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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.
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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
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Yu D, Guo L, Gao J, Liu J, Yang D. Evaluation of apical extrusion of debris and centering ability in different nickel-titanium files during curved root canal preparation. BMC Oral Health 2023; 23:395. [PMID: 37322508 PMCID: PMC10273756 DOI: 10.1186/s12903-023-03070-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/22/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Curved root canals lead to difficulties in cleaning, shaping and filling the root canal system. Apical extrusion of debris and root canal transportation are important factors causing postoperative complications. In clinical practice, commonly selected instruments include multifile NiTi systems, such as M3-Pro PLUS (M3-PRO), Orodeka Plex 2.0 (ODP), Rotate (ROT), and Protaper Gold (PTG), as well as single-file NiTi systems, such as M3-L Platinum 2019 (M3L), Waveone Gold (WOG), and Reciproc Blue (RCB). This study aimed to comprehensively evaluate the differences in the apical extrusion of debris and centering ability of the above NiTi files. METHODS Seventy 3D-printed resin teeth were used (n = 10). The apically extruded debris was collected in a preweighed centrifuge tube. The resin teeth with or without root canal preparation were cut into separate cross sections at 1 mm, 3 mm, 5 mm, and 7 mm away from the root apex, and then the root canal transportation and centering ratio of each cross section were calculated. RESULTS Apical extrusion of debris was highest in RCB but lowest in OD-P (P < 0.05). Root call deviation was lowest in ROT at the 3 mm level, in PTG at the 5 mm level, and in PTG and ROT at the 7 mm level (P < 0.05). The centering ratio of NiTi files was highest in the RCB group at the 3 mm level, in the PTG group at the 5 mm level, in the ROT group at the 7 mm level (P < 0.05). CONCLUSIONS For NiTi files with the same system, the cross-sectional design is the greatest factor affecting the extrusion of debris, and motion mode is the second. In addition, the multifile system could reduce the degree of root canal transportation.
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Affiliation(s)
- Dongsheng Yu
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Li Guo
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Jing Gao
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Jie Liu
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China
| | - Deqin Yang
- Northern Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, 404100, China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, 404100, China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, 404100, China.
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Shi L, Zhou J, Wan J, Yang Y. Shaping ability of ProTaper Gold and WaveOne Gold nickel-titanium rotary instruments in simulated S-shaped root canals. J Dent Sci 2022; 17:430-437. [PMID: 35028067 PMCID: PMC8740102 DOI: 10.1016/j.jds.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Lu Shi
- Department of Endodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Junling Zhou
- Department of Endodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jie Wan
- Department of Endodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yunfei Yang
- Department of Endodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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Evaluation of the Shaping Ability of Three Thermally Treated Nickel-Titanium Endodontic Instruments on Standardized 3D-printed Dental Replicas Using Cone-Beam Computed Tomography. MEDICINA-LITHUANIA 2021; 57:medicina57090901. [PMID: 34577824 PMCID: PMC8469020 DOI: 10.3390/medicina57090901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The aim of the present study is to compare the efficacy of three root canal preparation systems in the shaping of 3D-printed root canal replicas of single rooted teeth. Materials and Methods: Sixty 3D-printed root canal replicas were produced and divided into three groups, each consisting of twenty samples. Each group was shaped with a different instrument: Reciproc Blue R25/08 (VDW GmbH, Munich, Gemany), WaveOne Gold Primary 25/07 (Dentsply Sirona, Ballaigues, Switzerland), and ProTaper Gold F2 25/08 (Denstply Sirona). To ensure the reproducibility of pre- and post-operative CBCT images of the root canals, the endodontic printed replicas were placed in a mould of silicon impression material. A cone-beam computed tomography (CBCT) software was used to compare pre- and post-instrumentation images collected at three levels of the root canal length: 3, 6, and 9 mm from the apical foramen. The amount of transportation, centring ability, and curvature angle after shaping were evaluated for each system. The results were statistically analysed and compared using one-way analysis of variance (ANOVA). Results: Regarding the transportation of the root canal after shaping, significant differences between groups at 3 mm (p = 0.010721) and 6 mm (p = 0.000046) were recorded in the mesio-distal direction, while in the bucco-lingual significant differences were only observed at 6 mm (p = 0.000554). Reciproc Blue removed more dentin from the mesial and buccal wall of the root canal. When evaluating the centring ability of the three systems, significant differences were observed between the groups at the level of 9 mm (p = 0.037258) in the mesio-distal direction, and at the level of 6 mm (p = 0.038197) in the bucco-lingual direction. Significant differences of the canal curvature angle after shaping were also observed between groups (p = 0.000001). Reciproc Blue straightened the curvature the most, while ProTaper Gold the least. Conclusions: All systems produced minor root canal transportation. No instrument was able to achieve a perfect centring preparation of the root canal. All systems produced a small degree of root canal straightening.
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Assis RS, Lopes FC, Roperto R, Silva Sousa YTC, Brazão EH, Spazzin AO, Pereira GKR, Alves DM, Saquy PC, Sousa-Neto MD. Bond strength and quality of bond interface of multifilament fiberglass posts luted onto flat-oval root canals without additional dentin wear after biomechanical preparation. J Prosthet Dent 2020; 124:738.e1-738.e8. [PMID: 32694019 DOI: 10.1016/j.prosdent.2020.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 10/23/2022]
Abstract
STATEMENT OF PROBLEM An intraradicular retainer formed by multiple independent glass fiber filaments was developed aiming to allow better adaptation in flattened root canals; however, the performance of the new posts is unclear. PURPOSE The purpose of this in vitro study was to compare the bond strength (BS) and adhesive interface quality achieved in flattened root canals restored with conventional glass fiber posts (CFPs) and multifilament glass fiber posts (MFPs). MATERIAL AND METHODS The distal roots of mandibular molars with long oval root canals were endodontically treated, and the obturation material was removed and assigned to 2 groups (n=11) according to the type of retainer used: CFP (WhitePostDC#0.5; FGM) or MFP (CometTail#4; Synca). The posts were cemented with self-adhesive resin cement. The specimens were sectioned (2 slices per third). The most cervical slice in each third was used to evaluate the BS, while the adhesive interface in the apical slices was analyzed by scanning electron microscopy. BS data were analyzed by using a multilevel generalized linear model, and adhesive interface SEM data were analyzed by using a multilevel ordinal logistic regression model (α=.05). RESULTS Multilevel regression showed a statistically significant difference for the "type of retainer" factor (P=.001; CFP 2.61 ±1.30>MFP 1.59 ±1.54). No statistically significant differences were found for the "root thirds" factor (P=.346) or for the interaction of both factors (P=.114). The failure pattern was predominantly mixed or adhesive for CFP and adhesive to dentin for MFP. A better adaptation of the restorative material was observed in the cervical third for CFP and in the apical third for MFP (P<.001). CONCLUSIONS MFP resulted in lower BS values than CFP, with a higher prevalence of adhesive failures to dentin and better adaptation of the adhesive interface in the apical third.
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Affiliation(s)
- Rafael S Assis
- Postgraduate student, Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Fabiane Carneiro Lopes
- Postgraduate student, Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Renato Roperto
- Professor, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | | | - Elisabeth Helena Brazão
- Postgraduate student, School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil
| | - Aloísio O Spazzin
- Professor, School of Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | - Gabriel K R Pereira
- Professor, School of Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | - Daniela Meira Alves
- Postgraduate student, School of Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | - Paulo César Saquy
- Professor, Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Manoel Damião Sousa-Neto
- Professor, Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
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Canal Transportation and Centering Ability in Long Oval Canals: A Multidimentional Analysis. J Endod 2019; 45:1242-1247. [DOI: 10.1016/j.joen.2019.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/28/2019] [Accepted: 07/12/2019] [Indexed: 11/18/2022]
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[Cone-beam computed tomography for determination of mesial root canal curvatures of human mandibular first molars]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:824-829. [PMID: 33168507 PMCID: PMC6765546 DOI: 10.3969/j.issn.1673-4254.2018.07.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To investigate mesial root canal curvatures of human mandibular first molars using cone-beam computed tomography (CBCT). METHODS CBCT was performed for scanning the mandibular first molars of 1600 Chinese subjects, among whom the subjects identified to have middle mesial canals were divided into 5 age groups, namely group A (18-29 years), group B (30-39 years), group C (40-49 years), group D (50-59 years), and group E (60-80 years) for further analysis. All the CBCT images were reconstructed using Planmeca Romexis CBCT image reconstruction system, and the curvature of the mesial root was measured using the Schneider method. RESULTS A total of 2856 CBCT images were obtained from the 1600 subjects, among whom 168 (5.88%) were found to have middle mesial canals in the mandibular first molars. The prevalence of middle mesial canals was 37.50% in group A, 17.80% in group B, 14.88% in group C, 19.64% in group D, and 10.12% in group E. The moderate of the curvature in the mesiodistal direction was significantly higher in group A than in the other groups (P < 0.05); the curvature in mesiodistal direction differed significantly among the 5 groups (P < 0.05), and was the greatest in group A followed by group C and group D, and was the smallest in group E. The curvature in the buccolingual direction was similar among the 5 groups. The incidence of mesiodistal and buccolingual curvature of the middle mesial canals was significantly higher in the middle 1/3 of the root canal than in the upper 1/3 and apical 1/3 of the root canal. CONCLUSIONS The incidence of middle mesial canals in the mesial root of the mandibular first molars decreases with age. The middle mesial canal system of the mandibular first molar is complex and variable, and most of the first molars have obvious curvature in the mesiodistal and buccolingual directions. CBCT can provide reference for clinical treatment to reduce the treatment failure rate.
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