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Machado R, Moreira G, Comparin D, Barroso AP, Nascimento J, Ferraz CCR, Ignácio SA, da Fonseca Roberti Garcia L, Amaral RR, Shadid D, da Silva Neto UX. Postoperative pain after single-visit root canal treatments in necrotic teeth comparing instruments' kinematics and apical instrumentation limits - a prospective randomized multicenter clinical trial. BMC Oral Health 2024; 24:481. [PMID: 38643087 PMCID: PMC11032596 DOI: 10.1186/s12903-024-04225-6] [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: 12/28/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
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Affiliation(s)
- Ricardo Machado
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA.
| | - Guilherme Moreira
- Clinical Practice Limited to Endodontics, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Clinical Practice Limited to Endodontics, Cunha Porã and Francisco Beltrão, Paraná, Brazil
| | - Arthur Pimentel Barroso
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Jaqueline Nascimento
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Caio Cézar Randi Ferraz
- Piracicaba Dental School, Department of Restorative Dentistry, Division of Endodontics, State University of Campinas - FOP/UNICAMP, Piracicaba, São Paulo, Brazil
| | - Sérgio Aparecido Ignácio
- School of Dentistry, Department of Statistics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry, Division of Endodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | - David Shadid
- College of Dentistry, Department of Restorative Sciences, Division of Endodontics, Health Sciences Center, University of Oklahoma - COD/OUHSC, Oklahoma City, Oklahoma, USA
| | - Ulisses Xavier da Silva Neto
- School of Dentistry, Department of Endodontics, Pontifical Catholic University of Paraná - PUC/PR, Curitiba, Paraná, Brazil
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Yavaş E, Yekeler A, İlgen S, Uzunoğlu Özyürek E. In vitro assessment of the roles of initial preparation size and solvent application on apically extruded debris in endodontically treated teeth. J Dent Res Dent Clin Dent Prospects 2023; 17:250-255. [PMID: 38584998 PMCID: PMC10998170 DOI: 10.34172/joddd.2023.40665] [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: 09/15/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024] Open
Abstract
Background This study investigated the effects of solvent use and initial canal enlargement size on apically extruded debris (AED). Methods The palatal roots of 60 upper molars were assigned to two groups based on the initial preparation size: F3 or F4 ProTaper Universal files. The roots were obturated using the single-cone technique. Each group was subdivided based on the retreatment procedures: with or without solvent. After evaporation, the Eppendorf tubes were weighed using an electronic balance. The data were statistically analyzed (P=0.05). Results Using a solvent enhanced the amount of AED in samples initially prepared up to F3 or F4 files (P<0.05). When the solvent was used, the AED was greater in samples initially prepared up to the F4 file (P<0.05); however, when the solvent was omitted, the results were reversed (P<0.05). Conclusion Both parameters had a role in AED. Solvents should be used cautiously during root canal retreatment because of the potential for apical extrusion of filling materials. Using files with smaller tapers during initial preparation might be beneficial when considering the amount of AED compared to those with larger tapers.
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Affiliation(s)
| | | | | | - Emel Uzunoğlu Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Nouroloyouni A, Shahi S, Salem Milani A, Noorolouny S, Farhang R, Yousefi Azar A. In vitro apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc and Reciproc Blue instruments and a novel stainless steel rotary system (Gentlefile) versus manual instrumentation. J Dent Res Dent Clin Dent Prospects 2023; 17:136-141. [PMID: 38023797 PMCID: PMC10676536 DOI: 10.34172/joddd.2023.39271] [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: 04/13/2023] [Accepted: 09/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study compared apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc, Reciproc Blue, and Gentlefile (GF) rotary instruments versus the manual step-back technique. Methods This in vitro study was conducted on 80 extracted mandibular premolars with mature apices and a root curvature of<10°. The teeth were randomly assigned to 4 groups (n=20), standardized regarding working length, and placed in pre-weighed vials. The root canals were instrumented with Reciproc, Reciproc Blue, and GF systems and the manual step-back technique in the four groups. The vials containing the collected debris were then dried and weighed. The instrumentation time was also recorded for each group. Data were analyzed with one-way ANOVA and post hoc Games-Howell test (α=0.05). Results Minimum apical debris extrusion was noted in Reciproc, followed by Reciproc Blue, GF, and manual technique (P<0.05). Pairwise comparisons showed significantly lower apical extrusion of debris in the Reciproc compared with GF (P=0.015) and manual instrumentation (P=0.011) groups. The Reciproc system also had the shortest instrumentation time, followed by Reciproc Blue, GF, and manual instrumentation (P<0.05). Pairwise comparisons showed significant differences between all the systems (P<0.05) except between Reciproc and Reciproc Blue (P>0.05) in this respect. Conclusion Although all systems caused apical extrusion of debris, manual instrumentation caused maximum extrusion of debris. In contrast, the Reciproc system was superior to others regarding minimal apical extrusion of debris and the shortest instrumentation time.
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Affiliation(s)
- Ahmad Nouroloyouni
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Shahriar Shahi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Amin Salem Milani
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Sara Noorolouny
- Department of Pediatric Dentistry, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Robab Farhang
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Aysan Yousefi Azar
- Department of Endodontics, Faculty of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
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Kurt Ö, Zengin T, Üstün Y. Comparison of the effect of different glide path files on amount of apically extruded debris in curved root canals. AUST ENDOD J 2023; 49 Suppl 1:359-365. [PMID: 36946545 DOI: 10.1111/aej.12749] [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: 08/01/2022] [Revised: 01/30/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
It is essential to create a glide path before root canal preparation with nickel-titanium rotary files to avoid file breakage and preserve the original canal structure. The aim of this study was to compare the amount of apically extruded debris after using different glide path files. A total of 96 first mandibular molars with curved mesial roots were randomly divided into six groups (n = 16) which are K-files, Proglider, R-Pilot, TruNatomy Glider, WaveOne Gold Glider and group without a glide path. Apically extruded debris was measured after glide path and canal preparation. The highest amount of debris was found in the control group without a glide path and using a glide path file caused less debris and significant differences were observed between R-Pilot, TruNatomy Glider, ProGlider, WaveOne Gold Glider and K-file groups. It may be recommended to create a glide path before root canal shaping to reduce the amount of extrusion debris from the apical. Especially in curved and narrow root canals, it is recommended to use an R-Pilot file before root canal shaping in order to reduce the amount of apically extruded debris.
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Affiliation(s)
- Özge Kurt
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Talip Zengin
- Department of Molecular Biology and Genetics, Muğla Sitki Koçman University, Muğla, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Abduljalil M, Andac G, Basmaci F. 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 1:308-314. [PMID: 36571483 DOI: 10.1111/aej.12734] [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: 02/01/2022] [Revised: 07/18/2022] [Accepted: 12/18/2022] [Indexed: 12/27/2022]
Abstract
This study aimed to evaluate the amount of apically extruded debris caused by different NiTi files. One hundred mandibular premolars were included in this study. The specimens were divided into five groups (n = 20): (i) TruNatomy, (ii) WaveOne Gold, (iii) 2Shape, (iv) ProTaper Next and (v) Reciproc Blue. The extruded debris was collected into preweighed Eppendorf tubes. These tubes were weighed again, and the net weight of debris was calculated. Data were statistically analysed, and the significance level was set at 5%. The least amount of extruded debris was observed in the TruNatomy group (p < 0.05). Statistically significant differences were not found among (iii), (iv) and (v) groups (p > 0.05). However, these groups resulted in significantly higher amounts of debris when compared to (i) and (ii) groups (p < 0.05). The results lead us to conclude that all instrumentation systems caused apical extrusion of debris at varying weights.
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Affiliation(s)
- Mohamad Abduljalil
- Department of Endodontics, Faculty of Dentistry, European University of Lefke, Mersin 10, Turkey
| | - Gizem Andac
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
| | - Fatma Basmaci
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin 10, Turkey
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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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Quantitative Assessment of Apically Extruded Debris after Single-Files Supplemental Retreatment considering Apical Patency Influence: In Vitro Study. Int J Biomater 2022; 2022:7544813. [PMID: 36589768 PMCID: PMC9797296 DOI: 10.1155/2022/7544813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study aims to assess the impact of re-establishing apical patency on the quantity of debris extruded through the apex after three supplementary retreatment files (TruNatomy (TRN), WaveOne Gold (WOG), and XP endo Finisher R (XPFR)). Materials and Methods Eighty single-rooted mandibular premolars were prepared with ProTaper Universal rotary systems (PTU) up to F3 and obturated. The samples were divided into two main groups according to the presence or absence of the apical patency (n = 40), GI with apical patency and GII without apical patency. Based on the file system, which was adopted to eliminate the previous filling, each group had four subgroups (n = 10). In GI PTUR and GII PTUR, ProTaper Universal retreatment files (PTUR) were utilized only to remove the most primary filling material (control groups). In the other groups (PTUR) used, it was first followed by supplementary files. The quantity of debris extruded by different retreatment file systems was determined and compared to the corresponding control group with or without apical patency. Data were analyzed using a two-way ANOVA with a post hoc Tukey's multiple comparison test at a 5% significance level. Results There was a statistically significant difference among the control and experimental groups. XPFR had the least quantity of extruded debris. Apical patency did not affect the debris extrusion. Conclusion All tested files led to a significant apical debris extrusion regardless of apical patency.
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Uygun AD. Comparison of apical debris extrusion of different generation nickel-titanium instrument systems. Niger J Clin Pract 2022; 25:2010-2015. [PMID: 36537459 DOI: 10.4103/njcp.njcp_455_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM The aim of this study is to evaluate the apical debris extrusion amounts and preparation times of four different nickel-titanium systems with a similar cross-section design-Mtwo, RECIPROC, RECIPROC blue, and VDW.ROTATE. MATERIALS AND METHODS Eighty human mandibular central incisors were divided into four equal groups (n = 20). The test apparatus was inserted into an assembly that provided root canal temperature. Preparation times were recorded using a stopwatch, and the amount of extruded debris was collected in pre-weighed Eppendorf tubes. After drying, the net amount was determined by subtracting the previously measured Eppendorf tube weights from the total weight. RESULTS The Mtwo had the largest amount of debris, but there was no significant difference among the other groups. The VDW.ROTATE completed the preparation in a significantly shorter time than the RECIPROC blue and Mtwo. CONCLUSION Compared to other files, the Mtwo sequence produced significantly more debris and required significantly more time to complete the whole root canal preparation.
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Affiliation(s)
- A D Uygun
- Department of Endodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Mohammadi D, Mehran M, Frankenberger R, BabeveyNejad N, Banakar M, Haghgoo R. Comparison of apical debris extrusion during root canal preparation in primary molars using different file systems: an in vitro study. AUST ENDOD J 2022; 48:473-480. [PMID: 34751479 DOI: 10.1111/aej.12582] [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: 03/25/2021] [Revised: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to compare the amount of debris extrusion of four endodontic systems made of Nickle-Titanium alloy. This in vitro study was done on 80 extracted primary molars. They were selected by cone-beam computed tomography and randomly divided into four groups (n = 20) to be prepared to the apical size of 25 by one of the systems: Reciproc, Protaper Universal, Neolix, or Hyflex CM. Debris was collected into Eppendorf microtubes and placed in an incubator to evaporate the washing solution. Debris was weighed by a digital scale of 0.01 g precision. Data were statistically analysed using SPSS software. Tukey's comparison was used to determine the difference between the four file systems (α = 0.05). Debris extrusion after Reciproc preparation (0.00320) was significantly higher than the other (P < 0.05), with no significant difference having been observed among the other systems (P > 0.05). It can be concluded that all systems under investigation exhibited debris extrusion.
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Affiliation(s)
- Davood Mohammadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Ilam Medical University, Ilam, Iran
| | - Majid Mehran
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontics, Dental School, University of Marburg and University Medical Center Giessen and Marburg, Marburg, Germany
| | - Newsha BabeveyNejad
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Morteza Banakar
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
| | - Roza Haghgoo
- Department of Pediatric Dentistry, Faculty of Dentistry, Shahed University, Tehran, Iran
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Update in the Diagnosis and Treatment of Root Canal Therapy in Temporary Dentition through Different Rotatory Systems: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12112775. [PMID: 36428835 PMCID: PMC9689064 DOI: 10.3390/diagnostics12112775] [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: 10/24/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/15/2022] Open
Abstract
The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to obtain good results in less working time. The objective of this study is to compare the characteristics of the different current rotary systems to favor a correct diagnosis and subsequent treatment. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was carried out in PubMed, Embase Scopus, Cochrane and Web of Science databases, and was completed with a manual search. The following variables were extracted from the selected studies: author, year, sample, rotary systems used (length, diameter, taper, speed), obturation material and irrigant. From the initial electronic search of the five databases, 315 articles were identified. Once the duplicate articles were eliminated, a total of 233 remained. After reading both title and abstract, 200 articles were eliminated, leaving 33. On account of reading the full text, 22 were eliminated for not answering the research question or the inclusion criteria, leaving a total of 11 articles for the systematic review. Rotary systems which are able to adapt to the root anatomy of primary teeth and allow rapid and simple instrumentation, without producing excessive extrusion of debris at the root apex, will be the ones that provide the best results to the pediatric dentist during the performance of pulp treatment in primary teeth. Clinical success will only be achieved through proper prior diagnosis.
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11
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ZAN R, LENGER B. COMPARATIVE EVALUATION OF THE EFFECT OF DIFFERENT ROTARY INSTRUMENT SYSTEMS ON THE AMOUNT OF APICALLY EXTRUDED DEBRIS. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1128769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: The purpose of our study is to examine in vitro the amount of debris extrusion from the apical after root canal preparation with different rotary instruments.
Materials and Methods: In present study, 60 single root single-canal lower premolar human teeth were used. The teeth were randomly selected and divided into 4 main groups (n=15). Root canals are shaped by using 2Shape, One Curve and XP-3DEndo Shaper working in rotational motion and WaveOne Gold working reciprocal motion. Later, the weight of each eppendorf tube was weighed on a precision scale and the amount of debris extrusion from the apical was determined with 10ˉ4 precision by subtracting the empty weight of the tube. Since the parametric test assumptions were fulfilled in the evaluation of the data obtained regarding the amount of debris extrusion from the apical of file systems by loading them into the SPSS 22.0 program, One-Way Variance analysis was used and the level of error was taken as 0.05.
Results: When the amount of debris extrusion from the apical is ordered from high to low, it was seen that there are 2Shape, One Curve, XP-Endo Shaper, WaveOne Gold. However, the difference between study groups was not statistically significant (p> 0.05).
Conclusions: Considering the results obtained in terms of debris extrusion from the apical about the new generation files with different metallurgy, kinematics, structural features, designs and different configurations that we used ın present study, it was seen that these systems would not show any difference in terms of the effect of debris on the success of endodontic treatment.
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Affiliation(s)
- Recai ZAN
- SIVAS CUMHURIYET UNIVERSITY, FACULTY OF DENTISTRY
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Di Spirito F, Scelza G, Fornara R, Giordano F, Rosa D, Amato A. Post-Operative Endodontic Pain Management: An Overview of Systematic Reviews on Post-Operatively Administered Oral Medications and Integrated Evidence-Based Clinical Recommendations. Healthcare (Basel) 2022; 10:healthcare10050760. [PMID: 35627897 PMCID: PMC9141195 DOI: 10.3390/healthcare10050760] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 01/08/2023] Open
Abstract
Endodontic treatment comprises the overall management of pre-, intra- and post-operative symptoms, including post-operative endodontic pain, considered as a complication susceptible of chronicization. Post-operative pain is very common and highly unpreventable and has a multi-factorial etiology and a potential pathogenic link to the acute inflammation of the periapical area, secondary to localized chemical, mechanical, host and/or microbial damage occurring during endodontic treatment. Considering the multitude of heterogeneous technical and pharmacological approaches proposed to control post-operative endodontic pain, the present study primarily comprised an overview of systematic reviews of systematic reviews of randomized clinical trials, summarizing findings on post-operatively administered oral medications for post-operative endodontic pain control, in order to note the most effective type and dosage of such drugs. Secondarily, a narrative review of the current evidence on technical solutions to be observed during endodontic treatment procedures, to control post-operative pain, was conducted to provide integrated evidence-based clinical recommendations for optimal post-operative endodontic pain management.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
- Correspondence: or
| | - Giuseppe Scelza
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | | | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | - Donato Rosa
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
| | - Alessandra Amato
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Baronissi, 84081 Salerno, Italy; (G.S.); (F.G.); (D.R.); (A.A.)
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13
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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14
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Gurawa A, Mohana P, Abraham D, Gupta A, Chauhan P, Singh A, Jala S. Quantitative evaluation of apically extruded debris during root canal preparation with reciprocating single file system, continuous rotary multiple file system and manual technique: An in vitro study. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_167_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Wang LX, Chen H, Lin RT, Gu LS. Influence of pecking frequency at working length on the volume of apically extruded debris: A micro-computed tomography analysis. J Dent Sci 2021; 17:1274-1280. [PMID: 35784137 PMCID: PMC9236894 DOI: 10.1016/j.jds.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background/purpose There is no consensus to date on how many repetitive pecking motions at working length (WL) should be regarded as optimal during instrumentation. Therefore, this study aimed to evaluate the effect of pecking frequency at WL on the volume of apically extruded debris using three single-file systems in curved, oval-shaped canals. Materials and methods Forty-five single-rooted mandibular premolars with curved, oval-shaped canals were prescanned by micro-computed tomography, anatomically paired-matched, and randomly divided among three groups (n = 15 each): Reciproc Blue (RB), WaveOne Gold (WOG) and XP-endo Shaper (XPS). Samples were embedded in agarose gel to collect extruded debris. After preparation to the WL, each sample was rescanned after one, two, four, 10, and 20 pecking motions at WL, respectively. The debris volume was innovatively calculated by a modification of an existing method using micro-computed tomography. The apical preparation size was also measured. Data were compared using a two-way repeated-measures analysis of variance. Results All single-file systems extruded debris apically, irrespective of the pecking frequency at WL. The extruded debris volume correlated positively with the minor foramen size (P < 0.05); both increased with pecking frequency for each single-file system (P < 0.05). The minor foramen size corresponded to the instrument tip size when reaching the WL once. Conclusion To produce less debris extrusion and obtain a predictable foramen size corresponding to the instrument tip size, a single pecking motion may be preferred when using single-file systems. Caution should be exercised when applying the current results to clinical situations.
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Affiliation(s)
- Li-Xiao Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rui-Tian Lin
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Li-Sha Gu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Corresponding author. Hospital of Stomatology, Sun Yat-sen University, No. 56, Lingyuan West Road, Guangzhou, Guangdong, 510055, China. Fax: +86 20 83822807.
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Souza MA, Bonacina LV, Trento A, Bonfante FDC, Porsch HF, Ricci R, Lago BLT, Lago CTR, Gabrielli ES, Bervian J, Farina AP, Cecchin D. Influence of the apical limit of instrumentation and photodynamic therapy on the postoperative pain of lower molars with asymptomatic apical periodontitis. Photodiagnosis Photodyn Ther 2021; 36:102489. [PMID: 34416381 DOI: 10.1016/j.pdpdt.2021.102489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/29/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of present study was to evaluate the influence of apical limit of instrumentation and PDT on the postoperative pain of lower molars with asymptomatic apical periodontitis. METHODS Forty patients were included in the present study and were divided into 4 groups (n=10), according to apical limit of instrumentation and use of PDT: instrumentation at 0.0 measurement; instrumentation at 0.0 measurement+PDT; instrumentation 1mm beyond 0.0 measurement; instrumentation 1mm beyond 0.0 measurement+PDT. In the PDT, the root canals were filled with 0.01% methylene blue, remaining for 5 min. The low-intensity laser was used with 100 mW, 660-690 nm wavelength), using intra-canal fibre. Root canals were irradiated for 90 s, delivering total dose of 9 J and energy density of 320 J/cm2. After root canal preparation and PDT protocols, root canals were filled with gutta-percha and AH Plus endodontic sealer, being sealed with composite resin.The evaluation of postoperative pain was performed by visual analog scale after 24, 48, 72 hours and 7 days. Data were analysed by specific statistical tests, at level of 5%. RESULTS No statistical significant difference was observed among experimental groups in all evaluation periods, as well as in the intragroup analysis over time, regarding postoperative pain and analgesic medication consumption (p>0.05). CONCLUSIONS Apical limit of instrumentation and PDT have no influence on the postoperative pain of lower molars with asymptomatic apical periodontitis.
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Affiliation(s)
| | | | - Alexia Trento
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | | | - Rafaela Ricci
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | | | | | - Juliane Bervian
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Ana Paula Farina
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Doglas Cecchin
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
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Yılmaz Çırakoglu N, Özbay Y. Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. J Dent Res Dent Clin Dent Prospects 2021; 15:30-34. [PMID: 33927838 PMCID: PMC8058151 DOI: 10.34172/joddd.2021.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/01/2020] [Indexed: 11/09/2022] Open
Abstract
Background. This research aimed to investigate and compare the amount of apically extruded debris after root canal preparation using ProTaper Next, ProTaper Gold, and TruNatomy systems. Methods. Forty-five extracted mandibular premolar teeth with single canals with similar lengths were used. The root canals were prepared using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer, Ballaigues, Switzerland), or TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) files. Apically extruded debris during preparation was gathered into preweighed Eppendorf tubes. Then the Eppendorf tubes were incubated at 70°C for five days. The Eppendorf tubes were weighed again to determine their final weight plus the extruded debris. Results. The TRN system resulted in significantly less debris extrusion than the PTN system (P <0.05). There was no significant difference between the PTN and PTG groups and between the PTG and TRN groups (P >0.05). Conclusion. All the instrumentation systems caused apical extrusion of debris. However, the TRN system resulted in significantly less debris extrusion than the other systems.
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Affiliation(s)
| | - Yağız Özbay
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
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18
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Serefoglu B, Kandemir Demirci G, Miçooğulları Kurt S, Kaşıkçı Bilgi İ, Çalışkan MK. Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment. Restor Dent Endod 2021; 46:e5. [PMID: 33680894 PMCID: PMC7906842 DOI: 10.5395/rde.2021.46.e5] [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: 03/09/2020] [Revised: 05/03/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated. Materials and Methods Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level. Results Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05). Conclusions All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.
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Affiliation(s)
- Burcu Serefoglu
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
| | | | | | | | - Mehmet Kemal Çalışkan
- Department of Endodontics, Faculty of Dentistry, Ege University, Bornova, İzmir, Turkey
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Predin Djuric N, Van Der Vyver P, Vorster M, Vally ZI. Comparison of apical debris extrusion using clockwise and counter-clockwise single-file reciprocation of rotary and reciprocating systems. AUST ENDOD J 2021; 47:394-400. [PMID: 33638593 DOI: 10.1111/aej.12490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
The aim was to evaluate apical debris extrusion produced by a single-file system used in counter-clockwise reciprocation and compare it to rotary single-file systems used in clockwise rotation and clockwise reciprocation. A total of 100 first mandibular molars were divided into five groups (n = 20): (i) WaveOne Gold Glider and Primary instrument in counter-clockwise reciprocation; (ii) One G and One Curve file in clockwise rotation; (iii) One G and One Curve file in clockwise reciprocation; (iv) TruNatomy Glider and Prime instrument in clockwise rotation; and (v) TruNatomy Glider and Prime instrument in clockwise reciprocation. Apical debris extruded was measured after glide path preparation and canal preparation. WaveOne Gold displayed significantly higher amounts of apical debris extrusion in all the groups (P < 0.05). The lowest mean values were recorded by clockwise reciprocation groups: TruNatomy Glider, One Curve and TruNatomy Glider and Prime combined value, for glide path, canal preparation and combined mean values, respectively.
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Affiliation(s)
- Natasa Predin Djuric
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Peet Van Der Vyver
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Martin Vorster
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
| | - Zunaid Ismail Vally
- Department of Odontology, Faculty of Health Sciences, School of Dentistry, Oral and Dental Hospital, University of Pretoria, Pretoria, Gauteng, South Africa
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20
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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.
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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
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21
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Yalniz H, Koohnavard M, Oncu A, Celikten B, Orhan AI, Orhan K. Comparative evaluation of dentin volume removal and centralization of the root canal after shaping with the ProTaper Universal, ProTaper Gold, and One-Curve instruments using micro-CT. J Dent Res Dent Clin Dent Prospects 2021; 15:47-52. [PMID: 33927841 PMCID: PMC8058162 DOI: 10.34172/joddd.2021.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022] Open
Abstract
Background. The main goal of our study was to assess the volume of dentin removed and transportation in root canals using ProTaper Universal (PTU), ProTaper Gold (PTG) and One-Curve (OC). Ni-Ti rotary instruments in extracted human teeth using by micro-CT. Methods: Thirty human upper 1st premolar teeth with two separate root canals and sturdy, mature root tips were used in the present study. Specimens were decoronated and root length was standardized for micro CT scanning before root canal preparation done. The teeth were randomly separated into three categories (n = 10) according to the rotary NiTi system used for canal instrumentation, i.e., PTU (Dentsply, Maillefer), PTG (Dentsply, Maillefer), and OC (Micro-Mega SA). After root canal preparation, samples were scanned again on micro-CT by the same scanning parameters. Surface area, canal volume, structure model index (SMI), percentage of uninstrumented area and transportation parameters were obtained for each sample before and after micro-CT analyse. Results: No significant differences between the PTG and PTU in terms of the total volume of removed dentin, surface area and percentage of uninstrumented areas were found. However, regarding to parameters above, OC showed a lower efficacy than PTG and PTU in coronal section. Regarding canal transportation, PTG and OC showed lower mean transportation values at all levels. Conclusion: This paper demonstrated the root canal shaping abilities of the PTU, PTG, and OC NiTi file systems. The PTG and OC systems were associated less canal transportation and a better ability to preserve dentinal walls than PTU. There was no significance different between all rotary file systems for SMI values however, PTU and PTG showed greater canal volume and surface area change than OC file systems in coronal section.
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Affiliation(s)
- Hatice Yalniz
- Bezmialem Vakif University, Faculty of Dentistry, Department of Endodontics, Istanbul, Turkey
| | - Mehrdad Koohnavard
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Aysenur Oncu
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Berkan Celikten
- Ankara University, Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Ayse Isil Orhan
- Ankara Yildirim Beyazit University, Department of Pediatric Dentistry, Ankara, Turkey
| | - Kaan Orhan
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
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Hazar E, Özdemir O, Koçak M, Sağlam B, Koçak S. Apical debris extrusion of single-file systems in curved canals. ENDODONTOLOGY 2021. [DOI: 10.4103/endo.endo_105_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Cuellar MRC, Velásquez-Espedilla EG, Pedrinha VF, Vivan RR, Duarte MAH, Andrade FBD. Can kinematics, file diameter, and PUI influence the intracanal decontamination and apical bacterial extrusion? Braz Oral Res 2020; 35:e003. [PMID: 33206776 DOI: 10.1590/1807-3107bor-2021.vol35.0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022] Open
Abstract
The present study investigated the intracanal decontamination and apical extrusion of bacteria and debris from root canals instrumented with rotary and reciprocating systems (ProDesign Logic or ProDesign R), with different file diameters and using conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI). Eighty extracted mandibular premolars were contaminated with Enterococcus faecalis and randomly assigned to eight experimental groups according to the root canal instrumentation and irrigation technique employed (n = 10): G1: Prodesign Logic 25.06; G2: Prodesign R 25.06; G3 and G4 were instrumented with the same single-file systems, respectively, using 35.05 diameters and CSI. G5, G6, G7, and G8 were instrumented like the previous groups, but with PUI. Apically extruded debris during instrumentation was collected into pre-weighed microtubes. The weight of the empty microtube was subtracted from the final weight to establish the amount of extruded debris. Bacteria from root canals and extruded debris were collected for a microbiological evaluation of colony forming units (CFU/mL). For statistical analyses, the Mann-Whitney and Kruskal-Wallis followed by the Dunn's tests were used (α = 0.05). All instruments caused extrusion of debris. For irrigation techniques, PUI promoted greater debris and bacterial extrusion (p < 0.05). The CFU/mL count indicated that the instrumentation of the experimental groups were equally effective in the decontamination of the root canal (p > 0.05). The systems tested (regarding file diameter and kinematics) were associated with similar amounts of apically extruded debris and root canal decontamination. PUI was associated with greater debris and bacterial extrusion.
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Affiliation(s)
- Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Victor Feliz Pedrinha
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
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Ozlek E, Neelakantan P, Khan K, Cheung GSP, Rossi-Fedele G. Debris extrusion during root canal preparation with nickel-titanium instruments using liquid and gel formulations of sodium hypochlorite in vitro. AUST ENDOD J 2020; 47:130-136. [PMID: 32748569 DOI: 10.1111/aej.12424] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
This study compared the amount of apically extruded debris during root canal preparation with three single-file systems using liquid and gel-based formulations of sodium hypochlorite (NaOCl) or distilled water. Seventy-two single-canalled roots were divided into three groups: HyFlex EDM (Coltene-Whaledent); Reciproc Blue (VDW); and F-One Blue (Shanghai Fanta) and then divided into three subgroups: NaOCl liquid (Imicrly), NaOCl gel (Cerkamed Medical) and distilled water. The amount of extruded debris was calculated by determining the dry weight of the debris collected. Data were analysed using Kruskal-Wallis test with Bonferroni correction. Debris extrusion occurred in all subgroups. Both the instrument and the irrigant had an impact. The F-One Blue tended to extrude the least debris, though no significant difference was observed in the pairwise comparisons between instruments. NaOCl liquid resulted in significantly more extruded debris than NaOCl gel or distilled water. The results lead us to conclude that the NaOCl gel reduced debris extrusion compared to NaOCl liquid.
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Affiliation(s)
- Esin Ozlek
- Department of Endodontics, Faculty of Dentistry, The University of Van Yuzuncu Yil, Van, Turkey
| | - Prasanna Neelakantan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Khadija Khan
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Gary S P Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
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ALTUNBAŞ D, TOYOĞLU M. THE INFLUENCE OF DIFFERENT TORQUE SETTINGS ON THE AMOUNT OF APICALLY EXTRUDED DEBRIS DURING ROTARY INSTRUMENTATION. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.691090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Silveira CMM, Pimpão MV, Fernandes LA, Westphalen VPD, Cavenago BC, Carneiro E. Influence of Different Irrigation Solutions and Instrumentation Techniques on the Amount of Apically Extruded Debris. Eur Endod J 2019; 4:122-126. [PMID: 32161898 PMCID: PMC7006593 DOI: 10.14744/eej.2019.57966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/13/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The objective of the present study was to evaluate the influence of different irrigation solutions on the amount of extruded residues apically, varying the instrumentation technique in manual, continuous rotation, or reciprocation motions. The amounts of residue for each irrigation solution was also assessed. METHODS Two tests were performed. In the first test, 90 mandibular premolars were divided into nine groups (n=10). Each group was subjected to a different technique: ProTaper Universal, WaveOne Gold, or manual instruments, with different irrigation solutions [2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gel, or distilled water]. During the preparation of the root canal, the apically extruded material was collected in previously weighed glass vials. In the second test, irrigation solutions were weighed separately with the same weighing method. Data were analyzed using the Kolmogorov-Smirnov, one-way and two-way ANOVA, Levene, Tukey, and Games-Howell tests. RESULTS Apically extruded debris was observed in all groups. ProTaper Universal with continuous rotation using 2% CHX gel resulted in the greatest amount of debris (P<0.001). There were significant differences in the amounts of residue among the different groups (P<0.001). Moreover, when the weighing of the irrigation solutions was tested, the 2.5% NaOCl solution produced the greatest amount of residues compared with other irrigation solutions. CONCLUSION Different irrigation solutions influenced the amount of apically extruded debris during the preparation of the canal among the different instrumentation techniques. The ProTaper technique using 2% CHX gel resulted in the greatest amount of apically extruded debris.
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Affiliation(s)
| | | | | | | | | | - Everdan Carneiro
- Department of Endodontics, Pontifical Catholic University of Parana, Brazil
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27
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Topçuoğlu HS, Demirbuga S, Topçuoğlu G. Evaluation of apically extruded debris during the removal of canal filling material using three different Ni-Ti systems and hand files in teeth with simulated apical root resorption. Int Endod J 2019; 53:403-409. [PMID: 31605377 DOI: 10.1111/iej.13234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/07/2019] [Accepted: 10/08/2019] [Indexed: 01/23/2023]
Abstract
AIM To compare the weight of apically extruded debris produced during the removal of root canal filling material using various files in extracted teeth with simulated apical root resorption. METHODOLOGY The root canals of one hundred and twenty extracted mandibular premolar teeth were prepared with Revo-S files and filled using a cold lateral compaction technique with gutta-percha and a resin-based sealer (AdSeal; Meta-Biomed, Cheongwon, Korea). Sixty teeth were randomly assigned to four control groups (hand file, ProTaper Universal retreatment file, D-RaCe retreatment file, and Reciproc file) for the removal of root canal filling material. The apical portion of the remaining 60 teeth was modified to simulate apical root resoption, and the teeth were then randomly divided into 4 experimental groups (using the same techniques as in the control groups) for the removal of root canal filling material. Apically extruded debris was collected into pre-weighed Eppendorf tubes and then dried. The mean weight of the apically extruded debris was assessed with an analytical balance to an accuracy of 10-4 g. Data were analysed using two-way analysis of variance and a Tukey's post hoc test. RESULTS In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion compared to the groups without simulated resorption (P < 0.05). The amount of apically extruded debris was greatest in the hand file groups compared with the other groups (P < 0.05). In the groups with simulated apical root resorption, the Reciproc system was associated with the least weight of apically extruded debris (P < 0.05), whereas there was no significant difference between the ProTaper Universal retreatment and D-RaCe files (P > 0.05). In the groups without simulated apical root resorption, there was no significant difference between Reciproc, ProTaper Universal retreatment and D-RaCe retreatment files (P> 0.05). The time required to remove the root canal filling material was as follows: hand file > ProTaper Universal retreatment = D-RaCe retreatment > Reciproc (P < 0.05). CONCLUSIONS The weight of apically extruded debris was significantly greater in teeth with simulated apical root resorption than in those teeth without simulated apical root resorption. Hand files were associated with significantly more apically extruded debris in all groups during removal of root canal filling material.
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Affiliation(s)
- H S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - S Demirbuga
- Department of Restorative Dentistry, Erciyes University, Kayseri, Turkey
| | - G Topçuoğlu
- Private Practice in Pedodontics, Kayseri, Turkey
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Arruda-Vasconcelos R, Barbosa-Ribeiro M, Louzada LM, Mantovani GD, Gomes BPFA. Apically Extruded Debris Using Passive Ultrasonic Irrigation Associated with Different Root Canal Irrigants. Braz Dent J 2019; 30:363-367. [DOI: 10.1590/0103-6440201902674] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 02/21/2019] [Indexed: 11/21/2022] Open
Abstract
Abstract The present study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) associated with passive ultrasonic irrigation (PUI) using four different root canal irrigants, namely, 6% sodium hypochlorite (NaOCl), 2% chlorhexidine gel + saline solution (2% CHXg+SS), 2% chlorhexidine solution (2% CHXs) and SS alone. Sixty mandibular premolars with single straight root canals were selected and randomly assigned into 4 groups (n=15) according to the root canal irrigant used as follows: G1 (PUI + NaOCl), G2 (PUI + CHXg+SS), G3 (PUI+CHXs) and G4 (PUI+SS). Reciproc® R25 files (25/.08) were used during CMP and the debris extruded from each tooth were collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed by using an analytical microbalance. Data were statistically analysed by using ANOVA and post-hoc Tukey’s test (a=0.05). Debris extrusion was observed in all groups, irrespective of the root canal irrigating, with 2% CHXg + SS being associated with lower debris extrusion compared to other irrigants (p<0.05). No significant differences were observed between 6% NaOCl, 2% CHXs and SS. In conclusion, passive ultrasonic irrigation did not completely prevent apically extrusion of debris. PUI performed with 2% chlorhexidine gel + saline solution significantly minimized debris extrusion compared to 6% sodium hypochlorite, chlorhexidine solution and saline solution.
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Mendonça de Moura JD, Bueno CEDS, Fontana CE, Pelegrine RA. Extrusion of Debris from Curved Root Canals Instrumented up to Different Working Lengths Using Different Reciprocating Systems. J Endod 2019; 45:930-934. [PMID: 31109752 DOI: 10.1016/j.joen.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the extrusion of debris associated with the use of the Reciproc (VDW GmbH, Munich, Germany) and WaveOne Gold (Dentsply Maillefer, Ballaigues, Switzerland) reciprocating systems in curved canals instrumented up to different working lengths (WLs). METHODS Sixty mesial roots of extracted mandibular first molars with mesiobuccal canals having curvatures between 10° and 20° and independent foramina were randomly distributed into 4 experimental groups (n = 15) according to WL and the instrumentation system used: RC0, Reciproc and WL at the apical foramen; RC1, Reciproc and WL at 1 mm short of the apical foramen; WOG0, WaveOne Gold and WL at the apical foramen; and WOG1, WaveOne Gold and WL at 1 mm short of the apical foramen. The canals were irrigated with double-distilled water throughout the preparation. Each root was fit into an Eppendorf tube to collect the debris extruded through the foramen during instrumentation. After instrumentation, the roots were removed from the tubes, and the weight of the debris was obtained by subtracting the initial weight of the tubes from their final weight. The data were submitted to the analysis of variance parametric test complemented by the Tukey test. RESULTS No statistically significant difference was observed between the 4 experimental groups regarding the amount of debris extruded (P > .05). CONCLUSIONS The 2 reciprocating systems tested were associated with similar amounts of apically extruded debris, regardless of the working length used in the instrumentation.
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Affiliation(s)
| | | | - Carlos Eduardo Fontana
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
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Sen OG, Bilgin B, Koçak S, Sağlam BC, Koçak MM. Evaluation of Apically Extruded Debris Using Continuous Rotation, Reciprocation, or Adaptive Motion. Braz Dent J 2019; 29:245-248. [PMID: 29972449 DOI: 10.1590/0103-6440201801967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 03/12/2018] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the amount of apically extruded debris during root canal instrumentation using ProTaper Next (PTN), Twisted File (TF) Adaptive, and Reciproc instruments. Forty-five extracted human maxillary canines were selected and randomly assigned into 3 groups. The root canals were prepared using PTN instruments with continuous rotation (n=15), TF Adaptive instruments with adaptive motion (n=15), Reciproc instruments with reciprocating motion (n=15). During the preparations, canals were irrigated using distilled water and material extruded apically was collected in pre-weighed Eppendorf tubes. After a 5-day drying period in an incubator, the tubes were weighed and the dry weight of the extruded debris was calculated. Data distributions were assessed via the Shapiro-Wilk test, and groups were compared via the Kruskal-Wallis test. The greatest amount of debris extruded by TF Adaptive and the least by PTN, but the difference was insignificant between groups (p=0.259). All instrumentation systems were associated with debris extrusion.
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Affiliation(s)
- Ozgur Genc Sen
- Department of Endodontics, Faculty of Dentistry, Yuzuncu Yil University, Van, Turkey
| | - Burcu Bilgin
- Department of Endodontics, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
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Cabreira LJ, Gominho LF, Rôças IN, Dessaune-Neto N, Siqueira JF, Alves FR. Quantitative analysis of apically extruded bacteria following preparation of curved canals with three systems. AUST ENDOD J 2018; 45:79-85. [PMID: 30113734 DOI: 10.1111/aej.12287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 10/28/2022]
Abstract
This study compared the amount of apically extruded bacteria following preparation of curved root canals using two continuously rotating multifile and one reciprocating single-file systems. Mesiobuccal canals from maxillary molars were contaminated with Enterococcus faecalis and divided into three groups according to the instrumentation system: Reciproc (R25 instrument, 25/.08), BT-RaCe (10/.06, 35/.00 and 35/.04), and Mtwo (25/.06, 30/.05 and 35/.04). Apically extruded material was collected by a customized apparatus with 1.5% agarose gel covering the root apex to simulate the periradicular tissues. The extruded material was extracted from the gel and subjected to bacteriological culture for bacterial quantification. The three systems showed a high frequency of bacterial extrusion (>70%). There were no statistically significant differences in the counts of extruded bacteria between groups (P > 0.05). The incidence and amount of apical bacterial extrusion were similar between the three systems. The customized apparatus was effective in collecting apically extruded bacteria.
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Affiliation(s)
- Laura J Cabreira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Luciana F Gominho
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Federal University of Campina Grande, Campina Grande, PB, Brazil
| | - Isabela N Rôças
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Nilton Dessaune-Neto
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Vila Velha University, Vila Velha, ES, Brazil
| | - José F Siqueira
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Flávio R Alves
- Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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Alves FR, Paiva PL, Marceliano-Alves MF, Cabreira LJ, Lima KC, Siqueira JF, Rôças IN, Provenzano JC. Bacteria and Hard Tissue Debris Extrusion and Intracanal Bacterial Reduction Promoted by XP-endo Shaper and Reciproc Instruments. J Endod 2018; 44:1173-1178. [DOI: 10.1016/j.joen.2018.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 01/29/2023]
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Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files. J Endod 2018; 44:856-859. [DOI: 10.1016/j.joen.2018.01.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 11/21/2022]
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Topçuoğlu HS, Ulusan Ö, Topçuoğlu G, Biricik E. Apically extruded debris during the removal of canal filling material from root canals using three techniques. ACTA ACUST UNITED AC 2018; 9:e12337. [PMID: 29603889 DOI: 10.1111/jicd.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/01/2018] [Indexed: 01/13/2023]
Abstract
AIM In the present study, we evaluated the effect of the single-cone technique (SCT), cold lateral compaction (CLC), and wave vertical compaction (WVC) technique performed using two different sealers on the amount of apically extruded debris (AED) produced during the removal of canal filling material. METHODS Ninety extracted mandibular premolars were prepared with ProTaper instruments. The teeth were then randomly assigned to six groups (N = 15) for root canal filling: (a) group 1, CLC+AH Plus; (b) group 2, SCT+AH Plus; (c) group 3, WVC+AH Plus; (d) group 4, CLC+MTA Fillapex; (e) group 5, SCT+MTA Fillapex; and (f) group 6, WVC+MTA Fillapex. In all groups, the removal of canal filling material was performed with ProTaper retreatment instruments. The mean weight of the AED was assessed with an analytical balance. RESULTS The amount of AED was lowest in groups 2 and 5 (P < .05), with no difference between these groups (P > .05). Groups 3 and 6 produced the greatest amount of extruded debris (P < .05); there was no difference between these groups (P > .05). Additionally, there was no difference between groups 1 and 4 (P > .05). There was no significant difference among the groups regarding sealer type (P > .05). CONCLUSIONS The canal filling technique used affected the amount of AED produced during the removal of canal filling material, but not sealer type.
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Affiliation(s)
- Hüseyin S Topçuoğlu
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Özge Ulusan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Eda Biricik
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Xu K, Wang J, Wang K, Gen N, Li J. Micro-computed tomographic evaluation of the effect of the final apical size prepared by rotary nickel-titanium files on the removal efficacy of hard-tissue debris. J Int Med Res 2018; 46:2219-2229. [PMID: 29584511 PMCID: PMC6023043 DOI: 10.1177/0300060518757607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective This study was performed to compare the removal efficacy of hard-tissue debris in mandibular first molars prepared to various apical sizes. Methods The mesial root canals of 40 extracted mandibular first molars were prepared by rotary nickel-titanium files to an apical size of #25/0.04 (Group #2504), #30/0.04 (Group #3004), #35/0.04 (Group #3504), and #40/0.04 (Group #4004). Irrigation was performed with 5.25% NaOCl and 17% EDTA. Micro-computed tomography was used to scan the samples before and after root canal preparation. Remnant hard-tissue debris was identified, quantified, and visualized three-dimensionally using shape recognition and image superimposition analysis, and the debris was mapped to its location. Results After preparation, 11.67%±2.99% of the root canals contained hard-tissue debris in Group #2504, 8.00%±2.71% in Group #3004, 7.17%±2.88% in Group #3504, and 4.51%±1.61% in Group #4004. The amount of accumulated hard-tissue debris was significantly less in Group #4004 than in the other groups. However, there were no significant differences between Groups #3004 and #3504. Conclusions An increased final apical size resulted in significantly lower debris accumulation. However, no root canal in any group was completely free from hard-tissue debris, and debris was mostly found in the isthmus of the mesial root canals.
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Affiliation(s)
- Ke Xu
- Department of Endodontics, Stomatological Hospital Affiliated to Soochow University, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Juan Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Ke Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Nan Gen
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Jin Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
- Jin Li, Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China.
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Pedrinha VF, Brandão JMDS, Pessoa OF, Rodrigues PDA. Influence of File Motion on Shaping, Apical Debris Extrusion and Dentinal Defects: A Critical Review. Open Dent J 2018. [PMID: 29541265 PMCID: PMC5842382 DOI: 10.2174/1874210601812010189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Advances in endodontics have enabled the evolution of file manufacturing processes, improving performance beyond that of conventional files. In the present study, systems manufactured using state of the art methods and possessing special properties related to NiTi alloys (i.e., CM-Wire, M-Wire and R-Phase) were selected. The aim of this review was to provide a detailed analysis of the literature about the relationship between recently introduced NiTi files with different movement kinematics and shaping ability, apical extrusion of debris and dentin defects in root canal preparations. From March 2016 to January 2017, electronic searches were conducted in the PubMed and SCOPUS databases for articles published since January 2010. In vitro studies performed on extracted human teeth and published in English were considered for this review. Based on the inclusion criteria, 71 papers were selected for the analysis of full-text copies. Specific analysis was performed on 45 articles describing the effects of reciprocating, continuous and adaptive movements on the WaveOne Gold, Reciproc, HyFlex CM and Twisted File Adaptive systems. A wide range of testing conditions and methodologies have been used to compare the systems. Due the controversies among the results, the characteristics of the files used, such as their design and alloys, appear to be inconsistent to determine the best approach.
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Relationship between the Apical Preparation Diameter and the Apical Seal: An In Vitro Study. Int J Dent 2018; 2018:2327854. [PMID: 29552035 PMCID: PMC5818937 DOI: 10.1155/2018/2327854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/30/2017] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim of the study is to define the relationship between the apical preparation diameter and the apical sealing ability to highlight the importance of the preservation of the diameter and the original position of the apical foramen. Materials and Methods 50 extracted maxillary incisors were randomly allocated into three groups of 15 teeth each (n = 15) according to the apical preparation size: Group 1: finishing file F1 corresponding to size 20 reached the working length (ProTaper Universal system Dentsply®); Group 2: prepared up to size 30 corresponding to finishing file F30; Group 3: prepared up to size 50 corresponding to finishing file F5. Five teeth were assigned to positive and negative control groups. After the filling of the root canals, the teeth were isolated and immersed in a dye solution, then cut longitudinally, photographed, and the dye penetration were calculated using a computer software. Results Comparison of the three different apical preparation sizes showed no statistically significant differences regarding the apical microleakage. Conclusion The most important value of the dye penetration was observed in the group with the largest apical diameter.
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Zhang C, Liu J, Liu L. The influence of ProTaper and WaveOne on apically extruded debris: A systematic review and meta-analysis. J Conserv Dent 2018; 21:474-480. [PMID: 30294105 PMCID: PMC6161523 DOI: 10.4103/jcd.jcd_82_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Apically extruded debris produced during root canal preparation can induce postoperative inflammation and subsequent failure of root canal treatment. Therefore, debris production must be reduced to improve the outcome of root canal treatment. Aim: This study aimed to provide a theoretical basis for the improvement of root canal treatment by comparing the difference in the amount of apically extruded debris produced during the root canal preparation of extracted human teeth with ProTaper Universal (PTU), ProTaper Next (PTN), and WaveOne (WO). Materials and Methods: On March 30, 2017, three researchers searched five electronic databases (PubMed/Medline, Cochrane, Science Direct Online, Embase, and Web of Science) with no time limitations. Only articles written in English were retrieved, and 150 articles were obtained. Then, the three researchers independently selected articles in accordance with previously established inclusion and exclusion criteria, and inconsistent results were discussed. Data were analyzed through meta-analysis for standardized mean difference (SMD). Results: Eight studies met the inclusion criteria and were subjected to qualitative analysis. Four articles showed that PTU produced higher amounts of apical debris than WO; two articles showed that PTU produced lower amounts of apical debris than WO; and three articles showed that PTN produced lower amounts of apical debris than WO. Moreover, one article demonstrated that PTU produced higher amounts of apical debris than PTN. A meta-analysis showed that PTU and WO did not produce significantly different amounts of apically extruded debris: SMD = −0.26, Z = 0.50 (P > 0.05). PTU produced lower amounts of apically extruded debris than WO: SMD = −4.98, Z = 2.79 (P < 0.05). However, results were significantly heterogeneous among all the included studies (I2= 97%). No significant difference was found between PTU and WO in the amounts of apically extruded debris: SMD = 0.47, Z = 1.06 (P > 0.05). Conclusion: Currently available evidence shows that PTN can produce lower amounts of apical debris than WO (P < 0.05). Moreover, the amounts of apically extruded debris produced by PTU and WO are not significantly different (P > 0.05). Nevertheless, given the limited number of studies reviewed, a definitive conclusion cannot be reached.
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Affiliation(s)
- Chen Zhang
- Department of Oral Medical, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Jun Liu
- Department of Orthodontics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingshuang Liu
- Department of Endodontics, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Oral Medical, Qingdao University, Qingdao, China
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Costa EL, Sponchiado-Júnior EC, Garcia LFR, Marques AAF. Effect of large instrument use on shaping ability and debris extrusion of rotary and reciprocating systems. ACTA ACUST UNITED AC 2017; 9. [PMID: 28834333 DOI: 10.1111/jicd.12289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 11/28/2022]
Abstract
AIM The aim of the present study was to evaluate the effect of large instrument use on the shaping ability and apical debris extrusion of rotary and reciprocating systems in oval-shaped root canals. METHODS Forty-five mandibular premolars, with an 18-mm long, oval-shaped single canal, and apical diameter ranging from 300 to 350 μm, were separated into three groups (n=15), according to the system used: ProTaper Universal group, F5 (0.50/0.05); ProTaper Next (PTN group), X5 (0.50/0.06); and Reciproc (RC group), R50 (0.50/0.05). Cone-beam computed tomography was performed before and after preparation to analyze apical transportation (AT), centering ability (CA), and change in root canal diameter (CRCD). For evaluating apical debris extrusion, the roots were coupled to pre-weighed glass receptacles to collect the extruded debris during preparation. RESULTS All systems promoted AT and apical debris extrusion; the latter was higher for the PTN group (P<.05). No system presented perfect CA. The RC group demonstrated the largest CRCD (P<.05). CONCLUSIONS As consequences of their use, the large instruments promoted undesirable AT and debris extrusion, irrespective of the system used to perform root canal preparation. Moreover, no system was able to remain perfectly centralized within the root canal.
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Affiliation(s)
- Elielton L Costa
- School of Dentistry, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | | | - Lucas F R Garcia
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - André A F Marques
- Superior School of Health Sciences, State University of Amazonas, Manaus, Amazonas, Brazil
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Arslan D, Kustarci A. Efficacy of photon-initiated photoacoustic streaming on apically extruded debris with different preparation systems in curved canals. Int Endod J 2017; 51 Suppl 1:e65-e72. [PMID: 28708251 DOI: 10.1111/iej.12816] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 07/10/2017] [Indexed: 11/28/2022]
Abstract
AIM To determine the effect of photon-initiated photoacoustic streaming (PIPS) on the extrusion of debris using multiple-file (ProTaper Next-PTN) and single-file (One Shape-OS) continuous rotary systems in curved canals in human molar teeth. METHODOLOGY Sixty extracted maxillary first molar teeth with curved mesial roots, mature apices and of similar lengths were selected. Teeth having canals with apical diameters larger than size 15 were discarded. The teeth were randomly divided into four experimental groups (n = 15 teeth per group) according to the file used and irrigation systems: (i) OS with PIPS with a 2940 nm Er:YAG laser (0.3 W, 15 Hz, and 20 mJ), (ii) OS with conventional needle irrigation (CNI) with a 27-G needle, (iii) PTN with PIPS and (iv) PTN with CNI. The PIPS and CNI was applied during each file change for 20 s. Total irrigation and activation time was 1 min, and a total volume of 7.5 mL of bidistilled water was used as the irrigant. The apically extruded debris was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of dry extruded debris was assessed by subtracting the initial weight of the tube from the final weight. The results were analysed statistically using one-way analysis of variance and Tukey's post hoc tests. Bonferroni correction was used to compare the groups. RESULTS The PIPS irrigation technique was associated with significantly more debris extrusion than the CNI system (P < 0.05). The single-file (One Shape-OS) rotary system was associated with more debris than the multiple-file (ProTaper Next-PTN) rotary systems when the same irrigation system was used (P > 0.05). The total amount of debris extruded apically by PIPS activation was significantly greater than that by CNI (P < 0.05). CONCLUSIONS All file and irrigation systems extruded debris apically. PIPS activation was associated with significantly more extrusion debris in curved canals compared with no activation.
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Affiliation(s)
- D Arslan
- Department of Endodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul
| | - A Kustarci
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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41
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Topçuoğlu HS, Topçuoğlu G. Postoperative pain after the removal of root canal filling material using different techniques in teeth with failed root canal therapy: a randomized clinical trial. Acta Odontol Scand 2017; 75:249-254. [PMID: 28162017 DOI: 10.1080/00016357.2017.1283707] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study evaluated the intensity and duration of postoperative pain after the removal of root canal filling material in retreatment procedures of upper incisor teeth with chronic apical periodontitis, using different techniques. MATERIALS AND METHODS One hundred and thirty-five patients requiring retreatment of upper incisor teeth with chronic apical periodontitis were included in the study. The patients were assigned to three groups of 45 patients, according to the method used to remove old canal filling material. In group 1, canal filling material was removed using hand files. In group 2, the canal filling material was removed with ProTaper universal retreatment (PTUR) instruments. In group 3, Reciproc instruments were used to remove canal filling material. Teeth were then medicated with calcium hydroxide and sealed using temporary filling material. The presence of postoperative pain was assessed after 6, 12, 24, 48 and 72 h, 7 days, and finally after 10 days. RESULTS In all time intervals, except for 72 h, 7 days and 10 days, group 1 participants reported more intense postoperative pain than those in groups 2 and 3 (p = 0.02). In all time intervals, there was no difference in the pain scores between groups 2 and 3 (p = 0.08). In all groups, the intensity of postoperative pain decreased over time. The required time to remove canal filling material was less for the Reciproc group compared to the hand and ProTaper retreatment groups (p = 0.032). CONCLUSIONS Hand files caused greater postoperative pain after non-surgical endodontic retreatment (NSER) of upper incisor teeth with chronic apical periodontitis compared to the ProTaper retreatment and Reciproc files.
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Affiliation(s)
| | - Gamze Topçuoğlu
- Department of Pedodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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42
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Çiçek E, Koçak MM, Koçak S, Sağlam BC, Türker SA. Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study. J Appl Oral Sci 2017; 25:20-26. [PMID: 28198972 PMCID: PMC5289396 DOI: 10.1590/1678-77572016-0138] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/30/2016] [Indexed: 02/02/2023] Open
Abstract
Postoperative pain is a frequent complication associated with root canal treatment, especially during apical instrumentation of tooth with preexisting periradicular inflammation
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Affiliation(s)
- Ersan Çiçek
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Sibel Koçak
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Baran Can Sağlam
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
| | - Sevinç Aktemur Türker
- Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, Zonguldak, Turkey
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Western JS, Dicksit DD. Apical extrusion of debris in four different endodontic instrumentation systems: A meta-analysis. J Conserv Dent 2017; 20:30-36. [PMID: 28761250 PMCID: PMC5514807 DOI: 10.4103/0972-0707.209066] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing. OBJECTIVES Of this meta-analysis was to collect and analyze in vitro studies quantifying apically extruded debris while using Hand ProTaper (manual), ProTaper Universal (rotary), Wave One (reciprocating), and self-adjusting file (SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically. METHODOLOGY An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms "Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems." A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris. RESULTS Statistically significant difference was seen in the following comparisons: SAF < Wave One, SAF < Rotary ProTaper. CONCLUSIONS Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.
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Affiliation(s)
- J Sylvia Western
- Faculty of Dentistry, SEGi University, No. 9, Jalan Teknologi, Kota Damansara, PJU5, Selangor, Malaysia
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Ahn SY, Kim HC, Kim E. Kinematic Effects of Nickel-Titanium Instruments with Reciprocating or Continuous Rotation Motion: A Systematic Review of In Vitro Studies. J Endod 2016; 42:1009-17. [DOI: 10.1016/j.joen.2016.04.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 03/28/2016] [Accepted: 04/02/2016] [Indexed: 11/26/2022]
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Topçuoğlu HS, Zan R, Akpek F, Topçuoğlu G, Ulusan Ö, Aktı A, Düzgün S, Ağırnaslıgil M. Apically extruded debris during root canal preparation using Vortex Blue, K3XF, ProTaper Next and Reciproc instruments. Int Endod J 2015; 49:1183-1187. [DOI: 10.1111/iej.12572] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/02/2015] [Indexed: 11/28/2022]
Affiliation(s)
- H. S. Topçuoğlu
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - R. Zan
- Department of Endodontics; Faculty of Dentistry; Cumhuriyet University; Sivas Turkey
| | - F. Akpek
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - G. Topçuoğlu
- Department of Pedodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - Ö. Ulusan
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - A. Aktı
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - S. Düzgün
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
| | - M. Ağırnaslıgil
- Department of Endodontics; Faculty of Dentistry; Erciyes University; Kayseri Turkey
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