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Morales MDLNP, Sánchez JAG, Elmsmari F, Duran-Sindreu F, Salmon P, Jaramillo DE, Olivieri JG. Microcomputed tomographic evaluation of 6 NiTi files on the pericervical dentin and the smallest dentin thickness zones in mesial root canals of mandibular molars: an in vitro study. Clin Oral Investig 2024; 28:166. [PMID: 38388725 DOI: 10.1007/s00784-024-05493-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: 07/11/2023] [Accepted: 01/06/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate six files on the pericervical dentin (PCD) and the smallest dentin thickness zones (SDTZ) in mesial root canals of mandibular molars. MATERIALS AND METHODS Sixty mandibular molars with two mesial canals and Vertucci configuration were aleatory allocated in 6 experimental groups of 10 molars and 20 root canals. Specimens were scanned before instrumentation using the SkyScan 1275 (Bruker microCT, Kontich, Belgium). Group 1 was treated with WaveOne Gold (WG), group 2 with Reciproc Blue (RB), group 3 with TRUShape (TS), group 4 with XP-endo Shaper (XP), group 5 with iRace (IR), and group 6 with TruNatomy (TN). After instrumentation, the molars were scanned again and the images recorded were reconstructed with the NRecon v.1.7 (Bruker micro-CT) and analyzed with CTAn v.1.20.8 software (Bruker micro-CT) quantifying the changes produced in the surface, volume, structure thickness, SMI, and centroids at the Pericervical Dentin area of the root canals (PCD) located from the root canal orifices at the floor of the pulp chamber to 4 mm in the apical direction, and the changes in the Smallest Dentin Thickness Zones (SDTZ) located (from the furcation to 4 mm and 7 mm in the apical direction. The data obtained were compared using Wilcoxon and ANOVA with a 5% significance level. RESULTS XP and TN were similar in all the parameters (P >.05) at the PCD, but TN showed significant differences from WG, RB, TS, and IR (P <.05), while XP showed significant differences from WG (P <.05) in volume, surface, and structure thickness. Regarding the changes in the SDTZ, the amount of dentin removed was similar between the groups in both canals at the middle 1/3, at the cervical 1/3 for MB canals, and in ML canals for RB, TS, XP, IR, and TN (P>.05). The action of WG was significantly different from that of XP and TN in the cervical 1/3 of the ML canal (P <.05). CONCLUSIONS XP and TN rotatory files with small taper and volume maintained better with minor changes at the PCD and SDTZ, while WG reciprocation file produced the largest change. All the files were maintained centered at the PCD, and their performances were safe with a minimal thickness higher 0.5 mm at the SDTZ, and without risk of perforation. TRIAL REGISTRATION No clinical trials were indicated in this study. CLINICAL RELEVANCE The choice of endodontic files is a relevant factor in the conservative performance of root canal treatments.
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Affiliation(s)
| | - José Antonio González Sánchez
- Departments of Endodontics, School of Dentistry, International University of Catalunya, Sant Cugat del Valles, Barcelona, Spain.
| | - Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Fernando Duran-Sindreu
- Departments of Endodontics, School of Dentistry, International University of Catalunya, Sant Cugat del Valles, Barcelona, Spain
| | - Phil Salmon
- Department of Scientific Applications, Bruker micro-CT, Kontich, Belgium
| | - David E Jaramillo
- Department of Endodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Juan Gonzalo Olivieri
- Departments of Endodontics, School of Dentistry, International University of Catalunya, Sant Cugat del Valles, Barcelona, Spain
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Gioster-Ramos ML, Pivoto-João MMB, Pinto JC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Diamond-coated ultrasonic tip decreases debris and uninstrumented surface after preparation of curved canals with isthmus. Braz Oral Res 2023; 37:e102. [PMID: 38055520 DOI: 10.1590/1807-3107bor-2023.vol37.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/29/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this study was to evaluate root canal preparation with nickel titanium rotary instruments and complementary preparation with ultrasonic tip in curved canals of mandibular molars with isthmus. Twenty-eight mesial roots of mandibular molars with curvature between 20° and 40° and presence of isthmus throughout the entire extension of the root canals were prepared using ProDesign Logic CM (PDL) up to size 40.05, or HyFlex EDM (HFEDM) up to size 40.04. Complementary preparation was performed in the isthmus region using the ultrasonic insert E18D (Helse, Istmo Diamantada). The root canals were scanned using micro-CT (SkyScan 1176) at 9 µm voxel size before and after each preparation step. Transportation, percentage of increase in volume, debris and uninstrumented surface (UNS) were evaluated. Mann Whitney, Wilcoxon, paired and non-paired t-tests were used for statistical analysis (α = 0.05). The canals prepared with PDL and HFEDM obtained similar results for all the variables assessed before using E18D (p > 0.05). E18D significantly decreased the percentage of debris and UNS values in both Groups (p < 0.05). The complementary preparations with E18D caused a smaller quantity of debris in the isthmus of the canals previously prepared with PDL in comparison with HFEDM (p < 0.05). PDL and HFEDM provided similar root canal preparation. PDL promoted a smaller quantity of Debris in the isthmus than HFEDM after using E18D. E18D significantly improved cleaning, and reduced Debris and UNS.
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Affiliation(s)
- Maria Luiza Gioster-Ramos
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
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Post-Instrumentation Dentinal Microcracks Induced by Two NiTi Rotary Systems with Increased Super Elasticity and Shape Memory: A MicroCT Comparative and Methodological Ex Vivo Study. COSMETICS 2023. [DOI: 10.3390/cosmetics10010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
This study aimed to determine the incidence of dentinal microcracks after instrumenting the root canals of maxillary premolars using two novel rotary instrumentation systems. Micro-computed tomography (microCT) scans and images generated by sectioning and observation with a stereomicroscope were used to assess the specimens. Twenty-two freshly extracted maxillary premolars were collected and the specimens were divided into two groups of eleven. The tested radicular shaping systems were XP-Endo shaper and TRUShape (i.e., single file). The specimens were scanned with microCT pre- and post-instrumentation, and the newly formed microcracks were detected. The post-instrumentation scans were also compared with images obtained by sectioning method and stereomicroscope inspection, comparing the incidence of microcracks in either microCT scans or images. The results identified an overall incidence of 0.49% of newly formed microcracks, with no statistically significant differences (p = 0.689) between the shaping systems (0.11% for TRUShape and 0.87% for XP-Endo shaper). There were statistically significant differences (p < 0.001) between the microcracks incidence in microCT scans and the sectioning method (16.6% more for the latter). In conclusion, the results show that neither TRUShape nor XP-Endo shaper created dentinal microcracks during root canal instrumentation. The sectioning method with stereomicroscope evaluation overestimates the presence of microcracks with a statistically significant difference compared to microCT scans.
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Arias A, Peters OA. Present Status and Future Directions - Canal Shaping. Int Endod J 2022; 55 Suppl 3:637-655. [PMID: 35118683 PMCID: PMC9303733 DOI: 10.1111/iej.13698] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.
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Affiliation(s)
- A Arias
- School of Dentistry, Complutense University, Madrid, Spain
| | - O A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
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Tavares KIMC, Pinto JC, Santos-Junior AO, Esteves Torres FF, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals. Restor Dent Endod 2021; 46:e56. [PMID: 34909420 PMCID: PMC8636074 DOI: 10.5395/rde.2021.46.e56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.
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Affiliation(s)
| | - Jáder Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Pacheco-Yanes J, Gazzaneo I, Campello AF, Marceliano-Alves MF, Estrela C, Bueno MR, Lopes RT, Rôças IN, Alves FRF, Siqueira JF. Planned Apical Preparation Using Cone-Beam Computed Tomographic Measures: A Micro-Computed Tomographic Proof of Concept in Human Cadavers. J Endod 2021; 48:280-286. [PMID: 34871632 DOI: 10.1016/j.joen.2021.11.016] [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: 06/25/2021] [Revised: 10/12/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study assessed the amount of unprepared surface areas at the apical 4-mm segment of the root canal after a planned preparation based on cone-beam computed tomography (CBCT) measurements. METHODS Eighteen posterior mandible segments were obtained from cadavers and scanned using CBCT and micro-computed tomographic (micro-CT) imaging. CBCT images were used to measure the largest initial canal diameter from 29 root canals of premolars at 1, 2, 3, and 4 mm short of the apical foramen. Each measurement was used to select a master apical instrument with size/taper that was 1 diameter larger to prepare the apical 4 mm of each particular root canal. A post-preparation micro-CT scan was obtained, and the unprepared canal areas were calculated. RESULTS A very high amount of surface areas over the apical 4 mm of the root canal was included in the final preparation (mean >90%). The unprepared areas ranged from as low as 3.7% to a maximum of 14.6% (mean and median, 9.2% and 9.1%, respectively). CONCLUSIONS The proposed planned apical root canal preparation resulted in optimized root canal shaping with a substantial amount of prepared surface areas. The protocol used also resulted in a conservative canal enlargement using final instruments that were 1 size larger than the initial largest canal diameter.
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Affiliation(s)
- Juan Pacheco-Yanes
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isbelia Gazzaneo
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Marília F Marceliano-Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil
| | - Carlos Estrela
- School of Dentistry, Department of Endodontics, Federal University of Goiás, Goiânia, Brazil
| | | | - Ricardo T Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
| | - José F Siqueira
- Faculty of Dentistry, Department of Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
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Poly A, Marques F, Moura Sassone L, Karabucak B. The shaping ability of WaveOne Gold, TRUShape and XP-endo Shaper systems in oval-shaped distal canals of mandibular molars: A microcomputed tomographic analysis. Int Endod J 2021; 54:2300-2306. [PMID: 34473842 DOI: 10.1111/iej.13625] [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: 02/16/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 01/07/2023]
Abstract
AIM To compare the shaping ability of a heat-treated centric reciprocating file system (WaveOne Gold), a heat-treated eccentric rotary multifile system (TRUShape 3D Conforming Files), and a heat-treated expandable one-file rotary system (XP-endo Shaper) extending its activation time, in preparing oval-shaped root canals in extracted mandibular molars by means of microcomputed tomography (micro-CT) analysis. METHODOLOGY Thirty moderately curved oval-shaped distal roots of mandibular molars were selected. The normality of canal length, curvature angle, volume, surface area, structure model index, and aspect ratio were confirmed. The samples were randomly divided into three groups (n = 10). Micro-CT scans were taken before and after canals were instrumented using WaveOne Gold (size 35, .06 taper), or TRUShape (size 30, .06v taper), both following the manufacturer's instructions, or XP-endo Shaper following a new protocol with extended activation time. The mechanical preparation time for each sample was recorded. Pre- and postoperative images were analysed for the percentage of unprepared canal areas and the percentage of removed dentine. Data were compared between groups using the statistical analyses one-way ANOVA and Tukey tests (p < .05). RESULTS The percentage of unprepared canal areas was significantly higher with WaveOne Gold (% 11.5 ± 4.0) and TRUShape (% 12.4 ± 5.8) compared with XP-endo Shaper (% 5.2 ± 2.6) (p < .05). XP-endo Shaper removed significantly more dentine (3.3 ± 1.5 mm3 ) than WaveOne Gold (1.8 ± 0.8 mm3 ) and TRUShape (1.9 ± 0.8 mm3 ) (p < .05). No significant differences were seen for mechanical preparation time between WaveOne Gold (79 ± 31 s), TRUShape (104 ± 41 s) and XP-endo Shaper (71 ± 23 s) (p > .05). CONCLUSIONS The comparison of three recognized root canal filing systems has shown that with similar preparation times, the XP-endo Shaper removed more dentine (mm3 ) leaving less unprepared canal wall area (%) than WaveOne Gold and TRUShape when preparing oval-shaped root canals of extracted mandibular molars.
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Affiliation(s)
- Ane Poly
- Proclin Department, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Marques
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Luciana Moura Sassone
- Proclin Department, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Jeong JW, Sarmast ND, Terlier T, van der Hoeven R, Holland JN, Parikh N. Assessment of the cytotoxic effects and chemical composition of the insoluble precipitate formed from sodium hypochlorite and chlorhexidine gluconate. Int Endod J 2021; 54:1892-1901. [PMID: 34081782 DOI: 10.1111/iej.13583] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 12/27/2022]
Abstract
AIM To investigate (1) the cytotoxic potential of the brown precipitate (BP) formed with sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX), using both a small animal model of Caenorhabditis elegans (C. elegans) and cultured human gingival fibroblasts; and (2) the chemical composition of BP using Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS). METHODOLOGY Brown precipitate was obtained by mixing equal volumes of 6% NaOCl and 2% CHX and separating the BP from clear supernatant by centrifugation. The brown precipitate was weighed and solubilized in dimethyl sulfoxide for cytotoxicity experiments. The cytotoxic effect of BP was assessed using C. elegans larvae and primary immortalized human gingival fibroblasts-hTERT (hTERT-hNOF) cells. Various dilutions of BP (25 ng/µL-150 ng/µL), supernatant (0.15% v/v), NaOCl (1:100-1:1000 dilutions of 6% NaOCl) or CHX (1:500-1:1000 dilutions of 2% CHX) along with vehicle control (0.5% v/v ethanol and 0.15% v/v DMSO) or untreated control (growth medium) were tested on C. elegans larvae and hTERT-hNOF cells. Viability was assessed in C. elegans larvae using stereomicroscopy and in hTERT-hNOF cells using dehydrogenase-based colorimetric assay. ToF-SIMS was used to assess the chemical composition of BP in comparison with CHX and para-chloroaniline (PCA). The C. elegans and cell line data were analysed using Log-Rank test and Student's t-test, respectively (p < .05). RESULTS BP-75 ng/µL and BP-150 ng/µL were significantly more toxic to C. elegans larvae than the untreated, vehicle, supernatant or CHX treatment groups (p < .0001). Similarly, in hTERT-hNOF cells, BP-50 ng/µL, BP-75 ng/µL and BP-150 ng/µL induced significant cytotoxicity within 2 h compared with untreated, vehicle, supernatant and CHX treatments (p < .05). ToF-SIMS analysis of BP revealed ion composition characteristic of both CHX and the carcinogen PCA. CONCLUSIONS Brown precipitate was toxic in both C. elegans larvae and hTERT-hNOF cells. The ToF-SIMS analysis of BP revealed ions characteristic of CHX and PCA that could account for the toxicities observed in C. elegans larvae and human gingival fibroblasts. Because of the insoluble and toxic nature of BP, consecutive use of CHX and NaOCl irrigants should be avoided in root canal treatment.
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Affiliation(s)
- Ji Wook Jeong
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima D Sarmast
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tanguy Terlier
- SIMS Laboratory, Shared Equipment Authority, Rice University, Houston, TX, USA
| | - Ransome van der Hoeven
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Julian N Holland
- Office of Research, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Neha Parikh
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Yalniz H, Koohnavard M, Oncu A, Celikten B, Orhan AI, Orhan K. Comparative evaluation of dentin volume removal and centralization of the root canal after shaping with the ProTaper Universal, ProTaper Gold, and One-Curve instruments using micro-CT. J Dent Res Dent Clin Dent Prospects 2021; 15:47-52. [PMID: 33927841 PMCID: PMC8058162 DOI: 10.34172/joddd.2021.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background. The main goal of our study was to assess the volume of dentin removed and transportation in root canals using ProTaper Universal (PTU), ProTaper Gold (PTG) and One-Curve (OC). Ni-Ti rotary instruments in extracted human teeth using by micro-CT. Methods: Thirty human upper 1st premolar teeth with two separate root canals and sturdy, mature root tips were used in the present study. Specimens were decoronated and root length was standardized for micro CT scanning before root canal preparation done. The teeth were randomly separated into three categories (n = 10) according to the rotary NiTi system used for canal instrumentation, i.e., PTU (Dentsply, Maillefer), PTG (Dentsply, Maillefer), and OC (Micro-Mega SA). After root canal preparation, samples were scanned again on micro-CT by the same scanning parameters. Surface area, canal volume, structure model index (SMI), percentage of uninstrumented area and transportation parameters were obtained for each sample before and after micro-CT analyse. Results: No significant differences between the PTG and PTU in terms of the total volume of removed dentin, surface area and percentage of uninstrumented areas were found. However, regarding to parameters above, OC showed a lower efficacy than PTG and PTU in coronal section. Regarding canal transportation, PTG and OC showed lower mean transportation values at all levels. Conclusion: This paper demonstrated the root canal shaping abilities of the PTU, PTG, and OC NiTi file systems. The PTG and OC systems were associated less canal transportation and a better ability to preserve dentinal walls than PTU. There was no significance different between all rotary file systems for SMI values however, PTU and PTG showed greater canal volume and surface area change than OC file systems in coronal section.
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Affiliation(s)
- Hatice Yalniz
- Bezmialem Vakif University, Faculty of Dentistry, Department of Endodontics, Istanbul, Turkey
| | - Mehrdad Koohnavard
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Aysenur Oncu
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Berkan Celikten
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Ayse Isil Orhan
- Ankara Yildirim Beyazit University, Department of Pediatric Dentistry, Ankara, Turkey
| | - Kaan Orhan
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
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Pérez Morales MDLN, González Sánchez JA, Olivieri JG, Elmsmari F, Salmon P, Jaramillo DE, Terol FDS. Micro-computed Tomographic Assessment and Comparative Study of the Shaping Ability of 6 Nickel-Titanium Files: An In Vitro Study. J Endod 2021; 47:812-819. [PMID: 33549630 DOI: 10.1016/j.joen.2020.12.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/23/2020] [Accepted: 12/15/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This research studies and compares the shaping ability of WaveOne Gold (WG; Dentsply Tulsa Dental Specialties, Tulsa, OK), the Reciproc Blue (RB; VDW, Munich, Germany), TRUShape (TS, Dentsply Tulsa Dental Specialties), XP-endo Shaper (XP; FKG, La Chaux-de-Fonds, Switzerland), iRace (IR, FKG), and TruNatomy (TN; Dentsply Sirona, Ballaigues, Switzerland) in the preparation of moderately curved canals and using micro-computed tomographic technology. METHODS Sixty lower molars with 2 mesial canals were randomly distributed into 6 groups of 10 molars and 20 canals per group (n = 20). Specimens were scanned before and after preparation using the SkyScan 1275 (Bruker microCT, Kontich, Belgium). Group 1 was treated with WG, group 2 with RB, group 3 with TS, group 4 with XP, group 5 with IR, and group 6 with TN. After instrumentation, researchers quantified the changes produced in the canal geometry in terms of surface, volume, structure thickness, surface convexity index, structure model index, percentage of surface touched, and centroids. Wilcoxon and analysis of variance tests were performed to compare the values before and after preparation and the differences between groups. The significance level was established at 5%. RESULTS There were no significant differences between WG and RB (P > .05) and between TN and XP (P > .05). TN had significant differences with WG, RB, TS, and IR (P < .05). All the files produced similar apical transportation (P > .05). CONCLUSIONS WG and RB and TN and XP had similar shaping effectivity. TS and WG touched the highest percentages of canal surfaces (81% and 73%, respectively) but produced the biggest changes in the canal anatomy. TN and XP better kept the canal anatomy, but TN touched the lowest percentage of canal surface (50%). All the files used were able to clean and to shape moderately curved canals with minimal apical transportation.
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Affiliation(s)
- María de Las Nieves Pérez Morales
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - José Antonio González Sánchez
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain.
| | - Juan Gonzalo Olivieri
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - Firas Elmsmari
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | | | - David E Jaramillo
- Department of Endodontics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Fernando Durán-Sindreu Terol
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
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Lima CO, Barbosa AFA, Ferreira CM, Augusto CM, Sassone LM, Lopes RT, Fidel SR, Silva EJNL. The impact of minimally invasive root canal preparation strategies on the ability to shape root canals of mandibular molars. Int Endod J 2020; 53:1680-1688. [DOI: 10.1111/iej.13384] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Affiliation(s)
- C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - C. M. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - C. M. Augusto
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de JaneiroRJBrazil
| | - S. R. Fidel
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro RJ Brazil
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12
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An In Vitro Evaluation Study of the Geometric Changes of Root Canal Preparation and the Quality of Endodontic Treatment. Int J Dent 2020; 2020:8883704. [PMID: 32849874 PMCID: PMC7441414 DOI: 10.1155/2020/8883704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/22/2020] [Accepted: 07/31/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction The geometry of root canals differs in different parts, especially in the apical region, and it is affected by different preparation techniques. The aim of this study was to evaluate the geometric changes of root canal preparation by general dentists regardless of the endodontic instrumentation systems and to study the quality of endodontic treatment by evaluating the untouched areas after mechanical preparation and the smear layer removal. Materials and Methods 100 extracted maxillary canines were collected for the in vitro study from 10 dentists, and the dentists were asked to treat the teeth endodontically. The teeth then were separated and examined under an optical microscope to evaluate the root canal final diameter and the untouched areas. Then, the teeth were examined under a scanned electronic microscope to evaluate the smear layer in coronal, middle, and third parts of the canal. Statistical significance was set as P < 0.05. Results The mean diameter of the root canal after instrumentation in the coronal and middle thirds was 2.50 ± 1.12 and 1.75 ± 1.24 mm, respectively, and the untouched area percentage observed in the apical thirds was 71%. For smear layer removal, it was better in the coronal and middle thirds than in the apical (P < 0.05). Conclusion The changes in the diameter of the root canal, the percentage of untouched areas after mechanical preparation, and the percentage of smear layer were observed in a higher percent in the apical third than in the coronal and middle thirds, and this raises the question of changing the technique of processing the root canal, especially in the apical third.
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13
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Esentürk G, Akkas E, Cubukcu E, Nagas E, Uyanik O, Cehreli ZC. A micro-computed tomographic assessment of root canal preparation with conventional and different rotary files in primary teeth and young permanent teeth. Int J Paediatr Dent 2020; 30:202-208. [PMID: 31651057 DOI: 10.1111/ipd.12587] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Root canals of primary teeth are commonly prepared with endodontic files that are originally manufactured for permanent teeth. AIM This micro-computed tomography (micro-CT) study evaluated and compared the changes in root canal morphology after preparation with different conventional and rotary files in primary teeth and young permanent teeth. DESIGN Seventy-two extracted primary and permanent molars were selected and randomly assigned to three subgroups according to the file systems used (n = 12/each). After pre-scanning of teeth with micro-CT, root canals were prepared with One Shape and Revo-S rotary systems and conventional endodontic files. After rescanning procedure, changes in canal volume, surface area, uninstrumented surface area, and apical transportation were evaluated. Mann-Whitney U test, Kruskal-Wallis test, and Conover's multiple comparison test were used for statistical analysis (P = .05). RESULTS Instrumentation with rotary files resulted in significantly greater volume and surface area of root canals and less uninstrumented areas (P < .001) than with manual files (P < .001). Primary molars showed significantly less apical transportation than permanent teeth (P < .001). CONCLUSIONS Preparation of canals with rotary files could be a viable alternative to conventional files in primary teeth. Regardless of the file system used, uninstrumented areas still exist in both primary teeth and permanent teeth.
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Affiliation(s)
- Gülce Esentürk
- Department of Pediatric Dentistry, School of Dentistry, Hacettepe University, Ankara, Turkey.,Department of Pediatric Dentistry, School of Dentistry, Altinbas University, Istanbul, Turkey
| | - Efe Akkas
- Department of Mineralogy-Petrography, Division of Geological Engineering, Hacettepe University, Ankara, Turkey
| | - Evren Cubukcu
- Department of Mineralogy-Petrography, Division of Geological Engineering, Hacettepe University, Ankara, Turkey
| | - Emre Nagas
- Department of Endodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ozgur Uyanik
- Department of Endodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, School of Dentistry, Hacettepe University, Ankara, Turkey
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14
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TRUShape Versus XP-endo Shaper: A Micro–computed Tomographic Assessment and Comparative Study of the Shaping Ability—An In Vitro Study. J Endod 2020; 46:271-276. [DOI: 10.1016/j.joen.2019.10.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/18/2019] [Accepted: 10/25/2019] [Indexed: 11/17/2022]
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15
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Arias A, Macorra JC, Govindjee S, Peters OA. Effect of gamma-ray sterilization on phase transformation behavior and fatigue resistance of contemporary nickel-titanium instruments. Clin Oral Investig 2020; 24:3113-3120. [PMID: 31956927 DOI: 10.1007/s00784-019-03185-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 12/23/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to compare body temperature cyclic fatigue resistance (CF) of heat-treated NiTi rotary instruments submitted to gamma-irradiation or autoclave sterilization. MATERIALS AND METHODS A total of 176 instruments (88 Hyflex EDM (HEDM) and 88 TRUShape (TS)) were used. Forty-four of each were submitted to gamma-irradiation. Twenty-two in each group were further autoclaved, resulting in a total of eight groups (n = 22 each): TS-γ and HEDM-γ (gamma-irradiated)/TS-γ-ac and HEDM-γ-ac (gamma-irradiated and autoclaved)/TS-non-γ and HEDM-non-γ (non-sterilized controls, non-gamma-irradiated/non-autoclaved)/TS-non-γ-ac and HEDM-non-γ-ac (non-gamma-irradiated and autoclaved). Twenty in each were tested for CF. Weibull parameters were calculated and compared. The remainder was used for differential scanning calorimetry analysis. RESULTS TS instruments lasted significantly longer if not submitted to gamma-irradiation (TS-non-γ mean-life = 101.5 s, 95 CI% 91.7-112.3; TS-γ mean-life = 83.2 s, 95 CI% 76-91.1); further autoclaving did not significantly affect CF. Gamma-irradiation did not affect HEDM (HEDM-γ mean-life = 717.9 s, 95 CI% 636.8-809.3; HEDM-non-γ: mean-life = 678.8 s, 95 CI% 595.1-744.2); further sterilization significantly decreased fatigue resistance (HEDM-γ-ac mean-life = 524.1 s, 95 CI% 476.1-576.8; HEDM-non-γ-ac mean-life = 570.6, 95 CI% 512.3-635.5). Gamma irradiation benefited HEDM conversion to martensite state and its maintenance, while further autoclave sterilization reverted the benefit. CONCLUSIONS Gamma-irradiation and autoclaving differentially affected fatigue life span and transformation temperatures of contemporary martensitic rotary instruments manufactured with different methods. CLINICAL RELEVANCE Gamma-ray processing is increasingly utilized by manufacturers for clinician to use fully sterile packaged instruments; however, the sterilization method of choice should vary depending on the effects on the behavior of contemporary martensitic rotary instruments manufactured with different methods.
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Affiliation(s)
- Ana Arias
- Department of Conservative Dentistry, School of Dentistry, Complutense University, Plaza Ramon y Cajal s/n. Ciudad Universitaria, 28040, Madrid, Spain.
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
| | - José C Macorra
- Department of Conservative Dentistry, School of Dentistry, Complutense University, Plaza Ramon y Cajal s/n. Ciudad Universitaria, 28040, Madrid, Spain
| | - Sanjay Govindjee
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Ove A Peters
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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16
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Evaluation Algorithm of Root Canal Shape Based on Steklov Spectrum Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2019; 2019:4830914. [PMID: 31885681 PMCID: PMC6925727 DOI: 10.1155/2019/4830914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 11/17/2022]
Abstract
In recent years, we have seen more and more interest in the field of medical images and shape comparison motivated by the latest advances in microcomputed tomography (μCT) acquisition, modelling, and visualization technologies. Usually, biologists need to evaluate the effect of different root canal preparation systems. Current root canal preparation evaluation methods are based on the volume difference, area difference, and transportation of two root canals before and after treatment. The purpose of root canal preparation is to minimize the volume difference and ensure the complete removal of the smear layer. Previous methods can reflect some general geometric differences, but they are not enough to evaluate the quality of root canal shape. To solve this problem, we proposed a novel root canal evaluation method based on spectrum and eigenfunctions of Steklov operators, which can be served as a better alternative to current methods in root canal preparation evaluation. Firstly, the ideal root canal model was simulated according to the root canal model before and after preparation. Secondly, the Steklov spectrum of the two models was calculated. Thirdly, based on the spectrum and the histogram of the Gaussian curvature on the surface, the weight of each eigenvalue was computed. Therefore, the Steklov spectrum distance (SSD), which measures shape difference between the root canals, was defined. Finally, the calculation method that quantifies the root canal preparation effect of root canals was obtained. Through experiments, our method manifested high robustness and accuracy compared with existing state-of-the-art approaches. It also demonstrates the significance of our algorithm's advantages on a variety of challenging root canals through result comparison with counterpart methods.
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17
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De‐Deus G, Simões‐Carvalho M, Belladonna FG, Cavalcante DM, Portugal LS, Prado CG, Souza EM, Lopes RT, Silva EJNL. Arrowhead design ultrasonic tip as a supplementary tool for canal debridement. Int Endod J 2019; 53:410-420. [DOI: 10.1111/iej.13236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - L. S. Portugal
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - C. G. Prado
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Maranhão Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
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18
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Filizola de Oliveira DJ, Leoni GB, da Silva Goulart R, Sousa-Neto MDD, Silva Sousa YTC, Silva RG. Changes in Geometry and Transportation of Root Canals with Severe Curvature Prepared by Different Heat-treated Nickel-titanium Instruments: A Micro–computed Tomographic Study. J Endod 2019; 45:768-773. [DOI: 10.1016/j.joen.2019.02.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/05/2019] [Accepted: 02/08/2019] [Indexed: 11/15/2022]
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19
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Stringheta CP, Bueno CES, Kato AS, Freire LG, Iglecias EF, Santos M, Pelegrine RA. Micro‐computed tomographic evaluation of the shaping ability of four instrumentation systems in curved root canals. Int Endod J 2019; 52:908-916. [DOI: 10.1111/iej.13084] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- C. P. Stringheta
- Department of Endodontics São Leopoldo Mandic Dental Research Center CampinasSP Brazil
| | - C. E. S. Bueno
- Department of Endodontics São Leopoldo Mandic Dental Research Center CampinasSP Brazil
| | - A. S. Kato
- Department of Endodontics São Leopoldo Mandic Dental Research Center CampinasSP Brazil
| | - L. G. Freire
- Division of Endodontics Department of Restorative Dentistry School of Dentistry University of São Paulo São Paulo SP Brazil
| | - E. F. Iglecias
- Division of Endodontics Department of Restorative Dentistry School of Dentistry University of São Paulo São Paulo SP Brazil
| | - M. Santos
- Division of Endodontics Department of Restorative Dentistry School of Dentistry University of São Paulo São Paulo SP Brazil
| | - R. A. Pelegrine
- Department of Endodontics São Leopoldo Mandic Dental Research Center CampinasSP Brazil
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20
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Jensen LE, Murphy S, Williamson AE, Teixeira FB, Johnson WT, Friedl CC, Peters OA. Root canal preparation in mandibular premolars with TRUShape and Vortex Blue: A micro-computed tomography study. AUST ENDOD J 2019; 45:12-19. [PMID: 30614165 DOI: 10.1111/aej.12322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
Abstract
A comparison of the preparation ability of two root canal instrumentation systems in oval-shaped canals using micro-computed tomography was undertaken. Thirty extracted, single-rooted, human mandibular premolars with radiographically similar canal morphology were selected, allocated to two groups (N = 15) and prepared with TRUShape or Vortex Blue (VB). Each sample was subjected to three scans (20 μm resolution): pre-preparation and after preparation to sizes #30 and #40. Three-dimensional data sets were evaluated for canal volume, surface area and surface treatment. Matched axial slices in apical, middle and coronal root thirds were evaluated for cross-sectional area, roundness and transportation. Preparation with both instruments increased canal volumes and surface areas similarly and significantly (P < 0.001) with no significant difference between groups. TRUShape significantly enhanced surface treatment at both apical sizes (P < 0.05). Transportation exceeded 100 μm in only eight out of 90 cross sections. Both instruments performed similarly during preparation. TRUShape, however, significantly enhanced surface treatment.
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Affiliation(s)
- Lauren E Jensen
- Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Sarah Murphy
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | - Anne E Williamson
- Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Fabricio B Teixeira
- Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - William T Johnson
- Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Christopher C Friedl
- Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Ove A Peters
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.,Oral Health Centre, University of Queensland, Herston, Queensland, Australia
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21
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Sousa-Neto MDD, Silva-Sousa YC, Mazzi-Chaves JF, Carvalho KKT, Barbosa AFS, Versiani MA, Jacobs R, Leoni GB. Root canal preparation using micro-computed tomography analysis: a literature review. Braz Oral Res 2018; 32:e66. [DOI: 10.1590/1807-3107bor-2018.vol32.0066] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
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22
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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