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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.
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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
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Parkar A, Banga KS, Pawar AM, Luke AM. Extrusion of Sodium Hypochlorite in Oval-Shaped Canals: A Comparative Study of the Potential of Four Final Agitation Approaches Employing Agarose-Embedded Mandibular First Premolars. J Clin Med 2024; 13:2748. [PMID: 38792290 PMCID: PMC11121930 DOI: 10.3390/jcm13102748] [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: 04/05/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of this investigation was to assess the apical extrusion potential of sodium hypochlorite (NaOCl) in agarose-embedded mandibular first premolars employing four final agitation procedures. Methods: Based on CBCT confirmation of single oval-shaped canals, one hundred extracted mandibular first premolars were chosen. Using 5.25% NaOCl, the teeth were prepared using the XP Endo Shaper and divided into experimental and control groups. The following were the experimental groups: Group 1 comprised the XP-Endo Finisher, Group 2 the Ultrasonic Activation, Group 3 the Gentle File Finisher Brush, and Group 4 the 27-gauge side-vented needle. To test extrusion, the teeth were placed in a 0.2% agarose gel that contained the pH-sensitive dye m-cresol purple, allowing pixel quantification via ImageJ software (version 1.54i). Results: The XP Endo Finisher featured the most pixels, depicting higher apical extrusion (p < 0.01), followed by the side-vented needle, Gentle File Finisher Brush, and PUI, while the Control Group endured no extrusion. Conclusions: The effective irrigation method for root canal therapy is critical, especially in situations of open apices, resorption, or perforation. According to in vitro experiments, the XP-Endo Finisher has the maximum sodium hypochlorite extrusion, which is determined by parameters such as apical preparation size and irrigation system.
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Affiliation(s)
- Aalisha Parkar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Kulvinder Singh Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates;
- Centre of Medical and Bio-Allied Health Science Research (CMBHSR), Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates
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Monteiro TM, Cortes-Cid VO, Marceliano-Alves MFV, Campello AF, Bastos LF, Lopes RT, Siqueira JF, Alves FRF. Intracanal removal and apical extrusion of filling material after retreatment using rotary or reciprocating instruments: A new approach using human cadavers. Int Endod J 2024; 57:100-107. [PMID: 37886883 DOI: 10.1111/iej.13990] [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: 07/28/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
AIM This study compared intracanal removal of filling as well as the frequency and volume of extruded material after retreatment with either HyFlex or Reciproc instruments in mandibular teeth from cadavers. METHODOLOGY The root canals of 14 pairs of contralateral single-rooted teeth in mandibles of cadavers were instrumented with Reciproc R40 and filled using lateral compaction. The mandibles were scanned in a micro-computed tomographic (micro-CT) device before and after retreatment procedures. The contralateral teeth were assigned to two groups (n = 14) according to the retreatment protocol using either HyFlex or Reciproc instrument systems. In the HyFlex group, the HyFlex Remover instrument was worked 3 mm short of the working length (WL), followed by HyFlex CM 40.04 and 50.04 at the WL. In the Reciproc group, the R50 instrument was worked up at the coronal two thirds, followed by two more cycles until the WL was reached. Pre- and post-operative micro-CT images were analysed for extrusion and intracanal removal of filling material. RESULTS After retreatment, extrusion of filling material occurred in 11 (78%) and 14 (100%) teeth from HyFlex and Reciproc groups respectively (p > .05). A similar volume of extruded material was observed after retreatment with both systems (p > .05). A significant decrease in the intracanal filling volume was verified after retreatment with both tested systems (p < .05). However, residual filling material was found in all root canals, regardless of the system. The amount of filling material removed (HyFlex = 80.8%; Reciproc = 65.9%) and the operation time was similar between systems (p > .05). CONCLUSIONS A high frequency of filling material extrusion was observed after retreatment with the two systems in a cadaver model, with no significant difference between them. Both protocols obtained similar efficacy in filling material removal procedures, although none completely cleaned the canals.
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Affiliation(s)
- Thamyres M Monteiro
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
| | - Victor O Cortes-Cid
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
| | | | - Andrea F Campello
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Luan F Bastos
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ricardo T Lopes
- Department of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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Elheeny AAH, Sermani DI, Abdelmotelb MA. Postoperative pain perception and associated risk factors in children after continuous rotation versus reciprocating kinematics: A randomised prospective clinical trial. AUST ENDOD J 2023; 49 Suppl 1:345-352. [PMID: 37026535 DOI: 10.1111/aej.12746] [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: 05/18/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 04/08/2023]
Abstract
To compare the postoperative pain of continuous rotation and reciprocating movements after pulpectomy of non-vital primary molars and determine associated risk factors. 146 children aged 4-8 years with one primary molar indicated for pulpectomy were randomly assigned to two equal groups: those instrumented with continuous rotation motion (Hyflex EDM Coltene/Whaledent) and reciprocating motion (Reciproc R25 (VDW)). A 4-point pain scale was used to assess postoperative pain frequencies, which were compared at different intervals using the Chi-square test. Postoperative pain risk factors were determined using logistic regression analysis. There was no statistically significant difference between the follow-ups. Gender, pulp status, and radiographic radiolucency increased the risk of postoperative pain incidence. Postoperative pain likelihood in children with chronic apical periodontitis was 8.72 times that of children with necrotic pulps. Postoperative pain after instrumentation with both kinematics was comparable. Postoperative pain incidence is increased by preoperative pulp condition, radiographic radiolucency, and gender.
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Affiliation(s)
- Ahmad Abdel Hamid Elheeny
- Department of Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
| | - Dania Ibrahem Sermani
- Department of Paediatric Dentistry, Faculty of Dentistry, Minia University, El Minia, Egypt
- Intern at Minia University Minia Hospital, Minia University, El Minia, Egypt
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Krokidis A, Nicola B, Antonio C, Panopoulos P. Comparison of Two Reciprocating and Anatomical Single File Techniques in Cleaning Oval Anatomies. IRANIAN ENDODONTIC JOURNAL 2023; 18:41-46. [PMID: 36751407 PMCID: PMC9900148 DOI: 10.22037/iej.v18i1.33623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/12/2022] [Accepted: 11/30/2022] [Indexed: 02/09/2023]
Abstract
Introduction The present study aimed to compare the capability of two single-file shaping systems in disinfecting and cleaning long oval root canals. Materials and Methods Fifty single-rooted teeth were prepared, contaminated with Enterococcus faecalis and divided into two groups. Two samplings were obtained; S1 before chemo-mechanical preparation and S2 after the preparation. Depending on the group, chemo-mechanical preparation was performed with XP-endo Shaper (XPS) and Wave One Gold (WOG). Five teeth from each group were observed under scanning electron microscopy (1000×) to evaluate the cleanliness of root canals at 3, 6 and 9 mm from the apex. All probability (P-values) were two-tailed, statistical significance was set at 0.05 and analyses were conducted using SPSS statistical software. Results A significant reduction in the colony forming units was observed from S1 to S2 in both tested groups. In S2, XPS group obtained significantly lower colony forming units (P<0.001). In the cleanliness study, XPS group resulted in significantly cleaner canals compared to WOG. Conclusions Based on this in vitro study XPS system was more effective in disinfecting and cleaning long oval canals.
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Affiliation(s)
- Andreas Krokidis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece;,Corresponding author: Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece. E-mail:
| | - Barabanti Nicola
- Department of Restorative Dentistry, School of Dentistry, University of Brescia, Brescia, Italy
| | - Cerutti Antonio
- Department of Restorative Dentistry, School of Dentistry, University of Brescia, Brescia, Italy
| | - Panos Panopoulos
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece;
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Roshdy NN, Hassan R. Quantitative evaluation of apically extruded debris using TRUShape, TruNatomy, and WaveOne Gold in curved canals. BDJ Open 2022; 8:13. [PMID: 35595771 PMCID: PMC9122899 DOI: 10.1038/s41405-022-00106-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Objective
This study compared the quantity of extruded debris after instrumentation with TRUShape 3D Conforming files, TruNatomy files, and the WaveOne Gold reciprocating system.
Materials and methods
Fifty-one mesiobuccal canals with severe curvatures (25–40°) were assigned to three equal groups according to the rotary system used for preparation, either TRUShape, TruNatomy, or WaveOne Gold files. The extruded debris was collected in pre-weighed glass vials. The data were statistically analyzed using a one-way ANOVA test and Tukey’s post hoc test.
Results
The least extruded debris was obtained with the WaveOne Gold instruments compared to the TRUShape and TruNatomy files (p < 0.001).
Conclusions
Debris extrusion occurs independently of the motion or design of the instrument. The WaveOne Gold system outperformed TRUShape and TruNatomy files in this study.
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Gomes TC, Coelho JDA, Pinheiro LR, Duarte MAH, Rodrigues PDA. Influence of Apical Diameter on Filling Material Extrusion during Retreatment - A Micro-CT and CBCT evaluation. Braz Dent J 2022; 33:13-19. [PMID: 36477960 PMCID: PMC9733367 DOI: 10.1590/0103-6440202204961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
AIM To investigate whether foraminal widening performed at primary treatment has an effect on the amount of apically extruded obturator material during retreatment and to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting extruded obturator material. METHODS Forty palatal roots of maxillary molars were selected based on micro-CT and divided into two groups (n=20): with foraminal widening (WE) and without foraminal widening (NE). To standardize the apical foramen, all specimens were instrumented to the foramen using the Protaper Next system, up to instrument X3. The WE group was instrumented to the foramen up to instrument X5, and the NE group was instrumented 1 mm lower. The canals were obturated 1 mm below the apical foramen with gutta-percha and AH Plus and stored for 7 days at 37 °C and 95% humidity. Roots were fixed in microtubes filled with 1.5% agar gel. The obturation material was removed with Reciproc R50. Scans of the teeth and agar were performed using micro-CT and CBCT. Comparison between groups and between methods was performed using Mann-Withney test (p ≤0.05). RESULTS No statistical difference was found when comparing the extruded material between groups using micro-CT (p = 0.589) or CBCT (p = 0.953). CBCT measured a greater volume of extruded material than micro- CT (p = 0.0004). CONCLUSION Foraminal widening had no effect on the extrusion of filling material during retreatment. The CBCT favored the evaluation of apically extruded filling material.
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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.
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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
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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