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Yanık D, Özel Ş. Shaping ability of three instrumentation system in moderately curved canals: A micro-CT study. Microsc Res Tech 2024; 87:2399-2407. [PMID: 38813968 DOI: 10.1002/jemt.24613] [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: 03/08/2024] [Revised: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 05/31/2024]
Abstract
This study aims to compare the shaping ability of three systems using micro-computed tomography (micro-CT). Moderately-curved mesial canals of 36 mandibular molars were assigned to three groups (n = 24); Protaper Next (PTN, 0.25, 0.06), WaveOne Gold (WOG, 0.25, 0.07), TruNatomy (TRN, 0.25, 0.04), and instrumentation was performed. Pre- and post-micro-CT scans were obtained. Canal volume and surface, structure model index (SMI), centroid shift, canal transportation, and untouched canal were analyzed. One-way ANOVA and Student's t-test were used for statistics. There was no difference in SMI, centroid shift, and centering ability between the study groups (p > .05). Removed dentin and canal surface changes were lower in TRN, while untouched dentin walls were higher (p < .05). Cross-sections became more rounded (p < .05), but not significant between groups (p > .05). Considering the removed dentin by TRN, it can be used in critical dentin thickness, such as the danger zone (DZ). PTN, WOG, and WOG kept the original canal course similarly. Untouched dentin by TRN (41%) was wider than PTN and WOG, consequently, meticulous irrigation is recommended. TRN, which provides a controlled increase in canal volume, can be used in thin dentin such as the DZ, however, its use should be supported by copious irrigation and brushing considering the rate of untouched dentin walls. RESEARCH HIGHLIGHTS: TRN presented a higher untouched dentin wall compared to PTN and WOG. Canal volume and surface changes were the lowest in the TRN group. The centering abilities were similar in PTN, WOG, and TRN.
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Affiliation(s)
- Deniz Yanık
- Faculty of Dentistry, Department of Endodontics, Süleyman Demirel University, Isparta, Turkey
| | - Şelale Özel
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Altınbas University, İstanbul, Turkey
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Atmeh AR, Al Omari T, AlQifari AF, Jamleh A. Exploring morphometric transformations in temperature-sensitive NiTi instruments alongside real-time intracanal temperature dynamics. Int Endod J 2024; 57:1360-1370. [PMID: 38804711 DOI: 10.1111/iej.14100] [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: 03/16/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
AIM This study was twofold: (i) it aimed to investigate the morphometric changes of three temperature-sensitive nickel-titanium (NiTi) instruments at different temperatures, and (ii) to conduct an in vivo real-time analysis of intracanal temperature changes. METHODS Changes in the shape and length of XP-Endo Shaper, XP-Endo Finisher, and XP-Endo Finisher-R were evaluated in real time whilst heated in a temperature-controlled water bath from 22 to 45°C. Instruments were fixed to a laminated water-resistant 1 mm graph paper attached to a stone block. Instruments were imaged whilst subjected to increasing temperature using a digital camera attached to an operating microscope. From recorded videos, still frames were extracted at 10-s intervals and changes in the length and shape of each instrument were measured and changes were plotted against time. Moreover, the intracanal temperature of distal roots of lower molars was measured in vivo for patients attending the clinic for non-surgical root canal treatments. The temperature was measured using a K-type thermocouple probe inserted into the mid-root level after irrigating the canal with a solution set at room temperature (22°C) or heated to 45°C. The intraoral and intracanal temperatures were recorded using a video camera for 180 s at 5-s intervals to plot the change in the intraoral and intracanal temperature, after both irrigation solution temperatures, with time. RESULTS The shape transformation of XP-Endo Shaper began at 31.5 ± 2.0°C and reached its optimal transformation at 35.1 ± 1.0°C. For the Finisher and Finisher-R, shape transformations began at 29.2 ± 1.9 and 26.9 ± 2.2°C reaching the optimal transformation at 33.9 ± 1.4 and 32.7 ± 1.7°C, respectively. The average decreases in lengths of XP-Endo Shaper, Finisher, and Finisher-R after full transformation were 0.43 ± 0.23, 1.07 ± 0.22, and 1.15 ± 0.22 mm, respectively. The intracanal temperature reached 32.9 ± 0.8 and 33.2 ± 1.0°C after 3 min of application of irrigation solutions set at 22 or 45°C, respectively. CONCLUSION The tested instruments exhibited diverse changes in their shapes and lengths at varying temperatures. Despite the temperature of the irrigation solution, the intracanal temperature consistently remained lower than the intracanal temperature once equilibrium was reached. This highlights the importance of considering the temperature of irrigation solution during in vitro testing of endodontic instruments.
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Affiliation(s)
- 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
| | - Taher Al Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdullah F AlQifari
- Department of Endodontics, Regional Dental Centre in Qassim, Buraydah, Saudi Arabia
| | - Ahmed Jamleh
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Chicon JB, Fernandes Pavão VM, Gonçalves Cunha MH, Frozoni M. Influence of the Brushing Motions on the Dynamic Cyclic Fatigue Resistance of the Reciproc Blue Instrument: In vitro Study. J Endod 2024; 50:1340-1345. [PMID: 38964675 DOI: 10.1016/j.joen.2024.06.013] [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: 02/12/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION This study aimed to evaluate the dynamic cyclic fatigue resistance of Reciproc Blue files subjected to brushing motion. METHODS Twenty Reciproc Blue files (R25, VDW, Munich, Germany) were employed for chemical-mechanical preparation in root canals of 3D printed replicas of mandibular molars. The instruments were divided into two groups (n = 10): Group brushing motion, instrumentation with brushing motions; Group without brushing motion , instrumentation without brushing motions. Subsequently, the same instruments underwent cyclic fatigue testing using artificial canals consisting of a stainless-steel plate and an apical segment with a 45° curvature. Data regarding the time to fracture, number of cycles to fracture, and length of the fractured fragment were collected and subjected to statistical analysis using the t-test or Mann-Whitney test, with a significance level of 5%. Additionally, the fractured fragments were examined under a scanning electron microscope. RESULTS No statistical differences were observed between the groups in terms of time to fracture (P < .05), number of cycles to fracture (P < .05) and length of the fractured fragment (P < .05). CONCLUSION The brushing motion did not affect the dynamic cyclic fatigue resistance of Reciproc Blue files.
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Affiliation(s)
- Juliana Borsoi Chicon
- Department of Endodontic, São Leopoldo Mandic School of Dentistry, Campinas, SãP Paulo, Brazil.
| | | | | | - Marcos Frozoni
- Department of Endodontic, São Leopoldo Mandic School of Dentistry, Campinas, SãP Paulo, Brazil
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Kyaw MS, Ebihara A, Iino Y, Thu M, Maki K, Kimura S, Htun PH, Okiji T. Effect of repetitive up-and-down movements on torque/force generation, surface defects and shaping ability of nickel-titanium rotary instruments: an ex vivo study. BMC Oral Health 2024; 24:986. [PMID: 39180005 PMCID: PMC11344434 DOI: 10.1186/s12903-024-04689-6] [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: 05/08/2024] [Accepted: 07/30/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND The screw-in effect is a tendency of a nickel-titanium (NiTi) rotary endodontic file to be pulled into the canal, which can result in a sudden increase in stress leading to instrument fracture, and over-instrumentation beyond the apex. To reduce screw-in force, repeated up-and-down movements are recommended to distribute flexural stress during instrumentation, especially in curved and constricted canals. However, there is no consensus on the optimal number of repetitions. Therefore, this study aimed to examine how repeated up-and-down movements at the working length affect torque/force generation, surface defects, and canal shaping ability of JIZAI and TruNatomy instruments. METHODS An original automated root canal instrumentation device was used to prepare canals and to record torque/force changes. The mesial roots of human mandibular molars with approximately 30˚ of canal curvature were selected through geometric matching using micro-computed tomography. The samples were divided into three groups according to the number of up-and-down movements at the working length (1, 3, and 6 times; n = 24 each) and subdivided according to the instruments: JIZAI (#13/0.04 taper, #25/0.04 taper, and #35/0.04 taper) or TruNatomy (#17/0.02 taper, #26/0.04 taper, and #36/0.03 tape) (n = 12 each). The design, surface defects, phase transformation temperatures, nickel-titanium ratios, torque, force, shaping ability, and surface deformation were evaluated. Data were analyzed with the Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS The instruments had different designs and phase transformation temperatures. The 3 and 6 up-and-down movements resulted in a smaller upward force compared to 1 movement (p < 0.05). TruNatomy generated significantly less maximum torque, force, and surface wear than JIZAI (p < 0.05). However, TruNatomy exhibited a larger canal deviation (p < 0.05). No statistical differences in shaping ability were detected between different up-and-down movements. CONCLUSIONS Under laboratory conditions with JIZAI and TruNatomy, a single up-and-down movement at the working length increased the screw-in force of subsequent instruments in severely curved canals in the single-length instrumentation technique. A single up-and-down movement generated more surface defects on the file when using JIZAI. TruNatomy resulted in less stress generation during instrumentation, while JIZAI better maintained the curvature of root canals.
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Affiliation(s)
- Moe Sandar Kyaw
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Yoshiko Iino
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Myint Thu
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Keiichiro Maki
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Shunsuke Kimura
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Pyae Hein Htun
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Silva EJNL, Martins JNR, Ajuz N, Vieira VTL, Pinto R, Marques D, Braz Fernandes FM, Versiani MA. Multimethod Analysis of a Novel Multi-coloured Heat-treated Nickel-Titanium Rotary System: Design, Metallurgy, Mechanical Properties, and Shaping Ability. J Endod 2024:S0099-2399(24)00407-2. [PMID: 39089614 DOI: 10.1016/j.joen.2024.07.011] [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: 03/06/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION This study aimed to compare a new multicolored rotary system with four heat-treated rotary instruments using the multimethod approach. METHODS Three-hundred instruments of RCS Rainbow, Rotate, RaCe EVO, OneCurve, and ProTaper Ultimate systems were evaluated regarding their design (stereomicroscopy, scanning electron microscopy, and 3D surface scanning), metallurgy, and mechanical performance (cyclic fatigue, torsional resistance, bending and buckling resistance, and cutting ability). Unprepared surfaces after canal preparation of maxillary molars were evaluated using micro-computed tomography. Kruskal-Wallis and one-way analysis of variance post hoc Tukey tests were used for statistical comparisons (α = 5%). RESULTS Instruments exhibited variations in active blade length, number of spirals, and cross-sectional designs. RCS Rainbow showed specific phase transformation temperatures, highest bending (400.5gf) and buckling (286gf) resistance values, and lowest mean angle of rotation (529°) (P < .05). OneCurve exhibited superior cutting ability (8.4 mm) and longer time to fracture (112s). RaCe EVO displayed the lowest time to fracture (51s), maximum torque (1.2 N.cm), buckling (174gf), and bending resistance (261gf) values (P < .05). ProTaper Ultimate showed the highest torque (1.6 N.cm) and angle of rotation (611°) (P < .05), while its bending load (262gf) was comparable to RaCe EVO (P > .05). Rotate instrument showed intermediate values in the mechanical tests. No difference was observed regarding the unprepared canal surfaces (P > .05) CONCLUSIONS: RCS Rainbow demonstrates a trade-off between flexibility and other mechanical properties. Its dimensions exceeded those of other instruments, affording it higher torque resistance, yet concurrently reducing its flexibility, angle of rotation, and cutting ability. OneCurve stands out as a well-balanced choice by integrating geometric design and mechanical performance.
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Affiliation(s)
- Emmanuel J N L Silva
- School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil; Department of Endodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Natasha Ajuz
- School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Victor T L Vieira
- School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Ricardo Pinto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal; LIBPhys-FCT UID/FIS/04559/2013, Lisboa, Portugal
| | - Francisco M Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
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Gobbo LB, de Araújo LP, Vieira WDA, de-Jesus-Soares A, de Almeida JFA, Ferraz CCR. Impact of passive ultrasonic irrigation on the outcome of non-surgical root canal treatment: a systematic review and meta-analysis of randomized clinical trials. Evid Based Dent 2024:10.1038/s41432-024-01033-3. [PMID: 38951661 DOI: 10.1038/s41432-024-01033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/18/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE This systematic review aimed to assess the impact of Passive Ultrasonic Irrigation on the periapical healing rate of primary root canal treatment compared to conventional syringe irrigation. METHODS Registered a priori in the PROSPERO database, this review was conducted by two independent reviewers who performed an electronic search up to December 2023. The search included databases such as MEDLINE (PubMed), Scopus, Web of Science, Embase, LILACS, and the Cochrane Library, as well as grey literature. We included randomized clinical trials (RCTs) that focused on patients undergoing primary root canal treatments. The study compared intervention groups using PUI with control groups that did not use activation techniques. Periapical healing was assessed over follow-up periods of at least six months, utilizing either periapical radiographs or cone-beam computed tomography. To synthesize the findings, a meta-analysis and trial sequence analysis were conducted, employing the Relative Risk as the measure of effect, with a 95% confidence interval. The GRADE approach was utilized to assess the certainty of the evidence. RESULTS The meta-analysis incorporated three RCTs, involving 474 patients (501 teeth). The analysis revealed that PUI led to a higher rate of periapical healing compared to CSI (Relative Risk: 1.10; 95% Confidence Interval: 1.01-1.21, I² = 0%), with moderate certainty of evidence. CONCLUSIONS Despite the limited number of high-quality RCTs, the findings showed a positive impact of PUI on periapical healing rates in primary root canal treatments, in comparison to CSI. REGISTER CRD42021290894.
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Affiliation(s)
- Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | | | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
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Macedo FPG, Soares ADJ, Marceliano-Alves MFV, Martinez E, Lopes R, Bastos LF, Nascimento WM, Limoeiro AG, Dos Frozoni M. The effect of root canal preparation tapers on planktonic bacteria and biofilm reduction in the apical third: A correlative microtomography and microbiological laboratory study. Int Endod J 2024; 57:700-712. [PMID: 38404175 DOI: 10.1111/iej.14052] [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: 08/21/2023] [Revised: 01/05/2024] [Accepted: 02/11/2024] [Indexed: 02/27/2024]
Abstract
AIM To evaluate the influence of different preparation tapers on the reduction in planktonic bacteria and biofilms of Enterococcus faecalis and Candida albicans in the apical third (4 mm) of the mesial roots of mandibular molars, correlating decontamination with canal shape. METHODOLOGY After microtomography analysis for morphological standardization of the canals, 48 mandibular molar roots, each containing two canals (96 canals), were contaminated with E. faecalis and C. albicans and divided into four groups (n = 11) for canal instrumentation using ProDesign Logic 2 files with different tapers G (.03): # 25.03; G (.04): # 25.04; G (.05): # 25.05; and G (.06): # 25.06 and irrigation with 2.5% sodium hypochlorite. Four roots were examined under a scanning electron microscope (SEM) to qualitatively assess biofilm formation. Eight roots were used as the negative control group (samples were not contaminated). Bacteriological samples were taken exclusively from the apical third of the roots before and after chemical-mechanical preparation and bacterial counts were determined (CFU/mL). The final micro-CT scan was used to quantify the volume variation and unprepared canal area in the apical third. Statistical analysis was performed using the Kruskal-Wallis, Student-Newman-Keuls and Wilcoxon tests for analysis of microbiological data. anova and the Tukey or Games-Howell test were used for analysis of micro-CT data and Spearman's test for correlations (α = 5%). RESULTS All groups showed a significant reduction in bacteria (p < .05), with no statistically significant difference between groups. There was no significant difference in per cent volume increase between groups. The unprepared area (Δ%) was affected by the file used (p = .026) and was significantly lower for G (.06) compared to G (.03). There was no statistically significant correlation among bacterial reduction, volume and unprepared area (p > .05). CONCLUSION The different preparation tapers influenced root canal shaping in the apical third but did not improve decontamination in this region.
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Affiliation(s)
| | - Adriana de Jesus Soares
- Department of Endodontics, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil
| | - Marília Fagury Videira Marceliano-Alves
- Postgraduate Program in Dentistry, Iguaçu University, Rio de Janeiro, Brazil
- Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), KU Leuven (University of Leuven), Leuven, Belgium
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d'Excellence INFLAMEX, Université Paris Cité, Montrouge, France
| | - Elizabeth Martinez
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Ricardo Lopes
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Luan Ferreira Bastos
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Wayne Martins Nascimento
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Ana Grasiela Limoeiro
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Marcos Dos Frozoni
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
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Leal RMDS, Copelli FA, Pinto JC, Tanomaru-Filho M, Duarte MAH, Cavenago BC. Shaping ability of three heat-treated NiTi systems in Vertucci's type III root canals of mandibular incisors: An ex vivo study. Saudi Dent J 2024; 36:568-573. [PMID: 38690376 PMCID: PMC11056407 DOI: 10.1016/j.sdentj.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction The anatomical configuration classified as Vertucci's type III is described as the second most prevalent in mandibular incisors. Methods Thirty-six Vertucci's type III mandibular incisors were evaluated by micro-computed tomography (micro-CT) and divided into 3 groups (n = 12) according to the root canal preparation protocol (HyFlex CM [HCM], HyFlex EDM [HEDM], and Sequence Rotary File [SRF]). The teeth were scanned before and after performing 0.25 mm and 0.40 mm apical diameter preparations. The canal volume, dentin thickness, percentage of accumulated debris and untouched canal areas, transportation, and centering ability were measured. The data were statistically analyzed by ANOVA, Tukey, Kruskal-Wallis, and Dunn tests (P < 0.05). Results The volume increase was more evident in the apical third. After 0.40 mm preparation, the SRF system provided a higher reduction (P < 0.05) in dentin thickness on the buccal surface 1 mm from the apex. There was higher canal transportation in the bucco-lingual direction. The 0.40 mm apical preparation reduced the percentage of untouched canal areas. The apical third had the highest percentage of untouched canal areas. The cervical third had the lowest volume of accumulated debris. Conclusions Increasing the apical preparation to a diameter of 0.40 mm with the HCM, HEDM, and SRF systems in Vertucci's type III root canals of mandibular incisors proved to be safe and effective, reducing untouched canal areas. Clinical relevance Root flattening can be intense to the point of generating a root canal bifurcation. Despite the decrease in the root canal diameter, a greater enlargement of the apical region is necessary and safe.
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Affiliation(s)
| | | | - Jáder Camilo Pinto
- Department of Restorative Dentistry, School of Dentistry of Araraquara, Paulista State University, Araraquara, São Paulo, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry of Araraquara, Paulista State University, Araraquara, São Paulo, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil
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Pujari MD, Das M, Das A, Kamath DG, Henry J, Shyam A, Alhaleis DM. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024; 25:331-334. [PMID: 38956847 DOI: 10.5005/jp-journals-10024-3626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
AIM The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. MATERIALS AND METHODS In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of p < 0.05. RESULTS At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels (p < 0.001). CONCLUSION In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group. CLINICAL SIGNIFICANCE With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, et al. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.
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Affiliation(s)
- Mohan D Pujari
- Department of Conservative Dentistry and Endodontics, Aditya Dental College, Beed (MUHS Nashik), Maharashtra, India, Phone: +91 8149238157, e-mail:
| | - Maneesha Das
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
| | - Asutosh Das
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Dinesh G Kamath
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Kothamangalam, Ernakulam, Kerala, India
| | - Junu Henry
- Department of Prosthodontics, Al-azhar Dental College, Thodupuzha, Kerala, India
| | - Arun Shyam
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences & Hospital, Chalakkara, U.T. of Puducherry, India
| | - Doaa M Alhaleis
- Department of Operative and Restorative Dentistry, Dentistry Program, Batterjee Medical College, Jeddah, Saudi Arabia
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Dewes Cassal M, Cardoso Soares P, Dos Santos M. The Effect of Combined Ultrasonic Tip and Mechanized Instrumentation on the Reduction of the Percentage of Non-Instrumented Surfaces in Oval/Flat Root Canals: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e50041. [PMID: 38186463 PMCID: PMC10768610 DOI: 10.7759/cureus.50041] [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: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the effectiveness of the ultrasonic tip associated with mechanized instrumentation in reducing the percentage of non-instrumented surfaces of human teeth with oval or flattened root canals. The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Pubmed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, Embase, Web of Science, and Cochrane Library were searched for literature published till October 2022. Only in vitrostudies were included, which compared conventional mechanized endodontic treatment alone against conventional endodontic treatment in association with ultrasonic tips, evaluating the reduction in the percentage of non-instrumented walls (computed microtomography). Four studies were eligible for qualitative and quantitative analysis. The majority of the studies scored low for risk of bias. The meta-analysis comparing protocols demonstrated a reduced percentage of non-instrumented walls in groups using ultrasonic tips after the conventional mechanized technique (p<0.01) with a confidence interval of 1.04 (95%CI: 0.59, 1.50). The ultrasonic tip associated with mechanized instrumentation demonstrates a significant reduction in the percentage of non-instrumented surfaces in oval or flattened canals.
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Affiliation(s)
- Marcella Dewes Cassal
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
| | - Pedro Cardoso Soares
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
| | - Marcelo Dos Santos
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
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11
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Mamat R, Nik Abdul Ghani NR. The Complexity of the Root Canal Anatomy and Its Influence on Root Canal Debridement in the Apical Region: A Review. Cureus 2023; 15:e49024. [PMID: 38111413 PMCID: PMC10727774 DOI: 10.7759/cureus.49024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/20/2023] Open
Abstract
The main goal of root canal treatment is to eliminate the infection in the complex root canal system for the long-term preservation of a functional tooth. Proper debridement of the root canal system, especially in the apical portion, is essential for successful root canal treatment. The complexity of the canal anatomy in the apical region plays a crucial role in reducing the microbial load. Therefore, clinicians must have a thorough knowledge of the anatomy of the root canal system and its variations, especially in the apical portion. Root canal configurations in cross-section have been classified as round, oval, long oval, flattened, or irregularly shaped. Treating oval, long oval, flattened, or irregularly shaped canals is challenging and should be approached differently than a circular canal. Recognizing the root canal shape and apical anatomy determines the different strategies to be used in cleaning, shaping, and obturation to achieve the best result of root canal treatment. The recent development of the instrumentation system improves the treatment outcome for clinicians and patients. This review aimed to discuss the definition, prevalence, and instrumentation for cleaning and shaping in the apical area with the complexity of root canal systems. Therefore, with the aid of this review, we can better understand the variations in the anatomy of the root canal, especially at the apical portion.
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Affiliation(s)
- Rosnani Mamat
- Conservative Dentistry and Endodontics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Nik Rozainah Nik Abdul Ghani
- Conservative Dentistry and Endodontics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, MYS
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12
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Martins JNR, Silva EJNL, Marques D, Pinto R, Francisco H, Ajuz N, Rito Pereira M, Braz Fernandes FM, Versiani MA. Characterization of four heat-treated reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow patterns. Int Endod J 2023; 56:1412-1428. [PMID: 37698946 DOI: 10.1111/iej.13971] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/14/2023]
Abstract
AIM To compare the design, metallurgy, and mechanical properties of four heat-treated reciprocating instruments coupled with the evaluation of the irrigation flow using an in silico model. METHODOLOGY New EdgeOne Fire Primary, Easy-File Flex Regular 25, WaveOne Gold Primary and Reciproc Blue R25 instruments (n = 124) were initially evaluated regarding their design through stereomicroscopy, scanning electron microscopy and 3D surface scanning. In addition, energy-dispersive X-ray spectroscopy was utilized to determine their elemental composition, and differential scanning calorimetry tests to evaluate their phase transformation temperatures. Their mechanical performance was further assessed through torsional and bending tests. Using scans obtained from a real tooth and the instruments, a computational fluid dynamics assessment was conducted to determine the irrigation flow pattern, apical pressure, and wall shear stress in simulated canal preparation. Mood's median and One-way anova post hoc Tukey tests were used for statistical comparisons (α = 5%). RESULTS Reciproc Blue exhibited a superior number of blades (n = 8), whereas EdgeOne Fire had the highest overall volume (4.38 mm3 ) and surface area (32.32 mm2 ). At the 3-mm axial level, EdgeOne Fire displayed the lowest core diameter (0.13 mm), while Reciproc Blue had the highest (0.16 mm). All blades were symmetrical, and the tips of the instruments were non-active but differed from each other. The most irregular surfaces were observed in EdgeOne Fire and Easy-File Flex. All instruments were manufactured from nickel-titanium alloys and exhibited distinct phase transformation temperatures. WaveOne Gold and Reciproc Blue demonstrated the highest maximum torque values (1.87 and 1.62 N cm, respectively), while the lowest was observed on EdgeOne Fire (1.21 N cm) (p < .05). The most flexible (p < .05) were EdgeOne Fire (angle of rotation: 602.6°; maximum bending load: 251.4 g.f) and Reciproc Blue (533.2° and 235.6 g.f). There were no significant differences observed in the irrigation flow among the four domains generated by the tested instruments. CONCLUSIONS Despite observing variations in the design, phase transformation temperatures, and in the torsional and bending test outcomes among the four heat-treated reciprocating instruments, no significant differences were found in the irrigation flow pattern among the different groups in the simulated root canal preparations.
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Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE)-Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Implantologia, Lisboa, Portugal
| | - Emmanuel João Nogueira Leal Silva
- School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
- Fluminense Federal University, Rio de Janeiro, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE)-Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Implantologia, Lisboa, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Lisboa, Portugal
| | - Ricardo Pinto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Implantologia, Lisboa, Portugal
| | - Helena Francisco
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Implantologia, Lisboa, Portugal
- Grupo de Investigação Implantologia e Regeneração Óssea (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Natasha Ajuz
- School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Mário Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco Manuel Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
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Generali L, Checchi V, Borghi A, La Rosa GRM, Conte G, Zavattini A, Mannocci F, Angerame D, Consolo U, Pedullà E. Shaping ability of Procodile and R6 Reziflow nickel-titanium reciprocating instruments in curved mesial root canals of mandibular molars: A MicroCT study. Microsc Res Tech 2023; 86:1345-1352. [PMID: 37066970 DOI: 10.1002/jemt.24326] [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: 11/02/2021] [Revised: 03/29/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
To compare the shaping ability of Procodile and R6 Reziflow instruments used in reciprocating motion in severely curved root canals, assessed with micro-computed tomography (μCT). Fourteen extracted human mandibular first molars were randomly assigned to two instrumentation techniques (n = 14 mesial root canals): Procodile or R6 Reziflow. For both groups, root canals were prepared to the working length up to a size 25, .06 taper. Molars were virtually divided into apical, middle and coronal thirds and μCT was used to scan all samples pre- and post-root canal. Canal transportation, centring ability, volume, surface area and unprepared area were evaluated. Geometrical parameter changes were compared with preoperative values (one-way analyses of variance and Tukey multiple comparison post-hoc test) between groups and Student t-test within groups (α = 0.05) Significantly less transportation was observed associated with the Procodile technique in the molar's coronal third compared to the R6 Reziflow technique (p < .05). No significant differences in root canal centring ability, volume, surface area and unprepared area were observed. Procodile showed a lower percentage increase of surface area compared to R6 Reziflow (p < .05). The Procodile and R6 Reziflow techniques applied to first molar root canal performed similarly except for the less transportation observed in the coronal third using Procodile. RESEARCH HIGHLIGHTS: MicroCT analysis of canal geometry before and after instrumentation revealed that Procodile and R6 Reziflow showed a similar shaping ability to shape curved root canals without substantially modifications of the original tooth anatomy.
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Affiliation(s)
- Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Vittorio Checchi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Alessia Borghi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Giusy Rita Maria La Rosa
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Gianluca Conte
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Angelo Zavattini
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Science, King's College London, Guy's Tower, Guy's Hospital, London, UK
| | - Francesco Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Science, King's College London, Guy's Tower, Guy's Hospital, London, UK
| | - Daniele Angerame
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, Modena, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Wigler R, Herteanu M, Wilchfort Y, Kfir A. Efficacy of Different Irrigant Activation Systems on Debris and Smear Layer Removal: A Scanning Electron Microscopy Evaluation. Int J Dent 2023; 2023:9933524. [PMID: 37771362 PMCID: PMC10533223 DOI: 10.1155/2023/9933524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 08/19/2023] [Accepted: 09/02/2023] [Indexed: 09/30/2023] Open
Abstract
Background Irrigation is an essential component of root canal treatment to enable cleaning beyond the reach of mechanical instruments. The study aimed to assess and compare the efficacy of different final irrigation protocols, including sonic- and ultrasonic-powered irrigant-activation systems, on debris and smear layer removal in the coronal, middle, and apical thirds of straight oval root canals. Materials and Methods Straight oval root canals of 60 human mandibular incisors were prepared to size 40.04 and divided into four groups (n = 15) according to the final irrigation protocols: (a) Eddy sonic activation (b) endosonic passive ultrasonic irrigation (PUI), (c) irrisafe PUI, and (d) manual syringe and needle irrigation with no additional activation, which served as control. After the treatment procedures, the roots were split and observed using scanning electron microscopy. The presence of remaining debris and smear layer at the coronal, mid-root, and apical thirds of the canals were evaluated using a score system and statistically analyzed using multinominal models with significance level set at p < 0.05. Results None of the final irrigation protocols completely removed all debris and smear layer from all root canals. When the syringe and needle were used without activation, more debris and smear layer were found in the apical third of the canals. Activation of the final irrigant with each of the three devices significantly reduced the presence of debris in the apical third, compared to the syringe and needle final irrigation, with no difference among the three activation devices. Eddy and irrisafe activation also significantly reduced the residual smear layer in the apical third, compared to syringe and needle alone, while the reduction in the remaining smear layer by endosonic activation did not reach the significance level. Conclusions Removal of debris and smear layer from the apical part of the root canal by syringe and needle irrigation alone may be significantly improved by using sonic or ultrasonic activation of the final irrigant. Endosonic activation was less effective in removal of smear layer from the apical part of the canals compared to the other two activation systems.
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Affiliation(s)
- Ronald Wigler
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moran Herteanu
- The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Wilchfort
- The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Thomas AR, Reddy TVK, Tan JY, Qing SEJ, Qing CS, Xuan LY, Pai ARV. Analysis of Shaping Abilities of Rotary File Systems in Oval Canals with Moderate Root Curvature: A Randomized Controlled Ex Vivo Study. J Contemp Dent Pract 2023; 24:221-227. [PMID: 37469260 DOI: 10.5005/jp-journals-10024-3471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
AIM The purpose of this study was to evaluate and compare the canal transportation tendencies and centering ability of the TruNatomy shaper (TN) and XP-endo shaper (XPS) rotary systems in oval-shaped canals with moderate root curvature (15°-25°), using cone-beam computed tomography (CBCT) imaging. MATERIALS AND METHODS Sixty single-rooted permanent human teeth were chosen after considering the inclusion and exclusion criteria. The teeth were divided into two groups (n = 30). The test group was instrumented with TN files and the other with XPS according to manufacturer's instructions. CBCT images were taken before and after instrumentation to record the root canal distances from mesial, distal, buccal, and lingual borders of the root at 3, 5, and 7 mm distances from the root apex using a specific formula. Statistical analysis was done using the Statistical Package for the Social Sciences software program, version 20.0. The data were analyzed using the unpaired t test. RESULTS Both TN and XPS were safe for use in oval-shaped canals with moderate root curvature. However, the XPS showed higher buccolingual transportation as compared with TN at 3 mm from the apex and higher mesiodistal transportation at 3 and 5 mm levels from the apex as compared with TN. CONCLUSION Canal transportation has been detected in both systems; however, the values obtained were within the safe range (<0.3 mm). Overall, no significant difference was observed between TN and XPS (p > 0.05) in their canal transportation tendencies and centering ability. CLINICAL SIGNIFICANCE The study assesses the canal centering and transportation tendencies of the recently launched TN rotary system in extracted teeth with a combination of morphologies. The findings of the study are significant clinically as minimum transportation of the canal, minimal dentin removal, efficient disinfection, and three-dimensional obturation of the root canal are considered important factors in deciding the prognosis of endodontic therapy.
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Affiliation(s)
- Anchu Rachel Thomas
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia, Jalan Batu Hamper, Bukit Baru, Melaka, Malaysia, Phone: +60 1127292297, e-mail:
| | - Tripuravaram Vinay Kumar Reddy
- Department of Conservative Dentistry and Endodontics, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - Jee Yee Tan
- Department of Conservative Dentistry and Endodontics, Manipal University College Malaysia, Melaka, Malaysia
| | - Sharron Ee Jia Qing
- Department of Conservative Dentistry and Endodontics, Manipal University College Malaysia, Melaka, Malaysia
| | - Chee Sing Qing
- Department of Conservative Dentistry and Endodontics, Manipal University College Malaysia, Melaka, Malaysia
| | - Lim Ying Xuan
- Department of Conservative Dentistry and Endodontics, Manipal University College Malaysia, Melaka, Malaysia
| | - A R Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
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Silva EJNL, Martins JNR, Ajuz NC, Dos Santos Antunes H, Vieira VTL, Braz-Fernandes FM, Belladonna FG, Versiani MA. Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation. Clin Oral Investig 2023; 27:2427-2436. [PMID: 36749411 DOI: 10.1007/s00784-023-04899-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to compare 3 reciprocating systems regarding design, metallurgy, mechanical properties, and shaping ability. MATERIALS AND METHODS New Reciproc Blue R25, WaveOne Gold Primary, and REX 25 instruments (n=41 per group) were analyzed regarding design, metallurgy, and mechanical performance, while shaping ability (untouched canal walls, volume of removed dentin, and hard tissue debris) was tested in 36 anatomically matched root canals of mandibular molars. Results were compared using one-way ANOVA post hoc Tukey and Kruskal-Wallis tests with a significant level set at 5%. RESULTS All instruments showed symmetrical cross sections with asymmetrical blades, no radial lands, no major defects, and an almost equiatomic nickel and titanium ratio. The highest R-phase start temperatures were observed with WaveOne Gold (46.1°C) and REX (44.8°C), while Reciproc Blue had the lowest R-phase start (34.5°C) and finish (20°C) temperatures. WaveOne Gold had the lowest time to fracture (169 s) and the highest maximum load (301.6 gf) (P <0.05). The maximum torque of Reciproc Blue (2.2 N.cm) and WaveOne Gold (2.1 N.cm) were similar (P >0.05), but lower than REX (2.6 N.cm) (P <0.05). No statistical differences were observed among instruments in the angle of rotation (P >0.05) and in the shaping ability in both mesial and distal canals (P >0.05). CONCLUSION Although the overall design, temperature transition phases and mechanical behavior parameters were different among tested instruments, they were similar in terms of shaping ability. CLINICAL RELEVANCE All tested heat-treated NiTi reciprocating systems showed similar shaping ability, without clinically significant errors.
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Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil. .,Departament of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil. .,Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Natasha C Ajuz
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | | | | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
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Centering Ability of F6 SkyTaper and RaCe Rotary Files: A Cone-Beam Computed Tomography Study. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2023. [DOI: 10.52547/jrdms.8.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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18
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Wang H, Yang X, Zou L, Huang D, Zhou X, Xu J, Gao Y. Shaping outcome of ProTaper NEXT for root canal preparation in mandibular incisors: a micro-CT study. BMC Oral Health 2022; 22:302. [PMID: 35869473 PMCID: PMC9308234 DOI: 10.1186/s12903-022-02335-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Relatively high incidence of single canals with oval or round shape were observed in human mandibular incisors. In order to investigate the influence of the root canal morphology on root canal preparation, the shaping outcome of ProTaper NEXT in oval and round canals of mandibular incisors were evaluated by using micro-computed tomography (micro-CT) analysis. Methods This experiment was approved by the School Medical Ethics Committee. The sample size calculation was conducted using G*Power software. Intact mandibular incisors with a single canal were selected. Oval canals (2 < aspect ratio (AR) ≤ 4) and round canals (AR ≤ 2) were pair-matched according to canal length, and assigned to two experimental groups (13 per group). ProTaper NEXT was used for root canal preparation for both groups. Untouched canal wall (UCW), root canal morphological parameters and three-dimensional (3D) dentin thickness were evaluated in the entire root canal and each canal third after micro-CT scanning. Statistical analysis: Data were collected and analyzed with Mann–Whitney test and Friedman test using SPSS statistics software 25 (P < 0.05). Additionally, correlations of UCW area with canal morphological parameters were also investigated. Results After root canal preparation, no significant difference was observed in all analyzed parameters in the apical third between oval and round canal groups (P > 0.05). In the coronal two thirds of the canal, the post-operative structure model index (SMI), form factor and roundness were significantly increased, while the AR was significantly decreased in both groups (P < 0.05). In addition, in the coronal two thirds, significantly more UCW and higher UCWΔ% was observed in oval canal group (P < 0.05). Furthermore, UCW correlated very strongly to canal major diameter (0.924) and initial volume (0.938), and strongly to canal form factor (− 0.724), minor diameter (0.799) and canal area (0.882). Proximal dentin wall was associated with significantly thinner pre-operative dentin thickness and higher amount of dentin removal after root canal preparation in both oval and round canal groups. Conclusions (1) Both types of canals were more conical after root canal preparation, but oval root canals tend to leave more UCW area than round canals in the coronal two thirds of mandibular incisors, which contributes to the challenge for endodontic infection control. (2) Root canal preparation usually results in excessive dentin removal in the proximal dentin wall comparing with buccal and lingual walls in both types of canals of mandibular incisors. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02335-7.
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Comparison of EASYDO ACTIVATOR, passive ultrasonic, and needle irrigation techniques on the treatment of apical periodontitis: a study in rats. Clin Oral Investig 2022; 26:7157-7165. [PMID: 36053353 DOI: 10.1007/s00784-022-04677-6] [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: 04/20/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the long-term therapeutic effect of EASYDO ACTIVATOR, passive ultrasonic irrigation, and needle irrigation in experimental apical periodontitis in rats. MATERIALS AND METHODS Sprague-Dawley male rats were used to produce periapical lesions. The pulp chambers of the bilaterally first mandibular molars were exposed and left open for 21 days. The rats were divided into four groups according to different irrigation protocols. Seven days after irrigation, the mandibles were removed for micro-CT, histological, and immunohistochemical analysis. Serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were assessed by enzyme-linked immunosorbent assays (ELISA). Statistical data were analyzed by one-way analysis of variance (ANOVA) with LSD tests. RESULTS The passive ultrasonic irrigation and EASYDO ACTIVATOR groups had the smallest apical lesions compared to the other groups (P < 0.05), while the needle irrigation group had smaller lesions than the control group (P < 0.05). The EASYDO ACTIVATOR group had less inflammation infiltration compared to the control and needle irrigation groups (P < 0.05). The control and needle irrigation groups had more TNF-α expression compared to the passive ultrasonic irrigation and EASYDO ACTIVATOR groups (P < 0.05). The lowest IL-6 expression was observed in the EASYDO ACTIVATOR group. The EASYDO ACTIVATOR group had the lowest serum level of TNF-α than other groups (P < 0.05). IL-6 expression was significantly lower in the EASYDO ACTIVATOR group in comparison with the control and needle irrigation groups (P < 0.05). CONCLUSIONS EASYDO ACTIVATOR can significantly reduce the apical lesions and decrease the inflammatory response around the periapical area. CLINICAL RELEVANCE EASYDO ACTIVATOR is recommended for clinical application.
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20
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Root Canal Obturation by Electrochemical Precipitation of Calcium Phosphates. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Achieving adequate disinfection and preventing reinfection is the major goal in endodontic treatment. Variation in canal morphology and open porosity of dentine prevents achieving complete disinfection. Questionable biocompatibility of materials as well as a lack of sealing ability questions the usefulness of current obturation methods. With a novel disinfection approach based on the use of boron-doped diamond (BDD) electrodes having shown promising results it was the goal of this series of experiments to investigate the possibility of BDD-mediated in situ forming of a biocompatible obturation material. A combination of calcium phosphate and maleic acid was used as precursor solution while Ion Chromatography Mass Spectrometry (IC-MS), Raman spectroscopy (RAMAN), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), dye penetration and micro-computed tomography (µCT) were applied for characterizing the precipitate. It was possible to achieve a BDD-mediated precipitation of brushite in a clinically applicable timeframe. However, tight sealing of the canal system based on brushite could not be achieved.
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Chinchiyanont P, Yanpiset K, Banomyong D, Thongbai-On N. Shaping ability of non-adaptive and adaptive core nickel-titanium single-file systems with supplementary file in ribbon-shaped canals analysed by micro-computed tomography. AUST ENDOD J 2022; 49:38-47. [PMID: 35255157 DOI: 10.1111/aej.12609] [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: 06/29/2021] [Revised: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
Abstract
This study compared shaping ability between two single-file systems and before/after using supplementary file in untouched area, volume of removed dentin, maximum cut depth (the highest cut depth by main file) and remaining thinnest dentin (the thinnest root dentin after preparation). Ribbon-shaped distal canals of mandibular molars were prepared with non-adaptive core (WaveOne Gold) or adaptive core (XP-endo Shaper) files (n = 15/group) and additionally prepared with a supplementary file (XP-endo Finisher), and the shaping ability was investigated using micro-computed tomography. XP-endo Shaper group demonstrated significantly less overall untouched area than WaveOne Gold group (38.21 ± 6.98% vs. 47.68 ± 9.16%) (p < 0.05). No significant difference was detected between XP-endo Shaper and WaveOne Gold groups in volume of removed dentin (1.85 ± 0.53 vs. 1.66 ± 0.33 mm3 ), maximum cut depth (0.10-0.28 vs. 0.10-0.29 mm) and remaining thinnest dentin (0.66-0.80 vs. 0.78-0.88 mm). Supplementary XP-endo Finisher treatment significantly decreased untouched area (11%-23% reduction) (p < 0.05) with minimally cut root dentin (0.01-0.02 mm).
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Affiliation(s)
- Parichat Chinchiyanont
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Ahmed HMA. A critical analysis of laboratory and clinical research methods to study root and canal anatomy. Int Endod J 2022; 55 Suppl 2:229-280. [DOI: 10.1111/iej.13702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur
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Silva EJNL, De-Deus G, Souza EM, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Versiani MA. Present status and future directions - Minimal endodontic access cavities. Int Endod J 2022; 55 Suppl 3:531-587. [PMID: 35100441 DOI: 10.1111/iej.13696] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
In the last decades, the move of Medicine towards minimally invasive treatments is notorious and scientifically grounded. As Dentistry naturally follows its footsteps, minimal access preparation also became a trend topic in the endodontic field. This procedure aims to maximize preservation of dentine tissue, backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key-points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection, and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make it clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach like minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws, but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in-situ laboratory model or a large and well-controlled clinical trial to solve this matter.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Kapralos V, Valen H, Koutroulis A, Camilleri J, Ørstavik D, Sunde PT. The dentine-sealer interface: modulation of antimicrobial effects by irrigation. Int Endod J 2022; 55:544-560. [PMID: 35080277 DOI: 10.1111/iej.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
AIM Assess whether sodium hypochlorite (NaOCl) or chlorhexidine (CHX) and two irrigation protocols may alter the antibacterial properties of dentine and three endodontic sealers using a novel ex vivo tooth model. METHODOLOGY Prior to antibacterial testing, the tooth model was validated by means of scanning electron microscopy (SEM) to evaluate the separation between dentine and sealer surfaces. Root blocks prepared from extracted human roots were pretreated with 17% EDTA + 0.9% saline and subsequently treated with 1% NaOCl (G1), 2% CHX (G2) or no irrigant (G3). Two irrigation protocols were further investigated, "1% NaOCl + 17% EDTA" (P1) and "1% NaOCl + 17% EDTA + 2% CHX" (P2). Following irrigation, the root blocks were either filled with AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS), or left empty. All groups were incubated for 1, 7 and 28 days. Direct contact tests for planktonic E. faecalis and 48 hours E. faecalis biofilms were performed at the level of dentine and sealer surfaces. Statistical analysis was performed on the bacterial survival between irrigants (G1, G2 and G3) and between irrigation protocols (P1 and P2) (p<0.05). RESULTS The model was considered reproducible as SEM examination of dentine samples indicated consistent separation between dentine and sealer surfaces. Irrigation with CHX (G2) and irrigation protocol (P2) enhanced the antibacterial properties of dentine without sealer application as well as dentine in contact with all three sealers tested, especially against planktonic E. faecalis. G2 and P2 also improved the antibacterial effect of AH Plus surfaces for all three incubation times. No irrigation groups (G1, G2) or irrigation protocols (P1, P2) altered the antibacterial properties of BioRoot RCS surfaces against planktonic bacteria or biofilms. Only BioRoot RCS surfaces eliminated the planktonic E. faecalis in all irrigation groups (G1, G2, G3) and protocols (P1, P2) investigated while PCS surfaces eliminated E. faecalis in biofilms in all groups up to 7 days. CONCLUSIONS The tooth model was reproducible. CHX improved the antibacterial activity upon both sealer and dentine surfaces. Among sealers, BioRoot RCS was less affected by NaOCl and CHX, and exhibited high antibacterial properties regardless the irrigation applied.
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Affiliation(s)
- V Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855, Oslo, Norway
| | - A Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - D Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - P T Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
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Moraes RDR, Perez R, Silva ASSD, Machado AS, Lopes RT, Pintor AVB, Primo LG, Neves ADA. Micro-CT evaluation of root canal preparation with rotary instrumentation on prototyped primary incisors. Braz Oral Res 2021; 35:e132. [PMID: 34932661 DOI: 10.1590/1807-3107bor-2021.vol35.0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to evaluate the endodontic instrumentation outcomes with asymmetrical files compared to reciprocating and hand files (HFs) in 3D-printed prototypes of upper primary incisors using micro-computed tomography (micro-CT). For this purpose, 50 prototypes were randomly divided (n = 10) according to the instrumentation technique as follows: HFs, a reciprocating file (WaveOne® Gold [WOG]), and three asymmetrical movement files: XP-Endo® Shaper (XPS), XP-Endo® Finisher (XPF), and XP Clean (XPC). The specimens were scanned and, after registration of the baseline and instrumented volumes, changes in the root canal volume (RCV), debris accumulation, removed root material volume (RRMV), non-instrumented areas, and the presence of cracks/perforations were quantified. Data were analyzed by analysis of variance and Student's t-test, while the effect size was calculated for statistically significant outcomes. All groups showed an increase in RCV after instrumentation (p < 0.05), but this was higher with HFs (p < 0.05). Accumulated debris was higher for WOG and XPS (p < 0.05), but WOG exhibited more in the medium and apical third areas. HFs showed the highest RRMV (p < 0.05), especially at the apical third. The non-instrumented areas were lower for HFs and XPC than for the other systems (p < 0.05). Cracks were present in a few WOG (n = 2) and HF specimens (n = 3) and in this group, one of the cracked specimens and two others showed perforations. The asymmetric systems resulted in conservative dentin removal and fewer cracks/perforations as compared to HFs and a reciprocation file in prototyped primary upper incisors. XPC showed the best compromise between RRMV and non-instrumented areas with a low accumulation of debris.
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Affiliation(s)
- Rafael Dos Reis Moraes
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
| | - Renata Perez
- Corpo de Bombeiros Militar do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Saddock Sá da Silva
- Universidade Federal do Rio de Janeiro - UFRJ, Laboratory for Nuclear Instrumentation, Rio de Janeiro, RJ, Brazil
| | - Alessandra Silveira Machado
- Universidade Federal do Rio de Janeiro - UFRJ, Laboratory for Nuclear Instrumentation, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Universidade Federal do Rio de Janeiro - UFRJ, Laboratory for Nuclear Instrumentation, Rio de Janeiro, RJ, Brazil
| | - Andréa Vaz Braga Pintor
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
| | - Laura Guimarães Primo
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
| | - Aline de Almeida Neves
- Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Rio de Janeiro, RJ, Brazil
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Martins JNR, Silva EJNL, Marques D, Belladonna FG, Simões-Carvalho M, da Costa RP, Ginjeira A, Braz Fernandes FM, Versiani MA. Comparison of five rotary systems regarding design, metallurgy, mechanical performance, and canal preparation-a multimethod research. Clin Oral Investig 2021; 26:3299-3310. [PMID: 34860307 DOI: 10.1007/s00784-021-04311-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare the design, metallurgy, mechanical performance, and canal preparation of 5 rotary systems. MATERIAL AND METHODS A total of 735 25-mm NiTi instruments (sizes 0.17[0.18]/.02v, 0.20/.04v, 0.20/.07v, 0.25/.08v, 0.30/.09v) from ProTaper Gold, ProTaper Universal, Premium Taper Gold, Go-Taper Flex, and U-File systems were compared regarding overall geometry and surface finishing (stereomicroscopy and scanning electron microscopy), nickel and titanium ratio (energy-dispersive spectroscopy), phase transformation temperatures (differential scanning calorimetry), mechanical performance (torsional and bending tests), and unprepared canal surface (micro-CT). One-way ANOVA and Mood's median tests were used for statistical comparisons with a significance level set at 5%. RESULTS Stereomicroscopic analysis showed more spirals and high helical angles in the Premium Taper Gold system. All sets of instruments had symmetrical spirals, no radial lands, no major defects, and an almost equiatomic ratio between nickel and titanium elements, while differences were observed in their tips' geometry and surface finishing. At room temperature (20 °C), DSC test revealed martensitic characteristics for ProTaper Gold and Go-Taper Flex, and mixed austenite plus R-phase for the Premium Taper Gold, while ProTaper Universal and U-Files had full austenitic characteristics. Overall, larger instruments had higher torque resistance and bending load values than smaller ones, while a lack of consistency and mixed values were observed in the angle of rotation. The 0.25/.08v and 0.30/.09v instruments of ProTaper Universal and U-File had the highest maximum torques, the lowest angles of rotation, and the highest bending loads than other tested systems (P < .05). No significant difference was noted regarding the untouched root canal walls after preparation with the tested systems (P > .05). CONCLUSIONS Although differences observed in the overall geometry and phase transformation temperatures have influenced the results of mechanical tests, unprepared canal surface areas were equivalent among systems. CLINICAL RELEVANCE Root canal preparation systems with similar geometries might present different mechanical behaviors but equivalent shaping ability.
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Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal.
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal.
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Rui Pereira da Costa
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
| | - Francisco Manuel Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco Aurélio Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
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The Influence of Root Canal Preparation with ProTaper Next, WaveOne Gold, and Twisted Files on Dentine Crack Formation. MACHINES 2021. [DOI: 10.3390/machines9120332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Background: Root canal preparation constitutes an important factor for success in endodontics. However, various complications may occur during this stage. The aim of this study was to compare the incidence of cracks within radicular dentin after instrumentation with ProTaper Next (PTN), WaveOne Gold (WOG), and Twisted Files (TF), which utilize different kinematics. (2) Methods: Eighty single-rooted teeth were classified into four groups (n = 20). Three groups were instrumented using PTN (X1, X2), WOG (Primary), and TF (SM1–3). The non-instrumented group constituted the control group. Post-preparation, the roots were sectioned 3, 6, and 9 mm from the apex using a low-speed saw (Southbay Technology Inc., San Clemente, CA, USA). The specimens were viewed through a microscope at x25 magnification (Leica M320, Wetzlar, Germany), and their surface was assessed tactilely to determine the presence of the crack. (3) Results: Partial cracks within radicular dentine were observed in all study groups (PTN: n = 4/20%, WOG: n = 3/15%, TF: n = 4/20%); no cracks were observed in the control group. No significant differences were observed among experimental groups. OR values for the incidence of cracks were: OR = 11.182 for PTN, OR = 8.2 for WOG, and OR = 8.2 for TF. (4) Conclusions: Instrumentation with PTN, WOG, and TF may result in dentinal cracks formation.
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Wang LX, Chen H, Lin RT, Gu LS. Influence of pecking frequency at working length on the volume of apically extruded debris: A micro-computed tomography analysis. J Dent Sci 2021; 17:1274-1280. [PMID: 35784137 PMCID: PMC9236894 DOI: 10.1016/j.jds.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background/purpose There is no consensus to date on how many repetitive pecking motions at working length (WL) should be regarded as optimal during instrumentation. Therefore, this study aimed to evaluate the effect of pecking frequency at WL on the volume of apically extruded debris using three single-file systems in curved, oval-shaped canals. Materials and methods Forty-five single-rooted mandibular premolars with curved, oval-shaped canals were prescanned by micro-computed tomography, anatomically paired-matched, and randomly divided among three groups (n = 15 each): Reciproc Blue (RB), WaveOne Gold (WOG) and XP-endo Shaper (XPS). Samples were embedded in agarose gel to collect extruded debris. After preparation to the WL, each sample was rescanned after one, two, four, 10, and 20 pecking motions at WL, respectively. The debris volume was innovatively calculated by a modification of an existing method using micro-computed tomography. The apical preparation size was also measured. Data were compared using a two-way repeated-measures analysis of variance. Results All single-file systems extruded debris apically, irrespective of the pecking frequency at WL. The extruded debris volume correlated positively with the minor foramen size (P < 0.05); both increased with pecking frequency for each single-file system (P < 0.05). The minor foramen size corresponded to the instrument tip size when reaching the WL once. Conclusion To produce less debris extrusion and obtain a predictable foramen size corresponding to the instrument tip size, a single pecking motion may be preferred when using single-file systems. Caution should be exercised when applying the current results to clinical situations.
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Affiliation(s)
- Li-Xiao Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui-Tian Lin
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li-Sha Gu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Corresponding author. Hospital of Stomatology, Sun Yat-sen University, No. 56, Lingyuan West Road, Guangzhou, Guangdong, 510055, China. Fax: +86 20 83822807.
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Dos Santos Miranda ARL, de Moura JDM, Calefi PHS, Amoroso Silva PA, Marceliano-Alves MFV, Lopes RT, Vivan RR, Rodrigues PDA. Influence of conservative endodontic access cavities on instrumentation of oval-shaped straight root canals. Int Endod J 2021; 55:103-112. [PMID: 34561894 DOI: 10.1111/iej.13635] [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: 02/06/2021] [Accepted: 09/22/2021] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the influence of the design of endodontic access cavities on the percentage of unprepared areas of canal walls and flexural fatigue of instruments activated by reciprocating movement in oval-shaped straight root canals of extracted teeth. METHODOLOGY Forty-two mandibular incisors with oval canals were scanned by a microcomputed tomography (micro-CT) device for homogeneous selection and distribution of the samples. Then, the teeth were divided into two groups (n = 21) according to the design of access cavity being tested: ultraconservative endodontic access cavity (UltraAC) and traditional access cavity. The canals were accessed with the aid of a surgical microscope, instrumented with the WaveOne Gold Medium system and irrigated with 2.5% NaOCl and 17% EDTA. The unprepared areas of the canal wall were analysed by overlaying images before and after instrumentation and expressed as percentages. micro-CT data were analysed using t-test, Mann-Whitney and Wilcoxon tests. The endodontic instruments used during instrumentation were subjected to static flexural fatigue testing using an artificial stainless steel canal with a 60° angle of curvature and a radius of 5 mm, located 5 mm from the tip of the instrument. The instruments were activated until fracture occurred, and the time in seconds for the fracture was recorded using a digital timer. The number of cycles to fracture was calculated and analysed statistically. For flexural fatigue data, an anova test complemented by a Tukey range test was used. The significance level of 5% was used for all analyses. RESULTS There was no significant difference between the groups related to unprepared areas by the instrument during canal preparation (p > .05). The difference in flexural fatigue resistance between the groups was not significant. CONCLUSION The use of UltraAC did not interfere with the canal instrumentation of extracted mandibular incisors with straight and oval canals. There was no difference in the flexural fatigue resistance of the instruments in relation to access cavity design.
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Affiliation(s)
| | | | - Pedro Henrique Souza Calefi
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Pablo Andrés Amoroso Silva
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | | | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
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Scope of Preparation of Oval and Long-Oval Root Canals: A Review of the Literature. ScientificWorldJournal 2021; 2021:5330776. [PMID: 34475808 PMCID: PMC8407989 DOI: 10.1155/2021/5330776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/17/2021] [Indexed: 11/18/2022] Open
Abstract
Successful endodontic treatment depends on cleaning and disinfecting the root canals, in order to provide conditions for three-dimensional filling, which should prevent root canal reinfection. However, anatomical complexities pose a challenge during endodontic treatment. The present study was a literature review carried out in the following databases: PubMed, SciELO, and MEDLINE, which were searched for articles published from 2017 to 2021. Micro-CT studies published in English, which analysed the capacity for preparation of oval and long-oval root canals, were included. The following keywords were used: “oval-shaped canals,” “long-oval-shaped canals,” “endodontics,” and “micro-CT.” The aim of this study was to carry out a literature review of micro-CT studies on the scope of the capacity for preparation performed in oval and long-oval root canals with rotary and reciprocating instruments.
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Poly A, Marques F, Moura Sassone L, Karabucak B. The shaping ability of WaveOne Gold, TRUShape and XP-endo Shaper systems in oval-shaped distal canals of mandibular molars: A microcomputed tomographic analysis. Int Endod J 2021; 54:2300-2306. [PMID: 34473842 DOI: 10.1111/iej.13625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 01/07/2023]
Abstract
AIM To compare the shaping ability of a heat-treated centric reciprocating file system (WaveOne Gold), a heat-treated eccentric rotary multifile system (TRUShape 3D Conforming Files), and a heat-treated expandable one-file rotary system (XP-endo Shaper) extending its activation time, in preparing oval-shaped root canals in extracted mandibular molars by means of microcomputed tomography (micro-CT) analysis. METHODOLOGY Thirty moderately curved oval-shaped distal roots of mandibular molars were selected. The normality of canal length, curvature angle, volume, surface area, structure model index, and aspect ratio were confirmed. The samples were randomly divided into three groups (n = 10). Micro-CT scans were taken before and after canals were instrumented using WaveOne Gold (size 35, .06 taper), or TRUShape (size 30, .06v taper), both following the manufacturer's instructions, or XP-endo Shaper following a new protocol with extended activation time. The mechanical preparation time for each sample was recorded. Pre- and postoperative images were analysed for the percentage of unprepared canal areas and the percentage of removed dentine. Data were compared between groups using the statistical analyses one-way ANOVA and Tukey tests (p < .05). RESULTS The percentage of unprepared canal areas was significantly higher with WaveOne Gold (% 11.5 ± 4.0) and TRUShape (% 12.4 ± 5.8) compared with XP-endo Shaper (% 5.2 ± 2.6) (p < .05). XP-endo Shaper removed significantly more dentine (3.3 ± 1.5 mm3 ) than WaveOne Gold (1.8 ± 0.8 mm3 ) and TRUShape (1.9 ± 0.8 mm3 ) (p < .05). No significant differences were seen for mechanical preparation time between WaveOne Gold (79 ± 31 s), TRUShape (104 ± 41 s) and XP-endo Shaper (71 ± 23 s) (p > .05). CONCLUSIONS The comparison of three recognized root canal filing systems has shown that with similar preparation times, the XP-endo Shaper removed more dentine (mm3 ) leaving less unprepared canal wall area (%) than WaveOne Gold and TRUShape when preparing oval-shaped root canals of extracted mandibular molars.
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Affiliation(s)
- Ane Poly
- Proclin Department, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Marques
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Luciana Moura Sassone
- Proclin Department, School of Dentistry, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Papic M, Papic M, Zivanovic S, Vuletic M, Zdravkovic D, Misic A, Miletic Kovacevic M, Popovic M. The prevalence of oval-shaped root canals: A morphometric study using cone-beam computed tomography and image analysis software. AUST ENDOD J 2021; 48:158-169. [PMID: 34363716 DOI: 10.1111/aej.12554] [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: 02/08/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the prevalence of oval-shaped root canals at the apical, medial and coronal cross sections of all tooth groups using CBCT and image analysis software. Based on the diameter values, the long/short diameter ratio was calculated and each root canal was classified regarding its shape. Oval-shaped canals were present in 45% at the apical, 50% at the medial and 56% at the coronal level of all teeth. The mandibular central incisors presented oval canals in 24%, long oval in 28% and flat in 2% at the apical level. Mandibular molars showed a statistically significant difference (P < 0.05) in the distribution of oval-shaped canals between cross-sectional levels. Analysis of CBCT scans with an image analysis software could be a reliable and reproducible method and a valuable tool for objective determination of root canal shape in further research.
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Affiliation(s)
- Mirjana Papic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milos Papic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Suzana Zivanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Miona Vuletic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Dejan Zdravkovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Misic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marina Miletic Kovacevic
- Department of Histology and Embryology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milica Popovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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Unprepared surface areas, accumulated hard tissue debris, and dentinal crack formation after preparation using reciprocating or rotary instruments: a study in human cadavers. Clin Oral Investig 2021; 25:6239-6248. [PMID: 33903962 DOI: 10.1007/s00784-021-03922-8] [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: 10/06/2020] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study using contralateral teeth from human cadavers assessed the amount of unprepared wall surface areas (USA), accumulated hard tissue debris (AHTD), and dentinal crack formation after root canal preparation using either reciprocating or rotary instruments. MATERIALS AND METHODS Incisors with a single root canal from 11 human mandibles had their root canals prepared with Reciproc or Mtwo. Each contralateral tooth was treated with one of the test instruments in order to create matched pairs. Micro-CT scans were taken before and after preparation to instrument sizes 40 and 50 in both groups. USA and AHTD were evaluated in the full canal length or the apical portion only. Crack formation was also evaluated in the full root length. RESULTS After size 40, no significant differences in USA and AHTD were observed in the full canal length (P > .05). Separate analysis of the apical 4-mm canal revealed no difference in AHTD, but significantly more USA with Mtwo than Reciproc (P < .05). After size 50, the amount of USA was similar between groups both in the full canal and in the apical canal (P > .05). More AHTD were observed in the full canal after using Mtwo size 50 (P < .05), but no difference occurred in the apical canal only (P > .05). Intragroup analyses showed a significant decrease of USA and a significant increase of AHTD when preparation size increased from 40 to 50 (P < .05). In teeth without any pre-existing detectable dentinal defect (n = 38), crack formation occurred in 4 teeth, 2 from each preparation system. CLINICAL RELEVANCE Reciproc instrument size 40 resulted in more prepared areas in the apical canal than Mtwo instrument of the same size. However, the amount of AHTD did not differ between them at this file size. Canal enlargement to size 50 prepared more walls but created more debris. Dentinal defects were produced after preparation with both systems.
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Emara RS, Gawdat SI, El-Far HMM. Effect of XP-endo Shaper versus conventional rotary files on postoperative pain and bacterial reduction in oval canals with necrotic pulps: a randomized clinical study. Int Endod J 2021; 54:1026-1036. [PMID: 33560531 DOI: 10.1111/iej.13494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/26/2022]
Abstract
AIM To assess postoperative pain and bacterial reduction following the use of XP-endo Shaper versus conventional rotary files in preparation of oval canals with necrotic pulps. METHODOLOGY This superiority, parallel, randomized, double blinded clinical trial was conducted in the clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Sixty single-canalled mandibular premolars with necrotic pulps were randomly assigned into two equal groups. Canals were instrumented using XP-endo Shaper files in the intervention group and iRaCe rotary files in the control group. Bacterial samples were taken before and after canal instrumentation. Incidence and severity of postoperative pain was assessed using a modified VAS after 6, 12, 24 h and daily for 5 days. A culture method was used to assess the number of bacterial colony forming units. Incidence of analgesic intake as well as flare-ups was recorded. Data were analysed using chi-square, Fisher Exact, Mann-Whitney, Independent t-test, and Spearman's correlation for pain and bacterial counts. RESULTS The XP-endo Shaper compared with the iRaCe group was associated with a significantly lower incidence of postoperative pain at 6, 12, and 24 h (P = 0.039, 0.047, and 0.026, respectively), and severity of postoperative pain at 6 h (mean difference: 1.33, 95% CI: 0.307-2.352, P = 0.02), 12 h (mean difference: 1.1, 95% CI: 0.26-1.936, P = 0.007), 24 h (mean difference: 0.94, 95% CI: 0.178-1.701, P = 0.008) and 48 h (mean difference: 0.97, 95% CI: 0.192-1.747, P = 0.038). There was a significant decrease in bacterial count following canal instrumentation in both groups (P < 0.001) with no significant difference between them (mean difference: 0.83 × 105 , 95% CI: 0.336 × 105 -1.996 × 105 , P = 0.56). A weak correlation existed between postoperative pain severity and bacterial counts (P = 0.54). There was no significant difference in analgesic intake between the two groups (P = 0.085). Flare-ups occurred in 3.3% of teeth in the iRaCe group, while no flare-ups occurred in the XP-endo Shaper group. CONCLUSIONS XP-endo Shaper was associated with a significantly lower frequency of postoperative pain for up to 24 h, and lower severity of postoperative pain for up to 48 h compared with iRaCe files. Both systems were equally effective in bacterial reduction from oval root canals with necrotic pulps.
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Affiliation(s)
- R S Emara
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S I Gawdat
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - H M M El-Far
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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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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Xavier SR, de Lima CO, Marceliano-Alves MFV, Lacerda MFLS, Lopes RT, Campos CN. Shaping ability of two root canal instrumentation systems in oval-shaped canals: A microcomputed tomography study. AUST ENDOD J 2020; 47:252-259. [PMID: 33236472 DOI: 10.1111/aej.12469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/23/2020] [Accepted: 11/08/2020] [Indexed: 11/26/2022]
Abstract
The objective was to evaluate the shaping ability of XP-endo Shaper and Mtwo systems in oval-shaped canals preparation by microcomputed tomography (micro-CT) along the entire canal. The volume, surface area and percentage of unprepared area were evaluated by image processing in entire canal and apical third (5 mm). Apical transportation and centring ability were evaluated at 3, 5 and 7 mm from the apex. Forty single-canal oval canines were paired in two groups (n = 20) according to the instrumentation system: XP-endo Shaper and Mtwo. The teeth were scanned by micro-CT before and after instrumentation, using a thermal vat at 37°C. The XP-endo Shaper system was more effective in the instrumentation of oval-shaped canals when compared to Mtwo system, resulting in greater volume increases and lower percentage of unprepared canals walls in apical region. Regarding apical transportation and centring ability, no statistical difference was observed.
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Affiliation(s)
- Suelen Recepute Xavier
- Department of Dental Clinic, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | | | | | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Celso Neiva Campos
- Department of Dental Clinic, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
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Aksoy U, Küçük M, Versiani MA, Orhan K. Publication trends in micro-CT endodontic research: a bibliometric analysis over a 25-year period. Int Endod J 2020; 54:343-353. [PMID: 33075147 DOI: 10.1111/iej.13433] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 12/21/2022]
Abstract
AIM To conduct a bibliographic analysis of the research studies published in Endodontics using micro-computed tomography (micro-CT) as an analytical tool over a 25-year period. METHODOLOGY The Web of Science electronic database was accessed, and an advanced search using strict criteria was undertaken from January 1995 to June 2020 for studies in the field of Endodontics that used micro-CT as an analytical tool. A further search was conducted between January and August of 2020 for a combination of specific terms and descriptors. For each selected article, the following parameters were recorded: field of the study, analysed specimen, publication title and year, authorship, journal of publication, institution and country of origin, collaborating institutions and countries, and number of citations. The acquired data were analysed using descriptive statistics and graphical mappings. RESULTS The screening process identified 877 relevant articles that were classified into 30 thematic categories. The main fields of research were root canal preparation (23.8%), root canal anatomy (17.4%), canal filling (9.2%) and root canal retreatment (7.0%). The most productive half-decade comprised the period of 2015-2019 (n = 513; 58.5%), with the highest number of articles published in 2019 (n = 146; 16.6%). The authors who lead the list as first authors were G De-Deus, A Keleş, F Paqué, MA Versiani and Y Gu, respectively, whilst Versiani was the most productive (n = 51). The leading countries regarding the number of studies were Brazil, China and Turkey with 236, 130 and 65 publications, respectively. The University of São Paulo (n = 90; 10.3%) followed by Wuhan University (n = 37; 4.2%) and the University of Zurich (n = 18; 2.1%) were the prominent contributors by producing the largest number of articles, whilst the University of Zurich was the most-cited institution. The selected studies were published in 140 scientific journals, but the Journal of Endodontics and International Endodontic Journal accounted for almost 50% of the publications. CONCLUSION This bibliometric analysis portrayed an original and comprehensive view on the progress and trends of the use of micro-CT technology in endodontic research, and enabled a deep understanding of the development process in this field over the last 25 years.
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Affiliation(s)
- U Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - M Küçük
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - M A Versiani
- Dental Specialty Centre, Brazilian Military Police, Minas Gerais, Brazil
| | - K Orhan
- Department of Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
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De-Deus G, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Silva EJNL, Carvalhal JCA, Zamolyi RQ, Lopes RT, Versiani MA, Dummer PMH, Zehnder M. Contrast-enhanced micro-CT to assess dental pulp tissue debridement in root canals of extracted teeth: a series of cascading experiments towards method validation. Int Endod J 2020; 54:279-293. [PMID: 32920829 DOI: 10.1111/iej.13408] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/15/2022]
Abstract
AIM To validate a new method for the evaluation of pulp tissue debridement in the root canals of extracted teeth using an impregnation protocol involving potassium triiodide, a radiocontrast solution known as Lugol's, combined with micro-computed tomographic (micro-CT) imaging. METHODOLOGY The impact of NaOCl on the radiopacity of Lugol's solution was assessed using a two-fold dilution series of Lugol in distilled water and 5.25% NaOCl, which were then pipetted into transparent dishes and radiographed. To verify the influence of Lugol on the proteolytic effect of NaOCl, a dissolution test was performed using fresh bovine meat. Ten slices did not undergo any tissue processing, whilst twenty slices were fixed in formaldehyde for 24 h. After that, 10 of them were immersed in Lugol for another 24 h. Then, all specimens were placed in NaOCl and the time required for a complete tissue dissolution was recorded. For the last experiments (histological validation and micro-CT assessment), 8 extracted mandibular premolars with formerly vital pulps were immersed in buffered formalin, scanned in a micro-CT device, accessed, immersed in Lugol for 7 days and scanned again. Then, the root canals of 5 teeth were prepared and scanned, and the volume of remaining pulp tissue identified and quantified, whilst 3 teeth were histologically processed. The same specimens were subjected to histological assessment, and the images of the histologic sections were registered with the corresponding micro-CT images to verify whether the pulp tissue in the histological sections matched its counterpart in the Lugol-impregnated tissues identified in the micro-CT slices. RESULTS There was no discernible effect on radiopacity when NaOCl was mixed with Lugol's solution. Tissue processing did not affect the time required for the complete dissolution of fresh bovine meat. Histological evaluation revealed a correlation between micro-CT and histological images confirming the identification of Lugol-impregnated pulp tissue in micro-CT images. CONCLUSIONS The radiocontrast Lugol's solution was unaffected by NaOCl and did not interfere with its soft tissue dissolution capability. The impregnation protocol using Lugol's solution allowed the visualization of pulp tissue on the micro-CT images and the identification of pulp remnants after chemical-mechanical canal procedures.
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Affiliation(s)
- G De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - F G Belladonna
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - D M Cavalcante
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - M Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
| | - J C A Carvalhal
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - R Q Zamolyi
- Bonsucesso Federal Hospital, Rio de Janeiro, Rio de Janeiro, Brazil
| | - R T Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - M A Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - M Zehnder
- Division of Endodontology, Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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Mechanical Tests, Metallurgical Characterization, and Shaping Ability of Nickel-Titanium Rotary Instruments: A Multimethod Research. J Endod 2020; 46:1485-1494. [DOI: 10.1016/j.joen.2020.07.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 11/23/2022]
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Lima CO, Barbosa AFA, Ferreira CM, Augusto CM, Sassone LM, Lopes RT, Fidel SR, Silva EJNL. The impact of minimally invasive root canal preparation strategies on the ability to shape root canals of mandibular molars. Int Endod J 2020; 53:1680-1688. [DOI: 10.1111/iej.13384] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Affiliation(s)
- C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - C. M. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - C. M. Augusto
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de JaneiroRJBrazil
| | - S. R. Fidel
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroRJBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro RJ Brazil
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Barbosa AFA, Silva EJNL, Coelho BP, Ferreira CMA, Lima CO, Sassone LM. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars. Int Endod J 2020; 53:1666-1679. [DOI: 10.1111/iej.13383] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 12/17/2022]
Affiliation(s)
- A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro Brazil
| | - B. P. Coelho
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. M. A. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
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Rover G, Lima CO, Belladonna FG, Garcia LFR, Bortoluzzi EA, Silva EJNL, Teixeira CS. Influence of minimally invasive endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors. Int Endod J 2020; 53:1530-1539. [DOI: 10.1111/iej.13378] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 01/11/2023]
Affiliation(s)
- G. Rover
- Department of Dentistry Federal University of Santa Catarina Florianópolis SCBrazil
| | - C. O. Lima
- Department of Endodontics State University of Rio de Janeiro Rio de JaneiroRJBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University NiteróiRJBrazil
| | - L. F. R. Garcia
- Department of Dentistry Federal University of Santa Catarina Florianópolis SCBrazil
| | - E. A. Bortoluzzi
- Department of Dentistry Federal University of Santa Catarina Florianópolis SCBrazil
| | - E. J. N. L. Silva
- Department of Endodontics State University of Rio de Janeiro Rio de JaneiroRJBrazil
- Department of Endodontics Fluminense Federal University NiteróiRJBrazil
- Department of Endodontics Grande Rio University Duque de Caxias RJ Brazil
| | - C. S. Teixeira
- Department of Dentistry Federal University of Santa Catarina Florianópolis SCBrazil
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Amaral RR, Guimarães Oliveira AG, Braga T, Reher P, de Macêdo Farias L, Magalhães PP, Ferreira PG, Ilma de Souza Côrtes M. Quantitative Assessment of the Efficacy of Two Different Single-file Systems in Reducing the Bacterial load in Oval-Shaped Canals: A Clinical Study. J Endod 2020; 46:1228-1234. [PMID: 32653532 DOI: 10.1016/j.joen.2020.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This randomized clinical study compared the in vivo antibacterial efficacy of Reciproc Blue (RB), XP-endo Shaper (XP-S), and XP-endo Shaper associated with XP-endo Finisher (XP-F) systems in infected oval-shaped root canals with primary apical periodontitis. METHODS In this study, 28 human teeth with a single root and a single canal were randomly assigned to 2 groups according to the instrumentation technique: group 1, RB (n = 14) and group 2, XP-endo (XP-S and XP-F, n = 14). The single-rooted teeth were prepared by reciprocating and rotary nickel-titanium instruments with 5.25% sodium hypochlorite irrigation. Samples were collected from the canal at the baseline (S1), after chemomechanical preparation (S2), and after XP-F instrumentation (S3). The DNA extracts were subjected to quantitative analysis for total bacterial counts by quantitative real-time polymerase chain reaction. The data were analyzed using the analysis of variance test, and the level of significance was set at 5%. RESULTS All samples tested positive for the presence of bacteria at baseline, and the bacterial counts substantially reduced after treatment procedures (P < .01). The results showed no statistical difference between RB and XP-S instrumentation with respect to the bacterial reduction (P > .05). A marked bacterial reduction was observed after the use of the XP-F instrument (P < .01). CONCLUSIONS The XP-S and RB systems sharply reduced the bacterial load in oval-shaped root canals with primary apical periodontitis. XP-F used as a supplementary instrument to chemomechanical preparation promoted a significantly higher bacterial reduction.
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Affiliation(s)
- Rodrigo Rodrigues Amaral
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia; Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Anna Gabriella Guimarães Oliveira
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tiago Braga
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Peter Reher
- School of Dentistry and Oral Health Griffith University, Gold Coast, Queensland, Australia
| | - Luiz de Macêdo Farias
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paula Prazeres Magalhães
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Pedro Gonçalves Ferreira
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Ilma de Souza Côrtes
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Evaluation of Cross-Sectional Root Canal Shape and Presentation of New Classification of Its Changes Using Cone-Beam Computed Tomography Scanning. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10134495] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The root canal system is considering the most important factor in endodontic treatment, due to the complexity of its anatomy and morphology. The aim of this study was to evaluate the cross-sectional root canal shape in three thirds (coronal, middle, apical) in different age groups using cone-beam computed tomography scanning (CBCT) and to present a new classification for root canal shape changes. This cross-sectional study included 300 CBCT scans for patient aged 20–70, and these scans were evaluated to study the morphology of the cross-sectional root canal shape in coronal, middle, and apical thirds among three age groups, namely the young (20–44), middle (45–59), and elderly (60–70). The root canal shape was classified as round, oval, long oval, and ribbon (with or without isthmus). The cross-sectional root canal shape was identified in two groups: canals with an unchanging (constant) shape and canals with changing shape. In turn, in canals with changing shape, the change could be identified in the region of the middle or apical thirds of the canal. The results showed that root canal shape changes in two cases: (1) the presence of one or more canals in the root (with or without isthmus between them), and (2) with age, as it was observed that the cross-sectional shape of the root canal becomes round in the apical third with age. A new classification of the changes of root canal shape in three thirds (coronal, middle, apical) was presented in this study.
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Assessment of Mechanical Root Canal Preparation with Centric Reciprocating or Eccentric Rotary Kinematics: A Micro-computed Tomographic Study. J Endod 2020; 46:1309-1316. [PMID: 32565335 DOI: 10.1016/j.joen.2020.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this study was to compare, using micro-computed tomographic imaging, the preparation of mesial canals of mandibular molars with the Reciproc (VDW GmbH, Munich, Germany) and XP-endo Shaper (FKG, La Chaux-de-Fonds, Switzerland) systems, evaluating changes in dentin and canal volume, the percentage of untouched walls, the volume of accumulated hard tissue debris, and root canal deviation in the apical third. METHODS Twenty-four mandibular molars with 2 mesial root canals and a single foramen were anatomically paired and divided into 2 experimental groups (n = 12) according to the system used. The specimens were scanned before and after preparation with the SkyScan 1176 microtomographic scanner (Bruker-microCT, Kontich, Belgium) at a resolution of 17.42 μm. The resulting data were statistically compared at a significance level of 5% using the Student t test and the Mann-Whitney test. RESULTS A significant difference was observed in the untouched surface area for the total canal and the cervical and middle thirds, with the lowest untouched surface area in the XP-endo Shaper group (P < .05). The volume of accumulated hard tissue debris was significantly higher in the Reciproc group in the total canal as well as in the middle and apical thirds. There was no significant difference between the groups regarding the volume of dentin removed or the increase in canal volume and surface area (P > .05). CONCLUSIONS The XP-endo Shaper touched more walls and left less accumulated hard tissue debris in the root canal system than the Reciproc group. Although the XP-endo Shaper showed superior results, neither system was able to fully prepare the root canal.
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Velozo C, Silva S, Almeida A, Romeiro K, Vieira B, Dantas H, Sousa F, De Albuquerque DS. Shaping ability of XP‐endo Shaper and ProTaper Next in long oval‐shaped canals: a micro‐computed tomography study. Int Endod J 2020; 53:998-1006. [DOI: 10.1111/iej.13301] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- C. Velozo
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - S. Silva
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - A. Almeida
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - K. Romeiro
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - B. Vieira
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - H. Dantas
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - F. Sousa
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - D. S. De Albuquerque
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
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Wen C, Kong Y, Zhao J, Li Y, Yu M, Zeng S, Shi Z, Jiang Q. Efficacy of the photon-initiated photoacoustic streaming combined with different solutions on Enterococcus faecalis in the root canals. Microsc Res Tech 2020; 83:647-657. [PMID: 32064716 DOI: 10.1002/jemt.23455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/01/2020] [Accepted: 01/24/2020] [Indexed: 01/12/2023]
Abstract
This study aimed to evaluate the efficacy of different irrigation solutions used in photon-initiated photoacoustic streaming (PIPS) or conventional needle irrigation (CNI) for eradication of Enterococcus faecalis from artificial root canals. Altogether, 240 artificial root canal samples were included. The models were split and incubated for 2 days to allow formation of E. faecalis biofilm. The models were randomly divided into two groups (n = 120): CNI and laser-activated irrigation (LAI). Each group was divided into six subgroups according to different irrigation solutions: distilled water, 1% sodium hypochlorite (NaOCl), 2% NaOCl, 5.25% NaOCl, MTAD, and chlorhexidine, respectively. After irrigation, half of the samples (n = 10) were assessed immediately, and the other half of the samples (n = 10) were incubated for 6 hr. Bacterial suspensions were obtained from all samples before and after irrigation, and after incubation, and were quantified adenosine 5'-triphosphate (ATP) assay kit. The biofilms were examined using fluorescent microscopy and analyzed by Image Pro Plus software. Significant reduction of ATP, average fluorescence density after irrigation, and growth after incubation was obtained in LAI group than in CNI group (p < .05). LAI can improve bacteriostasis effect of 2% NaOCl (p < .05). PIPS improved the antibacterial effect of the 2% NaOCl used in root canal therapy.
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Affiliation(s)
- Cheng Wen
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuanyuan Kong
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Zhao
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yang Li
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Miao Yu
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sujuan Zeng
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhan Shi
- Human Biology Program, University of Toronto, Toronto, Ontario, Canada
| | - Qianzhou Jiang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Arıcan Öztürk B, Atav Ateş A, Fişekçioğlu E. Cone-Beam Computed Tomographic Analysis of Shaping Ability of XP-endo Shaper and ProTaper Next in Large Root Canals. J Endod 2020; 46:437-443. [PMID: 31911004 DOI: 10.1016/j.joen.2019.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/12/2019] [Accepted: 11/23/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate and compare the shaping abilities of the XPS (XP-endo Shaper) and PTN (ProTaper Next) systems by using cone-beam computed tomography on apical, middle, and coronal thirds of the pre-created large canals with different apical sizes. METHODS Seventy-two teeth with single canal were divided into 3 groups, and then large root canals were created with apical diameter #30 (Group 1), #35 (Group 2), or #40 (Group 3) by using hand files. Each group was again divided into 2 experimental groups, and root canals were instrumented with either XPS or PTN. Canals were scanned before and after instrumentation by using cone-beam computed tomography scanner to evaluate mesiodistal transportation, buccolingual transportation, centering ratio, percent increased prepared area (PA) (mm2), and percent increased prepared outline (PO) (mm) at 2, 5, and 8 mm from the apex. Data were statistically analyzed, and the significance level was set at P < .05. RESULTS There were no statistically significant differences in PA, PO, and centering ratio values between instruments in size 30 and size 35. The mean increases in PA and PO (P < .021) were statistically higher with XPS in size 40. PTN had statistically higher buccolingual transportation in size 30 and size 35. XPS had lower mesiodistal transportation values in all 3 apical sizes. CONCLUSIONS PTN system is able to remove the dentin even in cases of increased apical diameter. However, XPS has less canal transportation and better centering ability compared with PTN.
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Affiliation(s)
- Burçin Arıcan Öztürk
- 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
| | - Erdoğan Fişekçioğlu
- Department of DentoMaxillofacial Radiology, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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Fiallos NDM, Cecchin D, de Lima CO, Hirata R, Silva EJNL, Sassone LM. Antimicrobial effectiveness of grape seed extract against Enterococcus faecalis biofilm: A Confocal Laser Scanning Microscopy analysis. AUST ENDOD J 2019; 46:191-196. [PMID: 31814249 DOI: 10.1111/aej.12390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
Abstract
This study evaluated the antimicrobial effectiveness of 6.5% Vitis vinifera grape seed extract (GSE) against Enterococcus faecalis biofilm using confocal laser scanning microscopy (CLSM). Saline solution (SS), 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) were used for comparison. Dentin discs were inoculated with E. faecalis strain establishing a 3-week-old biofilm. Discs (n = 10) were exposed to 5.25% NaOCl, 2% CHX, 6.5% GSE and SS (negative control) for 10 min. Discs were stained with the fluorescent LIVE/DEAD-BacLight™ dye and analysed using CLSM. The proportion of dead cells in biofilm was analysed using one-way anova and Tukey tests (P < 0.05). A higher proportion of dead cells was found in GSE group compared with CHX and SS (P < 0.05). NaOCl group was associated with the highest proportion of dead cells (P < 0.05). GSE presented antimicrobial activity against E. faecalis; however, NaOCl was the most effective irrigant solution. GSE was more effective than CHX and SS.
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Affiliation(s)
| | - Doglas Cecchin
- Department of Endodontics, Passo Fundo University (UPF), Passo Fundo, Brazil
| | | | - Raphael Hirata
- Department of Microbiology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
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De‐Deus G, Simões‐Carvalho M, Belladonna FG, Cavalcante DM, Portugal LS, Prado CG, Souza EM, Lopes RT, Silva EJNL. Arrowhead design ultrasonic tip as a supplementary tool for canal debridement. Int Endod J 2019; 53:410-420. [DOI: 10.1111/iej.13236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - L. S. Portugal
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - C. G. Prado
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Maranhão Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
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