The purposes of this study were to evaluate the changes in root canal configuration with canal instrumentation using different file types and techniques and to investigate most appropriate instrumentation technique in maintaining the original canal configuration with different file types. Fifty curved mesiobuccal or distobuccal canals of extracted human maxillary molar teeth were instrumented using a step-back technique with stainless steel K-files or nickel-titanium K-files, a crown-down pressureless technique with stainless steel K-files or nickel-titanium K-files and nickel-titanium engine-driven files. Radiographs were taken before and after instrumentation using a specially designed device that allowed for the pre-and postinstrumentation canals to be taken with the same X-ray angulation. Magnified X-ray images on a magnifier screen were traced and post instrumentation canal images were compared with the preinstrumentation ones. Changes in canal curvature and the incidence of procedural accidents were analyzed. The results were as follows : Crown-down pressureless technique with nickel-titanium K-files and nickel-titanium engine-driven filing produced no significant changes in canal curvature (p>0.05), while the step-back technique with stainless steel K-files or nickel-titanium K-files (p<0.01) and the crown-down pressureless technique with stainless steel K-files (p<0.05) produced significant changes. With nickel-titanium K-file, crown-down pressureless technique produced significantly less changes in canal curvature than step-back technique (p<0.05), while there was no significant difference between techniques with stainless steel K-files (p>0.05). File types exerted no significant influences in the changes of canal curvature both in the step-back technique and crown-down pressureless technique (0>0.05). Regardless of the file types used, step-back technique produced more procedural accidents such as ledge or elbow formation, apical zipping and apical transportation than the crowndown pressureless technique and nickel-titanium engine-driven filing. Both with stainless steel K-files and with nickel-titanium K-files, the incidence of apical extrusion of canal debris was higher in step-back technique than in crown-down pressureless technique.
Purpose : The purpose of this study was to compare the conventional and digital radiography in the estimation of working length in mandibular molars. Materials and Methods : Sixty molar teeth were selected and divided into three groups in the basis of canal curves (0-$15^{\circ}$, 15-$30^{\circ}$, > $30^{\circ}$). After the placement of a 15 K-file, radiographs were taken with a conventional film (Fspeed) and a digital sensor. Canal lengths were measured in these images by two observers. Statistical analysis was performed with repeated measures of ANOVA and paired sample t-test with 95% confidence. Results : There was a high inter-observer agreement on the measurements of working length in conventional and digital radiographs. There was no significant difference between the mean values of measurements in conventional and digital radiography. Moreover, there was no significant difference between conventional and digital radiography with the actual values in the basis of canal curves. Conclusion : The accuracy of conventional and digital radiography in the determination of the working length was in an acceptable range.
The objective of this in vitro study was to evaluate the efficacy of a Ca(OH)$_2$removal before and after early coronal flaring using different types of instruments. 100 plastic blocks with 30$^{\circ}$artificial curved canals were used in this study and randomly divided into a control group and 4 experimental groups(GG, OS, GT, PT Group) 20 teeth each. The canals were instrumented, and Ca(OH)$_2$was temporary filled into the each canal. Irrigation was peformed with Max-i-Probe 25- 30-gauge probes before and after recapitulation. The results of this study were as follows 1. There were no significant difference among the groups in size of irrigating needle(p<0.05). 2. There was a significant difference between before and after recapitulation regardless size of irrigating needle(p<0.05). 3. Before recapitulation, there was a significant difference between 25- and 30-gauge needle in all groups(P<0.05). 4. After recapitulation, there was a significant difference between 25- and 30-gauge needle in the control group(p<0.05). But there were no significant difference among the experimental groups. It is concluded that the effectiveness of canal irrigation was decided to the depth of irrigating needle into the canal. The effect of canal irrigation tend to facilitate by the early coronal flaring. The recapitulation was the most effective during canal irrigation regardless the size of irrigating needle. Therefore, the recapitulation is a mandatory way to facilitate the effectiveness of canal irrigation during canal enlargement.
The purpose of this study was to compare the centering ratio and reduction of canal curvature according to the preparation sizes of #30, #40 and #50 using three rotary NiTi instruments which have different shaft tapers. Seventy-two simulated root canals in clear resin blocks (Endo Training Bloc; Dentsply Maillefer, Ballaigues, Switzerland) were divided as following 3 groups according to the file system; the 24 canal blocks prepared with each of ProTaper Universal system (Group P), LightSpeed eXtra system (Group L), and K3 (Group K). The pre- and post-instrumented root canals were scanned and superimposed to evaluate and calculate the centering ratio and reduction of canal curvature. Mean scores of each group were statistically analyzed using one-way ANOV A and Duncan's multiple range test for post-hoc comparison. The results were as followings: 1. Group L showed better centering ratio, followed by K and P. And all experimental groups generally showed increasing tendency of centering ratio as the apical size was increasing from #30 to #50, except at 1 mm level of group P where showed reducing tendency of centering ratio. The smaller the ratio, the better the instrument remained centered in the canal. 2. Group P showed more decrease of canal curvature at all apical shaping size (p < 0.05). Under the conditions of this study, the shaft design could affect the quality of canal shaping and the smooth taperless flexible (LightSpeed) shaft design was capable of preparing canals with good morphological characteristics in curved canals.
Tanomaru-Filho, Mario;Torres, Fernanda Ferrari Esteves;Pinto, Jader Camilo;Santos-Junior, Airton Oliveira;Tavares, Karina Ines Medina Carita;Guerreiro-Tanomaru, Juliane Maria
Restorative Dentistry and Endodontics
/
제45권3호
/
pp.34.1-34.7
/
2020
Objectives: This study evaluated by using micro-computed tomography (micro-CT) the filling ability and sealer apical extrusion promoted by a new Sealer Injection System (SIS; Angelus) with side openings needle, in comparison with the conventional injection system, associated with a new ready-to-use calcium silicate-based sealer (Bio-C Sealer). Materials and Methods: Acrylic resin models containing a main curved artificial canal and 3 simulated lateral canals in apical, middle and cervical thirds were used. The main root canals were prepared using a rotary system up to size 35.05. The canals were filled with Bio-C sealer by using a single cone technique and the conventional delivery system or SIS. Samples were scanned in micro-CT. The percentage of voids throughout the entire extension of the main root canal and in each third of the lateral canals, besides the apical extrusion of the sealer was calculated. Data were submitted to t-test (p < 0.05). Results: There was no difference between both systems in the main root canals filling. Although the volume percentage of voids was similar in the apical and middle thirds of lateral canals, SIS had the greatest filling ability of the cervical third lateral canal. Moreover, the conventional system showed the highest apical extrusion of the sealer. Conclusions: The conventional and SIS obturation systems had an appropriate filling ability of the main root canal. SIS had the best filling of the cervical third of the lateral canals, besides lower sealer apical extrusion, suggesting its clinical indication.
Objectives: To examine the surface topography of intact WaveOne (WO; Dentsply Sirona Endodontics) and WaveOne Gold (WOG; Dentsply Sirona Endodontics) nickel-titanium rotary files and to evaluate the presence of alterations to the surface topography after root canal preparations of severely curved root canals in molar teeth. Materials and Methods: Forty-eight severely curved canals of extracted molar teeth were divided into 2 groups (n = 24/each group). In group 1, the canals were prepared using WO and in group 2, the canals were prepared using WOG files. After the preparation of 3 root canals, instruments were subjected to atomic force microscopy analysis. Average roughness and root mean square values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way analysis of variance and post hoc Tamhane's tests at 5% significant level. Results: The surface roughness values of WO and WOG files significantly changed after use in root canals (p < 0.05). The used WOG files exhibited higher surface roughness change when compared with the used WO files (p < 0.05). Conclusions: Using WO and WOG Primary files in 3 root canals affected the surface topography of the files. After being used in root canals, the WOG files showed a higher level of surface porosity value than the WO files.
Recently the development of rotary instrument makes it possible that in root canal treatment operator saves much more time, maintans original curved canal shape and easily prepares continuous tapered root canal. The purpose of this experiment was to examine the smoothness of the internal surface of prepared root canal and the effectiveness of debridement in prepared root canal by SEM for the comparison of hand and Ni-Ti rotary instrument. 25 extracted human teeth were access opened and # 10 K-type file was introduced into canal until it was appeared at the apical foramen. The working length was established by subtracting 0.5mm from this measurement. Group 1. The root canal preparation was done to # 30 with working length and then step-back until # 45 with K-Flexofile (Maillefer, Swiss). Group 2. Root canal preparation was done by Naviflex Ni-Ti file (Brasseler, USA) as the same technique with group 1. Group 3. Canal was prepared by Profile .04 (Maillefer, Swiss) taper until #30. Group 4. With use of Quantec (Tycom, USA) root canal was prepared from file number 1 to 8. In group 1 and 2, the root canal irrigant was NaOCl and the other groups, NaOCl and RC-prep (Premine Dental Products, USA) was used. The prepared teeth were notched with high-speed bur as bucco-lingual direction and fractured with chisel and mallet, then examined with SEM. Group 1 showed smooth internal surface. There were scratches mainly to the axial direction. Group 2 showed similar characteristics to those in group 1. Group 3 showed more smoother and linear cutting surface with bised scratches. Group 4 has the almost same characteristics group 3 and there was no difference in the file design. Ni-Ti rotary root canal instrument prepare the dentinal wall more smoother than hand instrument. The effectiveness of debridement was not fully affected by file design. The isthmus area and accessory canals of the root canal system were not prepared in any group. According to the result, hand and rotary type instrumentation techniques were effective in removal of major amount of tissue from root canal but it was not complete. In the direction of cutting movement there was difference between them.
Objectives: The present study aimed to evaluate the shaping ability of 2 thermally treated nickel-titanium reciprocating systems in simulated curved canals. Materials and Methods: Forty simulated canals were prepared to apical size 25 using Reciproc Blue R25 (VDW) and WaveOne Gold Primary (Dentsply Sirona) instruments. Standard pre- and post-preparation images were taken and superimposed. The removal of resin material was measured at 5 standard points: the canal orifice, halfway between the canal orifice and the beginning of the curve, the beginning of the curve, the apex of the curve, and the end-point of the simulated canal. The data were analysed using the independent sample t-test with a 5% significance threshold. Results: The canals in which Reciproc Blue R25 was used showed a significantly greater widening than those in which WaveOne Gold was used at 4 of the 5 measurement points (p < 0.05). The Reciproc Blue R25 instrument removed significantly more resin from the inner aspect of the curve at 2 of the 5 points and similar amounts at the remaining 3 points. At the 2 apical points, there was no significant difference between the Reciproc Blue R25 and WaveOne Gold Primary instruments. Conclusion: Both instruments respected the original canal anatomy; however, WaveOne Gold resulted in a more conservative shape with less transportation.
In this study, 24 curved resin blocks were prepared by one of the following four methods: 1) Conventional technique using K-flexo files 2) Step-back technique using K-flexo files 3) Crown-down technique using K-flexo files 4) Canal Master instrumentation using Canal Master Resin blocks were sectioned, photographed, and evaluated the mean centering ratio and the mean area of dentin removed before and after the instrumentation. The results were as follows : I. the mean centering ratio 1. In the level 1 and level 3, there was no significant difference in the mean centering ratio. 2. In the level 2, Step-back technique showed the worst mean centering ratio among the tested groups(p<0.001) and there was no significant difference between the other three groups. 3. In the level 4, Canal Master instrumentation and Step-back technique showed better mean centering ratio than the other two techniques(p<0.001) and there was no significant difference between the two techniques. II. the mean area of dentin removed 1. In the level l and level 3, there was no significant difference in the mean area of dentin removed. 2. In the level 2, Canal Master instrumentation removed less dentin than the other three techniques(P<0.01). 3. In the level 4, Crown-down technique removed less dentin than the other three techniques(P<0.05).
Objectives: The aim of this study was to compare the cleaning efficacy of different final irrigation regimens in canal and isthmus of mandibular molars, and to evaluate the influence of related variables on cleaning efficacy of the irrigation systems. Materials and Methods: Mesial root canals from 60 mandibular molars were prepared and divided into 4 experimental groups according to the final irrigation technique: Group C, syringe irrigation; Group U, ultrasonics activation; Group SC, VPro StreamClean irrigation; Group EV, EndoVac irrigation. Cross-sections at 1, 3 and 5 mm levels from the apex were examined to calculate remaining debris area in the canal and isthmus spaces. Statistical analysis was completed by using Kruskal-Wallis test and Mann-Whitney U test for comparison among groups, and multivariate linear analysis to identify the significant variables (regular replenishment of irrigant, vapor lock management, and ultrasonic activation of irrigant) affecting the cleaning efficacy of the experimental groups. Results: Group SC and EV showed significantly higher canal cleanliness values than group C and U at 1 mm level (p < 0.05), and higher isthmus cleanliness values than group U at 3 mm and all levels of group C (p < 0.05). Multivariate linear regression analysis demonstrated that all variables had independent positive correlation at 1 mm level of canal and at all levels of isthmus with statistical significances. Conclusions: Both VPro StreamClean and EndoVac system showed favorable result as final irrigation regimens for cleaning debris in the complicated root canal system having curved canal and/or isthmus. The debridement of the isthmi significantly depends on the variables rather than the canals.
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