1
|
Macedo FPG, Soares ADJ, Marceliano-Alves MFV, Martinez E, Lopes R, Bastos LF, Nascimento WM, Limoeiro AG, Dos Frozoni M. The effect of root canal preparation tapers on planktonic bacteria and biofilm reduction in the apical third: A correlative microtomography and microbiological laboratory study. Int Endod J 2024; 57:700-712. [PMID: 38404175 DOI: 10.1111/iej.14052] [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: 08/21/2023] [Revised: 01/05/2024] [Accepted: 02/11/2024] [Indexed: 02/27/2024]
Abstract
AIM To evaluate the influence of different preparation tapers on the reduction in planktonic bacteria and biofilms of Enterococcus faecalis and Candida albicans in the apical third (4 mm) of the mesial roots of mandibular molars, correlating decontamination with canal shape. METHODOLOGY After microtomography analysis for morphological standardization of the canals, 48 mandibular molar roots, each containing two canals (96 canals), were contaminated with E. faecalis and C. albicans and divided into four groups (n = 11) for canal instrumentation using ProDesign Logic 2 files with different tapers G (.03): # 25.03; G (.04): # 25.04; G (.05): # 25.05; and G (.06): # 25.06 and irrigation with 2.5% sodium hypochlorite. Four roots were examined under a scanning electron microscope (SEM) to qualitatively assess biofilm formation. Eight roots were used as the negative control group (samples were not contaminated). Bacteriological samples were taken exclusively from the apical third of the roots before and after chemical-mechanical preparation and bacterial counts were determined (CFU/mL). The final micro-CT scan was used to quantify the volume variation and unprepared canal area in the apical third. Statistical analysis was performed using the Kruskal-Wallis, Student-Newman-Keuls and Wilcoxon tests for analysis of microbiological data. anova and the Tukey or Games-Howell test were used for analysis of micro-CT data and Spearman's test for correlations (α = 5%). RESULTS All groups showed a significant reduction in bacteria (p < .05), with no statistically significant difference between groups. There was no significant difference in per cent volume increase between groups. The unprepared area (Δ%) was affected by the file used (p = .026) and was significantly lower for G (.06) compared to G (.03). There was no statistically significant correlation among bacterial reduction, volume and unprepared area (p > .05). CONCLUSION The different preparation tapers influenced root canal shaping in the apical third but did not improve decontamination in this region.
Collapse
Affiliation(s)
| | - Adriana de Jesus Soares
- Department of Endodontics, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil
| | - Marília Fagury Videira Marceliano-Alves
- Postgraduate Program in Dentistry, Iguaçu University, Rio de Janeiro, Brazil
- Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), KU Leuven (University of Leuven), Leuven, Belgium
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d'Excellence INFLAMEX, Université Paris Cité, Montrouge, France
| | - Elizabeth Martinez
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Ricardo Lopes
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Luan Ferreira Bastos
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Wayne Martins Nascimento
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Ana Grasiela Limoeiro
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | - Marcos Dos Frozoni
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| |
Collapse
|
2
|
Yanık D, Özel Ş. Shaping ability of three instrumentation system in moderately curved canals: A micro-CT study. Microsc Res Tech 2024. [PMID: 38813968 DOI: 10.1002/jemt.24613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 05/31/2024]
Abstract
This study aims to compare the shaping ability of three systems using micro-computed tomography (micro-CT). Moderately-curved mesial canals of 36 mandibular molars were assigned to three groups (n = 24); Protaper Next (PTN, 0.25, 0.06), WaveOne Gold (WOG, 0.25, 0.07), TruNatomy (TRN, 0.25, 0.04), and instrumentation was performed. Pre- and post-micro-CT scans were obtained. Canal volume and surface, structure model index (SMI), centroid shift, canal transportation, and untouched canal were analyzed. One-way ANOVA and Student's t-test were used for statistics. There was no difference in SMI, centroid shift, and centering ability between the study groups (p > .05). Removed dentin and canal surface changes were lower in TRN, while untouched dentin walls were higher (p < .05). Cross-sections became more rounded (p < .05), but not significant between groups (p > .05). Considering the removed dentin by TRN, it can be used in critical dentin thickness, such as the danger zone (DZ). PTN, WOG, and WOG kept the original canal course similarly. Untouched dentin by TRN (41%) was wider than PTN and WOG, consequently, meticulous irrigation is recommended. TRN, which provides a controlled increase in canal volume, can be used in thin dentin such as the DZ, however, its use should be supported by copious irrigation and brushing considering the rate of untouched dentin walls. RESEARCH HIGHLIGHTS: TRN presented a higher untouched dentin wall compared to PTN and WOG. Canal volume and surface changes were the lowest in the TRN group. The centering abilities were similar in PTN, WOG, and TRN.
Collapse
Affiliation(s)
- Deniz Yanık
- Faculty of Dentistry, Department of Endodontics, Süleyman Demirel University, Isparta, Turkey
| | - Şelale Özel
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Altınbas University, İstanbul, Turkey
| |
Collapse
|
3
|
Călin C, Focșăneanu AM, Paulsen F, Didilescu AC, Niță T. Shaping Efficiency of Rotary and Reciprocating Kinematics of Engine-driven Nickel-Titanium Instruments in Moderate and Severely curved Root Canals Using Microcomputed Tomography: A Systematic Review of Ex Vivo Studies. J Endod 2024:S0099-2399(24)00169-9. [PMID: 38537784 DOI: 10.1016/j.joen.2024.03.009] [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: 12/29/2023] [Revised: 02/29/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION This systematic review aimed to compare reciprocating with continuous rotary instrumentation kinematics, by means of microcomputed tomography evaluations, in extracted human permanent teeth with moderate and severe canal curvatures. METHODS The research protocol was registered in the International Prospective Register of Systematic Reviews and given the reference number CRD42023404035. An electronic search was undertaken in MEDLINE (PubMed), EBSCO, Scopus, Web of Science databases until December 2021. Manual screening of issues in endodontic journals and references of relevant articles were assessed individually. The risk of bias (RoB) of the included articles was evaluated with the QUIN tool (Quality Assessment Tool for In Vitro Studies). RESULTS Among 1640 retrieved articles, 49 were included in the qualitative synthesis. Fifteen articles had low RoB, 33 articles had medium RoB, and only 1 study was at high RoB. Continuous rotary systems had better centering ability in both moderate and severe canal curvatures and resulted in less apical transportation in severely curved root canals. None of the kinematic systems was capable of instrumenting the entire canal surface area. Reciprocating kinematics systems tended to provide higher increase in surface area of severely curved canals and produced fewer dentinal microcracks in moderately curved canals. CONCLUSIONS The evidence presented in this review suggests that continuous rotary system seems to be better than reciprocating system in solving the major issues encountered during root canal instrumentation of extracted teeth with moderate and severe curvatures.
Collapse
Affiliation(s)
- Claudiu Călin
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Andreea C Didilescu
- Faculty of Dentistry, Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Tiberiu Niță
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery "Dan Theodorescu Hospital", Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| |
Collapse
|
4
|
Dewes Cassal M, Cardoso Soares P, Dos Santos M. The Effect of Combined Ultrasonic Tip and Mechanized Instrumentation on the Reduction of the Percentage of Non-Instrumented Surfaces in Oval/Flat Root Canals: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e50041. [PMID: 38186463 PMCID: PMC10768610 DOI: 10.7759/cureus.50041] [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] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the effectiveness of the ultrasonic tip associated with mechanized instrumentation in reducing the percentage of non-instrumented surfaces of human teeth with oval or flattened root canals. The study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Pubmed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, Embase, Web of Science, and Cochrane Library were searched for literature published till October 2022. Only in vitrostudies were included, which compared conventional mechanized endodontic treatment alone against conventional endodontic treatment in association with ultrasonic tips, evaluating the reduction in the percentage of non-instrumented walls (computed microtomography). Four studies were eligible for qualitative and quantitative analysis. The majority of the studies scored low for risk of bias. The meta-analysis comparing protocols demonstrated a reduced percentage of non-instrumented walls in groups using ultrasonic tips after the conventional mechanized technique (p<0.01) with a confidence interval of 1.04 (95%CI: 0.59, 1.50). The ultrasonic tip associated with mechanized instrumentation demonstrates a significant reduction in the percentage of non-instrumented surfaces in oval or flattened canals.
Collapse
Affiliation(s)
- Marcella Dewes Cassal
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
| | - Pedro Cardoso Soares
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
| | - Marcelo Dos Santos
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, BRA
| |
Collapse
|
5
|
Gioster-Ramos ML, Pivoto-João MMB, Pinto JC, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Diamond-coated ultrasonic tip decreases debris and uninstrumented surface after preparation of curved canals with isthmus. Braz Oral Res 2023; 37:e102. [PMID: 38055520 DOI: 10.1590/1807-3107bor-2023.vol37.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/29/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this study was to evaluate root canal preparation with nickel titanium rotary instruments and complementary preparation with ultrasonic tip in curved canals of mandibular molars with isthmus. Twenty-eight mesial roots of mandibular molars with curvature between 20° and 40° and presence of isthmus throughout the entire extension of the root canals were prepared using ProDesign Logic CM (PDL) up to size 40.05, or HyFlex EDM (HFEDM) up to size 40.04. Complementary preparation was performed in the isthmus region using the ultrasonic insert E18D (Helse, Istmo Diamantada). The root canals were scanned using micro-CT (SkyScan 1176) at 9 µm voxel size before and after each preparation step. Transportation, percentage of increase in volume, debris and uninstrumented surface (UNS) were evaluated. Mann Whitney, Wilcoxon, paired and non-paired t-tests were used for statistical analysis (α = 0.05). The canals prepared with PDL and HFEDM obtained similar results for all the variables assessed before using E18D (p > 0.05). E18D significantly decreased the percentage of debris and UNS values in both Groups (p < 0.05). The complementary preparations with E18D caused a smaller quantity of debris in the isthmus of the canals previously prepared with PDL in comparison with HFEDM (p < 0.05). PDL and HFEDM provided similar root canal preparation. PDL promoted a smaller quantity of Debris in the isthmus than HFEDM after using E18D. E18D significantly improved cleaning, and reduced Debris and UNS.
Collapse
Affiliation(s)
- Maria Luiza Gioster-Ramos
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Jáder Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | | | - Mário Tanomaru-Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| |
Collapse
|
6
|
Dantas WCF, Marceliano-Alves MFV, Marceliano EFV, Marques EF, de Carvalho Coutinho TM, Alves FR, Martin ASD, Pelegrine RA, Lopes RT, Bueno CEDS. Microtomographic Assessment of the Shaping Ability of the Hyflex CM and XP-endo Shaper Systems in Curved Root Canals. Eur J Dent 2023; 17:699-705. [PMID: 36220114 PMCID: PMC10569844 DOI: 10.1055/s-0042-1750694] [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: 10/17/2022] Open
Abstract
OBJECTIVE This study compared the shaping ability of the Hyflex CM and XP-endo Shaper rotary file systems in curved mesial canals of mandibular molars using micro-computed tomography. MATERIAL AND METHODS Seventeen mesial roots of extracted first mandibular molars with two independent mesial canals were scanned before and after root canal preparation with the tested rotatory file systems. Each mesial canal from the same specimen was prepared with one of the two systems. The parameters analyzed were canal centering (transportation) for the cervical, middle, and apical segments, as well as for the entire canal (0-10 mm from the apex); and canal volume increase, canal surface area increase, and unprepared canal walls for two segments, 0 to 4 mm and 0 to 10 mm from the apex. RESULTS There was no significant difference between both systems regarding canal centering (transportation), volume increase, and unprepared canal walls for the 0 to 10 mm segment (p> 0.05); however, a significant difference was observed for the 0 to 4 mm segment (p <0.01), where the Hyflex CM left 28.46% of unprepared walls and XP-endo Shaper left 13.26%. CONCLUSIONS The shaping ability of the two tested rotatory file systems in mesial roots of first mandibular molars was similar for all parameters in all the segments evaluated, except for the 0 to 4 mm segment, where XP-endo Shaper left a smaller area of unprepared canal walls than Hyflex CM.
Collapse
Affiliation(s)
| | | | | | | | | | - Flavio R.F. Alves
- Department of Endodontics and Dental Research, Iguaçu University, Nova Iguaçu, Brazil
| | - Alexandre Sigrist De Martin
- Department of Endodontics, São Leopoldo Mandic College, São Leopoldo Mandic Research Institute, Campinas, São Paulo, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic College, São Leopoldo Mandic Research Institute, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Departament of Nuclear Energy, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | |
Collapse
|
7
|
Santos LRKD, Pelegrine AA, da Silveira Bueno CE, Muniz Ferreira JR, Aloise AC, Stringheta CP, Martinez EF, Pelegrine RA. Pulp-Dentin Complex Regeneration with Cell Transplantation Technique Using Stem Cells Derived from Human Deciduous Teeth: Histological and Immunohistochemical Study in Immunosuppressed Rats. Bioengineering (Basel) 2023; 10:bioengineering10050610. [PMID: 37237680 DOI: 10.3390/bioengineering10050610] [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: 04/28/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to histologically verify the performance of pulp-derived stem cells used in the pulp-dentin complex regeneration. Maxillary molars of 12 immunosuppressed rats were divided into two groups: the SC (stem cells) group, and the PBS (just standard phosphate-buffered saline) group. After pulpectomy and canal preparation, the teeth received the designated materials, and the cavities were sealed. After 12 weeks, the animals were euthanized, and the specimens underwent histological processing and qualitative evaluation of intracanal connective tissue, odontoblast-like cells, intracanal mineralized tissue, and periapical inflammatory infiltrate. Immunohistochemical evaluation was performed to detect dentin matrix protein 1 (DMP1). In the PBS group, an amorphous substance and remnants of mineralized tissue were observed throughout the canal, and abundant inflammatory cells were observed in the periapical region. In the SC group, an amorphous substance and remnants of mineralized tissue were observed throughout the canal; odontoblasts-like cells immunopositive for DMP1 and mineral plug were observed in the apical region of the canal; and a mild inflammatory infiltrate, intense vascularization, and neoformation of organized connective tissue were observed in the periapical region. In conclusion, the transplantation of human pulp stem cells promoted partial pulp tissue neoformation in adult rat molars.
Collapse
Affiliation(s)
| | - André Antonio Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Implantodontia, Campinas 13045-755, Brazil
| | | | | | - Antonio Carlos Aloise
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Implantodontia, Campinas 13045-755, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas 13045-755, Brazil
| | - Elizabeth Ferreira Martinez
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Patologia Oral, Campinas 13045-755, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Endodontia, Campinas 13045-755, Brazil
| |
Collapse
|
8
|
Post-Operative Quality of Life after Single-Visit Root Canal Treatment Employing Three Different Instrumentation Techniques-An Institutional Randomized Clinical Trial. J Clin Med 2023; 12:jcm12041535. [PMID: 36836070 PMCID: PMC9965264 DOI: 10.3390/jcm12041535] [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: 01/22/2023] [Revised: 02/04/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
Root canal treatment (RCT) eliminates damaged pulpal tissue and protects the tooth from recurrent microbial invasion. Post-endodontic pain (PEP) is a frequently encountered complication of root canal therapy. It can have an impact on patients' quality of life (QoL) and their subjective perception of treatment options. Thus, a self-assessment questionnaire was used to evaluate and compare the influence of manual, rotary, and reciprocating file shaping procedures on immediate post-operative quality of life (POQoL) involving single-visit root canal therapy. It was a double-blinded, randomized, controlled clinical trial. A total of 120 participants were randomly assigned sequentially to three groups comprising 40 patients in each group: Group A: Hand K file (positive control); Group B: ProTaper Next file system; and Group C: WaveOne Gold. Post-operative pain was evaluated using a 4-point visual analog scale (VAS) after 12 h, 24 h, 48 h, 72 h, and 1 week. The highest post-operative pain was with manual instrumentation using hand K files, and the lowest was with reciprocating and rotating instrumentations. No significant difference was noted between the parameters of quality of life assessed, suggesting the filing system or technique had a similar effect.
Collapse
|
9
|
Çiftçioğlu E, Keleş A, Akbal Dinçer G, Ateş MO, Küçükay ES. Shaping ability of WaveOne Gold and OneReci by using two apical sizes: a micro-computed tomographic assessment. PeerJ 2023; 11:e15208. [PMID: 37131992 PMCID: PMC10149051 DOI: 10.7717/peerj.15208] [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: 12/21/2022] [Accepted: 03/19/2023] [Indexed: 05/04/2023] Open
Abstract
Backround OneReci (MicroMega, Besançon, France) is a recently introduced single-file reciprocating system with scarce information revealed on its shaping ability. This study aimed to compare the shaping abilities of OneReci and a well-documented single-file reciprocating system WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland) and evaluate the effect of increased apical enlargement on the preparation quality, using micro-computed tomography (micro-CT). Methods After an initial micro-CT scanning, twenty mesial root canals of mandibular molars were anatomically matched. The canals were assigned to two experimental groups (n = 10), using OneReci or WOG in different canals of the same root. The glide paths were created, and root canals were prepared twice, using size 25 and 35 instruments of the systems, respectively. The specimens were scanned with micro-CT after each preparation. The increase in canal volume, amount of dentin removal, unprepared root canal surface, canal transportation, centering ratio and preparation times were assessed. The data were analysed with independent sample t-tests, variance analyses, Friedman and Mann-Whitney U tests. The significance level was set at 5%. Results Each preparation increased the canal volume and dentin removal while decreasing the unprepared root surface. The difference between the systems became significant after preparation with size 35 instruments (p < 0.05). Regarding canal transportation and centering ratio, the difference was insignificant (p > 0.05). The first preparation step (glide path + size 25 instrument) was significantly faster in the OneReci group (p < 0.05). Conclusions Preparation with size 25 instruments of the systems appeared to be safe with similar shaping performances. Larger apical preparation promoted significantly higher dentin removal, volume increase, and prepared surface area in WOG.
Collapse
Affiliation(s)
| | - Ali Keleş
- Abant Izzet Baysal University, Bolu, Turkey
- Ondokuz Mayis University, Samsun, Turkey
| | | | | | | |
Collapse
|
10
|
Liu Y, Chen M, Tang W, Liu C, Du M. Comparison of five single-file systems in the preparation of severely curved root canals: an ex vivo study. BMC Oral Health 2022; 22:649. [PMID: 36577985 PMCID: PMC9798582 DOI: 10.1186/s12903-022-02668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel-titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals. METHODS A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal-Wallis test (CT, SEM-score), the level of significance was set at α = 0.05. RESULTS There were no significant differences between the five systems regarding the AD, VI, and UTA parameters (P > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex (P < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending (P < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups (P < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds (P < 0.01 and P < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds. CONCLUSION The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.
Collapse
Affiliation(s)
- Yina Liu
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Meizhi Chen
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Weilong Tang
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chang Liu
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| | - Minquan Du
- grid.49470.3e0000 0001 2331 6153The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,grid.49470.3e0000 0001 2331 6153Department of Preventive Dentistry, Hospital of Stomatology, Wuhan University, Hongshan District, Luo-Yu Road 237th, 430075 Wuhan, Hubei China
| |
Collapse
|
11
|
Zarean P, Özcan M, Zarean P, Haghani SO, Jahromi MZ, Al-Haj Husain N, Khabiri M. Micro-Computed Tomographic Assessment of Microcrack Formation before and after Instrumentation of Curved Root Canals with Neoniti Rotary Files. MATERIALS 2022; 15:ma15093002. [PMID: 35591336 PMCID: PMC9105525 DOI: 10.3390/ma15093002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023]
Abstract
The aim of this study was to assess the microcrack formation of moderately and severely curved root canals following instrumentation with Neoniti rotary files using micro-computed tomography. This in vitro study evaluated 18 extracted sound mandibular molars with two separate mesial canals and foramina in two groups (n = 9) with 5−20° (moderate) and 20−40° (severe) root canal curvature. The number of microcracks in the root canal walls was counted at baseline by micro-CT. Subsequently, the root canals were instrumented with 0.20/0.06 v Neoniti files as single files with a torque of 1.5 Ncm and a speed of 400 rpm. The number of microcracks was counted again postoperatively on micro-CT images using Amira software. Statistical analysis was performed using the Shapiro−Wilk test, Levene’s test and repeated-measures ANOVA (α = 0.05). The mean number of microcracks significantly increased postoperatively in both the moderately curved (11.59 ± 9.74 vs. 8.2 ± 7.4; p = 0.001) and the severely curved (13.23 ± 5.64 vs. 7.20 ± 5.94; p < 0.001) groups. However, the differences between the two groups were not significant (p = 0.668). Based on the results obtained, it can be stated that the instrumentation of moderately and severely curved root canals with Neoniti rotary files increases the number of microcracks. However, the higher degree of curvature does not necessarily translate to a higher number of microcracks after root canal instrumentation with this specific rotary system and methodological procedures.
Collapse
Affiliation(s)
- Parichehr Zarean
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (M.Ö.); (N.A.-H.H.)
| | - Paridokht Zarean
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (P.Z.); (P.Z.)
| | - Seyed Omid Haghani
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
| | - Maryam Zare Jahromi
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
- Correspondence:
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (M.Ö.); (N.A.-H.H.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Masoud Khabiri
- Department of Endodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan 81551-39998, Iran; (S.O.H.); (M.K.)
| |
Collapse
|
12
|
Varghese E, Venkatesh K. Comparative evaluation of cutting efficiency, cyclic fatigue, corrosion resistance, and autoclave cycle effects of three different file systems: An in-vitro micro-CT and metallurgy analysis. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_91_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
13
|
Tavares KIMC, Pinto JC, Santos-Junior AO, Esteves Torres FF, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals. Restor Dent Endod 2021; 46:e56. [PMID: 34909420 PMCID: PMC8636074 DOI: 10.5395/rde.2021.46.e56] [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: 06/07/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.
Collapse
Affiliation(s)
| | - Jáder Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| |
Collapse
|
14
|
Martins JNR, Silva EJNL, Marques D, Belladonna FG, Simões-Carvalho M, da Costa RP, Ginjeira A, Braz Fernandes FM, Versiani MA. Comparison of five rotary systems regarding design, metallurgy, mechanical performance, and canal preparation-a multimethod research. Clin Oral Investig 2021; 26:3299-3310. [PMID: 34860307 DOI: 10.1007/s00784-021-04311-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare the design, metallurgy, mechanical performance, and canal preparation of 5 rotary systems. MATERIAL AND METHODS A total of 735 25-mm NiTi instruments (sizes 0.17[0.18]/.02v, 0.20/.04v, 0.20/.07v, 0.25/.08v, 0.30/.09v) from ProTaper Gold, ProTaper Universal, Premium Taper Gold, Go-Taper Flex, and U-File systems were compared regarding overall geometry and surface finishing (stereomicroscopy and scanning electron microscopy), nickel and titanium ratio (energy-dispersive spectroscopy), phase transformation temperatures (differential scanning calorimetry), mechanical performance (torsional and bending tests), and unprepared canal surface (micro-CT). One-way ANOVA and Mood's median tests were used for statistical comparisons with a significance level set at 5%. RESULTS Stereomicroscopic analysis showed more spirals and high helical angles in the Premium Taper Gold system. All sets of instruments had symmetrical spirals, no radial lands, no major defects, and an almost equiatomic ratio between nickel and titanium elements, while differences were observed in their tips' geometry and surface finishing. At room temperature (20 °C), DSC test revealed martensitic characteristics for ProTaper Gold and Go-Taper Flex, and mixed austenite plus R-phase for the Premium Taper Gold, while ProTaper Universal and U-Files had full austenitic characteristics. Overall, larger instruments had higher torque resistance and bending load values than smaller ones, while a lack of consistency and mixed values were observed in the angle of rotation. The 0.25/.08v and 0.30/.09v instruments of ProTaper Universal and U-File had the highest maximum torques, the lowest angles of rotation, and the highest bending loads than other tested systems (P < .05). No significant difference was noted regarding the untouched root canal walls after preparation with the tested systems (P > .05). CONCLUSIONS Although differences observed in the overall geometry and phase transformation temperatures have influenced the results of mechanical tests, unprepared canal surface areas were equivalent among systems. CLINICAL RELEVANCE Root canal preparation systems with similar geometries might present different mechanical behaviors but equivalent shaping ability.
Collapse
Affiliation(s)
- Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal.
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal.
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudo de Medicina Dentária Baseada Na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, Lisbon, Portugal
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niteroi, Rio de Janeiro, Brazil
| | - Rui Pereira da Costa
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
| | - António Ginjeira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Cidade Universitária, 1649-003, Lisbon, Portugal
- Grupo de Investigação Em Bioquimica E Biologia Oral, Faculdade de Medicina Dentária, Unidade de Investigação Em Ciências Orais E Biomédicas (UICOB), Universidade de Lisboa, Lisbon, Portugal
| | - Francisco Manuel Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco Aurélio Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
15
|
Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
Collapse
Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Xu F, Zhang Y, Gu Y, Ping Y, Zhou R, Wang J. Shaping ability of four single-file systems in the instrumentation of second mesiobuccal canals of three-dimensional printed maxillary first molars. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1425. [PMID: 34733977 PMCID: PMC8506727 DOI: 10.21037/atm-21-3855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022]
Abstract
Background This study evaluated and compared the shaping ability of four advanced single-file nickel-titanium (NiTi) systems during the preparation of curved second mesiobuccal (MB2) canals in maxillary first molar replicas fabricated by three-dimensional (3D) printing via micro-computed tomography (Micro-CT) imaging. Methods A total of 60 3D-printed maxillary first molar replicas were constructed from one extracted tooth, with an angle of curvature ranging from 15° to 25°. The MB2 canals from these 60 replicas were divided into 4 groups of 15 replicas according to the canal instrumentation system used, namely, Waveone gold (WOG), Reciproc blue (RCB), XP-endo shaper (XPS) and M3-L. The specimens were scanned before and after preparation using Micro-CT. The pre- and post-instrumentation images of each specimen were superimposed, and the amount of resin removed, the change in surface area, the canal transportation, and centering ability were assessed using the Mimics software. Instrumentation time was also recorded. One-way analysis of variance and least significant difference (LSD) tests were used to statistically compare the groups. The significance level was set at 5%. Results Instrumentation time with M3-L was significantly longer than the other systems (P<0.05). The amount of resin removed and the change in surface area generated by the 4 systems were different at the apical, middle, and coronal thirds, and the total canal (P<0.05). Overall, WOG and XPS resulted in the less change than RCB and M3-L. There was no significant difference among the groups at the middle third regarding canal transportation and centering ability (P>0.05). However, a significant difference was found at the apical level (P<0.05), where RCB showed the poorest centering ability and the highest canal transportation (P<0.05). In addition, XPS resulted in the least canal transportation (P<0.05) at the coronal level, while there was no significant difference between the four groups in terms of centering ability. Conclusions The M3-L instrument required more time to prepare the curved MB2 canals compared with the other systems. Overall, WOG and XPS showed the least resin removal and surface area change. M3-L, XPS, and WOG instruments respected the original canal curvature better than RCB files.
Collapse
Affiliation(s)
- Fulu Xu
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Yuerong Zhang
- Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.,Department of General Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Yongchun Gu
- Department of Dentistry, The Ninth People's Hospital of Suzhou, China
| | - Yifan Ping
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Ruyu Zhou
- Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Juan Wang
- Department of Endodontics and Operative Dentistry, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| |
Collapse
|
18
|
Martins JNR, Silva EJNL, Marques D, Belladonna F, Simões-Carvalho M, Vieira VTL, Antunes HS, Braz Fernandes FMB, Versiani MA. Design, metallurgical features, mechanical performance and canal preparation of six reciprocating instruments. Int Endod J 2021; 54:1623-1637. [PMID: 33829516 DOI: 10.1111/iej.13529] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/05/2021] [Indexed: 11/28/2022]
Abstract
AIM To compare six reciprocating instruments regarding their geometric design, metallurgical characteristics, mechanical behaviour and ability to prepare root canals. METHODOLOGY A total of 246 new 25-mm NiTi instruments (41 per group) from six reciprocating systems (Reciproc, Reciproc Blue, One Files, One Files Blue, Reverso Silver, and WaveOne Gold) were evaluated throughout a multimethod approach regarding their design using stereomicroscopy (number of blades and helix angle) and scanning electron microscopy (blades symmetry, cross section and surface finishing), nickel-titanium composition, phase transformation temperatures, mechanical performance (cyclic fatigue, torsional and bending resistance) and unprepared canal surface area on anatomically matched mandibular molars assessed by micro-CT. One-way ANOVA and post hoc Tukey's or Mood's median tests were selected depending on sample distribution with significance level set at 5%. RESULTS The instruments had similarities regarding their metal composition and unprepared canal area, whilst differences in phase transformation temperatures and geometric design (number of blades, surface finishing and tip geometry) were observed. Overall, no difference was observed regarding the maximum torque values (P > 0.05), whilst One Files (72 s) and One Files Blue (414 s) had the shortest and longest times to fracture, respectively (P < 0.05). Similar angles of rotation were observed in Reciproc (310°), One Files (285°) and Reverso Silver (318°) instruments (P > 0.05), which were significantly lower than Reciproc Blue (492°), One Files Blue (456°) and WaveOne Gold (492°; P < 0.05). Maximum bending load demonstrated that Reciproc Blue (201.3 gf) was significantly more flexible that the other instruments (P < 0.05). CONCLUSION Although there were similarities in metal composition and percentage of unprepared canal surface, the instruments had differences in the overall geometric design, phase transformation temperatures and in the four mechanical resistance parameters (time to fracture, maximum torque, angle of rotation and maximum bending load).
Collapse
Affiliation(s)
- J N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - E J N L Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil.,Department of Endodontics, Fluminense Federal University, Niteroi, Brazil
| | - D Marques
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,LIBPhys-FCT UID/FIS/04559/2013, Lisboa, Portugal
| | - F Belladonna
- Department of Endodontics, Fluminense Federal University, Niteroi, Brazil
| | - M Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niteroi, Brazil
| | - V T L Vieira
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - H S Antunes
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - F M B Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - M A Versiani
- Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
| |
Collapse
|
19
|
Kabil E, Katić M, Anić I, Bago I. Micro-computed Evaluation of Canal Transportation and Centering Ability of 5 Rotary and Reciprocating Systems with Different Metallurgical Properties and Surface Treatments in Curved Root Canals. J Endod 2020; 47:477-484. [PMID: 33217469 DOI: 10.1016/j.joen.2020.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the transportation and centering ability of 5 different rotary and reciprocating file systems with different metallurgical properties and surface treatments in curved root canals. METHODS Fifty mesiobuccal round canals of upper molars with a curvature of 25°-40° were assigned to 5 experimental groups (n = 12) according to the instrumentation system used: ProTaper Next (Dentsply Sirona, York, PA), Reciproc Blue (RCB [VDW, Munich, Germany]), Reciproc (VDW), TruNatomy (TRN [Dentsply Sirona]), and XP-endo Shaper (FKG, La Chaux-de-Fonds, Switzerland). During instrumentation, 5 mL 2.5% sodium hypochlorite was used in each root canal. The final irrigation protocol included 15% EDTA followed by sodium hypochlorite irrigation. The micro-computed tomographic scanning of the samples was performed before and after instrumentation to analyze the transportation and centering ability at 3 canal levels. The results were analyzed with the 1-way analysis of variance test with the corresponding post hoc test. RESULTS Overall, RCB caused significantly more canal transportation compared with the other techniques (P < .05). There were no significant differences between the other techniques (P > .05). ProTaper Next had a significantly better ability to stay within the central axis of the root canal compared with the Reciproc and RCB techniques (P = .046 and P = .017, respectively). In the apical third, all techniques caused similar apical transportation and centering ability (P > .05). In the middle and cervical parts of the canal, the RCB caused significantly greater canal transportation than the other techniques (P < .05). CONCLUSIONS Under the limitations of this study, all tested techniques had similar transportation and centering abilities in the apical part of the canal. However, the overall results and those in the middle and coronal parts of the canal indicated that reciprocating instruments resulted in more canal transportation and less centered preparations.
Collapse
Affiliation(s)
- Emina Kabil
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Katić
- Department of Quality, National Laboratory for Length, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| |
Collapse
|
20
|
Haupt F, Pult JRW, Hülsmann M. Micro–computed Tomographic Evaluation of the Shaping Ability of 3 Reciprocating Single-File Nickel-Titanium Systems on Single- and Double-Curved Root Canals. J Endod 2020; 46:1130-1135. [DOI: 10.1016/j.joen.2020.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 11/27/2022]
|
21
|
Santos-Junior AO, Tanomaru-Filho M, Pinto JC, Tavares KIMC, Pivoto-João MMB, Guerreiro-Tanomaru JM. New Ultrasonic Tip Decreases Uninstrumented Surface and Debris in Flattened Canals: A Micro-computed Tomographic Study. J Endod 2020; 46:1712-1718. [PMID: 32682793 DOI: 10.1016/j.joen.2020.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The preparation of flattened root canals using reciprocating or rotary nickel-titanium instruments associated with the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) was evaluated by micro-computed tomographic imaging. METHODS Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were randomly divided into 2 experimental groups for preparation: a Reciproc Blue (RB; VDW GmbH, Munich, Germany) 40/.06 file in reciprocating motion or ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 40/.01 and 40/.05 files in rotary motion (n = 12). A complementary preparation was performed with the Flatsonic ultrasonic tip for both preparations. Micro-computed tomographic scanning at a resolution of 8.74 μm was performed before and after preparation with the nickel-titanium instruments and after the use of the Flatsonic tip. The percentages of increase in volume, debris, and uninstrumented surface were analyzed. The data obtained were submitted to the paired and unpaired t test, analysis of variance, and the Tukey test (α = 5%). RESULTS The percentage increase in volume, debris, and uninstrumented surface was similar between RB and PDL in the entire root canal (P > .05). The PDL promoted a lower percentage of debris in the cervical third and a lower percentage of increase in volume in the apical third in comparison with RB (P < .05). The Flatsonic decreased debris and uninstrumented surface after PDL preparation in all thirds (P < .05). After preparation with RB, the Flatsonic decreases the debris in the cervical third and the uninstrumented surface in the cervical and middle thirds (P < .05). CONCLUSIONS The preparation of flattened root canals using RB or PDL produced a high percentage of debris and uninstrumented surface. The Flatsonic ultrasonic tip significantly improved the cleaning of flattened root canals.
Collapse
Affiliation(s)
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.
| | - Jader Camilo Pinto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | | | | |
Collapse
|
22
|
Htun PH, Ebihara A, Maki K, Kimura S, Nishijo M, Okiji T. Cleaning and Shaping Ability of Gentlefile, HyFlex EDM, and ProTaper Next Instruments: A Combined Micro–computed Tomographic and Scanning Electron Microscopic Study. J Endod 2020; 46:973-979. [DOI: 10.1016/j.joen.2020.03.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 11/30/2022]
|
23
|
Bueno CSP, Oliveira DP, Pelegrine RA, Fontana CE, Rocha DGP, Gutmann JL, Bueno CES. Fracture incidence of WaveOne Gold files: a prospective clinical study. Int Endod J 2020; 53:1192-1198. [PMID: 32573799 DOI: 10.1111/iej.13349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022]
Abstract
AIM This prospective clinical study evaluated the incidence of instrument fracture observed after single-file root canal treatment of molars using WaveOne Gold instruments. METHODOLOGY Three standardized, experienced and calibrated specialists treated 750 maxillary and mandibular molars with curvatures less than 45° (2691 root canals) over a 12-month period. All the treatments were performed in a single session. A total of 1104 WaveOne Gold instruments were used, including 38 small, 750 primary, 228 medium and 88 large instruments. Intracanal procedures were performed according to the manufacturer's recommendations, and each instrument was used in a single clinical case. The instruments were examined after their removal from the canal, under an operating microscope at 8× magnification. RESULTS No fractures were observed in any of the 1104 instruments used. CONCLUSIONS No fractures of WaveOne Gold reciprocating instruments occurred during root canal preparations performed in maxillary and mandibular molars with curvatures less than 45° when used strictly according to the manufacturer's recommendations and applied in a single clinical case.
Collapse
Affiliation(s)
- C S P Bueno
- Faculdade São Leopoldo Mandic, Endodontia, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - D P Oliveira
- Faculdade São Leopoldo Mandic, Endodontia, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - R A Pelegrine
- Faculdade São Leopoldo Mandic, Endodontia, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - C E Fontana
- Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - D G P Rocha
- Faculdade São Leopoldo Mandic, Endodontia, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil.,Department of Endodontics, School of Dentistry, Pontifical Catholic University of Campinas, Campinas, SP, Brazil
| | - J L Gutmann
- Department of Endodontics, School of Dentistry, Pontifical Javeriana University, Bogotá, Colombia
| | - C E S Bueno
- Faculdade São Leopoldo Mandic, Endodontia, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| |
Collapse
|
24
|
Borges CC, Estrela C, Decurcio DDA, PÉcora JD, Sousa-Neto MD, Rossi-Fedele G. Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review. Braz Oral Res 2020; 34:e056. [PMID: 32578799 DOI: 10.1590/1807-3107bor-2020.vol34.0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022] Open
Abstract
This study presents an overview of the accuracy of cone beam computed tomography (CBCT) compared with micro-computed tomography (μCT) in the assessment of root canal morphology of extracted human permanent teeth. A database search in PubMed, PubMed Central, Embase, Scopus, Opengrey, Scielo and Virtual Health Library was conducted which compared root canal morphology of extracted human permanent teeth on the accuracy of CBCT with μCT. In accordance with PRISMA statement guidelines, data were extracted on study characteristics, target mediators, sampling and assay techniques and the parameters associated with obtaining the image and ability to identify the root canal morphology. Amongst 2734 records, ten fulfilled the inclusion criteria. Four studies compared the accuracy of CBCT and μCT in the assessment of root canal morphology using Vertucci's classification, with at least one CBCT group or subgroup of each study presented high agreement compared to the μCT. Six studies assessed more detailed root canal morphology, including two articles that found a lack of agreement between these imaging systems. Risk of bias was deemed low in three studies, moderate in four and high in three. CBCT can be as accurate as μCT in the assessment of several morphological features of extracted human permanent teeth; however there are some exceptions related to the more detailed morphological aspects. Voxel size likely influences the ability to detect these features, though the different aspects of exposure setting used in studies components may be confounding factors. CBCT may be considered for the assessment of root canal morphology ex-vivo.
Collapse
Affiliation(s)
- Caroline Cristina Borges
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás - UFG, Faculty of Dentistry, Department of Stomatological Sciences, Goiânia, Brazil
| | - Jesus Djalma PÉcora
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | | |
Collapse
|
25
|
Velozo C, Silva S, Almeida A, Romeiro K, Vieira B, Dantas H, Sousa F, De Albuquerque DS. Shaping ability of XP‐endo Shaper and ProTaper Next in long oval‐shaped canals: a micro‐computed tomography study. Int Endod J 2020; 53:998-1006. [DOI: 10.1111/iej.13301] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- C. Velozo
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - S. Silva
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - A. Almeida
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - K. Romeiro
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| | - B. Vieira
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - H. Dantas
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - F. Sousa
- Department of Morphology Health Science Center Federal University of Paraíba Paraíba Brazil
| | - D. S. De Albuquerque
- Department of Restorative Dentistry and Endodontics Dental College of Pernambuco University of Pernambuco Camaragibe Brazil
| |
Collapse
|
26
|
Micro–computed Tomographic Evaluation of the Shaping Ability of WaveOne Gold, TRUShape, EdgeCoil, and XP-3D Shaper Endodontic Files in Single, Oval-shaped Canals: An In Vitro Study. J Endod 2020; 46:244-251.e1. [DOI: 10.1016/j.joen.2019.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/31/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
|