CBCT-based assessment of root canal treatment using micro-CT reference images

The Impact of Coronal Flaring Files on Pericervical Dentin Thickness in Mandibular Molars

INTRODUCTION

This study aimed to assess the influence of different coronal flaring files on dentin removal in mandibular teeth using cone-beam computed tomographic (CBCT) images.

METHODS

CBCT images of 48 mandibular molar teeth were acquired and randomly divided into 2 main groups, with each main group further divided into 3 subgroups. In the first main group, root canal preparation was performed using TruNatomy (Dentsply Sirona, Ballaigues, Switzerland), ProTaper Gold (Dentsply Sirona), and One Curve (Micro-Mega, Besancon, France) files without the use of coronal flaring files. In the second main group, root canal preparation was performed using the same files with the use of coronal flaring files. After the completion of root canal preparation, a second set of CBCT images was obtained. Subsequently, the dentin removal and remaining critical dentin were assessed by measuring at 4 distinct points below the furcation level. Data were compared between groups using the Mann-Whitney U and Kruskal-Wallis tests with alpha set at 5%.

RESULTS

The ProTaper Gold files demonstrated higher dentin removal compared with the TruNatomy files. In the no-flaring groups, the One Curve files exhibited greater dentin removal than the TruNatomy files at specific levels. The use of coronal flaring files generally did not significantly impact dentin removal, except for certain cases in the TruNatomy and ProTaper Gold groups.

CONCLUSIONS

The TruNatomy instrument group was more effective in preserving pericervical dentin compared with the other instrument groups. Coronal flaring files can be confidently used to preserve critical dentin during root canal treatment.