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Silva EJNL, Peña-Bengoa F, Ajuz NC, Vieira VTL, Martins JNR, Marques D, Pinto R, Rito Pereira M, Braz-Fernandes FM, Versiani MA. Multimethod analysis of large- and low-tapered single file reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow. Int Endod J 2024; 57:601-616. [PMID: 38376108 DOI: 10.1111/iej.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare eight large- and low-tapered heat-treated reciprocating instruments regarding their design, metallurgy, mechanical properties, and irrigation flow through an in silico model. METHODOLOGY A total of 472 new 25-mm E-Flex Rex (25/.04 and 25/.06), Excalibur (25/.05), Procodile (25/.06), Reciproc Blue R25 (25/.08v), WaveOne Gold Primary (25/.07v), and Univy Sense (25/.04 and 25/.06) instruments were evaluated regarding their design (stereomicroscopy, scanning electron microscopy, and 3D surface scanning), metallurgy (energy-dispersive X-ray spectroscopy and differential scanning calorimetry), and mechanical performance (cyclic fatigue, torsional resistance, cutting ability, bending and buckling resistance). Computational fluid dynamics assessment was also conducted to determine the irrigation flow pattern, apical pressure, and wall shear stress in simulated canal preparations. Kruskal-Wallis and one-way anova post hoc Tukey tests were used for statistical comparisons (α = 5%). RESULTS Instruments presented variations in blade numbers, helical angles, and tip designs, with all featuring non-active tips, symmetrical blades, and equiatomic nickel-titanium ratios. Cross-sectional designs exhibited an S-shaped geometry, except for WaveOne Gold. Univy 25/.04 and Reciproc Blue displayed the smallest and largest core diameters at D3. Univy 25/.04 and E-Flex Rec 25/.04 demonstrated the longest time to fracture (p < .05). Reciproc Blue and Univy 25/.04 exhibited the highest and lowest torque to fracture, respectively (p < .05). Univy 25/.04 and Reciproc Blue had the highest rotation angles, whilst E-Flex Rec 25/.06 showed the lowest angle (p < .05). The better cutting ability was observed with E-Flex Rec 25/.06, Procodile, Excalibur, and Reciproc Blue (p > .05). Reciproc R25 and E-Flex Rec showed the highest buckling resistance values (p < .05), with WaveOne Gold being the least flexible instrument. The impact of instruments' size and taper on wall shear stress and apical pressure did not follow a distinct pattern, although Univy 25/.04 and E-Flex Rec 25/.06 yielded the highest and lowest values for both parameters, respectively. CONCLUSIONS Low-tapered reciprocating instruments exhibit increased flexibility, higher time to fracture, and greater angles of rotation, coupled with reduced maximum bending loads and buckling strength compared to large-tapered instruments. Nevertheless, low-tapered systems also exhibit lower maximum torque to fracture and inferior cutting ability, contributing to a narrower apical canal enlargement that may compromise the penetration of irrigants in that region.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Fernando Peña-Bengoa
- Department of Endodontics, School of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Natasha C Ajuz
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Victor T L Vieira
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Ricardo Pinto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mario Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco A Versiani
- Oral Health Center, Brazilian Military Police, Minas Gerais, Brazil
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Peña-Bengoa F, Magasich MC, Bustamante D, Wastavino C, Niklander SE, Cáceres C. Effect of Ultrasonic Activation on Dentinal Tubule Penetration of Bio-C Temp and Ultracal XS: A Comparative CLSM Assessment. Eur Endod J 2023; 8:268-273. [PMID: 38219037 PMCID: PMC10500209 DOI: 10.14744/eej.2023.24196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/21/2023] [Accepted: 05/25/2023] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE The aim of this study was to compare the effect of ultrasonic activation (UA) on tubular penetration between Bio-C Temp and Ultracal XS intracanal medicaments. METHODS Forty single-rooted human premolars were endodontically prepared and divided into 4 experimental groups (n=10): Bio-C Temp, Bio-C Temp+UA, UltraCal XS and UltraCal XS+UA. All medicaments were previously mixed with a specific calcium marker (Fluo-3) and passively injected into the canals. The samples were incubated for 7 days. For each tooth, 1 mm thick sections were obtained from the middle and apical thirds of the canals. The samples were examined by confocal laser scanning microscopy (CLSM) and the depth and area of penetration were determined for each group. The Student t test was used to compare results between groups (p<0.05). RESULTS UA increased the depth and penetration area of Bio-C Temp and Ultracal XS, showing significant differences in the penetration area of the apical third for Bio-C Temp (p<0.0339). Bio-C Temp presented greater tubular penetration than Ultracal XS, showing significant differences in the depth of penetration in the apical third (p<0.0005), and in the penetration area in the middle (p<0.0016) and apical third (p<0.0339) after UA. CONCLUSION UA increases tubular penetration (both depth and area) of Bio-C Temp at the apical third but has no significant effect on Ultracal XS. Bio-C Temp has a greater depth and tubular penetration area than Ultracal XS after UA. (EEJ-2023-02-024).
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Affiliation(s)
- Fernando Peña-Bengoa
- Department of Endodontics, Universidad Andres Bello Faculty of Dentistry, Viña del Mar, Chile
| | | | | | | | - Sven Eric Niklander
- Department of Oral Pathology and Medicine, Universidad Andres Bello Faculty of Dentistry, Viña del Mar, Chile
| | - Carolina Cáceres
- Department of Endodontics, Universidad Andres Bello Faculty of Dentistry, Viña del Mar, Chile
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Peña-Bengoa F, Contreras-San Martín J, Meléndez-Rojas P. Prevalence and C-shaped root canal configuration in lower molars in the metropolitan region, Chile. J Oral Res 2022. [DOI: 10.17126/joralres.2022.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Objetive: The aim of this study was to determine the prevalence, demographics, and root configuration of C-shaped canals of mandibular molars by means of cone beam computed tomography in the population of the Metropolitan Region, Chile. Material and Methods: 912 molars (456 first and 456 second molars) resulting from the analysis of 228 mandibular CT scans were evaluated. The root configuration was established by means of a panoramic reconstruction and axial tomographic sections, classifying the presence and type of canals through the analysis of five sections or cuts along the root. Data were statistically analyzed using a 5% confidence interval. Results: Of the 912 molars analyzed, 70 were classified as C-shaped canals (7.68%), corresponding to 58.33% of those molars that presented fused roots. 95.7% of this root canal configuration was observed in lower second molars, occurring more frequently in females (n=45, 64.29%). 45.65% of the cases that presented C-shaped canals were bilateral and the most frequent configuration was C3 (n=401, 66.63%) according to the Melton classification. Conclusion: The C-shaped canals of the mandibular molars in the studied population were observed mainly in second molars, showing a clear prevalence among females and a high percentage of bilaterality. The presence of fused roots significantly increases the possibility of finding this type of root configuration.
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Caceres C, Larrain MR, Monsalve M, Peña-Bengoa F. Dentinal Tubule Penetration and Adaptation of Bio-C Sealer and AH-Plus: A Comparative SEM Evaluation. Eur Endod J 2021; 6. [PMID: 34047295 PMCID: PMC8461482 DOI: 10.14744/eej.2020.96658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare and evaluate the dentinal tubule penetration and adaptation of a premixed bioceramic sealer and an epoxy-resin based sealer in the three radicular thirds. METHODS 30 wide roots, with single straight canals and totally formed apexes, were endodontically prepared and divided into two groups (n=14) according to the sealer used for root canal filling: AH-Plus (AHP) and Bio-C Sealer (BIOC). Two samples were left as controls. After the canals were filled, the samples were cut and viewed under Scanning Electron Microscopy by taking images to analyse the tubular penetration and adaptation of the sealers. The results were statistically analysed with the Shapiro Wilk, Levene and Mann-Whitney tests (P<0.05). RESULTS BIOC showed significantly higher penetration in dentinal tubules than AHP in the cervical, middle and apical thirds of the root canal (P<0.05) and better adaptation to the dentinal tubule walls. CONCLUSION Under the parameters of this study, BIOC exhibits higher penetration and better adaptation to the dentinal tubules compared to AHP.
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Affiliation(s)
- Carolina Caceres
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Maria Rosa Larrain
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Macarena Monsalve
- Undergraduate Students, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Fernando Peña-Bengoa
- From the Department of Endodontics, Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
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Peña-Bengoa F, Dufey N, Buchheister G. Evaluation of Internal Belaching with 35% Hydrogen Peroxide in Dentin Conditioned with 37% Phosphoric Acid and 17% EDTA. J Oral Res 2020. [DOI: 10.17126/joralres.2020.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: This study aimed to evaluate the effect of dentin surface treatment with 37% phosphoric acid or 17% ethylenedia-minetetraacetic acid (EDTA) before Internal Bleaching with 35% hydrogen peroxide using the walking bleach technique. Material and Methods: This experimental in vitro study used 66 human premolars extracted for orthodontic reasons, which were debrided, endodontically prepared, and pigmented with chromogens derived from blood decomposition. The samples were randomly divided into three groups (n=22). Group A: bleaching agent without dentin conditioning; group B: bleaching agent in dentin conditioned with phosphoric acid 37%; group C: bleaching agent in dentin conditioned with 17% EDTA. 4 applications of bleaching agent were used with a separation of 4 days between each session. The initial color (baseline) and after each application was determined by spectrophotometry, recording the CIE L*a*b* values and the total color variation between the initial parameters and the different evaluation times. Results: Data were statistically analyzed with the Wilcoxon test. This showed statistically significant differences for the total variation of the color between the study groups, with the control group in no case inferior to the rest. Conclusion: The application of 37% phosphoric acid increased the effectiveness of the bleaching agent when compared to 17% EDTA. However, these did not increase the effectiveness compared to the application of the bleaching agent without a previous dentin surface treatment.
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Peña-Bengoa F, Cáceres C, Niklander S, Meléndez P. Association between second mesiobuccal missed canals and apical periodontitis in maxillary molars of a Chilean subpopulation. J Clin Exp Dent 2020; 15:e173-e176. [PMID: 37008247 PMCID: PMC10062462 DOI: 10.4317/jced.60156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/27/2023] [Indexed: 02/20/2023] Open
Abstract
Background To determine the frequency of missed second mesiobuccal canals (MB2) and apical periodontitis in maxillary molars of a Chilean subpopulation using cone beam computed tomography (CBCT). Material and Methods Two previously calibrated operators evaluated CBCTs with a total of 588 upper molars, of which 179 endodontically treated molars were selected. Axial tomographic slices were used to study the frequency and association between the presence of apical periodontitis and untreated MB2 canals. Results Of the 179 endodontically treated molars, 45.78% (84) presented MB2 missed canals. Of the upper molars that presented MB2 missed canals, 70% were associated with apical periodontitis, which was statistically significant (p< 0.0001). Sixty-two corresponded to first molars (74%) and 22 to second molars (26%). Of the first molars, 34 (54.8%) presented with apical periodontitis and MB2 missed canals (p< 0.0001), while 12 (54.4%) of the second molars presented this association (p = 0.081). Conclusions MB2 missed canals are associated with a high degree of apical periodontitis and may be an important predictor of endodontic prognosis of upper molars. Key words:Endodontics, apical periodontitis, cone beam computed tomography, missed canals, maxillary molars.
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