The Effect of Using Different Kinematics Single File Systems with Coronal Preflaring Instruments on Postoperative Pain with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial

INTRODUCTION

The aim of this study was to investigate the effect of using coronal preflaring file (One Flare; OF) with rotational (One Curve; OC) and reciprocal (WaveOne Gold; WOG) single file systems on postoperative pain in mandibular premolar teeth with symptomatic irreversible pulpitis.

METHODS

Eighty patients were included in this prospective, superiority, parallel, and randomized controlled clinical trial. The patients were randomly divided into four groups (n = 20) based on the use of coronal preflaring and the kinematics of the shaping instrument: WOG (without coronal preflaring), WOG with coronal preflaring (OF), OC (without coronal preflaring), and OC with coronal preflaring (OF). Patients recorded their postoperative pain intensity at 6, 24, 48, and 72 hours using a 10-cm visual analog scale. Friedman and Wilcoxon's tests were used for intragroup comparisons, and Kruskal-Wallis test was used for intergroup comparisons. The post hoc analysis was performed using Dunn's test. The Chi-square test was used to compare gender and tooth localization according to the groups, and Kruskal-Wallis test was used to compare age and preoperative pain (P < .05).

RESULTS

At 6 and 24 hours, WOG and OC with coronal preflaring groups showed statistically significantly lower pain scores than WOG and OC groups without coronal preflaring (P < .05). No significant difference was found between the groups in terms of analgesic medication intake.

CONCLUSIONS

The use of coronal preflaring with both rotational and reciprocal single file systems in root canal preparation resulted in less postoperative pain in mandibular premolar teeth diagnosed with symptomatic irreversible pulpitis.

Shaping Ability and Buckling Resistance of TruNatomy, WaveOne gold, and XP-Endo Shaper Single-File Systems

Objectives

The target of the current study was to evaluate and compare the shaping ability and buckling resistance of various single-file systems (TruNatomy [TRN], WaveOne gold [WOG], and XP-Endo Shaper [XPS]).

Materials and Methods

Thirty recently extracted human first mandibular molars were chosen with severely curved mesiobuccal (MB) canals. Following access cavity preparation and determination of working length, teeth were randomly divided into three groups (n = 10) according to the instrumentation technique used, Group 1 (TRN), Group 2 (WOG), and Group 3 (XPS). Preinstrumentation and postinstrumentation, cone-beam computed tomography images were recorded at 3, 5, and 8 mm from the apex representing apical, middle, and coronal levels under the same circumstances, superimposed, and then canal transportation was determined using a particular equation. For buckling resistance calculation, files were loaded in the axial direction of the shaft and the maximum load was determined during the deflection of the file. One-way analysis of variance and Tukey test at 5% significance level were used to analyze data. Pearson's correlation between shaping ability and buckling resistance was performed.

Results

XPS and TRN displayed significantly less canal transportation than WOG at the coronal and middle levels. While WOG recorded the highest value of buckling resistance, XPS recorded the least.

Conclusions

XPS and TRN preserved the original curvature slightly better than WOG, while WOG reported the highest buckling resistance. There was a positive correlation between canal transportation and instrument resistance to buckle.

Clinical Relevance

Preservation of the original shape of the canal after instrumentation is beneficial.

Assessment of Postoperative Pain after Single-Visit Root Canal Treatment using Wave One® and One Shape® Single File System: A Clinical Study

BACKGROUND

Wave One^® (WO) and One Shape^® (OS) are among the common endodontic file systems having rotary and reciprocating movement of instrument, respectively. The study evaluated the postoperative pain after single-visit root canal treatment using single file rotary and reciprocating system.

MATERIALS AND METHODS

The present study was conducted in the department of conservative dentistry and endodontics on 68 teeth of patients aged between 20 and 45 years. Sixty-eight teeth were divided into two study groups. In Group A, instrumentation with OS file systems (n = 34) was done with subgroup A1 having patients without periapical lesion (n = 17) and subgroup A2 having patients with periapical lesion (n = 17). In Group B, instrumentation with WO file systems (n = 34) was done with subgroup B1 having patients without periapical lesion (n = 17) and subgroup B2 having patients with periapical lesion (n = 17). The root canal shaping procedures were performed according to the manufacturer's instructions for each instrument system. Presence of postobturation pain was accessed by visual analog scale (VAS) scale (0-10), where 0 showed no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain, and 10 worst possible pain.

RESULTS

The intensity of pain was measured with VAS score in patients without periapical lesions and with periapical lesions using WO and OS file system on the 1^st, 2^nd, 3^rd, and 7^th day. VAS score was found to be nonsignificant on the 1^st, 2^nd, 3^rd, and 7^th day in both groups (P > 0.05). Intergroup comparison of VAS score was found to be nonsignificant (P > 0.05).

CONCLUSION

Both systems were found to have similar effect with respect to postoperative pain. However, WO single file system presented less pain as compared to OS system in cases with periapical lesion. Large sample studies are required to substantiate the result obtained in this study.

Comparative evaluation of effect of rotary and reciprocating single-file systems on pericervical dentin: A cone-beam computed tomography study

AIM AND OBJECTIVE

The aim of this study is to evaluate and compare the effect of one shape, Neolix rotary single-file systems and WaveOne, Reciproc reciprocating single-file systems on pericervical dentin (PCD) using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

A total of 40 freshly extracted mandibular premolars were collected and divided into two groups, namely, Group A - Rotary: A1 - Neolix and A2 - OneShape and Group B - Reciprocating: B1 - WaveOne and B2 - Reciproc. Preoperative scans of each were taken followed by conventional access cavity preparation and working length determination with 10-k file. Instrumentation of the canal was done according to the respective file system, and postinstrumentation CBCT scans of teeth were obtained. 90 μm thick slices were obtained 4 mm apical and coronal to the cementoenamel junction. The PCD thickness was calculated as the shortest distance from the canal outline to the closest adjacent root surface, which was measured in four surfaces, i.e., facial, lingual, mesial, and distal for all the groups in the two obtained scans.

RESULTS

There was no significant difference found between rotary single-file systems and reciprocating single-file systems in their effect on PCD, but in Group B2, there was most significant loss of tooth structure in the mesial, lingual, and distal surface (P < 0.05).

CONCLUSION

Reciproc single-file system removes more PCD as compared to other experimental groups, whereas Neolix single file system had the least effect on PCD.

Comparative evaluation of apically extruded debris during root canal instrumentation using two Ni-Ti single file rotary systems: An in vitro study

BACKGROUND

Apical extrusion of debris during instrumentation is detrimental to the patient.

AIM

The aim of this study was to evaluate the apical extrusion of debris during root canal instrumentation using two single file rotary Ni-Ti systems.

MATERIALS AND METHODS

Thirty freshly extracted mandibular premolars with straight roots were sterilized and divided into two groups instrumented using: One Shape rotary Ni-Ti system with Endoflare orifice shaper (Group 1) and Neo-Niti rotary Ni-Ti system with C1 orifice shaper (Group 2). Preweighed Eppendorf tubes fitted for each tooth before instrumentation. During instrumentation, 1 mL of distilled water with a 30-gauge needle was used to irrigate after every instrument. Tips of the tooth were irrigated with 2 ml distilled water after removal from Eppendorf tubes. The total volume of irrigant in each group was the same 8 ml. All tubes were incubated at 68°C for 15 days and subsequently weighed. The difference between pre- and post-debris weights was calculated, and statistical analysis was performed using independent t-test and level of significance was set at 0.05.

RESULTS

The difference between pre- and post-weights was significantly greater for the One Shape system.

CONCLUSIONS

The Neolix Niti single file was associated with less extrusion compared to One Shape single file system.