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Călin C, Focșăneanu AM, Paulsen F, Didilescu AC, Niță T. Shaping Efficiency of Rotary and Reciprocating Kinematics of Engine-driven Nickel-Titanium Instruments in Moderate and Severely curved Root Canals Using Microcomputed Tomography: A Systematic Review of Ex Vivo Studies. J Endod 2024; 50:907-924. [PMID: 38537784 DOI: 10.1016/j.joen.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/29/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION This systematic review aimed to compare reciprocating with continuous rotary instrumentation kinematics, by means of microcomputed tomography evaluations, in extracted human permanent teeth with moderate and severe canal curvatures. METHODS The research protocol was registered in the International Prospective Register of Systematic Reviews and given the reference number CRD42023404035. An electronic search was undertaken in MEDLINE (PubMed), EBSCO, Scopus, Web of Science databases until December 2021. Manual screening of issues in endodontic journals and references of relevant articles were assessed individually. The risk of bias (RoB) of the included articles was evaluated with the QUIN tool (Quality Assessment Tool for In Vitro Studies). RESULTS Among 1640 retrieved articles, 49 were included in the qualitative synthesis. Fifteen articles had low RoB, 33 articles had medium RoB, and only 1 study was at high RoB. Continuous rotary systems had better centering ability in both moderate and severe canal curvatures and resulted in less apical transportation in severely curved root canals. None of the kinematic systems was capable of instrumenting the entire canal surface area. Reciprocating kinematics systems tended to provide higher increase in surface area of severely curved canals and produced fewer dentinal microcracks in moderately curved canals. CONCLUSIONS The evidence presented in this review suggests that continuous rotary system seems to be better than reciprocating system in solving the major issues encountered during root canal instrumentation of extracted teeth with moderate and severe curvatures.
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Affiliation(s)
- Claudiu Călin
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreea C Didilescu
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Tiberiu Niță
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery "Dan Theodorescu Hospital", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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De-Deus G, Arashiro FN, Souza EM, Silva EJNL, Guimarães TDM, Maciel ACDC, Oliveira DDS, Belladonna FG, Lopes RT, Versiani MA. The impact of long-term storage conditions on the development of experimental dentinal microcracks. AUST ENDOD J 2024; 50:60-68. [PMID: 37876340 DOI: 10.1111/aej.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/27/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
This study evaluated the impact of long-term storage conditions (medium and time) on the development of experimental dentinal microcracks through micro-computed tomography. Sixty freshly extracted premolars were stored in formalin, water, or dry conditions (n = 20) and scanned after 72 h, 30 days, 6 months and 3 years of extraction. The effect of the storage medium and time on the occurrence of dentinal defects was statistically evaluated. A total of 211 000 images were screened revealing the existence of 11 519 slices with dentinal defects. Dry conditions significantly contributed to the development of new defects in all time points. During the 3-year follow-up period, no new defects were detected in the teeth that were stored in water and, in a single tooth, in the formalin group, after 6 months of storage.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Fabio Nakao Arashiro
- Department of Endodontics, School of Dentistry Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
- Department of Endodontics, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
| | | | | | | | | | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marco Aurélio Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
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Özdayi K, Yilmaz S, Dumani A, Yoldas O. Effects of ultrasonics and trephine burs on dentinal microcrack formation during broken instrument removal procedures: A micro-CT analysis. AUST ENDOD J 2024; 50:123-130. [PMID: 37997642 DOI: 10.1111/aej.12820] [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: 03/27/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 11/25/2023]
Abstract
The objective of this study was to compare the effects of ultrasonic and trephine burs on microcrack formation during the removal of broken instruments, utilising micro-computed tomography (Micro-CT). Twenty-five extracted human mandibular molars were used for this study. The hand files were fractured into the mesiobuccal canal, except in the control group. In the ultrasonic group (n = 10), ultrasonic tips were used to retrieve the instrument, while in the trephine group (n = 10), trephine burs (Meitrac, Meisinger) and an extractor device were utilised. For the control group (n = 5), only staging platform was prepared. After the removal procedures, micro-CT images were obtained from the specimens. The chi-squared test was used to analyse the data, and significance was considered to be p < 0.05. Overall, 15 736 cross sections were analysed. No significant differences were found between control and experimental groups. Removal of broken instruments with trephine burs caused significantly more dentinal microcracks compared with ultrasonics (p = 0.016).
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Affiliation(s)
| | - Sehnaz Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Aysin Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Oguz Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Krug R, Schwarz F, Dullin C, Leontiev W, Connert T, Krastl G, Haupt F. Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications. Clin Oral Investig 2024; 28:192. [PMID: 38438798 PMCID: PMC10912265 DOI: 10.1007/s00784-024-05577-7] [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: 01/04/2024] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVES To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro. MATERIAL AND METHODS Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group. After treatment, the prepared access cavities were volumetrically assessed by micro-CT. Statistical significance was evaluated by one-way analysis of variance followed by post hoc comparisons with Tukey's HSD test and Pearson's chi-squared test for independence. RESULTS Both CONV and GE resulted in dentin loss and residual resin material. CS resulted in more dentin loss and less residual resin material than CG and GE (p < .05). All groups had some deviations from the original root canal but no perforations. The shortest working time was observed in the GE group. CONCLUSIONS Compared to the conventional freehand technique, GE resulted in significantly less radicular dentin loss, a few deviations but no perforations. CLINICAL RELEVANCE Guided endodontics can improve the speed and safety of fiber post removal without root perforation.
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Affiliation(s)
- R Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - F Schwarz
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - C Dullin
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - W Leontiev
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - T Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - G Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - F Haupt
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Abdelfattah RA, Nawar NN, Kataia EM, Saber SM. How loss of tooth structure impacts the biomechanical behavior of a single-rooted maxillary premolar: FEA. Odontology 2024; 112:279-286. [PMID: 37394683 PMCID: PMC10776703 DOI: 10.1007/s10266-023-00829-6] [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: 04/01/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
To evaluate the influence of the loss of coronal and radicular tooth structure on the biomechanical behavior and fatigue life of an endodontically treated maxillary premolar with confluent root canals using finite element analysis (FEA). An extracted maxillary second premolar was scanned to produce intact (IT) 3D model. Models were designed with an occlusal conservative access cavity (CAC) with different coronal defects; mesial defect (MO CAC), occlusal, mesial and distal defect (MOD CAC), and 2 different root canal preparations (30/.04, and 40/.04) producing 6 experimental models. FEA was used to study each model. A simulation of cycling loading of 50N was applied occlusally to stimulate the normal masticatory force. Number of cycles till failure (NCF) was used to compare strength of different models and stress distribution patterns via von Mises (vM) and maximum principal stress (MPS). The IT model survived 1.5 × 1010 cycles before failure, the CAC-30.04 had the longest survival of 1.59 × 109, while the MOD CAC-40.04 had the shortest survival of 8.35 × 107 cycles till failure. vM stress analysis showed that stress magnitudes were impacted by the progressive loss of coronal tooth structure rather than the radicular structure. MPS analysis showed that significant loss of coronal tooth structure translates into more tensile stresses. Given the limited size of maxillary premolars, marginal ridges have a critical role in the biomechanical behavior of the tooth. Access cavity preparation has a much bigger impact than radicular preparation on their strength and life span.
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Affiliation(s)
- Roaa Abdelwahab Abdelfattah
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt.
| | - Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
| | - Engy M Kataia
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Misr-Ismalia Road, El Sherouk City, Cairo, 11837, Egypt
- Department of Endodontics, Ain Shams University, Cairo, Egypt
- Centre for Innovative Dental Sciences (CIDS), Faculty of Dentistry, The British University in Egypt (BUE), El Sherouk City, 11837, Egypt
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Dumbryte I, Narbutis D, Androulidaki M, Vailionis A, Juodkazis S, Malinauskas M. Teeth Microcracks Research: Towards Multi-Modal Imaging. Bioengineering (Basel) 2023; 10:1354. [PMID: 38135945 PMCID: PMC10740647 DOI: 10.3390/bioengineering10121354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
This perspective is an overview of the recent advances in teeth microcrack (MC) research, where there is a clear tendency towards a shift from two-dimensional (2D) to three-dimensional (3D) examination techniques, enhanced with artificial intelligence models for data processing and image acquisition. X-ray micro-computed tomography combined with machine learning allows 3D characterization of all spatially resolved cracks, despite the locations within the tooth in which they begin and extend, and the arrangement of MCs and their structural properties. With photoluminescence and micro-/nano-Raman spectroscopy, optical properties and chemical and elemental composition of the material can be evaluated, thus helping to assess the structural integrity of the tooth at the MC site. Approaching tooth samples having cracks from different perspectives and using complementary laboratory techniques, there is a natural progression from 3D to multi-modal imaging, where the volumetric (passive: dimensions) information of the tooth sample can be supplemented by dynamic (active: composition, interaction) image data. Revelation of tooth cracks clearly shows the need to re-assess the role of these MCs and their effect on the structural integrity and longevity of the tooth. This provides insight into the nature of cracks in natural hard materials and contributes to a better understanding of how bio-inspired structures could be designed to foresee crack propagation in biosolids.
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Affiliation(s)
- Irma Dumbryte
- Institute of Odontology, Vilnius University, LT-08217 Vilnius, Lithuania
| | - Donatas Narbutis
- Institute of Theoretical Physics and Astronomy, Vilnius University, LT-10222 Vilnius, Lithuania
| | - Maria Androulidaki
- Microelectronics Research Group, Institute of Electronic Structure & Laser, Foundation for Research and Technology FORTH-Hellas, 70013 Heraklion, Crete, Greece
| | - Arturas Vailionis
- Stanford Nano Shared Facilities, Stanford University, Stanford, CA 94305, USA
- Department of Physics, Kaunas University of Technology, LT-51368 Kaunas, Lithuania
| | - Saulius Juodkazis
- Optical Sciences Centre and ARC Training Centre in Surface Engineering for Advanced Materials (SEAM), School of Science, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- WRH Program International Research Frontiers Initiative (IRFI), Tokyo Institute of Technology, Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan
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Nawar NN, Abdelfattah RA, Kataia M, Saber SM, Kataia EM, Kim HC. Effect of Proximal Caries-driven Access on the Biomechanical Behavior of Endodontically Treated Maxillary Premolars. J Endod 2023; 49:1337-1343. [PMID: 37517584 DOI: 10.1016/j.joen.2023.07.022] [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: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION This study investigated the effects from the carious cavity and access from it on the fracture resistance of endodontically treated maxillary premolars using finite element analysis (FEA). METHODS A maxillary premolar was used to compare 3 types of access cavity related to having a proximal carious defect: caries-driven access (CDA), conservative access that has a mesial component (MCA), as well as traditional access with the same mesial component (MTA). Cyclic loading was simulated on the occlusal surface, and number of cycles until failure (NCF) was compared with the intact tooth model (IT). Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (vM) and maximum principal stresses (MPS), with emphasis on pericervical region as a specific area of interest. RESULTS Maximum vM registered on the IT was 6.14 MPa. CDA provided the highest NCF with 92.28% of the IT, followed by MCA (84.90%) and MTA (83.79%). The vM and MPS analysis showed that the stress values and patterns are affected more by the proximity of the occlusal load to the tooth/restoration interface. Concerning the pericervical region, maximum vM was registered for IT (4.11 MPa), followed by CDA (4.85 MPa) and then MCA (8.13 MPa) and MTA (8.61 MPa), whereas the MPS analysis revealed that CDA showed the highest magnitude of tensile stresses. CONCLUSIONS A proximal CDA benefits the mechanical properties of maxillary premolars; however, its impact on the biological aspect should be assessed to provide a ruling for/against it.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | | | - Mohamed Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt
| | - Engy Medhat Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Restorative and Dental Materials Department, National Research Centre, Doki, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Haupt F, Wiegand A, Kanzow P. Risk factors for and clinical presentations indicative of vertical root fracture in endodontically treated teeth - a systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00323-0. [PMID: 37307871 DOI: 10.1016/j.joen.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The aim of this study was to identify specific clinical signs or symptoms and potential risk factors which are most likely associated with the presence of a vertical root fracture (VRF) in endodontically treated teeth (ETT). METHODS Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Scopus, and Web of Science) were searched by two reviewers in October 2022 for clinical studies, in which at least either the clinical presentation or potential risk factors associated with a VRF were assessed. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analyses of odds ratios (ORs) were performed separately for several signs or symptoms and risk factors. RESULTS Fourteen sources reporting on 2,875 teeth (489 with VRF and 2,388 without VRF) were included in the meta-analyses. Regarding the clinical presentation, the presence of sinus tracts (OR=4.87; 95%-CI: 1.58-15.0), increased periodontal probing depths (OR=13.24; 95%-CI: 5.44-32.22), swelling/abscess (OR=2.86; 95%-CI: 1.74-4.70), and tenderness to percussion (OR=1.74; 95% CI: 1.18-2.61) were significantly associated with the presence of a VRF (Padj. value<.05). None of the assessed risk factors (sex, type of teeth, tooth location, posts, indirect restoration, apical extension of the root canal filling), were found to be significantly associated with the presence of a VRF (Padj. value>.05). CONCLUSIONS Four clinical presentations were identified to be the most significant signs or symptoms for a VRF in ETT: presence of sinus tracts, increased probing depths, swelling/abscess, tenderness to percussion. None of the assessed risk factors pointed out to be significantly associated with a VRF. REGISTRATION CRD42022354108 (PROSPERO).
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
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Grande NM, Castagnola R, Minciacchi I, Marigo L, Plotino G. A review of the latest developments in rotary NiTi technology and root canal preparation. Aust Dent J 2023; 68 Suppl 1:S24-S38. [PMID: 37960998 DOI: 10.1111/adj.12998] [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] [Accepted: 10/18/2023] [Indexed: 11/15/2023]
Abstract
The introduction of nickel-titanium (NiTi) mechanical instruments dramatically changed clinical endodontics over the last few decades. Before NiTi, it was necessary to use more instruments to create an ideal root canal shape, and many approaches, sequences and techniques were developed over the years. Recently, NiTi endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments to improve their root canal preparation outcomes and reduce associated canal preparation risks during root canal treatment. Heat treatment is one of the most fundamental approaches to improving the fatigue resistance and flexibility of NiTi endodontic instruments. In addition, new kinematics have been developed to offer greater safety and efficiency. This narrative review describes the general properties and manufacturing of NiTi instruments, and the mechanical system evolution of NiTi instruments.
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Affiliation(s)
- N M Grande
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Castagnola
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - L Marigo
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Odontoiatria Generale e Ortodonzia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo. Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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Nawar NN, Elkholy MMA, Ha WN, Saber SM, Kim HC. Optimum shaping parameters of the middle mesial canal in mandibular first molars: A finite element analysis study. J Endod 2023; 49:567-574. [PMID: 36965769 DOI: 10.1016/j.joen.2023.03.007] [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: 12/30/2022] [Revised: 01/27/2023] [Accepted: 03/17/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION This study investigated the effect of shaping parameters of two different configurations of middle mesial canals (MMC) on the biomechanical behavior and life span of a mandibular first molar using finite element analysis (FEA). METHODS A mandibular molar with an independent MMC and another with a confluent MMC were scanned via micro-CT, and FEA models were produced. For each tooth, an intact model and 5 experimental models were produced differed by parameters of how MMC was shaped: unshaped MMC, 25/.04, 25/.06, 30/.04, and 30/.06. Cyclic loading of 50 N was applied on the occlusal surface in vertical and oblique scenarios, and the number of cycles until failure (NCF) was compared to the intact models. In addition, mathematical analyses evaluated the stress distribution patterns and calculated maximum von Mises and maximum principal stresses. RESULTS For both the independent and confluent MMC models, shaping the MMC reduced the NCF. The lifelog percentage of models was inversely proportional with radicular shaping parameters during the vertical and oblique loading scenarios. The shaping size of 30/.06 resulted in lower lifelog percentage than the cases with shaping size of 25/.04 in both of the independent and confluent MMC models. For all models, oblique loading reduced NCF more than vertical loading. CONCLUSION Shaping the MMC should be kept as conservative as 25/.04. Also, whether the MMC is independent or confluent is a deciding factor in whether to increase the apical diameter or the root canal taper when larger shaping parameters are needed.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Mostafa M A Elkholy
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; School of Dentistry, University of Western Australia, Perth, WA, Australia
| | - William Nguyen Ha
- Department of Endodontics, Sydney Dental School, University of Sydney
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Haupt F, Dullin C, Krebs M, Hettwer-Steeger I, Kanzow P, Rödig T. Micro-CT evaluation of frozen and embalmed human cadavers on the effect of root canal preparation on microcrack formation in old dentin. PLoS One 2023; 18:e0281124. [PMID: 36716302 PMCID: PMC9886256 DOI: 10.1371/journal.pone.0281124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/13/2023] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to evaluate the existence of preoperative dentinal defects among differently preserved dentoalveolar bone-blocks (frozen vs. embalmed) and to investigate the effect of varying apical forces (low: <4 N, high: 4-8 N) during root canal preparation on microcrack formation using micro-computed tomography (micro-CT). Thirteen embalmed and seven frozen bone-blocks containing 1-3 single rooted teeth were collected. The teeth were evenly divided into three groups (n = 10): FLow (frozen, <4 N), ELow (embalmed, <4 N), EHigh (embalmed, 4-8 N). After working length determination all specimens were scanned preoperatively. Root canal preparation was performed using nickel-titanium instruments sizes 25/.06 and 40/.06 (F6 SkyTaper; Komet, Lemgo, Germany). A postoperative scan was performed and image stacks were co-registered. All cross-sectional images were screened to identify the presence of dentinal defects. The results were expressed as the percentage of teeth/slices presenting dentinal defects. The statistical analyses were performed with Kruskal-Wallis-Test and Mann-Whitney-U-Test (α = 5%). Embalmed specimens presented a significantly higher percentage of slices with preoperative microcracks (p<0.05) than frozen specimens. No significant difference between groups was observed regarding the induction of microcracks (p>0.05). Root canal preparation does not induce microcracks in dentoalveolar bone-blocks from donors of old age, irrespective of the preservation method and the apically directed forces.
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
- * E-mail:
| | - Christian Dullin
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Marcel Krebs
- Department of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Serpa GC, Guedes OA, Freitas NSS, Silva JA, Estrela C, Decurcio DA. The effect of ultrasonic vibration protocols for cast post removal on the incidence of root dentin defects. J Oral Sci 2023; 65:190-194. [PMID: 37394544 DOI: 10.2334/josnusd.23-0048] [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: 07/04/2023]
Abstract
PURPOSE To investigate the effects of two ultrasonic vibration protocols for cast post removal (single or double ultrasound units) on the development of defects in root dentin. METHODS Sixty bovine incisors were selected. Fifteen roots were left unprepared (control). Forty-five roots were instrumented and filled. A 10-mm post space was prepared using #1-4 Largo drills. Fifteen teeth were prepared for post space and received no further procedure. Thirty roots had cast posts cemented and were submitted to ultrasonic vibration protocols for removal. The time necessary to remove each post was recorded. Roots were sectioned 3, 6, 9, and 12 mm from the coronal portion and viewed through a 25× magnification in a stereomicroscope. The presence of root fractures, partial cracks, and craze lines was registered. Chi-square and Fisher's exact tests were performed to compare the incidence of dentin defects. The Kruskal-Wallis test was performed to explore the difference between the time needed for post removal. The significance level was set at P = 0.05. RESULTS Root defects were observed in all experimental groups. There were no statistical differences comparing previous root canal treatment and post removal steps, either with 1 or 2 ultrasonic units, in the formation of defects (P = 0.544) or fractures (P = 0.679). CONCLUSION Ultrasonic vibration protocols for removing cast posts did not increase the number of dentin defects compared to root canal preparation and obturation and post space preparation steps.
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Affiliation(s)
- Giulliano C Serpa
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Orlando A Guedes
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás
| | | | - Julio A Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Carlos Estrela
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Daniel A Decurcio
- Department of Stomatology, School of Dentistry, Federal University of Goiás
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Barbosa AFA, de Lima CO, Sarmento EB, Gonçalves da Cunha G, Sassone LM, Lopes RT, da Silva EJNL. Impact of minimally invasive endodontics procedures on the development of dentinal microcracks. J Endod 2022; 48:1146-1151. [PMID: 35697303 DOI: 10.1016/j.joen.2022.05.006] [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: 02/22/2022] [Revised: 04/29/2022] [Accepted: 05/26/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION To evaluate the impact of root canal preparation in teeth with ultraconservative access cavities (UltraAC) on the development of dentinal microcracks using a non-destructive longitudinal micro-CT imaging experimental model. Root canal preparation in teeth with traditional access cavities (TradAC) was used as control. METHODS Forty mandibular molars were scanned in a micro-CT device, anatomically matched, and distributed into 4 groups according to the type of access cavity and instrumentation system: traditional/Reciproc (TradAC/RC); traditional/XP-endo Shaper (TradAC/XP); ultraconservative/Reciproc (UltraAC/RC) and ultraconservative/XP-endo Shaper (UltraAC/XP). After root canal preparation, the teeth were rescanned. After reconstruction and co-registration procedures, the images were screened from the furcation level to the apex to identify the presence of dentinal microcracks. RESULTS From a total of 15340 cross-section images, 19.65% (3014 slices) had some dentinal microcrack. The qualitative analysis demonstrated the presence of some dentinal microcrack in 11%, 33%, 19%, and 15% of the images of cross-sections in TradAC/RC, TradAC/XP, UltraAC/RC, and UltraAC/XP groups, respectively. All dentinal microcracks observed after root canal preparation were already present in the corresponding images before canal instrumentation. Therefore, no new microcracks were detected, regardless of the access cavity and root canal instrumentation system. CONCLUSIONS Root canal preparation with Reciproc or XP-Endo Shaper under traditional or ultraconservative access cavities did not create dentinal microcracks in extracted mandibular molars.
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Affiliation(s)
| | | | - Estéfano Borgo Sarmento
- Departament of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Departament of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Department of Dentistry, Federal University of Juiz de Fora, Governador Valadares, MG, Brasil
| | - Emmanuel João Nogueira Leal da Silva
- Departament of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Departament of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
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14
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Lahoud P, Jacobs R, Boisse P, EzEldeen M, Ducret M, Richert R. Precision medicine using patient-specific modelling: state of the art and perspectives in dental practice. Clin Oral Investig 2022; 26:5117-5128. [PMID: 35687196 DOI: 10.1007/s00784-022-04572-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/30/2022] [Indexed: 12/25/2022]
Abstract
The dental practice has largely evolved in the last 50 years following a better understanding of the biomechanical behaviour of teeth and its supporting structures, as well as developments in the fields of imaging and biomaterials. However, many patients still encounter treatment failures; this is related to the complex nature of evaluating the biomechanical aspects of each clinical situation due to the numerous patient-specific parameters, such as occlusion and root anatomy. In parallel, the advent of cone beam computed tomography enabled researchers in the field of odontology as well as clinicians to gather and model patient data with sufficient accuracy using image processing and finite element technologies. These developments gave rise to a new precision medicine concept that proposes to individually assess anatomical and biomechanical characteristics and adapt treatment options accordingly. While this approach is already applied in maxillofacial surgery, its implementation in dentistry is still restricted. However, recent advancements in artificial intelligence make it possible to automate several parts of the laborious modelling task, bringing such user-assisted decision-support tools closer to both clinicians and researchers. Therefore, the present narrative review aimed to present and discuss the current literature investigating patient-specific modelling in dentistry, its state-of-the-art applications, and research perspectives.
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Affiliation(s)
- Pierre Lahoud
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Philippe Boisse
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France
| | - Mostafa EzEldeen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - Maxime Ducret
- Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France.,Faculty of Odontology, Lyon 1 University, Lyon, France.,Laboratoire de Biologie Tissulaire Et Ingénierie Thérapeutique, UMR5305 CNRS/UCBL, Lyon, France
| | - Raphael Richert
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France. .,Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France. .,Faculty of Odontology, Lyon 1 University, Lyon, France.
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15
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Influence of moisture content of frozen and embalmed human cadavers for identification of dentinal microcracks using micro-computed tomography. J Mech Behav Biomed Mater 2022; 133:105310. [PMID: 35696968 DOI: 10.1016/j.jmbbm.2022.105310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate the influence of moisture content in frozen and embalmed human cadavers on the detection of dentinal microcracks using micro-computed tomography (micro-CT). The group of embalmed specimens included three mandibular and two maxillary segments each containing one tooth. The group of frozen cadavers consisted of two frozen mandibular bone-blocks with two teeth and one mandibular segment containing one tooth. The final number of teeth for each preservation method was n = 5. All specimens were scanned with eight different moisture conditions: 48 h wet, 2 h dry, 48 h wet, 24 h dry, 48 h wet, 1 wk dry, 48 h wet, 1 wk dry. Micro-CT images were screened for the presence of dentinal microcracks. Statistical analysis was performed by nonparametric analysis of variance (α = 5%). Only few microcracks were observed in wet and in 2 h dried bone-blocks with no significant differences (p = 0.63 and p = 0.23, respectively). There was a significant and steady increase of microcracks within the groups of dried specimens as follows: 2 h dry < 24 h dry < first wk dry < second wk dry (all p < 0.008). Preservation method had no significant influence on the visibility of microcracks (p = 0.98). Identification of dentinal microcracks on micro-CT images is influenced by moisture content of cadaveric bone-blocks irrespective of the preservation method.
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Puleio F, Lo Giudice G, Militi A, Bellezza U, Lo Giudice R. Does Low-Taper Root Canal Shaping Decrease the Risk of Root Fracture? A Systematic Review. Dent J (Basel) 2022; 10:dj10060094. [PMID: 35735636 PMCID: PMC9222076 DOI: 10.3390/dj10060094] [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: 04/22/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Minimal root-canal preparation has been suggested to reduce the risk of root fracture, but as a result, satisfactory cleaning and shaping do not take place. Large-scale taper instrumentation can contribute to removing infected tissue; however, it may weaken the tooth structure. The aim of this systematic review is to evaluate whether root-canal shaping with low-taper instruments decreases the risk of root fracture, compared to high-conicity shaping. A search was performed on Ovid MEDLINE, PubMed, and the Web of Science. The inclusion criteria were: studies comparing the root fracture resistance of endodontically treated teeth, shaped with low- and high-conicity taper instruments, in human trials, and via in vitro study. The review includes all types of endodontically treated teeth, with various instrument tapers. The scientific search engines produced 328 results. Only 20 of the results were evaluated after screening. Based on the articles analyzed, it is not clear whether a taper difference can determine differences in root fracture resistance. No randomized controlled trial (RCTs) with long follow-ups have been published to date. It must also be taken into account that the in vitro studies do not consider the numerous differences that there are between in vitro and clinical evaluation. The review was registered on the PROSPERO website, with the protocol number CRD42020151451.
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Affiliation(s)
- Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
- Correspondence:
| | - Angela Militi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.P.); (A.M.)
| | - Ugo Bellezza
- Department of Dentistry, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy;
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Neelakantan P, Vishwanath V, Taschieri S, Corbella S. Present status and future directions ‐ Minimally invasive root canal preparation and periradicular surgery. Int Endod J 2022; 55 Suppl 4:845-871. [DOI: 10.1111/iej.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - V. Vishwanath
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - S. Taschieri
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - S. Corbella
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
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18
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Wan B, Chung BH, Zhang MR, Kim SA, Swain M, Peters OA, Krishnan U, Moule A. The effect of varying occlusal loading conditions on stress distribution in roots of sound and instrumented molar teeth. A finite element analysis. J Endod 2022; 48:893-901. [DOI: 10.1016/j.joen.2022.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
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19
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Arias A, Peters OA. Present Status and Future Directions - Canal Shaping. Int Endod J 2022; 55 Suppl 3:637-655. [PMID: 35118683 PMCID: PMC9303733 DOI: 10.1111/iej.13698] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/01/2022]
Abstract
This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.
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Affiliation(s)
- A Arias
- School of Dentistry, Complutense University, Madrid, Spain
| | - O A Peters
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
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