1
|
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.
Collapse
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
| |
Collapse
|
2
|
Carlos de Morais R, Delatorre Bronzato J, de-Jesus-Soares A, Frozoni M, Talarico Leal Vieira V. Analysis of Cutting Capacity, Surface Finishing, and Mechanical Properties of NiTi Instruments 25/.04: ROTATE and LOGIC 2. J Endod 2024; 50:982-988. [PMID: 38537783 DOI: 10.1016/j.joen.2024.03.008] [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: 01/31/2024] [Revised: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION In an effort to enhance the quality of mechanized endodontic instruments, various thermal treatment methods, and design modifications have been suggested. However, upon evaluation, these endodontic instruments may exhibit microscopic irregularities. The objective of this in vitro study was to analyze the cutting capacity, surface finish, and mechanical properties of Nickel-Titanium 25/.04 Rotate (VDW GmbH, Munich, Germany) and LOGIC 2 (Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) rotary instruments. METHODOLOGY Twenty rotary instruments were divided into 2 groups: GR, the group with ROTATE instruments (n = 10); and GL2, the group with LOGIC 2 instruments (n = 10). They were evaluated for roughness, using a profilometer, for bending resistance, buckling resistance, and cutting capacity using a universal testing machine, as well as for torsional strength (torque and angular deflection) using a torquemeter. The instruments were visualized before and after the mechanical tests through scanning electron microscopy. RESULTS GR showed better surface finish in terms of roughness, greater cutting capacity, and greater angular deflection than GL2 (P < .05). However, GL2 showed better flexibility than GR (P < .05). GL2 and GR did not show statistically significant differences in terms of buckling and torque (P > .05). CONCLUSION The ROTATE and LOGIC 2 rotary instruments differed in their surface finish, cutting capacity, and mechanical properties, except for their buckling resistance and required fracture torque.
Collapse
Affiliation(s)
| | - Juliana Delatorre Bronzato
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, São Paulo, Brazil
| | - Victor Talarico Leal Vieira
- Department of Endodontics, School of Dentistry, Grande Rio University, Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
3
|
Chien PY, Walsh LJ, Peters OA. The extended finite element method in endodontics: A scoping review and future directions for cyclic fatigue testing of nickel-titanium instruments. Clin Exp Dent Res 2024; 10:e893. [PMID: 38770579 PMCID: PMC11106644 DOI: 10.1002/cre2.893] [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: 12/12/2023] [Revised: 04/02/2024] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES The present study reviews the current literature regarding the utilization of the extended finite element method (XFEM) in clinical and experimental endodontic studies and the suitability of XFEM in the assessment of cyclic fatigue in rotary endodontic nickel-titanium (NiTi) instruments. MATERIAL AND METHODS An electronic literature search was conducted using the appropriate search terms, and the titles and abstracts were screened for relevance. The search yielded 13 hits after duplicates were removed, and four studies met the inclusion criteria for review. RESULTS No studies to date have utilized XFEM to study cyclic fatigue or crack propagation in rotary endodontic NiTi instruments. Challenges such as modelling material inputs and fatigue criteria could explain the lack of utilization of XFEM in the analysis of mechanical behavior in NiTi instruments. CONCLUSIONS The review showed that XFEM was seldom employed in endodontic literature. Recent work suggests potential promise in using XFEM for modelling NiTi structures.
Collapse
Affiliation(s)
- Philip Yuan‐Ho Chien
- The University of Queensland, School of Dentistry, UQ Oral Health CentreHerstonQLDAustralia
| | - Laurence James Walsh
- The University of Queensland, School of Dentistry, UQ Oral Health CentreHerstonQLDAustralia
| | - Ove Andreas Peters
- The University of Queensland, School of Dentistry, UQ Oral Health CentreHerstonQLDAustralia
| |
Collapse
|
4
|
Ragozzini G, Abu Hasna A, dos Reis FAS, de Moura FB, Campos TMB, Bueno CES, Carvalho CAT, de Martin AS. Effect of Autoclave Sterilization on the Number of Uses and Resistance to Cyclic Fatigue of WaveOne Gold and Four Replica-Like Endodontic Instruments. Int J Dent 2024; 2024:6628146. [PMID: 38938694 PMCID: PMC11208808 DOI: 10.1155/2024/6628146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/31/2024] [Accepted: 05/22/2024] [Indexed: 06/29/2024] Open
Abstract
This study aimed to evaluate the effect of autoclave sterilization on the integrity and instruments' fracture number after multiple uses and cyclic fatigue of the original WaveOne Gold (Dentsply Sirona Endodontics) compared to four replica-like instruments (TF4-Gold, Roll-Wave-Gold, W-File, and Micro-Gold). The instruments were analyzed by scanning electron microscope (SEM) before being used in root canal instrumentation (baseline). One hundred and fifty human molars, freshly extracted for orthodontic reasons or periodontal disease and with severe curvature (between 30° and 60°), were used. Fifty teeth were instrumented with 10 instruments from each group and were evaluated for integrity. After sterilization in an autoclave, the instruments were analyzed by SEM. This procedure was repeated twice more, totaling three rounds of instrumentation, sterilization, and SEM analysis. Ten unused instruments from each group were evaluated for resistance to cyclic fatigue in a static test using a motor and a device simulating a canal with a 60° curvature angle. The instruments were driven by the motor until separation, visually verified, and the time measured in seconds. Data were analyzed by Chi-square, one-way ANOVA, and Tukey analysis, considering a significance level of 5%. It was found that there was no statistically significant difference between the groups tested in the effect of sterilization on the number of uses. The SEM analysis showed distortions in the instruments after the 3rd use. There was a statistically significant difference in the cyclic fatigue test between the results of WaveOne Gold, TF4 Gold, and Roll Wave Gold compared to W File and Micro Gold (P < 0.0001) and a statistically significant difference between the W File and Micro Gold groups (P < 0.0001). In conclusion, this study affirmed that WaveOne Gold, TF4-Gold, and Roll-Wave-Gold instruments exhibit comparable cyclic fatigue resistance. Besides, all examined instruments can be reliably employed for up to two cases.
Collapse
Affiliation(s)
- Gustavo Ragozzini
- Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Amjad Abu Hasna
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
- School of DentistryUniversidad Espíritu Santo, Samborondón, Ecuador
| | | | - Felipe Bernardo de Moura
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
| | | | | | - Cláudio Antonio Talge Carvalho
- Department of Restorative DentistryEndodontics DivisionInstitute of Science and TechnologySão Paulo State University (ICT-UNESP), Eng. Francisco José Longo Avenue 777, São José dos Campos, São Paulo CEP 12245-000, Brazil
| | - Alexandre Sigrist de Martin
- Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| |
Collapse
|
5
|
Marim AZ, Bueno CEDS, Stringheta CP, Pelegrine RA, De Martin AS, Rocha DGP, Nascimento WM, Limoeiro AG, Fontana CE. In vitro study of structural and chemical changes in two reciprocating files after multiple reuses and sterilisation. AUST ENDOD J 2024. [PMID: 38773855 DOI: 10.1111/aej.12861] [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: 11/24/2023] [Revised: 04/08/2024] [Accepted: 05/12/2024] [Indexed: 05/24/2024]
Abstract
To use scanning electron microscopy and energy dispersive X-ray spectroscopy to evaluate the metallurgical-chemical changes of WaveOne Gold (WOG) and R-Motion (RM), after multiple uses. The instruments were divided into groups (n = 8): WOG and RM-control groups, new instruments; WOG1 and RM1; WOG2 and RM2; WOG3 and RM3 after instrumentation of 1, 2 or 3 molars, respectively. Burrs occurred mainly in the control group and after the first use. The RM files were found to have a higher nickel content, which increased during reuse, and a decrease in oxygen content with increasing reuse, in addition to calcium impregnation, which occurred in greater amounts in the corrosion areas in the WOG files. The presence of topographic and chemical changes was demonstrated, indicating that caution should be taken when reusing endodontic instruments to avoid fractures.
Collapse
Affiliation(s)
- Amanda Zambaldi Marim
- Department of Endodontics, São Leopoldo Mandic School, São Leopoldo Mandic Research Center, São Paulo, Brazil
| | | | - Carolina Pessoa Stringheta
- Department of Endodontics, São Leopoldo Mandic School, São Leopoldo Mandic Research Center, São Paulo, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic School, São Leopoldo Mandic Research Center, São Paulo, Brazil
| | - Alexandre Sigrist De Martin
- Department of Endodontics, São Leopoldo Mandic School, São Leopoldo Mandic Research Center, São Paulo, Brazil
| | - Daniel Guimarães Pedro Rocha
- Pontifical Catholic University of Campinas, Department of Endodontics, Center os Life Sciences, São Paulo, Brazil
| | - Wayne Martins Nascimento
- Department of Endodontics, São Leopoldo Mandic School, São Leopoldo Mandic Research Center, São Paulo, Brazil
| | - Ana Grasiela Limoeiro
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Fontana
- Pontifical Catholic University of Campinas, Programa de Pós-Graduação Em Ciências da Saúde, Center os Life Sciences, São Paulo, Brazil
| |
Collapse
|
6
|
Abdellatif D, Iandolo A, Scorziello M, Sangiovanni G, Pisano M. Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review. Bioengineering (Basel) 2024; 11:499. [PMID: 38790365 PMCID: PMC11118078 DOI: 10.3390/bioengineering11050499] [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: 04/18/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. AIM The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. RESULTS At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. CONCLUSIONS The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.
Collapse
Affiliation(s)
| | | | | | | | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy (A.I.); (M.S.); (G.S.)
| |
Collapse
|
7
|
Namour A, El Mobadder M, Matamba P, Misoaga L, Magnin D, Arany P, Nammour S. The Safety of Removing Fractured Nickel-Titanium Files in Root Canals Using a Nd: YAP Laser. Biomedicines 2024; 12:1031. [PMID: 38790993 PMCID: PMC11117853 DOI: 10.3390/biomedicines12051031] [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: 03/30/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
The fracture of nickel-titanium (Ni-Ti) instruments during root canal instrumentation leads to compromised outcomes in endodontic treatments. Despite the significant impact of instrument facture during a root canal treatment, there is still no universally accepted method to address this complication. Several previous studies have shown the ability of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser to cut endodontic files. This study aims to determine safe irradiation conditions for a clinical procedure involving the use of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser for removing fractured nickel-titanium files in root canals. A total of 54 extracted permanent human teeth (n = 54) were used. This study involved nine distinct groups, each employing different irradiation conditions. Groups 1 s, 3 s, 5 s, 10 s, and 15 s simply consist of irradiation for 1, 3, 5, 10, and 15 s, respectively. After identifying the longest and safest duration time, four additional groups were proposed (labeled A, B, C, and D). Group A was composed of three series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT). Group B consisted of three series of irradiations of 5 s each separated by a rest time of 60 s (L5s + 60 s RT). Group C consisted of two series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT), and group D consisted of two series of irradiations of 5 s each separated by a rest time of 5 s (L5s + 5 s RT). In all groups, during the rest time, continuous irrigation with 2.5 mL of sodium hypochlorite (3% NaOCl) was carried out. The variation in temperature during irradiation was registered with a thermocouple during irradiation with different protocols. The mean and standard deviation of the temperature increase was noted. The calculation of the temperature was made as the Δ of the highest recorded temperature at the root surface minus (-) that recorded at baseline (37°). Additionally, scanning electron microscopy (SEM) was used after irradiation in all groups in order to assess the morphological changes in the root dentinal walls. The Nd: YAP laser irradiation parameters were a power of 3W, an energy of 300 mJ per pulse, a fiber diameter of 200 µm, a pulsed mode of irradiation with a frequency of 10 Hz, a pulse duration of 150 µs, and an energy density of 955.41 J/cm2. Our results show that the safest protocol for bypassing and/or removing broken instruments involves three series of irradiation of 5 s each with a rest time of 30 s between each series. Furthermore, our results suggest that continuous irradiation for 10 s or more may be harmful for periodontal tissue.
Collapse
Affiliation(s)
- Amaury Namour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
| | - Patrick Matamba
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Lucia Misoaga
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Delphine Magnin
- Bio- and Soft Matter Division, Institute of Condensed and Nanosciences, Université Catholique de Louvain (UCL), 1348 Louvain-la-Neuve, Belgium;
| | - Praveen Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA;
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| |
Collapse
|
8
|
Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024; 25:354-357. [PMID: 38956851 DOI: 10.5005/jp-journals-10024-3657] [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 assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth. MATERIALS AND METHODS For the study, 90 extracted primary maxillary incisors without internal or external resorption and with at least two-thirds of complete roots were chosen. Then, based on the kind of instruments used to clean and shape the canals, they were randomly assigned to three experimental groups, each consisting of 30 teeth. Group-I: The canal was instrumented manually with K-files, Group-II: The canal was instrumented with Kedo-S files, Group-III: The canal was instrumented with Kedo-SG Blue files. After the canals were finally instrumented, 2 mL of QMixTM solution was used to irrigate 15 samples from each group. The samples were subsequently allowed to remain in the canals for 90 seconds in order to eliminate the smear layer. After that a stereomicroscope was used to assess the cleaning effectiveness. RESULTS With irrigant solution, the highest mean value was found in manual K-files (2.86 ± 0.34), followed by Kedo-S files group (1.34 ± 0.26) and Kedo-SG Blue files (1.28 ± 0.18). Without irrigant solution, the highest mean value was found in manual K-files (2.92 ± 0.22) followed by Kedo-S files group (1.44 ± 0.18) and Kedo-SG Blue files (1.36 ± 0.14). There was a statistically significant difference found at all the three levels. CONCLUSION On conclusion, the current study's findings demonstrated that irrigation solution was significantly more effective in cleaning and removing smear layers from pediatric rotary files than manual K-files. CLINICAL SIGNIFICANCE The effectiveness of endodontic therapy depends on a successful chemomechanical preparation. The canals are instrumented using either hand files or rotary instruments; there are several irrigation and instrumentation techniques. In order to completely sterilize the canals, chemical agents are utilized for irrigation during instrumentation. Due to their numerous biological, antibacterial, anti-inflammatory, and antioxidant qualities, many natural compounds are also utilized as irrigants. How to cite this article: Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):354-357.
Collapse
Affiliation(s)
- AlWaleed Abushanan
- Department of Pediatric Dentistry, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia, Phone: +966115886281, e-mail:
| |
Collapse
|
9
|
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.
Collapse
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
| | | |
Collapse
|
10
|
De Pedro-Muñoz A, Rico-Romano C, Sánchez-Llobet P, Montiel-Company JM, Mena-Álvarez J. Cyclic Fatigue Resistance of Rotary versus Reciprocating Endodontic Files: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:882. [PMID: 38337577 PMCID: PMC10856014 DOI: 10.3390/jcm13030882] [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: 01/03/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: The failure of nickel-titanium (NiTi) rotary files is a complication related to endodontic instruments. The aim of this study was to compare the resistance to cyclic fatigue between rotary and reciprocating file systems. (2) Methods: Specific PICO: Population (P): artificial root canals; Interventions (I): instrumentation with NiTi rotary and reciprocating files; Comparison (C): rotary versus reciprocating files; Outcome (O): cyclic fatigue resistance. Studies were identified through bibliographic research using electronic databases (Medline, Embase, Scopus, SciELO, and WOS). The studies were combined using a random effects model by the inverse variance method. The effect size was the mean of the time to fracture (TTF) and number of cycles to fracture (NCF). Heterogeneity was assessed using the p value of the Q test for heterogeneity and the I2. (3) Results: TTF for rotary files was determined in 474.5 s and 839.1 for reciprocating without statistically significant differences. NCF for rotary systems was determined in 1444.2 and for reciprocating file systems in 4155.9 with statistically significant differences (p = 0.035), making reciprocating files more resistant. (4) Conclusions: Reciprocating files have better resistance to cyclic fatigue than rotary files. When tested in double curvature canals, reciprocating files also showed higher resistance.
Collapse
Affiliation(s)
- Ana De Pedro-Muñoz
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - Cristina Rico-Romano
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - Patricia Sánchez-Llobet
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Jesús Mena-Álvarez
- Department of Endodontics, Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.D.P.-M.); (C.R.-R.); (P.S.-L.)
| |
Collapse
|
11
|
Ventura BN, Gavini G, Iglecias EF, Freire LG, Caldeira CL. Using manual versus mechanized glide path instruments and ProTaper Gold versus ProTaper Next systems in curved canals: micro-CT study. Braz Oral Res 2024; 38:e006. [PMID: 38198306 DOI: 10.1590/1807-3107bor-2024.vol38.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/24/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.
Collapse
Affiliation(s)
- Breno Nappi Ventura
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Giulio Gavini
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | | | - Laila Gonzales Freire
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| | - Celso Luiz Caldeira
- Universidade de São Paulo - USP, School of Dentistry, Department of Operative Dentistry, São Paulo, SP, Brazil
| |
Collapse
|
12
|
Reda R, Di Nardo D, Zanza A, Bellanova V, Abbagnale R, Pagnoni F, D’Angelo M, Pawar AM, Galli M, Testarelli L. Upper First and Second Molar Pulp Chamber Endodontic Anatomy Evaluation According to a Recent Classification: A Cone Beam Computed Tomography Study. J Imaging 2023; 10:9. [PMID: 38248994 PMCID: PMC10817241 DOI: 10.3390/jimaging10010009] [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: 08/28/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 01/23/2024] Open
Abstract
(1) The possibility of knowing information about the anatomy in advance, in particular the arrangement of the endodontic system, is crucial for successful treatment and for avoiding complications during endodontic therapy; the aim was to find a correlation between a minimally invasive and less stressful endodontic access on Ni-Ti rotary instruments, but which allows correct vision and identification of anatomical reference points, simplifying the typologies based on the shape of the pulp chamber in coronal three-dimensional exam views. (2) Based on the inclusion criteria, 104 maxillary molars (52 maxillary first molars and 52 maxillary second molars) were included in the study after 26 Cone Beam Computed Tomography (CBCT) acquisitions (from 15 males and 11 females). And linear measurements were taken with the CBCT-dedicated software for subsequent analysis. (3) The results of the present study show data similar to those already published about this topic. Pawar and Singh's simplified classification actually seems to offer a schematic way of classification that includes almost all of the cases that have been analyzed. (4) The use of a diagnostic examination with a wide Field of View (FOV) and low radiation dose represents an exam capable of obtaining a lot of clinical information for endodontic treatment. Nevertheless, the endodontic anatomy of the upper second molar represents a major challenge for the clinician due to its complexity both in canal shape and in ramification.
Collapse
Affiliation(s)
- Rodolfo Reda
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Dario Di Nardo
- Operative Research Unit of Dentistry, Policlinico Universitario Campus Bio-Medico Foundation, Via Alvaro del Portillo 200, 00128 Rome, Italy;
| | - Alessio Zanza
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Valentina Bellanova
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Rosemary Abbagnale
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Francesco Pagnoni
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Maurilio D’Angelo
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India
| | - Massimo Galli
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.R.); (V.B.); (R.A.); (F.P.); (M.D.); (L.T.)
| |
Collapse
|
13
|
Dos Reis FAS, Abu Hasna A, Ragozzini G, de Moura FB, Campos TMB, de Martin AS, Carvalho CAT, Bueno CES. Assessing the cyclic fatigue resistance and sterilization effects on replica-like endodontic instruments compared to Reciproc Blue. Sci Rep 2023; 13:22956. [PMID: 38151487 PMCID: PMC10752872 DOI: 10.1038/s41598-023-50096-2] [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: 08/24/2023] [Accepted: 12/15/2023] [Indexed: 12/29/2023] Open
Abstract
This study aimed to evaluate the effect of the number of uses and autoclave sterilization on the cyclic fatigue resistance of four replica-like instruments RC Blue; Only One File Blue; Recip One Blue; and Micro Blue compared to the original system Reciproc Blue (VDW, Munich, Germany). The instruments were analyzed by scanning electron microscope (SEM) before being used in root canal instrumentation (baseline). Fifty molars were instrumented by ten instruments (n=10). After sterilization in an autoclave, the instruments were analyzed by SEM. This procedure was repeated twice more using different molars, totaling 3 rounds of instrumentation, sterilization and SEM analysis. Then, ten different instruments from each brand were tested for cyclic fatigue resistance. Number of uses data were analyzed using Chi-squared analysis, and cyclic fatigue data were analyzed by one-way Anova followed by Tukey's test as the data had normal distribution. The fracture times for all systems had no significant difference, but Micro Blue had significantly lower values than the other systems (p < 0.05). The SEM analysis showed distortions in the instruments after the 3rd use. Therefore, all tested instruments except of Micro Blue have similar resistance to cyclic fatigue, and all are reliable for use in up to 2-cases.
Collapse
Affiliation(s)
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo Avenue 777, São José dos Campos, SP, CEP 12245-000, Brazil.
- School of Dentistry, Universidad Espíritu Santo, Samborondón, Ecuador.
| | - Gustavo Ragozzini
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas, SP, Brazil
| | - Felipe Bernardo de Moura
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo Avenue 777, São José dos Campos, SP, CEP 12245-000, Brazil
| | | | | | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Eng. Francisco José Longo Avenue 777, São José dos Campos, SP, CEP 12245-000, Brazil
| | | |
Collapse
|
14
|
dos Reis FAS, Abu Hasna A, Ragozzini G, de Moura FB, Campos TMB, de Martin AS, Carvalho CAT, Bueno CES. Assessing the cyclic fatigue resistance and sterilization effects on replica-like endodontic instruments compared to Reciproc Blue. Sci Rep 2023; 13:22956. [DOI: https:/doi.org/10.1038/s41598-023-50096-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
AbstractThis study aimed to evaluate the effect of the number of uses and autoclave sterilization on the cyclic fatigue resistance of four replica-like instruments RC Blue; Only One File Blue; Recip One Blue; and Micro Blue compared to the original system Reciproc Blue (VDW, Munich, Germany). The instruments were analyzed by scanning electron microscope (SEM) before being used in root canal instrumentation (baseline). Fifty molars were instrumented by ten instruments (n=10). After sterilization in an autoclave, the instruments were analyzed by SEM. This procedure was repeated twice more using different molars, totaling 3 rounds of instrumentation, sterilization and SEM analysis. Then, ten different instruments from each brand were tested for cyclic fatigue resistance. Number of uses data were analyzed using Chi-squared analysis, and cyclic fatigue data were analyzed by one-way Anova followed by Tukey’s test as the data had normal distribution. The fracture times for all systems had no significant difference, but Micro Blue had significantly lower values than the other systems (p < 0.05). The SEM analysis showed distortions in the instruments after the 3rd use. Therefore, all tested instruments except of Micro Blue have similar resistance to cyclic fatigue, and all are reliable for use in up to 2-cases.
Collapse
|
15
|
Belladonna FG, Guimarães TDM, Silva EJNL, Vieira EDO, Lee JK, Rodrigues EDA, Souza EM, Versiani MA. Exploring the Efficacy of 6 Preparation Systems for Achieving Minimal Root Canal Transportation: A Micro-CT Investigation. J Endod 2023; 49:1722-1732. [PMID: 37717910 DOI: 10.1016/j.joen.2023.09.004] [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: 05/31/2023] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION This study aimed to assess the canal transportation with 6 preparation systems. METHODS Sixty curved mesial roots of mandibular molars were scanned, and their root canals (n = 20 per group) were prepared with XP-endo Shaper, BioRace, ProTaper Next, Twisted File Adaptive, Reciproc, or Reciproc Blue systems. After preparation, a new scan was conducted, and transportation was determined by comparing the geometric center of the canal in 13,542 cross-sectional slices. The transport direction frequencies were recorded, and linear transport were compared using a Univariate GLM model and Tukey honestly significant difference tests (α = 5 %). RESULTS Transportation was affected by the preparation system and root third (P < .05), with no significant effect observed for the root canal (P > .05). The Twisted File Adaptive had the highest transport (P < .05), and the lowest transports were observed with XP-endo Shaper, ProTaper Next, and BioRace (P < .05). Reciproc Blue and Reciproc showed intermediate results (P < .05). The apical and coronal third exhibited the lowest and highest transportation, respectively (P < .05). A significant interaction was observed between the preparation system and root third (P < .05). In the coronal third, transportation was mostly toward the disto-inside direction, whereas in the middle and apical thirds, transportation was predominantly toward the mesio-outside direction. CONCLUSIONS XP-endo Shaper had the lowest mean linear transportation followed by the ProTaper Next, BioRace, Reciproc Blue, and Reciproc systems. The Twisted File Adaptive system had the worst performance. The direction of transportation was generally toward the inner aspect of the canal at the coronal third and toward the outer aspect of the curve at the middle and apical thirds.
Collapse
Affiliation(s)
| | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Rio de Janeiro, Brazil; Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Jong-Ki Lee
- Private Practice, Changwon, Republic of Korea
| | | | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Estrela C, Bueno MR, Rossi-Fedele G, Decurcio DA, Guedes OA, Sousa-Neto MD, Estrela CRDA. Method to determine the root canal spatial geometry using an algorithm of the e-Vol DX CBCT software. Braz Dent J 2023; 34:40-49. [PMID: 38133091 PMCID: PMC10742355 DOI: 10.1590/0103-6440202305661] [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: 05/28/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
This study evaluated a method to determine the spatial geometry of root canal preparation (RCP) using navigation dynamics and a specific algorithm from a new CBCT software (e-Vol DX). CBCT scans of 168 root canals of mandibular molars were acquired before and after RCP, using nickel-titanium (NiTi) instruments (ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold). The spatial geometry of the root canals and the operative risk of disproportional wear of dentinal walls after RCP were evaluated using a new CBCT software. A 3-point scoring system was used after the measuring of cementum/dentin thickness before and after RCP in all root thirds. The root thirds were distributed into three parts of similar sizes, and the scores were categorized at three levels: 1. mild risk (1/3), 2. moderate risk (2/3), 3. severe risk (3/3). These levels were proposed according to the risk of creating disproportionate shapes, thin walls, or perforations. The data were analyzed statistically by Fischer's exact test (α = 5%). There were no significant differences in operative risk among the NiTi engine-driven systems, for the distal or mesial walls of all the root canal thirds (p>0.05). The spatial geometry method to assess operative risk allows clinical planning for a predictable enlargement of the root canal in all root thirds. Based on using a map-reading strategy on root canals in CBCT scans, NiTi engine-driven instruments did not present an increased operative risk during RCPs.
Collapse
Affiliation(s)
- Carlos Estrela
- Professor of Endodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | | | - Giampiero Rossi-Fedele
- Professor of Endodontics University of Adelaide, Dental School, Department of Endodontics, Adelaide, Australia
| | | | - Orlando Aguirre Guedes
- Professor of Oral Biology, School of Dentistry, Evangelical University of Goiás, GO, Brazil
| | - Manoel Damião Sousa-Neto
- Professor of Endodontics, School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
18
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| | | |
Collapse
|
19
|
Dos Reis-Prado AH, Abreu LG, de Arantes LC, Dos Santos de Paula K, de Castro Oliveira S, Goto J, Viana ACD, Benetti F. Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies. Clin Oral Investig 2023; 27:6291-6319. [PMID: 37704917 DOI: 10.1007/s00784-023-05243-4] [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: 09/15/2022] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This systematic review/meta-analysis investigated the influence of NaOCl on cyclic fatigue resistance of endodontic NiTi instruments. MATERIALS AND METHODS A systematic search until July 2022 in PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO, Cochrane Library, and grey literature was conducted. According to the PECOS strategy, only in vitro studies evaluating the effects of NaOCl on the cyclic fatigue resistance of NiTi instruments were eligible. Cyclic fatigue resistance was the primary outcome. A modified Joanna Briggs Institute's Checklist was used for risk of bias assessment. RESULTS Of the 2,445 records screened, 37 studies were included. Most studies used simulated canals made of stainless-steel block with severe to moderate curvatures. NaOCl concentration varied from 1-6%, mainly at 37 °C. Regarding fatigue resistance, 23 studies using 1.2% to 6% NaOCl showed a reduction in the resistance compared to the control groups, especially when pre-heated. Four meta-analyses were performed according to the tested NiTi systems. The meta-analyses indicated that the PTU F2 files had higher reduction of fatigue resistance after exposure to 5.25% NaOCl; no differences between NaOCl and no immersion were observed for Reciproc R25, WaveOne 25.08, and WaveOne Gold Primary files. Included studies had low risk of bias. CONCLUSION NaOCl appears to reduce cyclic fatigue resistance of certain NiTi files, especially when they are pre-heated, particularly in conventional NiTi files compared to some heat-treated instruments. It is possible that the temperature of the solution may have a greater influence on resistance than NaOCl itself. Important to note that an overall tendency toward no significant influence was observed among various systems. CLINICAL RELEVANCE Precautions are necessary when a pre-heated high-concentration NaOCl is used to enhance its properties during root canal preparation, mainly using conventional wire.
Collapse
Affiliation(s)
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lara Cancella de Arantes
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Kiani Dos Santos de Paula
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| |
Collapse
|
20
|
Yeniçeri Özata M, Falakaloğlu S, Keleş A, Adıgüzel Ö, Gündoğar M. Evaluation of shaping ability of different glide path instruments: a micro-computed tomography study. BMC Oral Health 2023; 23:780. [PMID: 37875946 PMCID: PMC10594883 DOI: 10.1186/s12903-023-03529-3] [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: 03/05/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND This study aimed to compare the shaping ability of different instruments, TruNatomy Glider (TRN-G), WaveOne Gold Glider (WOG-G), and ProGlider (Pro-G) using micro-computed tomography (micro-CT). METHODS The mesial canals of 27 mandibular molars with two separate mesial canals and moderate curvature were included in this study [n = 27 mesiobuccal (MB) and mesiolingual (ML) root canal]. According to the manufacturer's instructions, the glide path was created with TRN-G, WOG-G, and Pro-G glide path instruments (n = 9 MB and ML root canal in each group). Micro-CT scanning was performed before and after preparation. Mesiodistal (MD) and buccolingual (BL) transportation and the centering ratio were measured at three levels within the canal (3, 5 and 7 mm). A three-way robust ANOVA was used to compare the parameters. RESULTS TRN-G showed significantly greater transportation in the MD direction than the other instruments throughout the root canal (overall root canal) (p < 0.05). The best centering ability in the BL direction was shown by the WOG-G, regardless of level within the canal and canal distinction (MB vs. ML) (p < 0.05). There was no significant difference between groups according to the level within the canal and canal parameters (p > 0.05). Whether the root canal was MB or ML did not affect centering or transportation (p > 0.05). CONCLUSIONS Glide path instruments can be used to shape moderately curved canals with minimal apical transportation and better centering ability. All three tested glide path files can used safely before the shaping file.
Collapse
Affiliation(s)
- Merve Yeniçeri Özata
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey.
| | - Seda Falakaloğlu
- Department of Endodontics, School of Dentistry, İstanbul Health and Technology University, İstanbul, Turkey
| | - Ali Keleş
- Department of Endodontics, School of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
- Department of Endodontics, School of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Özkan Adıgüzel
- Department of Endodontics, School of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, School of Dentistry, İstanbul Medipol University, İstanbul, Turkey
| |
Collapse
|
21
|
Thu M, Ebihara A, Maki K, Kimura S, Kyaw MS, Kasuga Y, Nishijo M, Okiji T. Dynamic torque and screw-in force of four different glide path instruments assessed in simulated single- and double-curved canals: An in vitro study. J Dent Sci 2023; 18:1598-1603. [PMID: 37799866 PMCID: PMC10548005 DOI: 10.1016/j.jds.2023.02.015] [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: 01/23/2023] [Indexed: 03/05/2023] Open
Abstract
Background/purpose The glide path instruments are the introductory instruments into the canals; thus, they should be durable enough to withstand torsional stress/screw-in force. This study aimed to investigate the torque and screw-in force of TruNatomy Glider (TN), ProGLIDER (PG), Hyflex EDM (EDM) and Dent Craft RE (RE) glide path instruments in single- and double-curved canals. Materials and methods Each instrument brand was divided into two groups (n = 7 each) according to the canal configuration. Torque and screw-in force were recorded during automated instrumentation of simulated resin canals with XSmart IQ cordless motor after the canal patency was checked with a #10 K-file. The values were statistically analyzed using the Kolmogorov-Smirnov test followed by the Kruskal Wallis test and the Mann-Whitney U test with Bonferroni correction (α = 0.05). Results TN produced significantly higher torque than RE in single-curved canals and PG in double-curved canals (P < 0.05). EDM yielded significantly higher screw-in force than TN and RE in single-curved canals (P < 0.05), but there was no significant difference in double-curved canals (P > 0.05). A significant effect of different canal configurations was only detected for screw-in force in EDM (P < 0.05). Conclusion TN in single-curved canals and RE in double-curved canals yielded higher torque values, while EDM exhibited greater screw-in force in both canal configurations. No effect of different canal configurations was detected for torque, but a significant impact was detected for screw-in force in EDM.
Collapse
Affiliation(s)
- 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), Tokyo, 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), Tokyo, 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), Tokyo, 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), Tokyo, Japan
| | - 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), Tokyo, Japan
| | - Yuka Kasuga
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Miki Nishijo
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, 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), Tokyo, Japan
| |
Collapse
|
22
|
Coaguila-Llerena H, Lazo-Quezada G, Teves A, Zevallos-Chávez M, Faria G. Removal of separated instruments from unfavourable locations: Case reports using the HBW ultrasonic ring or a surgical approach. AUST ENDOD J 2023; 49:358-364. [PMID: 35932460 DOI: 10.1111/aej.12673] [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: 01/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023]
Abstract
Two patients were admitted to the dental clinic to evaluate two right mandibular first molars (both FDI no. 46). In Case 1, there was an accidental instrument separation, which was thought to have been bypassed; however, the instrument was located beyond the apical foramen, in the alveolar bone. The 1-week follow-up revealed that the fragment was close to the inferior alveolar nerve, thus allowing surgical removal to be performed. In Case 2, two separated instruments located in the apical third of the mesiobuccal and mesiolingual canals were removed using the HBW ultrasonic ring coupled to ISO 10 and 15 hand instruments. The 3-month and 1-year follow-ups (Case 1), and the 2-year and 3-year follow-ups (Case 2) showed a favourable evolution in both cases. It can be concluded that both the surgical approach and the HBW ultrasonic ring are viable options for the removal of separated instruments in unfavourable locations.
Collapse
Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | | | - Abel Teves
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo - USP, Bauru, Brazil
| | - Marco Zevallos-Chávez
- Department of Endodontics, Catholic University of Santa Maria - UCSM, Arequipa, Peru
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| |
Collapse
|
23
|
Selvaraj H, Krithikadatta J, Venkata Teja K. Scanning Electron Microscopic Analysis of Deformation of TruNatomy File Systems: An Ex-vivo Study. Cureus 2023; 15:e44183. [PMID: 37767243 PMCID: PMC10520576 DOI: 10.7759/cureus.44183] [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] [Received: 07/08/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
Aim The aim of the study was to assess the instrument deformation following the usage of the TruNatomy (Dentsply Sirona, USA) file system in extracted premolars using Scanning Electron Microscopy (SEM). Materials and Methods For the present study, 84 extracted mandibular bicuspids were selected. The teeth were divided into two groups: Group 1, TruNatomy (n=42), and Group 2, Hero Shaper (Micro Mega, France) (n=42). The samples were shaped with 0.03 taper to size 36 with TruNatomy instruments and 0.04 taper to size 30 with Hero Shaper instruments. 5 ml of 5.25% Sodium Hypochlorite (NaOCl) and 2 ml of 17% ethylenediaminetetraacetic acid (EDTA) were used for the final irrigation of root canals. The master apical file was used to instrument seven teeth samples for assessing the safety of the instruments after multiple uses and autoclaving. So, a total of six files per group was used for the analysis of any distortions, cracks or micro-fractures after instrumentation of 42 teeth, at the tip (D0) and 5 mm from the tip (D5) of the rotary file under SEM at 500x magnification. Statistical analysis To determine the significance between the groups, the Mann-Whitney U-test was applied. Results The mean surface wear of the instruments, at the tip (D0) in Group 1 was 1.2857 and in Group 2 was 1.4762. The mean spiral distortion of the instruments, at the tip (D0) in Group 1 was 1.1905 and in Group 2 was 1.4286. A statistically significant difference (P<0.05) was observed between the groups for surface wear and spiral distortion at the tip of the file (D0). There was no significant difference between groups for surface wear and spiral distortion values of the instruments at 5 mm from the tip (D5) (P>0.05). Conclusion The instrument distortion of the rotary file systems analysed was minimal following the biomechanical preparation of seven mandibular bicuspids without root curvature, using a single file. Therefore, both rotary file systems can be considered safe.
Collapse
Affiliation(s)
- Harish Selvaraj
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Jogikalmat Krithikadatta
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Mamata Institute of Dental Sciences, Hyderabad, IND
| |
Collapse
|
24
|
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.
Collapse
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
| | | |
Collapse
|
25
|
Suresh B, Jeevanandan G, Ravindran V, Mashyakhy M, Alessa N, Syed AA, Panda S, Assiry AA, Maganur PC, Vishwanathaiah S. Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050898. [PMID: 37238446 DOI: 10.3390/children10050898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue.
Collapse
Affiliation(s)
- Balaji Suresh
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
| | - Ganesh Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
| | - Vignesh Ravindran
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
| | - Mohammed Mashyakhy
- Restorative Dental Science Department, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Noura Alessa
- Department of Pediatric Dentistry and Orthodontics, Dental College, King Saud University, Riyadh 11545, Saudi Arabia
| | - Ather Ahmed Syed
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan 45152, Saudi Arabia
| | - Suman Panda
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan 45152, Saudi Arabia
| | - Ali Ahmed Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran 1988, Saudi Arabia
| | - Prabhadevi C Maganur
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan 45152, Saudi Arabia
| | - Satish Vishwanathaiah
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan 45152, Saudi Arabia
| |
Collapse
|
26
|
Abdelmomen I, Vincent M, Thiebaud F, Budzinski J, Bastogne T, Ben Zineb T, Engels-Deutsch M. Experimental Analysis of the Influence of Heat Treatments on the Flexibility of NiTi Alloy for Endodontic Instruments Manufacturing. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093437. [PMID: 37176319 PMCID: PMC10180458 DOI: 10.3390/ma16093437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
The flexibility of NiTi based endodontic files is improved by heat treatment, leading to lower risk of failure, ledges, and canal transportation during the preparation of curved root canals. The aim of this study is to investigate and clearly highlight the influence of every parameter of heat treatment on the flexibility of NiTi wires and thus of endodontic instruments. A full factorial Design of Experiment (DoE) and a designed bending-torsion bench following the ISO 3630-1 standard were used for this investigation. Temperature, holding time, and cooling method were selected as contributing factors, while maximum bending moment, hysteresis size, and stiffness during martensitic transformation were selected as outputs. Regression analysis was performed to estimate the relationship between contributing and output variables to assess how the experimentation fits with the model. The experimental results showed that wires heated at 425 °C for 30 min are more flexible. Moreover, heat treatment temperature is the most critical factor influencing the flexibility and hysteresis size of the NiTi wire followed by the holding time, while the cooling method has a negligible effect. The regression analysis showed that the model is effective at predicting the relationship between contributing factors, bending moment response, and hysteresis size.
Collapse
Affiliation(s)
| | - Marin Vincent
- Université de Lorraine, CNRS, LEM3, F-54000 Nancy, France
- Faculté d'Odontologie de Lorraine, Université de Lorraine, F-54000 Nancy, France
| | | | | | - Thierry Bastogne
- CYBERnano, F-54505 Nancy, France
- Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France
| | | | - Marc Engels-Deutsch
- Université de Lorraine, CNRS, LEM3, F-54000 Nancy, France
- Faculté d'Odontologie de Lorraine, Université de Lorraine, F-54000 Nancy, France
| |
Collapse
|
27
|
Chan WS, Gulati K, Peters OA. Advancing Nitinol: From heat treatment to surface functionalization for nickel–titanium (NiTi) instruments in endodontics. Bioact Mater 2023; 22:91-111. [PMID: 36203965 PMCID: PMC9520078 DOI: 10.1016/j.bioactmat.2022.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Nickel-titanium (NiTi) alloy has been extensively researched in endodontics, particularly in cleaning and shaping the root canal system. Research advances have primarily focused on the design, shape, and geometry of the NiTi files as well as metallurgy and mechanical properties. So far, extensive investigations have been made surrounding surface and thermomechanical treatments, however, limited work has been done in the realm of surface functionalization to augment its performance in endodontics. This review summarizes the unique characteristics, current use, and latest developments in thermomechanically treated NiTi endodontic files. It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization. Whilst clinical translation of this technology has yet to be fully realized, future research direction will lie in the use of nanotechnology. Nitinol (Nickel Titanium alloy) is widely used to clean/shape root canal system in endodontics. To enhance its performance, various thermo-mechanical and nano-engineering modifications have been performed. This comprehensive review summarizes the latest advances and future trends relating to functionalized NiTi endodontic files.
Collapse
|
28
|
Silnovic Z, Kvist T, Frisk F. Periapical status and technical quality in root canal filled teeth in a cross sectional study in Jönköping, Sweden. Acta Odontol Scand 2023; 81:249-254. [PMID: 36098980 DOI: 10.1080/00016357.2022.2121322] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To investigate the quality of root canal fillings and frequency of apical periodontitis (AP) in root canal filled teeth in a Swedish population. MATERIAL AND METHODS This study used data from a cross-sectional survey conducted in 2013. The root canal filling quality and periapical status were assessed in 491 root canal filled teeth in 196 individuals aged 20-70 years, randomly selected from the population of Jönköping, Sweden. All root canal filled teeth were examined with periapical radiographs. Three calibrated observers recorded length and density in root canal fillings as well as periapical status according to the Periapical Index. A root filling ending within 0.5-2 mm from the radiographic apex without lateral or apical voids was considered adequate. Data were analyzed in a generalized estimating equation (GEE) model with AP as dependent variable and gender, age, number of teeth, number of root filled teeth, tooth type, and root filling quality as independent variables. RESULTS Teeth with technically inadequate root fillings were associated with AP in a simple GEE-analysis. In the multiple GEE-model, the association between technical quality and apical peridontitis was nonsignificant when controlling for tooth type and gender. CONCLUSIONS The quality of root canal fillings is poor and the prevalence of AP in root canal filled teeth is high, particularly in molar teeth, in a Swedish population.
Collapse
Affiliation(s)
- Zlatan Silnovic
- Specialist clinic of Endodontology, Public Dental Health Service, Västra Götaland Region, Gothenburg, Sweden
| | - Thomas Kvist
- Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Frisk
- Department of Endodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
29
|
El Abed R, Al Raeesi D, Alshehhi A, Alkhatib Z, Khamis AH, Jamal M, Kim HC. Effect from Autoclave Sterilization and Usage on the Fracture Resistance of Heat-Treated Nickel-Titanium Rotary Files. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2261. [PMID: 36984141 PMCID: PMC10056662 DOI: 10.3390/ma16062261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess the effect of mechanical loading and heating on the cyclic fatigue and torsional fracture resistances of heat-treated nickel-titanium files after usage and autoclaving. Sixty files (One Curve) were tested for cyclic fatigue and torsional fracture resistances using customized devices. The files were divided into three groups according to the test conditions (n = 10); new (group-N), used for simulated canal shaping (group-U), and sterilized after use (group-S). For cyclic fatigue resistances, the files were freely rotated in a curved metal canal under body temperature; the time elapsed to fracture was recorded and the numbers of cycles to fracture (NCF) were calculated. For the torsional resistances, the file tip was fixed and rotated until the file fractured. The maximum torsional load and distortion angle were recorded. The toughness was calculated. Fracture fragments were examined with a scanning electron microscope. Data were analyzed using a one-way analysis of variance and Tukey's post hoc test at the significance level of 95%. Group-U showed significantly higher NCF than group-S (p < 0.05). However, there was no significant differences between groups-N and -S in the NCF (p > 0.05). Group-N showed a significantly bigger distortional angle and higher torsional toughness than groups-U and -S, but the ultimate torsional strength did not have significant difference between the groups. Under the limitation of this study, autoclave sterilization after single-usage did not improve the fracture resistance of heat-treated One Curve nickel-titanium files.
Collapse
Affiliation(s)
- Rashid El Abed
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Dana Al Raeesi
- Endodontic Department, Emirates Health Services Establishment, Dubai, United Arab Emirates
| | - Aisha Alshehhi
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Zuhair Alkhatib
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
- Emirates Endodontic Society, Dubai, United Arab Emirates
| | - Amar H. Khamis
- Biostatistics Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Mohamed Jamal
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 50612, Republic of Korea
- Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea
| |
Collapse
|
30
|
Post-Operative Quality of Life after Single-Visit Root Canal Treatment Employing Three Different Instrumentation Techniques-An Institutional Randomized Clinical Trial. J Clin Med 2023; 12:jcm12041535. [PMID: 36836070 PMCID: PMC9965264 DOI: 10.3390/jcm12041535] [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] [Received: 01/22/2023] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
Root canal treatment (RCT) eliminates damaged pulpal tissue and protects the tooth from recurrent microbial invasion. Post-endodontic pain (PEP) is a frequently encountered complication of root canal therapy. It can have an impact on patients' quality of life (QoL) and their subjective perception of treatment options. Thus, a self-assessment questionnaire was used to evaluate and compare the influence of manual, rotary, and reciprocating file shaping procedures on immediate post-operative quality of life (POQoL) involving single-visit root canal therapy. It was a double-blinded, randomized, controlled clinical trial. A total of 120 participants were randomly assigned sequentially to three groups comprising 40 patients in each group: Group A: Hand K file (positive control); Group B: ProTaper Next file system; and Group C: WaveOne Gold. Post-operative pain was evaluated using a 4-point visual analog scale (VAS) after 12 h, 24 h, 48 h, 72 h, and 1 week. The highest post-operative pain was with manual instrumentation using hand K files, and the lowest was with reciprocating and rotating instrumentations. No significant difference was noted between the parameters of quality of life assessed, suggesting the filing system or technique had a similar effect.
Collapse
|
31
|
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: 3] [Impact Index Per Article: 3.0] [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.
Collapse
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
| | | | | |
Collapse
|
32
|
Osaki RB, Bramante CM, Vivan RR, Alcalde MP, Calefi PHS, Duarte MAH. Influence of temperature on the torsional properties of two thermally treated NiTi rotary instruments. Braz Dent J 2023; 34:12-18. [PMID: 36888838 PMCID: PMC10027105 DOI: 10.1590/0103-6440202305094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/02/2023] [Indexed: 03/08/2023] Open
Abstract
This study aimed to evaluate the influence of temperature on torsional strength and angular deflection of two experimental NiTi rotary instruments manufactured from Blue and Gold thermal treatments and with identical cross-sections. A total of 40 experimental NiTi instruments 25.06 and with a triangular cross-section and manufactured from Blue and Gold thermal treatments were used (n=20). The torsional test was performed in the 3 mm from the tip of the instrument according to ISO 3630-1. The torsional test evaluated the torsional strength and angular deflection to failure at room temperature (21°C ± 1° C) and body temperature (36°C ±1°C). The fractured surface of each fragment was observed by using scanning electron microscopy (SEM). Data were analyzed using an unpaired t test for inter and intra-group comparison and the level of significance was set at 5%. The results showed that the body temperature did not affect the torsional strength and angular deflection of the instruments when compared with room temperature (P>0.05). However, at body temperature, the Blue NiTi instruments presented significantly lower angular deflection in comparison with Gold NiTi instruments (P<0.05). There was no significant difference regarding the torsional strength of the instruments at body temperature (P>0.05). The temperature did not affect the torsional strength of the instruments manufactured from Blue and Gold technology. However, the Blue NiTi instruments presented significantly lower angular deflection than Gold instruments at 36°C temperature.
Collapse
Affiliation(s)
- Roberto Barreto Osaki
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Clovis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Pedro Henrique Souza Calefi
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| |
Collapse
|
33
|
Hamed SA, Shabayek S, Hassan HY. Biofilm elimination from infected root canals using four different single files. BMC Oral Health 2022; 22:660. [PMID: 36585632 PMCID: PMC9805083 DOI: 10.1186/s12903-022-02690-5] [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] [Received: 07/12/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Enterococcus faecalis (E. faecalis) is the most commonly isolated bacterium from infected root canals. It is found in the form of a biofilm, which makes it more resistant to antimicrobials, and requires optimal chemomechanical strategies to maximize root canal disinfection. AIM To evaluate the efficacy of 4 different endodontic file systems against E. faecalis biofilm growth in root canals using colony-forming units per milliliter (CFU/mL) and scanning electron microscope (SEM). METHODS Eighty-five extracted human mandibular premolars with straight root canals and apical diameters not larger than the #15 K-file were randomly selected. After performing a pilot study (n = 15) to determine the ideal incubation period for E. faecalis biofilm development, sixty-five root canals were infected with E. faecalis, incubated for 3 weeks, and then mechanically prepared using one of four single files (XP-endo Shaper, Hyflex EDM, One Curve, and Fanta. AFTM F One) (n = 15). Five infected root canals were excluded for the positive control. Five non-contaminated root canals were included for the negative control. Samples were collected using sterile paper points pre- and post-instrumentation to determine the bacterial load (CFU/mL). Root canals from each group were topographically evaluated at the coronal, middle, and apical segments using scanning electron microscope (SEM). Bacterial reduction data were estimated and statistically analyzed by Kruskal-Wallis and Mann-Whitney U tests (post hoc test) (P ≤ .05). RESULTS XP-endo Shaper, Hyflex DEM, and One Curve significantly could eradicate E. faecalis biofilms in infected root canals with no significant difference among them compared to Fanta. AF™ F One. CONCLUSION None of the systems were capable of completely eliminating biofilms. XP-endo Shaper, Hyflex EDM, and One Curve mechanically eliminated E. faecalis biofilms compared to Fanta. AF™ F One from infected root canals.
Collapse
Affiliation(s)
- Sarah A. Hamed
- grid.33003.330000 0000 9889 5690Endodontic Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - Sarah Shabayek
- grid.33003.330000 0000 9889 5690Microbiology and Immunology Department, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
| | - Hayam Y. Hassan
- grid.33003.330000 0000 9889 5690Endodontic Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
34
|
Liu Y, Chen M, Tang W, Liu C, Du M. Comparison of five single-file systems in the preparation of severely curved root canals: an ex vivo study. BMC Oral Health 2022; 22:649. [PMID: 36577985 PMCID: PMC9798582 DOI: 10.1186/s12903-022-02668-3] [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] [Received: 10/08/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel-titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals. METHODS A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal-Wallis test (CT, SEM-score), the level of significance was set at α = 0.05. RESULTS There were no significant differences between the five systems regarding the AD, VI, and UTA parameters (P > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex (P < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending (P < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups (P < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds (P < 0.01 and P < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds. CONCLUSION The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.
Collapse
Affiliation(s)
- Yina Liu
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Meizhi Chen
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Weilong Tang
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chang Liu
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Minquan Du
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| |
Collapse
|
35
|
Jiang J, Sun J, Huang Z, Bi Z, Yu G, Yang J, Wang Y. The state of the art and future trends of root canal files from the perspective of patent analysis: a study design. Biomed Eng Online 2022; 21:90. [PMID: 36566212 PMCID: PMC9789667 DOI: 10.1186/s12938-022-01060-0] [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] [Received: 09/09/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
The goal of this review is to present a detailed and comprehensive description of the published work from the past decade regarding methods of improved material, geometric design, and additional functions in root canal files. The main improved methods of files and the most common technologies were further addressed, underlining their advantages and main limitations. Online databases (the Derwent Innovations Index) were consulted on this topic. Published work from 2010 to 2022 was collected and analyzed the relevant papers were chosen for inclusion in this review. The patent map classified the latest phase of the root canal files based on the analysis of the number of patents. The performance of the root canal files, such as materials. Directly affects the quality of the root canal therapy. We provided a thorough review of advances in the field of root canal files. In particular, three categories of improved methods were examined and compared, including material-based methods, geometry-based methods, and those based on additional functions. To understand this state of the art of different improved methods of root canal files, we conducted a literature analysis and a series of comparisons between different methods. The features and limitations of each method of root canal files were further discussed. Finally, we identified promising research directions in advancing the methods for the improved performance of root canal files. There is no perfect technology for all material/geometric design/additional functions, capable alone of fulfilling all the specificity and necessities of every patient. Although it is very promising, the material of the files remains understudied, and further work is required to make material science a pervasive technology in root canal therapy, and contribute to endodontic and periapical diseases by assisting in the subsequent development of root canal files.
Collapse
Affiliation(s)
- Jingang Jiang
- grid.411994.00000 0000 8621 1394Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080 Heilongjiang People’s Republic of China ,grid.19373.3f0000 0001 0193 3564State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, 150001 Heilongjiang People’s Republic of China
| | - Jianpeng Sun
- grid.411994.00000 0000 8621 1394Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080 Heilongjiang People’s Republic of China
| | - Zhiyuan Huang
- grid.19373.3f0000 0001 0193 3564State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, 150001 Heilongjiang People’s Republic of China
| | - Zhuming Bi
- grid.503846.c0000 0000 8951 1659Department of Civil and Mechanical Engineering, Purdue University Fort Wayne, West Lafayette, 46805 USA
| | - Guang Yu
- grid.12527.330000 0001 0662 3178Department of Mechanical Engineering, Tsinghua University, Beijing, 100084 People’s Republic of China
| | - Jingwen Yang
- grid.11135.370000 0001 2256 9319National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081 People’s Republic of China ,grid.11135.370000 0001 2256 9319Peking University School of Stomatology, Beijing, 100081 People’s Republic of China
| | - Yong Wang
- grid.11135.370000 0001 2256 9319National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081 People’s Republic of China ,grid.11135.370000 0001 2256 9319Peking University School of Stomatology, Beijing, 100081 People’s Republic of China
| |
Collapse
|
36
|
Severity of Post-Operative Pain after Instrumentation of Root Canals by XP-Endo and SAF Full Sequences Compared to Manual Instrumentation: A Randomized Clinical Trial. J Clin Med 2022; 11:jcm11237251. [PMID: 36498825 PMCID: PMC9740715 DOI: 10.3390/jcm11237251] [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] [Received: 11/11/2022] [Revised: 11/27/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
This investigation aimed to examine the post-operative pain experienced following single-visit root canal treatment using the XP-endo shaper sequence (XPS), full-sequence self-adjusting file (SAF), and manual K-files (HKF). A randomized equivalence parallel design, double-blinded clinical study was conducted on 120 patients with symptomatic irreversible pulpitis, with or without clinical signs of apical periodontitis. Only teeth with fully formed roots and no periapical lesions were incorporated in the study. Patients were apportioned to one of three groups (n = 40) randomly: Group 1-XPS, Group 2-SAF, and Group 3-HKF. Pre- and post-instrumentation pain was rated utilizing Visual Analog Scale (VAS) with a spectrum of 0-100 mm. The descriptive statistics and one-way ANOVA with 95% confidence intervals were used for statistical analysis. The mean VAS scores before instrumentation were consistent in all three groups. At 6, 24, 48, and 72 h, patients with root canals instrumented by SAF had the lowest post-instrumentation mean VAS score, followed by XPS. For all time intervals, the patients in the HKF group had the highest VAS score. The full-sequence SAF instrumentation resulted in less post-operative pain than the XP-endo plus protocol, while manual instrumentation with K-files resulted in the highest post-operative pain.
Collapse
|
37
|
Al-labed H, layous K, Alzoubi H. The Efficacy of Three Rotary Systems (Reciproc Blue, WaveOne Gold, and AF Blue R3) in Preparing Simulated, Highly Curved Root Canals: An In Vitro Study. Cureus 2022; 14:e30232. [PMID: 36381824 PMCID: PMC9650934 DOI: 10.7759/cureus.30232] [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] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Purpose This study aimed to evaluate the effectiveness of three rotary, single-file, and reciprocating systems in terms of preparation time and canal centralization in simulated highly curved root canal preparation. Materials and methods The study sample consisted of 45 simulated canals with a curvature of 40°. They were randomly distributed into three experimental groups: Group 1-Reciproc Blue; Group 2-WaveOne Gold; and Group 3-AF Blue R3. A glide path was established by #10 hand K-file, then red dye was colored on the simulated canals, and photographs of the sample were taken before preparation. Then, the canals of each group were prepared, and other photographs were taken after preparation. The images of the two phases were combined using AutoCAD, where the canal was divided into three parts and the preparation area was measured from the right and left sides of each part of the canal. The preparation time for each system was also measured. Results While there were no statistically significant differences in the rate of preserving canal centralization in the middle and apical thirds between preparation groups, a statistically significant difference was found in the coronal third, as the Reciproc Blue and WaveOne Gold systems have a greater ability to maintain the centrality of the canal compared to the AF Blue R3 system. While there were no statistically significant differences between the Reciproc Blue and WaveOne Gold systems in the coronal third, as for the preparation time, it was found that there were statistically significant differences in the preparation time between the groups in favor of the WaveOne Gold system. Conclusion Both preparation systems (Reciproc Blue and WaveOne Gold) maintained the anatomical shape and canal centrality, with more cons for WaveOne Gold compared to the Reciproc Blue system. Regarding the volumetric changes, AF Blue R3 had the greatest changes compared to the Reciproc Blue and WaveOne Gold systems. WaveOne Gold Group, in terms of canal preparation time, showed the least time among the investigated groups.
Collapse
|
38
|
Cyclic Fatigue Resistance of Nickel–Titanium Rotary Instruments after Simulated Clinical Use. Appl Bionics Biomech 2022; 2022:1716008. [PMID: 36267671 PMCID: PMC9578904 DOI: 10.1155/2022/1716008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Cyclic fatigue occurred in the curved canal when the instrument freely rotated leading to repeated compressive and tensile stresses. This study aims to evaluate the cyclic fatigue resistance (CFR) of new and used 2Shape and AF F-One rotary instrument systems by using an artificial stainless-steel canal. Methods A total of 80 rotary nickel–titanium (NiTi) instruments of two systems were used, 2Shape/TS2 and AF F-ONE/F5 (40 in each group). The instruments were subdivided into group A 20 instruments (10 per system) that remain unused, group B 20 instruments (10 per system) instrumented 20 root canals (each file prepared 1 canal for 2 minutes), group C 20 instruments (10 per system) instrumented 40 canals each for 2 minutes (each file prepared 2 canals), group D of 20 instruments (10 per system) prepared 60 canals each for 2 minutes (each file prepared 3 canals). After each canal instrumentation, the instruments were cleaned and sterilized by autoclave. Then, all the instruments underwent cyclic fatigue testing in an artificial stainless steel canal with a 50° canal curvature and a radius of curvature of 5 mm. The time and number of cycles to failure (NCF) were recorded. Data were analyzed using the Welch ANOVA test for intragroup comparison and the pairwise test for multiple comparisons. Results The unused instruments of the AF F-One rotary system showed statistically higher CFR than clinically used instruments (P < 0.05). 2Shape system was not affected by clinical use (P > 0.05). The mean NCF of AF F-One instruments was significantly higher than the equivalent file group of 2Shape instruments (P < 0.05). Conclusion A reduction in the CFR for AF F-One instruments after use was observed when compared to the new unused file group. The 2Shape system was not affected by clinical use. AF F-One performed better in terms of NCF.
Collapse
|
39
|
Ashkar I, Sanz JL, Forner L. Cyclic Fatigue Resistance of Glide Path Rotary Files: A Systematic Review of in Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6662. [PMID: 36234003 PMCID: PMC9571085 DOI: 10.3390/ma15196662] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
The aim of the present systematic review was to perform a qualitative synthesis of in vitro studies that assess the cyclic fatigue resistance of rotary glide path (GP) files of endodontic applications. Systematic electronic searches were performed in the Medline, Embase, Scopus, SciELO, and Web of Science databases on 15 February 2022, and were last updated on 1 April In vitro studies that evaluated and compared the cyclic fatigue resistance of at least one rotary GP file system with another rotary GP file system were included. A total of 25 studies were included in the qualitative synthesis. All studies assessing the difference in the cyclic fatigue resistance between continuous and reciprocating rotation in rotary glide path files found that the latter resulted in a significantly higher cyclic fatigue resistance, as evidenced by a higher number of cycles until fracture and/or time until fracture. Within the limitations of this review and the in vitro nature of the included studies, the results indicate that the cyclic fatigue resistance of rotary GP files may be influenced by several intrinsic factors of the files, such as their taper, cross-sectional design, alloy properties, kinematics, and external factors, such as the curvature and radius at which the file is activated, the irrigation or lubricant used, and the temperature.
Collapse
|
40
|
Guedes IG, Rodrigues RCV, Marceliano-Alves MF, Alves FRF, Rôças IN, Júnior JFS. Shaping ability of new reciprocating or rotary instruments with two cross-sectional designs: an ex vivo study. Int Endod J 2022; 55:1385-1393. [PMID: 36121392 DOI: 10.1111/iej.13834] [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: 06/13/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
AIM This study compared the shaping ability of four new reciprocating and rotary nickel-titanium instruments, with triangular or S-shaped cross-section, in the mesial canals of mandibular molars using micro-computed tomographic (micro-CT) evaluation. METHODOLOGY Twenty-four extracted mandibular molars with Vertucci's class IV configuration in the mesial root were selected for this study. The teeth were matched in fours according to anatomic similarities as revealed by micro-CT and then distributed into four groups of 12 mesial canals each according to the instrumentation technique: Reciproc Blue, R-motion, VDW.Rotate, and RaCe EVO. The final apical size of instrumentation was 30/.04 for 3 systems and 25/08 for the Reciproc Blue instrument. Micro-CT scans were taken before and after preparation to evaluate the canal volume, area and unprepared surface areas, as well as the centering ability, and the canal:root width ratio. RESULTS Preparation with all systems significantly increased the volume and area of the canals (P < .05). There were no significant differences between groups regarding the amount of unprepared areas in both the apical and full canal lengths (P > .05). Variation in the centre of gravity showed no significant difference between groups either (P > .05). The canal:root width ratio at levels 0 and 4 mm apically to the coronal canal opening was significantly increased by all systems (P < .01), with no significant differences between groups (P > .05). The canal width never exceeded 40% of the root width. CONCLUSIONS Reciprocating or rotary instruments, with a triangular or an S-shaped cross-section, performed equally in shaping Vertucci's class IV mesial canals of mandibular molars.
Collapse
Affiliation(s)
- Isabela G Guedes
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Renata C V Rodrigues
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.,Faculty of Dentistry, Veiga de Almeida University, Rio de Janeiro, RJ, Brazil
| | | | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| | - José F S Júnior
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.,Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil
| |
Collapse
|
41
|
A Novel Technique for Identification of Wear Values at Different Lengths after Multiple Clinical Use of Different File Systems. Medicina (B Aires) 2022; 58:medicina58081117. [PMID: 36013584 PMCID: PMC9416307 DOI: 10.3390/medicina58081117] [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: 07/26/2022] [Revised: 07/30/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The purpose of this research is to assess the wearing of the rotary file system (Protaper Next) and reciprocating file systems (Reciproc Blue and WaveOne Gold) at different lengths using a novel technique after in vivo clinical use. Materials and Methods Twelve different unused samples from each brand were accepted as reference values. For three different brands, the diameters of the files were measured by taking 12 samples used once, 12 samples used twice, and 12 samples used three times. Images were taken with a USB Micron Microscope, and file diameters were measured by determining limit values with Autocad. Result Reciproc Blue system was the most worn at apical 1 mm, and WaveOne Gold system was the most worn at apical 3 mm. PTN system exhibited the least wearing at any length. Moreover, less wearing was observed in the rotation motion than in the reciprocating motion. Conclusion In clinical practice, for the guttapercha to be fully adapted to the apical construction prepared according to the determined WL, the file should not undergo any wearing and volume reduction. Wearing—especially in the apical parts of the file—causes less preparation, and this situation could lead to apically obturation failure.
Collapse
|
42
|
Merchan LP, Probst LF, Simões ACCD, Raimundo ACS, Cavalcanti YW, Cavalcante DDFB, Câmara JVF, Pereira AC. Economic analysis of the different endodontic instrumentation techniques used in the Unified Health System. BMC Oral Health 2022; 22:344. [PMID: 35953805 PMCID: PMC9373286 DOI: 10.1186/s12903-022-02369-x] [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: 04/23/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess the financial impact of incorporating a new (reciprocal) technology into endodontic treatments in the public health system (SUS). METHODS This was a economic evaluation study (comparing the 3 different endodontic instrumentation techniques-manual, rotary and reciprocating), allocative efficiency analysis to optimize existing resources in the SUS, and financial contribution impact analysis of incorporation of a new technology. Thirty-one (31) 12 years-old volunteers were evaluated. RESULTS The incremental cost-effectiveness ratio (ICER) was calculated at R$1.34/min, - R$0.60/min and BRL 0.10/min for the single-rooted, bi-rooted and tri-rooted teeth, respectively, when the rotary technique was compared with the manual type. In turn, the ICER was R$ 21.04/min, - R$ 0.73/min and - R$ 2.81/min for the 3 types of teeth, respectively, when the reciprocating technique was compared with the manual type. The incremental financial impact of replacing manual endodontic with rotary endodontic treatments would be - R$ 2060963.66 in the case of single-rooted teeth, but the number of treatments would also be reduced (- 19,379). In the case of two-rooted teeth, the incremental financial impact would be BRL 34921540.62 with the possibility of performing an additional 204,110 treatments. In turn, BRL 11523561.50 represented the incremental financial impact for teeth with 3 or more roots and with an increase of 72,545 procedures. When we analyzed the incremental financial impact of replacing manual endodontic with reciprocating endodontic treatments, it would be - R$ 730227.80 in the case of single-rooted teeth, allowing for an additional 2538 treatments. In turn, R$ 21674853.00 represented the incremental financial impact for bi-radicular teeth, with an increase of 121,700 procedures. In the case of two-rooted teeth, the incremental financial impact would be BRL 13591742.90 with the possibility of performing an additional 40,670 treatments. CONCLUSIONS The reciprocating technique could improve access to endodontic treatment in the SUS as it allowed a simultaneous reduction in clinical time and associated costs. However, the higher number of endodontic treatments performed would have a financial impact.
Collapse
Affiliation(s)
- Laura Paredes Merchan
- Department of Public Health, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Livia Fernandes Probst
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Ana Clara Correa Duarte Simões
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Augusto Cesar Santos Raimundo
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil
| | | | | | - João Victor Frazão Câmara
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg, Saar, Germany
| | - Antonio Carlos Pereira
- Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil.
| |
Collapse
|
43
|
Matoug-Elwerfelli M, Abdou A, Almutairi W, Alhuthayli M, Aloyaynaa S, Almohareb R. Radiographic assessment of endodontic mishaps in an undergraduate student clinic: a 2-year retrospective study. PeerJ 2022; 10:e13858. [PMID: 35945941 PMCID: PMC9357366 DOI: 10.7717/peerj.13858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/17/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives The aim of this study was to compare the occurrence of instrumentation and obturation related endodontic procedural mishaps following the use of either, stainless steel hand or engine-driven rotary instrumentation techniques. Methods From a computerized hospital database, a total of 730 dental patient records who had received endodontic treatment by undergraduate dental students between August 2018 to September 2020 were retrieved. The inclusion criteria were primary (non-surgical) endodontic treatment on permanent teeth with complete radiographic records. Following record screening, a final sample of n = 475 dental records were included. Radiographic records were evaluated for both instrumentation and obturation related mishaps. The data was analysed using multiple logistic regression analysis (α = 0.05). Results Engine-driven rotary instrumentation resulted in a significant decrease in the overall occurrence of instrumentation related endodontic mishaps by 40% compared to hand instrumentation (Odds Ratio = 0.59 [0.36-0.97], p = 0.04). In particular, rotary instrumentation decreased ledge formation, perforation and obturation related mishaps, with minimal effect on the limitation of zipping. Conclusion The use of rotary instrumentation techniques may reduce the incidence of instrumentation and obturation endodontic mishaps in the undergraduate dental clinic.
Collapse
Affiliation(s)
| | - Ahmed Abdou
- Prosthetic Dentistry Department, Division of Biomaterials, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
| | - Wejdan Almutairi
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Malak Alhuthayli
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Shaikhah Aloyaynaa
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rahaf Almohareb
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| |
Collapse
|
44
|
A Multimethod Assessment of a New Customized Heat-Treated Nickel-Titanium Rotary File System. MATERIALS 2022; 15:ma15155288. [PMID: 35955223 PMCID: PMC9369791 DOI: 10.3390/ma15155288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to compare three endodontic rotary systems. The new Genius Proflex (25/0.04), Vortex Blue (25/0.04), and TruNatomy (26/0.04v) 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. The results were compared using one-way ANOVA, post hoc Tukey, and Kruskal−Wallis tests, with a significance level set at 5%. All instruments showed symmetrical cross-sections, with asymmetrical blades, no radial lands, no major defects, and almost equiatomic nickel−titanium ratios. Differences were noted in the number of blades, helical angles, cross-sectional design, and tip geometry. The Genius Proflex and the TruNatomy instruments had the highest and lowest R-phase start and finish temperatures, as well as the highest and lowest time and cycles to fracture (p < 0.05), respectively. The TruNatomy had the highest flexibility (p < 0.05), while no differences were observed between the Genius Proflex and the Vortex Blue (p > 0.05). No differences among tested systems were observed regarding the maximum torque, angle of rotation prior to fracture, and shaping ability (p > 0.05). The instruments showed similarities and differences in their design, metallurgy, and mechanical properties. However, their shaping ability was similar, without any clinically significant errors. Understanding these characteristics may help clinicians to make decisions regarding which instrument to choose for a particular clinical situation.
Collapse
|
45
|
Moreira EJL, Silva EJNL, Belladonna FG, Maciel AC, Vieira VTL, De-Deus G. Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable. Braz Dent J 2022; 33:47-53. [PMID: 36043568 DOI: 10.1590/0103-6440202204978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/23/2022] [Indexed: 11/21/2022] Open
Abstract
The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.
Collapse
Affiliation(s)
- Edson J L Moreira
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| | - Emmanuel J N L Silva
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| | - Felipe G Belladonna
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| | - Ana Carolina Maciel
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| | - Victor T L Vieira
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| | - Gustavo De-Deus
- Department of Endodontics; Fluminense Federal University (UFF); Niterói; RJ; Brazil
| |
Collapse
|
46
|
Uslu O, Haznedaroglu F, Keskin C. Comparison of mechanical resistance and standardisation between original brand and replica-like endodontic systems. AUST ENDOD J 2022; 49:149-158. [PMID: 35703893 DOI: 10.1111/aej.12639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
This study compared the original (ProTaper Next and Reciproc) endodontic systems with their replica-like brands (X File and Only One File) in terms of standardisation, design, phase-transformation behaviour, composition and mechanical behaviour. X File showed greater taper values than ProTaper Next, while Only One File had the greatest tip diameter. Both replica-like files had an active tip and greater dimensions than their reports. There were also significant differences between the original and replica-like systems in terms of their phase-transformation behaviour and the precision of the measurement lines. Only One File showed significantly lower cyclic fatigue and torsional resistance than Reciproc (p < 0.05). There were no significant differences in the cyclic fatigue, torsional resistance and composition of NiTi between X File and ProTaper Next (p > 0.05). Although replica systems show mechanical properties that can be acceptable, they are not consistent in terms of standardisation and design.
Collapse
Affiliation(s)
- Orkun Uslu
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.,Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
| | - Faruk Haznedaroglu
- Department of Endodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
47
|
Cross-sectional study of posterior tooth root fractures in 2015 and 2019 in a Chinese population. Clin Oral Investig 2022; 26:6151-6157. [PMID: 35670864 DOI: 10.1007/s00784-022-04564-0] [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: 01/12/2022] [Accepted: 05/22/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This study aimed to compare posterior tooth root fractures in endodontically treated teeth versus nonendodontically treated teeth in the Chinese population. MATERIALS AND METHODS We investigated 500 root fractured posterior teeth in 461 Chinese patients. The clinical information (age, sex of patients, tooth type) were recorded. The fractured teeth were divided into endodontically treated root fractured (ETRF) teeth and nonendodontically treated root fractured (NETRF) teeth. The morphology of the fractured root (circular, oval, other), the orientation of fracture lines (vertical and non-vertical), the restorations performed (crown, filling, non-filling), and the position of the teeth in the dental arch (normal, misaligned) were evaluated based on cone-beam computed tomography images. These data were compared between 2015 and 2019. ETRF% was calculated as ETRF/ETRF + NETRF. Vertical% was calculated as vertical/vertical + non-vertical. RESULTS There were 177 ETRF teeth and 323 NETRF teeth in this population. The total ETRF% was 29.3% in 2015 and 37.6% in 2019 (P = 0.087). The proportion of vertical root fracture in the ETRF group increased significantly in 2019 compared with that in 2015 (46.2% vs. 80.2%, P = 0.000). The ETRF% in female patients increased by 16.8%, but increased by only 1.2% in male patients in 2019 compared with that in 2015. The ETRF% of mandibular and maxillary premolars increased by 48.5% and 29.3%, respectively. The proportion of crown restoration increased by 2.4% in 2019 compared with that in 2015 in the ETRF group. CONCLUSIONS The proportion of NETRF teeth and non-vertical root fractures in posterior teeth is high in this Chinese population. The number of vertical root fractures in endodontically treated teeth increased significantly from 2015 to 2019. CLINICAL RELEVANCE More attention should be paid to endodontic treatment factors in the occurrence of root fractures, especially as female patients and premolars are more susceptible.
Collapse
|
48
|
Altufayli MD, Salim B, Katbeh I, Merei R, Mamasaidova Z. Shaping Ability of Reciproc Blue Versus One Curve in Curved Canal: An In-Vitro Study. Cureus 2022; 14:e24387. [PMID: 35619838 PMCID: PMC9126444 DOI: 10.7759/cureus.24387] [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] [Accepted: 04/22/2022] [Indexed: 11/25/2022] Open
Abstract
The introduction of nickel-titanium (NiTi) rotary instruments improved the root canal preparation of the narrow and curved root canals, especially after the introduction of thermomechanical treated (NiTi) alloys that have a high flexibility to prepare the curved canal reducing the common clinical complication, such as fracture, the change of the original shape of the root canal as a result of the change in the curvature of the curved root canal, the change of the working length which caused by the creation of the ledges, canal transporting and zipping especially in medium and highly curved canal. This study aimed to compare the shaping ability of two heat-treated nickel-titanium single file systems using reciprocation motion and rotary motion in curved canals. Materials and methods Thirty extracted human teeth with one curved root at 25 to 56 degrees were used, two NiTi single file systems were used to prepare the curved root canal in two groups: Reciproc R25 (Munich, Germany: VDW) group (n=15) and One Curve (Besancon, France: Micro-Mega) group (n=15). Curved root canal instrumentation outcomes were evaluated using cone-beam computed tomography (CBCT). Kruskal-Wallis with Bonferroni post hoc test was used to assess differences between working length, the angle and radius of curvature after instrumentation. Results There was a significant difference in angle and radius of curvature (-1.83° One Curve, -2.25° Reciproc blue and -0.18 mm One Curve, -0.19 mm Reciproc blue, respectively) (p<0.05) after instrumentation for both One Curve and Reciproc blue groups, and there was no significant difference in working length change (-0.16 mm One Curve, -0.32 mm Reciproc blue) after instrumentation of both One Curve and Reciproc blue groups (p>0.05). Conclusion The Reciproc blue single file system with reciprocation movement and One Curve with continuous movement cause a significant difference in curvature and radius of curved root canal affecting the original shape of the root canal with no significant difference in working length of the curved root canal.
Collapse
|
49
|
Chen C, Zhang W, Liang Y. Evaluation of apical root defects during canal instrumentation with two different nickel-titanium (NiTi) systems by optical coherence tomography (OCT) scan. J Dent Sci 2022; 17:763-770. [PMID: 35756775 PMCID: PMC9201542 DOI: 10.1016/j.jds.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/02/2021] [Indexed: 01/20/2023] Open
|
50
|
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).
Collapse
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
| | | |
Collapse
|