669). CONCLUSIONS Ultrasonic tips enable greater ease of removal of NiTi endodontic rotary files from the root canal system, with similar amounts of dentin removal between the two methods.
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Affiliation(s)
- Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (E.B.I.); (V.F.-L.); (C.R.-S.); (I.F.-M.)
| | - Eva Burgos Ibáñez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (E.B.I.); (V.F.-L.); (C.R.-S.); (I.F.-M.)
| | - Vicente Faus-Llácer
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (E.B.I.); (V.F.-L.); (C.R.-S.); (I.F.-M.)
| | - Celia Ruiz-Sánchez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (E.B.I.); (V.F.-L.); (C.R.-S.); (I.F.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
- Correspondence:
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (E.B.I.); (V.F.-L.); (C.R.-S.); (I.F.-M.)
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16
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Hirani A, Arora A, Hadwani K, Cherian A. Cyclic and spontaneous movement of a fractured and extruded instrument back into the root canal: A rare case report. J Conserv Dent 2022; 25:105-108. [PMID: 35722080 PMCID: PMC9200180 DOI: 10.4103/jcd.jcd_303_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Retreatment of endodontically involved teeth may require the removal of obstruction from root canal space. Instrument fracture is an undesirable and stressful incident which can negatively affect the prognosis of the tooth. Any corrective step taken should be performed with utmost care to prevent extrusion of the fragment into periapex. This case report describes a rare occurrence of movement of a fractured instrument during inter-appointment period. A previously treated left mandibular first molar with a fractured instrument was taken up for retreatment. During the course of treatment, the fractured fragment which was previously located in the apical third of the distal canal was dislodged into the periapical region. However, it was found that fragment moved back inside the canal after the inter-appointment period. The same sequence of events repeated before the instrument could be retrieved. Hydrostatic and vascular pressure build due to periapical inflammation could be cited reasons for such a movement.
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17
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Cho C, Jo HJ, Ha JH. Fiber-reinforced composite post removal using guided endodontics: a case report. Restor Dent Endod 2021; 46:e50. [PMID: 34909414 PMCID: PMC8636079 DOI: 10.5395/rde.2021.46.e50] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/20/2021] [Accepted: 06/15/2021] [Indexed: 12/02/2022] Open
Abstract
Although several techniques have been proposed to remove fiber-reinforced composite (FRC) post, no safe and efficient technique has been established. Recently, a guided endodontics technique has been introduced in cases of pulp canal obliteration. This study describes 2 cases of FRC post removal from maxillary anterior teeth using this guided endodontics technique with a dental operating microscope. Optically scanned data set from plaster cast model was superimposed with the data set of cone-beam computed tomography. By implant planning software, the path of a guide drill was selected. Based on them, a customized stent was fabricated and utilized to remove the FRC post. Employing guided endodontics, the FRC post was removed quickly and safely with minimizing the loss of the remaining tooth structure. The guided endodontics was a useful option for FRC post removal.
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Affiliation(s)
- Changgi Cho
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Hyo Jin Jo
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Jung-Hong Ha
- Department of Conservative Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
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18
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Rajda M, Miletić I, Baršić G, Krmek SJ, Šnjarić D, Baraba A. Efficacy of Reciprocating Instruments in the Removal of Bioceramic and Epoxy Resin-Based Sealers: Micro-CT Analysis. MATERIALS 2021; 14:ma14216670. [PMID: 34772195 PMCID: PMC8587586 DOI: 10.3390/ma14216670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/27/2022]
Abstract
The objective of this study was to evaluate the efficacy of reciprocating instruments in the removal of bioceramic and epoxy resin-based sealers using micro-CT analysis. Root canals of 40 extracted human teeth were instrumented with a size R25 Reciproc instrument. Specimens were randomly divided into two groups (n = 20) according to the root canal filling material. In the first group, root canals were obturated with AH Plus sealer and Reciproc R25 gutta-percha. In the second group, a combination of bioceramic gutta-percha (TotalFill BC) and bioceramic sealer (TotalFill BC) was used. After one week, the retreatment of all specimens was performed using Reciproc instruments. To analyze the differences in the filling remnants, specimens were scanned in a micro-CT device after obturation and after the retreatment procedure. Statistical analysis was performed using the Mann-Whitney U test (p < 0.05). A combination of bioceramic sealer and bioceramic gutta-percha was more effectively removed from canals using a reciprocating instrument, with a filling remnants volume of 4.01 ± 3.13 mm3, in comparison to the combination of epoxy resin-based sealer and gutta-percha (6.96 ± 2.70 mm3) (p < 0.05). A reciprocating instrument was more effective in removing bioceramic sealers than epoxy resin-based sealers, although none of the root canal filling materials were completely removed from the root canals.
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Affiliation(s)
- Marko Rajda
- Dental Health Center—Center, Runjaninova 4, 10000 Zagreb, Croatia;
| | - Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Gorana Baršić
- Department for Quality, Department for Measurement and Control, Faculty of Mechanical Engineering and Naval Architecture, IvanaLučića 5, 10002 Zagreb, Croatia;
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
| | - Damir Šnjarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Gundulićeva 5, 10000 Zagreb, Croatia; (I.M.); (S.J.K.)
- Correspondence:
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19
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Ballester B, Giraud T, Ahmed HMA, Nabhan MS, Bukiet F, Guivarc'h M. Current strategies for conservative endodontic access cavity preparation techniques-systematic review, meta-analysis, and decision-making protocol. Clin Oral Investig 2021; 25:6027-6044. [PMID: 34623506 DOI: 10.1007/s00784-021-04080-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/13/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs. MATERIALS AND METHODS A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05). RESULTS A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P < 0.05), (ii) there is no significant effect of the type of AC on the fracture resistance of teeth when one or two marginal ridges are lost (P > 0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P < 0.05). CONCLUSIONS Decreasing the AC extent does not necessarily present mechanical and biological advantages especially when one or more surfaces of the tooth structure are lost. To date, the evidence available does not support the application of TrussAC. UltraAC might be applied in limited occasions. CLINICAL RELEVANCE Maintaining the extent of AC design as small as practical without jeopardizing the root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.
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Affiliation(s)
- Benoit Ballester
- Assistance Publique Des Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de L'Information Médicale, Marseille, France
| | - Thomas Giraud
- Assistance Publique Des Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Frédéric Bukiet
- Assistance Publique Des Hôpitaux de Marseille, Marseille, France. .,Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France.
| | - Maud Guivarc'h
- Assistance Publique Des Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, EFS/CNRS, ADES, Marseille, France
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20
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A Modified Partial Platform Technique to Retrieve Instrument Fragments from Curved and Narrow Canals: A Report of 2 Cases. J Endod 2021; 47:1657-1663. [PMID: 34298031 DOI: 10.1016/j.joen.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/02/2021] [Accepted: 07/11/2021] [Indexed: 11/22/2022]
Abstract
Two cases are reported to present the "Burrow platform" (BP) technique. The BP technique uses a partial platform for retrieving instrument fragments, thereby reducing the loss of radicular dentin.The BP technique is a microscope-aided approach implementing coated ultrasonic tips to create an access to instrument fragments in the middle and apical thirds of the root canal. The technique consists of 4 steps: (1) coronal access, (2) radicular access, (3) partial platform, and (4) exposure of the fragment and retrieval. A precise, angulated access pathway is specific to the BP technique. In the coronal half, the radicular access pathway extends toward the outer wall of the curvature. In the apical half, the radicular access pathway is oriented toward the inside of the curvature. One and 4 instrument fragments were successfully retrieved in the respective cases. At follow-up, all teeth were asymptomatic and had responded favorably to the treatment.The BP technique may present a suitable alternative to fragment removal from curved canals and slender roots to avoid ledge formation, transportation, and perforation. Instrument retrieval using the BP technique can be performed using commonly available armamentarium.
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21
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Terauchi Y, Sexton C, Bakland LK, Bogen G. Factors Affecting the Removal Time of Separated Instruments. J Endod 2021; 47:1245-1252. [PMID: 34000326 DOI: 10.1016/j.joen.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Separated endodontic instruments may adversely affect the outcome of endodontic treatment. The combination of ultrasonic techniques and dental operating microscopes appears to be effective in the removal of separated instruments compared with more randomized techniques. This study evaluated the roles of root canal curvature and separated instrument length on the time needed to loosen and retrieve the instrument fragments. METHODS The retrieval procedures of 128 separated instruments referred to a private endodontic practice for retreatment by general practitioners were evaluated in patients who were monitored for a minimum of 6 months. Preoperative cone-beam computed tomographic images were used to measure separated instrument lengths in relation to the degrees of canal curvatures. Ultrasonic instruments were used in the initial phase to remove the tooth structure and to loosen the fractured instrument. In the second phase, ultrasonic instruments, wire loops, or XP Shapers (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) were used for fragment removal. The time periods for all procedures were recorded. Statistical analysis was completed applying log-normal regression, structural equation modeling, and linear regression using Stata Version 14.2 software (StataCorp LLC, College Station, TX). RESULTS All separated instruments were successfully retrieved. Using the protocol in this study, 89.8% of the instruments were removed using ultrasonic instruments alone with a mean time of 221 seconds. The instrument removal time was dependent on both the instrument length and the root canal curvature. Additionally, preparation times were proportionately longer with increasing separated instrument lengths when the loop device was required. CONCLUSIONS The preparation phase appears to have an important role in the retrieval of separated instruments. Preparation times for both non-loop and loop groups demonstrate that length and curvature are independent predictors of the log-transformed time. Generally, procedure times were extended with increasing file lengths and higher degrees of canal curvature.
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Affiliation(s)
| | - Christopher Sexton
- University of Queensland, School of Dentistry, Brisbane, Queensland, Australia
| | - Leif K Bakland
- Loma Linda University, School of Dentistry, Loma Linda, California
| | - George Bogen
- Department of Endodontics, University of Queensland, School of Dentistry, Brisbane, Queensland, Australia.
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22
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Bardales-Alcocer J, Ramírez-Salomón M, Vega-Lizama E, López-Villanueva M, Alvarado-Cárdenas G, Serota KS, Ramírez-Wong J. Endodontic Retreatment Using Dynamic Navigation: A Case Report. J Endod 2021; 47:1007-1013. [PMID: 33745944 DOI: 10.1016/j.joen.2021.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Dynamic navigation systems are used in dental implantology to optimize the accuracy of dental implant placement. METHODS A 30-year-old man was seen at the endodontic clinic of the Universidad Autónoma de Yucatán for pain in the left maxillary lateral incisor. A previously treated tooth with symptomatic apical periodontitis was diagnosed. The patient accepted treatment, and after signing an informed consent form, minimally invasive coronal access was performed through a zirconia crown. Then a post removal was performed with an ultrasonic tip to 2 mm before the apical gutta-percha limit, and the removal of material was completed manually with a K-file. RESULTS This case report demonstrates the use of dynamic navigation to remove a post from under a zirconia crown for the retreatment of a failing root canal procedure. The removal of fiber posts from endodontically treated teeth can present a unique challenge for clinicians. Numerous techniques and instrument kits are recommended for the removal of fiber posts, but the risk of excessive root structure damage is a major concern because the ability to differentiate the color difference between peripheral dentin and a bonded fiber post can complicate the accuracy of the removal. CONCLUSIONS The dynamic navigation system enabled minimally invasive removal of the fiber post with a high degree of accuracy, thus ensuring that there was no unnecessary removal of root structure. Dynamic navigation using real-time monitoring could reduce the attendant risk of iatrogenic errors in complex treatment cases.
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Affiliation(s)
| | | | - Elma Vega-Lizama
- Universidad Autónoma de Yucatán, Faculty of Dentistry, Mérida, Yucatán, México
| | | | | | - Kenneth S Serota
- University of Toronto, Faculty of Dentistry, Toronto, ON, Canada
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23
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Heggendorn FL, Teixeira Pinto LAL, Gonçalves LS, Lione VDOF, Cravo Junior WB, Soares Lutterbach MT. Biocorrosive behavior of sulphate-reducing bacteria in kerr endodontic files: Determination of the corrosion. J Conserv Dent 2021; 23:196-200. [PMID: 33384495 PMCID: PMC7720761 DOI: 10.4103/jcd.jcd_64_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: 03/03/2019] [Revised: 05/02/2019] [Accepted: 06/21/2019] [Indexed: 11/06/2022] Open
Abstract
Aims: This study determined the corrosion rate by mass loss caused by oral strains of sulphate-reducing bacteria (SRB) in Kerr endodontic files (KF), aiming the development of a biopharmaceutical that facilitates the removal of endodontic limb fragments from root canals. Materials and Methods: Nine new KF were analyzed after immersion in the modified Postgate E culture medium inoculated with Desulfovibrio desulfuricans oral (84 days), Desulfovibrio fairfieldensis in the consortium (84 days) and environmental D. desulfuricans (119 days). Results: Optical microscopy revealed corrosion suggestive areas in all files submitted to immersion in SRB cultures, presenting a statistical difference (P < 0.05) between the samples environmental D. desulfuricans and KF control and between oral D. desulfuricans and KF control. Epifluorescence microscopy revealed an active SRB biofilm over the entire metal surface of the KF, as evidenced by the SYTO® 9 fluorophore. Conclusion: SRB were capable of promoting biocorrosion in Kerr type endodontic files, but with low rate.
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Affiliation(s)
- Fabiano Luiz Heggendorn
- Department of Corrosion and Degradation, Laboratory of Biocorrosion and Biodegradation, National Institute of Technology, Rio de Janeiro, Brazil.,Department of Drugs and Medicine, Laboratory of Pharmaceutical Bioassays, School of Pharmacy, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Luiz André Lucas Teixeira Pinto
- Department of Corrosion and Degradation, Laboratory of Biocorrosion and Biodegradation, National Institute of Technology, Rio de Janeiro, Brazil
| | - Lucio Souza Gonçalves
- Post-Graduate Program in Dentistry, Faculty of Dentistry, Estacio de Sa University, Rio de Janeiro, Brazil
| | - Viviane de Oliveira Freitas Lione
- Department of Drugs and Medicine, Laboratory of Pharmaceutical Bioassays, School of Pharmacy, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Walter Barreiro Cravo Junior
- Department of Corrosion and Degradation, Laboratory of Biocorrosion and Biodegradation, National Institute of Technology, Rio de Janeiro, Brazil
| | - Marcia Teresa Soares Lutterbach
- Department of Corrosion and Degradation, Laboratory of Biocorrosion and Biodegradation, National Institute of Technology, Rio de Janeiro, Brazil
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PradeepKumar A, Kumar B, Krishnamoorthy S, Shanmugam S. The time taken for retrieval of separated instrument and the change in root canal volume after two different techniques using CBCT: An in-vitro study. Indian J Dent Res 2021; 32:489-494. [DOI: 10.4103/ijdr.ijdr_403_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, Silva ASDS, Bueno CEDS. Micro-computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod 2020; 46:1901-1906. [PMID: 32961214 DOI: 10.1016/j.joen.2020.09.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study was to conduct a micro-computed tomographic assessment of the effectiveness of 3 supplementary cleaning techniques in reducing the residual volume of gutta-percha and a bioceramic sealer after performing endodontic retreatment procedures in teeth with oval canals. METHODS Thirty-six mandibular premolars were instrumented with the ProTaper Next system (instruments X1-X3; Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and Bio-C Sealer (Angelus, Londrina, PR, Brazil) using the single-cone technique. The teeth were reinstrumented with the Reciproc R40 instrument (VDW, Munich, Germany) and divided into 3 groups according to the supplementary cleaning technique used (n = 12): ultrasonic-assisted irrigation (UAI), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) irrigation (EAI), or the XP-endo Finisher R system (XPR; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Micro-computed tomographic imaging was used to quantify the residual volume of filling material. One-way analysis of variance complemented by the Tukey test was used to perform the statistical analysis (P < .05). RESULTS Significant reductions were obtained in the residual filling material after supplementary cleaning (P < .05). XPR (47.5%) led to significantly greater (P < .05) filling material removal than UAI (16.6%) or EAI (22.6%). The removal values of the 2 latter systems were not significantly different. CONCLUSIONS XPR was more effective than UAI and EAI in removing filling material in mandibular premolars with oval canals. None of the tested supplementary cleaning techniques completely removed the residual filling material.
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Affiliation(s)
- Andrea Volponi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Saddock de Sá Silva
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Sadat Shojaee N, Vakilinezhad E, Shokouhi MM. In Vitro Comparison of Efficacy of Neolix and ProTaper Universal Retreatment Rotary Systems in Removal of Gutta-Percha Combined with Two Different Sealers. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2019. [PMID: 31875176 DOI: 10.30476/dentjods.2019.77825.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Statement of the Problem The complete removal of filling material is an important step to regain access to the entire canal and facilitate the disinfection of the root canal system. Rotary nickel-titanium (NiTi) instruments systems have been proposed as an effective removal technique for root canal retreatment. Purpose The aim of this study was to evaluate the efficacy of Neolix rotary system and ProTaper Universal retreatment system in the removal of gutta-percha combined with two different sealers. Materials and Method In vivo study, eighty extracted human permanent mandibular premolars were prepared using the ProTaper Universal rotary system to an apical size 30 (F3/0.06). The specimens were randomly divided into 4 groups (n=20) and subsequently filled with lateral condensation of gutta-percha and two sealers: AH-26 and Sure-Seal Root. The teeth were stored for 4 weeks at 37°C and 100% humidity and then retreated by one of the following rotary systems: Neolix or ProTaper Universal retreatment system. Teeth were then grooved and monitored under a stereomicroscope with 8× magnification. The images were transferred to the computer and the amount of filling material that remained on the root canal walls was scored using AutoCAD 2017 version 1.1software. Results were analyzed using one-way analysis of variance test and post hoc Tukey-HSD test (p< 0.05). Results The mean percentage of remaining gutta-percha and sealer was significantly higher in apical third in all groups (p< 0.01). Post hoc Tukey test showed that there is significantly higher residual filling material in the group filled with gutta-percha and Sure-Seal Root sealer and retreated by Neoniti rotary system compared with other groups in both coronal and middle third of the canal. Conclusion The Neoniti rotary system was as effective as ProTaper Universal retreatment system in retreatment of gutta-percha and AH-26 sealer but was significantly less effective in groups obturated with Sure-Seal Root sealer.
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Affiliation(s)
- Nooshin Sadat Shojaee
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Vakilinezhad
- Undergraduate Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Shokouhi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Fu M, Huang X, Zhang K, Hou B. Effects of Ultrasonic Removal of Fractured Files from the Middle Third of Root Canals on the Resistance to Vertical Root Fracture. J Endod 2019; 45:1365-1370. [PMID: 31564462 DOI: 10.1016/j.joen.2019.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to analyze the effects of ultrasonic removal of fractured files from the middle third of root canals on the vertical root fracture resistance. METHODS This study was an extension of a previous study assessing the effects of fractured file removal on dentinal microcracks. It included 18 bilaterally matched pairs of human mandibular incisors prepared and analyzed in the previous study. Briefly, 1 member of each pair was assigned to an ultrasonic or a control group. In the ultrasonic group, K-files were fractured in the middle third of canals followed by ultrasonic file removal and canal preparation. In the control group, the root canals were simply prepared. Micro-computed tomographic imaging was performed before and after treatment, and the cross-sectional root images were screened for microcracks. For the present study, 3-dimensional reconstruction was performed for volumetric assessments. The fracture resistance was measured using a universal testing machine. All data were statistically analyzed. RESULTS Fracture loads were significantly smaller in the ultrasonic group (P < .05). The percentage increase in the canal volume significantly influenced the root fracture resistance (P < .05), whereas microcracks had no significant effect (P > .05). CONCLUSIONS Ultrasonic removal of fractured instruments from the middle third of root canals lowers the vertical root fracture resistance, with increased dentin removal being the primary cause.
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Affiliation(s)
- Mei Fu
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Xiaoxiang Huang
- Department of General Dentistry, School of Stomatology, Capital Medical University, Beijing, China
| | - Kunya Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Benxiang Hou
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China.
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Microcomputed tomographic investigation of the trepan bur/microtube technique for the removal of fractured instruments from root canals without a dental operating microscope. Clin Oral Investig 2019; 24:1717-1725. [PMID: 31346785 DOI: 10.1007/s00784-019-03032-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/16/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the removal of fractured instruments in mandibular incisor canals by using the trepan bur/microtube technique without a dental operating microscope (DOM). MATERIALS AND METHODS Thirty-four mandibular incisors were selected, and 5-mm apical segments of #25/.06 taper K3 NiTi instruments were fractured in the apical portion of each canal. Coronal enlargement was performed, and a staging platform was prepared at the coronal aspect of the fractured instrument. Then, a trepan bur was used to expose 1-1.5 mm of the fragmented instrument, and a microtube device was used to withdraw the fragment. Microcomputed tomographic (micro-CT) imaging was used to evaluate the geometric changes in the root canal and dentin. The time required for fractured instrument removal in each sample was recorded, and the results were statistically analyzed with a paired t test. RESULTS The trepan bur/microtube technique exhibited a success rate of 76.47%, and the average fractured instrument removal time was 8.55 ± 5.81 min. The changes in canal volume and dentin volume from the coronal end of the fractured instrument to 1.5 mm apical to the end were significantly greater than those from the cementoenamel junction (CEJ) to the coronal end of the fractured instrument during fractured instrument removal (P < 0.0001). CONCLUSIONS The study showed that the trepan bur/microtube technique had a significant impact on geometric changes in the root canal and dentin from the coronal end of the fractured instrument to 1.5 mm apical to the end. CLINICAL RELEVANCE These findings suggest that the trepan bur/microtube technique may be an optional method for fractured instrument removal from relatively straight canals.
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Separated Instrument in Endodontics: Frequency, Treatment and Prognosis. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Summary
Instrument separation during endodontic therapy is a frequent accident with rotary instruments being more likely to separate than manual ones. The treatment of cases with a separated instrument can be either conservative or surgical. A conservative approach involves the following treatment choices: a) bypass of the fragment, b) removal of the fragment, c) instrumentation and obturation coronally to the fragment. Concerning the removal of a separated instrument, a variety of techniques and systems have been developed. Ultrasonics, in combination with the operative microscope constitute the most effective and reliable tools for removing a separated endodontic instrument from a root canal. The likelihood of successful removal depends on: the level of separation (coronal, middle or apical third); location in relation to the root canal curvature; the type of separated instrument; its length; the degree of canal curvature and the tooth type. Several complications may occur during the management of a separated instrument: separation of the ultrasonic tip or file used for bypassing or removing the instrument; further separation of the fragment; perforation; ledge; extrusion of the file into periapical tissues; tooth weakening due to dentin removal, as well as excessive temperature rise in periodontal tissues. Prognosis for a tooth retaining a separated instrument depends on the presence of a periapical lesion, the microbial load of the root canal during the time of separation and the quality of the obturation.
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De-Deus G, Belladonna FG, Zuolo AS, Simões-Carvalho M, Santos CB, Oliveira DS, Cavalcante DM, Silva EJNL. Effectiveness of Reciproc Blue in removing canal filling material and regaining apical patency. Int Endod J 2018; 52:250-257. [DOI: 10.1111/iej.12991] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- G. De-Deus
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - F. G. Belladonna
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - A. S. Zuolo
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - M. Simões-Carvalho
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - C. B. Santos
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - D. S. Oliveira
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - D. M. Cavalcante
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - E. J. N. L. Silva
- Department of Endodontics; Grande Rio University; Duque de Caxias Rio de Janeiro Brazil
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A web-based endodontic case difficulty assessment tool. Clin Oral Investig 2018; 22:2381-2388. [PMID: 29372446 DOI: 10.1007/s00784-018-2341-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment. MATERIALS AND METHODS Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s. RESULTS The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3-5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an 'educational tool' and for 'primary care triage' was deemed the most popular features and of greater importance than the secondary options of 'fee setting' and as a 'dento-legal justification tool'. CONCLUSIONS Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress. CLINICAL RELEVANCE EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing appropriate guidance on endodontic case management.
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Fu M, Huang X, He W, Hou B. Effects of ultrasonic removal of fractured files from the middle third of root canals on dentinal cracks: a micro-computed tomography study. Int Endod J 2018; 51:1037-1046. [DOI: 10.1111/iej.12909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/07/2018] [Indexed: 12/28/2022]
Affiliation(s)
- M. Fu
- Department of Endodontics; School of Stomatology; Capital Medical University; Beijing China
| | - X. Huang
- Department of General Dentistry; School of Stomatology; Capital Medical University; Beijing China
| | - W. He
- Department of Endodontics; School of Stomatology; Capital Medical University; Beijing China
| | - B. Hou
- Department of Endodontics; School of Stomatology; Capital Medical University; Beijing China
- Department of General Dentistry; School of Stomatology; Capital Medical University; Beijing China
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Bayram E, Bayram HM, Aslan T, Göktürk H, Ustün Y. Evaluation of calcium silicate cement bond strength after using gutta-percha solvents. Niger J Clin Pract 2018; 20:1417-1421. [PMID: 29303125 DOI: 10.4103/1119-3077.197020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the effect of different gutta-percha solvents (chloroform, Endosolv E, orange oil, and eucalyptol) on the push-out bond strength of calcium silicate cements (CSCs; white mineral trioxide aggregate [WMTA]; capsule-form mineral trioxide aggregate [CMTA], and Biodentine). MATERIALS AND METHODS One hundred and fifty extracted single-rooted human mandibular premolars were sectioned into 3-mm-thick slices. The canal lumens were enlarged for 1.35-mm-diameter standardized cavities. The samples were randomly divided into five groups (n = 30) according to the solvent type: G1, chloroform; G2, Endosolv E; G3, eucalyptol; G4, orange oil; G5, no solvent (control). After application of the solvents for 5 min, the specimens were divided into three subgroups (n = 10): (i) WMTA, (ii) CMTA, and (iii) Biodentine. The push-out bond strength was measured. Two-way ANOVA analysis of variance and post hoc Tukey tests were used for analyses (P = 0.05). RESULTS The highest push-out bond strength was observed in the Biodentine (P < 0.05), and the values of WMTA and CMTA were not significantly different in all solvent groups (P > 0.05). There were no statistically significant differences among the gutta-percha solvents and control group in WMTA (P > 0.05). CONCLUSIONS Gutta-percha solvents used during retreatment decreased the bond strength of Biodentine and CMTA to root dentin. The bond strength of WMTA was not affected by the use of gutta-percha solvents.
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Affiliation(s)
- E Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey
| | - H M Bayram
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey
| | - T Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - H Göktürk
- Department of Endodontics, Faculty of Dentistry, Gaziosmanpasa University, Tokat, Turkey
| | - Y Ustün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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A comparative study of cone-beam computed tomography and periapical radiographs in decision-making after endodontic instrument fractures. Int J Artif Organs 2017; 40:510-514. [PMID: 28574115 DOI: 10.5301/ijao.5000605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aimed to compare the diagnostic efficacies of periapical radiographs (PRs) and cone-beam computed tomography (CBCT) scans on clinicians' decision-making in diagnosing and providing treatment of fractured instruments in root canals during glide path preparation. METHODS 40 maxillary molar teeth were selected and randomly divided into 4 groups. In each experimental group (n = 10), Hedstroem stainless steel instruments were fractured in mesiobuccal (MB) or distobuccal (DB) root canals. In group 1 (#0.06), group 2 (#0.08), group 3 (#0.10), and group 4 (#0.15), instruments were forced to fracture. PRs and CBCT scans were evaluated and compared. Observers were asked to use the following scoring system to decide whether to: 1. remove the fragment; 2. leave the fragment in situ; 3. bypass the fragment; or 4. use a surgical approach for removing the fragment. RESULTS CBCT observers mostly decided on removing and bypassing the fractured fragment, while radiograph observers mostly decided to leave fragments in situ. However, there was no significant difference between these parameters when CBCT scans were compared to PRs for decision-making of the fractured instruments (p≥0.05) regarding different sizes of root canal instruments. CONCLUSIONS In decision-making regarding fractured instruments during glide path preparation, clinicians should strategize treatment options based on variables using high-resolution images that reflect accurate scenarios through PRs or CBCT scans that also take into account low radiation dosage in situ PRs have precedence for a diagnostic approach.
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Xu J, He J, Yang Q, Huang D, Zhou X, Peters OA, Gao Y. Accuracy of Cone-beam Computed Tomography in Measuring Dentin Thickness and Its Potential of Predicting the Remaining Dentin Thickness after Removing Fractured Instruments. J Endod 2017; 43:1522-1527. [DOI: 10.1016/j.joen.2017.03.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/05/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]
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Ozyurek T, Ozsezer-Demiryurek E. Efficacy of protaper next and protaper universal retreatment systems in removing gutta-percha in curved root canals during root canal retreatment. J Istanb Univ Fac Dent 2017; 51:7-13. [PMID: 28955590 PMCID: PMC5573468 DOI: 10.17096/jiufd.97431] [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: 05/31/2016] [Accepted: 08/08/2016] [Indexed: 11/28/2022] Open
Abstract
Purpose: The aim of this study was to compare the cleanliness of root canal walls after retreatment using ProTaper Next (PTN), ProTaper Universal
Retreatment (PTR) nickel-titanium (NiTi) systems and Hedström hand files in curved mesial canals of mandibular molar teeth and the time required for gutta-percha and
sealer removal. Materials and Methods: Ninety mandibular molar teeth with curved mesial roots were instrumented up to #35.04 with Mtwo NiTi rotary instruments and
obturated using the continuous wave of condensation technique. Removal of gutta-percha and sealer was performed using one of the following: PTN and PTR NiTi systems
and Hedström hand files. Samples were placed on the VistaScan phosphor plates in the mesio-distal direction and the radiographs were taken. The digital radiographs
were analyzed using AutoCAD software. Also, the total time required for gutta-percha removal was calculated by a chronometer. Results: The total retreatment time was significantly shorter in the PTN and PTR groups compared with the manual group (p<0.05). There was a
significant difference between the groups according to the total residual gutta-percha and sealer (p<0.05). The PTN and PTR groups left significantly less
gutta-percha and sealer remnant than the manual group (p<0.001). Conclusion: Within the limitations of this study, the PTN and PTR groups showed less residual gutta-percha and sealer than the manual group. The NiTi
rotary systems were significantly faster than the manual group in the time required for gutta-percha and sealer removal.
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Affiliation(s)
- Taha Ozyurek
- Department of Endodontics Faculty of Dentistry Ondokuz Mayıs University Turkey
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Aydemir S, Arukaslan G, Sarıdağ S, Kaya-Büyükbayram I, Ylıdıran Y. Comparing Fracture Resistance and the Time Required for Two Different Fiber Post Removal Systems. J Prosthodont 2017; 27:771-774. [DOI: 10.1111/jopr.12575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Seda Aydemir
- Department of Endodontics; Kocaeli University Faculty of Dentistry; Kocaeli Turkey
| | - Göze Arukaslan
- Department of Endodontics; Kocaeli University Faculty of Dentistry; Kocaeli Turkey
| | - Serkan Sarıdağ
- Department of Prosthodontics; Kocaeli University Faculty of Dentistry; Kocaeli Turkey
| | - Işıl Kaya-Büyükbayram
- Department of Endodontics; Istanbul Aydin University Faculty of Dentistry; Istanbul Turkey
| | - Yasemin Ylıdıran
- Department of Mechanical Engineering; Kocaeli University Faculty of Dentistry; Kocaeli Turkey
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Yang Q, Shen Y, Huang D, Zhou X, Gao Y, Haapasalo M. Evaluation of Two Trephine Techniques for Removal of Fractured Rotary Nickel-titanium Instruments from Root Canals. J Endod 2017; 43:116-120. [DOI: 10.1016/j.joen.2016.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 08/28/2016] [Accepted: 09/02/2016] [Indexed: 01/01/2023]
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Hülsmann M, Tulus G. Non-surgical retreatment of teeth with persisting apical periodontitis following apicoectomy: decision making, treatment strategies and problems, and case reports. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/etp.12098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Removal of Separated Endodontic K-File with the Aid of Hypodermic Needle and Cyanoacrylate. Case Rep Dent 2016; 2016:3970743. [PMID: 27781128 PMCID: PMC5066008 DOI: 10.1155/2016/3970743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/26/2016] [Accepted: 09/05/2016] [Indexed: 12/04/2022] Open
Abstract
A wide range of accidents might happen during the treatment of the root canal system, where the instrument separation is one of the most unpleasant occurrences. Several techniques have been developed to facilitate the removal of the fragments; however, they generally require specific devices that not always are available to the clinician. The aim of this case report is to present a simple alternative technique to remove from the root canals manual instruments fractured during the treatment. The case has its outline based on a 31-year-old patient who sought the clinic to have her maxillary first left premolar rehabilitated. The clinic and radiographic examinations revealed the need of endodontic retreatment and the presence of a fragment of a K-file instrument localized at the apical third of the palatine canal. The retreatment was initiated by the removal of the obturation materials followed by several unsuccessful attempts to take out the fractured instrument. Hence, it was chosen to perform the fragment removal using a hypodermic needle and cyanoacrylate adhesive. The fragment easily came out, which reinforces the technique adopted as a safe, simple, and low cost mean to solve the problem of fractured instruments using only items already present in the endodontic arsenal.
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Del Fabbro M, Corbella S, Sequeira‐Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev 2016; 10:CD005511. [PMID: 27759881 PMCID: PMC6461161 DOI: 10.1002/14651858.cd005511.pub3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal. This review updates one published in 2008. OBJECTIVES To assess effects of surgical and non-surgical therapy for retreatment of teeth with apical periodontitis.To assess effects of surgical root-end resection under various conditions, for example, when different materials, devices or techniques are used. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Trials Register (to 10 February 2016), the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), MEDLINE Ovid (1946 to 10 February 2016) and Embase Ovid (1980 to 10 February 2016). We searched the US National Registry of Clinical Trials (ClinicalTrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials (to 10 February 2016). We placed no restrictions regarding language and publication date. We handsearched the reference lists of the studies retrieved and key journals in the field of endodontics. SELECTION CRITERIA We included randomised controlled trials (RCTs) involving people with periapical pathosis. Studies could compare surgery versus non-surgical treatment or could compare different types of surgery. Outcome measures were healing of the periapical lesion assessed after one-year follow-up or longer; postoperative pain and discomfort; and adverse effects such as tooth loss, mobility, soft tissue recession, abscess, infection, neurological damage or loss of root sealing material evaluated through radiographs. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from included studies and assessed their risk of bias. We contacted study authors to obtain missing information. We combined results of trials assessing comparable outcomes using the fixed-effect model, with risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, and 95% confidence intervals (CIs). We used generic inverse variance for split-mouth studies. MAIN RESULTS We included 20 RCTs. Two trials at high risk of bias assessed surgery versus a non-surgical approach: root-end resection with root-end filling versus root canal retreatment. The other 18 trials evaluated different surgical protocols: cone beam computed tomography (CBCT) versus periapical radiography for preoperative assessment (one study at high risk of bias); antibiotic prophylaxis versus placebo (one study at unclear risk); different magnification devices (loupes, surgical microscope, endoscope) (two studies at high risk); types of incision (papilla base incision, sulcular incision) (one study at high risk and one at unclear risk); ultrasonic devices versus handpiece burs (one study at high risk); types of root-end filling material (glass ionomer cement, amalgam, intermediate restorative material (IRM), mineral trioxide aggregate (MTA), gutta-percha (GP), super-ethoxy benzoic acid (EBA)) (five studies at high risk of bias, one at unclear risk and one at low risk); grafting versus no grafting (three studies at high risk and one at unclear risk); and low energy level laser therapy versus placebo (irradiation without laser activation) versus control (no use of the laser device) (one study at high risk).There was no clear evidence of superiority of the surgical or non-surgical approach for healing at one-year follow-up (RR 1.15, 95% CI 0.97 to 1.35; two RCTs, 126 participants) or at four- or 10-year follow-up (one RCT, 82 to 95 participants), although the evidence is very low quality. More participants in the surgically treated group reported pain in the first week after treatment (RR 3.34, 95% CI 2.05 to 5.43; one RCT, 87 participants; low quality evidence).In terms of surgical protocols, there was some inconclusive evidence that ultrasonic devices for root-end preparation may improve healing one year after retreatment, when compared with the traditional bur (RR 1.14, 95% CI 1.00 to 1.30; one RCT, 290 participants; low quality evidence).There was evidence of better healing when root-ends were filled with MTA than when they were treated by smoothing of orthograde GP root filling, after one-year follow-up (RR 1.60, 95% CI 1.14 to 2.24; one RCT, 46 participants; low quality evidence).There was no evidence that using CBCT rather than radiography for preoperative evaluation was advantageous for healing (RR 1.02, 95% CI 0.70 to 1.47; one RCT, 39 participants; very low quality evidence), nor that any magnification device affected healing more than any other (loupes versus endoscope at one year: RR 1.05, 95% CI 0.92 to 1.20; microscope versus endoscope at two years: RR 1.01, 95% CI 0.89 to 1.15; one RCT, 70 participants, low quality evidence).There was no evidence that antibiotic prophylaxis reduced incidence of postoperative infection (RR 0.49, 95% CI 0.09 to 2.64; one RCT, 250 participants; low quality evidence).There was some evidence that using a papilla base incision (PBI) may be beneficial for preservation of the interdental papilla compared with complete papilla mobilisation (one RCT (split-mouth), 12 participants/24 sites; very low quality evidence). There was no evidence of less pain in the PBI group at day 1 post surgery (one RCT, 38 participants; very low quality evidence).There was evidence that adjunctive use of a gel of plasma rich in growth factors reduced postoperative pain compared with no grafting (measured on visual analogue scale: one day postoperative MD -51.60 mm, 95% CI -63.43 to -39.77; one RCT, 36 participants; low quality evidence).There was no evidence that use of low energy level laser therapy (LLLT) prevented postoperative pain (very low quality evidence). AUTHORS' CONCLUSIONS Available evidence does not provide clinicians with reliable guidelines for treating periapical lesions. Further research is necessary to understand the effects of surgical versus non-surgical approaches, and to determine which surgical procedures provide the best results for periapical lesion healing and postoperative quality of life. Future studies should use standardised techniques and success criteria, precisely defined outcomes and the participant as the unit of analysis.
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Affiliation(s)
- Massimo Del Fabbro
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Stefano Corbella
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Patrick Sequeira‐Byron
- University of BernDepartment of Preventive, Restorative and Pediatric DentistryFreiburgstrasse 7BernBernSwitzerlandCH‐3010
| | - Igor Tsesis
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv UniversityDepartment of EndodontologyTel AvivIsrael
| | - Eyal Rosen
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv UniversityDepartment of EndodontologyTel AvivIsrael
| | - Alessandra Lolato
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
| | - Silvio Taschieri
- Università degli Studi di MilanoDepartment of Biomedical, Surgical and Dental SciencesIRCCS Galeazzi Orthopaedic InstituteVia Riccardo Galeazzi 4MilanItaly20161
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Shetty K. Technique Tips – A Predictable Method for Retrieval of Silver Cones Using Ultrasonics. ACTA ACUST UNITED AC 2016; 43:396-7. [PMID: 29148693 DOI: 10.12968/denu.2016.43.4.396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Yürüker S, Görduysus M, Küçükkaya S, Uzunoğlu E, Ilgın C, Gülen O, Tuncel B, Görduysus MÖ. Efficacy of Combined Use of Different Nickel-Titanium Files on Removing Root Canal Filling Materials. J Endod 2016; 42:487-92. [PMID: 26778268 DOI: 10.1016/j.joen.2015.11.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 11/20/2015] [Accepted: 11/22/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to estimate the remaining amount of residual filling materials in root canals after retreatment using ProTaper Universal Retreatment (PTUR) files (Dentsply Maillefer, Ballaigues, Switzerland) alone or with the additional use of the Self-Adjusting File (SAF; ReDent-Nova, Ra'anana, Israel), Reciproc (VDW, Munich, Germany), or Hedström-files (H-file; VDW, Antaeos, Munich, Germany) with volumetric estimation using the stereologic method via cone-beam computed tomographic images. METHODS Forty-eight mandibular premolars with single canals were used. The canals were instrumented with ProTaper rotary instruments up to F4 and filled with gutta-percha and AH26 sealer (Dentsply De Trey, Johnson City, TN). All the samples were placed into the silicone models. Samples were scanned with cone-beam computed tomographic imaging and assigned into 4 groups (n = 12) according to retreatment files: the PTUR system group, the PTUR system plus SAF group, the PTUR system plus Reciproc group, and the PTUR system plus H-file group. The specimens were rescanned after retreatment procedures, and the volume estimations of the remaining filling materials were performed using the stereologic method. Data were analyzed using Kruskal-Wallis and Dunn tests. RESULTS There was no significant difference among the groups regarding mean percentage volumes of the filling materials before retreatment procedures (P > .05). None of the retreatment procedures provided complete removal of the filling materials. The additional use of the SAF did not significantly improve the removal of filling materials when compared with the PTUR system alone (P > .05). However, the additional use of Reciproc or hand H-files significantly improved the removal of filling materials when compared with the PTUR system alone (P < .05). CONCLUSIONS The additional use of files with different motion kinetics improved the removal of root canal fillings; however, none of the systems completely removed the root canal filling material from the root canals.
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Affiliation(s)
- Sinan Yürüker
- Department of Histology and Embryology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melahat Görduysus
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey; RAK College of Dental Science, RAK Medical and Health Science University, Ras Al Khaimah, United Arab Emirates
| | - Selen Küçükkaya
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
| | - Emel Uzunoğlu
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Can Ilgın
- Department of Histology and Embryology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Orhan Gülen
- Department of Dento-Maxillofacial Radiology, Ministry of Health, Ataturk Public Hospital, Ankara, Turkey
| | - Behram Tuncel
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mehmet Ömer Görduysus
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey; Department of Endodontics, Dental College, Sharjah University, University City, Sharjah, United Arab Emirates
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Pelegrine RA, Paulillo LAMS, Kato AS, Fontana CE, Pinheiro SL, De Martin AS, Bueno CEDS. Effect of Endodontic Retreatment on Push-out Bond Strength and Quality of Fiber Postbonding Interface of Resin Cements. J Contemp Dent Pract 2016; 17:42-8. [PMID: 27084862 DOI: 10.5005/jp-journals-10024-1801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study is to evaluate the impact of endodontic retreatment on push-out bond strength and dentin interface of two resin cements used for fiber postcementation during endodontic retreatment. MATERIALS AND METHODS The root canals of 40 extracted human canines were prepared, obturated and divided into four groups (n = 10). Gutta-percha was partially removed and fiber posts were immediately cemented in groups 1 and 2 using Panavia F with ED Primer and RelyX™ U200, respectively. In groups 3 and 4, the root canal access was sealed with temporary restorative cement, specimens were stored for 30 days, endodontically retreated, and fiber posts were cemented using the resin cements applied to groups 1 and 2, respectively. Push-out tests and scanning electron microscopy analyses of different areas were performed. Data from push-out bond strengths were analyzed by one-way analysis of variance and Tukey's tests. RESULTS Higher bond strength values were detected in the apical third for group 1 than group 3 (p < 0.05). No differences were observed in other comparisons between the same third of different groups (p > 0.05). Comparisons between different thirds in the same group revealed a higher bond strength in the apical third for group 1. Scanning electron microscopy showed formation of hybrid layer and extensive resin tags in group 1. No hybrid layer was observed in groups 2 and 4. CONCLUSION Endodontic retreatment had adverse effects on the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third, but not on RelyX™ U200. CLINICAL SIGNIFICANCE A significant interaction was detected between endodontic retreatment and resin cement, which indicated that endodontic retreatment might adversely affect the push-out bond strength and dentinal interface of Panavia F with ED Primer when used for fiber postcementation specifically in the apical third.
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Affiliation(s)
- Rina Andréa Pelegrine
- Professor, Department of Endodontics, São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil, Phone: +551932725219 e-mail:
| | | | - Augusto Shoji Kato
- Department of Endodontics, São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil
| | - Carlos Eduardo Fontana
- Department of Endodontics, São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil
| | - Sérgio Luiz Pinheiro
- Department of Restorative Dentistry, Catholic University of Campinas, Campinas, São Paulo, Brazil
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Lin C, Xu L, Chen YX, Liang Y, Chen XL, Lin Y, Huang XQ, Fang Y, Chen Z. A statistical model for predicting the retrieval rate of separated instruments and clinical decision-making. J Dent Sci 2015. [DOI: 10.1016/j.jds.2015.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Almaroof A, Alhashimi R, Mannocci F, Deb S. New functional and aesthetic composite materials used as an alternative to traditional post materials for the restoration of endodontically treated teeth. J Dent 2015; 43:1308-15. [PMID: 26362214 DOI: 10.1016/j.jdent.2015.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/04/2015] [Indexed: 11/24/2022] Open
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Wohlgemuth P, Cuocolo D, Vandrangi P, Sigurdsson A. Effectiveness of the GentleWave System in Removing Separated Instruments. J Endod 2015; 41:1895-8. [PMID: 26409807 DOI: 10.1016/j.joen.2015.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A separated instrument in a root canal system has the potential of severely affecting the outcome of endodontic therapy. This study evaluated the effectiveness of the minimally invasive GentleWave System (Sonendo Inc, Laguna Hills, CA) in removing separated stainless steel endodontic files from the apical and midroot regions of molar root canals. METHODS Thirty-six extracted human molars were accessed, and the glide path was confirmed to the apex. ISO #10, #15, and #20 K-file fragments of 2.5-mm length were separated at the apical (n = 18) or midroot (n = 18) region of the molars by engaging a weakened file with downward pressure. During analysis, the teeth were divided into 2 curved groups based on the curvature of the root (<30° and >30°). The success rate of instrument removal and the treatment time were noted. Statistical comparison was done with the Fisher exact test and independent 2-sample t test (P < .05). RESULTS The overall success rate of instrument removal when the separated files were engaged in the apical region was 61%, and for the midroot region, it was 83%. Less curved canals (<30°) showed a 91% success rate (n = 24), whereas canals with an angle of curvature greater than 30° showed a 42% success rate (n = 12). The median treatment time for instrument retrieval was 10 minutes 44 seconds. CONCLUSIONS The results revealed that the GentleWave System is effective in retrieving separated instruments while conserving the dentinal structure.
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Affiliation(s)
- Pierre Wohlgemuth
- Department of Endodontics, New York University College of Dentistry, New York, New York
| | - Davide Cuocolo
- Department of Endodontics, New York University College of Dentistry, New York, New York
| | | | - Asgeir Sigurdsson
- Department of Endodontics, New York University College of Dentistry, New York, New York.
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Solovyova OA, Vinnichenko YA, Vinnichenko AV. [Microinvasive endodontic access]. STOMATOLOGII︠A︡ 2015; 94:56-60. [PMID: 26331176 DOI: 10.17116/stomat201594356-60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- O A Solovyova
- Stavropol State Medical University, Stavropol, Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russian Medical Academy of Post-graduate Education
| | - Yu A Vinnichenko
- Stavropol State Medical University, Stavropol, Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russian Medical Academy of Post-graduate Education
| | - A V Vinnichenko
- Stavropol State Medical University, Stavropol, Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russian Medical Academy of Post-graduate Education
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Heggendorn FL, Gonçalves LS, Dias EP, de Oliveira Freitas Lione V, Lutterbach MTS. Biocorrosion of Endodontic Files through the Action of Two Species of Sulfate-reducing Bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis. J Contemp Dent Pract 2015; 16:665-73. [PMID: 26423503 DOI: 10.5005/jp-journals-10024-1738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This study assessed the biocorrosive capacity of two bacteria: Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis on endodontic files, as a preliminary step in the development of a biopharmaceutical, to facilitate the removal of endodontic file fragments from root canals. MATERIALS AND METHODS In the first stage, the corrosive potential of the artificial saliva medium (ASM), modified Postgate E medium (MPEM), 2.5 % sodium hypochlorite (NaOCl) solution and white medium (WM), without the inoculation of bacteria was assessed by immersion assays. In the second stage, test samples were inoculated with the two species of sulphur-reducing bacteria (SRB) on ASM and modified artificial saliva medium (MASM). In the third stage, test samples were inoculated with the same species on MPEM, ASM and MASM. All test samples were viewed under an infinite focus Alicona microscope. RESULTS No test sample became corroded when immersed only in media, without bacteria. With the exception of one test sample between those inoculated with bacteria in ASM and MASM, there was no evidence of corrosion. Fifty percent of the test samples demonstrated a greater intensity of biocorrosion when compared with the initial assays. CONCLUSION Desulfovibrio desulfuricans and D. fairfieldensis are capable of promoting biocorrosion of the steel constituent of endodontic files. CLINICAL SIGNIFICANCE This study describes the initial development of a biopharmaceutical to facilitate the removal of endodontic file fragments from root canals, which can be successfully implicated in endodontic therapy in order to avoiding parendodontic surgery or even tooth loss in such events.
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Affiliation(s)
- Fabiano Luiz Heggendorn
- Associate Professor, Medical School, Fluminense Federal University; School of Pharmacy, Federal University of Rio de Janeiro, Pharmaceutical Laboratory Bioassays; Laboratory of Biocorrosion and Biodegradation, National Institute of Technology, Rua Feliz da Cunha 11, ap. 806, Tijuca, CEP 20260300, Rio de Janeiro, Brazil, Phone: 55-21-9411-9341, e-mail:
| | | | - Eliane Pedra Dias
- Medical School, Fluminense Federal University, Rio de Janeiro, Brazil
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Yang Q, Cheung GSP, Shen Y, Huang D, Zhou X, Gao Y. The remaining dentin thickness investigation of the attempt to remove broken instrument from mesiobuccal canals of maxillary first molars with virtual simulation technique. BMC Oral Health 2015. [PMID: 26215404 PMCID: PMC4517344 DOI: 10.1186/s12903-015-0075-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background To investigate differences in the estimated minimum remaining dentin thickness (RDT) between periapical radiographs using the paralleling and parallax technique, after simulated removal of broken instrument from the mesiobuccal (MB) canal of maxillary first molar in virtual simulation model. The 3D measurement was taken as the standard for comparison. Methods Thirty-six maxillary first molars were scanned by micro-CT and reconstructed as 3-dimensional (3D) model. A virtual fragment of an instrument was created within the MB canal in software. Removal of the broken instrument was simulated in both the 3D and 2D dataset. Then, the models of all specimens were submitted to 2D and 3D measurements for the lowest (RDT) value in each. Differences in the values between the paralleling and parallax radiographic technique and the 3D-RDT value were analyzed with two-way Analysis of Variance. The Intra-class Correlation Coefficient (ICC) was used to assess consistency of the RDT measurements between the two periapical radiographic and techniques and 3D analysis. Results There was significant difference between RDT value obtained from the paralleling technique and 3D-RDT. There were no differences between RDT obtained from parallax (angled) technique and 3D-RDT. The ICC of RDT values between paralleling technique and 3D measurement were lower than 0.75. ICC between angled radiographs and 3D technique was close to 0.75. The optimal horizontal angle for the parallax technique was about 21°. Conclusions The virtual simulation technique can provide valuable insight into the benefit/risk analysis before removal of a broken instrument. Parallel radiographs overestimate the actual remain dentin thickness in mesiobuccal canals of maxillary first molars, whereas the parallel technique would give a closer estimate to the actual thickness at a projection angle of about 21°.
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Affiliation(s)
- Qian Yang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Gary Shun-Pan Cheung
- Area of Endodontics, Comprehensive Dental Care, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
| | - Dingming Huang
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Xuedong Zhou
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
| | - Yuan Gao
- Department of Operative Dentistry & Endodontics, State Key Laboratory of Oral Diseases, West China College & Hospital of Stomatology, Sichuan University, 14#, 3rd section of RenMin South Road, Chengdu, 610041, China.
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