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Ventura BN, Gavini G, Iglecias EF, Freire LG, Caldeira CL. Using manual versus mechanized glide path instruments and ProTaper Gold versus ProTaper Next systems in curved canals: micro-CT study. Braz Oral Res 2024; 38:e006. [PMID: 38198306 DOI: 10.1590/1807-3107bor-2024.vol38.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/24/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.
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Affiliation(s)
- Breno Nappi Ventura
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Giulio Gavini
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | | | - Laila Gonzales Freire
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Celso Luiz Caldeira
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
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Jamleh A, Albanyan H, Alaqla A, Alissa H, Alshetan N, Alraffa S, Alfadley A. Impact of cooling on shaping ability of thermally treated files in canal models with double curvature. PeerJ 2023; 11:e15830. [PMID: 37576504 PMCID: PMC10416767 DOI: 10.7717/peerj.15830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background This study compared the ability of thermally treated files in shaping simulated canals with double curvature. Fifty-six canals were enlarged to a final size of 25 with ProTaper Next (PTN) or ZenFlex (ZF). Materials Half of the samples were shaped with cooled files (n = 14 each). The amount of removed resin was measured and canal deviation was determined at eight levels. Shaping time and maximum shaping torque values were also recorded. Data were statistically analyzed using analysis of variance and LSD, Kruskal-Wallis, and chi-square tests at a 0.05 significance level. Results Compared to PTN and cooled PTN, ZF and cooled ZF required lesser time to shape the canals. The maximum torques were found comparable between the groups. All the groups generated negligible deviations at every canal level evaluated and maintained the canal geometry. Although not significant, the cooled PTN and ZF files exhibited lesser canal deviations than their counterparts. Conclusion All groups demonstrated similar shaping ability whilst maintaining the original curvature of the canal in simulated canals with double curvature. However, ZF groups were able to shape the canals faster than PTN groups. There was a trend that cooled files made lesser canal deviations compared to their counterparts.
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Affiliation(s)
- Ahmed Jamleh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hajar Albanyan
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ali Alaqla
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hamad Alissa
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nawaf Alshetan
- Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia
| | | | - Abdulmohsen Alfadley
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Falakaloğlu S, Silva EJNL, Yeniçeri Özata M, Gündoğar M. Shaping ability of different NiTi rotary systems during the preparation of printed mandibular molars. AUST ENDOD J 2023; 49:256-261. [PMID: 35770610 DOI: 10.1111/aej.12649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/18/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the shaping ability of XP-endo Shaper, TruNatomy and EdgeFile X3 during the preparation of resin-printed mandibular molar mesial root canals. Thirty-three resin-based mandibular mesial roots with two canals, obtained from extracted tooth cone-beam computed tomography (CBCT) image and printed on a three-dimensional (3D) printer, were divided into three experimental groups according to the different nickel-titanium (NiTi) systems used for root canal preparation. The specimens were scanned using CBCT imaging before and after root canal preparation. Then images were registered using a dedicated software and changes in the canal area, volume, untouched canal surface and the maximum and minimum dentine wall wear were calculated. The XP-endo Shaper instruments showed improved shaping ability with lower untouched root canal surface and better preservation of root canal anatomy during the preparation of resin-printed mandibular mesial root canals compared with TruNatomy and EdgeFile X3 systems.
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Affiliation(s)
- Seda Falakaloğlu
- Department of Endodontics, School of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | | | - Merve Yeniçeri Özata
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, School of Dentistry, İstanbul Medipol University, İstanbul, Turkey
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Bhardwaj A, Gupta RK, Ates AA, Wahjuningrum DA, Arıcan B, AlOmari T, Luke AM, Pawar AM. Comparison of Postoperative Pain After the Utilization of Different File Systems in Single Visit Endodontics. Patient Prefer Adherence 2023; 17:1025-1034. [PMID: 37090182 PMCID: PMC10115180 DOI: 10.2147/ppa.s405723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes. Patients and Methods A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment. Results The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time. Conclusion The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.
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Affiliation(s)
- Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
| | - Rudra Kumar Gupta
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
| | - Ayfer Atav Ates
- Department of Endodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Correspondence: Dian Agustin Wahjuningrum, Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia, Email
| | - Burçin Arıcan
- Department of Endodontics, Bahçeşehir University, School of Dental Medicine, Istanbul, Turkey
| | - Taher AlOmari
- Department of Conservative Dentistry, Jordan University of Science and Technology, Al-Ramtha, Jordan
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Alexander Maniangat Luke, Department of Clinical Science, College of Dentistry, Ajman University, J1 Building C Block, Al-Jurf 346, Ajman, United Arab Emirates, Email
| | - Ajinkya M Pawar
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, 400008, India
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Vivan RR, Costa VASM, Conti LC, Duque JA, Bramante CM, Só MVR, Alcalde MP, Duarte MAH. Effect of nickel-titanium alloys on root canal preparation and on mechanical properties of rotary instruments. Braz Oral Res 2022; 36:e085. [PMID: 35703710 DOI: 10.1590/1807-3107bor-2022.vol36.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/24/2022] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the quality of curved root canal preparation, torsional fatigue, and cyclic fatigue of rotary systems manufactured with different NiTi alloys. Ninety single-rooted canals with curvatures of 15° to 30o were scanned and divided into three groups according to the rotary system used: BT-Race (BTR) - 10.06, 35.00, 35.04; SequenceRotaryFile (SRF) - 15.04, 25.06, 35.04; and ProDesignLogic (PDL) - 25.01, 25.06, 35.05. Each system was used on three specimens. The teeth were prepared, scanned, and analyzed to assess increase in volume, transportation, and centering ability of the root canal. Torsional fatigue of glide path instruments (BTR 10.06, SRF 15.04 and PDL 25.01) and cyclic fatigue of the finishing instrument (BTR 35.04, SRF 35.04 and PDL 35.05) were obtained by analyzing completely new instruments (n = 10) and instruments after they had been used three times (n = 10). After the torsional and cyclic fatigue tests, the fractured surface of the new and used instruments were examined by scanning electron microscopy. Increase in volume, canal transportation, and centering ability showed no significant differences among the groups (p > 0.05). The torsional test showed that SRF 15.04 produced the highest torque values for both new and used instruments, followed by PDL 25.01 and BTR 10.06 (p < 0.05). PDL 25.01, both new and used, exhibited higher values of angular deflection followed by SRF 15.04 and BTR 10.06 (p < 0.05). As regards cyclic fatigue, use of PDL 35.05, both new and used, required a longer time and larger number of cycles than did SRF 35.04 and BTR 35.04 (p < 0.05). Clinical use affected the torsional fatigue of BTR; however, cyclic fatigue was not significantly affected (p < 0.05). All rotary systems were able to prepare the curved canals satisfactorily and were used safely on the three specimens. Relative to torsional fatigue, SRF 15.04 exhibited a higher torque, and PDL 25.01, higher angular deflection. BTR 10.06 was the most affected by clinical use. PDL 35.05 showed greater resistance to cyclic fatigue.
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Affiliation(s)
- Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Vanessa Abreu Sanches Marques Costa
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Leticia Citelli Conti
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Jussaro Alves Duque
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Clovis Monteiro Bramante
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Marcus Vinicius Reis Só
- Universidade Federal do Rio Grande do Sul - UFRS, Department of Endodontics , Porto Alegre , RS , Brazil
| | - Murilo Priori Alcalde
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry , Department of Dentistry, Endodontics, and Dental Materials , Bauru , SP , Brazil
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Uslu O, Haznedaroglu F, Keskin C. Comparison of mechanical resistance and standardisation between original brand and replica-like endodontic systems. AUST ENDOD J 2022; 49:149-158. [PMID: 35703893 DOI: 10.1111/aej.12639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
This study compared the original (ProTaper Next and Reciproc) endodontic systems with their replica-like brands (X File and Only One File) in terms of standardisation, design, phase-transformation behaviour, composition and mechanical behaviour. X File showed greater taper values than ProTaper Next, while Only One File had the greatest tip diameter. Both replica-like files had an active tip and greater dimensions than their reports. There were also significant differences between the original and replica-like systems in terms of their phase-transformation behaviour and the precision of the measurement lines. Only One File showed significantly lower cyclic fatigue and torsional resistance than Reciproc (p < 0.05). There were no significant differences in the cyclic fatigue, torsional resistance and composition of NiTi between X File and ProTaper Next (p > 0.05). Although replica systems show mechanical properties that can be acceptable, they are not consistent in terms of standardisation and design.
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Affiliation(s)
- Orkun Uslu
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.,Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
| | - Faruk Haznedaroglu
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Kumar T, Mittal S, Keshav V, Kaur R, Maakhni E. A comparative evaluation of remaining dentin thickness following biomechanical preparation of teeth using different rotary file systems: An in vitro study. J Conserv Dent 2022; 25:32-36. [PMID: 35722073 PMCID: PMC9200186 DOI: 10.4103/jcd.jcd_373_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/25/2021] [Accepted: 12/28/2021] [Indexed: 11/04/2022] Open
Abstract
Aim: Materials and Methodology: Statistical Analysis Used: Results: Conclusion:
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8
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Current technology in endodontic instrumentation: advances in metallurgy and manufacture. Br Dent J 2021; 231:49-57. [PMID: 34244648 DOI: 10.1038/s41415-021-3170-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/14/2020] [Indexed: 11/08/2022]
Abstract
Since the introduction of nickel-titanium endodontic instruments, there have been a myriad of developments which can be confusing and sometimes contradictory. This article seeks to review and articulate these advances, and allow the reader to better understand the benefits and the limitations of the systems available. Ultimately, this helps clinicians to engage more confidently with trade and have a more informed choice of the most appropriate file to use for each individual endodontic case. All this should facilitate more predictable endodontic outcomes.
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Zafar MS. Impact of Endodontic Instrumentation on Surface Roughness of Various Nickel-Titanium Rotary Files. Eur J Dent 2021; 15:273-280. [PMID: 33111285 PMCID: PMC8184277 DOI: 10.1055/s-0040-1718469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of the present study was to evaluate the surface roughness (SR) of various nickel-titanium (NiTi) rotary endodontic instruments (ProTaper Next [PTN], WaveOne Gold [WOG], and ProTaper Gold [PTG]) before and after root canal instrumentation. MATERIALS AND METHODS For each type (PTN, WOG, and PTG), the endodontic instrumentation was performed using extracted mandibular molar teeth's curved mesial root canals (curvature: 20-40 degrees) after determining the working length. Each NiTi file was cleaned, and sterilized following preparation of four root canals and characterized for surface properties before and after endodontic instrumentation using a contact-mode three-dimensional surface profiler. The data were analyzed statistically using Statistical Package for the Social Sciences for SR parameters including average surface roughness value (Sa), root mean square roughness (Sq), and peak to valley height (Sz). RESULTS Preinstrumentation assessment revealed a significant difference for all the three SR variables (p < 0.05) for the cutting blade and the flute area. WOG instruments showed the highest SR values (p = 0.000). The postinstrumentation assessment revealed significant differences in SR values in the blade and the flute between the three groups (p < 0.05), with WOG and PTG exhibiting the highest values in the blade and flute sections, respectively. CONCLUSIONS The SR parameters of intact PTN, WOG, and PTG NiTi files vary and that was increased following the endodontic instrumentation.
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Affiliation(s)
- Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al-Munawarah, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
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Root Canal Transportation after Root Canal Preparation with ProTaper Next, WaveOne Gold, and Twisted Files. J Clin Med 2020; 9:jcm9113661. [PMID: 33202555 PMCID: PMC7696375 DOI: 10.3390/jcm9113661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Root canal preparation during endodontic treatment may be associated with various complications, including a change in the original pathway of the root canal lumen. The aim of our study was to determine whether files of similar sizes that use various movement kinematics (rotary, reciprocal, adaptive motion) cause root canal transportation, and whether the differences between such systems are statistically significant. Methods: The degree of root canal transportation (DT) was calculated with the use of computed tomography scans for 3 groups of teeth (for each group: n = 20) in which the root canals were prepared using either rotary (ProTaper Next—PTN), reciprocal (WaveOne Gold—WOG), or adaptive movement (Twisted Files—TF) instruments. Results: For rotary ProTaper Next instruments, the mean value of the DT index was 0.0795 (SD = 0.0179) for 3 mm from the apex, 0.09 (SD = 0.0262) for 6 mm from the apex, and 0.106 (SD = 0.0221) for 9 mm from the apex. For reciprocal WaveOne Gold Primary instruments, the mean value of the DT index was 0.0355 (SD = 0.015) for 3 mm from the apex, 0.061 (SD = 0.02) for 6 mm from the apex, and 0.08 (SD = 0.25) for 9 mm from the apex. For Twisted Files, the mean value of the DT index was 0.05 (SD = 0.03) for 3 mm from the apex, 0.092 (SD = 0.17) for 6 mm from the apex, and 0.08 (SD = 0.02) for 9 mm from the apex. Conclusions: The use of PTN, WOG, and TF files resulted in root canal transportation to a different degree. The use of rotary PTN files produced the most transported preparation, whereas the use of WOG files produced the conservative root canal preparation that allowed the retention of the original shape of the root canal.
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Yammine SD, Jabbour EA. Apically Extruded Debris following Programmed Over Instrumentation of Curved Canals with Three Nickel Titanium Rotary Instruments. Eur J Dent 2020; 15:20-26. [PMID: 32864731 PMCID: PMC7902109 DOI: 10.1055/s-0040-1714175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES This in vitro study aimed to compare the amount of mixed and dried debris extruded with three endodontic NiTi (nickel-titanium) systems at three levels beyond the major apical foramen. The null hypothesis is that there would be no differences between the different rotary systems in terms of apically extruded debris. MATERIALS AND METHODS Forty-eight roots of human extracted molars with 20 to 40-degrees curvature were divided randomly into three groups (n = 16) instrumented with ProTaper Next, BT RaCe, and WaveOne Gold, respectively. Instrumentation was performed at the major foramen and over instrumented 0.5 mm, 1.0 mm and 1.5 mm beyond. Irrigation was performed with sodium hypochlorite. Apically extruded debris was collected. RESULTS Comparison of mixed extruded debris (solution/debris)and dried debris according to group and level of instrumentation showed that WaveOne Gold at the foramen and ProTaper Next beyond the foramen (p < 0.0001) resulted in significantly less extruded debris than other files and within the four levels using repeated measures analysis of variance (p < 0.0001b). CONCLUSIONS All systems exhibit extruded debris during instrumentation but in different amounts.
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Affiliation(s)
- Salwa Daoud Yammine
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
| | - Edgard Antoine Jabbour
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
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Yılmaz F, Eren İ, Eren H, Badi MA, Ocak M, Çelik HH. Evaluation of the Amount of Root Canal Dentin Removed and Apical Transportation Occurrence after Instrumentation with ProTaper Next, OneShape, and EdgeFile Rotary Systems. J Endod 2020; 46:662-667. [DOI: 10.1016/j.joen.2020.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/12/2020] [Accepted: 01/28/2020] [Indexed: 10/24/2022]
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13
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Canal Transportation and Centering Ability in Long Oval Canals: A Multidimentional Analysis. J Endod 2019; 45:1242-1247. [DOI: 10.1016/j.joen.2019.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/28/2019] [Accepted: 07/12/2019] [Indexed: 11/18/2022]
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14
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Özdemir O, Hazar E, Koçak MM, Koçak S, Sağlam BC. Evaluation of Postoperative Pain After Using Different File Systems: A Randomized Clinical Study. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.565698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Impact of new cross-sectional designs on the shaping ability of rotary NiTi instruments in S-shaped canals. Odontology 2019; 108:174-179. [PMID: 31446499 DOI: 10.1007/s10266-019-00450-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/31/2019] [Indexed: 10/26/2022]
Abstract
The aim was to compare the shaping ability of different rotary nickel-titanium instruments in simulated S-shaped canals. One hundred S-shaped canals in resin blocks were prepared to an apical size 25 using F6 SkyTaper (Komet), Silk Files .04, Silk Files .06, Prototypes .04, and Prototypes .06 (all Mani) (20 canals/group). Material removal was measured at 20 measuring points, beginning 1 mm from the endpoint of preparation. Incidence of canal aberrations, preparation time, and instrument failures were also recorded. Statistical analyses were performed using ANOVA, Student-Newman-Keuls and Chi-square test. Pooled data of all measuring points revealed that canals instrumented with Prototypes .04 were significantly better centered than those prepared with all other instruments, while Prototypes .06 and both Silk Files performed significantly better than F6 SkyTaper (p < 0.05). The preparation time differed significantly between all groups and Prototypes .04 allowed the fastest preparation (p < 0.05). There was no statistically significant association between type of instrument and incidence of aberrations (p > 0.05). The cross-sectional design had a marked impact on the shaping ability of the instruments, and less tapered instruments maintained the original canal curvature better than instruments having greater tapers.
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Česaitienė G, Venskutonis T, Mačiulskienė V, Cicėnas V, Samaitis V, Jasiūnienė E. Micro-Computed Tomography (Micro-CT) Evaluation of Effects of Different Rotary Glide Path Techniques on Canal Transportation and Centering in Curved Root Canals. Med Sci Monit 2019; 25:6351-6358. [PMID: 31444318 PMCID: PMC6719729 DOI: 10.12659/msm.916112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the ability of different rotary glide path techniques to maintain canal anatomy by comparing canal transportation and centring abilities in curved root canals using X-ray micro-computed tomography (micro-CT). MATERIAL AND METHODS We selected 36 root canals and randomly assigned them to 3 groups. The first group was instrumented using Pathfile (PF) 1 and PF2, the second group using PF2, and the third group using a Proglider (PG) instrument. Selected tooth samples were scanned using a micro-CT system with 8-µm resolution. Centring ability and transportation were compared at 5 levels: 0.5 mm (A0) and 1 mm (A1) from apical foramen, at the point of maximum root curvature (C0), at 1 mm below it (C-), and 1 mm above it (C+). Area, ratio of areas (RA), perimeter, centroid shift, mean diameter, and ratio of diameter ratios (RDR) were assessed. RESULTS In all groups, there were no significant differences between different levels in all parameters (p>0.05). In group 1, the centroid shift was greatest at A0 and C-, and the least impact was at C0. In group 2, the biggest impacts were at C- and A0, and the smallest at C+. In group 3, the greatest impacts were at A0 and A1, and the smallest at C0. CONCLUSIONS All 3 instrument groups performed very similarly, without significant differences in canal-shaping parameters. Overall, using just PF2 instead of PF 1 and 2 created very similar shaping results, which could reduce the number of instruments needed and the cost of treatment.
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Affiliation(s)
- Gabrielė Česaitienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tadas Venskutonis
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vita Mačiulskienė
- Department of Dental and Oral Pathology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vaidotas Cicėnas
- Prof. K. Baršauskas Ultrasound Research Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Vykintas Samaitis
- Prof. K. Baršauskas Ultrasound Research Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Elena Jasiūnienė
- Prof. K. Baršauskas Ultrasound Research Institute, Kaunas University of Technology, Kaunas, Lithuania.,Department of Electronics Engineering, Kaunas University of Technology, Kaunas, Lithuania
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Gavini G, Santos MD, Caldeira CL, Machado MEDL, Freire LG, Iglecias EF, Peters OA, Candeiro GTDM. Nickel-titanium instruments in endodontics: a concise review of the state of the art. Braz Oral Res 2018; 32:e67. [PMID: 30365608 DOI: 10.1590/1807-3107bor-2018.vol32.0067] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/11/2018] [Indexed: 11/22/2022] Open
Abstract
The introduction of automated instrumentation in endodontics represented a major advance in progress for this specialty, with improvements in the quality and predictability of root canal preparation and a significant reduction in procedural errors. In recent years, endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments. In addition, new movements have also been incorporated to offer greater safety and efficiency, optimizing the properties of the NiTi alloy, especially through eccentric rotary motion. An understanding of the mechanical properties of these new NiTi instruments and their effect on the clinical performance of root canal preparation is essential if dental practitioners are to select the instruments that provide optimal clinical outcomes, especially in curved or flattened canals. The objective of this literature review is to present and discuss the characteristics of the NiTi alloys used in the major instrumentation systems available in the market, as well as the influence of the metallurgical and mechanical properties of NiTi instruments and the movements that drive them, to enable more accurate and predictable planning of root canal preparation.
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Affiliation(s)
- Giulio Gavini
- Universidade de São Paulo - USP, School of Dentistry, Discipline of Endodontics, São Paulo, SP, Brazil
| | - Marcelo Dos Santos
- Universidade de São Paulo - USP, School of Dentistry, Discipline of Endodontics, São Paulo, SP, Brazil
| | - Celso Luis Caldeira
- Universidade de São Paulo - USP, School of Dentistry, Discipline of Endodontics, São Paulo, SP, Brazil
| | | | - Laila Gonzales Freire
- Universidade de São Paulo - USP, School of Dentistry, Discipline of Endodontics, São Paulo, SP, Brazil
| | - Elaine Faga Iglecias
- Universidade de São Paulo - USP, School of Dentistry, Discipline of Endodontics, São Paulo, SP, Brazil
| | - Ove Andrea Peters
- University of the Pacific, Arthur A. Dugoni School of Dentistry, Department of Endodontics, San Francisco, CA, United States
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18
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Assessment of Different Root Canal Preparation Techniques with Rotary Nickel-Titanium Instruments by Novice Students. Dent J (Basel) 2018; 6:dj6030046. [PMID: 30181430 PMCID: PMC6162720 DOI: 10.3390/dj6030046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/13/2018] [Accepted: 08/31/2018] [Indexed: 11/16/2022] Open
Abstract
This study investigated which preparation strategy for root canals leads to the best technical preparation quality, and moreover, which is perceived to be performed best by novice students. Sixty-four students were recruited to prepare one simulated root canal with each of the following: FlexMaster files (F), Mtwo files (M), and Reciproc files (R). After preparation, the students assessed the different instrument systems through a questionnaire. The technical quality of the root canal preparations was evaluated by the centering ratio of the preparation. A total of 186 prepared root canals were submitted for evaluation. With R, significantly better centered preparations were achieved when compared to M and F (p < 0.001). The students evaluated R faster than M and F, and evaluated F significantly (p < 0.05) slower than R and M. M was rated as the easiest system to learn and to handle, as well as the best at reaching the working length; therefore, it was evaluated as the overall favorite of the students. A difference was found between the students' perceptions and their achieved technical quality of root canal preparations.
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Drukteinis S, Peciuliene V, Dummer PMH, Hupp J. Shaping ability of BioRace, ProTaper NEXT and Genius nickel-titanium instruments in curved canals of mandibular molars: a MicroCT study. Int Endod J 2018; 52:86-93. [PMID: 29858500 DOI: 10.1111/iej.12961] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 05/30/2018] [Indexed: 01/13/2023]
Abstract
AIM To evaluate and compare the canal shaping ability of BioRace, ProTaper NEXT and Genius engine-driven nickel-titanium (NiTi) file systems in extracted mandibular first molars using micro-computed tomography (MCT). METHODOLOGY Sixty mesial root canals of mandibular first molars were randomly divided into three equal groups, according to the instrument system used for root canal preparation (n = 20): BioRace (BR), ProTaper NEXT (PTN) or Genius (GN). Root canals were prepared to the full WL using a crown-down technique up to size 35, .04 taper instruments for BR and GN groups and size 30, .07 taper instruments for the PTN group. MCT was used to scan the specimens before and after canal instrumentation. Changes in dentine volume, the percentage of uninstrumented canal surface and degree of canal transportation were evaluated in the coronal, middle and apical thirds of canals. Data were analysed statistically using one-way analysis of variance and Tuckey's post hoc tests with the significance level set at 5%. RESULTS There were no significant differences between the three groups in the terms of dentine removed after preparation and determination of the root canal volume, or percentage of uninstrumented canal surface (P > 0.05). No significant differences were found between the systems for canal transportation in any canal third (P > 0.05). CONCLUSIONS The shaping ability of the BR, PTN and GN NiTi file systems was equally effective. All instrumentation systems prepared curved root canal systems with no evidence of undesirable changes in 3D parameters or significant shaping errors.
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Affiliation(s)
- S Drukteinis
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - V Peciuliene
- Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - J Hupp
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA
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20
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Yammine S, Jabbour E, Diemer F, Majzoub Z. Canal Straightening Following Overinstrumentation with Three Nickel-Titanium Rotary Instruments. J Int Soc Prev Community Dent 2018; 8:245-251. [PMID: 29911063 PMCID: PMC5985682 DOI: 10.4103/jispcd.jispcd_18_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/30/2018] [Indexed: 12/22/2022] Open
Abstract
AIM The aim of the present in vitro study to compare canal straightening following shaping of curved canals with three types of new generation nickel-titanium (NiTi) rotary instruments-ProTaper Next (PTN)®, BT RaCe (BTR)®, and WaveOne Gold (WOG)®- and three different levels of protrusion beyond the major apical foramen. MATERIALS AND METHODS Forty-five extracted human maxillary and mandibular molars with at least one curved canal were distributed in three comparable groups of 15 canals each. The canals were instrumented to the major foramen and then overinstrumented with the final file 0.5 mm, 1 mm, and 1.5 mm beyond the foramen using PTN (Group PTN = 15), BTR (Group BTR = 15), and WOG (Group WOG = 15). Standardized pre- and post-instrumentation radiographs of the root canal were obtained for all groups using digital intraoral radiographs coupled with software. Differences in the degree of curvature were regarded as straightening and canal curvature was evaluated based on Schneider technique using the AmScope software for measurements and compared between groups and levels of instrumentation applying Mixed-model ANOVA. Significance was set at 0.05. RESULTS Canal curvature tended to gradually straighten out as the level of instrumentation increased in all three groups without statistically significant difference among the groups (P = 0.826). CONCLUSION Overinstrumentation in curved canals resulted in straightening of the canal curvature.
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Affiliation(s)
- Salwa Yammine
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Edgard Jabbour
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
| | - Franck Diemer
- Université Paul Sabatier, Institut Clément Ader, CHU de Toulouse, France
| | - Zeina Majzoub
- Department of Periodontology, Faculty of Dental Medicine, Lebanese University, Hadath, Beirut, Lebanon
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21
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Park HJ, Seo MS, Moon YM. Root canal volume change and transportation by Vortex Blue, ProTaper Next, and ProTaper Universal in curved root canals. Restor Dent Endod 2018; 43:e3. [PMID: 29487834 PMCID: PMC5816992 DOI: 10.5395/rde.2018.43.e3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/28/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this study was to compare root canal volume change and canal transportation by Vortex Blue (VB; Dentsply Tulsa Dental Specialties), ProTaper Next (PTN; Dentsply Maillefer), and ProTaper Universal (PTU; Dentsply Maillefer) nickel-titanium rotary files in curved root canals. Materials and Methods Thirty canals with 20°-45° of curvature from extracted human molars were used. Root canal instrumentation was performed with VB, PTN, and PTU files up to #30.06, X3, and F3, respectively. Changes in root canal volume before and after the instrumentation, and the amount and direction of canal transportation at 1, 3, and 5 mm from the root apex were measured by using micro-computed tomography. Data of canal volume change were statistically analyzed using one-way analysis of variance and Tukey test, while data of amount and direction of transportation were analyzed using Kruskal-Wallis and Mann-Whitney U test. Results There were no significant differences among 3 groups in terms of canal volume change (p > 0.05). For the amount of transportation, PTN showed significantly less transportation than PTU at 3 mm level (p = 0.005). VB files showed no significant difference in canal transportation at all 3 levels with either PTN or PTU files. Also, VB files showed unique inward transportation tendency in the apical area. Conclusions Other than PTN produced less amount of transportation than PTU at 3 mm level, all 3 file systems showed similar level of canal volume change and transportation, and VB file system could prepare the curved canals without significant shaping errors.
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Affiliation(s)
| | - Min-Seock Seo
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Wonkwang University, Daejeon, Korea
| | - Young-Mi Moon
- Department of Conservative Dentistry, Wonkwang University Daejeon Dental Hospital, Wonkwang University, Daejeon, Korea
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22
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Mamede-Neto I, Borges ÁH, Alencar AHG, Duarte MAH, Sousa Neto MD, Estrela C. Multidimensional Analysis of Curved Root Canal Preparation Using Continuous or Reciprocating Nickel-titanium Instruments. Open Dent J 2018; 12:32-45. [PMID: 29456772 PMCID: PMC5806212 DOI: 10.2174/1874210601812010032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 11/29/2022] Open
Abstract
Objective: To evaluate transportation (T) and centering ability (CA) of root canal preparations using continuous or reciprocating nickel-titanium endodontic files. Materials and Methods: Ninety-six mesiobuccal root canals of mandibular first and second molars were randomly divided into 6 groups (n=16) according to the rotary file used: 1. ProTaper Next; 2. ProTaper Gold; 3. Mtwo; 4. BioRaCe; 5. WaveOne Gold; 6. Reciproc. Root canals were prepared according to manufacturer’s instructions. Cone beam computed tomography scans were obtained before and after root canal preparation. Measurements were made at six different reference points: 2, 3 and 4 mm from the apex and 2, 3 and 4 mm below furcation in different directions. Results: The greatest Mesiodistal (MD) Transportation (T) was found for Reciproc files (p<0.05), and the greatest buccolingual (BL) T, for Reciproc, ProTaper Gold and ProTaper Next files (p<0.05). The greatest Mesiodistal (MD) Centering Ability (CA) was found for BioRaCe files (p<0.05), and the greatest Buccolingual (BL) CA, for BioRaCe and Mtwo files (p<0.05). Conclusion: All systems produced root canal transportation. No file system achieved perfect CA of root preparation. Reciproc files had the greatest MD T and BL T. BioRaCe files had the greatest MD CA, whereas BL CA was similar for BioRaCe and Mtwo files.
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Affiliation(s)
- Iussif Mamede-Neto
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | | | - Marco Antonio Hungaro Duarte
- Departament of Dentistry, Endodontics and Dental Material, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Manoel Damião Sousa Neto
- Departament of Restaurative Dentistry, Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
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Rödig T, Wagner J, Wiegand A, Rizk M. Efficacy of the ProTaper retreatment system in removing Thermafil, GuttaCore or vertically compacted gutta-percha from curved root canals assessed by micro-CT. Int Endod J 2018; 51:808-815. [PMID: 29363142 DOI: 10.1111/iej.12893] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/18/2018] [Indexed: 11/28/2022]
Abstract
AIM To evaluate ex vivo the efficacy of ProTaper Universal Retreatment files (Dentsply Sirona, Ballaigues, Switzerland) in removing Thermafil, GuttaCore (both Dentsply Sirona) or vertically compacted gutta-percha from curved root canals using micro-CT. METHODOLOGY Sixty curved molar roots with the same mean canal curvatures and radii in two directions were prepared using ProFile instruments (Dentsply Sirona) to size 30 with .04 taper and obturated with either Thermafil, GuttaCore or vertically compacted gutta-percha and AH Plus (n = 20). Specimens were retreated using the ProTaper Universal Retreatment files D1, D2 and D3 to working length, and root canal preparation was completed with ProTaper Next (Dentsply Sirona) to size ×4. Percentages of residual filling material and dentine removal were assessed using micro-CT imaging. Working time and procedural errors were recorded. Statistical analysis was performed using Kruskal-Wallis and Wilcoxon tests. RESULTS No significant differences between carrier-based and warm vertical compaction regarding residual filling material (14.2-19.3%) and dentine removal (2.7-3.2 mm3 ) were detected (P > 0.05). Time to reach working length was significantly faster for canals filled with GuttaCore than that observed for Thermafil and warm vertical compaction (P < 0.05). Five lateral perforations with the D3 file occurred during retreatment, one in the Thermafil and four in the vertical compaction group. CONCLUSIONS Remaining filling material and dentine removal were similar for all canal filling techniques. Regaining working length was significantly faster for GuttaCore compared with Thermafil and vertically compacted gutta-percha. Procedural errors occurred during retreatment of severely curved root canals with the ProTaper Universal Retreatment files in 5 of 60 canals (8%).
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Affiliation(s)
- T Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - J Wagner
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - A Wiegand
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - M Rizk
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Canal Transportation, Unprepared Areas, and Dentin Removal after Preparation with BT-RaCe and ProTaper Next Systems. J Endod 2017; 43:1683-1687. [DOI: 10.1016/j.joen.2017.04.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/08/2017] [Accepted: 04/16/2017] [Indexed: 11/21/2022]
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Lopes RMV, Marins FC, Belladonna FG, Souza EM, De-Deus G, Lopes RT, Silva EJNL. Untouched canal areas and debris accumulation after root canal preparation with rotary and adaptive systems. AUST ENDOD J 2017; 44:260-266. [DOI: 10.1111/aej.12237] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Rosa Maria Vianna Lopes
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias Rio de Janeiro Brazil
| | - Fernanda Cunha Marins
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias Rio de Janeiro Brazil
| | | | - Erick Miranda Souza
- Department of Dentistry II; Federal University of Maranhão; São Luis Maranhão Brazil
| | - Gustavo De-Deus
- Department of Endodontics; Fluminense Federal University (UFF); Niterói Rio de Janeiro Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Engineering Program; Federal University of Rio de Janeiro (UFRJ); Rio de Janeiro Rio de Janeiro Brazil
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Çiçek E, Koçak MM, Koçak S, Sağlam BC, Türker SA. Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study. J Appl Oral Sci 2017; 25:20-26. [PMID: 28198972 PMCID: PMC5289396 DOI: 10.1590/1678-77572016-0138] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/30/2016] [Indexed: 02/02/2023] Open
Abstract
Postoperative pain is a frequent complication associated with root canal treatment, especially during apical instrumentation of tooth with preexisting periradicular inflammation
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Affiliation(s)
- Ersan Çiçek
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Sibel Koçak
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Baran Can Sağlam
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Sevinç Aktemur Türker
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
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27
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Venino PM, Citterio CL, Pellegatta A, Ciccarelli M, Maddalone M. A Micro–computed Tomography Evaluation of the Shaping Ability of Two Nickel-titanium Instruments, HyFlex EDM and ProTaper Next. J Endod 2017; 43:628-632. [DOI: 10.1016/j.joen.2016.11.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/16/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
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Yammine S, Jabbour E, Nahas P, Majzoub Z. Foramen Changes following Over Instrumentation of Curved Canals with Three Engine-Driven Instruments: An In Vitro Study. IRANIAN ENDODONTIC JOURNAL 2017; 12:454-461. [PMID: 29225641 PMCID: PMC5722120 DOI: 10.22037/iej.v12i4.16268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/06/2017] [Accepted: 08/20/2017] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The present in vitro study aimed to evaluate and compare the changes in shape and surface area of the major foramen following shaping of curved canals with three new generation NiTi engine-driven instruments naming ProTaper Next, BT RaCe and WaveOne Gold- with 3 different levels of protrusion beyond the major apical foramen. METHODS AND MATERIALS A total of 45 extracted human molars with at least one curved canal were distributed in 3 comparable groups of 15 that were instrumented using either ProTaper Next (PTN), BT RaCe (BTR) or WaveOne Gold (WOG). The canals were instrumented to the major foramen and then over instrumented with the final file 0.5 mm, 1 mm and 1.5 mm beyond the foramen. Standardized pre- and post-instrumentation photographs of the foramen were obtained for all groups using a stereomicroscope. Foramen shape and surface area were evaluated using the AmScope software for measurements and compared between groups and levels of instrumentation applying binary conditional logistic regression and repeated measures ANOVA. The level of significance was set at 0.05. RESULTS Foramen shape tended to gradually change from circular to oval as the level of instrumentation increased in all groups. The original foramen shape in WOG group remained better than other groups. Foramen surface areas increased in all groups with Group BTR demonstrating significantly greater values than the other 2 groups. CONCLUSION Over instrumentation resulted in apical enlargement and ovalization in all 3 groups but with different patterns. These differences can be attributed to the final file size, design characteristics and kinematics of the 3 systems.
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Affiliation(s)
- Salwa Yammine
- Department of Endodontics, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon;
| | - Edgard Jabbour
- Department of Endodontics, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon;
| | - Paul Nahas
- Department of Restorative and Esthetic Dentistry, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon;
| | - Zeina Majzoub
- Department of Periodontology, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
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Apical transportation during removal of root canal filling with different retreatment systems. Int J Artif Organs 2016; 39:541-545. [PMID: 27901556 DOI: 10.5301/ijao.5000535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study aimed to compare apical transportation during retreatment using ProTaper Universal retreatment (PTUR), Mtwo R and D-RaCe instruments in curved root canals. METHODS 36 extracted mandibular molar teeth with curved mesiobuccal roots were selected. The teeth were embedded into acrylic blocks. The blocks were fixed on the experimental setup. After determining the working length (WL), mesiobuccal canals were prepared with ProTaper Universal rotary instruments to size F1 (20/0.06). After the obturation, the teeth were randomly divided into groups; the PTUR files were used as D1 (30/0.09) for coronal third and D2 (25/0.08) at WL. Mtwo R files, R1 (15/0.05) and R2 (25/0.05) were used at WL. D-RaCe files were used as DR1 (30/.10) in cervical third and DR2 (25/0.04) at WL. Image J analysis software was used to measure the apical transportation. Differences between the 3 groups were analyzed with a 1-way ANOVA or Kruskal-Wallis tests. RESULTS There was no significant difference between groups in the apical transportation in either the mesiodistal (p = 0.166) or buccolingual (p = 0.518) direction. Among the 3 groups, the apical transportation was the greatest in the D-RaCe group. CONCLUSIONS It can be concluded that all retreatment systems caused a similar level of apical transportation.
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Krokidis A, Bonfanti C, Cerutti A, Barabanti N, Zinelis S, Panopoulos P. Comparative analysis of SAF, Protaper Next and BT-Race in eliminating Enterococcus faecalis
from long oval canals: An ex vivo
study. AUST ENDOD J 2016; 43:110-114. [DOI: 10.1111/aej.12177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Andreas Krokidis
- Department of Endodontics; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Carlo Bonfanti
- Laboratory of Microbiology; School of Medicine; University of Brescia; Brescia Italy
| | - Antonio Cerutti
- Department of Restorative Dentistry; School of Dentistry; University of Brescia; Brescia Italy
| | - Nicola Barabanti
- Department of Restorative Dentistry; School of Dentistry; University of Brescia; Brescia Italy
| | - Spyros Zinelis
- Department of Biomaterials; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Panos Panopoulos
- Department of Endodontics; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
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Kumari MR, Krishnaswamy MM. Comparative Analysis of Crack Propagation in Roots with Hand and Rotary Instrumentation of the Root Canal -An Ex-vivo Study. J Clin Diagn Res 2016; 10:ZC16-9. [PMID: 27630946 DOI: 10.7860/jcdr/2016/17576.8122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Success of any endodontic treatment depends on strict adherence to 'endodontic triad'. Preparation of root canal system is recognized as being one of the most important stages in root canal treatment. At times, we inevitably end up damaging root dentin which becomes a Gateway for infections like perforation, zipping, dentinal cracks and minute intricate fractures or even vertical root fractures, thereby resulting in failure of treatment. Several factors may be responsible for the formation of dentinal cracks like high concentration of sodium hypochlorite, compaction methods and various canal shaping methods. AIM To compare and evaluate the effects of root canal preparation techniques and instrumentation length on the development of apical root cracks. MATERIALS AND METHODS Seventy extracted premolars with straight roots were mounted on resin blocks with simulated periodontal ligaments, exposing 1-2 mm of the apex followed by sectioning of 1mm of root tip for better visualization under stereomicroscope. The teeth were divided into seven groups of 10 teeth each - a control group and six experimental groups. Subgroup A & B were instrumented with: Stainless Steel hand files (SS) up to Root Canal Length (RCL) & (RCL -1 mm) respectively; sub group C & D were instrumented using ProTaper Universal (PTU) up to RCL and (RCL -1mm) respectively; subgroup E & F were instrumented using ProTaper Next (PTN) up to RCL & (RCL -1 mm) respectively. Stereomicroscopic images of the instrumentation sequence were compared for each tooth. The data was analyzed statistically using descriptive analysis by 'Phi' and 'Cramers' test to find out statistical significance between the groups. The level of significance was set at p< 0.05 using SPSS software. RESULTS Stainless steel hand file group showed most cracks followed by ProTaper Universal & ProTaper Next though statistically not significant. Samples instrumented up to 1mm short of working length (RCL-1mm) showed lesser number of cracks. CONCLUSION All groups showed cracks formation, the stainless steel group being the highest. Working 1mm short of apex reduces the incidence of crack formation.
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Affiliation(s)
- Manju Raj Kumari
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, J.S.S Dental College and Hospital , Mysuru India
| | - Manjunath Mysore Krishnaswamy
- Professor and Head of the Department, Department of Conservative Dentistry and Endodontics, J.S.S Dental College and Hospital , Mysuru, India
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Saberi N, Patel S, Mannocci F. Comparison of centring ability and transportation between four nickel titanium instrumentation techniques by micro-computed tomography. Int Endod J 2016; 50:595-603. [DOI: 10.1111/iej.12658] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/03/2016] [Indexed: 01/11/2023]
Affiliation(s)
- N. Saberi
- Department of Conservative Dentistry and Endodontology; King's College London Dental Institute; London UK
| | - S. Patel
- Department of Conservative Dentistry and Endodontology; King's College London Dental Institute; London UK
| | - F. Mannocci
- Department of Conservative Dentistry and Endodontology; King's College London Dental Institute; London UK
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da Silva Limoeiro AG, dos Santos AHB, De Martin AS, Kato AS, Fontana CE, Gavini G, Freire LG, da Silveira Bueno CE. Micro-Computed Tomographic Evaluation of 2 Nickel-Titanium Instrument Systems in Shaping Root Canals. J Endod 2016; 42:496-9. [DOI: 10.1016/j.joen.2015.12.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/04/2015] [Accepted: 12/06/2015] [Indexed: 10/22/2022]
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Elemam RF, Capelas JA, Vaz MAP, Viriato N, Pereira ML, Azevedo A, West J. Evaluating Transportation by Comparing Several uses of Rotary Endodontic Files. J Contemp Dent Pract 2015; 16:927-32. [PMID: 27018025 DOI: 10.5005/jp-journals-10024-1783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To evaluate the frequent use of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) systems on shaping ability of root canal utilizing Solidworks (2014, Dassault Systemes) software. MATERIALS AND METHODS Thirty-six root canals in clear resin blocks (Dentsply-Maillefer) were allocated into six experimental groups (n = 36). Six new sets of PTN instruments (Dentsply Maillefer, Ballaigues, Switzerland) were used six times to shape the resin blocks. A #15 K-file was inserted to the working length (WL), followed by ProGlider (PG) to create a glide path. Sequential use of PTN instrumentation in a crown-down technique was used to reach size (30/07) apically. Macroscopic photos of the blocks were taken before and after instrumentation, layered by Paint Shop Pro 9 from JascSoftware, and then canal transportation was measured using Solidwork 2014. The data were analyzed by SPSS software version 22. Multivariate statistical analysis general linear model (GLM) was also applied. Bonferroni correction test was used in multiple comparisons and the statistical significance was set to 0.05. RESULTS There was no difference in canal transportation resulted from utilizing PTN files after six multiple uses; in addition, the PTN files showed ability to maintain the original canal anatomy, especially in the apical level, where lowest total mean value of canal center displacement was seen (3 mm level) (0.019 ± 0.017). CONCLUSION ProTaper Next files can be used to prepare single and multiple canals in a single furcated tooth. CLINICAL SIGNIFICANCE ProTaper Next nickel-titanium (NiTi) file system is a safe instrument that respects the canal shape, allows practitioners to treat difficult cases with good results, and low risk of separation.
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Affiliation(s)
- Ranya F Elemam
- PhD, Department of Endodontics, Faculty of Dental Medicine University of Porto, Rua Dr. Manuel Pereira da Silva 4200-393, Porto, Portugal Phone: +351 92005818, e-mail:
| | - J A Capelas
- Department of Endodontics, Faculty of Dental Medicine University of Porto, Porto, Portugal
| | - Mário A P Vaz
- Department of Mechanical Engineering, Faculty of Engineering University of Porto, Porto, Portugal
| | - Nuno Viriato
- Laboratory of Optics and Experimental Mechanics, INEGI-Institute of Mechanical Engineering and Industrial Management Porto, Portugal
| | - M L Pereira
- Faculty of Dental Medicine, University of Porto, EPI Unit-Institute of Public Health University of Porto, Porto, Portugal
| | - A Azevedo
- Faculty of Dental Medicine, University of Porto, EPI Unit-Institute of Public Health University of Porto, Porto, Portugal
| | - John West
- Department of Endodontics, University of Washington School of Dentistry, Washington, USA
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Evaluation of the Shaping Characteristics of ProTaper Gold, ProTaper NEXT, and ProTaper Universal in Curved Canals. J Endod 2015; 41:1718-24. [DOI: 10.1016/j.joen.2015.07.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/10/2015] [Accepted: 07/12/2015] [Indexed: 11/20/2022]
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Pasqualini D, Alovisi M, Cemenasco A, Mancini L, Paolino DS, Bianchi CC, Roggia A, Scotti N, Berutti E. Micro–Computed Tomography Evaluation of ProTaper Next and BioRace Shaping Outcomes in Maxillary First Molar Curved Canals. J Endod 2015; 41:1706-10. [DOI: 10.1016/j.joen.2015.07.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 06/22/2015] [Accepted: 07/05/2015] [Indexed: 11/26/2022]
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Ferrara G, Taschieri S, Corbella S, Ceci C, Del Fabbro M, Machtou P. Comparative evaluation of the shaping ability of two different nickel-titanium rotary files in curved root canals of extracted human molar teeth. ACTA ACUST UNITED AC 2015; 8. [PMID: 26343421 DOI: 10.1111/jicd.12187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to compare the shaping ability of two different nickel-titanium rotary files in the curved root canals of extracted human molar teeth. METHODS Thirty root canals of 17 extracted human molars teeth were randomly assigned to two experimental groups (n = 15): ProTaper Next and ProTaper Universal (PTU), on the basis of the rotary files system used. The final size of all apical foramina was 0.25 mm in diameter. Standardized digital radiographs were taken before and after instrumentation in both clinical and proximal views, with a size 10 K-file inserted into the canal for the determination of the angle of curvature and apical transportation. Preparation time and fractured or deformed instruments were also recorded. The unpaired Student's t-test was used to compare results. RESULTS There was no significant difference between the two instruments with respect to canal straightening and apical transportation before and after instrumentation (P > 0.05). The use of both instruments resulted in a significant reduction in the angle of curvature after instrumentation (P < 0.05). Instrumentation time was significantly greater for PTU (P < 0.05). CONCLUSIONS The ProTaper Universal and ProTaper Next systems performed similarly with regard to the straightening of curved root canals and apical transportation. ProTaper Next was significantly faster than ProTaper Universal.
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Affiliation(s)
- Giulia Ferrara
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Istituto di Ricerca e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milano, Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Istituto di Ricerca e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milano, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Istituto di Ricerca e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milano, Italy
| | - Caterina Ceci
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Istituto di Ricerca e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milano, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Istituto di Ricerca e Cura a Carattere Scientifico, Istituto Ortopedico Galeazzi, Milano, Italy
| | - Pierre Machtou
- Université Paris 7 Diderot, Unité de Formation et de Recherche d'odontologie, Paris, France
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Türker SA, Uzunoğlu E. Apical root canal transportation of different pathfinding systems and their effects on shaping ability of ProTaper Next. J Clin Exp Dent 2015; 7:e392-5. [PMID: 26330936 PMCID: PMC4554239 DOI: 10.4317/jced.52309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/16/2015] [Indexed: 11/16/2022] Open
Abstract
Background This study aimed to compare glide path preparation of different pathfinding systems and their effects on the apical transportation of ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland) in mesial root canals of extracted human mandibular molars, using digital subtraction radiography. Material and Methods The mesial canals of 40 mandibular first molars (with curvature angles between 25° and 35°) were selected for this study. The specimens were divided randomly into 4 groups with 10 canals each. Glide paths were created in group 1 with #10, #15 and #20 K-type (Dentsply Maillefer, Ballaigues, Switzerland) stainless steel manual files; in group 2 with Path-File (Dentsply Maillefer) #1, #2, and #3 and in group 3 with #16 ProGlider (Dentsply Maillefer) rotary instruments; in group 4 no glide paths were created. All canals were instrumented up to ProTaper Next X2 to the working length. A double digital radiograph technique was used, pre and post-instrumentation, to assess whether apical transportation and/or aberration in root canal morphology occurred. Instrument failures were also recorded. The data were analyzed statistically using ANOVA and Tukey tests (p<0.05). Results No significant differences were found among groups regarding apical transportation (p>0.05). Two ProTaper Next instruments failed in-group 4. Conclusions Within the parameters of this study, there was no difference between the performance of path-finding files and ProTaper Next system maintained root canal curvature well and was safe to use either with path-finding files or alone. Key words:Glide path, PathFile, ProGlider, ProTaper Next, transportation.
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Affiliation(s)
- Sevinç-Aktemur Türker
- DDS, PhD, Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Emel Uzunoğlu
- DDS, PhD, Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Uzunoglu E, Turker SA. Comparison of Canal Transportation, Centering Ratio by Cone-beam Computed Tomography after Preparation with Different File Systems. J Contemp Dent Pract 2015; 16:360-5. [PMID: 26162254 DOI: 10.5005/jp-journals-10024-1690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM One Shape Apical 1 (OSA 1) is a new file for preparing the apical aspect of the root canal after One Shape (OS, Micro Mega, Besançon, France). This study compared apical transportation and centering ratios in curved root canals, which were instrumented with ProTaper Next (PTN, Dentsply Tulsa Dental Specialties, Tulsa, OK) up to size X3 and with OS up to OSA 1. MATERIALS AND METHODS Forty-eight mesial canals of mandibular molars were assigned into two groups (n = 24) with respect to canal length and curvature. Root canals were accessed conventionally and preperation was completed with PTN files up to X3 or with OS up to OSA 1 according to the manufacturer's protocols. Apical transportation was assessed pre- and postinstrumentation using cone-beam computed tomographic (CBCT) scans of 1, 2, 3, 4, and 5 mm sections. A Friedman test was performed to assess the significance between file systems. RESULTS No significant difference was found between the file systems regarding apical transportation and centering ratio values (p > 0.05). Transportation in the mesial direction was greater than the distal transportation for both file systems. CONCLUSION Considering apical transportation and centering ratio in curved canals, two systems provided similar results. CLINICAL SIGNIFICANCE Preparation up to One Shape Apical 1 or ProTaper Next X3 was shown similar results regarding apical transportation and centering ratio. Both systems were safe to use in curved molar root canals.
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Affiliation(s)
- Emel Uzunoglu
- Research Assistant Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey, Phone: +903123052260 e-mail:
| | - Sevinc Aktemur Turker
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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