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Immich F, de Araújo LP, da Gama RR, da Rosa WLDO, Piva E, Rossi-Fedele G. Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review. AUST ENDOD J 2024; 50:409-463. [PMID: 38923176 DOI: 10.1111/aej.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.
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Affiliation(s)
- Felipe Immich
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Lucas Peixoto de Araújo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
- School of Dentistry, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Evandro Piva
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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Spohr AR, Xavier SR, Malta CP, Pereira-Cenci T, Pappen FG, Morgental RD. Postoperative pain after endodontic reintervention: a randomized clinical trial. Braz Dent J 2022; 33:18-27. [PMID: 35766713 PMCID: PMC9645201 DOI: 10.1590/0103-6440202204785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
The present randomized clinical trial compared the prevalence and intensity of
postoperative pain in cases of endodontic reintervention using manual or
engine-driven reciprocating instruments. As secondary objectives, the analgesic
intake and time required for the root canal filling removal and
re-instrumentation were also evaluated. Forty-eight individuals with an
endodontically treated single-rooted tooth diagnosed with asymptomatic apical
periodontitis were included in the study. Patients were randomly assigned to two
comparison groups (n=24/group): reintervention with stainless steel manual
instruments or a nickel-titanium reciprocating system (Reciproc; VDW, Munich,
Germany). The endodontic reintervention was performed in two sessions with a
calcium hydroxide-based intracanal medication applied for 14 days before root
canal obturation. Working time for the root canal filling removal and
re-instrumentation was recorded with a digital stopwatch. After each visit,
postoperative pain intensity was assessed at 12, 24, and 48 hours and seven days
using the Numerical Rating Scale (NRS). The patients were also asked about
analgesic intake. Data were analyzed using Pearson chi-square, T and
Mann-Whitney U tests (α=0.05). No significant differences between groups were
found regarding the prevalence and intensity of pain or the need for analgesic
intake at any time point (P > 0.05). Working time was significantly shorter
in the reciprocating group (18 versus 41 minutes). In conclusion, manual and
reciprocating instruments achieved the same results in terms of prevalence and
intensity of postoperative pain and analgesic intake. However, filling material
removal and re-instrumentation of the root canals were more than twice as fast
when using the reciprocating system.
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Affiliation(s)
- Andressa Raquel Spohr
- Graduate Program in Dentistry, Federal University of Pelotas(UFPel), Pelotas, RS, Brazil
| | | | - Cristiana Pereira Malta
- Graduate Program in Dental Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Tatiana Pereira-Cenci
- Graduate Program in Dentistry, Federal University of Pelotas(UFPel), Pelotas, RS, Brazil
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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Sinha S, Singh K, Singh A, Priya S, Kumar A, Kawle S. Quantitative Evaluation of Apically Extruded Debris in Root Canals prepared by Single-file Reciprocating and Single File Rotary Instrumentation Systems: A Comparative In vitro Study. J Pharm Bioallied Sci 2021; 13:S1398-S1401. [PMID: 35017997 PMCID: PMC8686909 DOI: 10.4103/jpbs.jpbs_225_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/11/2021] [Accepted: 05/09/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Prevention of the debris from extruding to the periapical region is an important aspect to be taken care of as its extrusion can result in pain, periapical inflammation, and delayed healing owing to the presence of highly infective components in the debris. AIM The present trial was aimed to compare and assess the amount of debris extruded apically using the single-file reciprocating system - WaveOne GOLD and single file rotary system - OneShape in root canal preparations in vitro. MATERIALS AND METHODS Thirty mandibular premolars were divided into two groups (15 samples each) prepared with a single-file reciprocating system - WaveOne GOLD and single-file rotary system - OneShape. Debris extruded was collected and then stored in an incubator. The final weight was calculated after obtaining the mean of three consecutive weights obtained for each tooth. The data were compared using the ANOVA and Turkey's post hoc analysis. RESULTS Debris extrusions were recorded in both groups and analysis revealed statistical differences in weight before and after the instrumentation procedures in both groups. When compared, reciprocating single file - WaveOne GOLD extruded more debris than rotary single file system - OneShape with a P < 0.001. CONCLUSIONS The rotary instrumentation systems extrude lesser debris apically than the reciprocating instrumentation system. The difference found was statistically significant.
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Affiliation(s)
- Sonal Sinha
- Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Bihar, India,Address for correspondence: Dr. Sonal Sinha, Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna - 801 503, Bihar, India. E-mail:
| | - Konark Singh
- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Bihar, India
| | - Anju Singh
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
| | - Swati Priya
- Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Bihar, India
| | | | - Sahil Kawle
- Department of Conservative Dentistry and Endodontics, Dr. G D Pol Foundation's, YMT Dental College and Hospital, Mumbai, Maharashtra, India
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Glide path enlargement of curved molar canals using HyFlex EDM glide path file versus PathFile: a comparative study of preparation time and postoperative pain. BMC Oral Health 2021; 21:150. [PMID: 33757499 PMCID: PMC7989036 DOI: 10.1186/s12903-021-01512-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 03/11/2021] [Indexed: 12/01/2022] Open
Abstract
Background This randomized clinical trial aimed to compare the preparation time and severity of postoperative pain between HyFlex Electric Discharge Machine (EDM) glide path file (GPF) and PathFile. Methods Eighty patients whose molar teeth had at least one severely curved canal were treated by the same specialist. After access cavity preparation, the patients were randomly assigned to receive glide path enlargement with either HyFlex EDM GPF or PathFile. ProTaper Next X1 and X2 files were used to prepare the canals. The time of preparation was assessed and the severity of postoperative pain over the next 7 days was recorded. The preparation time and the postoperative pain scores were compared using the Linear Mixed Models (P ≤ 0.05). Results Glide path enlargement time was significantly shorter with HyFlex EDM GPF (27.828 ± 2.345 s) than with PathFile (48.942 ± 2.864 s) (P < 0.001). The highest postoperative pain score was recorded on the first day and the pain decreased over time in both groups. HyFlex EDM GPF group patients reported significantly less postoperative pain than PathFile group patients overall (P < 0.001). Conclusions Postoperative pain and glide path preparation time could be reduced by using HyFlex EDM GPF system. Trial registration PKUSSNCT, PKUSSNCT-17B12, Registered 24 October 2017.
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Effect of Rotary and Reciprocating Instrumentation Motions on Postoperative Pain Incidence in Non-Surgical Endodontic Treatments: A Systematic Review and Meta-Analysis. Eur Endod J 2021; 6:3-14. [PMID: 33609019 PMCID: PMC8056811 DOI: 10.14744/eej.2020.51523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE A systematic review and meta-analysis were conducted to determine whether there are postoperative pain differences resulting from rotary and reciprocation engine-driven instrumentation motions in non-surgical endodontic treatment or retreatment at 12, 24, and 48 hours. METHODS Four electronic databases (PubMed, Embase, Cochrane Library, and Scopus) were searched to identify randomised controlled trials that compared the effects of rotary and reciprocating instrumentation motions on postoperative pain. Two authors independently screened the search results, extracted the data, and assessed the quality using the Cochrane risk of bias tool. Due to numerous variables across studies, the random effect inverse variance method for meta-analysis was applied. When significant heterogeneity among studies was present, the random effects multi-variable meta-regression analysis was performed to determine the source of heterogeneity. RESULTS At all time intervals, the incidence of postoperative pain was higher in the reciprocating instrumentation group, but was not statistically significant. There was no significant difference in the analgesic intake between groups. Meta-regression analysis determined study population sizes as a significant heterogeneous factor, while significance was not observed for preoperative pain or the pulpal diagnosis. CONCLUSION There was no difference in postoperative pain at 12, 24, and 48 hours after non-surgical root canal treatment and retreatment, using reciprocating or rotary instrumentation motions.
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Yammine SD, Jabbour EA. Apically Extruded Debris following Programmed Over Instrumentation of Curved Canals with Three Nickel Titanium Rotary Instruments. Eur J Dent 2020; 15:20-26. [PMID: 32864731 PMCID: PMC7902109 DOI: 10.1055/s-0040-1714175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES This in vitro study aimed to compare the amount of mixed and dried debris extruded with three endodontic NiTi (nickel-titanium) systems at three levels beyond the major apical foramen. The null hypothesis is that there would be no differences between the different rotary systems in terms of apically extruded debris. MATERIALS AND METHODS Forty-eight roots of human extracted molars with 20 to 40-degrees curvature were divided randomly into three groups (n = 16) instrumented with ProTaper Next, BT RaCe, and WaveOne Gold, respectively. Instrumentation was performed at the major foramen and over instrumented 0.5 mm, 1.0 mm and 1.5 mm beyond. Irrigation was performed with sodium hypochlorite. Apically extruded debris was collected. RESULTS Comparison of mixed extruded debris (solution/debris)and dried debris according to group and level of instrumentation showed that WaveOne Gold at the foramen and ProTaper Next beyond the foramen (p < 0.0001) resulted in significantly less extruded debris than other files and within the four levels using repeated measures analysis of variance (p < 0.0001b). CONCLUSIONS All systems exhibit extruded debris during instrumentation but in different amounts.
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Affiliation(s)
- Salwa Daoud Yammine
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
| | - Edgard Antoine Jabbour
- Department of Restorative/Esthetic Dentistry and Endodontics, Faculty of Dental Medicine, Lebanese University, Campus Rafic Hariri, Hadath, Beirut, Lebanon
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de Miranda Candeiro GT, Bradaschia-Correa V, Gama Vaz SC, Bitu Sousa F, Avelar RL, Gavini G, Silva Costa CP, Carvalho CN. Spontaneous Bisphosphonate-related Osteonecrosis Associated with a Tooth that Had a Necrotic Pulp: A Case Report. IRANIAN ENDODONTIC JOURNAL 2020; 15:188-194. [PMID: 36703802 PMCID: PMC9709851 DOI: 10.22037/iej.v15i3.27849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 01/28/2023]
Abstract
This study reports the endodontic treatment performed in a patient who presented with spontaneous bone exposure in the mandible while using intravenous bisphosphonate medication (Zometa , Novartis Pharmaceuticals Co., Basel, Switzerland). A 63-year-old female patient was referred to a private dental clinic at Fortaleza, Brazil. The patient reported that one year before, she had undergone chemotherapy for the treatment of lung cancer and associated bone metastasis. Among the medications administered was the zolendronic acid, with dosage of 4 mg every 21 days. In the oral exam, the presence of extensive bone exposure was observed in the lingual region near tooth 37. The patient reported severe pain on palpation in the region; in the pulpal sensitivity test with cold stimulus, there was an absence of pain, characteristic of pulp necrosis. Radiographically, no periapical lesion was observed. Thus, endodontic treatment was performed, and instrumentation with Reciproc R25 files in the mesial root canals and R40 in the distal canal was done, alongside with abundant 2.5% sodium hypochlorite irrigation. Interappointment medication with calcium hydroxide was maintained for 15 days. In the second session, there was the spontaneous detachment of the exposed cortical bone fragment. The root canals were filled with gutta-percha and Endosequence BC Sealer cement. After two years, complete tissue repair was observed, and the patient presented with normal periapical tissues and the tooth in masticatory function. It may be concluded that a possible relationship between pulp and periapical infections and osteonecrosis exists in patients who use bisphosphonates.
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Affiliation(s)
| | | | | | - Fabrício Bitu Sousa
- Post Graduation Program in Dental Sciences, University Christus, Fortaleza, Brazil
| | - Rafael Linard Avelar
- Post Graduation Program in Dental Sciences, University Christus, Fortaleza, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Ceci Nunes Carvalho
- Post Graduation Program in Dentistry, CEUMA University, São Luís, Brazil; ,Corresponding author: Ceci Nunes Carvalho, School of Dentistry, CEUMA University, São Luis, Maranhão, Brazil; b Discipline of Dental Materials, School of Dentistry, Federal University of Maranhão, Maranhão, Brazil. E-mail:
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Pappen FG, Xavier SR, Pilownic KJ, Santos LGP, Gomes APN, Felix AC, Demarco FF, Souza EM. Impact of infected and noninfected human dentine debris on bone healing in rats. Int Endod J 2019; 52:1679-1690. [DOI: 10.1111/iej.13178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- F. G. Pappen
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - S. R. Xavier
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - K. J. Pilownic
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - L. G. P. Santos
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - A. P. N. Gomes
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - A. C. Felix
- Central Vivarium Federal University of Pelotas PelotasBrazil
| | - F. F. Demarco
- Graduate Program in Dentistry Federal University of Pelotas PelotasBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luis Brazil
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Saha SG, Gupta RK, Bhardwaj A, Misuriya A, Saha MK, Nirwan AS. Comparison of the incidence of postoperative pain after using a continuous rotary system, a reciprocating system, and a Self-Adjusting File system in single-visit endodontics: A prospective randomized clinical trial. J Conserv Dent 2018; 21:333-338. [PMID: 29899640 PMCID: PMC5977786 DOI: 10.4103/jcd.jcd_336_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aim: The aim of this study is to compare the incidence of postoperative pain using the ProTaper Next (PTN), WaveOne Gold (WOG), and Self-Adjusting File (SAF) systems. Materials and Methods: Two hundred and fourteen patients with irreversible pulpitis were selected for single-visit endodontics. The teeth were blindly assigned to three groups based on the instrumentation system used: Group A (PTN), Group B (WOG), and Group C (SAF). Participants were asked to note the incidence of the pre- and postoperative pain on a visual analog scale at different time intervals. Paired t-test and one-way ANOVA were used along with post hoc Tukey's test. Results: The greatest mean pain in Group A (PTN) and Group B (WOG) was found to be maximum in the first 24 h with a significant reduction in pain at the subsequent observation time points of 48 h, 72 h, and 7 days. Group C (SAF) showed minimum pain followed by Group B followed by Group A which showed comparatively higher pain scores even at the end of 7 days. Conclusions: In single-visit endodontics, SAF system may prove to be a better system compared with PTN and WOG as it produces minimal postoperative pain, thus improving the overall acceptance of endodontic treatment.
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Affiliation(s)
- Suparna Ganguly Saha
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Rudra Kumar Gupta
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Abhinav Misuriya
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Mainak Kanti Saha
- Department of Prosthodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Amit Singh Nirwan
- Department of Oral and Maxillofacial Surgery, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
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