Comparative Analysis of Canal Centering Ability of Different Single File Systems Using Cone Beam Computed Tomography- An In-Vitro Study

Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography

Aim

This study was planned to evaluate and compare the cleaning efficacy of three pediatric rotary files with the standard Protaper adult file system in primary teeth using cone-beam computed tomography (CBCT).

Materials and methods

A total of 40 extracted deciduous second molars, with palatal/mesial roots having at least two-thirds of root length and an intact furcation area, were distributed randomly among four groups, with each group containing 10 teeth. Canal preparation of group I (Pro AF Baby Gold), group II (Kedo SG Blue), group III (Prime Pedo), and group IV (Protaper) was done. Pre- and postoperative CBCT images were taken. The volumetric changes of the root canals were assessed and subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 16 and R Studio 3.1.1. Volumetric changes within the groups were analyzed using paired t-tests and between the groups using analysis of variance (ANOVA).

Results

The comparison of mean volume difference between groups using ANOVA was statistically significant with F = 4.467, p = 0.002. A Tukey post hoc test revealed that group IV was statistically significant compared with groups I (p = 0.033) and III (p = 0.008) but was not statistically significant with group II (p = 0.170). There was no statistically significant difference in volumetric changes within the three pediatric rotary file systems.

Conclusion

Protaper removed more dentin than all the pediatric rotary files, but it was not statistically significant over Kedo SG Blue. Among the pediatric rotary files, Kedo SG Blue removed more dentin than Pro AF Baby Gold and Prime Pedo, but they were not statistically significant.

How to cite this article

Nainer Chidambaram JV, Jayaprakash J, Arangannal P. Volumetric Analysis of Various Pediatric Rotary Files in the Preparation of Primary Root Canals Using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2024;17(1):15-20.

Canal Transportation and Volumetric Dentin Removal Abilities of Ni-Ti Rotary File Systems in Curved Primary Root Canals: CBCT Study

Current improvements in nickel-titanium (Ni-Ti) rotary file systems have created a paradigm shift in the root canal therapy of primary teeth. Therefore, it is necessary to perform a comprehensive evaluation regarding the efficiencies of newly manufactured instruments for different parameters. The current study was conducted to evaluate the abilities of RaceEvo, R-Motion, ProTaper Gold (PTG) systems in curved primary root canals with regard to the patterns of canal transportation and volumetric dentin removal by using cone-beam computed tomography (CBCT). Two experimental sets were designed following the determination of experimental groups by using pre- and post-operative CBCT data: canal transportation and volumetric dentin removal. The highest amount of canal transportation was significantly detected in the PTG group in comparison to RaceEvo and R-Motion groups. When the mean values of volumetric dentin removal data were analyzed across all groups, the PTG group again exhibited the significantly highest value of dentin removal volumetrically, compared to RaceEvo, R-Motion and manual instrumentation groups. It is possible to state that R-Motion and RaceEvo rotary systems could be used as reliable alternatives without causing adverse mechanical effects and maintaining the original root canal anatomy of curved primary root canal systems compared with PTG rotary systems and manual instrumentation, with a high diagnostic sensitivity of CBCT in pediatric endodontics when the alternative methods are not adequate.

Cone-Beam Computed Tomography Assessment of Canal-Centering Ability for Traditionally Used Nickel Titanium and Nickel Titanium Files with Reciprocating Hand Piece and Wave-One Files

Aim of the Study:

Need for our study was to evaluate a comparison between canal preparation ability of nickel–titanium (NiTi) hand files with step-back manual technique, of NiTi files installed on a reciprocating hand piece and of Wave-One files utilizing noninvasive cone-beam computed tomography (CBCT) technique.

Materials and Methods:

Thirty extracted intact single-rooted human mandibular premolars were used in the study, segregated in three sets of 10 specimens each, where canal instrumentation was done by different methods using NiTi in step-back technique, using reciprocating hand piece with NiTi files and using primary file with the use of Wave-One reciprocating system. Later, evaluation of centering ability was conducted using the references through CBCT images.

Results:

Hand NiTi files showed even less canal centering ability as compared to other two sets. Mesiodistal diameter at 9 mm length of the prepared canal was 1.06 and later was 0.98, which shows excessive preparation in case of Set I versus Set II. In case of comparison between Set III and Set I, mesiodistal diameter at 9 mm length of the prepared canal was 0.99, and later was 1.06, depicting better canal shaping ability with Wave-One file.

Conclusion:

The use of hand NiTi files installed on a reciprocating hand piece would be economically beneficial producing the similar results as that of wave one without any deviation from the original canal anatomy.

Cone-beam computed tomographic analysis of apical transportation and centering ratio of ProTaper and XP-endo Shaper NiTi rotary systems in curved canals: an in vitro study

Background

Cleaning and shaping of the root canal system is an important step of endodontic treatment. Canal transportation is a common procedural error in preparation of curved canals. This study aimed to compare the canal transportation and centering ratio of two rotary files in curved canals using cone-beam computed tomography (CBCT).

Methods

Forty-four extracted human mandibular first molars with mature apices and 10° to 30° apical curvature were selected. The samples were randomly divided into two groups (n = 22) with similar curvature. The canals were prepared with ProTaper and XP-endo Shaper file systems according to the manufacturers’ instructions. The CBCT images were obtained using Cranex 3D CBCT scanner before and after root canal preparation, and canal transportation and centering ratio of the files at 3, 4 and 5 mm levels from the apex were calculated. Data were compared between the two groups using independent t-test at 0.05 level of significance.

Results

The ProTaper Universal caused greater canal transportation and had lower centering ratio than XP-endo Shaper in both mesiodistal and buccolingual directions at all levels from the apex. The difference between the two groups regarding canal transportation was significant at all levels from the apex in buccolingual direction (P < 0.05) except for 3 mm from the apex (P > 0.05). The difference between the two groups regarding centering ratio was not significant (P > 0.05) in mesiodistal direction at all levels except for 4 mm from the apex (P < 0.05).

Conclusion

The ProTaper Universal causes greater canal transportation in both buccolingual and mesiodistal directions than XP-endo Shaper.

Root canal curvature as a prognostic factor influencing the diagnostic accuracy of radiographic working length determination and postoperative canal axis modification: an in vitro comparative study

Background

Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique.

Methods

Radiographic image analysis was performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10°–25°) and severe canal curvature (26°–70°). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real canal length was determined by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland).

Results

There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P > 0.05).

Conclusions

A standardized digital periapical radiographic method performed similarly to the CBCT technique near to its true working length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.

Estimation Accuracy of Root Canal Curvatures from Different Dental Diagnostic Imaging Techniques: An In Vitro Experimental Study

In clinical endodontics, preoperative estimation of root canal curvature is crucial regarding the prevention of iatrogenic errors. Reproduction of the two-dimensional radiographic images causes certain proximal view curvatures not seen. Therefore, the present study is aimed at investigating the degree of root canal curvature identified in different radiographic views. A total of 60 human permanent single-rooted teeth with varying degrees of curvature were selected. The root canal curvature for each tooth was measured on cone-beam computed tomography (CBCT) images (clinical view), standard digital periapical view (0° angle), digital periapical horizontal parallax view (30° angle), and digital periapical proximal view (0° angle), by using the Schneider method. No statistically significant difference was found in the degree of curvatures estimated on CBCT images and standard digital periapical view (0° angle) in the same tooth. The results revealed a significant difference between the proximal view and the other three groups (p < 0.05). There was no significant difference in this respect between the horizontal parallax view (30° angle), clinical view (CBCT images), and standard digital periapical view (p > 0.05). Proximal view curvatures cannot be predicted or estimated only from examining a clinical view radiograph. A horizontal parallax view (30° angle) is highly recommended as specific guidelines on how to estimate root canal curvature in case difficulty assessment protocols.

Preoperative Estimation of Endodontic Working Length with Cone-Beam Computed Tomography and Standardized Paralleling Technique in comparison to Its Real Length

An accurate estimation of the working canal length is essential for successful root canal treatment. This study is aimed at investigating the diagnostic accuracy of root canal length estimation on cone-beam computed tomography (CBCT) scans and digital paralleling radiographs (PAs), using the real canal length as a gold standard, and at evaluating the influence of canal curvature on this estimation. Sixty extracted human premolar teeth were selected for this study. Root canal length measurement was performed on CBCT scans (NewTom, Giano, Verona, Italy) and digital paralleling radiography (EzRay Air W; Vatech, Korea). The real working length was established by subtracting 0.5 mm from the actual canal length. No significant difference was found between CBCT and digital paralleling radiography. There was a tendency for underestimation of the root canal length measured on the CBCT images in 52 (86.7%) of the examined teeth and overestimation in 5 teeth (8.3%). All the digital radiographs slightly overestimated the real canal length. The analysis revealed a strong correlation between the estimation from moderate to severe curvature for digital radiography and CBCT images. Preoperative working length estimation can be made closest to its real clinical canal length on the standardized paralleling technique, using a long (16-inch) target-receptor distance.

A micro-CT evaluation of the performance of rotary and reciprocating single-file systems in shaping ability of curved root canals

To compare the shaping ability of different single-file systems in the preparation of mesial curved canals of mandibular molars using micro-CT technology. Fifteen mesial roots of mandibular molars with two independent and curved canals (n = 30) were selected, scanned at a resolution of 26.7 μm anatomically matched, and distributed into three groups (n = 10), according to the preparation system: WaveOne 25.08, Reciproc 25.08, and OneShape 25.06. A final micro-CT scanning was performed, data sets were registered with their respective counterparts, and compared regarding the three-dimensional (volume, surface area, and structure model index - SMI) and two-dimensional (perimeter, area, roundness, major and minor diameters) parameters, as well as, canal transportation, using ANOVA and post hoc Tukey tests (α = 5%). Overall, no difference was observed between groups regarding area, perimeter, volume, surface area, and canal transportation (p > 0.05). Within group, no canal transportation was significantly higherobserved in the apical third (0.10 ± 0.05 mm) compared to coronal (0.08±0.040 mm) and middle (0.07 ± 0.03 mm) thirds (p < 0.05). Structure model index (SMI) was statistically higher after preparation with OneShape instrument (0.36 ± 0.26) compared to other systems (p < 0.05). Within the parameters of this study, similar shaping ability was observed in the preparation of mesial curved root canals of mandibular molars with Reciproc, OneShape and WaveOne systems.

Comparison of Shaping Ability of Different Single-File Systems Using Microcomputed Tomography

OBJECTIVES

 To evaluate the shaping ability of four different single-file systems using micro-computed tomography (micro-CT).

MATERIALS AND METHODS

 Eighty mesiobuccal and mesiolingual canals of permanent mandibular molars were randomly assigned to four groups according to the file used; WaveOne Gold, RECIPROC Blue, HyFlex EDM, and One Shape (n = 20). The samples were scanned using micro-CT for the preinstrumentation record; then the canals were instrumented and scanned for the postinstrumentation records.

STATISTICAL ANALYSIS

 The data were then analyzed statistically using one-way analysis of variance (ANOVA) with the level of significance set at α = 0.05.

RESULTS

 The results of canal centering ratio and canal transportation showed that no significant difference was found among the four file groups at the middle and the coronal levels. However, a significant difference was found at the apical level (p < 0.05), where WaveOne Gold showed the best centering ratio and the least amount of canal transportation. The change in the canal volume was significant at the coronal level (p < 0.05), whereas the change in the canal volume was higher for the HyFlex EDM group than the other groups. No significant difference was found between the other groups at the apical level, middle level, or in the total percentage of canal volume.

CONCLUSION

 WaveOne Gold produced a more centralized canal preparation with a lesser amount of transportation at the apical level. HyFlex EDM showed the highest canal volumetric change at the coronal level. The interim design of the endodontic files has a high impact on the behavior of the file inside the root canal.

Comparative Assessment of Canal Transportation and Centering Ability of Reciproc and One Shape File Systems Using CBCT-An In Vitro Study

INTRODUCTION

Root canal preparation leads to deviation of the canal anatomy causing canal transportation which affects the success of the treatment. Cone Beam Computed Tomography (CBCT) is a non invasive imaging technique to analyse the shape of the root canal before and after the preparation.

AIM

The purpose of this study was to investigate and evaluate the canal transportation in curved mandibular molar root canals and centering ability of Reciproc and One Shape file systems after instrumentation using CBCT.

MATERIALS AND METHODS

Twenty mandibular molars were taken and allocated into two groups (n=10): Group 1-One Shape and Group 2-Reciproc. The canals were then scanned using CS 3D CBCT scanner (Carestream) before and after preparation, to assess the transportation and centering values at different levels respectively from the apex. The data gathered were then assessed statistically with Mann-Whitney test.

RESULTS

Analysis revealed that Reciproc and One Shape showed statistically no significant difference in terms of canal transportation and centering ability (p>0.05).

CONCLUSION

One shape and Reciproc performed similar in terms of canal transportation & centering ability.

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems

Introduction:

The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT).

Methods and Materials:

A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups (n=13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey’s post hoc tests were used for two-by-two comparisons.

Results:

Gates-Glidden drills with hand files removed significantly more (P<0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems (P>0.05).

Conclusion:

The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls.