CT evaluation of apical canal transportation associated with stainless steel hand files, oscillatory technique and pro taper rotary system

Apical transportation of manual NiTi instruments and a hybrid technique in severely curved simulated canals

Aim:

To evaluate the apical transportation induced by two instrumentation techniques in severely curved simulated canals.

Materials and Methods:

Forty simulated canals were divided into two groups (n = 20), according to the following instrumentation techniques: ProTaper Universal Manual System and a hybrid technique. The simulated canals in the ProTaper group were prepared following the technique recommended by the manufacturer: SX files in the cervical third of the root canal and S1, S2, and F1 files up to the working length. In the hybrid group, preparation was performed with K-files sizes 15, 20, and 25 to the working length, followed by cervical preparation with Gates Glidden burs 1, 2, and 3. Apical finishing was performed with the ProTaper manual files S2 and F1. To analyze apical transportation, the simulated canals were photographed before and after preparation at ×8. The images of the root canals pre- and post-instrumentation were superimposed to measure the distance between the inner and outer walls along the first 3 mm of the apical third.

Results:

The hybrid group presented the highest apical transportation values; however, with no statistically significant difference in comparison with the ProTaper group (P > 0.05).

Conclusions:

Both techniques induced similar apical transportation in the original path of the simulated root canals.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey's tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

Apical transportation associated with ProTaper Universal F1, F2 and F3 instruments in curved canals prepared by undergraduate students

Objective

This study evaluated apical transportation associated with ProTaper^® Universal Fl, F2 and F3 rotary files in curved canais prepared by undergraduate students.

Material and Methods

Twenty mesial roots of mandibular molars with curvatures ranging between 25° and 35° were selected. Mesiobuccal canals were instrumented by twenty students with the ProTaper^® system (Dentsply-Maillefer, Ballaigues, Switzerland) according to the manufacturer's instructions. Pre-fiaring was performed with Sl and SX files. A #15 K-file was inserted into the root canal up to the working length (WL), and an initial digital radiograph was taken in a buccolingual direction (baseline). Afterwards, the S1, S2, F1, F2, and F3 files were employed up to the WL. Other radiographies were taken in the same orientation of the baseline after the use of the Fl, F2, and F3 files, with each file inserted into the root canal. The radiographic images were overlapped, and the Image J software was used to measure the distance between the rotary files' ends and the #15 K-file's end, characterizing the apical transportation. Data were analyzed by Repeated Measure ANOVA and by the SNK post hoc test (P<0.05).

Results

It was verified that file size affected apical transportation significantly (P<0.001). The F3 file showed higher apical transportation than Fl and F2, while between these last files there was no difference.

Conclusion

The undergraduate students produced lower apical transportation in curved canals when they did not use the F3 rotary file.

Wizard CD Plus and ProTaper Universal: analysis of apical transportation using new software

OBJECTIVE

This study has two aims: 1) to evaluate the apical transportation of the Wizard CD Plus and ProTaper Universal after preparation of simulated root canals; 2) to compare, with Adobe Photoshop, the ability of a new software (Regeemy) in superposing and subtracting images.

MATERIAL AND METHODS

Twenty five simulated root canals in acrylic-resin blocks (with 20º curvature) underwent cone beam computed tomography before and after preparation with the rotary systems (70 kVp, 4 mA, 10 s and with the 8×8 cm FoV selection). Canals were prepared up to F2 (ProTaper) and 24.04 (Wizard CD Plus) instruments and the working length was established to 15 mm. The tomographic images were imported into iCAT Vision software and CorelDraw for standardization. The superposition of pre- and post-instrumentation images from both systems was performed using Regeemy and Adobe Photoshop. The apical transportation was measured in millimetres using Image J. Five acrylic resin blocks were used to validate the superposition achieved by the software. Student's t-test for independent samples was used to evaluate the apical transportation achieved by the rotary systems using each software individually. Student's t-test for paired samples was used to compare the ability of each software in superposing and subtracting images from one rotary system per time.

RESULTS

The values obtained with Regeemy and Adobe Photoshop were similar to rotary systems (P>0.05). ProTaper Universal and Wizard CD Plus promoted similar apical transportation regardless of the software used for image's superposition and subtraction (P>0.05).

CONCLUSION

Wizard CD Plus and ProTaper Universal promoted little apical transportation. Regeemy consists in a feasible software to superpose and subtract images and appears to be an alternative to Adobe Photoshop.