An In Vitro Evaluation Study of the Geometric Changes of Root Canal Preparation and the Quality of Endodontic Treatment

Finite element study of the fatigue behaviour of nickel-titanium endodontic files utilised with pecking motion technique

The purpose of the study is to evaluate the influence of the pecking motion (reciprocal axial motion) surgical technique on the durability behaviour of the Nickel-Titanium endodontic files using Finite Element Analysis (FEA). A commonly used endodontic file, ProTaper Universal F2, is selected for the study. Root canal treatment procedure is simulated on a test-bench (simulated root canal) proposed by G. Gambarini for cyclic fatigue loading of endodontic files with and without the pecking motion via FEA. The hysteresis energy density is used as evaluation criteria for low cycle fatigue life estimation of Shape Memory Alloy files. In an additional study, the root canal treatment procedure is also simulated for an FEA model of a molar tooth with significant root canal curvature to understand the influence of the realistic curvature of a root canal on the fatigue behaviour of endodontic files. For the simulated root canal, analysis accurately predicts the endodontic file's failure location, and fatigue life estimation based on the hysteresis energy density is shown to increase significantly with the introduction of the pecking motion, an observation confirmed by reported experimental results. Molar tooth simulations reveal greater file fatigue resistance than in simulated root canals, confirming the pecking motion's efficacy in enhancing file durability, even in real root canal conditions. Simulations indicate that the pecking motion technique increases the fatigue life of endodontic files for simulated as well as real root canals and the hysteresis energy is confirmed as an acceptable parameter to quantify fatigue life of Nickel-Titanium endodontic files.

Evaluation of Dentinal Thickness and Remaining Dentine Volume around Root Canals Using Cone-Beam Computed Tomography Scanning

BACKGROUND

The remaining dentinal thickness is a significant factor to deal with when planning post-endodontic treatment.

AIM

To assess the changes in the root canal dentinal thickness of intact and endodontically treated teeth using CBCT scans in the coronal, middle, and apical third of the root canal.

MATERIAL AND METHODS

Three hundred CBCT scans for three age groups were analyzed to study the dentinal thickness pre- and post-endodontic treatment. The dentinal thickness (DT) was measured along the buccal, mesial, distal, and lingual/palatal walls from the inner surface of the root canal to the outer surface in mm. Statistical analysis was set at 0.05.

RESULTS

The results of this study showed that the buccal, palatal, distal, and mesial dentinal thickness in intact and endodontically treated teeth is different. The differences were statistically significant when comparing the parameters of "healthy" and "treated" teeth (p < 0.05). There were no statistically significant differences in indicators associated with age (p > 0.05). In the coronal third of the root canal, the least amount of dentin tissue lost was 4.2% for mandibular canines.

CONCLUSIONS

The dentinal thickness in the coronal and middle third of the root decreases significantly more than the apical third. The most loss of dentine volume was among molar teeth, and the remaining dentinal thickness was less than 1 mm, which would increase the risk of complication while preparing the canal for a post.

The Application of Nano Silver Argitos as a Final Root Canal Irrigation for the Treatment of Pulpitis and Apical Periodontitis. In Vitro Study

BACKGROUND

Endodontic treatment of various forms of pulpitis with variations of root canal system anatomy should be performed with high quality. The use of various antibacterial agents is aimed at maintaining the success of endodontic treatment. The aim of this study was to evaluate the penetration and fixation of the nano-silver solution on the dentinal surface during endodontic treatment.

MATERIALS AND METHODS

the study was carried out on 70 extracted single-rooted teeth, randomly divided into two groups. In the teeth of the first group, the smear layer was removed after canal preparation with 17% EDTA solution; in the second group, the smear layer was not removed. In both groups, for the final treatment of the canal, a colloidal 1% solution of нанo серебра nanosilver was used. Samples were cut and prepared for analysis using micro-CT, scanning electron microscopy (SEM), X-ray microanalysis and energy dispersive spectrometry (elemental mapping).

RESULTS

in 100% of cases in groups of teeth with a preserved smear layer, the ability of a 1% colloidal solution of nanosilver with particles of 1-2 nm to be fixed on dentin with a removed and preserved smear layer and to leave a film on the dentinal surface was established. In the samples with removed smear layer, silver was found in 73.5% of cases.

CONCLUSION

The nano-silver solution with a particle size of 1-2 nm proved its ability to penetrate the dentinal surfaces and create a final film covering the dentinal surface of the root canal before applying the sealer.

Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis

Background

XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted.

Methods

A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias.

Results

Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56).

Conclusions

The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01644-7.