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Danaci Z, Yeter KY. Evaluation of Pain Following the Use of Different Single-file Glide Path Systems: A Randomized Clinical Trial. J Endod 2024; 50:120-128. [PMID: 37924939 DOI: 10.1016/j.joen.2023.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/17/2023] [Accepted: 10/29/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION This study aimed to evaluate postoperative pain intensity following glide-path preparation using the ProGlider (PG) and WaveOne Gold Glider (WOGG) systems in asymptomatic teeth with necrotic pulp and periapical lesions. METHODS In this randomized clinical trial (ClinicalTrials.gov ID: NCT05955742) maxillary and mandibular molars with asymptomatic apical periodontitis of 78 patients (age, 18-65 years) were included. The patients were randomly divided into 3 groups: control (n = 26), PG (n = 26), and WOGG (n = 26). All the systems were used according to the manufacturer's instructions, and all the root canal treatments were completed by a single operator within 2 sessions. Postoperative pain was assessed using a numerical rating scale at 6, 12, 18, 24, 48, and 72 hours. Analgesics administered and abscess formation were also recorded. Statistical analyses were performed using the Mann-Whitney U, Bonferroni Dunn, Friedman, Chi-square, and Fisher exact tests. RESULTS The postoperative pain at 12 and 18 hours was lower in the WOGG group than in the other groups (P < .05). The postoperative pain scores at 6 and 24 hours were higher among women than among men (P < .05). The highest postoperative pain scores were observed at 6 hours (P < .05). CONCLUSIONS The WOGG glide-path file system was associated with less postoperative pain than the other systems. Abscess formation and analgesic use were higher in the PG group than in the other groups. Postoperative pain was greater in women than in men.
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Affiliation(s)
- Zeliha Danaci
- Department of Endodontics, Eskisehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey
| | - Kübra Yeşildal Yeter
- Department of Endodontics, Eskisehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey.
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Nouroloyouni A, Shahi S, Salem Milani A, Noorolouny S, Farhang R, Yousefi Azar A. In vitro apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc and Reciproc Blue instruments and a novel stainless steel rotary system (Gentlefile) versus manual instrumentation. J Dent Res Dent Clin Dent Prospects 2023; 17:136-141. [PMID: 38023797 PMCID: PMC10676536 DOI: 10.34172/joddd.2023.39271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study compared apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc, Reciproc Blue, and Gentlefile (GF) rotary instruments versus the manual step-back technique. Methods This in vitro study was conducted on 80 extracted mandibular premolars with mature apices and a root curvature of<10°. The teeth were randomly assigned to 4 groups (n=20), standardized regarding working length, and placed in pre-weighed vials. The root canals were instrumented with Reciproc, Reciproc Blue, and GF systems and the manual step-back technique in the four groups. The vials containing the collected debris were then dried and weighed. The instrumentation time was also recorded for each group. Data were analyzed with one-way ANOVA and post hoc Games-Howell test (α=0.05). Results Minimum apical debris extrusion was noted in Reciproc, followed by Reciproc Blue, GF, and manual technique (P<0.05). Pairwise comparisons showed significantly lower apical extrusion of debris in the Reciproc compared with GF (P=0.015) and manual instrumentation (P=0.011) groups. The Reciproc system also had the shortest instrumentation time, followed by Reciproc Blue, GF, and manual instrumentation (P<0.05). Pairwise comparisons showed significant differences between all the systems (P<0.05) except between Reciproc and Reciproc Blue (P>0.05) in this respect. Conclusion Although all systems caused apical extrusion of debris, manual instrumentation caused maximum extrusion of debris. In contrast, the Reciproc system was superior to others regarding minimal apical extrusion of debris and the shortest instrumentation time.
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Affiliation(s)
- Ahmad Nouroloyouni
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Shahriar Shahi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Amin Salem Milani
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Sara Noorolouny
- Department of Pediatric Dentistry, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Robab Farhang
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Aysan Yousefi Azar
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
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Zhang Q, Gu J, Shen J, Ma M, Lv Y, Wei X. Apically extruded debris, canal transportation, and shaping ability of nickel-titanium instruments on contracted endodontic cavities in molar teeth. J Oral Sci 2023; 65:203-208. [PMID: 37532528 DOI: 10.2334/josnusd.23-0050] [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: 08/04/2023]
Abstract
PURPOSE Apically extruded debris, canal transportation and shaping ability were compared between contracted endodontic cavities (CECs) and traditional endodontic cavities (TECs) after instrumentation with XP-endo Shaper (XPS), ProTaper Gold (PTG), ProTaper for hand-use (HPT) and Hero Shaper. METHODS The CECs or TECs groups were sub-divided into 24 groups according to root canal morphology and nickel-titanium (Ni-Ti) instruments. The weight of apically extruded debris was calculated using the Myers and Montgomery model. Pre- and postoperative images of teeth were scanned using micro-CT and the three-dimensional models were constructed and compared. RESULTS Under CECs or TECs, XPS and PTG produced less apical debris and formed less canal transportation than HPT and Hero Shaper (P < 0.05). XPS group under CECs extruded less apical debris than that under TCEs for round canals with curvature of 20°-35° (P < 0.05). The centering ratios of four tested instruments were higher under TECs than those under CECs (P < 0.05). The HPT and Hero Shaper had more transportation under CECs than that under TCEs (P < 0.05). No statistical difference was found regarding shaping ability among all the groups. CONCLUSION Under CECs, XPS preserves the original root canal anatomy, meanwhile it produces less apical debris than the other instruments.
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Affiliation(s)
- Qinqin Zhang
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
| | - Jingyi Gu
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
| | - Jiadi Shen
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
| | - Ming Ma
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
| | - Ying Lv
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
| | - Xin Wei
- Department of Endodontics, Affiliated Stomatological Hospital of Nanjing Medical University
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Kurt Ö, Zengin T, Üstün Y. Comparison of the effect of different glide path files on amount of apically extruded debris in curved root canals. AUST ENDOD J 2023; 49 Suppl 1:359-365. [PMID: 36946545 DOI: 10.1111/aej.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/30/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
It is essential to create a glide path before root canal preparation with nickel-titanium rotary files to avoid file breakage and preserve the original canal structure. The aim of this study was to compare the amount of apically extruded debris after using different glide path files. A total of 96 first mandibular molars with curved mesial roots were randomly divided into six groups (n = 16) which are K-files, Proglider, R-Pilot, TruNatomy Glider, WaveOne Gold Glider and group without a glide path. Apically extruded debris was measured after glide path and canal preparation. The highest amount of debris was found in the control group without a glide path and using a glide path file caused less debris and significant differences were observed between R-Pilot, TruNatomy Glider, ProGlider, WaveOne Gold Glider and K-file groups. It may be recommended to create a glide path before root canal shaping to reduce the amount of extrusion debris from the apical. Especially in curved and narrow root canals, it is recommended to use an R-Pilot file before root canal shaping in order to reduce the amount of apically extruded debris.
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Affiliation(s)
- Özge Kurt
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Talip Zengin
- Department of Molecular Biology and Genetics, Muğla Sitki Koçman University, Muğla, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Laslami K, Khaldoune S, Sy A, Drouri S, Benkiran I. Apical Extrusion: Is It an Inherent Occurrence During Every Endodontic Treatment? Cureus 2023; 15:e45211. [PMID: 37720124 PMCID: PMC10504573 DOI: 10.7759/cureus.45211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
The aim of this literature review was to analyze all available scientific data on apical extrusion and to identify and associate the possible factors influencing the occurrence of apical extrusion, ranging from the choice of the canal shaping system, the irrigation technique, to the choice of diameter and the apical limit of preparation. A bibliographic search for relevant articles on apical extrusion of debris, irrigants, and bacteria was performed using the following databases: PubMed, Cochrane Library, and ScienceDirect. This search identified articles published between 2010 and 2023 in two languages (French and English). After selective sorting, 25 relevant documents were included. All the studies retained clearly agree on the inherent nature of apical extrusion during endodontic treatment. At the same time, we also understand that the amount of extrusion can be influenced by a number of parameters throughout endodontic therapy. According to this review, despite the undeniable nature of apical extrusion during endodontic therapy, studies with relatable experimental models that approach in vivo conditions are required to establish exploitable conclusions regarding apical extrusion and its prevention.
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Affiliation(s)
- Kaoutar Laslami
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Salma Khaldoune
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Aly Sy
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Sofia Drouri
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Imane Benkiran
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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Wang LX, Chen H, Lin RT, Gu LS. Influence of pecking frequency at working length on the volume of apically extruded debris: A micro-computed tomography analysis. J Dent Sci 2021; 17:1274-1280. [PMID: 35784137 PMCID: PMC9236894 DOI: 10.1016/j.jds.2021.11.012] [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: 11/03/2021] [Revised: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background/purpose There is no consensus to date on how many repetitive pecking motions at working length (WL) should be regarded as optimal during instrumentation. Therefore, this study aimed to evaluate the effect of pecking frequency at WL on the volume of apically extruded debris using three single-file systems in curved, oval-shaped canals. Materials and methods Forty-five single-rooted mandibular premolars with curved, oval-shaped canals were prescanned by micro-computed tomography, anatomically paired-matched, and randomly divided among three groups (n = 15 each): Reciproc Blue (RB), WaveOne Gold (WOG) and XP-endo Shaper (XPS). Samples were embedded in agarose gel to collect extruded debris. After preparation to the WL, each sample was rescanned after one, two, four, 10, and 20 pecking motions at WL, respectively. The debris volume was innovatively calculated by a modification of an existing method using micro-computed tomography. The apical preparation size was also measured. Data were compared using a two-way repeated-measures analysis of variance. Results All single-file systems extruded debris apically, irrespective of the pecking frequency at WL. The extruded debris volume correlated positively with the minor foramen size (P < 0.05); both increased with pecking frequency for each single-file system (P < 0.05). The minor foramen size corresponded to the instrument tip size when reaching the WL once. Conclusion To produce less debris extrusion and obtain a predictable foramen size corresponding to the instrument tip size, a single pecking motion may be preferred when using single-file systems. Caution should be exercised when applying the current results to clinical situations.
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Affiliation(s)
- Li-Xiao Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui-Tian Lin
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li-Sha Gu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Corresponding author. Hospital of Stomatology, Sun Yat-sen University, No. 56, Lingyuan West Road, Guangzhou, Guangdong, 510055, China. Fax: +86 20 83822807.
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