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Serpa GC, Guedes OA, Freitas NSS, Silva JA, Estrela C, Decurcio DA. The effect of ultrasonic vibration protocols for cast post removal on the incidence of root dentin defects. J Oral Sci 2023; 65:190-194. [PMID: 37394544 DOI: 10.2334/josnusd.23-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
PURPOSE To investigate the effects of two ultrasonic vibration protocols for cast post removal (single or double ultrasound units) on the development of defects in root dentin. METHODS Sixty bovine incisors were selected. Fifteen roots were left unprepared (control). Forty-five roots were instrumented and filled. A 10-mm post space was prepared using #1-4 Largo drills. Fifteen teeth were prepared for post space and received no further procedure. Thirty roots had cast posts cemented and were submitted to ultrasonic vibration protocols for removal. The time necessary to remove each post was recorded. Roots were sectioned 3, 6, 9, and 12 mm from the coronal portion and viewed through a 25× magnification in a stereomicroscope. The presence of root fractures, partial cracks, and craze lines was registered. Chi-square and Fisher's exact tests were performed to compare the incidence of dentin defects. The Kruskal-Wallis test was performed to explore the difference between the time needed for post removal. The significance level was set at P = 0.05. RESULTS Root defects were observed in all experimental groups. There were no statistical differences comparing previous root canal treatment and post removal steps, either with 1 or 2 ultrasonic units, in the formation of defects (P = 0.544) or fractures (P = 0.679). CONCLUSION Ultrasonic vibration protocols for removing cast posts did not increase the number of dentin defects compared to root canal preparation and obturation and post space preparation steps.
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Affiliation(s)
- Giulliano C Serpa
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Orlando A Guedes
- Department of Endodontics, School of Dentistry, Evangelical University of Goiás
| | | | - Julio A Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Carlos Estrela
- Department of Stomatology, School of Dentistry, Federal University of Goiás
| | - Daniel A Decurcio
- Department of Stomatology, School of Dentistry, Federal University of Goiás
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Diagnosis of cracked tooth: Clinical status and research progress. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:357-364. [PMID: 36425316 PMCID: PMC9678967 DOI: 10.1016/j.jdsr.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
Cracked tooth is a common dental hard tissue disease.The involvement of cracks directly affects the selection of treatment and restoration of the affected teeth.It is helpful to choose more appropriate treatment options and evaluate the prognosis of the affected tooth accurately to determine the actual involvement of the crack.However, it is often difficult to accurately and quantitatively assess the scope of cracks at present.So it is necessary to find a real method of early quantitative and non-destructive crack detection.This article reviews the current clinical detection methods and research progress of cracked tooth in order to provide a reference for finding a clinical detection method for cracked tooth.
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Toia CC, Teixeira FB, Cucco C, Valera MC, Cavalcanti BN. Volumetric Evaluation of Voids and Gaps of Different Calcium-Silicate Based Materials Used in Furcal Perforations: A Micro-CT Study. Dent J (Basel) 2022; 10:dj10030041. [PMID: 35323243 PMCID: PMC8947349 DOI: 10.3390/dj10030041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed at evaluating volumetrically gaps and voids of calcium-silicate based materials of different generations and handling properties (BC—Endosequence BC RRM-Fast Set Condensable Putty, MTA—ProRoot MTA, and BIO—Biodentine) in simulated furcal perforations in an ex vivo setup by microcomputed tomography (Micro-CT) analysis. Thirty-six extracted human mandibular molars with sound furcation areas were selected. Standardized perforations were created in the furcation area of the pulp chamber using #4 diamond burs. The specimens were randomly assigned to three groups (BC, MTA and BIO; n = 12). Samples were then scanned (SkyScan 1172; Bruker-microCT, Kontich, Belgium), and three-dimensional (3D) images reconstructed. The relative volume of gaps (VG%) and voids (VV%) present on each material was calculated. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey’s HSD test (p < 0.05). Mean VG% for BC, MTA, and BIO groups were, respectively, 0.513%, 1.128%, 1.460%, with BC presenting statistically (p < 0.05) fewer gaps formation than the other groups. Mean VV% were, respectively, 0.018%, 0.037%, and 0.065%. The was no statistical difference regarding VV%. There were no gap-free and void-free samples. BC group had the lowest VG% among the groups with a significant statistical difference (p < 0.05).
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Affiliation(s)
- Cassia Cestari Toia
- Department of Operative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Sao Jose dos Campos 12245-000, Brazil; (C.C.T.); (M.C.V.)
| | - Fabricio Batista Teixeira
- Department of Endodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA; (F.B.T.); (C.C.)
| | - Carolina Cucco
- Department of Endodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA; (F.B.T.); (C.C.)
| | - Marcia Carneiro Valera
- Department of Operative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Sao Jose dos Campos 12245-000, Brazil; (C.C.T.); (M.C.V.)
| | - Bruno Neves Cavalcanti
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-(734)-548-2743
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Zhou J, Fu J, Xiao M, Qiao F, Fu T, Lv Y, Wu F, Sun C, Li P, Wu L. New technique for detecting cracked teeth and evaluating the crack depth by contrast-enhanced cone beam computed tomography: an in vitro study. BMC Oral Health 2022; 22:48. [PMID: 35236348 PMCID: PMC8892748 DOI: 10.1186/s12903-022-02085-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cracked teeth may cause various clinical symptoms depending on the extension depth of the crack and the subsequent bacterial infections. However, techniques to reliably determine the extension depths of cracks in teeth before treatment are lacking. The aim of this study was to develop a new technique based on contrast-enhanced cone beam computed tomography (CBCT) to improve the accuracy of crack depth evaluation in vitro. Methods We developed an in vitro artificial simulation model of cracked teeth. Pre-experimental CBCT (pre-CBCT), and micro-computed tomography (micro-CT) were first performed for all cracked teeth (n = 31). Contrast-enhanced CBCT was then performed by infiltrating the crack with ioversol under vacuum conditions. The sensitivities of pre-CBCT and contrast-enhanced CBCT for the diagnosis of cracked teeth were calculated. According to the K-means clusters, crack depths measured by micro-CT were changed into categorical variables. Bland–Altman plot and the intraclass correlation coefficient (ICC) were used to analyze the consistency of the crack depths between the pre-CBCT and contrast-enhanced CBCT, as well as the ICC between the contrast-enhanced CBCT and micro-CT. Receiver operating characteristic (ROC) curves were generated to assess the ability for predicting crack depth in the differential diagnosis using pre-CBCT and contrast-enhanced CBCT. Restricted cubic splines were also used to model the non-linear relationship between the crack depths of contrast-enhanced CBCT and micro-CT. Results The sensitivities of pre-CBCT and contrast-enhanced CBCT were 48.4%, and 67.7%, respectively. The ICC value of crack depth as measured by pre-CBCT and contrast-enhanced CBCT was 0.847 (95% confidence interval [CI] 0.380–0.960; P < 0.001). The areas under ROC curves (AUC) of pre-CBCT and contrast-enhanced CBCT were different: the AUC of pre-CBCT was 0.958 (P = 0.000, 95% CI 0.843–1.074), and the AUC of contrast-enhanced CBCT was 0.979 (P = 0.000, 95% CI 0.921–1.037), and the difference was not statistically significant (Z = − 0.707, P = 0.480). The ICC value of crack depth as measured by contrast-enhanced CBCT and micro-CT was 0.753 (95% CI 0.248–0.911; P < 0.001). Conclusion Contrast-enhanced CBCT under vacuum conditions with a contrast medium can significantly improve the crack detection rate of cracked teeth; however, it cannot measure the crack depths accurately.
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Affiliation(s)
- Jie Zhou
- Department of Stomatology, Wuqing People Hospital, Tianjin, China
| | - Jieni Fu
- Department of Endodontics, Hangzhou Stomatological Hospital, Hangzhou, Zhejiang, China
| | - Mo Xiao
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Feng Qiao
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Tiantian Fu
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yangyang Lv
- Department of Endodontics, Wuxi Stomatology Hospital, Jiangsu, China
| | - Fei Wu
- Department of Endodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Cuicui Sun
- Department of Endodontics, Tianjin Stomatological Hospital, Tianjin, China
| | - Peng Li
- Department of Radiology, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Ligeng Wu
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China.
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Silveira F, Tonelli S, de Toubes K, Brabo Pereira A, de Oliveira Miranda A, Fernandes L, Nunes E. Dentinal microcracks induced by endodontic procedures: A scientometric and bibliometric analysis. J Conserv Dent 2022; 25:78-87. [PMID: 35722065 PMCID: PMC9200181 DOI: 10.4103/jcd.jcd_469_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 12/18/2021] [Accepted: 12/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Due to the large number of publications relating the occurrence of dental microcracks to endodontic procedures, this bibliometric study evaluated the scientific pattern and trends in literature and provided an overview of scientific production in this context. Aim: To analyze, quantify, and characterize the scientific production and trends of published articles evaluating dentinal microcracks formation after endodontic treatment procedures between 2010 and 2020 using bibliometric indicators. Materials and Methods: Published articles were found by the search in the Medline (PubMed) and Scopus database using the combination of the following keywords: Dentinal crack OR Dentinal Microcrack OR Crack formation OR Dentin Defect AND Endodontic treatment OR Root canal preparation OR Canal Preparation OR Root canal treatment OR endodontic procedures. The search was also conducted in the Journal of Endodontics and International Endodontic Journal. After inclusion and exclusion criteria application, data from all studies included were collected. Results: Among the 556 results after the search, 45 studies were included and analyzed in this bibliometry. No trend was observed in terms of the increasing number of articles over time. Most of them used an in vitro design, compared the effect of different endodontic techniques/systems for root canal instrumentation on dentinal microcracks formation, and were conducted in Turkey, Brazil, and India. Journal of Endodontics and International Endodontic Journal were the main journals with a higher number of articles published. Interestingly, studies conducted with some funding did not lead to higher citation numbers. Moreover, a relevant proportion of studies did not consider the inclusion of control groups, baseline evaluation, or statistical analysis. Micro-CT was the main technique used to evaluate microcrack presence. Conclusion: Microcrack formation after the use of different endodontic techniques/systems has been constantly evaluated in the literature. There is a pattern of methodologies used, which may explain the concentration of these studies in specific journals and countries.
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Versiani MA, Cavalcante DM, Belladonna FG, Silva EJNL, Souza EM, De-Deus G. A critical analysis of research methods and experimental models to study dentinal microcracks. Int Endod J 2021; 55 Suppl 1:178-226. [PMID: 34743355 DOI: 10.1111/iej.13660] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
The purpose of this narrative review was to discuss the scientific milestones that led to the current understanding of the root dentinal microcrack phenomenon based on the interplay between the usage of micro-computed tomography (micro-CT) as an analytical tool alongside a close-to-mouth experimental model. In 2009, reports on the development of dentinal microcracks in extracted teeth after root canal preparation triggered an awareness of the potential for vertical root fractures (VRFs) of endodontically treated teeth could be developed from defects created by the mechanical stress of nickel-titanium preparation systems on dentine. This assumption was taken for granted, even though no cause-effect relationship had been scientifically demonstrated. Since then, several studies using the sectioning method with extracted teeth have been published and the large discrepancy amongst their outcomes soon become evident. Moreover, the high frequency of reported dentinal microcracks largely contrasted with the clinical incidence of VRFs, raising doubts on their methodological reliability. Using micro-CT technology, it was demonstrated by several studies that, in extracted teeth, dentinal defects already existed before the endodontic procedures, indicating that the initial reports framed a non-existing cause-effect relationship between canal preparation and dentinal microcracks. Although these new findings contributed to a better comprehension of this phenomenon, the misconception that microcracks were the starting point for VRFs was only surpassed with a new in situ approach using fresh cadavers. Surprisingly, microcracks were not identified in sound teeth. As a conclusion, dentinal microcracks in extracted teeth can be considered a non-natural occurrence observed only in a laboratory set-up as a consequence of dehydration and storage conditions. Thus, dentinal microcracks shall not be considered as the starting point for VRFs as they do not manifest in non-extracted teeth. Identifying dentinal microcracks as a laboratory phenomenon highlights the impact of recent scientific developments to disclaim the clinical relevance of laboratory-obtained outcomes.
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Affiliation(s)
| | | | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
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Chellapilla PK, Boddeda MR, Jyothi M, Uppalapati LV, Konagala RK, Dasari L. Influence of obturating techniques on root dentin crack propagation: A micro-computed tomography assessment. J Conserv Dent 2021; 24:72-76. [PMID: 34475684 PMCID: PMC8378482 DOI: 10.4103/jcd.jcd_591_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim is to assess and compare the microcrack formation in radicular dentin after obturating the root canals with cold lateral condensation (CLC), warm vertical condensation (WVC), and injectable gutta-percha (IGP) techniques using micro-computed tomography (CT). Materials and Methods: Human extracted mandibular premolar teeth (n = 60) were haphazardly assigned based on the obturation technique into three experimental groups (n = 20 each). Root canals are cleaned and shaped with M Two rotary files and 3% sodium hypochlorite irrigant. Cross-sectional images were taken with Micro-CT to record the baseline defects present on root samples. After root canal obturation either with CLC or WVC or injectable obturation techniques, micro-CT images were captured again to analyze the increase in the number and type of dentinal defects. Statistical analysis of data was performed using the Mann–Whitney U test and the Mcnemar test at 5% significance level. Results: An increase in the number of radicular micro-cracks was identified in samples obturated with lateral condensation technique (1.66%). No change in the percentage of micro-cracks was recorded after obturation with warm vertical or injectable guttapercha (IGP) techniques (P > 0.05). The three obturation techniques were not statistically different in the occurrence of micro-cracks after obturation. Conclusion: The three obturating techniques tested showed no significant increase in radicular dentin defects' occurrence or propagation.
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Affiliation(s)
- Praveen Kumar Chellapilla
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Mohan Rao Boddeda
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Mandava Jyothi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Lakshman Varma Uppalapati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
| | - Lohita Dasari
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andra Pradesh, India
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Cavalcante DM, Belladonna FG, Simões‐Carvalho M, Carvalhal JCA, Souza EM, Lopes RT, Silva EJNL, Dummer PMH, De‐Deus G. Do pre‐existing microcracks play a role in the fracture resistance of roots in a laboratory setting? Int Endod J 2020; 53:1506-1515. [DOI: 10.1111/iej.13370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Affiliation(s)
- D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - J. C. A. Carvalhal
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís MaranhãoBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
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Almeida A, Romeiro K, Cassimiro M, Gominho L, Dantas E, Silva S, Albuquerque D. Micro-CT analysis of dentinal microcracks on root canals filled with a bioceramic sealer and retreated with reciprocating instruments. Sci Rep 2020; 10:15264. [PMID: 32943675 PMCID: PMC7498450 DOI: 10.1038/s41598-020-71989-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022] Open
Abstract
This study aimed to analyze the potential occurrence of dentinal defects after the removal of a root canal filling with two different sealers using Reciproc (RC) or Reciproc Blue (RB). The mesial roots of 60 mandibular molars with a Vertucci type IV configuration were selected. The samples were initially instrumented with Reciproc (R25) and then divided into the following four experimental groups according to the endodontic sealer and retreatment instrument (n = 15): BC Sealer/Reciproc (BCRC); BC Sealer/Reciproc Blue (BCRB); AH Plus/Reciproc (AHRC); and AH Plus/Reciproc Blue (AHRB). Then, the samples were scanned under micro-CT after obturation and removal of the filling material. Two analyses were conducted. First, an evaluation was performed on all the axial images, and another analysis evaluated each millimeter of the 10 mm from the apex. Dentinal defects were observed in all the samples. All of the identified defects in the images after filling material removal were present in the corresponding images after obturation. The use of AH Plus and EndoSequence BC Sealer, and filling material removal using RC and RB instruments did not induce dentinal defects.
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Affiliation(s)
- Andressa Almeida
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil.
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Marcely Cassimiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Luciana Gominho
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Eugênia Dantas
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, PB, Brazil
| | - Silmara Silva
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco (UPE), Avenida General Newton Cavalcanti, 1650, Camaragibe, PE, 54753-020, Brazil
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Alim BA, Garip Berker Y. Evaluation of different root canal filling techniques in severely curved canals by micro-computed tomography. Saudi Dent J 2020; 32:200-205. [PMID: 32405223 PMCID: PMC7211901 DOI: 10.1016/j.sdentj.2019.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 11/25/2022] Open
Abstract
AIM To fill the severely curved root canals with different filling techniques and to compare these techniques using micro-computed tomography (micro-CT). MATERIALS AND METHODS Sixty extracted mandibular first molars (degree of root canal curvature >25°) were selected. All samples were divided into four groups and filled with one of the following techniques: lateral condensation, single-cone, continuous-wave obturation, and core carrier. After they were scanned by micro-CT, the total area, filled area and void area of the root canal were calculated. The Mann-Whitney U and Kruskal-Wallis tests were used for statistical analysis (p < 0.05). RESULTS It was shown that significantly more filling material was used in the lateral condensation and core carrier technique groups at 2 and 5 mm than in the single-cone and continuous-wave obturation technique groups (p < 0.05). It was observed no statistically significant difference at 8 mm (p > 0.05). CONCLUSION No technique could completely fill in root canal. Regarding the coronal part, all techniques can be used for more effective filling as long as a good condensation is achieved. The use of a plugger with an optimal size according to the localisation of root canal curvature and the choice of a heat-resistant root canal sealer affects the success of the treatment in the thermoplastic techniques.
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Affiliation(s)
- Betul Aycan Alim
- Department of Endodontics, Bezmialem Vakıf University, Faculty of Dentistry, Fatih, Istanbul, Turkey
| | - Yıldız Garip Berker
- Department of Endodontics, Istanbul Kent University, Faculty of Dentistry, Taksim, Istanbul, Turkey
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Zuli TAB, Guedes OA, Gonçalves GFZA, da Silva Júnior AR, Borges ÁH, Aranha AMF. Effect of post space preparation drills on the incidence of root dentin defects. Restor Dent Endod 2020; 45:e53. [PMID: 33294418 PMCID: PMC7691261 DOI: 10.5395/rde.2020.45.e53] [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: 02/21/2020] [Revised: 05/03/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. Materials and Methods Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance. Results Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). Conclusions PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.
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Affiliation(s)
| | - Orlando Aguirre Guedes
- Department of Endodontics, School of Dentistry, Centro Universitário de Anápolis - UniEvangélica, Anápolis, GO, Brazil
| | | | | | - Álvaro Henrique Borges
- Department of Oral Sciences, School of Dentistry, University of Cuiabá - UNIC, Cuiabá, MT, Brazil
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Arnarsdottir EK, Karunanayake GA, Pettit NE, Phillips C, Saemundsson SR, Tawil PZ. Periapical Microsurgery: Assessment of Different Types of Light-emitting Diode Transilluminators in Detection of Dentinal Defects. J Endod 2019; 46:252-257. [PMID: 31831180 DOI: 10.1016/j.joen.2019.10.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/22/2019] [Accepted: 10/29/2019] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This study evaluated 4 different light-emitting diode (LED) transilluminators and the impact of operator experience in the detection of dentinal defects through an ex vivo TRUEJAW surgical model (Dental Engineering Laboratories, Santa Barbara, CA). METHODS Forty-four extracted and endodontically treated mandibular premolar teeth were evaluated. Teeth were mounted in the models followed by surgical flaps and osteotomies to expose the apical third of the roots. After apical resection, the root-end surfaces were randomly inspected for the presence or absence of dentinal defects using a dental operating microscope (DOM) at ×19.4 magnification by experienced and novice LED evaluators. The assessment was made with the DOM light and 4 masked LED transilluminators of different diameters and luminous flux. The teeth were examined outside the models to establish the ground truth. The sensitivity, specificity, and kappa and McNemar test values of each light source by examiner were calculated. RESULTS The use of LED transilluminators improved the diagnostic sensitivity of dentinal defects when compared with the DOM light alone for both examiners. For the LED-experienced evaluator, the medium-low transilluminator had statistically significant higher sensitivity than the DOM light and the small-low and small-high transilluminators (P < .05). For the novice LED evaluator, the medium-high transilluminator had the highest sensitivity. There was a statistically significant difference between the sensitivities of the medium-low transilluminator between the examiners (P < .05). CONCLUSIONS Within the limitations of this ex vivo surgical study, dentinal defects were more often detected with the LED transilluminators with a larger diameter and increased lumens. The operator's LED transilluminator experience was found to have a positive effect on the detection of dentinal defects using transillumination.
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Affiliation(s)
- Elisa K Arnarsdottir
- Department of Endodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina
| | - Glen A Karunanayake
- Department of Endodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina
| | - Nicholas E Pettit
- Department of Endodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina
| | - Ceib Phillips
- Department of Orthodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina
| | - Sigurdur Runar Saemundsson
- Department of Pediatric Dentistry, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina
| | - Peter Z Tawil
- Department of Endodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina.
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De‐Deus G, Cavalcante DM, Belladonna FG, Carvalhal J, Souza EM, Lopes RT, Versiani MA, Silva EJNL, Dummer PMH. Root dentinal microcracks: a post‐extraction experimental phenomenon? Int Endod J 2019; 53:137-142. [DOI: 10.1111/iej.13208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - J. Carvalhal
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - M. A. Versiani
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
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14
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Arashiro FN, De‐Deus G, Belladonna FG, Cavalcante DM, Coelho MS, Silva EJNL, Pereira KFS, Silva PG, Lopes RT, Souza EM. Dentinal microcracks on freshly extracted teeth: the impact of the extraction technique. Int Endod J 2019; 53:440-446. [DOI: 10.1111/iej.13239] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- F. N. Arashiro
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - M. S. Coelho
- Faculty of Dentistry São Leopoldo Mandic Campinas Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Brazil
| | - K. F. S. Pereira
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - P. G. Silva
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
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15
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Fu M, Huang X, Zhang K, Hou B. Effects of Ultrasonic Removal of Fractured Files from the Middle Third of Root Canals on the Resistance to Vertical Root Fracture. J Endod 2019; 45:1365-1370. [PMID: 31564462 DOI: 10.1016/j.joen.2019.08.009] [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: 06/05/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to analyze the effects of ultrasonic removal of fractured files from the middle third of root canals on the vertical root fracture resistance. METHODS This study was an extension of a previous study assessing the effects of fractured file removal on dentinal microcracks. It included 18 bilaterally matched pairs of human mandibular incisors prepared and analyzed in the previous study. Briefly, 1 member of each pair was assigned to an ultrasonic or a control group. In the ultrasonic group, K-files were fractured in the middle third of canals followed by ultrasonic file removal and canal preparation. In the control group, the root canals were simply prepared. Micro-computed tomographic imaging was performed before and after treatment, and the cross-sectional root images were screened for microcracks. For the present study, 3-dimensional reconstruction was performed for volumetric assessments. The fracture resistance was measured using a universal testing machine. All data were statistically analyzed. RESULTS Fracture loads were significantly smaller in the ultrasonic group (P < .05). The percentage increase in the canal volume significantly influenced the root fracture resistance (P < .05), whereas microcracks had no significant effect (P > .05). CONCLUSIONS Ultrasonic removal of fractured instruments from the middle third of root canals lowers the vertical root fracture resistance, with increased dentin removal being the primary cause.
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Affiliation(s)
- Mei Fu
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Xiaoxiang Huang
- Department of General Dentistry, School of Stomatology, Capital Medical University, Beijing, China
| | - Kunya Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Benxiang Hou
- Department of Endodontics, School of Stomatology, Capital Medical University, Beijing, China.
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16
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Çapar İD, Gök T, Uysal B, Keleş A. Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techniques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation. Microsc Res Tech 2019; 82:1748-1755. [PMID: 31313438 DOI: 10.1002/jemt.23341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/19/2019] [Accepted: 06/24/2019] [Indexed: 11/10/2022]
Abstract
The aim of the study was to compare different imaging methods in the diagnosis of microcracks on root dentin and to evaluate the frequency of dentinal microcracks observed after root canal preparation using the ProTaper Universal (PTU) system of different sizes. A total of 30 mandibular molars' mesial roots were scanned with microcomputed tomography (micro-CT) and cone beam computed tomography (CBCT) imaging methods before instrumentation. Root canal instrumentation was performed up to PTU F2 and F4 files. After instrumentation stages, the roots were scanned again with micro-CT and then with CBCT in same parameters. All roots were sectioned horizontally at 2, 4, 6, 8, and 10 mm from the apices of the specimens. The sections were imaged under a stereomicroscope. Finally, imaging of the sections was done by scanning electron microscopy (SEM). Statistical data analysis of instrumentation steps was performed using Friedman and Wilcoxon tests, and the data of imaging methods were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p = .05). Instrumentation with the PTU system up to F2 and F4 files significantly increased the number of microcracks compared with preoperative samples according to micro-CT imaging (p < .05). For detecting microcracks on the root dentin, there were no statistically significant differences between micro-CT (43.9%) and stereomicroscopy (45.8%) (p < .05). SEM showed significantly higher percentage of microcracks (88.3%) (p > .05). No microcrack was observed using the CBCT method. There were no statistically differences between micro-CT and stereomicroscopy. SEM showed more dentinal microcracks while no microcrack was observed with CBCT.
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Affiliation(s)
- İsmail D Çapar
- Private Practice, Periodent Dental Clinic, İstanbul, Turkey
| | - Tuba Gök
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Banu Uysal
- Private Practice, Pros' Esthetic Oral and Dental Health Clinic, İzmir, Turkey
| | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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17
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Rödig T, Krämer J, Müller C, Wiegand A, Haupt F, Rizk M. Incidence of microcracks after preparation of straight and curved root canals with three different NiTi instrumentation techniques assessed by micro-CT. AUST ENDOD J 2019; 45:394-399. [PMID: 30907062 DOI: 10.1111/aej.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2019] [Indexed: 01/31/2023]
Abstract
This study evaluated the effect of three different NiTi instrumentation techniques on the incidence of microcracks after the preparation of straight and curved root canals using micro-CT. Roots from mandibular premolars and maxillary molars (n = 66) with the same mean canal curvatures were assigned to three groups of straight and three groups of curved roots (n = 11). After preoperative micro-CT scans, root canals were prepared with Reciproc, OneShape and ProTaper Next to size 25. Specimens were scanned again, and pre- and post-operative cross-sectional images (n = 75 263) were screened to identify the presence of dentinal microcracks. Overall, microcracks were detected in 2.97% (n = 2236) of the cross-sectional images. No new dentinal microcracks were observed after root canal instrumentation of straight and curved canals with the tested NiTi systems. Instrumentation with Reciproc, OneShape and ProTaper Next did not induce the formation of dentinal microcracks irrespective of canal curvature.
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Affiliation(s)
- Tina Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Juliane Krämer
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Christine Müller
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Franziska Haupt
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Marta Rizk
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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18
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De‐Deus G, Cavalcante DM, Belladonna FG, Carvalhal J, Souza EM, Lopes RT, Versiani MA, Silva EJNL, Dummer PMH. Root dentinal microcracks: a post‐extraction experimental phenomenon? Int Endod J 2018; 52:857-865. [DOI: 10.1111/iej.13058] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - J. Carvalhal
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís MaranhãoBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de JaneiroBrazil
| | - M. A. Versiani
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
| | - P. M. H. Dummer
- School of Dentistry College of Biomedical and Life Sciences Cardiff University Cardiff UK
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Wang Y, Liu S, Dong Y. In vitro study of dentinal tubule penetration and filling quality of bioceramic sealer. PLoS One 2018; 13:e0192248. [PMID: 29390037 PMCID: PMC5794174 DOI: 10.1371/journal.pone.0192248] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 01/18/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate the dentinal tubule penetration and filling quality of a bioceramic sealer (iRoot SP). Forty-two roots of extracted adult lower incisors were selected. After instrumentation with Protaper Universal to F3, 40 roots were chosen and randomly divided into 4 groups, as follows: iRoot SP single cone group, iRoot SP warm vertical group, AH Plus single cone group, and AH Plus warm vertical group. Before root canal filling, sealers were mixed with Rhodamine B dye for visualization under confocal laser scanning microscope. All samples were sectioned at 2, 4, and 6 mm to apex. Then, the percentages of void areas, gap regions, and segments of sealer that penetrated into dentinal tubules in each section were calculated. Non-parametric test was used for statistical analysis (α = 0.05). We found that filling techniques and types of sealer had no statistically significant effects on the occurrence of voids and gaps. The segments of iRoot SP penetrated into dentinal tubules were statistically more than that of AH Plus in both single cone and warm vertical techniques at 2 mm to apex (P < 0.05). Regardless of the filling technique used, iRoot SP can achieve comparable filling quality and better dentinal tubules penetration than AH Plus. Considering the good bioactivity of iRoot SP, it may help improve the seal of root canal system.
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Affiliation(s)
- Yahui Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
| | - Siyi Liu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
| | - Yanmei Dong
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, P.R.China
- * E-mail:
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20
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Rödig T, Müller C, Hoch M, Haupt F, Schulz X, Wiegand A, Rizk M. Moisture content of root canal dentine affects detection of microcracks using micro-computed tomography. Int Endod J 2017; 51:357-363. [DOI: 10.1111/iej.12850] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/24/2017] [Indexed: 01/02/2023]
Affiliation(s)
- T. Rödig
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - C. Müller
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - M. Hoch
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - F. Haupt
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - X. Schulz
- Department of Medical Statistics; University Medical Center Göttingen; Göttingen Germany
| | - A. Wiegand
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
| | - M. Rizk
- Department of Preventive Dentistry; Periodontology and Cariology; University Medical Center Göttingen; Göttingen Germany
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