Root Canal Transportation and Centering Ability of Nickel-Titanium Rotary Instruments in Mandibular Premolars Assessed Using Cone-Beam Computed Tomography

Evaluation of Canal Transportation and Centering Ability of RaCe and Af f-one Systems by Cone-beam Computed Tomography: An in Vitro Study

Introduction

Rotary systems have made significant advances to improve their root canal preparation efficacy. These instruments can properly preserve the root canal anatomy and morphology. The present in vitro study aimed to compare canal transportation and centering ability of RaCe and Af f-one systems using cone-beam computed tomography.

Materials and Methods

Thirty-six mandibular molars were included. The samples were randomly assigned to two groups (n=18): group 1, RaCe, and group 2, Af f-one. Canal preparation was conducted using the respective files according to the manufacturers' instructions. The cone-beam computed tomographic scanning of the samples was performed before and after preparation. The data were analyzed by using two-way ANOVA.

Results

In both the RaCe and Af f-one rotary systems, canal centrality and transportation were similar at coronal, middle, and apical cross-sections. In addition, canal transportation and centrality were identical in the RaCe and Af f-one rotary files (P<0.05).

Conclusion

The two studied rotary systems did not exhibit significant differences in root canal transportation and preservation of root canal centrality in the apical, middle, and coronal thirds.

Dynamic Cyclic Fatigue and Differential Scanning Calorimetry Analysis of R-Motion

INTRODUCTION

The aim of this study was to assess the dynamic cyclic fatigue resistance of an R-Motion file at simulated body temperature and document corresponding phase transformations compared to OneCurve and HyFlex EDM (HFEDM).

METHODS

R-Motion (25/.06), OneCurve (25/.06), and HFEDM (25/.06) files were selected and divided into 3 groups (n = 9) according to the file type. Dynamic cyclic fatigue testing was done with a custom-made artificial stainless-steel canal that had a 90° angle of curvature and a 5-mm radius of curvature. Files were operated continuously at body temperature until fracture in the artificial canal. The time to fracture was calculated. Statistical analysis was performed, and significance was set at 5%. Phase transformation temperatures for 2 instruments of each group were analysed by differential scanning calorimetry (DSC) analysis.

RESULTS

The highest mean time to fracture value was measured in the HFEDM group (277.84 ± 2.51), followed by the R-Motion group (115.09 ± 0.01), whilst the lowest value was found in the OneCurve group (44.28 ± 3.63). Post hoc pairwise comparisons were all statistically significant (P < .001). DSC heating curves show austinite start temperatures to be 33.94 °C and 43.32 °C and austinite finish temperatures to be 35.09 °C and 50 °C for R-Motion and HFEDM, respectively. DSC cooling curves show martensite start temperatures to be 27.54 °C and 44.52 °C and martensite finish temperatures to be 29.13 °C and 37.68 °C for R-Motion and HFEDM, respectively. DSC curves of OneCurve failed to demonstrate transformation temperatures within the tested heat range.

CONCLUSIONS

Crystalline arrangement of Ni and Ti atoms within the NiTi alloys greatly affects the dynamic cyclic fatigue resistance of the file.

Cone-beam computed tomography analysis of primary root canals transportation and dentin loss after instrumentation with two-pediatric rotary files

Background

This in vitro study aims to compare rotary files (Fanta and Zuanba) with manual K files according to the amount of dentin removed and canal transportation in primary mandibular second molars by CBCT images.

Methods

This experimental study was conducted on 60 extracted human second primary molars. That were divided into three groups according to root canal preparation group "I" instrumented with manual K-files, group "II" instrumented with rotary Fanta files, and group "III" instrumented with rotary Zuanba files. After root canal preparation, teeth were scanned before and after mechanical preparation with CBCT scanner. Then the amount of dentin removed was determined at three levels, including the coronal, middle and apical levels. Data were statically analysed using the Kruskal–Wallis test.

Result

No statistically significant difference in the amount of dentin removed were noted between the manual and the rotary groups at the coronal and apical RC levels (P = 0.420) and (P = 0.819) respectively but significant difference was noted at the middle third (P = 0.043). Regarding RC transportation, no significant difference was noted among the three groups with the exception of the apical RC level (P = 0.043).

Conclusion

Although no significant differences were noted between rotary and manual files, the rotary files showed better performance.

Shaping ability of ProTaper Gold and WaveOne Gold nickel-titanium rotary instruments in simulated S-shaped root canals

Background/purpose

Gold metal technology improves flexibility and the resistance to cyclic fatigue of the endodontic mechanical files. This study compared the performance of ProTaper Gold (PTG) multiple file system and WaveOne Gold (WOG) single file system in simulated S-shaped root canals, which represents one of the most challenging root canal morphology.

Materials and methods

Forty S-shaped canals (n = 20 canals/per group) in resin blocks were instrumented to an apical size of 0.25 mm using PTG and WOG Primary, respectively. The total amount of resin removal, canal transportation, centering ratio, and the degree of canal straightening were measured in Photoshop CS6 software. Statistical analysis was performed by using Mann–Whitney U-test (α = .05).

Results

None of the files fractured during the instrumentation. The WOG group removed significantly less amount of resin at 0, 3, 6, 7 and 9 mm from the apex (P < .05). The WOG group remained more centered in canals at 0 mm from the apex (P < .05). The PTG group showed a better centering ability and less canal transportation at 4, 5 and 6 mm from the apex (P < .05). In the coronal curvature portion, the use of WOG Primary significantly decreased curvature angle and increased radius compared with PTG instruments (P < .05). There was no significant difference between the two groups in terms of the apical curvature angle and radius change (P > .05).

Conclusion

The WOG Primary file has a less aggressive dentin cutting and more centered apical preparation. The PTG system is more advantageous in shaping the coronal curvature of S-shaped canal.

Cone-Beam Computed Tomography Assessment of Canal-Centering Ability for Traditionally Used Nickel Titanium and Nickel Titanium Files with Reciprocating Hand Piece and Wave-One Files

Aim of the Study:

Need for our study was to evaluate a comparison between canal preparation ability of nickel–titanium (NiTi) hand files with step-back manual technique, of NiTi files installed on a reciprocating hand piece and of Wave-One files utilizing noninvasive cone-beam computed tomography (CBCT) technique.

Materials and Methods:

Thirty extracted intact single-rooted human mandibular premolars were used in the study, segregated in three sets of 10 specimens each, where canal instrumentation was done by different methods using NiTi in step-back technique, using reciprocating hand piece with NiTi files and using primary file with the use of Wave-One reciprocating system. Later, evaluation of centering ability was conducted using the references through CBCT images.

Results:

Hand NiTi files showed even less canal centering ability as compared to other two sets. Mesiodistal diameter at 9 mm length of the prepared canal was 1.06 and later was 0.98, which shows excessive preparation in case of Set I versus Set II. In case of comparison between Set III and Set I, mesiodistal diameter at 9 mm length of the prepared canal was 0.99, and later was 1.06, depicting better canal shaping ability with Wave-One file.

Conclusion:

The use of hand NiTi files installed on a reciprocating hand piece would be economically beneficial producing the similar results as that of wave one without any deviation from the original canal anatomy.

Comparative evaluation of canal transportation, centering ability, and dentin removal between ProTaper Gold, One Curve, and Profit S3: An in vitro study

Aim:

The aim of the study was to compare the canal transportation, centering ability, and dentin removal of Profit S3 (PS3), One Curve (OC), and ProTaper Gold (PTG) systems using cone-beam computed tomography (CBCT).

Materials and Methods:

Thirty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all the teeth in arch form was taken using CBCT. To increase standardization, crowns were removed and only teeth measuring 16 mm were included in the study. The samples were randomly divided into three groups, with ten samples in each group; Group I was instrumented with PS3, Group II was instrumented with OC, and Group III – PTG. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and dentin removal at 3, 6, and 9 mm, from the apex.

Statistical Analysis:

One-way-ANOVA and the independent t-test were done for the pairwise comparison. The significance level was set at P = 0.05; statistical analysis was performed with SPSS statistics version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

The mean canal centering ratio and canal apical transportation for PS3, OC and PTG show no statistical difference (P > 0.05). The mean value of dentin removal showed a statistically significant difference between the three groups (P < 0.05). PS3 and OC rotary file showed less removal of dentin compared to PTG (P < 0.00).

Conclusion:

It was evident that PS3, OC, and PTG had no statistically significant difference when analyzed based on canal transportation and canal centering ratio. However, there was a significant difference among the three groups comparing the removal of dentin. PS3 and OC rotary file showed less removal of dentin compared to PTG.

Maintenance Evaluation of the Original Anatomy of the Root Canal Diameters Instrumented with Mtwo and BioRace Systems

Objective:The aim of the present study was to evaluate maintenance of the original anatomy of the root canal diameters instrumented with the Mtwo rotary instruments and BioRace file systems. Material and method:Acrylic resin blocks with 160 simulated root canals with an angle curvature 15°-30° were taken into consideration in the present comparative study. The 160 simulated root canals were divided into two groups, each of them containing 80 acrylic resin blocks. Each group was divided into two subgroups (n=40 canals each). The simulated root canals subgroups were prepared with Mtwo and BioRace rotary nickel-titanium instruments. The results were scrutinized using analysis of variance (ANOVA)-test and Tukey's test. The significance level was set at P < 0.05. Results:No significant difference was noted between the Mtwo rotary instruments and BioRace files as they both had equal value in the coronal section (P=.000) in S1 (D1) and S1 (Dpi). The results of Tukey's test revealed a significant difference between the Mtwo rotary instruments and BioRace files in middle and apical section with the value (P=.003) in S3 (Dpi) and S4 (Dpi). The results of Tukey's test found out a significant difference between the Mtwo rotary instruments and BioRace files in the middle and apical section with the respective values (P=.003) in S3 (Ai) and (P=.006) in S4 (Ai). Conclusion:Ccording to the findings of the present study, enlargement of the root canal diameters resulted to be better on the middle and apical section of the canal prepared with Mtwo instruments in comparison with BioRace instruments. Thus, Mtwo instruments will increase the rate of success of endodontic therapy.

Comparison of Shaping Ability of Different Single-File Systems Using Microcomputed Tomography

OBJECTIVES

 To evaluate the shaping ability of four different single-file systems using micro-computed tomography (micro-CT).

MATERIALS AND METHODS

 Eighty mesiobuccal and mesiolingual canals of permanent mandibular molars were randomly assigned to four groups according to the file used; WaveOne Gold, RECIPROC Blue, HyFlex EDM, and One Shape (n = 20). The samples were scanned using micro-CT for the preinstrumentation record; then the canals were instrumented and scanned for the postinstrumentation records.

STATISTICAL ANALYSIS

 The data were then analyzed statistically using one-way analysis of variance (ANOVA) with the level of significance set at α = 0.05.

RESULTS

 The results of canal centering ratio and canal transportation showed that no significant difference was found among the four file groups at the middle and the coronal levels. However, a significant difference was found at the apical level (p < 0.05), where WaveOne Gold showed the best centering ratio and the least amount of canal transportation. The change in the canal volume was significant at the coronal level (p < 0.05), whereas the change in the canal volume was higher for the HyFlex EDM group than the other groups. No significant difference was found between the other groups at the apical level, middle level, or in the total percentage of canal volume.

CONCLUSION

 WaveOne Gold produced a more centralized canal preparation with a lesser amount of transportation at the apical level. HyFlex EDM showed the highest canal volumetric change at the coronal level. The interim design of the endodontic files has a high impact on the behavior of the file inside the root canal.

Canal transportation and centering ratio after preparation in severely curved canals: analysis by micro-computed tomography and double-digital radiography

OBJECTIVES

This study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation.

MATERIALS AND METHODS

Mesial root canals of mandibular molars with severe curvature (25-70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%).

RESULTS

The micro-CT method showed that XPS's shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023).

CONCLUSIONS

Micro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups.

CLINICAL RELEVANCE

Root canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.

Negotiation, Centering Ability and Transportation of Three Glide Path Files in Second Mesiobuccal Canals of Maxillary Molars: A CBCT Assessment

Introduction

The aim of this study was to compare negotiation, centering ability and transportation of three path finder rotary instruments (ProGlider, ScoutRace and M3 Pro-Gold Path File) to create glide path in second mesiobuccal (MB2) canals of maxillary molars with cone-beam computed tomography (CBCT).

Methods and Materials

In this in vitro study, 66 maxillary molars with separate second MB2 canals were selected with the following criteria: having 18-21 mm root length, without any resorption or calcification in radiography, without previous treatment and 20-40^º curve according to Schneider's method. Then MB2 canals were randomly divided into three groups (n=22). CBCT scan before and after root canal negotiation was taken. A #10 K-file for determination of working length was inserted into all canals. In group1; ProGlider file, group2; ScoutRace file and in group 3; M3 Pro-Gold Path file was implemented. The calculated data from CBCT based on reaching full working length (RFWL) or not (NRFWL) were analyzed using the Pearson Chi-square test. Centering ability was calculated by Fisher's exact test and amount of transportation was determined with the Pearson Chi-square test in SPSS software.

Results

ProGlider file had the least RFWL and ScoutRace was the best, but the results were not statistically significant (P>0.05). Regarding the centering ability and transportation, all 3 groups showed no significant differences (P>0.05), except at level of 2 mm from the apex in buccopalatal direction for ProGlider and ScoutRace files (P<0.05).

Conclusion

In spite of insignificantly different results, ScoutRace file was better than other groups in negotiating and centering ability in mesiodistal direction of the MB2 canal in maxillary molars. Also, ProGlider file was significantly better than ScoutRace regarding transportation at level of 2 mm from apex in buccopalatal direction.

Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies

Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.