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De-Deus G, Arashiro FN, Souza EM, Silva EJNL, Guimarães TDM, Maciel ACDC, Oliveira DDS, Belladonna FG, Lopes RT, Versiani MA. The impact of long-term storage conditions on the development of experimental dentinal microcracks. AUST ENDOD J 2024; 50:60-68. [PMID: 37876340 DOI: 10.1111/aej.12806] [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: 02/03/2023] [Revised: 07/27/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
This study evaluated the impact of long-term storage conditions (medium and time) on the development of experimental dentinal microcracks through micro-computed tomography. Sixty freshly extracted premolars were stored in formalin, water, or dry conditions (n = 20) and scanned after 72 h, 30 days, 6 months and 3 years of extraction. The effect of the storage medium and time on the occurrence of dentinal defects was statistically evaluated. A total of 211 000 images were screened revealing the existence of 11 519 slices with dentinal defects. Dry conditions significantly contributed to the development of new defects in all time points. During the 3-year follow-up period, no new defects were detected in the teeth that were stored in water and, in a single tooth, in the formalin group, after 6 months of storage.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Fabio Nakao Arashiro
- Department of Endodontics, School of Dentistry Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Department of Endodontics, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
| | | | | | | | | | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Aurélio Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
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Ek B, Zweig S, Roges RG, Berdan Y, Roges RA, Abulhamael A, Kutbi A, Alqutub AW, Alothmani OS, Siddiqui AY. Prevalence of Vertical Root Fractures in a University Endodontics Program versus a Private Endodontics Office. Int J Dent 2023; 2023:2098629. [PMID: 38149084 PMCID: PMC10751159 DOI: 10.1155/2023/2098629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/30/2023] [Accepted: 12/05/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Vertical root fractures (VRFs) typically have a poor prognosis with an extraction or occasionally root amputation as the preferred treatment. VRFs have been considered an epidemic, motivating changes in the access openings, as well as in the preparation and disinfection protocols of endodontic treatment. Hence, we aimed to evaluate the prevalence of VRFs by tracking cases in both a University Endodontic Program (UEP) and a private endodontics practice (PP). We also evaluated changes in prevalence during COVID-19 along with the alterations in the frequency of cases diagnosed by clinical and radiographic signs which were later confirmed by direct visualization compared to those in which the suspicion was based on clinical and radiographic signs alone. Methods and Materials This retrospective study looked at the prevalence of VRF in patient records at UEP and a PP. Data for the pre-COVID-19 and COVID-19 time periods were extracted from patient records and referral letters then compared. Data for suspected and confirmed prevalence were compared. Results The UEP group included 21,156 patients while the PP group comprised 7,209 patients. The prevalence of VRFs in the former cohort was 1.80%, while 2.62% of the latter cohort exhibited VRFs with a combined total of 2.01%. The combined total prevalence of VRFs pre-COVID-19 was 1.72%, increasing from 2.1% to 3.82% during COVID-19 (p < 0.0001). The same applied to suspected cases for both clinical settings. The increase in confirmed cases between the two periods was statistically significant for the UEP group (p=0.0202) but it was insignificant for the PP group (p=0.0721). Conclusion The combined prevalence for VRFs was 2.01% for all years denying the claim that VRF is a pandemic phenomenon. COVID-19 period saw almost a double increase in the prevalence of VRF compared to pre-COVID-19 era. This was consequently associated with a significant increase in the number of suspected VRF cases.
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Affiliation(s)
- Berit Ek
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Stefan Zweig
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Ramon G. Roges
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Yaara Berdan
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Rafael A. Roges
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Ayman Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abrar Kutbi
- University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa W. Alqutub
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Osama S. Alothmani
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amna Y. Siddiqui
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Zogheib C, Roumi R, Baldi A, Palopoli P, Pasqualini D, Berutti E, Alovisi M. The effect of ultrasonic access cavity preparation on dentinal inner walls: a micro-CT study on cadaveric samples. Oral Radiol 2023; 39:639-645. [PMID: 37000330 DOI: 10.1007/s11282-023-00680-z] [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: 11/14/2022] [Accepted: 03/02/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE The objective of this study is to evaluate the occurrence of coronal dentinal micro-cracks after access cavity refinement using high-speed burs and ultrasonic tips by means of micro-computed tomography (micro-CT) analysis. METHODS In this study, 18 mandibular cadaveric incisors were divided into two groups according to the protocol of the preparation of the conventional access cavity. The diamond bur 802 # 12 was used until the perforation of the pulp roof. Then, the Endo-Z bur was used for the group #1 and the ultrasonic tip Start-X # 1 for the group #2 to finish and refine the access cavity. The preparation time of each access cavity has been recorded. The teeth underwent a micro-CT scan before and after the preparation of the access cavity. Fisher's exact test, the Chi-square test, the Kolmogorov-Smirnov test, the Mann-Whitney test, and the Student's test were used for statistical evaluation. RESULTS The percentage of teeth with new micro-cracks is not significantly different between the two groups (-p-value < 0.5). The number of newly formed micro-cracks and extension size were not significantly different between the two groups. The direction of extension of the micro- cracks was occluso-apical. The average duration of the access cavity is significantly smaller with the Endo-Z system (-p- value < 0.001). The roughness of walls surfaces has no statistically difference between the two groups. CONCLUSION The use of ultrasound, although slower, is considered safe in the creation of dentinal micro-cracks, in the preparation of the access cavity.
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Affiliation(s)
- C Zogheib
- Department of Endodontics, Saint Joseph University of Beirut, Beirut, Lebanon
| | - R Roumi
- Department of Endodontics, Saint Joseph University of Beirut, Beirut, Lebanon
| | - A Baldi
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | | | - D Pasqualini
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | - E Berutti
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
| | - M Alovisi
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, Turin, Italy
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Branawal HC, Mittal N, Rani P, Ayubi A, Samad S. Comparison of Dentinal Defects Induced by Rotary, Reciprocating, and Hand Files in Oval Shaped Root Canal - An In-Vitro Study. Indian J Dent Res 2023; 34:433-437. [PMID: 38739827 DOI: 10.4103/ijdr.ijdr_132_23] [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: 02/17/2023] [Accepted: 10/04/2023] [Indexed: 05/16/2024] Open
Abstract
AIM To evaluate and compare the formation of dentinal defects using hand Hedstrom files, XP-Shaper, TruNatomy, and Reciproc Blue file systems when used for oval shaped root canals. MATERIALS AND METHODS One hundred and five extracted human mandibular premolars with single root and oval canals were selected for the study. Twenty-one teeth were unprepared (control), and the remaining teeth were divided into the prepared groups (n = 21), that is, Group H-Files, Group XP-Shaper, Group TruNatomy, and Group Reciproc Blue. All selected teeth were de-coronated perpendicular to the long axis of the tooth by using a diamond-coated disk with water cooling, leaving root segments approximately 16 mm in length. Each group was prepared according to the above file system. Then all roots were sectioned perpendicular to their long axes at 3, 6, and 9 mm from the apex using a diamond-coated disk under a continuous water stream. Each specimen was then checked for the presence of dentinal defects/microcracks. RESULT The XP-Endo shaper group had the lowest number of defects (01/21 roots) 4.7%; TN (04/21) 19%, H-Files (04/21) 19%, and RC Blue (05/21) 23.8% had the highest incidence of defects. However, no significant difference was detected among these groups (P > 0.05). CONCLUSION The motor-driven root canal instrumentation with rotary and reciprocating files and hand files may create microcracks in the radicular dentine, whereas the XP-Shaper file system produces minimal or less cracks compared to other tested rotary file systems and H-file instrumentation.
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Affiliation(s)
- Harakh Chand Branawal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, BHU, Varanasi, Uttar Pradesh, India
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Bhavsar BA, Sharma P, Surana P, Badnaware S, Jadhaw D, Jain A. Oval Root Canals Prepared With Two Different Endodontic Rotary Files: An In Vitro Study Comparing the Incidence of Dental Defects. Cureus 2023; 15:e35914. [PMID: 37038573 PMCID: PMC10082335 DOI: 10.7759/cureus.35914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE This study aims to investigate and compare the establishment of dentinal cracks during root canal preparation using a stereomicroscope and a scanning electron microscope (SEM). MATERIALS AND METHODS Sixty removed human mandibular premolars were separated into three groups of 20: two experimental and one control. Within the randomized controlled experimental groups, root canals were constructed. Group I: the Waldent walflex file and Group II: the Trunatomy (TRN) file. Group III: the control group received no preparations. The surfaces of the roots were checked for dentinal cracks using a stereomicroscope and SEM following sectioning at 3, 6, and 9 mm from the apex. The Chi-square test was used to examine the data. RESULTS In the control group, no fissures appeared. Cracks in Waldent Walflex were almost 66.7% between the 3mm and 6mm range. At both the 6 mm and 9 mm levels, there was no statistically significant difference between the experimental groups (P > 0.05). Defects were found to be substantially higher in the apical region of samples than in the median and coronal sections. CONCLUSION Dentinal fissures were created by every rotary file used in the tests. There were more flaws in the Waldent Walflex file group than in the Trunatomy file group.
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Three Visual-Diagnostic Methods for the Detection of Enamel Cracks: An In Vitro Study. J Clin Med 2023; 12:jcm12030973. [PMID: 36769621 PMCID: PMC9917518 DOI: 10.3390/jcm12030973] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
Tooth fractures are a common cause of tooth loss, frequently starting as enamel cracks. However, methods for the detection of enamel cracks are poorly investigated. The aim of the study was the validation of three clinical methods for the detection of enamel cracks: dental operating microscope (DOM), near-infrared transillumination (NIR), and fiber-optic transillumination (FOTI), with hard-tissue slices serving as controls. A total of 89 extracted teeth, set up as diagnostic models, were investigated, and the maximum crack depth was scored by two examiners. The actual crack depth was determined microscopically (25×) using horizontal sections. The accuracy of each method was analyzed using receiver operating characteristic (ROC) curves. Across all tooth surfaces, the area under the curve (AUC) amounted to 0.57 (DOM), 0.70 (FOTI), and 0.67 (NIR). For crack detection on vestibular/oral surfaces, the AUC was 0.61 (DOM), 0.78 (FOTI), and 0.74 (NIR); for proximal surfaces, it was 0.59 (DOM), 0.65 (FOTI), and 0.67 (NIR). However, the actual crack depth was underestimated with each method (p < 0.001). Under in vitro conditions, FOTI and NIR are suitable for detection of enamel cracks, especially on vestibular and oral tooth surfaces. However, an exact estimation of crack depth is not possible. Therefore, FOTI and NIR seem to be helpful for the clinical detection of enamel cracks.
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Influence of moisture content of frozen and embalmed human cadavers for identification of dentinal microcracks using micro-computed tomography. J Mech Behav Biomed Mater 2022; 133:105310. [PMID: 35696968 DOI: 10.1016/j.jmbbm.2022.105310] [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: 04/24/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate the influence of moisture content in frozen and embalmed human cadavers on the detection of dentinal microcracks using micro-computed tomography (micro-CT). The group of embalmed specimens included three mandibular and two maxillary segments each containing one tooth. The group of frozen cadavers consisted of two frozen mandibular bone-blocks with two teeth and one mandibular segment containing one tooth. The final number of teeth for each preservation method was n = 5. All specimens were scanned with eight different moisture conditions: 48 h wet, 2 h dry, 48 h wet, 24 h dry, 48 h wet, 1 wk dry, 48 h wet, 1 wk dry. Micro-CT images were screened for the presence of dentinal microcracks. Statistical analysis was performed by nonparametric analysis of variance (α = 5%). Only few microcracks were observed in wet and in 2 h dried bone-blocks with no significant differences (p = 0.63 and p = 0.23, respectively). There was a significant and steady increase of microcracks within the groups of dried specimens as follows: 2 h dry < 24 h dry < first wk dry < second wk dry (all p < 0.008). Preservation method had no significant influence on the visibility of microcracks (p = 0.98). Identification of dentinal microcracks on micro-CT images is influenced by moisture content of cadaveric bone-blocks irrespective of the preservation method.
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Zarean P, Özcan M, Zarean P, Haghani SO, Jahromi MZ, Al-Haj Husain N, Khabiri M. Micro-Computed Tomographic Assessment of Microcrack Formation before and after Instrumentation of Curved Root Canals with Neoniti Rotary Files. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3002. [PMID: 35591336 PMCID: PMC9105525 DOI: 10.3390/ma15093002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023]
Abstract
The aim of this study was to assess the microcrack formation of moderately and severely curved root canals following instrumentation with Neoniti rotary files using micro-computed tomography. This in vitro study evaluated 18 extracted sound mandibular molars with two separate mesial canals and foramina in two groups (n = 9) with 5−20° (moderate) and 20−40° (severe) root canal curvature. The number of microcracks in the root canal walls was counted at baseline by micro-CT. Subsequently, the root canals were instrumented with 0.20/0.06 v Neoniti files as single files with a torque of 1.5 Ncm and a speed of 400 rpm. The number of microcracks was counted again postoperatively on micro-CT images using Amira software. Statistical analysis was performed using the Shapiro−Wilk test, Levene’s test and repeated-measures ANOVA (α = 0.05). The mean number of microcracks significantly increased postoperatively in both the moderately curved (11.59 ± 9.74 vs. 8.2 ± 7.4; p = 0.001) and the severely curved (13.23 ± 5.64 vs. 7.20 ± 5.94; p < 0.001) groups. However, the differences between the two groups were not significant (p = 0.668). Based on the results obtained, it can be stated that the instrumentation of moderately and severely curved root canals with Neoniti rotary files increases the number of microcracks. However, the higher degree of curvature does not necessarily translate to a higher number of microcracks after root canal instrumentation with this specific rotary system and methodological procedures.
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Affiliation(s)
- Parichehr Zarean
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (M.Ö.); (N.A.-H.H.)
| | - Paridokht Zarean
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Seyed Omid Haghani
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
| | - Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (M.Ö.); (N.A.-H.H.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Masoud Khabiri
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
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Tatchev D, Tsenova-Ilieva I, Vassilev T, Karova E. The effect of experimental conditions in root dentin microcracks detection by micro-computed tomography. J Mech Behav Biomed Mater 2022; 128:105108. [DOI: 10.1016/j.jmbbm.2022.105108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
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De-Deus G, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Moreira Cavalcante D, Versiani MA. A critical analysis of research methods and experimental models to study root canal fillings. Int Endod J 2022; 55 Suppl 2:384-445. [PMID: 35226760 DOI: 10.1111/iej.13713] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Canal filling materials and techniques have been one of the most studied topics in Endodontics. A simple search using the mesh term "root canal filling" in PubMed revealed more than 11,000 articles, an impressive number that is much higher than "root canal disinfection" (5,544 articles) or even the popular "root canal preparation" (8,527 articles). The overriding importance attributed to root filling procedures is not merely intuitive. It derived from the appealing relevance given by the appearance of the white lines in common radiographs grounded on retrospective clinical data that had identified the quality of a root filling as one of the major causes of treatment failure (lack of healing). Since the publication of the Washington study, impressive efforts have been made for the release of new materials and techniques, as well as, for the development of a plethora of laboratory methods to assess the quality of root filling procedures. This narrative review aims to address and discuss the most relevant laboratory methods to assess the root canal filling. Since filling quality improvements have not translated into higher success rates, as reported in longitudinal clinical studies, more than to deliver a simple methodology-based review, this paper aims to present an in-depth critical view on the assessment of laboratory methods used to study the filling materials and techniques. Recent data indicate that the long-term dimensional stability/degradation over time of endodontic sealers plays a central role in the treatment outcome. In this context, laboratory methods should be developed focusing on predicting, at least to some degree, the long-term clinical behaviour of root canal fillings, rather than simply ranking different materials or techniques.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Silva EJNL, De-Deus G, Souza EM, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Versiani MA. Present status and future directions - Minimal endodontic access cavities. Int Endod J 2022; 55 Suppl 3:531-587. [PMID: 35100441 DOI: 10.1111/iej.13696] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
In the last decades, the move of Medicine towards minimally invasive treatments is notorious and scientifically grounded. As Dentistry naturally follows its footsteps, minimal access preparation also became a trend topic in the endodontic field. This procedure aims to maximize preservation of dentine tissue, backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key-points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection, and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make it clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach like minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws, but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in-situ laboratory model or a large and well-controlled clinical trial to solve this matter.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Tan VL, Hardiman R, Pilbrow V, Parashos P. Dentinal microcracks and cemental tears related to chemo-mechanical root canal instrumentation: a micro-CT Cadaver Study. Aust Dent J 2021; 67:76-82. [PMID: 34762293 DOI: 10.1111/adj.12887] [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: 10/11/2021] [Revised: 11/03/2021] [Accepted: 11/07/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The prevalence of radicular defects after root canal instrumentation is unresolved. This study used micro-CT to assess the relationship between the formation of radicular defects and chemo-mechanical instrumentation in a cadaver model. METHODS Maxillary and mandibular molars (n = 24) were sectioned from cadaver specimens as a tissue block containing the teeth, alveolar bone and attached mucogingival tissues. After a baseline micro-CT scan (13.45 μm), the specimens were distributed into 3 groups (n = 8 molars): Reciproc® , ProTaper Next™ and Mtwo® . Micro-CT scans of each specimen were obtained after access, glide path and preparation with each instrument. The pre-operative and final post-operative micro-CT cross-sectional images of the roots were screened by two blinded examiners to identify any pre-existing and new radicular defects. Pre-existing and new radicular defects were examined histologically. RESULTS Overall, 16 pre-existing radicular defects were identified in 12 of the 24 molars (50%). Most of these were cemental tears (87.5%), and not true dentinal microcracks. New dentinal microcracks were observed in the post-operative micro-CT scans of only 3 canals (3.9%; 3/77). However, only one of these defects was found to be present histologically. CONCLUSIONS Within the limitations of the study, chemo-mechanical instrumentation did not routinely promote the formation of radicular defects.
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Affiliation(s)
- V L Tan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Hardiman
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - V Pilbrow
- The Australian Institute of Archaeology, Department of Archaeology and History, La Trobe University, Bundoora, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Versiani MA, Cavalcante DM, Belladonna FG, Silva EJNL, Souza EM, De-Deus G. A critical analysis of research methods and experimental models to study dentinal microcracks. Int Endod J 2021; 55 Suppl 1:178-226. [PMID: 34743355 DOI: 10.1111/iej.13660] [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: 09/01/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
The purpose of this narrative review was to discuss the scientific milestones that led to the current understanding of the root dentinal microcrack phenomenon based on the interplay between the usage of micro-computed tomography (micro-CT) as an analytical tool alongside a close-to-mouth experimental model. In 2009, reports on the development of dentinal microcracks in extracted teeth after root canal preparation triggered an awareness of the potential for vertical root fractures (VRFs) of endodontically treated teeth could be developed from defects created by the mechanical stress of nickel-titanium preparation systems on dentine. This assumption was taken for granted, even though no cause-effect relationship had been scientifically demonstrated. Since then, several studies using the sectioning method with extracted teeth have been published and the large discrepancy amongst their outcomes soon become evident. Moreover, the high frequency of reported dentinal microcracks largely contrasted with the clinical incidence of VRFs, raising doubts on their methodological reliability. Using micro-CT technology, it was demonstrated by several studies that, in extracted teeth, dentinal defects already existed before the endodontic procedures, indicating that the initial reports framed a non-existing cause-effect relationship between canal preparation and dentinal microcracks. Although these new findings contributed to a better comprehension of this phenomenon, the misconception that microcracks were the starting point for VRFs was only surpassed with a new in situ approach using fresh cadavers. Surprisingly, microcracks were not identified in sound teeth. As a conclusion, dentinal microcracks in extracted teeth can be considered a non-natural occurrence observed only in a laboratory set-up as a consequence of dehydration and storage conditions. Thus, dentinal microcracks shall not be considered as the starting point for VRFs as they do not manifest in non-extracted teeth. Identifying dentinal microcracks as a laboratory phenomenon highlights the impact of recent scientific developments to disclaim the clinical relevance of laboratory-obtained outcomes.
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Affiliation(s)
| | | | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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Martins JCLGD, Oliveira BP, Duarte DA, Antonino ACD, Aguiar CM, Câmara AC. Micro-computed tomographic assessment of dentinal microcrack formation in straight and curved root canals in extracted teeth prepared with hand, rotary and reciprocating instruments. Int Endod J 2021; 54:1362-1368. [PMID: 33760261 DOI: 10.1111/iej.13521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
AIM To compare microcrack formation in roots of extracted teeth after the shaping of straight and curved root canals with hand, rotary and reciprocating files using micro-computed tomographic (micro-CT) analysis. METHODOLOGY Thirty straight mandibular incisors and 30 severely curved mesial roots of mandibular molars were randomly divided into 6 experimental groups (n = 10) according to the systems used for the root canal preparation and the root canal curvature: ProTaper Universal for Hand Use (Dentsply Sirona, Ballaigues, Switzerland), HyFlex EDM (Coltene-Whaledent, Altstätten, Switzerland) and Reciproc Blue (VDW, Munich, Germany) files used in mandibular incisors (straight canals) and mesial roots of mandibular molars (curved canals). The roots were imaged with micro-CT scanning at an isotropic resolution of 14 μm before and after root canal preparation, and the cross-sectional images generated were assessed to detect microcracks. RESULTS All dentinal defects identified after root canal preparation were already present before instrumentation, and no new microcracks were detected. Dentinal microcracks were present in 19% (ProTaper Universal for Hand Use), 11% (Hyflex EDM) and 23% (Reciproc Blue) of the cross-sections when the instrumentation was performed in mandibular incisors. Instrumentation of mandibular molars revealed microcracks in 15% (ProTaper Universal for Hand Use), 16% (Hyflex EDM) and 17% (Reciproc Blue) of the cross-sections. CONCLUSIONS Preparation of straight and curved root canals with ProTaper Universal for Hand Use, HyFlex EDM and Reciproc Blue systems did not produce microcracks in extracted teeth when evaluated with micro-CT.
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Affiliation(s)
- J C L G D Martins
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Recife, PE, Brazil
| | - B P Oliveira
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Recife, PE, Brazil
| | - D A Duarte
- Department of Nuclear Energy, Federal University of Pernambuco, Recife, PE, Brazil
| | - A C D Antonino
- Department of Nuclear Energy, Federal University of Pernambuco, Recife, PE, Brazil
| | - C M Aguiar
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Recife, PE, Brazil
| | - A C Câmara
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Recife, PE, Brazil
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15
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Pandey SH, Patni PM, Jain P, Raghuwanshi S, Sanwatsarkar G, Chaturvedi A. Light emitting diode assessment of dentinal microcracks after root canal preparation with 4 different heat-treated file systems. Minerva Dent Oral Sci 2021; 70:257-262. [PMID: 34264044 DOI: 10.23736/s2724-6329.21.04523-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM The purpose of this research was to evaluate the dentinal microcracks formation after root canal preparation with Hyflex EDM (Electrical Discharge Machining), Neolix Neoniti A1 EDM, Wave One Gold and Edge File X1 under illumination and magnification. MATERIALS AND METHODS 150 mandibular molars with 2 different mesial canals extracted for periodontal reasons were included in the study. The samples were decoronated at 15mm from the apex using a carborundum disc under copious water cooling. Access opening was done using a round bur. Sectioning of the distal root was done. Patency of mesial canals were checked using a 10K file. The samples were randomly divided into 5 groups using simple randomization technique. Group 1: Uninstrumented group. Group 2: Hyflex EDM(HEDM). Group 3: Neolix Neoniti A1(NA1). Group 4: Wave One Gold (WOG). Group 5: Edge File X1(EFX). Biomechanical preparation in all groups was done following the manufacturer's instructions. Sectioning was done at 3mm, 6mm, and 9mm from the apex using a 0.13mm circular saw under copious water cooling. Sections were observed at 16x magnification under the dental operating microscope and illumination using a Light Emitting Diode (LED) curing light. The chi-square test was used to determine the statistically significant differences at P < .05. Intergroup comparison was done by the Post hoc Tukey test. RESULTS Total of 1800 images were analyzed. The highest number of cracks was seen in Neoniti A1 group (43.33%) while the least number of cracks were seen with Wave One Gold group (13.33%). There was statistically difference between reciprocating groups and the rotary group. CONCLUSIONS Within the limitations of this study, it can be concluded that all the heat-treated file systems produced dentinal microcracks. Rotary group(NA1 and HEDM) produced significantly more cracks than Reciprocation group (WOG and EFX).
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Affiliation(s)
- Sanket H Pandey
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India -
| | - Pallav M Patni
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Pradeep Jain
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Swadhin Raghuwanshi
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Gauri Sanwatsarkar
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
| | - Arpita Chaturvedi
- Department of Conservative Dentistry and Endodontics, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India
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Belladonna FG, Rodrigues LLC, Leal ASM, Oliveira HE, Maciel ACDC, Cavalcante DM, Silva EJNL, Valois ÉM, Souza EM, De-Deus G. Is canal overinstrumentation able to produce apical root dentinal microcracks in extracted teeth? Int Endod J 2021; 54:1647-1652. [PMID: 33932037 DOI: 10.1111/iej.13540] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/27/2021] [Indexed: 12/19/2022]
Abstract
AIM To assess the impact of mechanical overinstrumentation of root canals in extracted teeth on the development of dentinal microcracks in the apical portion of the root by means of micro-computed tomographic (micro-CT) analysis. Root canal preparation short of the canal terminus and at the apical foramen (AF) were used as controls. METHODOLOGY Twenty 2-rooted maxillary premolars with two canals were selected, scanned in a micro-CT device and the root canals prepared sequentially using Reciproc M-Wire R25 instruments to working lengths: 1 mm short of the AF (AF - 1 mm), at the AF (AF), and overinstrumentation (AF + 1 mm). A micro-CT scan of each specimen was performed after each time point. After reconstruction and co-registration procedures, the images were screened from the cementoenamel junction to the apex (n = 55 352) to identify the presence of dentinal microcracks in the apical third of the root. RESULTS After the analyses of 55 352 slices, dentinal microcracks were visualized in 12.45% of the images (6892 slices), with 5.73% (3174 slices) in the cervical, 3.57% (1976 slices) in the middle and 3.15% (1740 slices) in the apical third. All dentinal microcracks observed at all time points (AF - 1 mm, AF and AF + 1 mm) were already present in the corresponding images before canal instrumentation. Therefore, no new microcracks were detected, regardless of the working length used for canal instrumentation. CONCLUSION Reciprocating root canal preparation either short, at or beyond the AF (overinstrumentation) did not create dentinal microcracks in the roots of extracted 2-rooted maxillary premolars.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University (UFF), Niterói, Brazil
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Jamleh A, Alghilan M, Alsharif A, Alqahtani N, Aloqayli A, Aljarrah A. Vertical Load and Torque during Postspace Preparation and Their Influence on Microcrack Development. J Prosthodont 2021; 31:252-256. [PMID: 34021671 DOI: 10.1111/jopr.13392] [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] [Accepted: 05/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate, in vitro, the magnitudes of vertical load and torque generated during post space preparation of root canal treated teeth and their influence on microcrack development. MATERIALS AND METHODS Forty extracted premolars with single canals were decoronated. The roots were prepared using ProTaper Next system (Dentsply Sirona) to X3 file, obturated, and provisionalized. After a 3-week incubation period, the roots were distributed into 2 groups according to the post drill system used (ParaPost fiber post and RelyX fiber post). During post space preparation, the vertical load, torque, and preparation time were recorded. Before and after the post space preparation, the roots were imaged with micro-computed tomography (SkyScan 1172; Bruker micro-CT) to detect new microcracks. The data were analyzed using the Mann-Whitney U-test and chi-square test. RESULTS In ParaPost and RelyX, the post space was prepared in 48.31 ±25.28 and 47.71 ±13.36 seconds, respectively (p = 0.360). The peak vertical load generated with ParaPost (20.23 ±7.80 N) was significantly lower than that of RelyX (29.43 ±5.82 N) (p = 0.010). The maximum torque attained with ParaPost (1.42 ±0.61 N.cm) was found to be significantly lower than that of RelyX (3.23 ±1.58 N.cm) (p = 0.000). No post drill fracture or visible deformation was noticed throughout the experiment. New microcracks were found in three ParaPost samples only. CONCLUSIONS The choice of postdrill influenced the loads and torques generated during postspace preparation. The ParaPost system showed favorably lower load and torque values during the postspace preparation compared with the RelyX system.
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Affiliation(s)
- Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Centre, Ministry of 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, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Asma Alsharif
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nouf Alqahtani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,Department of Endodontics, King Abdulaziz Medical city, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulrahman Aloqayli
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,Orthodontics Resident, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulkader Aljarrah
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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18
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Aggarwal A, Nawal RR, Yadav S, Talwar S, Kunnoth S, Mahajan P. Comparative Evaluation of Dentinal Microcrack Formation before and after Root Canal Preparation Using Rotary, Reciprocating, and Adaptive Instruments at Different Working Lengths-A Micro-computed Tomographic Study. J Endod 2021; 47:1314-1320. [PMID: 34023360 DOI: 10.1016/j.joen.2021.05.004] [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: 11/21/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This study aimed to compare root dentinal microcrack formation after root canal shaping using rotary, reciprocating, and adaptive instruments at different working lengths using micro-computed tomographic imaging. METHODS One hundred eighty extracted mature mandibular molar mesial roots with 2 separate canals were selected. The mesial roots were resected at the cementoenamel junction and randomly divided into 4 groups (n = 45) based on the nickel-titanium file system used: ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer), Twisted File Adaptive (SybronEndo, Orange, CA), and Reciproc Blue (VDW, Munich, Germany). Each of the 4 groups were then subdivided into 3 groups (n = 15) depending on the working length used for root canal preparation (ie, instrumentation 1 mm short, flush, and 1 mm beyond the major apical foramen). The roots were imaged with micro-computed tomographic scanning before and after root canal preparation. The cross-sectional images generated were screened to detect the presence of new microcracks. RESULTS The ProTaper Universal system significantly increased the number of postinstrumentation microcracks at all working lengths (P ≤ .05). No significant increase (P > .05) in postinstrumentation microcracks was observed in the ProTaper Gold, Twisted File Adaptive, or Reciproc Blue groups. CONCLUSIONS Rotary instrumentation induced a higher number of dentinal microcracks compared with reciprocating and adaptive instruments. Instrumentation at different working lengths did not significantly influence the formation of dentinal microcracks.
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Affiliation(s)
- Arunima Aggarwal
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Ruchika Roongta Nawal
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Seema Yadav
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sangeeta Talwar
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India.
| | - Sriram Kunnoth
- Department of Applied Mechanics, Indian Institute of Technology, New Delhi, India
| | - Puneet Mahajan
- Department of Applied Mechanics, Indian Institute of Technology, New Delhi, India
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PradeepKumar AR, Shemesh H, Nivedhitha MS, Hashir MMJ, Arockiam S, Uma Maheswari TN, Natanasabapathy V. Diagnosis of Vertical Root Fractures by Cone-beam Computed Tomography in Root-filled Teeth with Confirmation by Direct Visualization: A Systematic Review and Meta-Analysis. J Endod 2021; 47:1198-1214. [DOI: 10.1016/j.joen.2021.04.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 12/19/2022]
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20
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Guha A, Pandharikar R, Shivangi S, Rao RD, Verma M, Jain AK. Comparative evaluation of dentinal crack formation after root canal preparation with Neoendo Flex and Mani Silk files: An in vitro study. J Conserv Dent 2021; 23:468-472. [PMID: 33911355 PMCID: PMC8066664 DOI: 10.4103/jcd.jcd_428_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/27/2020] [Accepted: 11/24/2020] [Indexed: 11/30/2022] Open
Abstract
Context: Neoendo Flex and Mani Silk are recently launched nickel–titanium (NiTi) rotary files. Dentinal cracks and file separation remain a critical problem in the endodontic domain. Aim: The aim was to evaluate and compare the incidence of dentinal crack formation after root canal preparation with Neoendo flex and Mani silk files. Materials and Methods: Thirty-six extracted single-rooted premolars with straight, single root canals were selected for the study. The specimens were randomly assigned to three groups, with 12 samples in each group. The root canal preparation for the three groups was done with hand K-file, Mani Silk, and Neoendo Flex files, respectively, following which the specimens were horizontally sectioned at 3, 6, and 9 mm from the apex. Sectioned samples were viewed under a stereomicroscope to determine the presence or absence of dentinal cracks. The data were analyzed using one-way ANOVA and Chi-square test. Results: Hand K-files and Mani Silk files produced a lesser number of cracks than Neoendo Flex files; however, the difference was not statistically significant among the three file groups at 3 mm and 6 mm (P > 0.05). A statistically significant difference between the groups was seen at 9 mm, where Mani Silk files produced fewer cracks than K files and Neoendo Flex files (P = 0.007). Overall, Neoendo Flex significantly produced more cracks than Mani Silk and hand K-files (P = 0.0029). Conclusions: Both hand K files and NiTi rotary instruments may cause dentinal cracks. Neoendo Flex files tend to produce more dentinal cracks than Mani silk and K-file.
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Affiliation(s)
- Ananya Guha
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Richa Pandharikar
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shreya Shivangi
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rahul D Rao
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Meenakshi Verma
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Ashish K Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
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21
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Influence of additional apical enlargement on microcrack formation in root dentine: a micro-computed tomography investigation. Clin Oral Investig 2021; 25:4137-4143. [PMID: 33409686 DOI: 10.1007/s00784-020-03745-z] [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: 07/15/2020] [Accepted: 12/15/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To assess the effect of additional apical enlargement using nickel titanium (NiTi) instruments on the incidence of microcracks using micro-computed tomographic analysis. MATERIALS AND METHODS Fifty-one premolars with single canals were enlarged to ProTaper Gold (PTG) F2 (25/08) (Dentsply Sirona), ProFile Vortex Blue (VB) 25/06 (Dentsply Tulsa), or WaveOne Gold (WOG) primary (25/07) (Dentsply Sirona) NiTi rotary instruments (n = 17 each). Afterward, additional apical enlargement was performed in each group with its corresponding larger instrument (F3 (30/09), VB 30/06, or WOG Medium (35/06) instruments, respectively). All teeth were imaged with micro-computed tomography before canal enlargement and after initial and additional apical enlargements to detect new microcracks at the apical 5 mm. An Aligned Rank Transform ANOVA was conducted to examine the effects of file type and canal enlargement on the number of new microcracks resulting from enlargement. A Kruskal-Wallis test was run to compare the file types at each canal enlargement stage. RESULTS A significant main effect (P = 0.026) of canal enlargement on the number of new microcracks was found; the number of apical microcracks found after additional enlargement was significantly greater than baseline (P = 0.021); no significant difference was found between baseline and initial enlargement (P = 0.506) and between initial enlargement and additional enlargement (P = 0.252). The Kruskal-Wallis tests found no difference between file types at baseline (P = 0.348), after initial enlargement (P = 0.369) or additional enlargement (P = 0.133). CONCLUSIONS Regardless of the instrumentation system used, additional apical enlargement led to the formation of high number of new microcracks. CLINICAL SIGNIFICANCE The results indicated that additional enlargement induced significant number of apical microcracks.
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Amiri P, Tour Savadkouhi S, abbasi M. Comparative Evaluation of Dentinal Microcrack Incidence After Root Canal Preparation by BioRaCe and Edge Taper Platinum. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2020. [DOI: 10.29252/jrdms.5.4.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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23
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Miguéns-Vila R, Martín-Biedma B, De-Deus G, Belladonna FG, Peña-López A, Castelo-Baz P. Micro-computed Tomographic Evaluation of Dentinal Microcracks after Preparation of Curved Root Canals with ProTaper Gold, WaveOne Gold, and ProTaper Next Instruments. J Endod 2020; 47:309-314. [PMID: 33096193 DOI: 10.1016/j.joen.2020.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the influence of rotary (ProTaper Next [PTN; Dentsply Maillefer, Ballaigues, Switzerland] and ProTaper Gold [PTG, Dentsply Maillefer]) and reciprocating (WaveOne Gold [WOG, Dentsply Maillefer]) systems in dentinal microcrack generation after the preparation of curved root canals using micro-computed tomographic analysis. METHODS Twenty-four human mandibular molars with curved roots were scanned in a micro-computed tomographic device using an isotropic resolution of 6.78 μm and randomly assigned into 1 of 3 experimental groups (n = 8) according to the root canal instrumentation system used (PTN, PTG, or WOG). Then, the root canals were prepared up to PTN X2, PTG F2, and WOG Primary instruments in the PTN, PTG, and WOG groups, respectively. After canal preparation, each specimen was scanned again. Pre- and postoperative cross-sectional images of the roots (N = 35,304) were analyzed to identify the presence of dentinal microcracks. RESULTS Overall, 26% of the images presented dentinal defects (n = 9188). Dentinal microcracks were observed in 24.6%, 26%, and 27.4% of the postinstrumentation images from the PTN, PTG, and WOG groups, respectively. However, all of these dentinal microcracks were already present in the corresponding preoperative images. No new microcracks were generated after the preparation of curved root canals of mandibular molars using the aforementioned systems. CONCLUSIONS Root canal instrumentation with PTN, PTG, and WOG systems did not induce the formation of new dentinal microcracks.
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Affiliation(s)
- Ramón Miguéns-Vila
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | | | - Gustavo De-Deus
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | | | - Pablo Castelo-Baz
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Palma PJ, Marques JA, Casau M, Santos A, Caramelo F, Falacho RI, Santos JM. Evaluation of Root-End Preparation with Two Different Endodontic Microsurgery Ultrasonic Tips. Biomedicines 2020; 8:biomedicines8100383. [PMID: 32998221 PMCID: PMC7601836 DOI: 10.3390/biomedicines8100383] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/19/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study is to compare root-end preparation performed with two different ultrasonic tips-CVDentus and NSK-and respective time requirements. After root-end resection, 32 teeth were randomly divided in two groups, according to the ultrasonic tip used for root-end preparation. Preparation time was recorded. Photomicrographs were taken to assess the following parameters: root surface microcracking, marginal integrity and presence of debris. One ultrasonic tip from each group was analyzed through scanning electron microscopy before and after root-end preparation. The significance level was set at α = 0.05. Incidence of microcracks in both groups was 12.5%. Solely intracanal microcracking was found, consistently positioned within the widest side of the remaining dentine. No statistically significant differences were verified between both experimental groups regarding marginal integrity (p = 0.102) and preparation time (p = 0.780), whereas statistical differences (p = 0.003) were found concerning the presence of debris (the minimum registered score was mostly verified in CVDentus group). NSK tips showed major morphological changes, with extensive surface wear and noticeable loss of particles, which was not verified on CVDentus tips. Our findings suggest significant differences regarding root-end preparation walls quality, with CVDentus tips showing better results. Concerning microcracking, as well as preparation time and marginal integrity, both ultrasonic tips showed similar results. Qualitative analysis exposed NSK tips major morphological changes and wear after use, which was not verified on CVDentus tips.
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Affiliation(s)
- Paulo J. Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Correspondence: ; Tel.: +351-239-249-151
| | - Joana A. Marques
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
| | - Margarida Casau
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (M.C.); (A.S.)
| | - André Santos
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (M.C.); (A.S.)
| | - Francisco Caramelo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Rui I. Falacho
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (J.A.M.); (J.M.S.)
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
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25
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Cavalcante DM, Belladonna FG, Simões‐Carvalho M, Carvalhal JCA, Souza EM, Lopes RT, Silva EJNL, Dummer PMH, De‐Deus G. Do pre‐existing microcracks play a role in the fracture resistance of roots in a laboratory setting? Int Endod J 2020; 53:1506-1515. [DOI: 10.1111/iej.13370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Affiliation(s)
- D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - J. C. A. Carvalhal
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís MaranhãoBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
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26
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Silva EJNL, Pinto KP, Ferreira CM, Belladonna FG, De-Deus G, Dummer PMH, Versiani MA. Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature. Int Endod J 2020; 53:1618-1635. [PMID: 32854167 DOI: 10.1111/iej.13391] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 12/14/2022]
Abstract
In the last decade, several access cavity designs involveing minimal removal of tooth tissue have been described for gaining entry to pulp chambers during root canal treatment. The premise behind this concept assumes that maximum preservation of as much of the pulp chamber roof as possible during access preparation would maintain the fracture resistance of teeth following root canal treatment. However, the smaller the access cavity, the more difficult it may be to visualize and debride the pulp chamber as well as locate, shape, clean and fill the canals. At the same time, a small access cavity may increase the risk of iatrogenic complications as a result of poor visibility, which may have an impact on treatment outcome. This study aimed to critically analyse the literature on minimal access cavity preparations, propose new nomenclature based on self-explanatory abbreviations and highlight the areas in which more research is required. The search was conducted without restrictions using specifics terms and descriptors in four databases. A complementary screening of the references within the selected studies, as well as a manual search in the highest impact journals in endodontics, namely International Endodontic Journal and Journal of Endodontics, was also performed. The initial search retrieved 1831 publications. The titles and abstracts of these papers were reviewed, and the full text of 94 studies was assessed. Finally, a total of 28 studies were identified as evaluating the influence of minimally invasive access cavity designs on the fracture resistance of teeth and on the different stages of root canal treatment (orifice location, canal shaping, canal cleaning, canal filling and retreatment). Overall, the studies had major methodological drawbacks and reported inadequate and/or inconclusive results on the utility of minimally invasive access preparations. Furthermore, they offered limited scientific evidence to support the use of minimally invasive access cavities to improve the outcome of root canal treatment and retreatment; they also provided little evidence that they preserved the fracture resistance of root filled teeth to a greater extent than traditional access cavity preparations. It was concluded that at present, there is a lack of supporting evidence for the introduction of minimally invasive access cavity preparation into routine clinical practice and/or training of undergraduate and postgraduate students.
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Affiliation(s)
- E J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - K P Pinto
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - C M Ferreira
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - F G Belladonna
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - G De-Deus
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - M A Versiani
- Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
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27
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Almeida A, Romeiro K, Cassimiro M, Gominho L, Dantas E, Silva S, Albuquerque D. Micro-CT analysis of dentinal microcracks on root canals filled with a bioceramic sealer and retreated with reciprocating instruments. Sci Rep 2020; 10:15264. [PMID: 32943675 PMCID: PMC7498450 DOI: 10.1038/s41598-020-71989-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022] Open
Abstract
This study aimed to analyze the potential occurrence of dentinal defects after the removal of a root canal filling with two different sealers using Reciproc (RC) or Reciproc Blue (RB). The mesial roots of 60 mandibular molars with a Vertucci type IV configuration were selected. The samples were initially instrumented with Reciproc (R25) and then divided into the following four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC); BC Sealer/Reciproc Blue (BCRB); AH Plus/Reciproc (AHRC); and AH Plus/Reciproc Blue (AHRB). Then, the samples were scanned under micro-CT after obturation and removal of the filling material. Two analyses were conducted. First, an evaluation was performed on all the axial images, and another analysis evaluated each millimeter of the 10 mm from the apex. Dentinal defects were observed in all the samples. All of the identified defects in the images after filling material removal were present in the corresponding images after obturation. The use of AH Plus and EndoSequence BC Sealer, and filling material removal using RC and RB instruments did not induce dentinal defects.
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Affiliation(s)
- Andressa Almeida
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil.
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Marcely Cassimiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Luciana Gominho
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Eugênia Dantas
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Silmara Silva
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
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28
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Zuli TAB, Guedes OA, Gonçalves GFZA, da Silva Júnior AR, Borges ÁH, Aranha AMF. Effect of post space preparation drills on the incidence of root dentin defects. Restor Dent Endod 2020; 45:e53. [PMID: 33294418 PMCID: PMC7691261 DOI: 10.5395/rde.2020.45.e53] [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: 02/21/2020] [Revised: 05/03/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. Materials and Methods Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance. Results Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). Conclusions PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.
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Affiliation(s)
| | - Orlando Aguirre Guedes
- Department of Endodontics, School of Dentistry, Centro Universitário de Anápolis - UniEvangélica, Anápolis, GO, Brazil
| | | | | | - Álvaro Henrique Borges
- Department of Oral Sciences, School of Dentistry, University of Cuiabá - UNIC, Cuiabá, MT, Brazil
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29
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Lopes FC, Roperto R, Akkus A, de Queiroz AM, Francisco de Oliveira H, Sousa-Neto MD. Effect of carbodiimide and chlorhexidine on the bond strength longevity of resin cement to root dentine after radiation therapy. Int Endod J 2019; 53:539-552. [PMID: 31715008 DOI: 10.1111/iej.13252] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/11/2019] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effect of carbodiimide (EDC) and chlorhexidine (CHX) on the bond strength (BS) of resin cement to root dentine of teeth submitted to radiotherapy. METHODOLOGY One hundred and twenty extracted maxillary canines were selected and assigned to 2 groups (n = 60): nonirradiated and irradiated (30 cycles of 2 Gy, total 60 Gy). Roots lengths were standardized, and canals were prepared and filled. Post spaces were then prepared, and the samples were redistributed according to dentine treatment (n = 20): saline solution (SF); CHX 2%; or EDC 0.5M. After drying the post space, fibreglass posts were cemented. Cross-sectioned slices were obtained, and in half of the specimens of each subgroup (n = 10), the analysis was performed immediately; the others (n = 10) were stored for 10 months before analyses. The most cervical slice of each third was subjected to a push-out test and failure pattern analysis (n = 10), and the most apical slice submitted to the analysis of the adhesive interface by SEM (n = 5). The bond strength data were submitted to anova and Tukey tests, the adhesive interface adaptation was submitted to Kruskal-Wallis and Dunn's tests, and the Chi-square test was used to evaluate the type of failure. RESULTS The irradiated specimens had significantly lower bond strength (13.8 ± 4.3) than the nonirradiated (18.1 ± 3.1; P < 0.001). For the irradiated teeth, the bond strengths were significantly lower in the SF and CHX groups (P < 0.001). Also, the bond strengths reduced significantly after 10 months in the SF and CHX groups (P < 0.001). Cohesive failures occurred in dentine for irradiated specimens. Poorer interface adaptation, dentine fractures and microfractures were observed in irradiated specimens, and better adaptation was observed for specimens after EDC treatment. CONCLUSIONS Radiotherapy was associated with lower bond strength and worse interface adaptation. Dentine treatment with EDC contributed to adhesive interface longevity during the cementation of glass fibre posts in nonirradiated and irradiated teeth.
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Affiliation(s)
- F C Lopes
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - R Roperto
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - A Akkus
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.,Department of Macromolecular Science and Engineering, School of Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - A M de Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - H Francisco de Oliveira
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - M D Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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30
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Arashiro FN, De‐Deus G, Belladonna FG, Cavalcante DM, Coelho MS, Silva EJNL, Pereira KFS, Silva PG, Lopes RT, Souza EM. Dentinal microcracks on freshly extracted teeth: the impact of the extraction technique. Int Endod J 2019; 53:440-446. [DOI: 10.1111/iej.13239] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- F. N. Arashiro
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - M. S. Coelho
- Faculty of Dentistry São Leopoldo Mandic Campinas Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Brazil
| | - K. F. S. Pereira
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - P. G. Silva
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
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31
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Microcomputed tomography assessment of microcracks following temporary filling placement. Clin Oral Investig 2019; 24:1387-1393. [DOI: 10.1007/s00784-019-03093-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/22/2019] [Indexed: 10/25/2022]
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32
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PradeepKumar AR, Shemesh H, Archana D, Versiani MA, Sousa-Neto MD, Leoni GB, Silva-Sousa YT, Kishen A. Root Canal Preparation Does Not Induce Dentinal Microcracks In Vivo. J Endod 2019; 45:1258-1264. [DOI: 10.1016/j.joen.2019.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/24/2019] [Accepted: 06/27/2019] [Indexed: 01/05/2023]
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33
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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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34
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Çapar İD, Gök T, Uysal B, Keleş A. Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techniques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation. Microsc Res Tech 2019; 82:1748-1755. [PMID: 31313438 DOI: 10.1002/jemt.23341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/19/2019] [Accepted: 06/24/2019] [Indexed: 11/10/2022]
Abstract
The aim of the study was to compare different imaging methods in the diagnosis of microcracks on root dentin and to evaluate the frequency of dentinal microcracks observed after root canal preparation using the ProTaper Universal (PTU) system of different sizes. A total of 30 mandibular molars' mesial roots were scanned with microcomputed tomography (micro-CT) and cone beam computed tomography (CBCT) imaging methods before instrumentation. Root canal instrumentation was performed up to PTU F2 and F4 files. After instrumentation stages, the roots were scanned again with micro-CT and then with CBCT in same parameters. All roots were sectioned horizontally at 2, 4, 6, 8, and 10 mm from the apices of the specimens. The sections were imaged under a stereomicroscope. Finally, imaging of the sections was done by scanning electron microscopy (SEM). Statistical data analysis of instrumentation steps was performed using Friedman and Wilcoxon tests, and the data of imaging methods were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p = .05). Instrumentation with the PTU system up to F2 and F4 files significantly increased the number of microcracks compared with preoperative samples according to micro-CT imaging (p < .05). For detecting microcracks on the root dentin, there were no statistically significant differences between micro-CT (43.9%) and stereomicroscopy (45.8%) (p < .05). SEM showed significantly higher percentage of microcracks (88.3%) (p > .05). No microcrack was observed using the CBCT method. There were no statistically differences between micro-CT and stereomicroscopy. SEM showed more dentinal microcracks while no microcrack was observed with CBCT.
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Affiliation(s)
- İsmail D Çapar
- Private Practice, Periodent Dental Clinic, İstanbul, Turkey
| | - Tuba Gök
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Banu Uysal
- Private Practice, Pros' Esthetic Oral and Dental Health Clinic, İzmir, Turkey
| | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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35
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PradeepKumar AR, Shemesh H, van Loveren C, JothiLatha S, Shireen F, VijayaBharathi R, Kishen A. Impact of apical extent of root canal filling on vertical root fracture: a case–control study. Int Endod J 2019; 52:1283-1289. [DOI: 10.1111/iej.13134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- A. R. PradeepKumar
- Department of Conservative Dentistry & Endodontics Thai Moogambigai Dental College & Hospital Dr. MGR Educational and Research Institute Chennai India
| | - H. Shemesh
- Department of Endodontology Academic Centre for Dentistry Amsterdam(ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - C. van Loveren
- Department of Cariology, Endodontology and Pedodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - S. JothiLatha
- Department of Conservative Dentistry and Endodontics Tamil Nadu Government Dental College and Hospital Chennai India
| | | | - R. VijayaBharathi
- Department of Dental and Maxillofacial Surgery SMF‐Dr. Rangarajan Memorial Hospital Chennai India
| | - A. Kishen
- Faculty of Dentistry University of Toronto, Department of Dentistry and Mount Sinai Hospital, Sinai Health System Toronto Ontario Canada
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36
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Rödig T, Krämer J, Müller C, Wiegand A, Haupt F, Rizk M. Incidence of microcracks after preparation of straight and curved root canals with three different NiTi instrumentation techniques assessed by micro-CT. AUST ENDOD J 2019; 45:394-399. [PMID: 30907062 DOI: 10.1111/aej.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2019] [Indexed: 01/31/2023]
Abstract
This study evaluated the effect of three different NiTi instrumentation techniques on the incidence of microcracks after the preparation of straight and curved root canals using micro-CT. Roots from mandibular premolars and maxillary molars (n = 66) with the same mean canal curvatures were assigned to three groups of straight and three groups of curved roots (n = 11). After preoperative micro-CT scans, root canals were prepared with Reciproc, OneShape and ProTaper Next to size 25. Specimens were scanned again, and pre- and post-operative cross-sectional images (n = 75 263) were screened to identify the presence of dentinal microcracks. Overall, microcracks were detected in 2.97% (n = 2236) of the cross-sectional images. No new dentinal microcracks were observed after root canal instrumentation of straight and curved canals with the tested NiTi systems. Instrumentation with Reciproc, OneShape and ProTaper Next did not induce the formation of dentinal microcracks irrespective of canal curvature.
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Affiliation(s)
- Tina Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Juliane Krämer
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Christine Müller
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Franziska Haupt
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Marta Rizk
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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37
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Alsolaihim A, Alsolaihim A, Alowais L. In vivo and in vitro diagnosis of cracked teeth: A review. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_92_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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38
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Brosh T, Metzger Z, Pilo R. Circumferential root strains generated during lateral compaction with stainless steel vs. nickel-titanium finger spreaders. Eur J Oral Sci 2018; 126:518-525. [DOI: 10.1111/eos.12569] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Tamar Brosh
- Department of Oral Biology; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Zvi Metzger
- Department of Endodontology; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Raphael Pilo
- Department of Oral Rehabilitation; The Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
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39
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Yamin PA, Pereira RD, Lopes FC, Queiroz AM, Oliveira HF, Saquy PC, Sousa-Neto MD. Longevity of bond strength of resin cements to root dentine after radiation therapy. Int Endod J 2018; 51:1301-1312. [PMID: 29729026 DOI: 10.1111/iej.12945] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 04/26/2018] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the bond strength and adhesive interface between several resin cements and root dentine immediately and 6 months after radiotherapy. METHODOLOGY Sixty maxillary canines were selected and randomly assigned to two groups (n = 30): one group was not irradiated and the other one was subjected to a cumulative radiation dose of 60 Gy. The teeth were sectioned to obtain roots 16 mm long and the canals were prepared with the Reciproc system (R50) and filled using a lateral condensation technique with an epoxy resin sealer. Each group was divided into three subgroups (n = 10) according to the resin cement used for fibreglass fibre post cementation: RelyX-U200, Panavia-F2.0 and RelyX ARC. The posts were cemented in accordance with the manufacturer's recommendations. Three 1-mm-thick dentine slices were then obtained from each root third. The first two slices in the crown-apex direction of each third were selected for the push-out test. The failure mode after debonding was determined with a stereo microscope. The third slice from each root third was selected for scanning electron microscopy (SEM) analyses to examine the resin cement-dentine interface with 100, 1000, 2000 and 4000× magnification. Bond strength data were analysed by anova and Tukey's test (α = 0.05). RESULTS Significantly lower bond strength (P < 0.0001) was obtained after irradiation compared to nonirradiated teeth. RelyX-U200 cemented fibre posts had the higher bond strength (15.17 ± 5.89) compared with RelyX ARC (P < 0.001) and Panavia-F2.0 (P < 0.001). The evaluation after 6 months revealed lower bond strength values compared to the immediate values (P < 0.001) for irradiated and nonirradiated teeth. Cohesive failures occurred in the irradiated dentine. SEM revealed fractures, microfractures and fewer collagen fibres in irradiated root dentine. RelyX-U200 and Panavia-F2.0 were associated with a juxtaposed interface of the cement with the radicular dentine in irradiated and nonirradiated teeth, and for RelyX ARC, hybrid layer formation and tags were observed in both irradiated and nonirradiated teeth. CONCLUSION Radiation was associated with a decrease in the push-out bond strength and with lower resin cement/root dentine interface adaptation. Self-adhesive resin cement was a better alternative for fibre post cementation in teeth subjected to radiation therapy. The bond strength decreased after 6 months.
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Affiliation(s)
- P A Yamin
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - R D Pereira
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - F C Lopes
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - A M Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, Ribeirão Preto, Brazil
| | - H F Oliveira
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - P C Saquy
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - M D Sousa-Neto
- Department of Restorative Dentistry, University of São Paulo, Ribeirão Preto, Brazil
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Carlesi T, Nigro G, Giacomo LD, Plotino G, Malagnino VA. Dentinal Microcrack Formation During Root Canal Treatment with Mtwo Instruments and MicroSeal Filling Technique. JOURNAL OF ADVANCED ORAL RESEARCH 2018. [DOI: 10.1177/2320206818801260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective:The purpose of this study was to evaluate dentinal microcrack formation during root canal treatment using Mtwo NiTi rotary instruments and MicroSeal filling technique.Materials and Methods:Forty-five single-rooted teeth were selected for the present study and divided into 3 different groups ( n = 15): Group 1, in which root canals were instrumented with Mtwo rotary files; Group 2, in which root canals were instrumented with Mtwo rotary files and filled using the MicroSeal technique; and Group 3, that acts as a control group in which no instrumentation nor obturation were performed. Then, roots were sectioned 3 mm, 6 mm, and 9 mm from the apex and the cut surface has been observed under a stereomicroscope to check for the presence or absence of dentinal microcracks. Number of dentinal microcracks was registered for each group at different levels and data were statistically analyzed using the Chi-square test with a level of significance set at P < .05.Results:No statistically significant differences were registered among groups ( P < .05). No microcracks were detected in Groups 1 and 3, while two dentinal microcracks were registered in Group 2.Conclusions:Mtwo rotary instruments and the MicroSeal root canal filling technique did not significantly induce dentinal microcrack formation.
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Affiliation(s)
- Teocrito Carlesi
- Unit of Endodontics, Department of Oral Science, Nano and Biotechnology, University of “G. d’Annunzio” Chieti–Pescara, Chieti, Italy
| | - Giuseppe Nigro
- Unit of Endodontics, Department of Oral Science, Nano and Biotechnology, University of “G. d’Annunzio” Chieti–Pescara, Chieti, Italy
| | - Luigi Di Giacomo
- Unit of Endodontics, Department of Oral Science, Nano and Biotechnology, University of “G. d’Annunzio” Chieti–Pescara, Chieti, Italy
| | - Gianluca Plotino
- Private Practice, Grande Plotino & Torsello Studio di Odontoiatria, Rome, Italy
| | - Vito Antonio Malagnino
- Unit of Endodontics, Department of Oral Science, Nano and Biotechnology, University of “G. d’Annunzio” Chieti–Pescara, Chieti, Italy
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Dehydration Induces Cracking in Root Dentin Irrespective of Instrumentation: A Two-dimensional and Three-dimensional Study. J Endod 2018; 44:120-125. [DOI: 10.1016/j.joen.2017.07.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 07/27/2017] [Accepted: 07/31/2017] [Indexed: 12/20/2022]
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42
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Bayram HM, Bayram E, Ocak M, Uzuner MB, Geneci F, Celik HH. Micro–computed Tomographic Evaluation of Dentinal Microcrack Formation after Using New Heat-treated Nickel-titanium Systems. J Endod 2017; 43:1736-1739. [DOI: 10.1016/j.joen.2017.05.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/26/2017] [Accepted: 05/30/2017] [Indexed: 11/24/2022]
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43
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Bucchi C, Gimeno-Sandig A, Manzanares-Céspedes C. Enlargement of the apical foramen of mature teeth by instrumentation and apicoectomy. A study of effectiveness and the formation of dentinal cracks. Acta Odontol Scand 2017; 75:488-495. [PMID: 28678588 DOI: 10.1080/00016357.2017.1344877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In the last few years there have been attempts to revascularize mature necrotic teeth instead of performing a standard root canal treatment. Apical foramen enlargement (AFE) would be necessary for regenerative treatments of mature teeth. In the literature, AFE has been made through apicoectomy and instrumentation. However, no standardized methods have been described yet, which may affect the success of the therapy. Our aim was to describe the effectiveness and damage to dental structures of five methods for AFE. METHODS Two hundred and ten human teeth were assigned to one control group (n = 10) and four treatment groups (n = 50 each): instrumentation was up to file #80 0.5 mm coronal to the apex (I), at apex level (II), 0.5 mm beyond the apex (III) and apicoectomy at 2 and 4 mm from the apex (IV). The apical foramen diameter was measured before and after treatment. The formation of clinically visible fractures (CVF) and microcracks was analysed clinically and with ESEM, respectively. Thirty-two in situ sheep's teeth were also instrumented, to compare damage in in situ and ex vivo teeth. RESULTS The foramen diameter was augmented by 0.15, 0.47, 0.54 0.06 and 0.32 mm in human teeth of groups I, II, III, apicoectomy at 2 and 4 mm, respectively. CVF were more frequent as the working length was augmented. No statistical differences were found for microcrack formation. In situ teeth showed significantly less damage. CONCLUSIONS Instrumentation at apex level seems to be the most effective and least harmful technique for AFE, while apicoectomy is not a useful method.
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Affiliation(s)
- Cristina Bucchi
- Department of Patology and Experimental Terapeuthics, Universidad de Barcelona, Barcelona, Spain
- Department of Integral Adult Dentistry, CICO Research Centre, Universidad de La Frontera, Temuco, Chile
| | - Alvaro Gimeno-Sandig
- Biotherium Campus Bellvitge, Scientific and Technological Centers, Universidad de Barcelona, Barcelona, Spain
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Rödig T, Müller C, Hoch M, Haupt F, Schulz X, Wiegand A, Rizk M. Moisture content of root canal dentine affects detection of microcracks using micro-computed tomography. Int Endod J 2017; 51:357-363. [DOI: 10.1111/iej.12850] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/24/2017] [Indexed: 01/02/2023]
Affiliation(s)
- T. Rödig
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - C. Müller
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - M. Hoch
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - F. Haupt
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - X. Schulz
- Department of Medical Statistics; University Medical Center Göttingen; Göttingen Germany
| | - A. Wiegand
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - M. Rizk
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
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Coelho MS, Card SJ, Tawil PZ. Light-emitting diode assessment of dentinal defects: the role of presumed extraction forces. Restor Dent Endod 2017; 42:232-239. [PMID: 28808640 PMCID: PMC5553023 DOI: 10.5395/rde.2017.42.3.232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/09/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives The evaluation of iatrogenic dentinal defects in extracted teeth may be influenced by extraction forces and prolonged dry times. The purpose of this study was to compare the presence of dentinal defects in freshly extracted, periodontally compromised teeth with those in a group of teeth with uncontrolled extraction forces and storage time. Materials and Methods The experimental group consisted of eighteen roots obtained from teeth extracted due to periodontal reasons with class II or III mobility. They were kept in saline and sectioned within 1 hour following extraction. The control group consisted of matched root types obtained from an anonymous tooth collection, consistent with previous dentinal defect studies. The slices were obtained at 3, 6, and 9 mm from the apex. The imaging process exposed all specimens to no more than 60 seconds of dry time. The × 12.8 magnification was used for the 9 mm slices and × 19.2 magnification for the 3 mm and 6 mm slices under light-emitting diode (LED) transillumination. The root canal spaces and periodontal tissues were masked to minimize extraneous factors that might influence the evaluators. Chi-square test was used for statistical analysis. Results Dentinal defects were detected in 17% of the experimental group teeth, compared to 61% of control teeth (p = 0.015). Conclusions LED transillumination assessment of freshly extracted roots with class II or III mobility showed smaller number of dentinal defects than roots with uncontrolled storage time and extraction forces. The use of freshly extracted roots with mobility should be considered for future dental defect assessment studies.
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Affiliation(s)
- Marcelo Santos Coelho
- Department of Endodontics, Universidade Paulista School of Dentistry, Sorocaba, SP, Brazil
| | - Steven J Card
- Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
| | - Peter Z Tawil
- Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
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Dentinal Microcrack Development after Canal Preparation: A Longitudinal in Situ Micro-computed Tomography Study Using a Cadaver Model. J Endod 2017; 43:1553-1558. [PMID: 28735793 DOI: 10.1016/j.joen.2017.04.027] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 04/23/2017] [Accepted: 04/24/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the development of dentinal microcracks after root canal preparation with Reciproc and ProTaper Universal systems using an in situ cadaver model by means of a micro-computed tomography (micro-CT) imaging system. METHODS At autopsy, 8 maxillary bone blocks having at least the first and second premolar teeth (n = 16) were excised, scanned at a resolution of 13.18 μm, and randomly distributed into 2 groups (n = 8) according to the preparation protocol: Reciproc and ProTaper Universal systems. Root canals were prepared up to R25 and F2 instruments in the Reciproc and ProTaper Universal groups, respectively. After the preparation procedures, the specimens were scanned again, and the registered preoperative and postoperative cross-section images of the roots (n = 19,060) were screened to identify the presence of dentinal defects. RESULTS In the Reciproc group, 9176 cross-section images were analyzed, and no crack was observed. In the ProTaper Universal group, 244 of 9884 cross-section slices (2.46%) had dentinal defects; however, all defects were already present in the corresponding preoperative images, indicating that no new microcrack was created after canal preparation. CONCLUSIONS In situ root canal preparation of maxillary premolars with Reciproc and ProTaper Universal systems did not induce the formation of dentinal microcracks in a cadaver model as observed by micro-CT.
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Bayram HM, Bayram E, Ocak M, Uygun AD, Celik HH. Effect of ProTaper Gold, Self-Adjusting File, and XP-endo Shaper Instruments on Dentinal Microcrack Formation: A Micro–computed Tomographic Study. J Endod 2017; 43:1166-1169. [DOI: 10.1016/j.joen.2017.02.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 02/01/2017] [Accepted: 02/12/2017] [Indexed: 11/15/2022]
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Preexisting Dentinal Microcracks in Nonendodontically Treated Teeth: An Ex Vivo Micro–computed Tomographic Analysis. J Endod 2017; 43:896-900. [DOI: 10.1016/j.joen.2017.01.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/14/2017] [Accepted: 01/17/2017] [Indexed: 11/22/2022]
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49
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Zuolo ML, De-Deus G, Belladonna FG, Silva EJNLD, Lopes RT, Souza EM, Versiani MA, Zaia AA. Micro–computed Tomography Assessment of Dentinal Micro-cracks after Root Canal Preparation with TRUShape and Self-adjusting File Systems. J Endod 2017; 43:619-622. [DOI: 10.1016/j.joen.2016.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/12/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
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Pirani C, Friedman S, Gatto MR, Iacono F, Tinarelli V, Gandolfi MG, Prati C. Survival and periapical health after root canal treatment with carrier-based root fillings: five-year retrospective assessment. Int Endod J 2017; 51 Suppl 3:e178-e188. [DOI: 10.1111/iej.12757] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 02/15/2017] [Indexed: 11/30/2022]
Affiliation(s)
- C. Pirani
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - S. Friedman
- Faculty of Dentistry; University of Toronto; Toronto Ontario Canada
| | - M. R. Gatto
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - F. Iacono
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - V. Tinarelli
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - M. G. Gandolfi
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - C. Prati
- Endodontic Clinical Section; Department of Biomedical and Neuromotor Sciences (DIBINEM); School of Dentistry; Alma Mater Studiorum University of Bologna; Bologna Italy
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