• Restorative Dentistry and Endodontics
• /
• v.41 no.1
• /
• pp.6-11
• /
• 2016

Objectives: The purpose of this in vitro study was to evaluate the accuracy of working length (WL) determination of four electronic apex locators (EALs), namely, Root ZX (RZX), Elements diagnostic unit and apex locator (ELE), SybronEndo Mini Apex locator (MINI) and Propex pixi (PIXI) using Stainless steel (SS) and nickel-titanium (NiTi) hand files. The null hypothesis was that there was no difference between canal length determination by SS and NiTi files of 4 EALs. Materials and Methods: Sixty extracted, single rooted human teeth were decoronated and the canal orifice flared. The actual length (AL) was assessed visually, and the teeth were embedded in an alginate model. The electronic length (EL) measurements were recorded with all four EALs using SS and NiTi files at '0.5' reading on display. The differences between the AL and EL were compared. Results: The results obtained with each EAL with SS and NiTi files were compared with AL. A paired sample t test showed that there was a statistical significant difference between EAL readings with SS and NiTi files for RZX and MINI (p < 0.05). The accuracy of RZX, ELE, MINI and PIXI within ${\pm}0.5 mm$ of AL with SS/NiTi files were 93.3%/70%, 90%/91.7%, 95%/68.3%, and 83.3%/83.3%, respectively. Conclusions: The results of this study indicate that Root ZX was statistically more accurate with NiTi files compared to SS files, while MINI was statistically more accurate with SS files compared to NiTi files. ELE and PIXI were not affected by the alloy type of the file used to determine WL.

• Restorative Dentistry and Endodontics
• /
• v.30 no.5
• /
• pp.393-401
• /
• 2005

The purpose of this study was to compare the canal configuration after shaping by ProTaper rotary files and ProTaper hand files in resin simulated canals. Forty resin simulated canals with a curvature of J-shape and S-shape were divided into four groups by 10 blocks each Simulated root canals in resin block were prepared by ProTaper rotary files and ProTaper hand files using a crown-down pressureless technique All simulated canals were prepared up to size $\#25$ file at end-point of preparation. Pre- and post-instrumentation images were recorded with color scanner. Assessment of canal shape was completed with an image analysis program. Measurements were made at 0, 1, 2, 3, 4, 5, 6 and 7 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrumentation time was recorded. The data were analyzed statistically using independent t-test. The result was that ProTaper hand files cause significantly less canal transportation from original axis of canal body and maintain original canal configuration better than ProTaper rotary files, however ProTaper hand files take more shaping time.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.28 no.4
• /
• pp.620-625
• /
• 2001

The pulpectomy or root canal treatment on primary teeth is to be done when there is evidence of chronic in flammation or necrosis in the radicular pulp. Due to the tortuous and ribbon-shaped anatomy of the primary teeth, the instrumentation of endodontic hand files and barbed broaches is not an easy procedure. Recently, many automatic Ni-Ti rotary instruments have been developed and has made endodontic treatment easier and faster. This report describes two cases of root canal treatment on primary molars using Ni-Ti rotary files. The cervical constricture was eliminated by the crown-down method, as smaller file proceeded unhindered into the apical third of the canal. In addition, the crown-down technique enhanced the efficacy of the endodontic irrigant. The use of rotary instrumentation for primary teeth seemed to be a more effective way to debride the uneven walls of primary teeth.

• Restorative Dentistry and Endodontics
• /
• v.23 no.1
• /
• pp.257-268
• /
• 1998

During cleaning and shaping of narrow and curved canals, it is very difficult or nearly impossible to maintain the original canal shape. Procedural accidents such as, ledge, zipping, perforation, and instrument breakage are frequently occurred and even may lead to failure of endodontic therapy. To prevent these kinds of accidents, various instrumentation techniques and materials have been introduced. Recently some nickel titanium (NiTi) files are introduced and it is reported that These NiTi files created rounder preparations with less transportation than conventional instruments in curved canals. This study compared the change of the canal curvature and procedural accidents after instrumentation produced by stainless steel K-flexo file, and NiTi rotary files (Profile 29 and Quantec 2000). Thirty narrow and curved canals (25-45 degree) of extracted human molars were randomly divided into three groups. In group 1, canals were instrumented using a step-back and watch-winding/pull motion with K-flexo files. In group 2, canals were prepared with Profile 29. Group 3, canals were prepared with Quantec 2000 files. Before and after preparation of canals, periapical radiographs were taken and scanned. The change of canal curvature were measured using Photoshop 4.0 program and the incidence of procedural accidents were also evaluated. The results were as follows: 1. All group showed some loss of canal curvature after instrumentation. 2. Average loss of canal curvature was $6.70{\pm}5.31$ degree for group 1, $3.80{\pm}2.57$ degree for group 2, and $5.40{\pm}4.83$ degree for group 3. All group There was significant change in curvature between before and after instrumentation (p<0.05). But there was no statistical difference amoung 3 groups. 3. In group I, there were no procedural accidents, such as ledging, perforation, or instrument fracture. In group 2, two cases of ledge and one case of instrument fracture were produced Goup 3, each one case of ledge, perforation and instrument fracture were occurred. Whthin the limits of above results, It seems that NiTi rotary instrumentation is not All Mighty and if we use uncarefully, it is more dangerous to produce some procedural accidents than conventional hand files. But more studies should be taken to evaluate the exact effects of NiTi rotary instrumentations.

• Restorative Dentistry and Endodontics
• /
• v.22 no.1
• /
• pp.244-253
• /
• 1997

During preparation of narrow curved canals, procedural accidents such as, ledge, zipping, and transportation are frequently encountered and may lead to failure of endodontic therapy. To reduce these procedural errors and efficiently manage curved canals, various modifications in instrumentation technique and the design and flexibility of instruments have been advocated. This study compared the maintenance of the original canal curvature, cross sectional canal shape, and preparation time during instrumentation with stainless steel hand (K-Flexo) file, and nickel-titanium rotary files (Profile and Lightspeed). Thirty resin blocks with simulated curved canals of 20~25 degrees were used and divided into three groups of 10 each. In group 1, canals were instrumented using a quarter turn/pull technique with K-Flexofiles. Group 2 canals were prepared with rotary NiTi Profiles. Group 3 was prepared with rotary NiTi Lightspeed instrument. Before and after instrumentation, all canals were scanned using stereo microcope, FlexCam camera, and Photoshop 3.0 computer program. The results were as follows : 1. All groups showed some loss of canal curvature after instrumentation. Average loss of canal curvature was 8.6 degrees for K-Flexofile, 7.7 degrees for Profile, and 5.8 degrees for Lightspeed. Lightspeed exhibited significantly less curvature loss than K-Flexofile (p<0.05). 2. At the apical 1-mm level, Profile produced significantly rounder canals than Lightspeed (p<0.05). At the 3-mm level, Profile and Lightspeed exhibited significantly rounder canals than K-Flexofile (p<0.05). 3. Preparation with Lightspeed was significantly faster than Profile and K-Flexofile, and Profile was faster than K-Flexofile (p<0.05). 4. There was no significant difference in incidence of zipping between the hand K-Flexofile and rotary NiTi (Profile and Lightspeed) instruments. Most of apical canals were slightly widened near the apical foramen. As a results of this study, rotary NiTi instruments are superior to the K-Flexofile in regard to the maintenance of original canal curvature, cross-sectional shape and preparation time. But more investigations and studies should be needed to evaluate the ideal canal instrumentation.

• Restorative Dentistry and Endodontics
• /
• v.34 no.1
• /
• pp.1-7
• /
• 2009

The purpose of this study was to compare the stress distributions of NiTi rotary instruments based on their cross-sectional geometries of triangular shape-based cross-sectional design, S-shaped cross-sectional design and modified rectangular shape-based one using 3D FE models. NiTi rotary files of S-shaped and modified rectangular design of cross-section such as Mtwo or NRT showed larger stress change while file rotation during simulated shaping. The stress of files with rectangular cross-section design such as Mtwo, NRT was distributed as an intermittent pattern along the long axis of file. On the other hand, the stress of files with triangular cross-section design was distributed continuously. When the residual stresses which could increase the risk of file fatigue fracture were analyzed after their withdrawal. the NRT and Mtwo model also presented higher residual stresses. From this result, it can be inferred that S-shaped and modified rectangular shape-based files were more susceptible to file fracture than the files having triangular shape-based one.

• Restorative Dentistry and Endodontics
• /
• v.28 no.1
• /
• pp.41-49
• /
• 2003

There are increasing usage of Nickel-Titanium rotary files in modern clinical endodontic treatment because it is effective and faster than hand filing due to reduced step. This study was conducted to evaluate the effect of canal preparations using 3 different rotary Nickel-Titanium files that has different cross sectional shape and taper on the maintenance of canal curvature. Simulated resin block were instrumented with Profile(Dentsply, USA), GT rotary files(Dentsply, USA), Hero 642(Micro-Mega France), and Pro-Taper(Dentsply, USA). The image of Pre-instrumentation and Post-instrumentation were acquired using digital camera and overspreaded in the computer. Then the total differences of canal diameter, deviation at the outer portion of curvature, deviation at the inner portion of curvature, movement of center of the canal and the centering ratio at the pre-determined level from the apex were measured. Results were statistically analyzed by means of ANOVA, followed by Scheffe test at a significance level of 0.05. The results were as follows； 1. Deviation at the outer portion of curvature, deviation at the inner portion of curvature were showed largest in Pro-Taper so also did in the total differences of canal diameter(p＜0.05). 2. All the groups showed movements of center Profile combined with GT rotary files and Hero 642 has no difference but Pro-Taper showed the most deviation(p＜0.05). 3. At the 1, 2, 3mm level from the apex movements of center directed toward the outer portion of curvature, but in 4, 5 mm level directed toward the inner portion of curvature(p＜0.05). As a results of this study, it could be concluded that combined use of other Nickel-Titanium rotary files is strongly recommended when use Pro-Taper file because it could be remove too much canal structure and also made more deviation of canal curvature than others.

• Restorative Dentistry and Endodontics
• /
• v.23 no.2
• /
• pp.561-574
• /
• 1998

The purposes of this study were to observe the difference in the root canal wall after hand instrumentation or engine-driven Ni-Ti instrumentation under the scanning electron microscope, and to evaluate the apical leakage provided by continuous wave of canal filling technique with or without root canal sealer and smear layer. Twenty recently extracted human maxillary anterior teeth were instrumented with K-type files or engine-driven Ni-Ti files, Quantec series 2000$^{TM}$ and irrigated with 5.25% NaOCl alone or 15% EDT A and final flush of 5.25% NaOCl. After the instrumentation and flushing, teeth were split in half with a knife and a mallet. They were then examined with a scanning electron microscope Forty-four recently extracted human maxillary anterior teeth were divided into four groups with and without smear layer and then warm vertical canal filling using System-B with or without sealer. The extent of leakage was scored after immersion in India ink for 1 week. The results were as follows: 1. No significant difference of smear layer was observed between K-type file-instrumented group and engine-driven Ni-Ti file-instrumented group. 2. A group without smear layer showed significantly less apical leakage than a group with smear layer when sealer was used for the canal filling (p<0.01). 3. There was no significant difference between a group without sealer and smear layer and a group without sealer and with smear layer (p<0.01). 4. In groups without smear layer, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01). 5. When root canals were irrigated with NaOCl alone, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01).

• Restorative Dentistry and Endodontics
• /
• v.24 no.2
• /
• pp.399-407
• /
• 1999

Apical extrusion of canal debris is occurred inadvertently during root canal preparation and this could produce interappointment discomfort or postinstrumentation pain. The purpose of this study was to investigate the influence of canal preparation methods on the apical extrusion of canal debris by means of comparing the amounts of apically extruded debris with several kinds of instrumentation methods. In the first experiment, 40 incisors were divided into four groups of 10 each. They were instrumented using one of the four techniques: Step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation with Quantec series 2000, and Profile .04 taper series 29. Root canal irrigation was done with 2.52% sodium hypochlorite solution. In the second experiment, 80 incisors were divided into five groups of 16 each and instrumented using step-back, crown-down pressureless technique with stainless steel K-files, engine-driven instrumentation such as Quantec SC, Quantec LX, and Profile .04 taper series 29 No irrigation procedure was performed in this second experiment. Extruded debris from each tooth was collected in a container and weighed by the use of an electronic balance after desiccation. With or without canal irrigation, step-back technique produced significantly more amount of apical debris than the other groups (p<0.05). However, there was no significant difference among crown-down pressureless technique, engine-driven instrumentation with Quantec LX, Quantec SC, or Profile. Therefore, either by hand or engine-driven instrumentation, it is concluded that to minimize apical debris, techniques using reaming motion of files should be applied rather than filing motion.