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Habeeb MA. Comparative evaluation of debris and irrigation extruded apically using different design of needles and penetration depth - An In Vitro study. Indian J Dent Res 2023; 34:266-269. [PMID: 38197344 DOI: 10.4103/ijdr.ijdr_32_23] [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: 01/11/2024] Open
Abstract
Aim : The aim of this study was to measure the amount of material extruded in the periapical area using three irrigation needles (Max-I-Probe, NaviTip Fx and IrriFlex flexible needle). Materials and Methods : Mandibular premolars were selected for this study and glass vials were used to gather the extruded debris and they were preweighed. The samples were divided into two groups: Group A (1 mm penetration of needle from working length), which was subdivided into three subgroups: Subgroup A1: Irrigation was made by Max-I-Probe. Subgroup A2: Irrigation was made by NaviTip Fx. Subgroup A3: Irrigation was made by IrriFlex flexible needle. Group B (3 mm penetration of needle), which was subdivided into three subgroups: Subgroup B1: Irrigation was made by Max-I-Probe. Subgroup B2: Irrigation was made by NaviTip Fx. Subgroup B3: Irrigation was made by IrriFlex flexible needle. XP-endo Shaper was used for chemomechanical preparation. After removal from vials, the teeth were incubated and then removed from the incubator and weighed again three times. The average of the readings was taken. Analysis of variance (ANOVA) and least significance difference tests were applied to analyse data. Results : All of the needles caused debris extrusion. There was a significant difference between groups (P ≤ 0.001) according to the depth of penetration. The lowest value for debris was observed in subgroup B3 while subgroup A2 had shown the highest mean. Conclusion Results revealed that the design and depth of needles significantly affected the debris extrusion. Using more flexible needles and shorter penetration depth for irrigation so that we don't need to push the needles so far apically.
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Affiliation(s)
- Maha A Habeeb
- Department of Conservative Dentistry, College of Dentistry, University of Uruk, Baghdad, Iraq
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Quantitative Evaluation of Apically Extruded Debris of Root Canal Dentin Layer with WaveOne, ProTaper Next, ProTaper Gold Rotary File Systems. COATINGS 2022. [DOI: 10.3390/coatings12040451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Endodontic flare-up or post-operative pain occurs when debris such as necrotic pulp tissue, dentin chips, irrigants, and microorganisms are extruded from the apical foramen intraoperatively into the periradicular tissue during root canal instrumentation. This study compared the amount of apical debris extrusion of the root canal dentin layer after using reciprocating and rotary file systems (WaveOne, ProTaper Next and ProTaper Gold). Sixty extracted human maxillary central incisors with one canal and closed apex were included in the study. Samples were randomly and equally divided into three groups (n = 20) according to the file systems used for preparation of the root canal. Teeth in the WO group were instrumented by WaveOne, while the PTN group were instrumented by ProTaper Next, and teeth samples in the PTG group were cleaned and shaped by ProTaper Gold. The mean apically extruded debris weight in grams was estimated using the modified Myers and Montgomery experimental model. Analysis of variance (ANOVA) test was used for the comparison of debris weight in three groups. Post hoc LSD test was applied for pairwise comparison of debris weight. The α value of significance was 0.05. The WO group had significantly lower mean debris weight than the PTN and PTG groups (p = 0.001). Post hoc pairwise comparison revealed that there was a statistically significant difference in mean debris weight between the WO group and PTN group (0.0215 vs. 0.0341, p = 0.001); and the WO group and PTG group (0.0215 vs. 0.0324, p = 0.003). Root canal preparations with different file systems were associated with apical extrusion of the debris from the root canal dentin layer. However, the WaveOne system resulted in a comparatively lower amount of apical debris layer extrusion than the ProTaper Next and ProTaper Gold rotary file systems.
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Abdelwahed A, Roshdy NN. Assessment of Post-operative Pain after using EdgeFile X7 and Protaper Next Rotary Systems in Patients with Symptomatic Pulpitis in Mandibular Molars: A Randomized Controlled Clinical Trial. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study was to evaluate the incidence of post-operative pain and analgesics intake after single-visit endodontic treatment using Edge File X7 and ProTaper Next (PTN) rotary files in mandibular molars having symptomatic pulpitis.
METHODS: The study included 60 patients complaining of symptomatic pulpitis in mandibular molar teeth. After confirming the diagnosis clinically and radiographically, patients were assigned into two equal groups; Group (I): Instrumentation was done with Edge File X7 (EF) rotary files and Group (II): Instrumentation was done with PTN rotary files. The patients underwent standardized single visit endodontic treatment procedures using 2.5% sodium hypochlorite for irrigation. Modified visual analogue scale was used to access pain preoperatively, and then postoperatively after 6, 12, 24, 48, and 72 h. An analgesic (ibuprofen 400 mg) was prescribed to the patient who suffered from persistent pain. The incidence and/or number of analgesic tablets intake were recorded. Data of pain score were compared using Mann–Whitney U test for intergroup comparisons and Freidman’s test followed by Dunn’s post hoc test for intragroup comparisons.
RESULTS: No statistically significant difference was detected between EF and PTN groups regarding the incidence and intensity of pain at different time intervals (p > 0.05). There was a significant reduction in the mean VAS score through the follow-up periods in both groups (p < 0.001). The incidence of analgesic intake was not significant in both groups.
CONCLUSION: The incidence of post-operative pain and the analgesic intake in terms of frequency and quantity were found to be similar with both rotary systems for all the post-operative time points.
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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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Eliasz W, Czarnecka B, Surdacka A. Apical Extrusion of Debris during Root Canal Preparation with ProTaper Next, WaveOne Gold and Twisted Files. MATERIALS 2021; 14:ma14216254. [PMID: 34771780 PMCID: PMC8585032 DOI: 10.3390/ma14216254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/25/2022]
Abstract
(1) Background: Apical extrusion of debris is an example of a complication that may arise during root canal treatment, and it has been proven to be an unavoidable occurrence during endodontic treatment by numerous authors. Even though it may not hinder the long-term outcome of treatment, it may lead directly to increased levels of postoperative pain and, therefore, lower levels of patient acceptance and satisfaction. The aim of the study was to assess the weight of apically extruded debris during root canal preparation with instruments that use different movement kinematics (rotary, reciprocating, and adaptive motion); (2) Methods: The study was performed using the Myers and Montgomery model. Sixty human premolar teeth were inserted into preweighed Eppendorf tubes and randomly classified into three groups. After manual glide-path preparation, teeth in each group were instrumented to working length set 1 mm short of the anatomical apex using the standard sequence provided by the manufacturers (for Group 1: ProTaper Next X1 & X2; for Group 2: WaveOne Gold Primary, for Group 3: Twisted Files SM1-SM3). Root canals were irrigated with 1 mL of 0.9% NaCl solution between each file insertion. The tubes with collected debris were stored in an incubator at 70 °C for 5 days in order to evaporate the liquid component. Measurement of the weight of extruded debris was performed by subtracting the preinstrumentation from the postinstrumentation weight of the tubes. The results were analyzed with Kruskal-Wallis ANOVA, with significance level set at 0.05; (3) Results: The weight of extruded debris was 0.337 mg (SD = 0.148) for Group 1, 0.305 mg (SD = 0.201) for Group 2, and 0.348 mg (SD = 0.135) for Group 3. (4) Conclusions: Engine-driven root canal preparation with the use of instruments ProTaper Next, WaveOne Gold and Twisted Files that use different movement kinematics (rotary, reciprocating, and adaptive motion) was associated with apical extrusion of debris to a similar extent.
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Affiliation(s)
- Wojciech Eliasz
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
- Correspondence: ; Tel.: +48-732-571-657
| | - Beata Czarnecka
- Department of Biomaterials and Experimental Dentistry, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
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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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Ates AA, Arıcan B, Testarelli L, Gambarini G, Zanza A, Seracchiani M. Influence of Clinical Operative Technique on Debris Extrusion of Two Reciprocating Files. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Cunha SA, Soares CJ, Rosatto CMP, Vieira JVSM, Pereira RADS, Soares PBF, Leles CR, Moura CCG. Effect of Endodontic Sealer in Young Molars Treated by Undergraduate Students - A Randomized Clinical Trial. Braz Dent J 2020; 31:589-597. [PMID: 33237229 DOI: 10.1590/0103-6440202003258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/01/2020] [Indexed: 11/21/2022] Open
Abstract
The progression of caries in permanent molar teeth of young patients, frequently result in endodontic treatment. This randomized blinded clinical trial assessed the effect of two endodontic sealers (Sealer 26 and AH Plus) on the incidence of pain and apical repair after endodontic treatment of young molar teeth, and secondly identify factors associated with the outcomes. Endodontic treatment was performed by undergraduate students in molar teeth (n=69) of young patients (n=54) at the Endodontic and Restorative Public Extension Clinic Service. Protaper Next was used and the endodontic sealers were allocated which were restored with direct composite resin. Two primary clinical outcomes - apical repair and postoperative pain, were assessed after 12 and 24 months for blinded operators. Description of incidence rates and mixed-model regression using Generalized Estimation Equations (GEE). After 2 years 69 molar teeth of 54 patients were evaluated. No effect of the endodontic sealer was observed irrespective of period of evaluation. Apical repair incidences and asymptomatic teeth were, respectively, 90.5 and 89.3, 96.8 and 90.0% during 1 and 2 years of follow-up. Failed apical repair was associated with unsatisfactory pulpectomy (p=0.003) and periapical conditions (p=0.007) as well as their interaction (p=0.016). None of these independent variables was able to predict the occurrence of pain in both periods. Prognosis of apical repair is dependent on the initial conditions. Endodontic treatment of young molars associated with composite resin restorations performed by undergraduate students have satisfactory results after 2 years and was effective to prevent the risk of permanent teeth loss.
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Affiliation(s)
- Suely Aparecida Cunha
- Biomechanics Research Group, Department of Operative Dentistryand Dental Materials, School of Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Carlos José Soares
- Biomechanics Research Group, Department of Operative Dentistryand Dental Materials, School of Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Camila Maria Peres Rosatto
- Department of Endodontics, School of Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Renata Afonso da Silva Pereira
- Biomechanics Research Group, Department of Operative Dentistryand Dental Materials, School of Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, UFU - Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Cláudio Rodrigues Leles
- Department of Prevention and Oral Rehabilitation, School of Dentistry, UFG - Universidade Federal de Goiás, Goiânia, GO, Brazil
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