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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. [PMID: 38923176 DOI: 10.1111/aej.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [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.
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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
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Uzunoğlu Özyürek E, Küçükkaya Eren S, Karahan S. Effect of treatment variables on apical extrusion of debris during root canal retreatment: A systematic review and meta-analysis of laboratory studies. J Dent Res Dent Clin Dent Prospects 2024; 18:1-16. [PMID: 38881644 PMCID: PMC11179139 DOI: 10.34172/joddd.40501] [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: 07/07/2023] [Accepted: 12/06/2023] [Indexed: 06/18/2024] Open
Abstract
Background This study aimed to systematically and comprehensively review the effect of various treatment variables on apically extruded debris (AED) during non-surgical root canal retreatment (NSRCRT). Methods The study protocol is shared in the Open Science Framework database (https://osf.io/kjtdg/?view_only=17060180705745ec9dae9a01614f3880). An electronic search was conducted up to July 2022 to reveal related studies. Two reviewers critically assessed the studies for eligibility against inclusion and exclusion criteria and data extraction. Quantitative data synthesis was performed, and the risk of bias in the studies was also evaluated. Results Forty-six studies were included in the systematic review and 14 in the meta-analysis. Conflicting or limited evidence was found for the effect of sealer type, obturation technique, and solvent use. The manual instrumentation increased the amount of AED compared to rotary instrumentation during the removal of filling materials (P<0.001). There was no significant difference in the amount of AED between the use of rotary and reciprocating files during the removal of filling materials (P=0.181). Conclusion Rotary instruments can be recommended instead of manual instruments during the removal of filling materials to control the amount of AED. Further studies with a low risk of bias are needed to clarify the effect of other treatment variables on AED during NSRCRT.
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Affiliation(s)
- Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Kiraz G, Kaya BÜ, Ocak M, Uzuner MB, Çelik HH. Micro-CT evaluation of the removal of root fillings using rotary and reciprocating systems supplemented by XP-Endo Finisher, the Self-Adjusting File, or Er,Cr:YSGG laser. Restor Dent Endod 2023; 48:e36. [PMID: 38053777 PMCID: PMC10695726 DOI: 10.5395/rde.2023.48.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This study aimed to compare the effectiveness of a single-file reciprocating system (WaveOne Gold, WOG) and a multi-file rotary system (ProTaper Universal Retreatment, PTUR) in removing canal filling from severely curved canals and to evaluate the possible adjunctive effects of XP-Endo Finisher (XPF), the Self-Adjusting File (SAF), and an erbium, chromium: yttrium, scandium, gallium garnet (Er,Cr:YSGG) laser using micro-computed tomography (μCT). Materials and Methods Sixty-six curved mandibular molars were divided into 2 groups based on the retreatment technique and then into 3 based on the supplementary method. The residual filling volumes and root canals were evaluated with μCT before and after retreatment, and after the supplementary steps. The data were statistically analyzed with the t-test, Mann-Whitney U test, analysis of covariance, and factorial analysis of variance (p < 0.05). Results PTUR and WOG showed no significant difference in removing filling materials (p > 0.05). The supplementary techniques were significantly more effective than reciprocating or rotary systems only (p < 0.01). The supplementary steps showed no significant differences in canal filling removal effectiveness (p > 0.05), but XPF showed less dentin reduction than the SAF and Er,Cr:YSGG laser (p < 0.01). Conclusions The supplementary methods significantly decreased the volume of residual filling materials. XPF caused minimal changes in root canal volume and might be preferred for retreatment in curved root canals. Supplementary approaches after retreatment procedures may improve root canal cleanliness.
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Affiliation(s)
- Gülsen Kiraz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Mert Ocak
- Department of Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Muhammet Bora Uzuner
- Department of Anatomy, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Hakan Hamdi Çelik
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Dos Reis-Prado AH, Abreu LG, de Arantes LC, Dos Santos de Paula K, de Castro Oliveira S, Goto J, Viana ACD, Benetti F. Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies. Clin Oral Investig 2023; 27:6291-6319. [PMID: 37704917 DOI: 10.1007/s00784-023-05243-4] [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: 09/15/2022] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This systematic review/meta-analysis investigated the influence of NaOCl on cyclic fatigue resistance of endodontic NiTi instruments. MATERIALS AND METHODS A systematic search until July 2022 in PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO, Cochrane Library, and grey literature was conducted. According to the PECOS strategy, only in vitro studies evaluating the effects of NaOCl on the cyclic fatigue resistance of NiTi instruments were eligible. Cyclic fatigue resistance was the primary outcome. A modified Joanna Briggs Institute's Checklist was used for risk of bias assessment. RESULTS Of the 2,445 records screened, 37 studies were included. Most studies used simulated canals made of stainless-steel block with severe to moderate curvatures. NaOCl concentration varied from 1-6%, mainly at 37 °C. Regarding fatigue resistance, 23 studies using 1.2% to 6% NaOCl showed a reduction in the resistance compared to the control groups, especially when pre-heated. Four meta-analyses were performed according to the tested NiTi systems. The meta-analyses indicated that the PTU F2 files had higher reduction of fatigue resistance after exposure to 5.25% NaOCl; no differences between NaOCl and no immersion were observed for Reciproc R25, WaveOne 25.08, and WaveOne Gold Primary files. Included studies had low risk of bias. CONCLUSION NaOCl appears to reduce cyclic fatigue resistance of certain NiTi files, especially when they are pre-heated, particularly in conventional NiTi files compared to some heat-treated instruments. It is possible that the temperature of the solution may have a greater influence on resistance than NaOCl itself. Important to note that an overall tendency toward no significant influence was observed among various systems. CLINICAL RELEVANCE Precautions are necessary when a pre-heated high-concentration NaOCl is used to enhance its properties during root canal preparation, mainly using conventional wire.
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Affiliation(s)
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lara Cancella de Arantes
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Kiani Dos Santos de Paula
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Hassan HY, Hadhoud FM, Mandorah A. Retreatment of XP-endo Shaper and R-Endo files in curved root canals. BMC Oral Health 2023; 23:38. [PMID: 36694152 PMCID: PMC9872356 DOI: 10.1186/s12903-023-02735-3] [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: 07/17/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To compare the retreatment efficiency of XP-endo Shaper and R-Endo files in curved root canals using ImageJ software. METHODS Forty extracted mandibular first molars with curved mesial canals (25°-35°) were chosen. Access cavities, preparation and obturation of root canals were performed. Roots were randomly distributed into two groups corresponding to the retreatment files used. Group 1 retreated with XP-endo Shaper file, and group 2 retreated with R-Endo files. Each root was sectioned and photographed. ImageJ software was used to estimate the percentage of residual filling material that existed on the three root canal segments. Mann-Whitney U and the Kruskal-Wallis tests were used to compare the percentages of residual filling material between the teeth segments (P < .05). RESULTS The R-Endo group showed a significantly higher median percentage of residual filling material than the XP-endo Shaper group. In both groups, the coronal segments had the highest median of the residual filling material, followed by the middle and apical segments. CONCLUSION XP-endo Shaper is significantly more effective than R-Endo in removing root canal filling materials in the coronal, middle, and apical segments.
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Affiliation(s)
- Hayam Y. Hassan
- grid.33003.330000 0000 9889 5690Endodontic Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - Fahd M. Hadhoud
- grid.411303.40000 0001 2155 6022Endodontic Department, Faculty of Dental Medicine Assiut Branch, Al-Azhar University, Assiut, Egypt ,grid.412895.30000 0004 0419 5255Restorative and Dental Materials Department, Faculty of Dentistry, Taif University, P.O Box 11099, Taif, 21944 Saudi Arabia
| | - Ayman Mandorah
- grid.412895.30000 0004 0419 5255Restorative and Dental Materials Department, Faculty of Dentistry, Taif University, P.O Box 11099, Taif, 21944 Saudi Arabia
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