Objectives: The purpose of this study was to conduct a systematic review and meta-analysis of in vitro studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals. Materials and Methods: PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis. Results: Seventeen in vitro studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [-0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk. Conclusions: Although both techniques decrease the microbial content (with reductions of 23.32%-88.47% and 23.33%-89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.
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.
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.
This paper consider fuzzy control of a single-inverted pendulum attached to the tip end of a rotating arm driven by a direct driven motor. Control objectives stabilization of the pendulum at the upright position and regulation of the arm at an arbitrary specified position. Fuzzy control is an effective method to achieve multiple control objectives in control of nonlinear systems. In this paper, fuzzy logic control is proposed to obtain increased control performance and stability.
Fuzzy controller design consists of intuition, and any other information about how to control system, into a set of rules. These rules can then be applied to the system. It is very important to decide parameters of IF-THEN rules. Because Fuzzy controller can make more adequate force to the plant by means of parameter optimization, which is accomplished by learning procedure. In this paper, we apply adaptive fuzzy controller designed to the Rotary Inverted Pendulum.
Objectives: The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used. Materials and Methods: Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from 'least possible discomfort' (1) to 'greatest possible discomfort' (10). The Wilcoxon signed-rank test was used to determine significant differences at p < 0.05. Results: Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660). Conclusions: Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.
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.
Journal of Dental Rehabilitation and Applied Science
/
v.22
no.2
/
pp.173-180
/
2006
Objectives The aim of this study is to compare the quality of root canal preparation completed using MFile-$System^{(R)}$ instrument ( Komet, Gebr.Brsaseler, Germany) and conventional stainless steel file in the canals of Maxillary molar teeth that had a canal curvature between $25^{\circ}$ or more Materials & Methods Buccal canals of 24 first and second maxillary molar teeth, extracted for periodontal and prosthetic reasons were used. Tissue fragments and calcified debris were removed from teeth by scaling and the teeth were stored in 10% formalin solution for 24 hour. Then, teeth were stored in saline until used. To be included the roots had to have completed formed apices and angle of curvature ranging between $25^{\circ}$ or more according to the criteria described by Schneider(1971). Palatal and Second mesiobuccal canals were not included. Teeth were embedded into transparent acrylic. The teeth were randomly divided into two experimental groups. All teeth were scanned by Dental CT (PSR9000N, Asahi, Japan) to determine the root canal shape before instrumentation. Image slices were prepared from the apical end point to the pulp chamber. The first two sections were 2 mm from the apical end of root and 2 mm below the orifice. Further section was recorded, dividing the distance between the sections of apical and coronal levels into two equal lengths. 12 teeth were instrumented using stainless steel fileand another 12 teeth were instrumented using MFile-$System^{(R)}$. Following the completion of the instrumentation, the teeth were again scanned and compared with the cross sectional images taken prior to canal preparation. Amount of transportation and centering ability was assessed. Student's t-test was used for statistical analysis. Result Less transportation occurred with MFile-$System^{(R)}$ rotary instrumentation than stainless steel instrument. MFile-$System^{(R)}$ had better centering ability than stainless steel instrument. Conclusion MFile-$System^{(R)}$ rotary instrumentation transported canals less and had good centering ability.
Umesh Kumar;Pragnesh Parmar;Ruchi Vashisht;Namita Tandon;Charan Kamal Kaur
Journal of Dental Anesthesia and Pain Medicine
/
v.23
no.2
/
pp.91-99
/
2023
Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.
The purposes of this study were to investigate the effects of variability of training on the acquisition of motor skill of closed loop type tracking task using Rotary Pursuit, and to determine if there was a bilateral transfer effect to the non-dominant hand following practice with the dominant hand. Twelve healthy volunteer students (5 males and 7 females, aged 25 to 37) were randomly divided into a constant practice group and a variable practice group. A photoelectric rotary pursuit apparatus with stop clock and repeat cycle timer by Lafayette Instrumentation Co. was used for this study. Rotary pursuit is a closed loop task in which a subject attempts to keep a photoelectric stylus on a lighted target in motion. Subjects performed the clockwise circular pursuit task while standing. Experimental procedure was divided into three sessions, namely, pre-test, training, and post-test. The constant group practiced all 60 trials at 30 rpm. Variable practice group did a varied practice session with 15 trials at speeds of 20 rpm, 26 rpm, 34 rpm, and 46 rpm. No one in either group practiced with their non-dominant arm. A Mann-Whitney test and a Wilcoxon Signed Ranks test were used for statistical analyses. The results of this study showed no different training effect between groups on the post-test with the dominant hand. However, bilateral transfer effect of rotary pursuit task between hands was demonstrated. Possible mechanisms are discussed.
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