Removing Fractured Endodontic Files with a Tube Technique-The Strength of the Glued Joint: Tube-Endodontic File Setup

One recommended technique for removing broken root canal instruments is to glue the fragment into a cannula adapted to it (i.e., the tube technique). The aim of the study was to determine the influence of the adhesive kind and length of the joint on the breaking force. During the investigation, 120 files (60 H-files and 60 K-files) and 120 injection needles were used. Fragments of broken files were glued into the cannula using one of three materials: cyanoacrylate adhesive, composite prosthetic cement, or glass ionomer cement. The lengths of the glued joints were 2 and 4 mm. After the polymerization of adhesives, a tensile test was carried out to find a breaking force. The results were statistically analyzed (p < 0.05). For 4 mm lengths of glued joints, the breaking force was higher than for 2 mm for both file types (K and H). In the case of K-type files, the breaking force was higher for cyanoacrylate and composite adhesives than glass ionomer cement. For H-type files, no significant difference in joint strength was found between binders at 4 mm, while at 2 mm, a much better connection was obtained for cyanoacrylate glue than prosthetic cements.

Shaping ability of two root canal instrumentation systems in oval-shaped canals: A microcomputed tomography study

The objective was to evaluate the shaping ability of XP-endo Shaper and Mtwo systems in oval-shaped canals preparation by microcomputed tomography (micro-CT) along the entire canal. The volume, surface area and percentage of unprepared area were evaluated by image processing in entire canal and apical third (5 mm). Apical transportation and centring ability were evaluated at 3, 5 and 7 mm from the apex. Forty single-canal oval canines were paired in two groups (n = 20) according to the instrumentation system: XP-endo Shaper and Mtwo. The teeth were scanned by micro-CT before and after instrumentation, using a thermal vat at 37°C. The XP-endo Shaper system was more effective in the instrumentation of oval-shaped canals when compared to Mtwo system, resulting in greater volume increases and lower percentage of unprepared canals walls in apical region. Regarding apical transportation and centring ability, no statistical difference was observed.

Ex vivo shaping ability of reciprocating instruments operated by new users: Reciproc versus WaveOne

OBJECTIVES

To compare two reciprocating NiTi systems operated by novices for use in curved root canals.

METHODS

Fifty mesial roots of extracted mandibular first molars, with 2-2 canal configuration, were scanned with micro-CT and divided into 2 groups according to canal length and curvature: Reciproc and WaveOne. Each system was used to prepare one of the two canals by fourth-year dental students, who were new to reciprocating files and were blinded to the system being used. After another scanning, the pre- and post-instrumentation images were compared 3-dimensionally in software.

RESULTS

Some 43 to 46% of the canal wall area remained un-instrumented. Significantly higher proportions of canals were transported towards the isthmus or furcation aspect than the mesial or external aspect. Mean transported distance was the greatest in the coronal one-third. Remaining dentine wall was the thinnest at the furcal aspect near the middle root region. No significant difference was noted between the two brands in the parameters examined.

CONCLUSIONS

Both brands of reciprocating file left similar amounts of un-instrumented canal wall, and resulted in similar extent of canal transportation.

CLINICAL RELEVANCE

NiTi reciprocating files can safely be used by new users to prepare curved root canals into a predictable shape.

A case of accidental aspiration of an endodontic instrument by a child treated under conscious sedation

Dental management of children with attention-deficit hyperactivity disorder (ADHD) often requires the need for pharmacological behavior management techniques such as the use of sedation. The purpose of this article is to describe a clinical case involving accidental aspiration of an Endodontic instrument during root canal therapy under sedation. To our knowledge, this is the first case report of aspiration of an Endodontic instrument and should serve to heighten the awareness with regard to aspiration during dental procedures under sedation. It also emphasizes the need for proper isolation techniques in patients treated under sedation, thereby preventing such complications.

Influence of electrochemical polishing on the mechanical behaviour of nickel-titanium rotary files

The purpose of this study was to evaluate the influence of electrochemical polishing on the cyclic fatigue, cutting efficiency and surface topography of Miltex nickel-titanium rotary files. A group of files were submitted to electrochemical polishing. New files and polished files were tested for flexural fatigue and for cutting efficiency. Scanning electron microscopy observations of all files were carried out to compare the surface morphologies of polished and new files. The t-test was used to compare the groups for cutting efficiency. Scanning electron microscopy analysis indicated that the polishing resulted in more regular surfaces in relation to the new files. Electropolished files attained a significantly higher number of cycles to fracture than new unpolished files. No statistical difference exists between the groups in relation to the cutting efficiency (t-test, P < 0.05). The polished files keep their integrity for a significantly higher number of cycles to fracture than the new files, without compromising cutting efficiency.

Electrochemical induced dissolution of fragments of nickel-titanium endodontic files and their removal from simulated root canals

AIM

To improve the dissolution process of NiTi endodontic rotary files aiming at fragment removal and the recovery of the original path of the root canal during a clinically acceptable period of time.

METHODOLOGY

Anodic polarization curves and redox curves were obtained to determine the conditions necessary for the dissolution of endodontic files. Anodic polarization of K3 files was performed, and analysis of variance (P < 0.05) was used to compare different test times in relation to weight loss, length loss and electrical charge generated in each solution. The polarization of fragments in simulated root canals was undertaken to evaluate the dissolution process. After the tests, a size 10 K-file was used to verify the possibility to bypass the fragment. The total electrical charge of each test was obtained from the corresponding graph area. Radiographic analysis of the simulated canals was used before and after the tests to verify fragment dissolution.

RESULTS

The weight loss values, the length loss values and the total values of electrical charge in each period of time were significantly higher (P < 0.05) in the tests using the selected solution compared with the solution previously proposed. A progressive consumption of the K3 file tip was observed up to 30 min. The anodic polarization of file fragments in simulated root canals for 60 min resulted in their partial dissolution and enabled the recovery of the original canal pathway with size 10 K-files.

CONCLUSIONS

Increasing fluoride concentration resulted in greater active dissolution of NiTi files. The dissolution of fractured files in simulated root canals enabled the recovery of its original path during a clinically acceptable period of time.