1
|
Immich F, de Araújo LP, da Gama RR, da Rosa WLDO, Piva E, Rossi-Fedele G. Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review. AUST ENDOD J 2024; 50:409-463. [PMID: 38923176 DOI: 10.1111/aej.12870] [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: 05/20/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.
Collapse
Affiliation(s)
- Felipe Immich
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Lucas Peixoto de Araújo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
- School of Dentistry, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Evandro Piva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | |
Collapse
|
2
|
Mali S, Patil A, Sharma D, Jaiswal H, Saoji HA, Sinha A, Singh R. The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study. Cureus 2024; 16:e54310. [PMID: 38496119 PMCID: PMC10944652 DOI: 10.7759/cureus.54310] [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: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona, Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.
Collapse
Affiliation(s)
- Sheetal Mali
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Amit Patil
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Deepak Sharma
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Himmat Jaiswal
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Hrishikesh A Saoji
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Anamika Sinha
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College And Research Institute, Bilaspur, IND
| |
Collapse
|
3
|
Abduljalil M, Andac G, Basmaci F. Response to 'Impacts of different Nickel-Titanium rotary and reciprocating root canal preparation systems on the amount of apically extruded debris'. AUST ENDOD J 2023; 49 Suppl 1:537-538. [PMID: 37017245 DOI: 10.1111/aej.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/06/2023]
Affiliation(s)
- Mohamad Abduljalil
- Department of Endodontics, Faculty of Dentistry, European University of Lefke, Mersin10, Turkey
| | - Gizem Andac
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | - Fatma Basmaci
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| |
Collapse
|
4
|
Al Omari T, El-Farraj H, Arıcan B, Atav Ateş A. Apical debris extrusion of full-sequenced rotary systems in narrow ribbon-shaped canals. AUST ENDOD J 2021; 48:245-250. [PMID: 34125465 DOI: 10.1111/aej.12540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/24/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023]
Abstract
The apically extruded debris caused by TruNatomy System (TRN), RACE EVO system (RE) and VDW Rotate (VR) systems in mandibular anterior teeth with ribbon-shaped root canals were compared. The root canals (n = 20 in each group) were irrigated with NaOCl 2.5%, and the extruded debris was collected at pre-weighted Eppendorf tubes. The amount of apically extruded debris (mg) and the treatment time (s) were recorded. Tukey pairwise comparisons were performed to compare groups with a 95% confidence level. VR had significantly less debris extrusion values and treatment time than RE and TRN (P < 0.05). Although no difference was observed between RE and TRN in terms of apically extruded debris (P > 0.05), a significant difference in favour of RE was observed in terms of treatment time (P < 0.05). All the instruments extruded debris at varying weights.
Collapse
Affiliation(s)
- Taher Al Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamza El-Farraj
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Burçin Arıcan
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Ayfer Atav Ateş
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| |
Collapse
|
5
|
Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer. Int J Dent 2021; 2021:8816628. [PMID: 33815503 PMCID: PMC7994073 DOI: 10.1155/2021/8816628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.
Collapse
|
6
|
da Silva EJNL, de Moura SG, de Lima CO, Barbosa AFA, Misael WF, Lacerda MFLS, Sassone LM. Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study. Restor Dent Endod 2021; 46:e16. [PMID: 34123752 PMCID: PMC8170380 DOI: 10.5395/rde.2021.46.e16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/05/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.
Collapse
Affiliation(s)
- Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Sara Gomes de Moura
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Waleska Florentino Misael
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
7
|
Yammine SD, Jabbour EA. Apically Extruded Debris following Programmed Over Instrumentation of Curved Canals with Three Nickel Titanium Rotary Instruments. Eur J Dent 2020; 15:20-26. [PMID: 32864731 PMCID: PMC7902109 DOI: 10.1055/s-0040-1714175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES This in vitro study aimed to compare the amount of mixed and dried debris extruded with three endodontic NiTi (nickel-titanium) systems at three levels beyond the major apical foramen. The null hypothesis is that there would be no differences between the different rotary systems in terms of apically extruded debris. MATERIALS AND METHODS Forty-eight roots of human extracted molars with 20 to 40-degrees curvature were divided randomly into three groups (n = 16) instrumented with ProTaper Next, BT RaCe, and WaveOne Gold, respectively. Instrumentation was performed at the major foramen and over instrumented 0.5 mm, 1.0 mm and 1.5 mm beyond. Irrigation was performed with sodium hypochlorite. Apically extruded debris was collected. RESULTS Comparison of mixed extruded debris (solution/debris)and dried debris according to group and level of instrumentation showed that WaveOne Gold at the foramen and ProTaper Next beyond the foramen (p < 0.0001) resulted in significantly less extruded debris than other files and within the four levels using repeated measures analysis of variance (p < 0.0001b). CONCLUSIONS All systems exhibit extruded debris during instrumentation but in different amounts.
Collapse
Affiliation(s)
- Salwa Daoud Yammine
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
| | - Edgard Antoine Jabbour
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
| |
Collapse
|
8
|
Gummadi A, Panchajanya S, Ashwathnarayana S, Santhosh L, Jaykumar T, Shetty A. Apical extrusion of debris following the use of single-file rotary/reciprocating systems, combined with syringe or ultrasonically-facilitated canal irrigation. J Conserv Dent 2019; 22:351-355. [PMID: 31802818 PMCID: PMC6873604 DOI: 10.4103/jcd.jcd_14_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aim: The aim of the study is to quantify the amount of debris extrusion after instrumentation with single-file rotary and reciprocating systems used either with conventional irrigation (CI) or passive ultrasonic irrigation (PUI) systems. Methodology: Sixty extracted human mandibular incisors were randomly assigned to two groups (n = 30); rotary single-file system, One Shape (OS-Group 1) and reciprocating single-file system, WaveOne (WO-Group 2) instruments. The two groups were further subdivided into two subgroups (n = 15); (A) PUI and (B) CI. The apically extruded debris was collected in preweighed glass vials as per the Myers and Montgomery method. After drying, the mean weight of debris was assessed with a microbalance and statistically analyzed using analysis of variance and Student's t-test. Results: The reciprocating file system produced significantly more debris compared to the rotary file system using either of the irrigation systems (P = 0.04). CI produced significantly more (P = 0.02) debris extrusion compared to PUI irrespective of the file system used. Conclusion: Under the conditions of this study, both systems caused apical debris extrusion. Rotary single-file system produced less debris extrusion compared to reciprocating single-file system. Use of PUI may be advocated as an alternative to CI, as it causes lesser apical debris extrusion.
Collapse
Affiliation(s)
- Ankita Gummadi
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Srinivas Panchajanya
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Srirekha Ashwathnarayana
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Lekha Santhosh
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - T Jaykumar
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Ashwija Shetty
- Department of Conservative Dentistry and Endodontics, The Oxford Dental College, Bengaluru, Karnataka, India
| |
Collapse
|