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Al Omari T, Atmeh AR, Algahtani FN, Dkmak A, Albanna RHI, Tabnjh A. The effect of irrigation solution temperature and novel heat-treated rotary files on apical debris extrusion and canal preparation time. AUST ENDOD J 2024. [PMID: 39022875 DOI: 10.1111/aej.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/27/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
This study aimed to compare apical debris extrusion and canal preparation time with ProTaper Gold (PTG) and ProTaper Ultimate (PTU) files at different temperatures. Mesio-buccal roots of 60 mandibular first molars were distributed into six groups depending on the file type (PTG, PTU) and irrigation solution temperature (20, 37, 45°C). During instrumentation, extruded debris were collected and weighed to measure the mass in milligrams. The canal preparation time was recorded in seconds. ANOVA followed by Bonferroni post-hoc tests were used for analysis. The amount of debris extrusion was significantly higher in PTU, which was affected by the irrigation solution temperature (p < 0.05). The difference in canal preparation time was not significant between the two file systems, however, it was significant between the different temperatures (p = 0.001). Both file systems had shorter canal preparation times at 20°C. The irrigation solution temperature could influence the debris extrusion and time of canal preparation.
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Affiliation(s)
- Taher Al Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Amre R Atmeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Fahda N Algahtani
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Alaa Dkmak
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami Haitham Issa Albanna
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Abedelmalek Tabnjh
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Ahmad MZ. Assessment of Debris Extrusion in Curved Canals: An In Vitro Analysis of Various Single-File Endodontic Instrumentation Systems. Int J Dent 2024; 2024:8367693. [PMID: 39007058 PMCID: PMC11245337 DOI: 10.1155/2024/8367693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/27/2024] [Accepted: 05/31/2024] [Indexed: 07/16/2024] Open
Abstract
Objectives Rotary single-file endodontic systems are commonly used for root canal treatment. However, very few studies have evaluated the apical extrusion of debris generated by these systems during canal preparation at normal body temperature in laboratory conditions. The aim of this study was to evaluate the amount of apically extruded debris caused by seven different single-file endodontic instrumentation systems at body temperature in mandibular molar teeth with curved root canals. Methods One hundred forty mandibular first permanent molars were randomly divided into seven groups (n = 20) to be prepared by one of the following systems at 35°C: Reciproc Blue (REC Blue), WaveOne Gold (WOG), One Reci (OR), Neoniti, HyFlex EDM (HEDM), One Curve (OC), or XP Shaper (XPS). Debris was collected into preweighted Eppendorf tubes. The weight of the extruded debris was recorded by subtracting the weight of the tooth-free apparatus from the post-procedure weight. Data were analyzed by one-way ANOVA and Tukey's tests (p < 5%). Results REC Blue, WOG, and OR groups extruded significantly more debris from the apex than XPS, OC, and Neoniti groups (p < 0.05). No significant difference was observed among the XPS, OC, Neoniti, and HEDM groups (p > 0.05). Conclusion All the instruments were associated with debris extrusion. However, REC Blue, WOG, and OR extrude significantly more debris than other instruments. The amount of debris with different files was REC Blue > OR > WOG > HEDM > OC > Neoniti > XPS. XPS, Neoniti, and OC caused significantly less extrusion of debris than REC Blue, WOG, and OR.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Department of Conservative Dental Sciences College of Dentistry Qassim University, Buraydah 52571, Saudi Arabia
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Abat VH, Bayrak GD, Gündoğar M. Assessment of apical extrusion in regenerative endodontics: a comparative study of different irrigation methods using three-dimensional immature tooth models. Odontology 2024:10.1007/s10266-024-00961-x. [PMID: 38913232 DOI: 10.1007/s10266-024-00961-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 06/04/2024] [Indexed: 06/25/2024]
Abstract
To investigate the apical extrusion of sodium hypochlorite in immature permanent teeth caused by conventional syringe irrigation (CSI), EDDY, XP-endo Finisher file (XP-F), and a new laser irrigation activation system [shock-wave-enhanced-emission-photo-acoustic-streaming (SWEEPS)]. Three-dimensionally printed forty-nine teeth with immature central incisor morphology were randomly assigned to seven experimental groups, based on the irrigation activation methods and insertion depths (1 mm and 2 mm short of the working length) as follows: CSI-1, CSI-2, EDDY-1, EDDY-2, XP-1, XP-2, and SWEEPS. Prior to the irrigation activation process, samples were placed in metacresol mixed agar gel in Eppendorf tubes. To evaluate NaOCI extrusion into the gel, each sample was digitally photographed, and the area of apical extrusion was analyzed using ImageJ software. To examine potential significant differences between the continuous variables, the Mann-Whitney U test and Kruskal-Wallis H test, were applied (P = .05). The SWEEPS resulted in a greater amount of apical extrusion compared to the CSI method, regardless of the insertion depth (P < 0.001). The SWEEPS resulted in greater apical extrusion scores compared to EDDY-2 (P < 0.001). The EDDY-1 resulted in greater amount of apical extrusion scores compared to EDDY-2 (P < 0.001). This study, the first to show the effect of the novel SWEEPS technology on NaOCI extrusion, found that irrigation activation can cause different levels of apical extrusion depending on the method and distance from the working length. It is crucial to consider the potential occurrence of apical extrusion when applying activation methods to immature teeth.
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Affiliation(s)
- Vahide Hazal Abat
- Department of Endodontics, Faculty of Dentistry, Uskudar University, Istanbul, Turkey.
| | - Gökçen Deniz Bayrak
- Department of Pediatric Dentistry, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
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Xiqian L, Ying Z, Mian M. The effect of apical patency on postoperative pain following endodontic therapy: A systematic review and meta-analysis. Eur J Oral Sci 2024; 132:e12986. [PMID: 38632110 DOI: 10.1111/eos.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
This systematic review and meta-analysis aimed to determine whether apical patency increases postoperative pain after endodontic therapy. This study explored the degree and incidence of postoperative pain during root canal therapy, as well as the number of required analgesic doses. We searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from the date of database inception until May 2023. RevMan 5.4 software was used for data analysis. Twelve studies were considered eligible for meta-analysis. The mean pain scores on days 1 (mean difference [MD] = -1.69) and 2 (MD = -0.85) differed significantly between the apical patency and non-patency groups. The odds for pain after 24 h were significantly lower (OR 0.59) in the apical patency group than in the non-patency group. Furthermore, the mean number of required analgesic doses was not significantly different between the two groups. In conclusion, apical patency significantly alleviated postoperative pain (low-quality evidence) and reduced the incidence of pain (moderate evidence). However, high-quality randomized controlled trials are required to validate these findings.
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Affiliation(s)
- Liu Xiqian
- Department of Stomatology, Changzhi Medical College Affiliated Heping Hospital, Changzhi City, Shanxi Province, China
| | - Zhai Ying
- Department of Stomatology, Yangquan Coal Industry Group General Hospital, Yangquan City, Shanxi Province, China
| | - Mao Mian
- Department of Pharmacy, Sichuan Cancer Hospital and Institute, Chengdu, China
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Parkar A, Banga KS, Pawar AM, Luke AM. Extrusion of Sodium Hypochlorite in Oval-Shaped Canals: A Comparative Study of the Potential of Four Final Agitation Approaches Employing Agarose-Embedded Mandibular First Premolars. J Clin Med 2024; 13:2748. [PMID: 38792290 PMCID: PMC11121930 DOI: 10.3390/jcm13102748] [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: 04/05/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of this investigation was to assess the apical extrusion potential of sodium hypochlorite (NaOCl) in agarose-embedded mandibular first premolars employing four final agitation procedures. Methods: Based on CBCT confirmation of single oval-shaped canals, one hundred extracted mandibular first premolars were chosen. Using 5.25% NaOCl, the teeth were prepared using the XP Endo Shaper and divided into experimental and control groups. The following were the experimental groups: Group 1 comprised the XP-Endo Finisher, Group 2 the Ultrasonic Activation, Group 3 the Gentle File Finisher Brush, and Group 4 the 27-gauge side-vented needle. To test extrusion, the teeth were placed in a 0.2% agarose gel that contained the pH-sensitive dye m-cresol purple, allowing pixel quantification via ImageJ software (version 1.54i). Results: The XP Endo Finisher featured the most pixels, depicting higher apical extrusion (p < 0.01), followed by the side-vented needle, Gentle File Finisher Brush, and PUI, while the Control Group endured no extrusion. Conclusions: The effective irrigation method for root canal therapy is critical, especially in situations of open apices, resorption, or perforation. According to in vitro experiments, the XP-Endo Finisher has the maximum sodium hypochlorite extrusion, which is determined by parameters such as apical preparation size and irrigation system.
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Affiliation(s)
- Aalisha Parkar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Kulvinder Singh Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates;
- Centre of Medical and Bio-Allied Health Science Research (CMBHSR), Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates
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Al-Ani AM, Ali AH, Koller G. Assessment of Bacterial Load and Post-Endodontic Pain after One-Visit Root Canal Treatment Using Two Types of Endodontic Access Openings: A Randomized Controlled Clinical Trial. Dent J (Basel) 2024; 12:88. [PMID: 38668000 PMCID: PMC11049031 DOI: 10.3390/dj12040088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The need for controlling bacteria and pain during root canal therapy is undeniable. This clinical trial aimed to assess whether there is a difference in colony-forming unit (CFU) reduction after instrumentation and post-endodontic pain after root canal treatment (RCT) using a traditional endodontic cavity (TEC) versus a conservative endodontic cavity (CEC). This clinical study was conducted on 89 patients designated for a single-visit RCT. Patients were allocated randomly (TEC n = 45 and CEC n = 44). The access opening was gained accordingly in each group by a single operator. A pre-instrumentation sample of root canal dentin was collected using an endodontic file; the second sample was collected similarly, right after shaping and cleaning the root canal. The CFU was calculated based on the samples collected. The pain level was recorded preoperatively and at 1, 7, and 21 days postoperatively utilizing a visual analog scale (VAS). There were no statistically significant differences in the CFU reduction between the TEC and CEC groups (p > 0.05). Additionally, there were no statistically significant differences found in postoperative pain levels between the TEC and CEC at 1, 7, and 21 days (p > 0.05). Despite the limitations of this study, both the CEC and TEC demonstrate a decrease in bacteria within the root canals and alleviate postoperative pain with no difference between them.
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Affiliation(s)
- Ahmed M. Al-Ani
- Aesthetic and Restorative Dentistry Department, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq;
| | - Ahmed H. Ali
- Aesthetic and Restorative Dentistry Department, College of Dentistry, University of Baghdad, Baghdad 10071, Iraq;
| | - Garrit Koller
- Conservative and MI Dentistry (Including Endodontics), King’s College London Dental Institute at Guy’s Hospital, King’s Health Partners, London SE1 9RT, UK;
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London WC2R 2LS, UK
- London Centre for Nanotechnology, London WC1H 0AH, UK
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Uzunoğlu Özyürek E, Küçükkaya Eren S, Karahan S. Effect of treatment variables on apical extrusion of debris during root canal retreatment: A systematic review and meta-analysis of laboratory studies. J Dent Res Dent Clin Dent Prospects 2024; 18:1-16. [PMID: 38881644 PMCID: PMC11179139 DOI: 10.34172/joddd.40501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/06/2023] [Indexed: 06/18/2024] Open
Abstract
Background This study aimed to systematically and comprehensively review the effect of various treatment variables on apically extruded debris (AED) during non-surgical root canal retreatment (NSRCRT). Methods The study protocol is shared in the Open Science Framework database (https://osf.io/kjtdg/?view_only=17060180705745ec9dae9a01614f3880). An electronic search was conducted up to July 2022 to reveal related studies. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and data extraction. Quantitative data synthesis was performed, and the risk of bias in the studies was also evaluated. Results Forty-six studies were included in the systematic review and 14 in the meta-analysis. Conflicting or limited evidence was found for the effect of sealer type, obturation technique, and solvent use. The manual instrumentation increased the amount of AED compared to rotary instrumentation during the removal of filling materials (P<0.001). There was no significant difference in the amount of AED between the use of rotary and reciprocating files during the removal of filling materials (P=0.181). Conclusion Rotary instruments can be recommended instead of manual instruments during the removal of filling materials to control the amount of AED. Further studies with a low risk of bias are needed to clarify the effect of other treatment variables on AED during NSRCRT.
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Affiliation(s)
- Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Abbara MT, Akil S, Hamadah O, Achour H, Mahayni G, Alsayed Tolibah Y. Can diode laser 810 nm decrease post endodontic pain in patients with asymptomatic necrotic maxillary incisors? A four-arm randomized controlled trial. BDJ Open 2024; 10:23. [PMID: 38485988 PMCID: PMC10940693 DOI: 10.1038/s41405-024-00203-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 03/18/2024] Open
Abstract
AIM To find the best method for applying the diode laser 810 nm to relieve post-endodontic pain on necrotic maxillary incisors with periapical lesions within a single-visit treatment. METHODS Eighty patients with a necrotic incisor, diagnosed with asymptomatic apical periodontitis, received standardized cleaning and shaping procedures, then divided randomly with a 1:1:1:1 allocation ratio into four groups: Group 1: control group with no laser application, Group 2: applying the diode laser as an irrigation activation system (IAS), Group 3: applying the diode laser from the buccal and palatal mucosa, Group 4: applying the diode laser as an IAS and from buccal and palatal mucosa. The postoperative pain was assessed using the visual analog scale (VAS) 1, 3, 7, and 14 days after the treatment. The mean values of the VAS score were statistically analyzed used Kruskal-Walis and Mann-Whitney U tests. The level of significance was set at a = 0.05. RESULTS During 14 days after treatment, there was a statistically significant difference between mean values of VAS scores in the four groups (P value < 0.05); Group 1 scored the highest score, whereas Group 4 showed the lowest one. Moreover, Group 4 showed favorable outcomes compared with Group 2 and Group 3 during the first three days after treatment. CONCLUSION Diode laser reduced postoperative pain after necrotic teeth with large-sized apical lesion treatment, whereas using diode laser either as an IAS or LLLT reduced the postoperative pain compared with the control group. Moreover, the usage of a diode laser in both previous techniques represents the best protocol for postoperative pain relief during 14 days of treatment. CLINICAL RELEVANCE The clinical significance of this study is to investigate the best method to reduce postoperative pain using diode lasers 810 nm; where the results of this study indicated that the more diode laser exposer in LLLT and IAS, the less postoperative pain after endodontic procedures.
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Affiliation(s)
- Mohammad Tamer Abbara
- DDs, MSc,Ph.D student at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Samar Akil
- DDS,MSc,Ph.D Associate Professor at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Omar Hamadah
- DDS,MSc,Ph.D Associate Professor at the department of Oral Medicine, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Hassan Achour
- DDS,MSc,Ph.D Associate Professor at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Ghina Mahayni
- DDs, Faculty of Dentistry, Al-Sham Private University, P.O. Box 3062, Damascus, Syria
| | - Yasser Alsayed Tolibah
- DDs, MSc,Ph.D student at the department of Pediatric Dentistry, Faculty of Dentistry, Damascus, University, P.O. Box 3062, Damascus, Syria.
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Abdel-Baset ST, Fahmy SH, Obeid MF. Can instrumentation kinematics affect postoperative pain and substance P levels? A randomized controlled trial. BMC Oral Health 2024; 24:102. [PMID: 38233887 PMCID: PMC10792914 DOI: 10.1186/s12903-024-03882-x] [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: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND This study aimed to assess the influence of continuous rotation and reciprocation kinematics on postoperative pain (POP) levels and substance P (SP) levels in patients diagnosed with irreversible pulpitis and symptomatic apical periodontitis (SAP). MATERIALS AND SUBJECTS A total of twenty patients were randomly assigned into two groups: Continuous Rotation Group (CRG) (n = 10), subjected to mechanical preparation with the EdgeEndox7 rotary system (Albuquerque, NM, USA), and Reciprocation Group (RG) (n = 10), treated with the EdgeOne Fire reciprocating system (Albuquerque, NM, USA). Apical fluid (AF) samples were collected, and SP levels were quantified through radioimmunoassay. POP was assessed using the Numerical Rating Scale (NRS) at various time intervals (preoperatively, 6 h, 12 h, 24 h, 48 h, and 72 h). Data were statistically analyzed utilizing the independent t-test, Mann-Whitney U test, Friedman's test, and Nemenyi post hoc test. RESULTS There was a significant increase in SP levels in the reciprocating group compared to the continuous rotation group (P ≤ 0.05). Additionally, patients in the reciprocating group reported significantly higher POP levels (P ≤ 0.05) at all measured intervals (6 h, 12 h, 24 h, and 48 h), with both groups exhibiting similar pain level reductions at the 72-hour mark. CONCLUSION Our findings suggest that continuous rotation kinematics in root canal preparation leads to a considerable reduction in SP expression and POP. TRIAL REGISTRATION The study protocol was retrospectively registered on the www. CLINICALTRIALS gov database (NCT06081335) at (13/10/2023) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-RecIM012135).
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Affiliation(s)
| | - Sarah Hossam Fahmy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Maram Farouk Obeid
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
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Pedullà E, Iacono F, Pitrolo M, Barbagallo G, La Rosa GRM, Pirani C. Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment. AUST ENDOD J 2023; 49:623-630. [PMID: 37667824 DOI: 10.1111/aej.12795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/17/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Abstract
The aim of the study was to evaluate the impact of kinematics and irrigation protocols on the extrusion of apical debris during removal of different obturation techniques. A total of 144 single-rooted teeth were instrumented and obturated with Thermafil+AH Plus, Thermafil+AH Plus Bioceramic and single gutta-percha cone+AH Plus Bioceramic. Samples were divided according to the retreatment kinematics: continuous rotation or Jeni motion. Each sub-group was subjected to conventional irrigation or irrigation activated by EDDY. Extruded debris was collected in Eppendorf tubes, weighted and retreatment time was digitally recorded. Data were analysed with two-way ANOVA (p < 0.05). Debris extrusion was not significantly different between all groups. EDDY activation system and CanalPro Jeni required significantly longer time compared with other groups to remove Thermafil+AH Plus and single cone+AH Plus Bioceramic. Within current limitations, obturation technique, irrigation protocol and kinematics tested had no influence on apical extrusion debris, while they significantly impacted the retreatment time.
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Affiliation(s)
- Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | | | - Martina Pitrolo
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | | | - Giusy Rita Maria La Rosa
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Tartari T, Wilchenski BS, de Souza Lima LA, Vivan RR, Ballal V, Duarte MAH. The use of sodium hypochlorite mixed with etidronic acid during canal preparation increases debris extrusion. AUST ENDOD J 2023; 49:584-591. [PMID: 37571801 DOI: 10.1111/aej.12788] [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: 03/31/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023]
Abstract
The purpose of this study was to compare the impact of different irrigation protocols on debris extrusion. Single-rooted teeth were distributed into groups based on the irrigation protocols (n = 40): 2.5% NaOCl (biomechanical preparation: 20 mL and final irrigation: 5 mL); 2.5% NaOCl (biomechanical preparation: 20 mL) + 17% EDTA (final irrigation: 2 mL) + 2.5% NaOCl (final irrigation: 3 mL); and a mixture of 5% NaOCl +18% HEDP (biomechanical preparation: 20 mL and final irrigation: 5 mL). The canals were prepared using a reciprocating instrument size 40/0.06. For final irrigation, the groups were reassigned based on the agitation methods (n = 10): (a) no agitation; (b) ultrasonic; (c) sonic; and (d) continuous rotation. The control group (n = 10) received saline solution without agitation. The amount of debris extruded was measured by weight and analysed using One-way ANOVA (α < 0.05). The subgroups treated with NaOCl + HEDP mixture showed a significantly higher amount of extruded debris (p < 0.05), while there was no difference among agitation methods in all groups (p > 0.05).
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Affiliation(s)
- Talita Tartari
- Department of Restorative Dentistry, Piracicaba School of Dentistry, State University of Campinas, Piracicaba, Brazil
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Brenda Stefhany Wilchenski
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Luana Arantes de Souza Lima
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Vasudev Ballal
- Department of Conservative Dentistry & Endodontics, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics, and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Nouroloyouni A, Safavi Hir F, Farhang R, Noorolouny S, Salem Milani A, Alyali R. Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9945236. [PMID: 37936828 PMCID: PMC10627714 DOI: 10.1155/2023/9945236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023]
Abstract
The new Gentlefile (GF) system, made of stainless steel and developed by MedicNRG in Kibbutz Afikim, Israel, claims to have advantages over traditional nickel-titanium files. However, research has shown that nickel-titanium files are mechanically superior due to their increased flexibility, cutting efficiency, and ability to maintain canal anatomy with less risk of procedural errors. This study compared the amount of debris extrusion and the time required for root canal instrumentation using GF versus the nickel-titanium ProTaper Universal (PTU) system and a manual step-back (MSB) stainless steel technique. This in vitro experimental study utilized 66 extracted human single-canal mandibular premolars with mature apices and root curvature of less than 10 degrees. The teeth were randomly divided into three groups (n = 22) and standardized for working length before being placed in preweighed vials. Group 1 was instrumented with PTU, Group 2 with GF, and Group 3 with the MSB technique. Extruded debris was collected in the vials, dried in an incubator, and weighed using the same scale. The change in weight indicates the debris amount. Instrumentation time was recorded using a stopwatch. The normal distribution of data was assessed using the Kolmogorov-Smirnov test. The groups were then compared regarding the amount of extruded debris and instrumentation time using the Kruskal-Wallis test and one-way ANOVA, followed by the Games-Howell test, respectively (alpha = 0.05). No significant difference in apical debris extrusion was found among the three groups (P > 0.05). However, a significant difference in instrumentation time was detected between the groups (P < 0.05). MSB instrumentation took significantly longer than both the PTU (P = 0.001) and GF (P = 0.001) systems. The GF system did not demonstrate reduced apical debris extrusion or faster instrumentation time compared to PTU. MSB had the longest instrumentation time compared to the other techniques.
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Affiliation(s)
- Ahmad Nouroloyouni
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Fatemeh Safavi Hir
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Robab Farhang
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Sara Noorolouny
- Department of Pediatric Dentistry, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Amin Salem Milani
- Department of Endodontics, School of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Rashin Alyali
- Department of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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13
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Kurt Ö, Zengin T, Üstün Y. Comparison of the effect of different glide path files on amount of apically extruded debris in curved root canals. AUST ENDOD J 2023; 49 Suppl 1:359-365. [PMID: 36946545 DOI: 10.1111/aej.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/30/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
It is essential to create a glide path before root canal preparation with nickel-titanium rotary files to avoid file breakage and preserve the original canal structure. The aim of this study was to compare the amount of apically extruded debris after using different glide path files. A total of 96 first mandibular molars with curved mesial roots were randomly divided into six groups (n = 16) which are K-files, Proglider, R-Pilot, TruNatomy Glider, WaveOne Gold Glider and group without a glide path. Apically extruded debris was measured after glide path and canal preparation. The highest amount of debris was found in the control group without a glide path and using a glide path file caused less debris and significant differences were observed between R-Pilot, TruNatomy Glider, ProGlider, WaveOne Gold Glider and K-file groups. It may be recommended to create a glide path before root canal shaping to reduce the amount of extrusion debris from the apical. Especially in curved and narrow root canals, it is recommended to use an R-Pilot file before root canal shaping in order to reduce the amount of apically extruded debris.
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Affiliation(s)
- Özge Kurt
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Talip Zengin
- Department of Molecular Biology and Genetics, Muğla Sitki Koçman University, Muğla, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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14
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Laslami K, Khaldoune S, Sy A, Drouri S, Benkiran I. Apical Extrusion: Is It an Inherent Occurrence During Every Endodontic Treatment? Cureus 2023; 15:e45211. [PMID: 37720124 PMCID: PMC10504573 DOI: 10.7759/cureus.45211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
The aim of this literature review was to analyze all available scientific data on apical extrusion and to identify and associate the possible factors influencing the occurrence of apical extrusion, ranging from the choice of the canal shaping system, the irrigation technique, to the choice of diameter and the apical limit of preparation. A bibliographic search for relevant articles on apical extrusion of debris, irrigants, and bacteria was performed using the following databases: PubMed, Cochrane Library, and ScienceDirect. This search identified articles published between 2010 and 2023 in two languages (French and English). After selective sorting, 25 relevant documents were included. All the studies retained clearly agree on the inherent nature of apical extrusion during endodontic treatment. At the same time, we also understand that the amount of extrusion can be influenced by a number of parameters throughout endodontic therapy. According to this review, despite the undeniable nature of apical extrusion during endodontic therapy, studies with relatable experimental models that approach in vivo conditions are required to establish exploitable conclusions regarding apical extrusion and its prevention.
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Affiliation(s)
- Kaoutar Laslami
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Salma Khaldoune
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Aly Sy
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Sofia Drouri
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
| | - Imane Benkiran
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, University Hassan II, Casablanca, MAR
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15
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Abduljalil M, Andac G, Basmaci F. Impacts of different Nickel-Titanium rotary and reciprocating root canal preparation systems on the amount of apically extruded debris. AUST ENDOD J 2023; 49 Suppl 1:308-314. [PMID: 36571483 DOI: 10.1111/aej.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/18/2022] [Accepted: 12/18/2022] [Indexed: 12/27/2022]
Abstract
This study aimed to evaluate the amount of apically extruded debris caused by different NiTi files. One hundred mandibular premolars were included in this study. The specimens were divided into five groups (n = 20): (i) TruNatomy, (ii) WaveOne Gold, (iii) 2Shape, (iv) ProTaper Next and (v) Reciproc Blue. The extruded debris was collected into preweighed Eppendorf tubes. These tubes were weighed again, and the net weight of debris was calculated. Data were statistically analysed, and the significance level was set at 5%. The least amount of extruded debris was observed in the TruNatomy group (p < 0.05). Statistically significant differences were not found among (iii), (iv) and (v) groups (p > 0.05). However, these groups resulted in significantly higher amounts of debris when compared to (i) and (ii) groups (p < 0.05). The results lead us to conclude that all instrumentation systems caused apical extrusion of debris at varying weights.
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Affiliation(s)
- Mohamad Abduljalil
- Department of Endodontics, Faculty of Dentistry, European University of Lefke, Mersin 10, Turkey
| | - Gizem Andac
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - Fatma Basmaci
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
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16
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Shetty K, Arora A. Re:'Debris extrusion during root canal preparation with nickel-titanium instruments using liquid and gel formulations of sodium hypochlorite in vitro'. AUST ENDOD J 2023; 49:455. [PMID: 35861505 DOI: 10.1111/aej.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 07/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Karthik Shetty
- Manipal College of Dental Sciences, Mangalore (Manipal Academy of Higher Education, Manipal), Mangalore, Karnataka, India
| | - Arpit Arora
- Manipal College of Dental Sciences, Mangalore (Manipal Academy of Higher Education, Manipal), Mangalore, Karnataka, India
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17
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Azizi Mazreah S, Shirvani A, Azizi Mazreah H, Dianat O. Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta-analysis. AUST ENDOD J 2023; 49:396-417. [PMID: 35988128 DOI: 10.1111/aej.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty-six full-text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta-analysis. The meta-analysis was conducted using the random-effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount (p = 0.00) and frequency (p = 0.00) of extrusion than the open-ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open-ended (p = 0.00 or p = 0.01) and closed-ended needle (p = 0.00) irrigation.
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Affiliation(s)
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
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18
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Gayatri S, Mathew S, Kumaravadivel K, Thangavel B, Thangaraj DN, Shaji A. Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth With Simulated Apical Root Resorption: An In Vitro Study. Cureus 2023; 15:e40904. [PMID: 37492825 PMCID: PMC10365891 DOI: 10.7759/cureus.40904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 07/27/2023] Open
Abstract
Aim The aim of this study was to compare the amount of debris produced apically during the removal of root canal obturating material by using various files in extracted teeth with simulated apical root resorption. Materials and methods An in vitro study was conducted in the root canals of 90 extracted mandibular premolar teeth that were prepared with a ProTaper Gold rotary file (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and an AH Plus sealer (Dentsply Maillefer, Ballaigues, Switzerland) using a cold lateral compaction technique. A total of 45 mandibular premolar teeth were randomly assigned to three control groups (i.e., the ProTaper Universal retreatment file (Dentsply Maillefer), the Reciproc Blue file (VDW, Munich, Germany), and the HyFlex Remover file (Coltene/Whaledent, Altstatten, Switzerland) for the removal of root canal filling material, whereas the remaining 45 teeth were treated as the experimental group and their apical portion was modified to simulate apical root resorption. The teeth of this experimental group were randomly divided into three subgroups according to the same three techniques used with the control groups for the removal of root canal filling materials. The apically extruded debris was collected into pre-weighed borosilicate glass tubes and then dried. The mean weight of the apically extruded debris was assessed using an analytical balance to an accuracy of 10-4 g. Further, the data were analyzed using the Kruskal-Wallis test and Tukey's post hoc test. Results In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion than the groups without simulated root resorption (a < 0.05). In both the control groups and experimental groups, the ProTaper Universal retreatment file was associated with the least weight of the apically extruded debris (a < 0.05), followed by the Reciproc Blue file and the HyFlex Remover file. Conclusion The amount of debris extruded apically was significantly greater in the teeth with simulated apical root resorption than in those without it. Further, during the removal of the root canal filling materials, HyFlex Remover was associated with significantly more apically extruded debris in all groups.
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Affiliation(s)
- Sasti Gayatri
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Sebeena Mathew
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Karthick Kumaravadivel
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Boopathi Thangavel
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Deepa N Thangaraj
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| | - Athira Shaji
- Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
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19
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Mehra D, Sinha DJ, Singh S, Verma N, Rani P, Parvez B. Comparison of single and multiple file rotary endodontic instruments for debris and irrigant extrusion: An in vitro study. J Conserv Dent 2023; 26:288-291. [PMID: 37398865 PMCID: PMC10309133 DOI: 10.4103/jcd.jcd_62_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/04/2023] [Accepted: 03/06/2023] [Indexed: 07/04/2023] Open
Abstract
Aim The aim of this study was to assess and compare the quantity of apically debris which was extruded apically by TruNatomy (TN), ProTaper Next (PTN), HyFlex electric discharge machining (EDM), and HyFlex controlled memory (CM), following root canal preparation. Materials and Methods Sixty extracted single-canal mandibular premolars were used. The root canal preparation was done with TN, HyFlex EDM, PTN, or HyFlex CM files. The preweight debris, which was extruded apically, was collected in the Eppendorf tube and later on incubated at 670°C for 3 days and weighed again to record the extruded debris. Results The result showed that there was a significant reduction in debris extrusion by TN system, followed by PTN system, HyFlex EDM, and maximum extrusion in HyFlex CM (P < 0.05). Between the PTN and TN groups as well as between the HyFlex EDM and HyFlex CM groups, statistically significant difference was not observed (P > 0.05). Conclusion Apical debris extrusion is the inherent nature of the all file systems. Nevertheless, the TN file system produced substantially minimum debris extrusion among other systems compared in the study.
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Affiliation(s)
- Deepika Mehra
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Dakshita Joy Sinha
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Sarita Singh
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Neha Verma
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Priyanka Rani
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Beenish Parvez
- Department of Conservative Dentistry and Endodontics, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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20
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Jose J, Thamilselvan A, Teja KV, Rossi-Fedele G. Influence of access cavity design, sodium hypochlorite formulation and XP-endo Shaper usage on apical debris extrusion - A laboratory investigation. AUST ENDOD J 2023; 49:6-12. [PMID: 35679461 DOI: 10.1111/aej.12637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
This study assessed the amount of apically extruded debris during root canal preparation using XP-endo shaper and the supplemental use of XP-endo finisher comparing the use of traditional endodontic access or conservative endodontic access cavities and liquid or gel-based formulations of 5.25% sodium hypochlorite or distilled water as supplemental agents. Maxillary first premolar teeth (N = 148) were randomly divided based on their access cavity design and sub-grouped according to the supplemental agent used. The amount of extruded debris was analysed based on the dry weight of the debris collected using a previously established laboratory methodology. Debris extrusion occurred in all groups. Overall, the traditional endodontic access cavity design was associated with more debris extrusion compared to the conservative type. The use of sodium hypochlorite solution showed higher debris extrusion than the gel, whilst distilled water had intermediate values.
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Affiliation(s)
- Jerry Jose
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Aishuwariya Thamilselvan
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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21
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Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent 2023; 26:31-35. [PMID: 36908725 PMCID: PMC10003277 DOI: 10.4103/jcd.jcd_378_22] [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: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/19/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The study aimed to determine the apical debris extrusion and microbial elimination from infected root canals after using different irrigant activation methods. Materials and Methods Forty freshly extracted human mandibular premolars were selected and randomly assigned to four groups (n = 10). The teeth were mechanically prepared, sterilized, and inoculated with Enterococcus faecalis for 1 week. Irrigation was done with 3% sodium hypochlorite following conventional syringe irrigation-Group 1, manual dynamic agitation (MDA)-Group 2, passive ultrasonic irrigation (PUI)-UltraX -Group 3, and sonic irrigation (SI)-EndoActivator -Group 4, and the extruded debris were collected using Myers and Montgomery model. The microbial samples were taken from the canals using sterile paper points, cultured and recorded as colonies. The amount of extruded debris was measured by subtracting the final weight of the Eppendorf tube with debris from the initial weight of the tube. Results I. Group 3 showed the least apical debris extrusion (P < 0.05), followed by Groups 2 and 1 and the highest with Group 4. II. Group 3 showed the least colony-forming units (CFUs)/ml, followed by Group 4, and finally, Group 2 showed lesser mean CFUs/ml compared to Group 1 (P < 0.05). Conclusion All the irrigation activation methods were associated with apical debris extrusion, with the PUI system extruding the least amount of debris compared to the other groups. Irrigation activation techniques were beneficial in reducing the microbial load from the infected canals with the PUI system showing a complete elimination of the microbes, followed by SI and MDA.
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Affiliation(s)
- K. Sadia Ada
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Shibani Shetty
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - K. B. Jayalakshmi
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Prasanna Latha Nadig
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - P. G Manje Gowda
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Arul K. Selvan
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
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22
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Al-Saffar FB, Al-Gharrawi HA. A Comparative Evaluation of the Apically Extruded Debris from Root Canals Prepared by R-Motion NiTi File System. Int J Dent 2023; 2023:5731248. [PMID: 37152476 PMCID: PMC10156454 DOI: 10.1155/2023/5731248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/07/2023] [Accepted: 04/07/2023] [Indexed: 05/09/2023] Open
Abstract
Background Apically extruded debris (AED) is an inherent concern during root canal treatment for both endodontists and general practitioners. The present study investigates the AED of the novel R-Motion single-file reciprocating system compared to standard single reciprocating and multifile rotary systems. Materials and Methods Fifty-six moderately curved palatal roots of upper maxillary first molars were selected for the present study. The samples were then divided randomly into four groups (n = 14)- Group I: R-motion (RM), Group II: WaveOne Gold (WOG), Group III: ProTaper Next (PTN), and Group IV: HyFlex EDM (HFEDM). The researcher has modified Myers and Montgomery's method to simulate human body temperature. Vials were used to collect debris and weighted using a 0.00001 sensitive balance before and after instrumentation. The instrumentation of all experimented groups was done at 37°C, terminated at master apical file #25. An auto syringe with a side vented needle was used to deliver 8 ml of deionized water for irrigation of each sample during preparation. Vials were stored in a dry sealed desiccator which contained CaSO4 crystals, for 24 hr before weighing. The weight of the collected debris was obtained by subtracting the preinstrumentation weight from the postinstrumentation weight for each vial. The Kruskal-Wallis and Mann-Whitney U tests were performed to analyse the statistical difference in the amount of debris between the tested groups at a 0.05 significance level. Results The RM system produced less debris extrusion than all tested groups, with a significant difference between the former and the WOG and the PTN systems. However, WOG, PTN, and HFEDM showed no statistically significant difference in the amount of AED. Conclusion All tested groups produced apical debris in different amounts. The RM produced substantially less AED than WOG and PTN. Meanwhile, WOG, PTN, and HFEDM caused a comparable amount of AED.
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Affiliation(s)
- Farah B. Al-Saffar
- Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad 10001, Iraq
| | - Hikmet A. Al-Gharrawi
- Department of Conservative Dentistry, College of Dentistry, Mustansiriyah University, Baghdad 10001, Iraq
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23
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Roshdy NN, Hassan R. Quantitative evaluation of apically extruded debris using TRUShape, TruNatomy, and WaveOne Gold in curved canals. BDJ Open 2022; 8:13. [PMID: 35595771 PMCID: PMC9122899 DOI: 10.1038/s41405-022-00106-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Objective
This study compared the quantity of extruded debris after instrumentation with TRUShape 3D Conforming files, TruNatomy files, and the WaveOne Gold reciprocating system.
Materials and methods
Fifty-one mesiobuccal canals with severe curvatures (25–40°) were assigned to three equal groups according to the rotary system used for preparation, either TRUShape, TruNatomy, or WaveOne Gold files. The extruded debris was collected in pre-weighed glass vials. The data were statistically analyzed using a one-way ANOVA test and Tukey’s post hoc test.
Results
The least extruded debris was obtained with the WaveOne Gold instruments compared to the TRUShape and TruNatomy files (p < 0.001).
Conclusions
Debris extrusion occurs independently of the motion or design of the instrument. The WaveOne Gold system outperformed TRUShape and TruNatomy files in this study.
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24
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Uygun AD. Comparison of apical debris extrusion of different generation nickel-titanium instrument systems. Niger J Clin Pract 2022; 25:2010-2015. [PMID: 36537459 DOI: 10.4103/njcp.njcp_455_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM The aim of this study is to evaluate the apical debris extrusion amounts and preparation times of four different nickel-titanium systems with a similar cross-section design-Mtwo, RECIPROC, RECIPROC blue, and VDW.ROTATE. MATERIALS AND METHODS Eighty human mandibular central incisors were divided into four equal groups (n = 20). The test apparatus was inserted into an assembly that provided root canal temperature. Preparation times were recorded using a stopwatch, and the amount of extruded debris was collected in pre-weighed Eppendorf tubes. After drying, the net amount was determined by subtracting the previously measured Eppendorf tube weights from the total weight. RESULTS The Mtwo had the largest amount of debris, but there was no significant difference among the other groups. The VDW.ROTATE completed the preparation in a significantly shorter time than the RECIPROC blue and Mtwo. CONCLUSION Compared to other files, the Mtwo sequence produced significantly more debris and required significantly more time to complete the whole root canal preparation.
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Affiliation(s)
- A D Uygun
- Department of Endodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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25
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Mohammadi D, Mehran M, Frankenberger R, BabeveyNejad N, Banakar M, Haghgoo R. Comparison of apical debris extrusion during root canal preparation in primary molars using different file systems: an in vitro study. AUST ENDOD J 2022; 48:473-480. [PMID: 34751479 DOI: 10.1111/aej.12582] [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: 03/25/2021] [Revised: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to compare the amount of debris extrusion of four endodontic systems made of Nickle-Titanium alloy. This in vitro study was done on 80 extracted primary molars. They were selected by cone-beam computed tomography and randomly divided into four groups (n = 20) to be prepared to the apical size of 25 by one of the systems: Reciproc, Protaper Universal, Neolix, or Hyflex CM. Debris was collected into Eppendorf microtubes and placed in an incubator to evaporate the washing solution. Debris was weighed by a digital scale of 0.01 g precision. Data were statistically analysed using SPSS software. Tukey's comparison was used to determine the difference between the four file systems (α = 0.05). Debris extrusion after Reciproc preparation (0.00320) was significantly higher than the other (P < 0.05), with no significant difference having been observed among the other systems (P > 0.05). It can be concluded that all systems under investigation exhibited debris extrusion.
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Affiliation(s)
- Davood Mohammadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Ilam Medical University, Ilam, Iran
| | - Majid Mehran
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontics, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Marburg, Germany
| | - Newsha BabeveyNejad
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Morteza Banakar
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Roza Haghgoo
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
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26
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SERÇE FİKİRLİ B, ALTUNKAYNAK B, KAYAOĞLU G. Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.945129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method: Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.
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Affiliation(s)
| | | | - Güven KAYAOĞLU
- Department of Endodontics, Faculty of Dentistry, Gazi University
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Quantitative Evaluation of Apically Extruded Debris of Root Canal Dentin Layer with WaveOne, ProTaper Next, ProTaper Gold Rotary File Systems. COATINGS 2022. [DOI: 10.3390/coatings12040451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Endodontic flare-up or post-operative pain occurs when debris such as necrotic pulp tissue, dentin chips, irrigants, and microorganisms are extruded from the apical foramen intraoperatively into the periradicular tissue during root canal instrumentation. This study compared the amount of apical debris extrusion of the root canal dentin layer after using reciprocating and rotary file systems (WaveOne, ProTaper Next and ProTaper Gold). Sixty extracted human maxillary central incisors with one canal and closed apex were included in the study. Samples were randomly and equally divided into three groups (n = 20) according to the file systems used for preparation of the root canal. Teeth in the WO group were instrumented by WaveOne, while the PTN group were instrumented by ProTaper Next, and teeth samples in the PTG group were cleaned and shaped by ProTaper Gold. The mean apically extruded debris weight in grams was estimated using the modified Myers and Montgomery experimental model. Analysis of variance (ANOVA) test was used for the comparison of debris weight in three groups. Post hoc LSD test was applied for pairwise comparison of debris weight. The α value of significance was 0.05. The WO group had significantly lower mean debris weight than the PTN and PTG groups (p = 0.001). Post hoc pairwise comparison revealed that there was a statistically significant difference in mean debris weight between the WO group and PTN group (0.0215 vs. 0.0341, p = 0.001); and the WO group and PTG group (0.0215 vs. 0.0324, p = 0.003). Root canal preparations with different file systems were associated with apical extrusion of the debris from the root canal dentin layer. However, the WaveOne system resulted in a comparatively lower amount of apical debris layer extrusion than the ProTaper Next and ProTaper Gold rotary file systems.
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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AlChalabi A, Alkhalidi E, Chakmakchi M. Apically Extruded Debris during Instrumentation using Different Engine Driven File Systems: A Comparative In Vitro Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the present study was to evaluate and compare the amount of apically extruded debris using three engine driven systems.
METHODS: Sixty mandibular premolars with single root were used. The samples were divided into three groups with 20 teeth for each group: group 1 Neolix Neoniti A1 (25, 0.08), group 2 WaveOne GOLD Primary (25.07, red), and group 3 Protaper Next (PTN), using X1 (017/0.04), X2 (025/0.06) files. All files were used to prepare the root canals according to manufacturer instruction. Root canal preparation for each group was done according to manufacturer instructions using 16:1 gear reduction hand piece powered by a torque controlled electric motor. Debris collection was made using apparatus described by Myers and Montgomery. The extruded debris weight was measured by subtracting the weight of the empty Eppendorf tubes from the weight of the debris containing tubes results were statistically analyzed.
RESULTS: One-way analysis of variance test revealed that there was statistically significant differences between all the three groups being tested (p < 0.001) showed that apical extrusion of the debris of WaveOne Gold was the least followed by Neolix Neoniti and finally PTN which showed the most apical extrusion of debris with a significant difference between all groups.
CONCLUSIONS: WaveOne Gold was found to be the least apical extruded debris system among all groups.
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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Maheswari D, Mallick R, Shandilya A, Solanki H, Panda S, Sarangi P. Quantitative evaluation of apically extruded debris during biomechanical preparation using hand K-file, protaper next, and waveone – An In Vitro study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S802-S807. [PMID: 36110614 PMCID: PMC9469283 DOI: 10.4103/jpbs.jpbs_194_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The instrumentation technique which produces least amount of apically extruded debris is desirable to use in biomechanical preparation of root canal. Aim: To quantitatively evaluate apically extruded debris during instrumentation with hand K-file, ProTaper Next, and WaveOne. Materials and Methods: Forty-five extracted human single-rooted mandibular premolars with straight, single canal and single apical foramen were selected after radiographic evaluation and divided equally into three groups. Cleaning and shaping was done using hand K-files in step-back technique, ProTaper Next, and WaveOne single-file system. Debris extruded apically was collected into Eppendorf tubes and stored in an incubator at 37°C temperature for 5 days for drying. Weight of dry debris was measured using electronic microbalance with an accuracy of 10−5 g. Statistical Analysis: Student's t-test, with P value < 0.05 is statistically significant. Results: Statistically significant (P < 0.05) amount of debris was extruded by all three instrumentation systems: hand K-file- 1.9220 mg, ProTaper Next- 1.4940 mg, and WaveOne- 0.9940 mg. Least amount of debris produced by WaveOne was statistically significant (P < 0.05) when compared with the other two systems. Conclusion: The WaveOne reciprocating system extruded least amount of debris in comparison to hand K-file and ProTaper Next.
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Gurawa A, Mohana P, Abraham D, Gupta A, Chauhan P, Singh A, Jala S. Quantitative evaluation of apically extruded debris during root canal preparation with reciprocating single file system, continuous rotary multiple file system and manual technique: An in vitro study. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_167_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hespanhol FG, Guimarães LS, Antunes LAA, Antunes LS. Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e30. [PMID: 36090511 PMCID: PMC9436646 DOI: 10.5395/rde.2022.47.e30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022]
Abstract
Objectives This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment. Materials and Methods A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours. Conclusions Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.
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Affiliation(s)
| | - Ludmila Silva Guimarães
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Niterói, RJ, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Niterói, RJ, Brazil
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Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An in vitro study. J Conserv Dent 2022; 25:547-554. [PMID: 36506635 PMCID: PMC9733558 DOI: 10.4103/jcd.jcd_273_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
Background Guided conservative endodontic access is a novel technique and the influence of such access cavities on apical debris extrusion (ADE) can have a significant effect on postoperative pain. Objective This study compared ADE and preparation time (PT) in the mesial canals of the mandibular first permanent molars in different access cavity designs and the amount of sodium hypochlorite in the extruded debris using attenuated total reflection-Fourier transform infrared spectrometer (ATR-FTIR). Materials and Methods Human mandibular first permanent molars (N = 72) were selected and randomly divided into six groups (n = 12) based on type of cavity design and files used: Group 1, Conservative Access Cavity [ConsAC])-WaveOne Gold; Group 2, ConsAC-Mtwo; Group 3, ConsAC-XP-endo shaper; Group 4, Traditional Access Cavity [TradAC])-WaveOne; Group 5, TradAC-Mtwo; and Group 6, TradAC-XP-endo shaper. All the ConsAC were prepared with a customized template fabricated using cone beam computed tomography. ADE evaluation was done using the Myers and Montgomery set up. All the instruments were used according to the manufacturers' instructions, followed by a final irrigation using Endoactivator. The time taken for preparation was calculated using a digital watch. Five samples in each group was taken and subjected to ATR-FTIR analysis. Results There was no significant difference between the groups with respect to ADE (P > 0.05). Whereas, a statistically significant difference was seen in PT between the TradAC and ConsAC (P < 0.05). Using ATR-FTIR, it was found that all the samples of extruded debris had the presence of sodium hypochlorite. Conclusions All instrumentation systems produced ADE irrespective of access cavity design. The time taken for preparation of canals in ConsAC was significantly longer compared to TradAC. Clinical Relevance ADE can translate clinically as postoperative pain. Assessing the ADE in ConsAC could shed light on the type of file systems that can be used in such cavities in order to minimize postoperative pain clinically.
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Affiliation(s)
- Sathish Sundar
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Sathish Sundar, Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, No. 1, Alapakkam Main Road, Maduravoyal, Chennai - 600 095, Tamil Nadu, India. E-mail:
| | - Aswathi Varghese
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
| | - Krithika J. Datta
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
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Namsoy E, Serefoglu B, Hulsmann M, Caliskan MK. Influence of various application systems on the amount of extruded irrigant in simulated immature teeth with regard to gravity: An ex-vivo study. Niger J Clin Pract 2022; 25:1831-1837. [DOI: 10.4103/njcp.njcp_270_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Atesci AA, Topaloglu-Ak A, Turan E, Oncag O, Kaval ME. Evaluation of Postoperative Pain Following Single-Visit Root Canal Treatment with Rotary and Reciprocal Ni–Ti File Systems in Children. Medicina (B Aires) 2021; 58:medicina58010050. [PMID: 35056358 PMCID: PMC8780144 DOI: 10.3390/medicina58010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives: Postoperative pain is a common symptom of a flare-up after root canal treatments (RCTs). Insufficient instrumentation, extrusion of irrigation solutions and debris, and the existence of a periapical lesion are the factors affecting postoperative pain after root canal treatments. The aim of this study was to evaluate the postoperative pain and instrumentation time of the single-file reciprocating system and multiple-file Ni–Ti rotary system in children ages 9–12 years old. Materials and Methods: Our study was conducted on 51 permanent mandibular molars with the diagnosis of irreversible pulpitis. Patients were randomly assigned into two groups, and RCTs were completed with either the Reciproc Blue or Protaper NEXT file systems. Instrumentation time for each system was noted, and patients were given a pain scale that included a visual analog scale for 6, 24, 48, and 72 h after treatment. Postoperative pain scores and instrumentation times were analyzed statistically with a chi-square test and Student’s t-test. Results: There was no statistically significant difference in postoperative pain between the Reciproc Blue and Protaper NEXT systems at all time intervals. Instrumentation time was significantly shorter in the Reciproc Blue group in comparison with the Protaper NEXT group. Conclusions: Postoperative pain findings following RCT using single-file reciprocating systems were similar to the rotary system group. However, chair time in the reciprocating system group was significantly lower. This provided a comfortable and patient-friendly treatment approach for children, and could enhance their cooperation.
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Affiliation(s)
| | - Aslı Topaloglu-Ak
- Department of Pediatric Dentistry, School of Dentistry, Istanbul Aydın University, Istanbul 34295, Turkey
- Correspondence:
| | - Ece Turan
- Independent Researcher, Izmir 35220, Turkey; (A.A.A.); (E.T.)
| | - Ozant Oncag
- Department of Pediatric Dentistry, School of Dentistry, Ege University, Izmir 35040, Turkey;
| | - Mehmet Emin Kaval
- Department of Endodontics, School of Dentistry, Ege University, Izmir 35040, Turkey;
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Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
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Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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Apically Extruded Debris in Curved Root Canals Using a New Reciprocating Single-File Shaping System. J Endod 2021; 48:117-122. [PMID: 34699902 DOI: 10.1016/j.joen.2021.10.002] [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: 07/25/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The present study addresses the influence of 5 different shaping file systems on apical debris extrusion (AED) using 2 different irrigation protocols. METHODS One hundred fifty mandibular first permanent molars were divided into 2 groups and 10 subgroups. The mesial root canals were shaped using One Reci (MicroMega), WaveOne Gold Primary (Dentsply Sirona, York, PA), and ProTaper Next (Dentsply Sirona) using reciprocating motion and One Curve (MicroMega) and ProTaper Next using continuous rotation. The first group and the second one were respectively irrigated with 10 and 5 mL distilled water. RESULTS When the same instrumentation technique was used, the G10 mL subgroups showed statistically lower AED than the G5 mL subgroups (P < .05). The One Reci and One Curve subgroups, in both groups, produced statistically lower AED than the remaining subgroups. CONCLUSIONS The cross section of the instrument could be the main parameter in determining the amount of AED. The irrigation volume used during the shaping procedure might affect the amount of AED.
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Eliasz W, Czarnecka B, Surdacka A. Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files. MATERIALS 2021; 14:ma14216254. [PMID: 34771780 PMCID: PMC8585032 DOI: 10.3390/ma14216254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/25/2022]
Abstract
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal-Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
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Affiliation(s)
- Wojciech Eliasz
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
- Correspondence: ; Tel.: +48-732-571-657
| | - Beata Czarnecka
- Department of Biomaterials and Experimental Dentistry, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
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Ajina MA, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J 2021; 55 Suppl 1:119-152. [PMID: 34674279 DOI: 10.1111/iej.13650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Despite enjoying high favourable outcome rates, root canal treatment is not always successful. Root canal retreatment is a widely practised option for managing a non-healing root treated tooth. A basic distinction between retreatment and initial treatment is the requirement to remove the existing root filling material occupying the root canal space. Only then, can the technical deficiencies and possible causes of failure be addressed. Hence, the successful removal of the root filling material is critical to achieving the objectives of retreatment. Many different materials and techniques have been used for root canal filling, which have been documented in a plethora of studies; these are mainly laboratory studies investigating the removal of root filling materials. To help guide future research, which may then better inform clinical practice in relation to retreatment procedures, the focus of this narrative review is on the research methods and experimental models employed to study the removal of root filling materials. The current available literature demonstrates great variation in the research methodologies used to study the removal of root filling material, including direct visualization by splitting tooth samples or clearing, three-dimensional radiographic imaging including using microcomputed tomography or cone-beam computed tomography, and a combination of these techniques. Depending on the research method employed, variation also exists in quantification of root filling material removal; these include measurements of surface area, volume or weight, and criteria-based (semi-quantitative) assessment. Experimental models, using human teeth or resin models, differ with respect to standardization techniques and replication of the clinical scenario including initial sample preparation, canal filling, allocation and technical aspects of retreatment procedures. Future models should replicate, as closely as possible, the clinical scenario. Currently, microcomputed tomography provides a highly detailed, non-invasive and non-destructive method of objectively assessing and quantifying root filling removal.
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Affiliation(s)
- Mahdi A Ajina
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Pratik K Shah
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Bun San Chong
- Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Comparison of Apical Extrusion of Bacteria After Glide Path Preparation Between Manual K File, One G Rotary, and WaveOne Gold Glider Reciprocation Preparations. Eur Endod J 2021; 6:221-225. [PMID: 34650017 PMCID: PMC8461488 DOI: 10.14744/eej.2021.30602] [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] [Indexed: 11/20/2022] Open
Abstract
Objective: To compare the amount of apically extruded bacteria between hand-filed preparations, rotary and reciprocation glide path preparations in curved canals of extracted teeth infected with Enterococcus faecalis. Methods: Forty mandibular first molar teeth were decoronated, fitted into rubber stoppers and fixed onto glass vials. The mesiobuccal canals from mandibular first molar teeth were infected with Enterococcus faecalis, then randomly assigned to one of five groups for glide path preparation: manual stainless-steel file (K-files), rotary file (One G), reciprocating file (WaveOne Gold Glider) and two control groups. After glide path preparation, 0.01 mL of saline was taken from the experimental vials. The solution was plated on tryptic soy agar and colonies of bacteria were counted as colony-forming units. The results were analysed statistically using Kruskal-Wallis and post hoc Mann-Whitney U tests. Results: The manual K-file group was associated with significantly more bacteria extrusion compared to the rotary and reciprocating groups (P<0.05). However, no significant difference occurred between rotary and reciprocation instruments. Conclusion: All instrumentation techniques resulted in a measurable amount of apical extrusion of bacteria. Manual K-files extruded the highest quantity of bacteria compared to One G rotary file and WaveOne Gold Glider reciprocation file during glide path preparation.
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Nabavizadeh M, Shokouhi MM, Kheirandish M, Sahebi S, Sadatshojaee N, Abbaszadegan A. A Comparison of the Apical Extrusion of Debris during the Preparation of Root Canal with Medin, RaCe, and ProTaper Rotary Systems. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:193-197. [PMID: 34514067 PMCID: PMC8417540 DOI: 10.30476/dentjods.2020.84776.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/20/2020] [Accepted: 09/12/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: The extrusion of intracanal debris is one of the challenging problems related to almost all root canal preparation systems, which may cause flare-ups and impairment in the healing process. Purpose: This study was conducted to evaluate the amount of apically-extruded debris during root canal preparation using Medin (MEDIN Co., Czech Republic) rotary system compared with
two common rotary systems, including ProTaper (Dentsply Maillefer., Switzerland) and RaCe (FKG Dentaire, Switzerland). Materials and Method: In this in vitro study, Sixty mandibular premolars with single canal were randomly assigned to three groups (n=20). The root canals were prepared with Medin, ProTaper,
and RaCe rotary instruments based on their manufacturers’ instructions. The debris were collected into pre-weighted Eppendorf tubes. The weight of the extruded debris was
calculated by subtracting the pretreatment weight of the vials. Data were analyzed using the Kruskal-Wallis test at a 5% significance level. Results: Medin instrument caused significantly less debris extrusion in comparison with ProTaper and RaCe (p< 0.05). The differences between the ProTaper and RaCe rotary
systems were not statistically significant (p= 0.752). Conclusion: Within the limitations of this in vitro study, Medin rotary system produced less apical extrusion than ProTaper and RaCe.
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Affiliation(s)
- Mohammadreza Nabavizadeh
- Oral and Dental Disease Research Center, Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Shokouhi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Kheirandish
- Dental Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nooshin Sadatshojaee
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Rathi N, Jain SA, Thosar N, Baliga S, Ahmed F, Mehta J. Comparative Evaluation of Cleaning Efficiency and Apical Extrusion of Debris Using Two Pediatric Rotary Endodontic Files: An In Vitro Study. Int J Clin Pediatr Dent 2021; 14:196-200. [PMID: 34413591 PMCID: PMC8343693 DOI: 10.5005/jp-journals-10005-1918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim and objective Apical extrusion of debris and cleaning efficacy in primary root canal treatment has not been well elucidated by using specialized pediatric rotary endodontic files. The purpose of this study is to compare the amount of apically extruded debris and cleaning efficacy during the preparation of primary molar root canals using Pro AF Baby Gold and Kedo-S pediatric rotary files. Materials and methods Twenty extracted primary molar teeth were assigned randomly to two groups (n = 10 teeth for each group), injected with Indian Ink and instrumented using Kedo-S and Pro AF Baby Gold pediatric rotary files, respectively. The apically extruded debris was collected and dried in pre-weighed using Eppendorf tubes. The dry weight was calculated by subtracting the preoperative weight from the postoperative weight. The cleaning efficacy was evaluated after the diaphanization process. Statistics: Data were analyzed statistically using the independent sample t-test. Results The amount of apically extruded debris was significantly less for the Pro AF Baby rotary files group compared to the Kedo-S rotary files group (p < 0.05). Cleaning efficacy was significantly better with Pro AF Baby Gold when compared to Kedo-S rotary files in the apical region of the tooth. Conclusion All instruments caused apically extruded debris in primary teeth. Pro AF baby Gold files can be used with less apical extrusion of debris. Cleaning efficacy was shown to be better with the Pro AF Baby Gold pediatric rotary endodontic file. How to cite this article Rathi N, Jain SA, Thosar N, et al. Comparative Evaluation of Cleaning Efficiency and Apical Extrusion of Debris Using Two Pediatric Rotary Endodontic Files: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(2):196–200.
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Affiliation(s)
- Nilesh Rathi
- Department of Pediatrics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Shreyans A Jain
- Department of Pediatrics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Nilima Thosar
- Department of Pediatrics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Sudhindra Baliga
- Department of Pediatrics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Faraz Ahmed
- Department of Pediatric and Preventive Dentistry, Kidz Dental Care, Mumbai, Maharashtra, India
| | - Jayati Mehta
- Department of Pediatrics and Preventive Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
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El-Din SN, Ali MM, Hassan R. Comparison of Apically Extruded Debris Associated with Different Irrigation Techniques after Removal of Intracanal Medicaments. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study aimed to compare the effect of XP-endo Finisher file (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation technique using side-vented needle (SVN) on the amount of apically extruded debris after the removal of calcium hydroxide Ca(OH)2 and double antibiotic paste (DAP). Materials and Methods: Sixty extracted human mandibular premolars were used. After decronation, all canals were prepared up to the ProTaper Next X4 file (Dentsply Maillefer, Ballaigues, Switzerland). After dryness, teeth were randomly assigned into 2 groups (n=30) according to the Type of intracanal medication used; Ca(OH)2 and DAP then incubated at 37 °C and 100% humidity. After one week, Samples in each group were randomly assigned to 3 subgroups (n=10) according to the method used for medicament removal: XPF, PUI and SVN. Debris extruded during the removal procedure were collected into pre-weighed Eppendorf tubes then left to dry in an incubator at 37°C for 15 days. The amount of extruded debris was assessed with an analytical balance and calculated by subtracting the initial weight from the final weight of the tube. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. Results: there was no statistically significant difference regarding the amount of apically extruded debris after using the three irrigation techniques in removal of both Ca(OH)2 and DAP (P-value = 0.141, Effect size = 0.160) and (P-value = 0.237, Effect size = 0.073) respectively. Conclusions: Neither XPF nor PUI increase the risk of intracanal medicament extrusion beyond the apex.
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Çanakçi BC, Er Ö, Genç Şen Ö, Süt N. The effect of two rotary and two reciprocating NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth: A randomized controlled trial. Int Endod J 2021; 54:2016-2024. [PMID: 34383324 DOI: 10.1111/iej.13609] [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: 03/03/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 01/07/2023]
Abstract
AIM This randomized clinical trial aimed to assess the effect of two rotary (ProTaper Retreatment + ProTaper Gold and Hyflex EDM) and two reciprocating (Reciproc Blue and WaveOne Gold) NiTi systems on postoperative pain after root canal retreatment on single-rooted incisor teeth. METHODOLOGY One hundred and eighty patients scheduled for root canal retreatment were randomly assigned to one of the four groups according to the NiTi system (ProTaper Retreatment + ProTaper Gold, Hyflex EDM, Reciproc Blue or WaveOne Gold) used for the removal of root canal fillings and further canal preparation. The working length was determined to be 1 mm shorter than the '0.0' mark of the apex locator. Root canals were filled with gutta-percha and an epoxy resin-based root canal sealer using a lateral compaction technique. The teeth were restored using a resin composite material. A single operator performed the retreatments in a single visit. The incidence and intensity of postoperative pain were rated on a numeric rating scale by patients 24, 48 and 72 h after retreatment. The number of analgesic tablets (400 mg Ibuprofen) taken by patients was also recorded. Data were analysed using the Mann-Whitney U, Wilcoxon and chi-square tests. RESULTS For the intensity of postoperative pain, the difference between the four groups was not significantly different (p > .05). No significant difference was found between the groups in terms of analgesic medication intake (p > .05). CONCLUSIONS The rotary and reciprocating NiTi systems tested in this study were associated with similar intensity of postoperative pain and intake of analgesics following root canal retreatment on single-rooted incisor teeth completed in one visit.
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Affiliation(s)
- Burhan Can Çanakçi
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Er
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Özgür Genç Şen
- Department of Endodontics, Faculty of Dentistry, Yüzüncü Yıl University, Van, Turkey
| | - Necdet Süt
- Department of Biostatistics, Medical Faculty, Trakya University, Edirne, Turkey
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Al Omari T, El-Farraj H, Arıcan B, Atav Ateş A. Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. AUST ENDOD J 2021; 48:245-250. [PMID: 34125465 DOI: 10.1111/aej.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/24/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023]
Abstract
The apically extruded debris caused by TruNatomy System (TRN), RACE EVO system (RE) and VDW Rotate (VR) systems in mandibular anterior teeth with ribbon-shaped root canals were compared. The root canals (n = 20 in each group) were irrigated with NaOCl 2.5%, and the extruded debris was collected at pre-weighted Eppendorf tubes. The amount of apically extruded debris (mg) and the treatment time (s) were recorded. Tukey pairwise comparisons were performed to compare groups with a 95% confidence level. VR had significantly less debris extrusion values and treatment time than RE and TRN (P < 0.05). Although no difference was observed between RE and TRN in terms of apically extruded debris (P > 0.05), a significant difference in favour of RE was observed in terms of treatment time (P < 0.05). All the instruments extruded debris at varying weights.
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Affiliation(s)
- Taher Al Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamza El-Farraj
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Burçin Arıcan
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Ayfer Atav Ateş
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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Yılmaz Çırakoglu N, Özbay Y. Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. J Dent Res Dent Clin Dent Prospects 2021; 15:30-34. [PMID: 33927838 PMCID: PMC8058151 DOI: 10.34172/joddd.2021.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/01/2020] [Indexed: 11/09/2022] Open
Abstract
Background. This research aimed to investigate and compare the amount of apically extruded debris after root canal preparation using ProTaper Next, ProTaper Gold, and TruNatomy systems. Methods. Forty-five extracted mandibular premolar teeth with single canals with similar lengths were used. The root canals were prepared using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer, Ballaigues, Switzerland), or TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) files. Apically extruded debris during preparation was gathered into preweighed Eppendorf tubes. Then the Eppendorf tubes were incubated at 70°C for five days. The Eppendorf tubes were weighed again to determine their final weight plus the extruded debris. Results. The TRN system resulted in significantly less debris extrusion than the PTN system (P <0.05). There was no significant difference between the PTN and PTG groups and between the PTG and TRN groups (P >0.05). Conclusion. All the instrumentation systems caused apical extrusion of debris. However, the TRN system resulted in significantly less debris extrusion than the other systems.
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Affiliation(s)
| | - Yağız Özbay
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
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Predin Djuric N, Van Der Vyver P, Vorster M, Vally ZI. Comparison of apical debris extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and reciprocating systems. AUST ENDOD J 2021; 47:394-400. [PMID: 33638593 DOI: 10.1111/aej.12490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
The aim was to evaluate apical debris extrusion produced by a single-file system used in counter-clockwise reciprocation and compare it to rotary single-file systems used in clockwise rotation and clockwise reciprocation. A total of 100 first mandibular molars were divided into five groups (n = 20): (i) WaveOne Gold Glider and Primary instrument in counter-clockwise reciprocation; (ii) One G and One Curve file in clockwise rotation; (iii) One G and One Curve file in clockwise reciprocation; (iv) TruNatomy Glider and Prime instrument in clockwise rotation; and (v) TruNatomy Glider and Prime instrument in clockwise reciprocation. Apical debris extruded was measured after glide path preparation and canal preparation. WaveOne Gold displayed significantly higher amounts of apical debris extrusion in all the groups (P < 0.05). The lowest mean values were recorded by clockwise reciprocation groups: TruNatomy Glider, One Curve and TruNatomy Glider and Prime combined value, for glide path, canal preparation and combined mean values, respectively.
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Affiliation(s)
- Natasa Predin Djuric
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Peet Van Der Vyver
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Martin Vorster
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Zunaid Ismail Vally
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
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da Silva EJNL, de Moura SG, de Lima CO, Barbosa AFA, Misael WF, Lacerda MFLS, Sassone LM. Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study. Restor Dent Endod 2021; 46:e16. [PMID: 34123752 PMCID: PMC8170380 DOI: 10.5395/rde.2021.46.e16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/05/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.
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Affiliation(s)
- Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Sara Gomes de Moura
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Waleska Florentino Misael
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
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Bürklein S, Donnermeyer D, Hentschel TJ, Schäfer E. Shaping Ability and Debris Extrusion of New Rotary Nickel-Titanium Root Canal Instruments. MATERIALS 2021; 14:ma14051063. [PMID: 33668333 PMCID: PMC7956538 DOI: 10.3390/ma14051063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
The aim was to evaluate the canal straightening and the amount of apically extruded debris associated with five rotary nickel-titanium when preparing curved root canals. A total of 100 root canals in extracted human teeth (angles of curvatures 20°–30°; radii 5.9–13.5 mm) were divided into five groups (n = 20/group). The groups were balanced with respect to the angle and the radius of canal curvature. The root canals were prepared using conventional austenite 55-NiTi alloy instruments F360, F6 SkyTaper (both Komet, Lemgo, Germany), and the heat-treated NiTi Jizai, Silk-Complex and Silk-Standard instruments (all Mani, Tochigi, Japan) to an apical size 25. The amount of extruded debris was assessed with a micro balance. Statistical analysis was performed using Kruskal–Wallis test with Bonferroni correction at a significance level of p < 0.05. During canal preparation, neither instrument fractures nor procedural preparation errors were noticed. Regarding canal straightening, the use of Jizai instruments resulted in the significantly lowest straightening (p < 0.05), while no significant differences were obtained between all other groups (p > 0.05). Regarding the amount of apically extruded debris, no significant differences between all groups were obtained (p > 0.05). Within the limitations of this study, all instruments performed well, and especially the Jizai instruments showed an excellent shaping ability.
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Affiliation(s)
- Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
| | - Tim Julian Hentschel
- Private Practice, Zahnärztliche Gemeinschaftspraxis Die Kessels, Brüsseler Straße 11a, 53332 Bornheim, Germany;
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, Westphalian Wilhelms-University, Albert-Schweitzer-Campus 1, Building W 30, 48149 Münster, Germany;
- Correspondence: ; Tel.: +49-251-8347040; Fax: +49-251-8343749
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