Effects of liquid- and paste-type EDTA on smear-layer removal during rotary root-canal instrumentation

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Gin Chen

2011-03-01

Conclusions: The use of paste/gel-type chelators during rotary nickel–titanium instrumentation resulted in improved cleanliness in the coronal and middle parts of the root canal. We recommend using liquid EDTA as a final flushing solution during root-canal preparation because it provides a better smear layer-free condition before 3-dimensional root-canal obturation.

Comparative Analysis of Crack Propagation in Roots with Hand and Rotary Instrumentation of the Root Canal -An Ex-vivo Study.

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Kumari, Manju Raj; Krishnaswamy, Manjunath Mysore

2016-07-01

Success of any endodontic treatment depends on strict adherence to 'endodontic triad'. Preparation of root canal system is recognized as being one of the most important stages in root canal treatment. At times, we inevitably end up damaging root dentin which becomes a Gateway for infections like perforation, zipping, dentinal cracks and minute intricate fractures or even vertical root fractures, thereby resulting in failure of treatment. Several factors may be responsible for the formation of dentinal cracks like high concentration of sodium hypochlorite, compaction methods and various canal shaping methods. To compare and evaluate the effects of root canal preparation techniques and instrumentation length on the development of apical root cracks. Seventy extracted premolars with straight roots were mounted on resin blocks with simulated periodontal ligaments, exposing 1-2 mm of the apex followed by sectioning of 1mm of root tip for better visualization under stereomicroscope. The teeth were divided into seven groups of 10 teeth each - a control group and six experimental groups. Subgroup A & B were instrumented with: Stainless Steel hand files (SS) up to Root Canal Length (RCL) & (RCL -1 mm) respectively; sub group C & D were instrumented using ProTaper Universal (PTU) up to RCL and (RCL -1mm) respectively; subgroup E & F were instrumented using ProTaper Next (PTN) up to RCL & (RCL -1 mm) respectively. Stereomicroscopic images of the instrumentation sequence were compared for each tooth. The data was analyzed statistically using descriptive analysis by 'Phi' and 'Cramers' test to find out statistical significance between the groups. The level of significance was set at phand file group showed most cracks followed by ProTaper Universal & ProTaper Next though statistically not significant. Samples instrumented up to 1mm short of working length (RCL-1mm) showed lesser number of cracks. All groups showed cracks formation, the stainless steel group being the highest

Effect of Instrument Design and Access Outlines on the Removal of Root Canal Obturation Materials in Oval-shaped Canals.

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Niemi, Tuomas K; Marchesan, Melissa A; Lloyd, Adam; Seltzer, Robert J

2016-10-01

The aim of this study was to compare the effectiveness of TRUShape (TS) instruments with ProFile Vortex Blue (VB) instruments for the removal of obturation materials during retreatment of single-canal mandibular premolars performed through 2 access outlines. Initial root canal treatment was completed through a contracted endodontic cavity (CEC) design. Canals were instrumented to an F2 ProTaper instrument, obturated with warm lateral condensation of gutta-percha with AH Plus sealer, and allowed to set for 30 days at 37°C and 100% humidity. For retreatment, specimens were divided into 2 groups (n = 24) on the basis of access outline, CEC or traditional endodontic cavity (TEC). Retreatment was initiated by using ProTaper Retreatment instruments (D1-D3). Specimens were then stratified, further divided (n = 12), and reinstrumented up to TS 40 .06v or 40 .06 VB. Irrigation was performed by using 8.25% NaOCl and QMix 2in1. Retreatment time was recorded. Teeth were sectioned and photographed, and the percentage of remaining obturation materials was measured. Data were analyzed with Kruskal-Wallis analysis of variance for two-factor tests (α canal surface when compared with TEC-VB, CEC-TS, and TEC-TS (P ≤ .05). None of these other combinations were different from each other (P > .05). Significantly more time was required for retreatment with CEC-TS (27.68 ± 1.4 minutes) than the other groups (P root canal surface of mandibular premolars. However, in the presence of a CEC access design, using TS instruments removed more obturating material in single-rooted, oval-shaped canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A comparison of three rotary systems and hand instrumentation technique for the elimination of Enterococcus faecalis from the root canal.

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Gorduysus, Melahat; Nagas, Emre; Torun, Ozgur Yildirim; Gorduysus, Omer

2011-12-01

The aim of this study was to compare the in vitro reduction of a bacterial population in a root canal by mechanical instrumentation using three rotary systems and hand instrumentation technique. The root canals contaminated with a suspension of Enterococcus faecalis were instrumented using ProTaper, K3, HeroShaper and K-file hand instrumentation technique. Later the root canals were sampled. After serial dilutions, samples were incubated in culture media for 24 h. Bacterial colonies were counted and the results were given as number of colony-forming units per millilitre. The results showed that all the canal instrumentation systems reduced the number of bacterial cells in the root canals. Statistically, ProTaper instruments were more effective in reducing the number of bacteria than the other rotary files or hand instruments. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

Cone-beam computed tomography analysis of curved root canals after mechanical preparation with three nickel-titanium rotary instruments

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Elsherief, Samia M.; Zayet, Mohamed K.; Hamouda, Ibrahim M.

2013-01-01

Cone beam computed tomography is a 3-dimensional high resolution imaging method. The purpose of this study was to compare the effects of 3 different NiTi rotary instruments used to prepare curved root canals on the final shape of the curved canals and total amount of root canal transportation by using cone-beam computed tomography. A total of 81 mesial root canals from 42 extracted human mandibular molars, with a curvature ranging from 15 to 45 degrees, were selected. Canals were randomly divided into 3 groups of 27 each. After preparation with Protaper, Revo-S and Hero Shaper, the amount of transportation and centering ability that occurred were assessed by using cone beam computed tomography. Utilizing pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. Canals were metrically assessed for changes (surface area, changes in curvature and transportation) during canal preparation by using software SimPlant; instrument failures were also recorded. Mean total widths and outer and inner width measurements were determined on each central canal path and differences were statistically analyzed. The results showed that all instruments maintained the original canal curvature well with no significant differences between the different files (P = 0.226). During preparation there was failure of only one file (the protaper group). In conclusion, under the conditions of this study, all instruments maintained the original canal curvature well and were safe to use. Areas of uninstrumented root canal wall were left in all regions using the various systems. PMID:23885273

Assessment of three root canal preparation techniques on root canal geometry using micro-computed tomography: In vitro study

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Shaikha M Al-Ali

2012-01-01

Full Text Available Aim: To assess the effects of three root canal preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. Materials and Methods: Thirty extracted Human Maxillary Molars having three separate roots and similar root shape were randomly selected from a pool of extracted teeth for this study and stored in normal saline solution until used. A computed tomography scanner (Philips Brilliance CT 64-slice was used to analyze root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using stainless steel K-Files, Ni-Ti rotary ProTaper and rotary SafeSiders instruments. Differences in dentin volume removed, the surface area, the proportion of unchanged area and canal transportation were calculated using specially developed software. Results: Instrumentation of canals increased volume and surface area. Statistical analysis found a statistically significant difference among the 3 groups in total change in volume (P = 0.001 and total change in surface area (P = 0.13. Significant differences were found when testing both groups with group III (SafeSiders. Significant differences in change of volume were noted when grouping was made with respect to canal type (in MB and DB (P < 0.05. Conclusion: The current study used computed tomography, an innovative and non destructive technique, to illustrate changes in canal geometry. Overall, there were few statistically significant differences between the three instrumentation techniques used. SafeSiders stainless steel 40/0.02 instruments exhibit a greater cutting efficiency on dentin than K-Files and ProTaper. CT is a new and valuable tool to study root canal geometry and changes after preparation in great details. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

Efficacy of Reciproc(®) and Profile(®) Instruments in the Removal of Gutta-Percha from Straight and Curved Root Canals ex Vivo.

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Marfisi, Karem; Mercadé, Montserrat; Plotino, Gianluca; Clavel, Tatiana; Duran-Sindreu, Fernando; Roig, Miguel

2015-01-01

To compare the efficacy of Reciproc(®) (VDW GmbH) and ProFile(®) (Dentsply Maillefer) instruments at removing gutta-percha from straight and curved root canals ex vivo filled using the cold lateral condensation and GuttaMaster(®) (VDW GmbH) techniques. Forty mesial roots of mandibular molars with two curved canals and 80 single-rooted teeth with straight root canals, a total of 160 root canals, were randomly assigned to eight groups (canals per group = 20) according to filling technique, retreatment instrument and root canal curvature as follows: Group I, cold lateral condensation/ProFile(®)/straight; Group II, cold lateral condensation/ProFile(®)/curved; Group III, cold lateral condensation/Reciproc(®)/straight; Group IV, cold lateral condensation/Reciproc(®)/curved; Group V, GuttaMaster(®)/ProFile(®)/straight; Group VI, GuttaMaster(®)/ProFile(®)/curved; Group VII, GuttaMaster(®)/Reciproc(®)/straight; and Group VIII, GuttaMaster(®)/Reciproc(®)/curved. The following data were recorded: procedural errors, retreatment duration and canal wall cleanliness. Means and standard deviations were calculated and analysed using the Kruskal-Wallis test, one-way analysis of variance and Tukey's test (P straight (P = 0.0001) and curved (P = 0.0003) root canals. Reciproc(®) were statistically more effective than ProFile(®) instruments in removing GuttaMaster(®) from straight root canals (P = 0.021). Regardless of filling technique or retreatment instrument, gutta-percha was removed more rapidly from curved than from straight root canals (P = 0.0001). Neither system completely removed filling material from the root canals. Compared with ProFile(®) instruments, Reciproc(®) instruments removed GuttaMaster(®) filling material from straight and curved root canals more rapidly.

Periapical repair after root canal filling with different root canal sealers.

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Tanomaru-Filho, Mário; Tanomaru, Juliane Maria Guerreiro; Leonardo, Mario Roberto; da Silva, Lea Assed Bezerra

2009-01-01

The aim of this study was to evaluate periapical repair after root canal filling with different endodontic sealers. Sixty-four root canals from dog s teeth were filled, divided into 4 groups (n=16). Root canals were instrumented with K-type files and irrigated with 1% sodium hypochlorite solution. Root canals were filled in the same session by active lateral condensation of the cones and sealers: Intrafill, AH Plus, Roeko Seal and Resilon/Epiphany System. After 90 days, the animals were euthanized and the tissues to be evaluated were processed and stained with hematoxylin and eosin. For histopathological analysis, the following parameters were evaluated: inflammatory process, mineralized tissue resorption, and apical mineralized tissue deposition. Histopathological analysis demonstrated that Intrafill had less favorable results in terms of apical and periapical repair, compared to the other sealers (p0.05). In conclusion, AH Plus and the materials Roeko Seal and Epiphany are good options for clinical use in Endodontics.

The Effects of NiTi Hand and Rotary Canal Master U and K-Flex Instrumentation of Root Canal Morphology

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1992-09-01

Rotary Canal Master "U" and K-Flex Instrumentation of Root Canal Morphology 6. AUTHOR(S) Robert H. Haller 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES... endodontic failure. B. STATET OF THE PREL]2U Conventional endodontic instruments have re.nained basically unchanged since the introduction of the K-type...F;hcw"e that this nO𔃾 instruneent destim tended ti- produce rounder pr rMticns with • t!-rnnVortaticn than c rnvrnticnal 4 endodontic instruments

K-file vs ProFiles in cleaning capacity and instrumentation time in primary molar root canals: An in vitro study

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N Madan

2011-01-01

Full Text Available Objectives: This study compares the efficiency of manual K-files and rotary ProFiles in cleaning capacity and instrumentation time in primary molar root canals. Materials and Methods: Seventy-five maxillary and mandibular primary molar root canals were instrumented with ProFiles and K-files in the step-back manner from size #10 to #40. The teeth were decalcified, dehydrated and cleared, and analyzed for the presence of dye remaining on the root canal walls, which served as an evidence of cleaning capacity of both the techniques. Results: The results showed a significant difference in the cleaning capacity of the root canals with ProFiles and K-files, in apical and coronal thirds of the root canal. ProFiles have been found to be more efficient in cleaning the coronal thirds and K-files in cleaning apical thirds of the root canals. Both the techniques were almost equally effective in cleaning the middle thirds of the canals. The time taken during the cleaning of the root canals appeared to be statistically shorter with K-files than profiles.

Preparation of severely curved simulated root canals using engine-driven rotary and conventional hand instruments.

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Szep, S; Gerhardt, T; Leitzbach, C; Lüder, W; Heidemann, D

2001-03-01

This in vitro study evaluated the efficacy and safety of six different nickel-titanium engine-driven instruments used with a torque-controlled engine device and nickel-titanium hand and stainless steel hand instruments in preparation of curved canals. A total of 80 curved (36 degrees) simulated root canals were prepared. Images before and after were superimposed, and instrumentation areas were observed. Time of instrumentation, instrument failure, change in working length and weight loss were also recorded. Results show that stainless steel hand instruments cause significantly less transportation towards the inner wall of the canal than do nickel-titanium hand instruments. No instrument fracture occurred with hand instruments, but 30-60% breakage of instruments was recorded during instrumentation with the engine-driven devices. The working length was maintained by all types of instruments. Newly developed nickel-titanium rotary files were not able to prevent straightening of the severely curved canals when a torque-controlled engine-driven device was used.

Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-file Systems.

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Prabhakar, Attiguppe R; Yavagal, Chandrashekar; Dixit, Kratika; Naik, Saraswathi V

2016-01-01

Primary root canals are considered to be most challenging due to their complex anatomy. "Wave one" and "one shape" are single-file systems with reciprocating and rotary motion respectively. The aim of this study was to evaluate and compare dentin thickness, centering ability, canal transportation, and instrumentation time of wave one and one shape files in primary root canals using a cone beam computed tomographic (CBCT) analysis. This is an experimental, in vitro study comparing the two groups. A total of 24 extracted human primary teeth with minimum 7 mm root length were included in the study. Cone beam computed tomographic images were taken before and after the instrumentation for each group. Dentin thickness, centering ability, canal transportation, and instrumentation times were evaluated for each group. A significant difference was found in instrumentation time and canal transportation measures between the two groups. Wave one showed less canal transportation as compared with one shape, and the mean instrumentation time of wave one was significantly less than one shape. Reciprocating single-file systems was found to be faster with much less procedural errors and can hence be recommended for shaping the root canals of primary teeth. How to cite this article: Prabhakar AR, Yavagal C, Dixit K, Naik SV. Reciprocating vs Rotary Instrumentation in Pediatric Endodontics: Cone Beam Computed Tomographic Analysis of Deciduous Root Canals using Two Single-File Systems. Int J Clin Pediatr Dent 2016;9(1):45-49.

Evaluation of Root Canal Cleaning and Shaping Efficacy of Three Engine-driven Instruments: SafeSider, ProTaper Universal and Lightspeed LSX.

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Wigler, Ronald; Koren, Tal; Tsesis, Igor

2015-11-01

To compare the cleaning effectiveness and shaping ability of SafeSider, ProTaper Universal and Lightspeed rotary instruments during the preparation of curved root canals in extracted human teeth. A total of 63 roots with curved root canals were divided into three groups. Canals were prepared using SafeSider, ProTaper Universal or Lightspeed LSX. Using pre- and post-instrumentation radiographs, straightening of the canal curvatures and loss of working length were determined with a computer image analysis program. The amounts of debris at the apical 5 mm were quantified on the basis of a numerical evaluation scale. The data were analyzed statistically using the two-way analysis of variance (ANOVA). There was significantly more transportation among the Lightspeed LSX group compared to the SafeSider and ProTaper Universal groups only at the 4 mm level (p engine-driven instruments with regards to debris removal. SafeSider, ProTaper Universal and Lightspeed LSX rotary instruments maintained the original canal curvature well at the apical 3 mm and were safe to use. No difference was found in cleaning efficacy and none rendered the apical part of the canal free of debris. SafeSider, ProTaper Universal and Lightspeed LSX rotary instruments are safe to use in curved root canals.

The effect of a manual instrumentation technique on five types of premolar root canal geometry assessed by microcomputed tomography and three-dimensional reconstruction

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Li, Ke-Zeng; Gao, Yuan; Zhang, Ru; Hu, Tao; Guo, Bin

2011-01-01

Together with diagnosis and treatment planning, a good knowledge of the root canal system and its frequent variations is a necessity for successful root canal therapy. The selection of instrumentation techniques for variants in internal anatomy of teeth has significant effects on the shaping ability and cleaning effectiveness. The aim of this study was to reveal the differences made by including variations in the internal anatomy of premolars into the study protocol for investigation of a single instrumentation technique (hand ProTaper instruments) assessed by microcomputed tomography and three-dimensional reconstruction. Five single-root premolars, whose root canal systems were classified into one of five types, were scanned with micro-CT before and after preparation with a hand ProTaper instrument. Instrumentation characteristics were measured quantitatively in 3-D using a customized application framework based on MeVisLab. Numeric values were obtained for canal surface area, volume, volume changes, percentage of untouched surface, dentin wall thickness, and the thickness of dentin removed. Preparation errors were also evaluated using a color-coded reconstruction. Canal volumes and surface areas were increased after instrumentation. Prepared canals of all five types were straightened, with transportation toward the inner aspects of S-shaped or multiple curves. However, a ledge was formed at the apical third curve of the type II canal system and a wide range in the percentage of unchanged canal surfaces (27.4-83.0%) was recorded. The dentin walls were more than 0.3 mm thick except in a 1 mm zone from the apical surface and the hazardous area of the type II canal system after preparation with an F3 instrument. The 3-D color-coded images showed different morphological changes in the five types of root canal systems shaped with the same hand instrumentation technique. Premolars are among the most complex teeth for root canal treatment and instrumentation techniques

The effect of a manual instrumentation technique on five types of premolar root canal geometry assessed by microcomputed tomography and three-dimensional reconstruction

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Hu Tao

2011-06-01

Full Text Available Abstract Background Together with diagnosis and treatment planning, a good knowledge of the root canal system and its frequent variations is a necessity for successful root canal therapy. The selection of instrumentation techniques for variants in internal anatomy of teeth has significant effects on the shaping ability and cleaning effectiveness. The aim of this study was to reveal the differences made by including variations in the internal anatomy of premolars into the study protocol for investigation of a single instrumentation technique (hand ProTaper instruments assessed by microcomputed tomography and three-dimensional reconstruction. Methods Five single-root premolars, whose root canal systems were classified into one of five types, were scanned with micro-CT before and after preparation with a hand ProTaper instrument. Instrumentation characteristics were measured quantitatively in 3-D using a customized application framework based on MeVisLab. Numeric values were obtained for canal surface area, volume, volume changes, percentage of untouched surface, dentin wall thickness, and the thickness of dentin removed. Preparation errors were also evaluated using a color-coded reconstruction. Results Canal volumes and surface areas were increased after instrumentation. Prepared canals of all five types were straightened, with transportation toward the inner aspects of S-shaped or multiple curves. However, a ledge was formed at the apical third curve of the type II canal system and a wide range in the percentage of unchanged canal surfaces (27.4-83.0% was recorded. The dentin walls were more than 0.3 mm thick except in a 1 mm zone from the apical surface and the hazardous area of the type II canal system after preparation with an F3 instrument. Conclusions The 3-D color-coded images showed different morphological changes in the five types of root canal systems shaped with the same hand instrumentation technique. Premolars are among the most

Shaping ability of NT Engine and McXim rotary nickel-titanium instruments in simulated root canals. Part 1.

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Thompson, S A; Dummer, P M

1997-07-01

The aim of this study was to determine the shaping ability of NT Engine and McXim nickel-titanium rotary instruments in simulated root canals. In all, 40 canals consisting of four different shapes in terms of angle and position of curvature were prepared by a combination of NT Engine and McXim instruments using the technique recommended by the manufacturer. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, loss of canal length and three-dimensional canal form. Overall, the mean preparation time for all canals was 6.01 min, with canal shape having a significant effect (P Engine and McXim instruments prepared canals rapidly, with few deformations, no canal blockages and with minimal change in working length. The three-dimensional form of the canals demonstrated good flow and taper characteristics.

The failures of root canal preparation with hand ProTaper.

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Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C; Tuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-07-01

The failures of root canal preparation are due to some anatomical deviation (canal in "C" or "S") and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Our study was made on technique errors while preparing the canal roots with hand ProTaper. Our study was made "in vitro" on 84 extracted teeth (molars, premolars, incisors and canines). The canal root of these teeth were cleansed and shaped with hand ProTaper by crown-down technique and canal irrigation with NaOCl(2,5%). The dental preparation control was made by X-ray. During canal root preparation some failures were observed like: canal root overinstrumentation, zipping and stripping phenomenon, discarded and/or fractured instruments. Hand ProTaper represents a revolutionary progress of endodontic treatment, but a deviation from accepted rules of canal root instrumentation can lead to failures of endodontic treatment.

Reduction in bacterial counts in infected root canals after rotary or hand nickel-titanium instrumentation--a clinical study.

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Rôças, I N; Lima, K C; Siqueira, J F

2013-07-01

To compare the antibacterial efficacy of two instrumentation techniques, one using hand nickel-titanium (NiTi) instruments and the other using rotary NiTi instruments, in root canals of teeth with apical periodontitis. Root canals from single-rooted teeth were instrumented using either hand NiTi instruments in the alternated rotation motion technique or rotary BioRaCe instruments. The irrigant used in both groups was 2.5% NaOCl. DNA extracts from samples taken before and after instrumentation were subjected to quantitative analysis by real-time polymerase chain reaction (qPCR). Qualitative analysis was also performed using presence/absence data from culture and qPCR assays. Bacteria were detected in all S1 samples by both methods. In culture analysis, 45% and 35% of the canals were still positive for bacterial presence after hand and rotary NiTi instrumentation, respectively (P > 0.05). Rotary NiTi instrumentation resulted in significantly fewer qPCR-positive cases (60%) than hand NiTi instrumentation (95%) (P = 0.01). Intergroup comparison of quantitative data showed no significant difference between the two techniques. There was no significant difference in bacterial reduction in infected canals after instrumentation using hand or rotary NiTi instruments. In terms of incidence of positive results for bacteria, culture also showed no significant differences between the groups, but the rotary NiTi instrumentation resulted in more negative results in the more sensitive qPCR analysis. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Root Canal Transportation and Centering Ability of Nickel-Titanium Rotary Instruments in Mandibular Premolars Assessed Using Cone-Beam Computed Tomography.

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Mamede-Neto, Iussif; Borges, Alvaro Henrique; Guedes, Orlando Aguirre; de Oliveira, Durvalino; Pedro, Fábio Luis Miranda; Estrela, Carlos

2017-01-01

The aim of this study was to evaluate, using cone-beam computed tomography (CBCT), transportation and centralization of different nickel-titanium (NiTi) rotary instruments. One hundred and twenty eight mandibular premolars were selected and instrumented using the following brands of NiTi files: WaveOne, WaveOne Gold, Reciproc, ProTaper Next, ProTaper Gold, Mtwo, BioRaCe and RaCe. CBCT imaging was performed before and after root canal preparation to obtain measurements of mesial and distal dentin walls and calculations of root canal transportation and centralization. A normal distribution of data was confirmed by the Kolmogorov-Smirnov and Levene tests, and results were assessed using the Kruskal-Wallis test. Statistical significance was set at 5%. ProTaper Gold produced the lowest canal transportation values, and RaCe, the highest. ProTaper Gold files also showed the highest values for centering ability, whereas BioRaCe showed the lowest. No significant differences were found across the different instruments in terms of canal transportation and centering ability (P > 0.05). Based on the methodology employed, all instruments used for root canal preparation of mandibular premolars performed similarly with regard to canal transportation and centering ability.

Efficacy of different instrumentation techniques on reducing Enterococcus faecalis infection in experimentally infected root canals

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Ebru Özsezer Demiryürek

2014-03-01

Conclusion: This study indicates that instruments with a greater taper play an important role in maximizing the effectiveness of mechanical preparation. However, since using mechanical instrumentation alone is insufficient to completely eliminate root canal infection, the use of complementary antibacterial compounds is necessary.

A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study

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Prasanthi, Nalam NVD; Rambabu, Tanikonda; Sajjan, Girija S; Varma, K Madhu; Satish, R Kalyan; Padmaja, M

2016-01-01

Aim: The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions. Materials and Methods: Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (n = 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (n = 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans. Statistical Analysis: The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests. Results: Increase in root canal surface area was significantly more (P 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups. Conclusion: LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems. PMID:27656062

Evaluation of the Self-Adjusting File system (SAF) for the instrumentation of primary molar root canals: a micro-computed tomographic study.

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Kaya, E; Elbay, M; Yiğit, D

2017-06-01

The Self-Adjusting File (SAF) system has been recommended for use in permanent teeth since it offers more conservative and effective root-canal preparation when compared to traditional rotary systems. However, no study had evaluated the usage of SAF in primary teeth. The aim of this study was to evaluate and compare the use of SAF, K file (manual instrumentation) and Profile (traditional rotary instrumentation) systems for primary-tooth root-canal preparation in terms of instrumentation time and amounts of dentin removed using micro-computed tomography (μCT) technology. Study Design: The study was conducted with 60 human primary mandibular second molar teeth divided into 3 groups according to instrumentation technique: Group I: SAF (n=20); Group II: K file (n=20); Group III; Profile (n=20). Teeth were embedded in acrylic blocks and scanned with a μCT scanner prior to instrumentation. All distal root canals were prepared up to size 30 for K file,.04/30 for Profile and 2 mm thickness, size 25 for SAF; instrumentation time was recorded for each tooth, and a second μCT scan was performed after instrumentation was complete. Amounts of dentin removed were measured using the three-dimensional images by calculating the difference in root-canal volume before and after preparation. Data was statistically analysed using the Kolmogorov-Smirnov and Kruskal-Wallis tests. Manual instrumentation (K file) resulted in significantly more dentin removal when compared to rotary instrumentation (Profile and SAF), while the SAF system generated significantly less dentin removal than both manual instrumentation (K file) and traditional rotary instrumentation (Profile) (psystems. Within the experimental conditions of the present study, the SAF seems as a useful system for root-canal instrumentation in primary molars because it removed less dentin than other systems, which is especially important for the relatively thin-walled canals of primary teeth, and because it involves less

Influence of NiTi alloy on the root canal shaping capabilities of the ProTaper Universal and ProTaper Gold rotary instrument systems

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Jussaro Alves DUQUE

Full Text Available Abstract Objective This study aimed to evaluate the influence of the NiTi wire in Conventional NiTi (ProTaper Universal PTU and Controlled Memory NiTi (ProTaper Gold PTG instrument systems on the quality of root canal preparation. Material and Methods Twelve mandibular molars with separate mesial canals were scanned using a high-definition microcomputed tomography system. The PTU and PTG instruments were used to shape twelve mesial canals each. The canals were scanned after preparation with F2 and F3 instruments of the PTU and PTG systems. The analyzed parameters included the remaining dentin thickness at the apical and cervical levels, root canal volume and untouched canal walls. Data was analyzed for statistical significance by the Friedman and Dunn’s tests. For the comparison of data between groups, the Mann-Whitney test was used. Results In the pre-operative analysis, there were no statistically significant differences between the groups in terms of the area and volume of root canals (P>.05. There was also no statistically significant difference between the systems with respect to root canal volume after use of the F2 and F3 instruments. There was no statistical difference in the dentin thickness at the first apical level between, before and after instrumentation for both systems. At the 3 cervical levels, the PTG maintained centralization of the preparation on the transition between the F2 and F3 instruments, which did not occur with the PTU. Conclusion The Conventional NiTi (PTU and Controlled Memory NiTi (PTG instruments displayed comparable capabilities for shaping the straight mesial root canals of mandibular molars, although the PTG was better than the PTU at maintaining the centralization of the shape in the cervical portion.

Influence of NiTi alloy on the root canal shaping capabilities of the ProTaper Universal and ProTaper Gold rotary instrument systems

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DUQUE, Jussaro Alves; VIVAN, Rodrigo Ricci; CAVENAGO, Bruno Cavalini; AMOROSO-SILVA, Pablo Andrés; BERNARDES, Ricardo Affonso; de VASCONCELOS, Bruno Carvalho; DUARTE, Marco Antonio Hungaro

2017-01-01

Abstract Objective This study aimed to evaluate the influence of the NiTi wire in Conventional NiTi (ProTaper Universal PTU) and Controlled Memory NiTi (ProTaper Gold PTG) instrument systems on the quality of root canal preparation. Material and Methods Twelve mandibular molars with separate mesial canals were scanned using a high-definition microcomputed tomography system. The PTU and PTG instruments were used to shape twelve mesial canals each. The canals were scanned after preparation with F2 and F3 instruments of the PTU and PTG systems. The analyzed parameters included the remaining dentin thickness at the apical and cervical levels, root canal volume and untouched canal walls. Data was analyzed for statistical significance by the Friedman and Dunn’s tests. For the comparison of data between groups, the Mann-Whitney test was used. Results In the pre-operative analysis, there were no statistically significant differences between the groups in terms of the area and volume of root canals (P>.05). There was also no statistically significant difference between the systems with respect to root canal volume after use of the F2 and F3 instruments. There was no statistical difference in the dentin thickness at the first apical level between, before and after instrumentation for both systems. At the 3 cervical levels, the PTG maintained centralization of the preparation on the transition between the F2 and F3 instruments, which did not occur with the PTU. Conclusion The Conventional NiTi (PTU) and Controlled Memory NiTi (PTG) instruments displayed comparable capabilities for shaping the straight mesial root canals of mandibular molars, although the PTG was better than the PTU at maintaining the centralization of the shape in the cervical portion. PMID:28198973

A new software for dimensional measurements in 3D endodontic root canal instrumentation

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Raffaele Sinibaldi

2012-01-01

Full Text Available The main issue to be faced to get size estimates of 3D modification of the dental canal after endodontic treatment is the co-registration of the image stacks obtained through micro computed tomography (micro-CT scans before and after treatment. Here quantitative analysis of micro-CT images have been performed by means of new dedicated software targeted to the analysis of root canal after endodontic instrumentation. This software analytically calculates the best superposition between the pre and post structures using the inertia tensor of the tooth. This strategy avoid minimization procedures, which can be user dependent, and time consuming. Once the co-registration have been achieved dimensional measurements have then been performed by contemporary evaluation of quantitative parameters over the two superimposed stacks of micro-CT images. The software automatically calculated the changes of volume, surface and symmetry axes in 3D occurring after the instrumentation. The calculation is based on direct comparison of the canal and canal branches selected by the user on the pre treatment image stack.

Evaluation of the root canal shaping ability of two rotary nickel-titanium systems.

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Al-Manei, K K; Al-Hadlaq, S M S

2014-10-01

The aim was to investigate the canal shaping abilities of the twisted file (TF) and GT series X file (GTX) systems. Sixty mesial root canals of mandibular molars with curvatures of 15-50° were divided randomly into two groups of 30 canals each. The teeth were sectioned horizontally at 3, 6 and 9 mm from the apex. Root canals were prepared with TF and GTX files, respectively, and the shaping abilities of the systems were evaluated at three levels (coronal, middle and apical) based on the comparison of pre- and post-instrumentation photographs using AutoCAD software. Preparation time was also assessed. Data from the two groups were compared statistically using the Student's t-test. There was no significant difference between the rotary systems in terms of change in root canal cross-sectional area, root canal transportation, centring ability or minimum dentine thickness. Remaining dentine thickness at the coronal and middle levels was similar in the TF and GTX groups, but GTX instruments left significantly less dentine than TF instruments on the mesial aspects of root canals at the apical level. Root canal preparation with TF instruments required significantly less time than with GTX instruments. The TF and GTX NiTi rotary instruments showed similar shaping abilities, but root canal preparation was more rapid with the TF than with the GTX system. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments.

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Neelakantan, P; Khan, K; Li, K Y; Shetty, H; Xi, W

2018-07-01

To examine the efficacy of a novel supplementary irrigant agitating brush (Finisher GF Brush, MedicNRG, Kibbutz Afikim, Israel) on the debridement of root canals prepared with a novel stainless steel rotary instrumentation system (Gentlefile; MedicNRG), or nickel titanium rotary instruments in oval root canals. Mandibular premolars (n = 72) were selected and divided randomly into three experimental groups (n = 24) after microCT scanning: group 1, canal preparation to rotary NiTi size 20, .04 taper (R20); group 2, rotary NiTi to size 25, .04 taper (R25) and group 3, Gentlefile size 23, .04 taper (GF). Specimens were subdivided into two subgroups: subgroup A, syringe-and-needle irrigation (SNI); subgroup B, Finisher GF Brush (GB). Ten untreated canals served as controls. Specimens were processed for histological evaluation, and the remaining pulp tissue (RPT) was measured. Data were analysed using Mann-Whitney and Kruskal-Wallis tests (P = 0.05). All experimental groups had significantly less RPT than the control (P  0.05). When instrumented with R20, there was no significant difference between SNI and GF (P rotary NiTi. Root canal debridement did not significantly differ between the instruments when syringe irrigation was used. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems.

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Thakur, Bhagyashree; Pawar, Ajinkya M; Kfir, Anda; Neelakantan, Prasanna

2017-11-01

To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control). Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05). All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004). Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth. Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.

Radiographic evaluation of the quality of root canal obturation of single-matched cone Gutta-percha root canal filling versus hot lateral technique

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Randa Suleiman Obeidat

2014-01-01

Full Text Available Aim: The aim of this study is to evaluate radiographically the quality of root canal filling in mesiodistal and buccolingual view when comparing matched cone condensation and warm lateral Gutta-percha condensation using system B heating instrument in a low-heat warm lateral condensation technique in0 vitro. Materials and Methods: A total of 40 mandibular premolars with straight single canals were divided into two groups with 20 each. The root canals were shaped by hand file and Revo-S rotary files to size (25, 0.06 at the end point, then they filled by Gutta-percha cone and meta-seal sealer. In group A, a single matched cone technique was used to fill the root canals. In group B, a hot lateral condensation using system B instrument at 101°C was performed. Result: The result of this study showed no significant difference in density of Gutta-percha fill in apical and coronal two-third when comparing matched cone root canal filling and hot lateral technique (P > 0.05. The only significant difference (P < 0.05 was in matched cone between buccolingual and mesiodistal view in the coronal two-third. Conclusion: Within the limitation of this study, single matched cone technique has a good density in the apical one-third as that of the hot lateral technique so it may be used for filling narrow canals. In the coronal two-third of the root canal, single matched cone technique showed inferior density of root canal filling which can be improved by using accessory cones Gutta-percha in wide canal.

Effect of coronal flaring on apical extrusion of debris during root canal instrumentation using single-file systems.

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Topçuoğlu, H S; Üstün, Y; Akpek, F; Aktı, A; Topçuoğlu, G

2016-09-01

To evaluate the effect of coronal flaring on the amount of debris extruded apically during root canal preparation using the Reciproc, WaveOne (WO) and OneShape (OS) single-file systems. Ninety extracted single-rooted mandibular incisor teeth were randomly assigned to six groups (n = 15 for each group) for canal instrumentation. Endodontic access cavities were prepared in each tooth. In three of the six groups, coronal flaring was not performed; coronal flaring was performed with Gates-Glidden drills on all teeth in the remaining three groups. The canals were then instrumented with one or other of the following single-file instrument systems: Reciproc, WO and OS. Debris extruded apically during instrumentation was collected into pre-weighed Eppendorf tubes. The tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. Data were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests (P = 0.05). Reciproc and WO files without coronal flaring produced significantly more debris compared with the other groups (P  0.05). All single-file systems caused apical extrusion of debris. Performing coronal flaring prior to canal preparation reduced the amount of apically extruded debris when using Reciproc or WO systems. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Micro-computed Tomographic Analysis of Apical Microcracks before and after Root Canal Preparation by Hand, Rotary, and Reciprocating Instruments at Different Working Lengths.

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de Oliveira, Bruna Paloma; Câmara, Andréa Cruz; Duarte, Daniel Amancio; Heck, Richard John; Antonino, Antonio Celso Dantas; Aguiar, Carlos Menezes

2017-07-01

This study aimed to compare apical microcrack formation after root canal shaping by hand, rotary, and reciprocating files at different working lengths using micro-computed tomographic analysis. Sixty mandibular incisors were randomly divided into 6 experimental groups (n = 10) according to the systems and working lengths used for the root canal preparation: ProTaper Universal for Hand Use (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex CM (Coltene-Whaledent, Allstetten, Switzerland), and Reciproc (VDW, Munich, Germany) files working at the apical foramen (AF) and 1 mm short of the AF (AF - 1 mm). The teeth were imaged with micro-computed tomographic scanning at an isotropic resolution of 14 μm before and after root canal preparation, and the cross-sectional images generated were assessed to detect microcracks in the apical portion of the roots. Overall, 17 (28.3%) specimens presented microcracks before instrumentation. Apical microcracks were present in 1 (ProTaper Universal for Hand Use), 3 (Hyflex CM), and 2 (Reciproc) specimens when the instrumentation terminated at the AF. When instrumentation was terminated at AF - 1 mm, apical microcracks were detected in 3 (ProTaper Universal for Hand Use) and 4 (Hyflex CM and Reciproc) specimens. All these microcracks detected after root canal preparation were already present before instrumentation, and no new apical microcrack was visualized. For all groups, the number of slices presenting microcracks after root canal preparation was the same as before canal preparation. Root canal shaping with ProTaper Universal for Hand Use, HyFlex CM, and Reciproc systems, regardless of the working length, did not produce apical microcracks. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Assessment Using AutoCAD Software of the Preparation of Dentin Walls in Root Canals Produced by 4 Different Endodontic Instrument Systems

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Cristina Cabanillas

2015-01-01

Full Text Available Objectives. To compare the effectiveness of four instrument systems for preparing oval root canals: manual instrumentation (Step-Back technique, ProTaper Universal, ProTaper Next, and Wave One. Material and Methods. For the purpose of this assessment, 60 teeth extracted for orthodontic or periodontal reasons, specifically canines and premolars with full coronal and root anatomy, were used and 15 samples were assigned to each group. The section of the canals was compared before and after instrumenting and the section of untouched canal wall was measured using AutoCAD software. The data was analysed by means of Shapiro-Wilk, ANOVA, and Kruskal-Wallis tests. Results. In the apical third, 100% of the canals were prepared with all the systems. In the middle third, a p value of 0.5989 in the Kruskal-Wallis test was obtained, which indicates no significant difference between the groups. At the coronal third level, the results obtained revealed that Wave One had a significantly lower mean average than the rest (p<0.05. Conclusions. There are no differences between the various root canal instrument systems in the apical and middle thirds. At the coronal third level, Wave One system showed performance significantly worse than the rest, among which there were no differences.

Assessment Using AutoCAD Software of the Preparation of Dentin Walls in Root Canals Produced by 4 Different Endodontic Instrument Systems.

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Cabanillas, Cristina; Monterde, Manuel; Pallarés, Antonio; Aranda, Susana; Montes, Raquel

2015-01-01

Objectives. To compare the effectiveness of four instrument systems for preparing oval root canals: manual instrumentation (Step-Back technique), ProTaper Universal, ProTaper Next, and Wave One. Material and Methods. For the purpose of this assessment, 60 teeth extracted for orthodontic or periodontal reasons, specifically canines and premolars with full coronal and root anatomy, were used and 15 samples were assigned to each group. The section of the canals was compared before and after instrumenting and the section of untouched canal wall was measured using AutoCAD software. The data was analysed by means of Shapiro-Wilk, ANOVA, and Kruskal-Wallis tests. Results. In the apical third, 100% of the canals were prepared with all the systems. In the middle third, a p value of 0.5989 in the Kruskal-Wallis test was obtained, which indicates no significant difference between the groups. At the coronal third level, the results obtained revealed that Wave One had a significantly lower mean average than the rest (p < 0.05). Conclusions. There are no differences between the various root canal instrument systems in the apical and middle thirds. At the coronal third level, Wave One system showed performance significantly worse than the rest, among which there were no differences.

Comparison of Curved Root Canals Prepared with Various Chelating Agents

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2012-06-01

aqueous base (11). According to Bramante and Betti, instrumentation with NiTi hand files using EDTA caused greater deviation of the root canal from...15. Peters OA, Peters CI, Schonenberger K, Barbakow F. ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by

Effective analysis of the use of peracetic acid after instrumentation of root canals contaminated with Enterococcus faecalis.

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Cord, Caroline Berwanger; Velasco, Rafael Vidal Cortez; Ribeiro Melo Lima, Laíla Fernanda; Rocha, Daniel Guimarães Pedro; da Silveira Bueno, Carlos Eduardo; Pinheiro, Sérgio Luiz

2014-08-01

The aim of this study was to evaluate the effectiveness of peracetic acid (PAA) in cleaning root canals contaminated with Enterococcus faecalis. Sixty first and second mandibular molars were used. Their mesiobuccal canals were prepared with the Reciproc System (VDW, Munich, Germany). The canals were irrigated with 10 mL saline during instrumentation. The teeth were randomly divided into 3 groups (n = 20), according to the irrigation solution to be used after instrumentation: group PAA (5 mL 1% PAA), group EDTA/sodium hypochlorite (NaOCl) (5 mL 17% EDTA followed by 5 mL 2.5% sodium hypochlorite), and group S (5 mL saline). Microbiological samples were collected before instrumentation and after final irrigation. Bacterial quantification was performed by counting the number of colony-forming units (CFUs/mL). The results were analyzed by the nonparametric Wilcoxon and Kruskal-Wallis tests. The 3 groups showed a significant reduction (P  .05). According to the results of the present study, the effectiveness of 1% PAA was similar to that of 17% EDTA + 2.5% NaOCl in cleaning curved root canals contaminated with E. faecalis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A method for three-dimensional analysis of the root canal system, before and after mechanical instrumentation, using X-ray Micro-computed tomography

DEFF Research Database (Denmark)

Markvart, Merete; Bjørndal, Lars; Larsen, Per

. Extracted molar teeth were embedded in resin and kept moisturized. Each root canal was instrumented with NiTi instruments to #40. The teeth were scanned before and after instrumentation, using a microCT40 micro-tomography (SCANCO Medical AG, Bassersdorf, Switzerland). The reconstructed slices were imported......Clinical studies have shown a connection between the reduction of micro-organisms in the root canal and the degree of apical enlargement. The aim of this study was to create a non-invasive 3D model for monitoring the apical enlargement in molar teeth before and after mechanical instrumentation...

Efficacy of Twisted File Adaptive, Reciproc and ProTaper Universal Retreatment instruments for root-canal-filling removal: A cone-beam computed tomography study.

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Akbulut, Makbule Bilge; Akman, Melek; Terlemez, Arslan; Magat, Guldane; Sener, Sevgi; Shetty, Heeresh

2016-01-01

The aim of this study was to evaluate the efficacy of Twisted File (TF) Adaptive, Reciproc, and ProTaper Universal Retreatment (UR) System instruments for removing root-canal-filling. Sixty single rooted teeth were decoronated, instrumented and obturated. Preoperative CBCT scans were taken and the teeth were retreated with TF Adaptive, Reciproc, ProTaper UR, or hand files (n=15). Then, the teeth were rescanned, and the percentage volume of the residual root-canal-filling material was established. The total time for retreatment was recorded, and the data was statistically analyzed. The statistical ranking of the residual filling material volume was as follows: hand file=TF Adaptive>ProTaper UR=Reciproc. The ProTaper UR and Reciproc systems required shorter periods of time for retreatment. Root canal filling was more efficiently removed by using Reciproc and ProTaper UR instruments than TF Adaptive instruments and hand files. The TF Adaptive system was advantageous over hand files with regard to operating time.

Unusual root canal morphology of mandibular second premolars: A case series and review

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Snehal Sonarkar

2017-01-01

Full Text Available Mandibular second premolars (MSPs have varied anatomy ranging from 1 to 3 roots and 1–5 canals. Successful endodontic treatment is achieved by proper access opening, cleaning, and shaping and three-dimensional obturation. This case series describes five cases in which MSPs have been diagnosed with aberrant canal system. The Case 1 and 5 has one root with Vertucci's Type V canal configuration. The Case 2 has two roots with two canals, the Case 3 has one root with Vertucci's Type IV canal configuration, whereas the Case 4 has three roots with three canals. This case series also describes a classification for describing the root configuration. The clinical implications of this paper are first to reach at appropriate diagnosis of canal system using diagnostic aids (angulated radiographs and dental operating microscope. Second, to use advanced endodontic instruments for achieving successful endodontic therapy (NiTi rotary instruments.

The fluid mechanics of root canal irrigation.

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Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

2010-12-01

Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

The fluid mechanics of root canal irrigation

International Nuclear Information System (INIS)

Gulabivala, K; Ng, Y-L; Gilbertson, M; Eames, I

2010-01-01

Root canal treatment is a common dental operation aimed at removing the contents of the geometrically complex canal chambers within teeth; its purpose is to remove diseased or infected tissue. The complex chamber is first enlarged and shaped by instruments to a size sufficient to deliver antibacterial fluids. These irrigants help to dissolve dying tissue, disinfect the canal walls and space and flush out debris. The effectiveness of the procedure is limited by access to the canal terminus. Endodontic research is focused on finding the instruments and clinical procedures that might improve success rates by more effectively reaching the apical anatomy. The individual factors affecting treatment outcome have not been unequivocally deciphered, partly because of the difficulty in isolating them and in making the link between simplified, general experimental models and the complex biological objects that are teeth. Explicitly considering the physical processes within the root canal can contribute to the resolution of these problems. The central problem is one of fluid motion in a confined geometry, which makes the dispersion and mixing of irrigant more difficult because of the absence of turbulence over much of the canal volume. The effects of treatments can be understood through the use of scale models, mathematical modelling and numerical computations. A particular concern in treatment is that caustic irrigant may penetrate beyond the root canal, causing chemical damage to the jawbone. In fact, a stagnation plane exists beyond the needle tip, which the irrigant cannot penetrate. The goal is therefore to shift the stagnation plane apically to be coincident with the canal terminus without extending beyond it. Needle design may solve some of the problems but the best design for irrigant penetration conflicts with that for optimal removal of the bacterial biofilm from the canal wall. Both irrigant penetration and biofilm removal may be improved through canal fluid

[In vitro comparison of root canal preparation with step-back technique and GT rotary file--a nickel-titanium engine driven rotary instrument system].

Science.gov (United States)

Krajczár, Károly; Tóth, Vilmos; Nyárády, Zoltán; Szabó, Gyula

2005-06-01

The aim of the authors' study was to compare the remaining root canal wall thickness and the preparation time of root canals, prepared either with step-back technique, or with GT Rotary File, an engine driven nickel-titanium rotary instrument system. Twenty extracted molars were decoronated. Teeth were divided in two groups. In Group 1 root canals were prepared with step-back technique. In Group 2 GT Rotary File System was utilized. Preoperative vestibulo-oral X-ray pictures were taken from all teeth with radiovisiograph (RVG). The final preparations at the mesiobuccal canals (MB) were performed with size #30 and palatinal/distal canals with size #40 instruments. Postoperative RVG pictures were taken ensuring the preoperative positioning. The working time was measured in seconds during each preparation. The authors also assessed the remaining root canal wall thickness at 3, 6 and 9 mm from the radiological apex, comparing the width of the canal walls of the vestibulo-oral projections on pre- and postoperative RVG pictures both mesially and buccally. The ratios of the residual and preoperative root canal wall thickness were calculated and compared. The largest difference was found at the MB canals of the coronal and middle third level of the root, measured on the distal canal wall. The ratio of the remaining dentin wall thickness at the coronal and the middle level in the case of step-back preparation was 0.605 and 0.754, and 0.824 and 0.895 in the cases of GT files respectively. The preparation time needed for GT Rotary File System was altogether 68.7% (MB) and 52.5% (D/P canals) of corresponding step-back preparation times. The use of GT Rotary File with comparison of standard step-back method resulted in a shortened preparation time and excessive damage of the coronal part of the root canal could be avoided.

Shaping ability of NT Engine and McXim rotary nickel-titanium instruments in simulated root canals. Part 2.

Science.gov (United States)

Thompson, S A; Dummer, P M

1997-07-01

The aim of this laboratory-based study was to determine the shaping ability of NT Engine and McXim nickel-titanium rotary instruments in simulated root canals. A total of 40 canals with four different shapes in terms of angle and position of curve were prepared with NT Engine and McXim instruments, using the technique recommended by the manufacturer. Part 2 of this report describes the efficacy of the instruments in terms of prevalence of canal aberrations, the amount and direction of canal transportation and overall postoperative shape. Pre- and postoperative images of the canals were taken using a video camera attached to a computer with image analysis software. The pre- and postoperative views were superimposed to highlight the amount and position of material removed during preparation. No zips, elbows, perforations or danger zones were created during preparation. Forty-two per cent of canals had ledges on the outer aspect of the curve, the majority of which (16 out of 17) occurred in canals with short acute curves. There were significant differences (P Engine and McXim rotary nickel-titanium instruments created no aberrations other than ledges and produced only minimal transportation. The overall shape of canals was good.

3D Analysis of D-RaCe and Self-Adjusting File in Removing Filling Materials from Curved Root Canals Instrumented and Filled with Different Techniques

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Neslihan Simsek

2014-01-01

Full Text Available The aim of this study was to compare the efficacy of D-RaCe files and a self-adjusting file (SAF system in removing filling material from curved root canals instrumented and filled with different techniques by using microcomputed tomography (micro-CT. The mesial roots of 20 extracted mandibular first molars were used. Root canals (mesiobuccal and mesiolingual were instrumented with SAF or Revo-S. The canals were then filled with gutta-percha and AH Plus sealer using cold lateral compaction or thermoplasticized injectable techniques. The root fillings were first removed with D-RaCe (Step 1, followed by Step 2, in which a SAF system was used to remove the residual fillings in all groups. Micro-CT scans were used to measure the volume of residual filling after root canal filling, reinstrumentation with D-RaCe (Step 1, and reinstrumentation with SAF (Step 2. Data were analyzed using Wilcoxon and Kruskal-Wallis tests. There were no statistically significant differences between filling techniques in the canals instrumented with SAF (P=0.292 and Revo-S (P=0.306. The amount of remaining filling material was similar in all groups (P=0.363; all of the instrumentation techniques left filling residue inside the canals. However, the additional use of SAF was more effective than using D-RaCe alone.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

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PASTERNAK-JÚNIOR, Braulio; de SOUSA NETO, Manoel Damião; DIONÍSIO, Valdeci Carlos; PÉCORA, Jesus Djalma; SILVA, Ricardo Gariba

2012-01-01

Objective This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques. PMID:22437679

A quantitative analysis of rotary, ultrasonic and manual techniques to treat proximally flattened root canals

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Fabiana Soares Grecca

2007-04-01

Full Text Available OBJECTIVE: The efficiency of rotary, manual and ultrasonic root canal instrumentation techniques was investigated in proximally flattened root canals. MATERIAL AND METHODS: Forty human mandibular left and right central incisors, lateral incisors and premolars were used. The pulp tissue was removed and the root canals were filled with red die. Teeth were instrumented using three techniques: (i K3 and ProTaper rotary systems; (ii ultrasonic crown-down technique; and (iii progressive manual technique. Roots were bisected longitudinally in a buccolingual direction. The instrumented canal walls were digitally captured and the images obtained were analyzed using the Sigma Scan software. Canal walls were evaluated for total canal wall area versus non-instrumented area on which dye remained. RESULTS: No statistically significant difference was found between the instrumentation techniques studied (p<0.05. CONCLUSION: The findings of this study showed that no instrumentation technique was 100% efficient to remove the dye.

Root canal preparation in endodontics: conventional versus laser methods

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Goodis, Harold E.; White, Joel M.; Marshall, Sally J.; Marshall, Grayson W.; Moskowitz, Emrey

1992-06-01

Conventional cleaning and shaping of root canal systems employs hand and/or rotary instrumentation to remove the contents of the canal and shape the canal to receive a filling material. With the advent of the Nd:YAG laser system another method of accomplishing proper cleaning and shaping is evaluated. Single rooted teeth were radiographed bucco- lingually and mesio-distally and were divided into 2 groups. The first group was accessed and the root canal systems cleaned and shaped with a step back technique utilizing hand files and gates glidden burs. At completion of the procedure the teeth were again radiographed at the same positions as those prior to the procedure. The teeth were split longitudinally and examined under scanning electron microscopy to assess cleaning. The second group of teeth were accessed, and cleaning and shaping was accomplished using the Nd:YAG laser in combination with hand files and rotary instruments. These teeth were subjected to the same analysis as those in the first group. The before and after radiographs of each group were subjected to image analysis to determine effectiveness of the two methods in shaping the canal systems. We will discuss the ability of Nd:YAG to clean and shape root canal spaces and remove smear layer and organic tissue remnants from those areas.

Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls

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Milton Carlos Kuga

2012-02-01

Full Text Available The aim of this study was to evaluate the efficacy of three rotary instrument systems (K3, ProTaper and Twisted File in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the ProTaper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1 - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the ProTaper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (×1000. The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05.

[Root canal treatment of mandibular first premolar with 4 root canals: a case report].

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Liu, Xin-yang; Zhan, Fu-Liang

2015-10-01

The mandibular first premolar can be considered one of the most challenging teeth to treat, due to the complexity of its root canal morphology and increased incidence of multiple canals. A case of endodontic treatment of a mandibular first premolar exhibiting a total of 4 distinct root canals and 4 apical foramina was described. Anatomic variation of root canal morphology should be considered in endodontic treatment to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation might allow the flow of sealer into the narrowed but unprepared part of the canal, thereby facilitating optimum chemo-mechanical debridement of the root canal system.

Ex vivo evaluation of various instrumentation techniques and irrigants in reducing E. faecalis within root canals.

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Basmaci, F; Oztan, M D; Kiyan, M

2013-09-01

To evaluate ex vivo the effectiveness of single-file instrumentation techniques compared with serial Ni-Ti rotary instrumentation with several irrigation regimens in reducing E. faecalis within root canals. A total of 81 extracted human mandibular premolar teeth with a single root canal were infected with E. faecalis before and after canal preparation. Samples were divided randomly into 9 groups, as follows: group 1-A: sterile phosphate-buffered saline + Self-adjusting file, group 1-B: 5% sodium hypochlorite + 15% EDTA + Self-adjusting file, group 1-C: 5% sodium hypochlorite + 7% maleic acid + Self-adjusting file, group 2-A: sterile phosphate-buffered saline + Reciproc (R25), group 2-B: 5% sodium hypochlorite + 15% EDTA + Reciproc (R25), group 2-C: 5% sodium hypochlorite + 7% maleic acid + Reciproc (R25), group 3-A: sterile phosphate-buffered saline + ProTaper, group 3-B: 5% sodium hypochlorite + 15% EDTA + ProTaper, group 3-C: 5% sodium hypochlorite + 7% maleic acid + ProTaper. anova was used to analyse statistically the differences in terms of reduction in colony counts between the groups, and Dunn's post hoc test was used for multiple comparisons. All techniques and irrigation regimens significantly reduced the number of bacterial cells in the root canal (P irrigants. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

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Braulio Pasternak-Júnior

2012-02-01

Full Text Available OBJECTIVE: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG. MATERIAL AND METHODS: The operators prepared one canal with RaCe rotary instruments and another with Flexo-files. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radialis, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. RESULTS: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. CONCLUSION: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Torsional Performance of ProTaper Gold Rotary Instruments during Shaping of Small Root Canals after 2 Different Glide Path Preparations.

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Arias, Ana; de Vasconcelos, Rafaela Andrade; Hernández, Alexis; Peters, Ove A

2017-03-01

The purpose of this study was to assess the ex vivo torsional performance of a novel rotary system in small root canals after 2 different glide path preparations. Each independent canal of 8 mesial roots of mandibular molars was randomly assigned to achieve a reproducible glide path with a new set of either PathFile #1 (Dentsply Maillefer, Ballaigues, Switzerland) and #2 or ProGlider (Dentsply Maillefer) after negotiation with a 10 K-file. After glide path preparation, root canals in both groups were shaped with the same sequence of ProTaper Gold (Dentsply Tulsa Dental Specialties, Tulsa, OK) following the directions for use recommended by the manufacturer. A total of 16 new sets of each instrument of the ProTaper Gold (PTG) system were used. The tests were run in a standardized fashion in a torque-testing platform. Peak torque (Ncm) and force (N) were registered during the shaping procedure and compared with Student t tests after normal distribution of data was confirmed. No significant differences were found for any of the instruments in peak torque or force after the 2 different glide path preparations (P > .05). Data presented in this study also serve as a basis for the recommended torque for the use of PTG instruments. Under the conditions of this study, differences in the torsional performance of PTG rotary instruments after 2 different glide path preparations could not be shown. The different geometry of glide path rotary systems seemed to have no effect on peak torque and force induced by PTG rotary instruments when shaping small root canals in extracted teeth. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography.

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Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-06-20

Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (p<0.001). Similarly, there was a statistically significant difference in root canal straightening after preparation between the techniques (p<0.001). Neither manual nor rotary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal.

Root canal shaping using rotary nickel-titanium files in preclinical dental education in Turkey.

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Ünal, Gül Çelik; Maden, Murat; Orhan, Ekim Onur; Sarıtekin, Erdal; Teke, Anıl

2012-04-01

The purposes of this study were to evaluate the ability of a group of third-year dental students without any endodontic clinical experience to use the ProTaper Instruments (Dentsply Maillefer) to decrease the amount of straightening of curved canals on human molar teeth and to determine the incidence of instrument fractures and instrumentation time. Thirty-one undergraduate dental students in Turkey received a training session. The students prepared a total of 144 root canals in human mandibular or maxillary molar teeth with ProTaper. Fifty-six teeth were excluded due to unreadable image, misinformation, or straight or severe curve. Using pre- and post-preparation digital radiographs, the straightening of curved root canals was investigated. Loss of working length and incidence of fracture were also noted. A total of eighty-eight curved root canals were selected. Mesiobuccal or mesiolingual roots with curvatures of between 20° and 43° as assessed by Schneider's method and working length of between 15 mm and 22.5 mm were included in the study. The means of the curved root canals before and after the instrumentation were 29.5° ± 6° and 27° ± 6.3°, respectively. The means of the working length before and after the instrumentation were 19 mm ± 2.1 mm and 18.3 mm ± 1.9 mm, respectively. A statistically significant difference between straightening of curved root canals and loss of working length was found between before and after instrumentation (psession.

Evaluation of Root Canal Preparation Using Rotary System and Hand Instruments Assessed by Micro-Computed Tomography

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Stavileci, Miranda; Hoxha, Veton; Görduysus, Ömer; Tatar, Ilkan; Laperre, Kjell; Hostens, Jeroen; Küçükkaya, Selen; Muhaxheri, Edmond

2015-01-01

Background Complete mechanical preparation of the root canal system is rarely achieved. Therefore, the purpose of this study was to evaluate and compare the root canal shaping efficacy of ProTaper rotary files and standard stainless steel K-files using micro-computed tomography. Material/Methods Sixty extracted upper second premolars were selected and divided into 2 groups of 30 teeth each. Before preparation, all samples were scanned by micro-computed tomography. Thirty teeth were prepared with the ProTaper system and the other 30 with stainless steel files. After preparation, the untouched surface and root canal straightening were evaluated with micro-computed tomography. The percentage of untouched root canal surface was calculated in the coronal, middle, and apical parts of the canal. We also calculated straightening of the canal after root canal preparation. Results from the 2 groups were statistically compared using the Minitab statistical package. Results ProTaper rotary files left less untouched root canal surface compared with manual preparation in coronal, middle, and apical sector (protary techniques completely prepared the root canal, and both techniques caused slight straightening of the root canal. PMID:26092929

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments.

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Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

2015-01-01

Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (PProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems.

Endoscopic root canal treatment.

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Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

2009-10-01

To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

Postoperative quality of life following single-visit root canal treatment performed by rotary or reciprocating instrumentation: a randomized clinical trial.

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Pasqualini, D; Corbella, S; Alovisi, M; Taschieri, S; Del Fabbro, M; Migliaretti, G; Carpegna, G C; Scotti, N; Berutti, E

2016-11-01

To compare the impact of rotary and reciprocating instrumentation on postoperative quality of life (POQoL) after single-visit primary root canal treatment. A randomized controlled clinical trial was designed and carried out in a University endodontic practice in northern Italy. Healthy subjects with asymptomatic irreversible pulpitis, symptomatic irreversible pulpitis or pulp necrosis with or without apical periodontitis (symptomatic or asymptomatic) scheduled for primary root canal treatment were enrolled. Single-visit root canal treatment was performed with ProTaper ™ S1-S2-F1-F2 (rotary group, n = 23) and WaveOne ™ Primary (reciprocating group, n = 24). Irrigation was performed with 5% NaOCl and 10% EDTA. Root canal filling was performed with the continuous-wave technique and ZOE sealer. POQoL indicators were evaluated for 7 days post-treatment. The variation of each indicator over time was compared using anova for repeated measures (P rotary group (mean, P = 0.077; maximum, P = 0.015). Difficulty in eating (P = 0.017), in performing daily activities (P = 0.023), in sleeping (P = 0.021) and in social relations (P = 0.077), was more evident in the reciprocating group. Patients' perception of the impact of treatment on POQoL was more favourable in the rotary group (P = 0.006). Multirooted tooth type and pre-existing periradicular inflammation were associated with a decrease in POQoL. Reciprocating instrumentation affected POQoL to a greater extent than rotary instrumentation. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Decreased levels of matrix metalloproteinase-2 in root-canal exudates during root canal treatment.

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Pattamapun, Kassara; Handagoon, Sira; Sastraruji, Thanapat; Gutmann, James L; Pavasant, Prasit; Krisanaprakornkit, Suttichai

2017-10-01

To determine the matrix metalloproteinase-2 (MMP-2) levels in root-canal exudates from teeth undergoing root-canal treatment. The root-canal exudates from six teeth with normal pulp and periradicular tissues that required intentional root canal treatment for prosthodontic reasons and from twelve teeth with pulp necrosis and asymptomatic apical periodontitis (AAP) were sampled with paper points for bacterial culture and aspirated for the detection of proMMP-2 and active MMP-2 by gelatin zymography and the quantification of MMP-2 levels by ELISA. By gelatin zymography, both proMMP-2 and active MMP-2 were detected in the first collection of root-canal exudates from teeth with pulp necrosis and AAP, but not from teeth with normal pulp, and their levels gradually decreased and disappeared at the last collection. Consistently, ELISA demonstrated a significant decrease in MMP-2 levels in the root-canal exudates of teeth with pulp necrosis and AAP following root canal procedures (papical lesions, similar to the clinical application of MMP-8 as a biomarker. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vertical Root Fracture initiation in curved roots after root canal preparation: A dentinal micro-crack analysis with LED transillumination.

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Miguéns-Vila, Ramón; Martín-Biedma, Benjamín; Varela-Patiño, Purificación; Ruíz-Piñón, Manuel; Castelo-Baz, Pablo

2017-10-01

One of the causative factors of root defects is the increased friction produced by rotary instrumentation. A high canal curvature may increase stress, making the tooth more susceptible to dentinal cracks. The purpose of this study was to evaluate dentinal micro-crack formation with the ProTaper NEXT and ProTaper Universal systems using LED transillumination, and to analyze the micro-crack generated at the point of maximum canal curvature. 60 human mandibular premolars with curvatures between 30-49° and radii between 2-4 mm were used. The root canals were instrumented using the Protaper Universal® and Protaper NEXT® systems, with the aid of the Proglider® system. The obtained samples were sectioned transversely before subsequent analysis with LED transillumination at 2 mm and 8 mm from the apex and at the point of maximum canal curvature. Defects were scored: 0 for no defects; and 1 for micro-cracks. Root defects were not observed in the control group. The ProTaper NEXT system caused fewer defects (16.7%) than the ProTaper Universal system (40%) ( P Universal system caused significantly more micro-cracks at the point of maximum canal curvature than the ProTaper NEXT system ( P Universal system. A higher prevalence of defects was found at the point of maximum curvature in the ProTaper Universal group. Key words: Curved root, Micro-crack, point of maximum canal curvature, ProTaper NEXT, ProTaper Universal, Vertical root fracture.

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

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Sonal Soi

2015-09-01

Full Text Available Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no peri-apical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical fo-ramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal prepa-ration using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30. The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calcu-lated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001. The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg. Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a sig-nificantly higher amount of debris than GT and RaCe systems.

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

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Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

2015-01-01

Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001). The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems. PMID:26697144

Histological analysis of cleaning efficacy of hand and rotary instruments in the apical third of the root canal: A comparative study.

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Arya, Ashtha; Bali, Dildeep; Grewal, Mandeep S

2011-07-01

To compare the cleaning efficiency of manual and rotary instrumentation in the apical third of the root canal system. In group 1 (n=10), instrumentation was performed with stainless steel K-file; in group 2 (n=10), it was done with hand ProTaper files; and in group 3 (n=10), instrumentation was done with ProTaper rotary. Distilled water was used for irrigation. The apical third was sectioned transversally and histologically processed. The cross sections were examined under optic microscope and debris was measured using Motic software. Instrumentation with stainless steel K-files showed minimum amount of debris, followed by ProTaper hand files, and rotary ProTaper files were least effective with maximum amount of debris; however, there were no significant differences between the three experimental groups. Both the manual and rotary instrumentation are relatively efficient in cleaning the apical third of the root canal system and the choice between manual and rotary instrumentation should depend on case to case basis.

IN VITRO COMPARISON OF GUTTA-PERCHA-FILLED AREA PERCENTAGES IN ROOT CANALS INSTRUMENTED AND OBTURATED WITH DIFFERENT TECHNIQUES*

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Ayça YILMAZ

2017-04-01

Full Text Available Purpose: To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA. Materials and Methods: One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20 according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC, G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. Results: The mean of the PGFA in Thermafil (G2, ProTaper-Obturator (G5 and HEROfill (G8 groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. Conclusion: The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

In vitro comparison of gutta-percha-filled area percentages in root canals instrumented and obturated with different techniques.

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Yilmaz, Ayca; Karagoz-Kucukay, Isil

2017-01-01

To evaluate the efficacy of different obturation techniques in root canals instrumented either by hand or rotary instruments with regard to the percentage of gutta- percha-filled area (PGFA). One hundred and sixty extracted mandibular premolars with single, straight root canals were studied. Root canals were prepared to an apical size of 30 by hand with a modified crown-down technique or the ProTaper and HEROShaper systems. Teeth were divided into eight groups (n=20) according to the following instrumentation and obturation techniques: G1: Hand files+lateral condensation (LC), G2: Hand files+Thermafil, G3: ProTaper+LC, G4: ProTaper+single-cone, G5: ProTaper+ProTaper-Obturator, G6: HEROShaper+LC, G7: HEROShaper+single-cone, G8: HEROShaper+HEROfill. Horizontal sections were cut at 1, 3, 5, 7, 9, 11 and 13 mm from the apical foramen. A total of 1120 sections obtained were digitally photographed under a stereomicroscope set at 48X magnification. The cross-sectional area of the canal and the gutta-percha was measured by digital image analysis and the PGFA was calculated for each section. The mean of the PGFA in Thermafil (G2), ProTaper-Obturator (G5) and HEROfill (G8) groups was significantly higher than the other groups. In G3 and G4, PGFA showed no significant difference in the apical segments whereas PGFA was significantly higher at the middle and coronal segments in G3. In G6 and G7, PGFA showed no significant difference in the apical and middle segments whereas PGFA was significantly higher at the coronal segments in G6. The carrier-based gutta-percha obturation systems revealed significantly higher PGFA in comparison to single-cone and lateral condensation techniques.

A cost-minimization analysis of root canal treatment before and after education in nickel-titanium rotary technique in general practice.

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Koch, M; Tegelberg, A; Eckerlund, I; Axelsson, S

2012-07-01

To compare root canal treatments performed before and after education in a nickel-titanium rotary technique (NiTiR) with respect to costs for instrumentation and number of instrumentation sessions in a County Public Dental Service in Sweden.   Following education, 77% of the general dental practitioners adopted completely the NiTiR. The randomly selected sample comprised 850 root canal treatments: 425 performed after the education, mainly using the NiTiR-technique (group A) and 425 performed before, using mainly stainless steel hand instrumentation (SSI) (group B). The number of instrumentation sessions in root canal treatments in group A and B was calculated. A CMA was undertaken on the assumption that treatment outcome was identical in group A and B. Direct costs associated with SSI and NiTiR were estimated and compared. Investment costs required for implementation of NiTiR were calculated, but not included in the CMA. Instrumentation sessions were counted in 418 (98%) root canal treatments performed in group A and 419 (99%) in group B. The number of instrumentation sessions in group A was significantly lower; 2.38, compared with 2.82 in group B (P session was saved. Root canal treatments in teeth with one canal, and three or more canals, were completed in significantly fewer instrumentation sessions after the education (P sessions were SEK 2587 (USD 411) for group A and SEK 2851 (USD 453) for group B, for teeth with one canal, and SEK 2946 (USD 468) for group A and SEK 3510 (USD 558) for group B, for teeth with three or more canals (year 2011). Root canal treatments of teeth with two canals showed no significant difference with respect to number of instrumentation sessions and costs. Significantly fewer instrumentation sessions were required in group A, and root canal instrumentation therefore costs less than in group B. On the assumption that treatment outcome is identical in group A and B, root canal instrumentation performed after the education was more

Exploiting the potential of free software to evaluate root canal biomechanical preparation outcomes through micro-CT images.

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Neves, A A; Silva, E J; Roter, J M; Belladona, F G; Alves, H D; Lopes, R T; Paciornik, S; De-Deus, G A

2015-11-01

To propose an automated image processing routine based on free software to quantify root canal preparation outcomes in pairs of sound and instrumented roots after micro-CT scanning procedures. Seven mesial roots of human mandibular molars with different canal configuration systems were studied: (i) Vertucci's type 1, (ii) Vertucci's type 2, (iii) two individual canals, (iv) Vertucci's type 6, canals (v) with and (vi) without debris, and (vii) canal with visible pulp calcification. All teeth were instrumented with the BioRaCe system and scanned in a Skyscan 1173 micro-CT before and after canal preparation. After reconstruction, the instrumented stack of images (IS) was registered against the preoperative sound stack of images (SS). Image processing included contrast equalization and noise filtering. Sound canal volumes were obtained by a minimum threshold. For the IS, a fixed conservative threshold was chosen as the best compromise between instrumented canal and dentine whilst avoiding debris, resulting in instrumented canal plus empty spaces. Arithmetic and logical operations between sound and instrumented stacks were used to identify debris. Noninstrumented dentine was calculated using a minimum threshold in the IS and subtracting from the SS and total debris. Removed dentine volume was obtained by subtracting SS from IS. Quantitative data on total debris present in the root canal space after instrumentation, noninstrumented areas and removed dentine volume were obtained for each test case, as well as three-dimensional volume renderings. After standardization of acquisition, reconstruction and image processing micro-CT images, a quantitative approach for calculation of root canal biomechanical outcomes was achieved using free software. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Scanning Electron Microscopic Evaluation of Residual Smear Layer Following Preparation of Curved Root Canals Using Hand Instrumentation or Two Engine-Driven Systems.

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Khademi, Abbasali; Saatchi, Masoud; Shokouhi, Mohammad Mehdi; Baghaei, Badri

2015-01-01

In this experimental study, the amount of smear layer (SL) remnants in curved root canals after chemomechanical instrumentation with two engine-driven systems or hand instrumentation was evaluated. Forty-eight mesiobuccal roots of mandibular first molars with curvatures ranging between 25 and 35 degrees (according to Schneider's method) were divided into three groups (n=16) which were prepared by either the ProTaper Universal file series, Reciproc single file system or hand instrumentation. The canals were intermittently irrigated with 5.25% NaOCl and 17% (ethylenediaminetetraacetic acid) EDTA, followed by distilled water as the final rinse. The roots were split longitudinally and the apical third of the specimens were evaluated under 2500× magnification with a scanning electron microscope (SEM). The mean scores of the SL were calculated and analyzed using the non-parametric Kruskal-Wallis and Mann-Whitney U tests. The mean scores of the SL were 2.00±0.73, 1.94±0.68 and 1.44±0.63 µm for the ProTaper Universal, Reciproc and hand instrumentation, respectively. Mean score of SL was significantly less in the hand instrumentation group than the ProTaper (P=0.027) and Reciproc (P=0.035) groups. The difference between the two engine-driven systems, however, was not significant (P=0.803). The amount of smear layer in the apical third of curved root canals prepared with both engine-driven systems was similar and greater than the hand instrumentation technique. Complete cleanliness was not attained.

Review of root canal irrigant delivery techniques and devices

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Yeon-Jee Yoo

2011-05-01

Full Text Available Introduction Eliminating the residual debris and bacteria in the root canal system is one of the main purposes of the endodontic treatment. However, the complexity on the anatomy of the root canal system makes it difficult to eliminate the bacterial biofilm existing along the root canal surface and necrotic pulp tissue by mechanical instrumentation and chemical irrigation. Recently, more effective irrigant delivery systems for root canal irrigation have been developed. The purpose of this review was to present an overview of root canal irrigant delivery techniques and devices available in endodontics. Review The contents of this paper include as follows; - syringe-needle irrigation, manual dynamic irrigation, brushes - sonic and ultrasonic irrigation, passive ultrasonic irrigation, rotary brush, RinsEndo, EndoVac, Laser Conclusion Though technological advances during the last decade have brought to fruition new agitation devices that rely on various mechanisms, there are few evidence based study to correlate the clinical efficacy of these devices with improved outcomes except syringe irrigation with needle and ultrasonic irrigation. The clinicians should try their best efforts to deliver antimicrobial and tissue solvent solutions in predictable volumes safely to working length.

Osmolarity and root canal antiseptics.

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Rossi-Fedele, G; Guastalli, A R

2014-04-01

Antiseptics used in endodontics for disinfection purposes include root canal dressings and irrigants. Osmotic shock is known to cause the alteration of microbial cell viability and might have a role in the mechanism of action of root canal antiseptics. The aim of this review was to determine the role of osmolarity on the performance of antiseptics in root canal treatment. A literature search using the Medline electronic database was conducted up to 30 May 2013 using the following search terms and combinations: 'osmolarity AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmolality AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmotic AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; osmosis AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm; sodium chloride AND root canal or endodontic or antiseptic or irrigation or irrigant or medication or dressing or biofilm'. Publications were included if the effects of osmolarity on the clinical performance of antiseptics in root canal treatment were stated, if preparations with different osmolarities values were compared and if they were published in English. A hand search of articles published online, 'in press' and 'early view', and in the reference list of the included papers was carried out following the same criteria. A total of 3274 publications were identified using the database, and three were included in the review. The evidence available in endodontics suggests a possible role for hyperosmotic root canal medicaments as disinfectants, and that there is no influence of osmolarity on the tissue dissolution capacity of sodium hypochlorite. There are insufficient data to obtain a sound conclusion regarding the role of hypo-osmosis in root canal disinfection, or osmosis in any further desirable

A study on FlexMaster : a Ni-Ti rotary engine driven system for root canal preparation.

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Alam, M S; Bashar, A K; Begumr, J A; Kinoshita, J I

2006-07-01

In the present study, the effectiveness of recently introduced rotary Nickel Titanium FlexMaster engine driven system was evaluated for cleaning and shaping of root canals in extracted human teeth and compared with that done by the Nickel Titanium Flexofile hand instruments. A total of 40 root canals from 36 extracted mandibular and maxillary teeth with curvature ranging between 20 and 30 degree were divided into two groups, consisting 20 canals in each. FlexMaster instrumentation was done in 20 canals, using crown-down technique and manual filing with Flexofile was done in other 20 canals, using conventional and step-back techniques. 5.25% sodium hypochlorite (NaOCl) solution and 17% ethelene di-amine tetra-acetic acid (EDTA) were used alternatively for irrigation after canal preparation by each instrument size. Time needed for canal preparation of individual canal was recorded. A procedural error such as instrument breakage was also noted. After preparation, all the roots were cut longitudinally by using diamond burs in turbine handpiece and examined under scanning electron microscope. Apical region was quantified for debris and smear layer based on a 5-score numerical evaluation scale. The data established for scoring the debris and smear layer and preparation time of individual canal were analyzed statistically using the Mann-Whitney U test. Completely cleaned root canals were not found with any of the two instruments and none of the instruments maintained the original canal uniformity and regular dentine surface. Because significantly less debris was found in the apical region using the manual filing technique (p< 0.05). Thus the flexmaster system was found to produce less cleaner root canal walls than manual technique. Only one FlexMaster finishing file sized 30 was separated in the apical region during preparation of 30 degree curved canal. The time taken by FlexMaster was significantly better (p< 0.01) than that of hand instruments.

Efficacy of reciprocating and rotary NiTi instruments for retreatment of curved root canals assessed by micro-CT.

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Rödig, T; Reicherts, P; Konietschke, F; Dullin, C; Hahn, W; Hülsmann, M

2014-10-01

To compare the efficacy of reciprocating and rotary NiTi-instruments in removing filling material from curved root canals using micro-computed tomography. Sixty curved root canals were prepared and filled with gutta-percha and sealer. After determination of root canal curvatures and radii in two directions as well as volumes of filling material, the teeth were assigned to three comparable groups (n = 20). Retreatment was performed using Reciproc, ProTaper Universal Retreatment or Hedström files. Percentages of residual filling material and dentine removal were assessed using micro-CT imaging. Working time and procedural errors were recorded. Statistical analysis was performed by variance procedures. No significant differences amongst the three retreatment techniques concerning residual filling material were detected (P > 0.05). Hedström files removed significantly more dentine than ProTaper Universal Retreatment (P  0.05). Reciproc and ProTaper Universal Retreatment were significantly faster than Hedström files (P = 0.0001). No procedural errors such as instrument fracture, blockage, ledging or perforation were detected for Hedström files. Three perforations were recorded for ProTaper Universal Retreatment, and in both NiTi groups, one instrument fracture occured. Remnants of filling material were observed in all samples with no significant differences between the three techniques. Hedström files removed significantly more dentine than ProTaper Universal Retreatment, but no significant differences between both NiTi systems were detected. Procedural errors were observed with ProTaper Universal Retreatment and Reciproc. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Cervical shaping in curved root canals: comparison of the efficiency of two endodontic instruments

OpenAIRE

Busquim Sandra Soares Kühne; Santos Marcelo dos

2002-01-01

The aim of this study was to determine the removal of dentin produced by number 25 (0.08) Flare files (Quantec Flare Series, Analytic Endodontics, Glendora, California, USA) and number 1 e 2 Gates-Glidden burs (Dentsply - Maillefer, Ballaigues, Switzerland), in the mesio-buccal and mesio-lingual root canals, respectively, of extracted human permanent inferior molars, by means of measuring the width of dentinal walls prior and after instrumentation. The obtained values were compared. Due to th...

[Glide path management of rotary nickel-titanium instruments in simulated root canals].

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Han, Y; Bai, Y H; Hou, X M

2018-02-18

To compare the shaping ability of ProGlider, HyFlex EDM Glidepath File and RaCe ISO 10 with that of PathFile and stainless steel K-file hand instruments in simulated root canals. A total of 60 simulated resin blocks were divided randomly into five groups (n=12), each group prepared with each instrument, respectively. Preparation time was recorded. Pre- and post-operative images were obtained using a scanner and superimposed using Photoshop. The material removal from the inner and outer canal walls beginning from 0 mm at the end point of the canal were measured using ImageJ. Centering ability was determined, accordingly. The data were analyzed using the One-Way ANOVA at a significance level of P0.05). The removal of resin from the outer wall at the apical portion was significantly lower for HyFlex EDM Glidepath File than for ProGlider (PEDM Glidepath File the second most, and the other 3 groups among the same levels. As far as the centering ability was concerned, at the apical portion, HyFlex EDM Glidepath File was the best, ProGlider the second best, no significant difference identified among the other 3 groups. At the curvature portion, ProGlider and HyFlex EDM Glidepath File were the best, PathFile the second, RaCe ISO 10 the third, the worst was the SS K-file. At the straight portion, the difference amongt the 5 groups was not significant. The shaping abilities of ProGlider, HyFlex EDM Glidepath File and RaCe ISO 10 were better or comparable to that of PathFile, while the preparation time for ProGlider reduced significantly, and HyFlex EDM Glidepath File and RaCe ISO 10 removed significantly more resin at the straight portion of the canal.

The efficacy of two rotary NiTi instruments and H-files to remove gutta-percha from root canals

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Akpınar, Kerem E.; Altunbaş, Demet

2012-01-01

Objective: The aim of this study was to evaluate the efficacy of R-Endo® and K3® rotary nickel-titanium instruments compared with manual instrumentation with H-files, with use of a solvent, for removal of gutta-percha during retreatment. Study design: Forty five freshly extracted human single-rooted teeth, each with one root canal, were instrumented with K-files and filled using cold lateral compaction of gutta-percha and AH 26® sealer. The teeth were randomly divided into three groups of 15 specimens each. Removal of gutta-percha was performed with the following devices and techniques: Group 1 (H-files), Group 2 (R-Endo®), and Group 3 (K3®). The specimens were rendered transparent for the evaluation of the area of remaining gutta-percha/sealer in buccolingual and mesiodistal directions. Statistical analysis as performed by using one-way ANOVA and Kruskal-Wallis tests (p=0.05). Results: All retreatment techniques used in this study left some filling material inside the root canal. Images in buccolingual and mesiodistal directions showed no significant differences between the groups (p>0.05). Conclusions: Under the experimental conditions, the remaining filling material after retreatment was similar for each group. Key words:Gutta-percha removal, K3®, NiTi, R-Endo®. PMID:22143729

Semiconductor laser irradiation improves root canal sealing during routine root canal therapy

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Hu, Xingxue; Wang, Dashan; Cui, Ting; Yao, Ruyong

2017-01-01

Objective To evaluate the effect of semiconductor laser irradiation on root canal sealing after routine root canal therapy (RCT). Methods Sixty freshly extracted single-rooted human teeth were randomly divided into six groups (n = 10). The anatomic crowns were sectioned at the cementoenamel junction and the remaining roots were prepared endodontically with conventional RCT methods. Groups A and B were irradiated with semiconductor laser at 1W for 20 seconds; Groups C and D were ultrasonically rinsed for 60 seconds as positive control groups; Groups E and F without treatment of root canal prior to RCT as negative control groups. Root canal sealing of Groups A, C and E were evaluated by measurements of apical microleakage. The teeth from Groups B, D and F were sectioned, and the micro-structures were examined with scanning electron microscopy (SEM). One way ANOVA and LSD-t test were used for statistical analysis (α = .05). Results The apical sealing of both the laser irradiated group and the ultrasonic irrigated group were significantly different from the control group (pirrigated group (p>0.5). SEM observation showed that most of the dentinal tubules in the laser irradiation group melted, narrowed or closed, while most of the dentinal tubules in the ultrasonic irrigation group were filled with tooth paste. Conclusion The application of semiconductor laser prior to root canal obturation increases the apical sealing of the roots treated. PMID:28957407

Effect of Peracetic Acid as A Final Rinse on Push Out Bond Strength of Root Canal Sealers to Root Dentin.

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Gaddala, Naresh; Veeramachineni, Chandrasekhar; Tummala, Muralidhar

2015-05-01

Smear layer which was formed during the instrumentation of root canals hinders the penetration of root canal sealers to root dentin and affect the bond strength of root canal sealers to root dentin. Final irrigant such as demineralizing agents are used to remove the inorganic portion of the smear layer. In the present study, peracetic acid used as a final rinse, to effect the bond strength of root canal sealers to root dentin. The purpose of the present study was to evaluate the efficacy of peracetic acid as a final irrigant on bond strength of root canal sealers to root dentin. Sixty six freshly extracted human single rooted mandibular premolars were used for this study. After decoronation the samples were instrumented with Protaper upto F3 and irrigated with 5.25% NaOcl. The teeth were then divided into three groups based on final irrigant used: Group-1(control group) Canals were irrigated with distilled water. Group-2: Canals were irrigated with peracetic acid. Group-3: Canals were irrigated with smear clear. Each group was further divided into three subgroups (n=30) based on the sealer used to obturate the canals. Subgroup-1: kerr, Subgroup-2: Apexit plus, Subgroup-3: AH PLUS. Each sealer was mixed and coated to master cone and placed in the canal. The bonding between sealer and dentin surface was evaluated using push out bond strength by universal testing machine. The mean bond strength values of each group were statistically evaluated using Two-way ANOVA followed by Tukey post-hoc test. Significant difference was found among the bond strength of the sealers. But, there is no statistically significant difference between the groups irrigated with peracetic acid and smear clear compared to control group. AH Plus showed highest bond strength irrespective of the final irrigant used. Peracetic acid when employed as final irrigant improved the bond strength of root canal sealers compared to control group but not statistically significant than smear clear.

Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations.

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de Pablo, Oliver Valencia; Estevez, Roberto; Heilborn, Carlos; Cohenca, Nestor

2012-01-01

Root canal anatomy may present clinicians with a complex clinical challenge that requires diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. This article discusses the clinical implications of endodontic therapy on permanent mandibular first molars. The number of roots on the mandibular first molar is directly related to ethnicity. Canal morphology has a significant effect on treatment protocol: Mesial roots present two canals on a regular basis, adopting 2-2 and 2-1 as the most common configurations. A third canal is present in 2.6% of the population. The most common configuration in the distal root is type I (62.7%), followed by type II (14.5%) and type IV (12.4%). Diagnosis and treatment of complex root canal systems often require specialized training that may be beyond the scope of the average general practitioner. Access modifications are required to find extra roots and/or canals. The instrumentation of the third root requires a different access and small, flexible instruments, given the curvature that is usually present buccally in the apical third. The incidence of isthmuses is 55% in the mesial root and 20% in the distal root. This anatomical configuration should be taken into consideration during endodontic treatment as well as during periapical surgery.

Scanning electron microscopic evaluation of root canal surfaces ...

African Journals Online (AJOL)

Scanning electron microscopic evaluation of root canal surfaces prepared with three rotary endodontic systems: Lightspeed, ProTaper and EndoWave. ... fracture with LightSpeed (LS), ProTaper (PT) and EndoWave (Ew) rotary instruments.

Effectiveness of ProTaper Universal retreatment instruments used with rotary or reciprocating adaptive motion in the removal of root canal filling material.

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Capar, I D; Arslan, H; Ertas, H; Gök, T; Saygılı, G

2015-01-01

To compare the effectiveness of ProTaper Universal retreatment instruments with continuous rotation and adaptive motion (AM; a modified reciprocating motion that combines rotational and reciprocating motion) in the removal of filling material. Mesiobuccal root canals in 36 mandibular first molars were instrumented up to size F2 with the ProTaper Universal instrument (Dentsply Maillefer, Ballaigues, Switzerland) and filled using sealer and ProTaper Universal F2 gutta-percha cones. Gutta-percha was then down-packed and the root canal backfilled using the extruder hand-piece of the Elements Obturation System (SybronEndo, Orange, CA, USA). The teeth were assigned to two groups (n = 18), and removal of the root fillings was performed using one of the following techniques: group 1) ProTaper Universal retreatment files used with rotational motion (RM) and group 2) ProTaper Universal retreatment files used with adaptive motion (AM) (600° clockwise/0° counter-clockwise to 370° clockwise/50° counter-clockwise). The teeth were sectioned, and both halves were analysed at 8 × magnification. The percentage of remaining filling material was recorded. The data were analysed statistically using the Student's t-test at a 95% confidence level (P ProTaper Universal retreatment files with adaptive motion removed more filling materials from root canals than the rotational movement. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Ultrastructural investigation of root canal dentine surface after application of active ultrasonic method

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Mitić Aleksandar

2008-01-01

Full Text Available INTRODUCTION The basic work principle of all ultrasonic techniques is the piezoelectric effect of producing high frequency ultrasounds of small length, which are transmitted over the endodontic extensions or canal instruments into the root canal. When in contact with the tissue, ultrasonic vibrations are converted into mechanical oscillations. Ultrasonic waves and the obtained oscillations along with the synergic effect of irrigation bring about the elimination of smear layer from the root canal walls. OBJECTIVE The aim of the study was to ultrastucturally examine the effect of smear layer removal from the walls of canals by the application of the active ultrasonic method without irrigation, that is by the application of ultrasound and irrigation using distilled water and 2.5% NaOCl. METHOD The investigation comprised 35 single-canal, extracted human teeth. After removal of the root canal content, experimental samples were divided into three groups. According to the procedure required, the first group was treated by ultrasound without irrigation; the second one by ultrasound with irrigation using distilled water; and the third group was treated by ultrasound and irrigation using 2.5% NaOCl solution. The control samples were treated by machine rotating instruments (Pro-File and were rinsed by distilled water. RESULTS The obtained results showed that the ultrasonic treatment of the root canal without irrigation did not remove the smear layer. The dentine canals are masked, and big dentine particles are scattered on the intertubular dentine. The ultrasonic treatment by using irrigation with distilled water provides cleaner dentine walls and open dentine tubules but with smaller particles on the intertubular dentine. The ultrasound treatment by using irrigation with 2.5% NaOCl solution provides a clean intertubular dentine surface without a smear layer and clearly open dentine tubules. CONCLUSION Instrumentation of the root canal by application of

Hand-operated and rotary ProTaper instruments: a comparison of working time and number of rotations in simulated root canals.

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Pasqualini, Damiano; Scotti, Nicola; Tamagnone, Lorenzo; Ellena, Federica; Berutti, Elio

2008-03-01

The aim of this study was to compare the effective shaping time and number of rotations required by an endodontist working with hand and rotary ProTaper instruments to completely shape simulated root canals. Eighty Endo Training Blocks (curved canal shape) were used. Manual preflaring was performed with K-Flexofiles #08-10-12-15-17 and #20 Nitiflex at a working length of 18 mm. Specimens were then randomly assigned to 2 different groups (n = 40); group 1 was shaped by using hand ProTaper and group 2 with ProTaper rotary. The number of rotations made in the canal and the effective time required to achieve complete canal shaping were recorded for each instrument. Differences between groups were analyzed with the nonparametric Mann-Whitney U test (P Hand ProTaper required significantly fewer rotations (P ProTaper, whereas the effective working time to fully shape the simulated canal was significantly higher (P hand ProTaper.

Root canal debris removal using different irrigating needles: An SEM study

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Sheetal Ghivari

2011-01-01

Full Text Available Aim: This study was carried out to compare the efficacy of three irrigating needle designs in removal of debris from different parts of the root canal. Materials and Methods: Thirty human maxillary canines were prepared using HERO Shaper rotary system and irrigated with 1 ml of 5.25% sodium hypochlorite (NaOCl after each instrument change. Three 25-gauge irrigation needle designs - brush-covered Navi Tip FX (Group I, side-vented needle RC Twents (Group II and single-beveled (Group III irrigating needles - were tested for their efficiency in debris removal in three different parts of the root canal (n=10 canals per group. Following instrumentation, the roots were vertically sectioned and divided into coronal, middle and apical thirds for observation under scanning electron microscope (×200 magnification. Debris on the canal wall was evaluated by using a four-scale scoring system described by Paque and his co-workers. Results: The canals irrigated with brush-covered needle Navi Tip FX (Group I showed lower average debris score, indicating greater removal of debris in coronal third as compared to middle and apical thirds, whereas the canals irrigated with side-vented needle (Group II and single-beveled needle (Group III exhibited lower average score in the middle third than coronal and apical thirds. All the three needle designs exhibited higher debris score in apical third of the root canal. Tukey multiple comparisons test was applied at a significance level of P>0.05. A statistically significant difference (P<0.05 was observed in the debris removal in the coronal and middle thirds of root canals irrigated with brush-covered Navi Tip FX (Group I and side-vented (Group II needles, respectively, when compared with other needle design groups. Conclusion: Within the limitations of this study, it can be concluded that all the needle designs tested were effective in certain regions of the root canal with apical third uncleaned. Side-vented needle by

Clinical and Radiographic Evaluation of Procedural Errors during Preparation of Curved Root Canals with Hand and Rotary Instruments: A Randomized Clinical Study

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Khanna, Rajesh; Handa, Aashish; Virk, Rupam Kaur; Ghai, Deepika; Handa, Rajni Sharma; Goel, Asim

2017-01-01

Background: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. Aim: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Materials and Methods: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Statistical Analysis: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). Results: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Conclusion: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex. PMID:29042727

The effect of intermittent passive ultrasonic irrigation and rotary instruments on microbial colonies of infected root canals

International Nuclear Information System (INIS)

AlMadi, Ebtissam M; Balto, Hanan A

2008-01-01

To study the effectiveness of reduction of E. faecalis in root canals with passive ultrasonic irrigation (PUI) of 2.25% NaOCl for 1.5 min intermittently during hand instrumentation and continuously after rotary instrumentation. Forty-eight extracted single rooted teeth were filled with E. faecalis suspension and divided into 4 groups. They were either hand instrumented alone using the stepback technique, hand instrumented with PUI of the 2.25% NaOCl intermittently for a total of 1.5 min during the instrumentation, rotary instrumented with ProFile 0.04 alone, or rotary instrumented with PUI of the irrigant for 1.5 min. There was significantly more bacterial growth in the hand instrumented group than in the hand instrumented group with PUI, and marginal significant difference in the hand instrumented group with PUI compared to the rotary instrumented group. No differences were found between the rotary instrumented groups. It was concluded that intermittent use of PUI of 2.25% NaOCl for a total of 1.5 min (half of the current recommended time) during hand instrumentation reduced bacterial colonies significantly. There was no difference in bacterial reduction when rotary instrumentation was used with or without PUI. (author)

Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

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Holderrieth, Silke; Gernhardt, Christian Ralf

2009-07-01

The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

Comparison of the Effect of Canal Preparation by Step Back Technique Using Hand Instruments and Gates Glidden Drills with ProTaper Universal Rotary System on the Root Resistance to Vertical Fracture

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A Abbaszadegan

2013-06-01

Full Text Available Introduction: Cleaning and shaping of the root canal system with an efficient and safe technique are the major goals of root canal treatment. The aim of this study was to compare the conventional root canal preparation technique by hand instruments and Gates Glidden drills with ProTaper Universal Rotary system on the root susceptibility to vertical fracture. Methods: Thirty extracted human mandibular premolars were randomly assigned to two groups. In group I, apical preparation was performed with k-files up to #40 utilizing step back technique and coronal flaring was done with Gates Glidden drills. In group II, ProTaper Universal Rotary instruments were used up to the file F4. All teeth were obturated with lateral compaction technique using gutta-percha and AH26 sealer. A simulated periodontal ligament was fabricated, and the teeth were mounted. A stainless steel finger spreader #35 was mounted in an Instron testing machine and the necessary load to cause a root fracture was inserted and recorded. The obtained data were analyzed statistically using T-test. Results: The force required to fracture was significantly lower for the roots prepared by ProTaper instruments in comparison with the specimens prepared by hand instruments and Gates Glidden drills (P< 0.001. Conclusion: Canal preparation with ProTaper rotary instruments can make the roots more susceptible to vertical fracture than traditional instrumentation with k-files and Gates Glidden drills.

Evaluation of complications of root canal treatment performed by undergraduate dental students.

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AlRahabi, Mothanna K

2017-12-01

This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students were investigated by retrospective chart review. Root canal obturation was evaluated on the basis of the length of obturation being ≤2 mm from the radiographic apex, with uniform radiodensity and good adaptation to root canal walls. Inadequate root canal obturation included cases containing procedural errors such as furcal perforation, ledge, canal transportation, strip perforation, root perforation, instrument separation, voids in the obturation, or underfilling or overfilling of the obturation. In 193 (68.9%) teeth, RCT was adequate and without procedural errors. However, in 87 (31.1%) teeth, RCT was inadequate and contained procedural errors. The frequency of procedural errors in the entire sample was 31.1% as follows: underfilling, 49.9%; overfilling, 24.1%; voids, 12.6%; broken instruments, 9.2%; apical perforation, 2.3%; and root canal transportation, 2.3%. There were no significant differences (p > 0.05) in the type or frequency of procedural errors between the fourth- and fifth-year students. Lower molars (43.1%) and upper incisors (19.2%) exhibited the highest and lowest frequencies of procedural errors, respectively. The technical quality of RCT performed by undergraduate dental students was classified as 'adequate' in 68.9% of the cases. There is a need for improvement in the training of students at the preclinical and clinical levels.

CT evaluation of canal preparation using rotary and hand NI-TI instruments: An in vitro study.

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Nagaraja, Shruthi; Sreenivasa Murthy, B V

2010-01-01

Controlled, uniformly tapered radicular preparation is a great challenge in endodontics. Improper preparation can lead to procedural errors like transportation of foramen, uneven dentine thickness, stripping of root canal, formation of ledge, zip, and elbow in curved canals. These procedural errors and their sequel can adversely affect the prognosis of treatment. The present in vitro study aims to evaluate canal preparation based on the following factors: canal transportation, remaining dentine thickness and comparing centering ability between hand Ni-Ti K files and ProTaper rotary Ni-Ti instruments using computed tomography (CT). For evaluation, 30 mesiobuccal roots of maxillary molars were selected. Of these, 15 roots were distributed into two groups where Group 1 included hand instrumentation with Ni-Ti K-files; and Group 2 comprised ProTaper NiTi rotary system. Pre instrumentation and post instrumentation three-dimensional CT images were obtained from root cross-sections that were 1 mm thick from apex to the canal orifice; scanned images were then superimposed and compared. It was observed that the manual technique using hand Ni-Ti K-file produced lesser canal transportation and maintained greater dentine thickness than the rotary ProTaper technique at middle and coronal third and this difference was statistically significant. No significant difference was seen with regard to canal transportation and remaining root dentine at apical levels. With regard to centering ratio, no significant difference was seen between both the groups at all levels. ProTaper should be used judiciously, especially in curved canals, as it causes higher canal transportation and thinning of root dentine at middle and coronal levels. None of the groups showed optimal centering ability.

Root canal treatment of mandibular second premolar tooth with taurodontism

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Vujašković Mirjana

2008-01-01

Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

Root canal treatment of a maxillary first premolar with three roots

OpenAIRE

Mathew, Josey; Devadathan, Aravindan; Syriac, Gibi; Shamini, Sai

2015-01-01

Successful root canal treatment needs a thorough knowledge of both internal and external anatomy of a tooth. Variations in root canal anatomy constitute an impressive challenge to the successful completion of endodontic treatment. Undetected extra roots and canals are a major reason for failed root canal treatment. Three separate roots in a maxillary first premolar have a very low incidence of 0.5?6%. Three rooted premolars are anatomically similar to molars and are sometimes called ?small mo...

Effects of multiple root canal usage on the surface topography and fracture of two different Ni-Ti rotary file systems.

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Kottoor, Jojo; Velmurugan, Natanasabapathy; Gopikrishna, Velayutham; Krithikadatta, Jogikalmat

2013-01-01

The purpose of this study was to evaluate the effect of multiple root canal usage on the surface topography and fracture of Twisted File (TF) and ProTaper (PT) rotary Ni-Ti file systems, using scanning electron microscope (SEM). Ten sets of PT and TF instruments were used to prepare the mesial canals of mandibular first molars. TF 25, 0.06 taper and PT F1 instruments were analyzed by SEM when new and thereafter every three root canal usages. This sequence was repeated for both the TF and PT groups until 12 uses. Two images of the instrument were recorded, one of the instrument tip and the other 5 mm from the tip, both at × 100 magnification. The sequential use was continued till the instrument fractured and the number of root canal usages for the file to fracture was noted. All fracture surfaces were examined under the SEM. Fresh TF instruments showed no surface wear when compared to PT instruments (P 0.05), while at the 9 th usage TF showed a steep increase in the spiral distortion score when compared to PT (P < 0.05). PT instruments fractured at a mean root canal usage of 17.4, while TF instruments showed a mean root canal usage of 11.8. Fractographically, all the TF instruments failed due to torsion, while all the PT instruments failed because of cyclic fatigue. PT instruments showed more resistance to fracture than TF instruments.

Root canal treatment of bilateral three-rooted maxillary first premolars

Directory of Open Access Journals (Sweden)

Bhavana Gandhi

2012-01-01

Full Text Available In endodontics, several anatomic variations occur in teeth, both externally and in the internal root morphology, which play a very significant role in the diagnosis and treatment outcome. A thorough knowledge of the root canal anatomy, careful interpretation of the angled radiographs, proper endodontic access cavity preparation, and exploration of the root canal are the prerequisites for endodontic success. In a maxillary first premolar, it is rare to find extra roots and canals, and the aim of the present article is to report a case about the successful diagnosis and clinical management of bilateral three-rooted maxillary first premolars, with three independent root canals.

21 CFR 872.3810 - Root canal post.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal post. 872.3810 Section 872.3810 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3810 Root canal post. (a) Identification. A root canal... of the platinum group intended to be cemented into the root canal of a tooth to stabilize and support...

CT evaluation of canal preparation using rotary and hand NI-TI instruments: An in vitro study

Science.gov (United States)

Nagaraja, Shruthi; Sreenivasa Murthy, B V

2010-01-01

Background: Controlled, uniformly tapered radicular preparation is a great challenge in endodontics. Improper preparation can lead to procedural errors like transportation of foramen, uneven dentine thickness, stripping of root canal, formation of ledge, zip, and elbow in curved canals. These procedural errors and their sequel can adversely affect the prognosis of treatment. Aim/Objectives: The present in vitro study aims to evaluate canal preparation based on the following factors: canal transportation, remaining dentine thickness and comparing centering ability between hand Ni-Ti K files and ProTaper rotary Ni-Ti instruments using computed tomography (CT). Materials and Methods: For evaluation, 30 mesiobuccal roots of maxillary molars were selected. Of these, 15 roots were distributed into two groups where Group 1 included hand instrumentation with Ni-Ti K-files; and Group 2 comprised ProTaper NiTi rotary system. Pre instrumentation and post instrumentation three-dimensional CT images were obtained from root cross-sections that were 1 mm thick from apex to the canal orifice; scanned images were then superimposed and compared. Result: It was observed that the manual technique using hand Ni-Ti K-file produced lesser canal transportation and maintained greater dentine thickness than the rotary ProTaper technique at middle and coronal third and this difference was statistically significant. No significant difference was seen with regard to canal transportation and remaining root dentine at apical levels. With regard to centering ratio, no significant difference was seen between both the groups at all levels. Conclusion: ProTaper should be used judiciously, especially in curved canals, as it causes higher canal transportation and thinning of root dentine at middle and coronal levels. None of the groups showed optimal centering ability. PMID:20582214

Unpredictable Root Canal Morphology: Expect the Unexpected

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Sohez J Makani

2015-01-01

Full Text Available Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root. Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report

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Thikamphaa Bertrand

2016-02-01

Full Text Available This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT. C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

Comparison of the Effect of Canal Preparation by Step Back Technique Using Hand Instruments and Gates Glidden Drills with ProTaper Universal Rotary System on the Root Resistance to Vertical Fracture

OpenAIRE

A Abbaszadegan; Z Sadat Aleyasin; M Sedigh Shamsi; Sh Shahriari

2013-01-01

Introduction: Cleaning and shaping of the root canal system with an efficient and safe technique are the major goals of root canal treatment. The aim of this study was to compare the conventional root canal preparation technique by hand instruments and Gates Glidden drills with ProTaper Universal Rotary system on the root susceptibility to vertical fracture. Methods: Thirty extracted human mandibular premolars were randomly assigned to two groups. In group I, apical preparation was performed ...

Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals - a micro-computed tomography study.

Science.gov (United States)

Rödig, T; Hausdörfer, T; Konietschke, F; Dullin, C; Hahn, W; Hülsmann, M

2012-06-01

To compare the efficacy of two rotary NiTi retreatment systems and Hedström files in removing filling material from curved root canals. Curved root canals of 57 extracted teeth were prepared using FlexMaster instruments and filled with gutta-percha and AH Plus. After determination of root canal curvatures and radii in two directions, the teeth were assigned to three identical groups (n = 19). The root fillings were removed with D-RaCe instruments, ProTaper Universal Retreatment instruments or Hedström files. Pre- and postoperative micro-CT imaging was used to assess the percentage of residual filling material as well as the amount of dentine removal. Working time and procedural errors were recorded. Data were analysed using analysis of covariance and analysis of variance procedures. D-RaCe instruments were significantly more effective than ProTaper Universal Retreatment instruments and Hedström files (P ProTaper group, four instrument fractures and one lateral perforation were observed. Five instrument fractures were recorded for D-RaCe. D-RaCe instruments were associated with significantly less residual filling material than ProTaper Universal Retreatment instruments and hand files. Hedström files removed significantly less dentine than both rotary NiTi systems. Retreatment with rotary NiTi systems resulted in a high incidence of procedural errors. © 2012 International Endodontic Journal.

Effects of multiple root canal usage on the surface topography and fracture of two different Ni-Ti rotary file systems

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Jojo Kottoor

2013-01-01

Full Text Available Aim: The purpose of this study was to evaluate the effect of multiple root canal usage on the surface topography and fracture of Twisted File (TF and ProTaper (PT rotary Ni-Ti file systems, using scanning electron microscope (SEM. Materials and Methods: Ten sets of PT and TF instruments were used to prepare the mesial canals of mandibular first molars. TF 25, 0.06 taper and PT F1 instruments were analyzed by SEM when new and thereafter every three root canal usages. This sequence was repeated for both the TF and PT groups until 12 uses. Two images of the instrument were recorded, one of the instrument tip and the other 5 mm from the tip, both at ×100 magnification. The sequential use was continued till the instrument fractured and the number of root canal usages for the file to fracture was noted. All fracture surfaces were examined under the SEM. Results: Fresh TF instruments showed no surface wear when compared to PT instruments (P 0.05, while at the 9 th usage TF showed a steep increase in the spiral distortion score when compared to PT (P < 0.05. PT instruments fractured at a mean root canal usage of 17.4, while TF instruments showed a mean root canal usage of 11.8. Fractographically, all the TF instruments failed due to torsion, while all the PT instruments failed because of cyclic fatigue. Conclusion: PT instruments showed more resistance to fracture than TF instruments.

Effects of irrigation solutions and Calcium hydroxide dressing on root canal treatments of periapical lesions

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Vita Nirmala

2006-03-01

Full Text Available The preparation of root canal in endodontic treatment plays an important role in treating non vital teeth with periapical lesion. Some factors influence the success of root canal treatment in short and long terms are the irrigation of root canal using antiseptic solution and the use of root canal medicament. The aim of this literature study is to determined the effect of irrigation solution and Calcium hydroxide dressing in root canal treatment of periapical lesions. The use of root canal medicament during the endodontic treatment could sterilized and decreased the number of pathogenic microorganism of root canal. An effective root canal irrigation solution must be able to dissolve organic and anorganic debris, lubricate endodontic instruments, disinfect microorganisms, non toxic and economical. The best irrigation solution has maximum antimicrobial effect with minimum toxicity. Division of calcium hydroxide into Calcium and hydroxyl ions is responsible for alkalinization of cavity, subsequently it makes the condition of cavity to be inappropriate for bacterial endotoxin in vitro as well as in vivo, and considered as the only clinically effective medicament in inactivating bacterial endotoxin. Calcium hydroxide is the only medication which has the ability to clinically inactive bacterial endotoxin in vitro in vivo and accepted as the best of root canal medication.

Wear promoted in the apical third of simulated canals after instrumentation with protaper universal system

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Kathrein Tapia da Silva

2009-10-01

Full Text Available OBJECTIVE: This study evaluated the wear in the apical third of simulate canals after preparation with ProTaper Universal Rotary System. MATERIAL AND METHODS: 24 sets of instruments were used in 24 simulated canals in transparent epoxy resin blocks with degree of curvature of either 20°or 40°. The canals were photographed preoperatively and after preparation of the apical stop with ProTaper F3, F4 and F5 instruments. The initial and final images were exported to Adobe Photoshop® software and superimposed to detect the root canal wall differences (in mm between them, in two points located 1 (A and 5 (B mm from the point where the working length was established. Data were subjected to analysis of variance to verify the existence of interaction among the factors: canal curvature, instrument size and curve location. Significant level was set at 5%. RESULTS: Regardless of the location and the canal curvature, F4 and F5 instruments produced the greatest wear (p<0.05. CONCLUSIONS: There was a deviation from the original pathway towards the outside of the root curvature in both analyzed points. All instruments produced canal transportation, but the F4 and F5 instruments produced more than the other instruments, and should thus be used with care in curved canals.

Effects of self-adjusting file, Mtwo, and ProTaper on the root canal wall.

Science.gov (United States)

Hin, Ellemieke S; Wu, Min-Kai; Wesselink, Paul R; Shemesh, Hagay

2013-02-01

The purpose of this ex vivo study was to observe the incidence of cracks in root dentin after root canal preparation with hand files, self-adjusting file (SAF), ProTaper, and Mtwo. One hundred extracted mandibular premolars with single canals were randomly selected. Two angulated radiographs were taken for each tooth, and the width of the canal was measured at 9 mm from the apex. Five groups of 20 teeth each were comparable in canal width. The control group was left unprepared. Four experimental groups were instrumented with hand files, ProTaper, Mtwo, and SAF. Roots were then sectioned horizontally and observed under a microscope. The presence of dentinal cracks and their location were noted. The difference between the experimental groups was analyzed with a χ(2) test. No cracks were observed in the control group. In the experimental groups, ProTaper, Mtwo, and SAF caused cracks in 35%, 25%, and 10% of teeth, respectively. The hand-file group did not show any dentinal cracks (P ProTaper and Mtwo caused more cracks than hand files (P .05). Instrumentation of root canals with SAF, Mtwo, and ProTaper could cause damage to root canal dentin. SAF has a tendency to cause less dentinal cracks as compared with ProTaper or Mtwo. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Incidence of apical root cracks and apical dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths

NARCIS (Netherlands)

Liu, R.; Kaiwar, A.; Shemesh, H.; Wesselink, P.R.; Hou, B.; Wu, M.K.

2013-01-01

Introduction The aim of this study was to compare the incidence of apical root cracks and dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths. Methods Two hundred forty mandibular incisors were mounted in resin blocks with simulated

Comparative evaluation of fracture and defect in reciproc and rotary files in severe curved root canals

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Mahdis Bagherian

2015-03-01

Full Text Available Introduction: Root canal instrumentation is an important phase in root canal therapy. Since success in endodontic treatment depends on file defect and fracture, the aim of this study was to compare the evaluation of defect and fracture in rotary and reciproc files in severe curved root canals. Materials & Methods: In this experimental study, 60 mesial canals of human closed apex molars with more than 30° canal curvature were randomly divided into two groups. In first group M-two rotary files number# 15, 20, and 25 and in second group R25 reciproc file were used for filing, respectively. A ×8 magnifier was applied to evaluate the defect or fracture presence in each side and if it were observed, a new file would be replaced. Therefore, the number of prepared canals with each file and fractured or defective files and the place of fracture in root canal were recorded. Kaplan Meier curve and log rank test were done by using SPSS v.22. Results: In rotary group, seven and two files were fractured and defected, respectively and four files were fractured and no defect was observed in reciproc group. Although the mean of the number of prepared canals until fracture or defect in rotary and reciproc groups was 3.3 and 7.06, respectively, there were no significant differences between two systems. All file’s fractures occurred in apical regions . Conclusion: The results showed that there was no significant difference in defects or fractures of rotary and reciproc systems. Reciproc instruments can be more effective than rotary ones because the root canal preparation in rotary instruments is longer than in reciproc system.

Efficacy of ProTaper universal retreatment files in removing filling materials during root canal retreatment.

Science.gov (United States)

Giuliani, Valentina; Cocchetti, Roberto; Pagavino, Gabriella

2008-11-01

The aim of this study was to evaluate the efficacy of the ProTaper Universal System rotary retreatment system and of Profile 0.06 and hand instruments (K-file) in the removal of root filling materials. Forty-two extracted single-rooted anterior teeth were selected. The root canals were enlarged with nickel-titanium (NiTi) rotary files, filled with gutta-percha and sealer, and randomly divided into 3 experimental groups. The filling materials were removed with solvent in conjunction with one of the following devices and techniques: the ProTaper Universal System for retreatment, ProFile 0.06, and hand instruments (K-file). The roots were longitudinally sectioned, and the image of the root surface was photographed. The images were captured in JPEG format; the areas of the remaining filling materials and the time required for removing the gutta-percha and sealer were calculated by using the nonparametric one-way Kruskal-Wallis test and Tukey-Kramer tests, respectively. The group that showed better results for removing filling materials was the ProTaper Universal System for retreatment files, whereas the group of ProFile rotary instruments yielded better root canal cleanliness than the hand instruments, even though there was no statistically significant difference. The ProTaper Universal System for retreatment and ProFile rotary instruments worked significantly faster than the K-file. The ProTaper Universal System for retreatment files left cleaner root canal walls than the K-file hand instruments and the ProFile Rotary instruments, although none of the devices used guaranteed complete removal of the filling materials. The rotary NiTi system proved to be faster than hand instruments in removing root filling materials.

Micro-CT analyses of apical enlargement and molar root canal complexity

DEFF Research Database (Denmark)

Markvart, Merete; Darvann, Tron Andre; Larsen, Per

2012-01-01

AIM: To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical enlargement in molar teeth and to quantify and visualize spatial details of instrumentation efficacy in root canals of different complexity. METHODOLOGY: Maxillary and mandibular molar teeth wer...

[Application of hand-use ProTaper instruments in endodontic treatment of molar canals].

Science.gov (United States)

Ma, Sui-qi; Xie, Qian; Zhou, Yin-feng

2010-07-01

To evaluate the application of hand-use ProTaper instruments in endodontic treatment of molar canals. A total of 203 permanent molars were randomly divided into the experimental group (99 molars) and control group (104 molars) prepared by hand-use ProTaper instruments and standard stainless steel K-file, respectively. The molars in the two groups were obturated by cold lateral condensation technique. The root canal preparation and obturation were evaluated by radiograph, and the working time of preparation and post-operative emergencies were analyzed. The preparation time in the experimental group was obviously shorter than that in the control group (Phand-use ProTaper instruments may improve the effect of root canal treatment of the molars and shorten the working time and reduce the post-operative emergencies.

Radiological evaluation of the morphological changes of root canals shaped with ProTaper for hand use and the ProTaper and RaCe rotary instruments.

Science.gov (United States)

Aguiar, Carlos M; Câmara, Andréa C

2008-12-01

This study evaluated, by means of the radiography examination, the occurrence of deviations in the apical third of root canals shaped with hand and rotary instruments. Sixty mandibular human molars were divided into three groups. The root canals in group 1 were instrumented with ProTaper (Dentsply/Maillefer, Ballaigues, Switzerland) for hand use, group 2 with ProTaper and group 3 with RaCe. The images obtained by double superimposition of the pre- and postoperative radiographs were evaluated by two endodontists with the aid of a magnifier-viewer and a fivefold magnifier. Statistical analysis was performed using the Fisher-Freeman-Halton. The instrumentation using the ProTaper for hand use showed 25% of the canals with a deviation in the apical third, as did the ProTaper, while the corresponding figure for the RaCe (FKG Dentaire, La-Chaux-de-Fonds, Switzerland) was 20%, but these results were not statistically significant. There was no correlation between the occurrence of deviations in the apical third and the systems used.

Curved canals: Ancestral files revisited

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Jain Nidhi

2008-01-01

Full Text Available The aim of this article is to provide an insight into different techniques of cleaning and shaping of curved root canals with hand instruments. Although a plethora of root canal instruments like ProFile, ProTaper, LightSpeed ® etc dominate the current scenario, the inexpensive conventional root canal hand files such as K-files and flexible files can be used to get optimum results when handled meticulously. Special emphasis has been put on the modifications in biomechanical canal preparation in a variety of curved canal cases. This article compiles a series of clinical cases of root canals with curvatures in the middle and apical third and with S-shaped curvatures that were successfully completed by employing only conventional root canal hand instruments.

Micro-computed tomographic comparison of nickel-titanium rotary versus traditional instruments in C-shaped root canal system.

Science.gov (United States)

Yin, Xingzhe; Cheung, Gary Shun-Pan; Zhang, Chengfei; Masuda, Yoshiko Murakami; Kimura, Yuichi; Matsumoto, Koukichi

2010-04-01

The purpose of this study was to assess the efficacy of instrumentation of C-shaped canals with ProTaper rotary system and traditional instruments by using micro-computed tomography (micro-CT). Twenty-four mandibular molars with C-shaped canals were selected in pairs and sorted equally into 2 groups, which were assigned for instrumentation by ProTaper rotary system (ProTaper group) or by K-files and Gates-Glidden burs (Hand Instrument group). Three-dimensional images were constructed by micro-CT. The volume of dentin removed, uninstrumented canal area, time taken for instrumentation, and iatrogenic error of instrumentation were investigated. Hand Instrument group showed greater amount of volumetric dentin removal and left less uninstrumented canal area than ProTaper group (P ProTaper group than for Hand Instrument group (P Hand Instrument group than for ProTaper group. It was concluded that ProTaper rotary system maintained the canal curvature with speediness and few procedural errors, whereas traditional instrumentation can clean more canal surface. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

International Nuclear Information System (INIS)

Moura-Netto, Cacio; Palo, Renato Miotto; Pinto, Larissa Fernanda; Daltoe, Gisele; Mello-Moura, Anna Carolina Volpi

2015-01-01

Abstract: Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I) and WaveOne (Group II) and the oscillatory system Tilos (Group III). Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation. (author)

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

Directory of Open Access Journals (Sweden)

Cacio MOURA-NETTO

2015-01-01

Full Text Available Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I and WaveOne (Group II and the oscillatory system Tilos (Group III. Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation.

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

Energy Technology Data Exchange (ETDEWEB)

Moura-Netto, Cacio, E-mail: caciomn@usp.br [Universidade Cruzeiro do Sul (UNICSUL), Sao Paulo, SP (Brazil). Fac. de Odontologia; Palo, Renato Miotto [Universidade Estadual Paulista Julio de Mesquita Filho (ICT/UNESP), Sao Jose dos Campos, SP (Brazil). Instituto de Ciencia e Tecnologia; Pinto, Larissa Fernanda; Daltoe, Gisele; Mello-Moura, Anna Carolina Volpi [Universidade Ibirapuera (UNIB), Sao Paulo, SP (Brazil). Fac. de Odontologia

2015-03-01

Abstract: Root canal preparation is an important step in endodontic treatment. The anatomical complexity of the middle third of the root compromises the effective cleaning of this area. Thus, advances have been made in instrumentation techniques and instruments for this purpose. The aim of this study was to evaluate the effects of three different instrumentation systems on the enlargement of the middle thirds of root canals in mandibular incisors. The preparation methods used were the reciprocating systems Reciproc (Group I) and WaveOne (Group II) and the oscillatory system Tilos (Group III). Comparisons were made by three-dimensional image reconstruction with cone-beam computed tomography before and after instrumentation. Changes in area, perimeter, centering ability, and pattern of preparation were analyzed. The results were subjected to ANOVA complemented by the Tukey’s test. Changes in area, perimeter, and tendency of transportation showed similar results among groups. The transportation index of the Tilos system was significantly lower than that of the other groups. Qualitative analysis of the preparation pattern showed that the Tilos system had a more uniform preparation, although Reciproc and WaveOne preparations appeared more rounded, incompatible with the original canal anatomy. There was similarity in the systems’ performance on flattened areas, although the Tilos system presented a better pattern of root canal preparation and a lower index of transportation. (author)

Reducing surface tension in endodontic chelator solutions has no effect on their ability to remove calcium from instrumented root canals.

Science.gov (United States)

Zehnder, Matthias; Schicht, Olivier; Sener, Beatrice; Schmidlin, Patrick

2005-08-01

The aim of this study was to evaluate the effect of reducing surface tension in endodontic chelator solutions on their ability to remove calcium from instrumented root canals. Aqueous solutions containing 15.5% EDTA, 10% citric acid, or 18% 1- hydroxyethylidene-1, 1-bisphosphonate (HEBP) were prepared with and without 1% (wt/wt) polysorbate (Tween) 80 and 9% propylene glycol. Surface tension in these solutions was measured using the Wilhelmy method. Sixty-four extracted, single-rooted human teeth of similar length were instrumented and irrigated with a 1% sodium hypochlorite solution and then randomly assigned (n = 8 per group) to receive a final one-minute rinse with 5 ml of test solutions, water, or the pure aqueous Tween/propylene glycol solution. Calcium concentration in eluates was measured using atomic absorption spectrometry. Incorporation of wetting agents resulted in a reduction of surface tension values by approximately 50% in all tested solutions. However, none of the solutions with reduced surface tension chelated more calcium from canals than their pure counterparts (p > 0.05).

Bacterial action of carbon dioxide laser radiation in experimental dental root canals

International Nuclear Information System (INIS)

Zakariasen, K.L.; Dederich, D.N.; Tulip, John; DeCoste, Sandra; Jensen, S.E.; Pickard, M.A.

1986-01-01

The ability of a carbon dioxide laser to sterilize the root canal of human teeth has been investigated. Three oral bacteria, Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus, and three other bacteria, Bacillus cereus, Staphyloccus aureus, and Pseudomonoas aeruginosa were used as experimental organisms. Exposure of cells on glass slides to laser radiation showed there was little difference in the exposure required to kill these six organisms. Complete recovery of bacteria from the root canal was initially a problem and was only achieved when bacterial manipulations and removal were carried out in rapid succession, within 5 min of inoculation. However, the geometry of the instrumented canal and the laser alignment were major factors in achieving consistent cell death of oral bacteria in the root canals. Using sets of 10 teeth, four repeated exposures of 10 W for 1 s was found to sterilize 4 or more of the teeth

Unusual Root Canal Morphology of the Maxillary Second Molar: A Case Report

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Neslihan Şımşek

2013-01-01

Full Text Available Introduction. This clinical case report presents the successful endodontic treatment of a maxillary second molar that has a mandibular molar-like anatomy with no palatal root and with each of its roots containing two separate root canals. Cone-beam computed tomography (CBCT was used to confirm this unusual anatomy. Methods. A 34-year-old male patient was referred to the Department of Endodontics at Inonu University’s Faculty of Dentistry because of severe pain in his right maxillary second molar. Clinical and radiographic examinations identified unusual roots and root canals anatomy, and CBCT was planned in order to understand the nature of these variations. Cleaning and shaping procedures were performed using the crown down technique with Sybron Endo (Glendora, CA, USA rotary instruments, and endodontic treatment was completed with gutta-percha cones and AH Plus resin sealers using the cold lateral compaction technique. Conclusions. The maxillary second molar exhibits aberrations and variations in terms of the numbers and configurations of its roots and root canals, and CBCT can be a useful imaging technique in endodontics.

Apically Extruded Debris during Root Canal Instrumentation with Reciproc Blue, HyFlex EDM, and XP-endo Shaper Nickel-titanium Files.

Science.gov (United States)

Uslu, Gülşah; Özyürek, Taha; Yılmaz, Koray; Gündoğar, Mustafa; Plotino, Gianluca

2018-05-01

The purpose of this study was to investigate the amount of apically extruded debris by Reciproc Blue (REC Blue; VDW, Munich, Germany), HyFlex EDM (HEDM; Coltene/Whaledent, Altstätten, Switzerland), and XP-endo Shaper (XPS; FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) files during root canal preparation at body temperature. Sixty extracted single-rooted mandibular premolar human teeth were randomly assigned to 3 groups (n = 20). The canals were instrumented using 1 of the following instruments: REC Blue, HEDM, or XPS. Apically extruded debris during instrumentation was collected into preweighed Eppendorf tubes. All the procedures were performed at 35°C. The amount of extruded debris was calculated by subtracting the weight value of the tooth-free apparatus from the postpreparation weight value. The data were analyzed using the Kruskal-Wallis test at a 5% significance level. All the instruments tested caused extrusion of some debris from the apical foramen. XPS extruded significantly less debris from the apex than REC Blue (P  .05). Within the limitations of this in vitro study, the amount of apically extruded debris registered for the different files tested was REC Blue > HEDM > XPS, with a statistical difference only between XPS and REC Blue. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Computed tomography assessment of the efficiency of different techniques for removal of root canal filling material

International Nuclear Information System (INIS)

Dall'agnol, Cristina; Barletta, Fernando Branco; Hartmann, Mateus Silveira Martins

2008-01-01

This study evaluated the efficiency of different techniques for removal of filling material from root canals, using computed tomography (CT). Sixty mesial roots from extracted human mandibular molars were used. Root canals were filled and, after 6 months, the teeth were randomly assigned to 3 groups, according to the root-filling removal technique: Group A - hand instrumentation with K-type files; Group B - reciprocating instrumentation with engine-driven K-type files; and Group C rotary instrumentation with engine-driven ProTaper system. CT scans were used to assess the volume of filling material inside the root canals before and after the removal procedure. In both moments, the area of filling material was outlined by an experienced radiologist and the volume of filling material was automatically calculated by the CT software program. Based on the volume of initial and residual filling material of each specimen, the percentage of filling material removed from the root canals by the different techniques was calculated. Data were analyzed statistically by ANOVA and chi-square test for linear trend (α=0.05). No statistically significant difference (p=0.36) was found among the groups regarding the percent means of removed filling material. The analysis of the association between the percentage of filling material removal (high or low) and the proposed techniques by chi-square test showed statistically significant difference (p=0.015), as most cases in group B (reciprocating technique) presented less than 50% of filling material removed (low percent removal). In conclusion, none of the techniques evaluated in this study was effective in providing complete removal of filling material from the root canals. (author)

Computed tomography assessment of the efficiency of different techniques for removal of root canal filling material

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Dall' agnol, Cristina; Barletta, Fernando Branco [Lutheran University of Brazil, Canoas, RS (Brazil). Dental School. Dept. of Dentistry and Endodontics]. E-mail: fbarletta@terra.com.br; Hartmann, Mateus Silveira Martins [Uninga Dental School, Passo Fundo, RS (Brazil). Postgraduate Program in Dentistry

2008-07-01

This study evaluated the efficiency of different techniques for removal of filling material from root canals, using computed tomography (CT). Sixty mesial roots from extracted human mandibular molars were used. Root canals were filled and, after 6 months, the teeth were randomly assigned to 3 groups, according to the root-filling removal technique: Group A - hand instrumentation with K-type files; Group B - reciprocating instrumentation with engine-driven K-type files; and Group C rotary instrumentation with engine-driven ProTaper system. CT scans were used to assess the volume of filling material inside the root canals before and after the removal procedure. In both moments, the area of filling material was outlined by an experienced radiologist and the volume of filling material was automatically calculated by the CT software program. Based on the volume of initial and residual filling material of each specimen, the percentage of filling material removed from the root canals by the different techniques was calculated. Data were analyzed statistically by ANOVA and chi-square test for linear trend ({alpha}=0.05). No statistically significant difference (p=0.36) was found among the groups regarding the percent means of removed filling material. The analysis of the association between the percentage of filling material removal (high or low) and the proposed techniques by chi-square test showed statistically significant difference (p=0.015), as most cases in group B (reciprocating technique) presented less than 50% of filling material removed (low percent removal). In conclusion, none of the techniques evaluated in this study was effective in providing complete removal of filling material from the root canals. (author)

Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals

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Marcia Carneiro Valera

2009-12-01

Full Text Available OBJECTIVE: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. MATERIAL AND METHODS: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12 according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a initial sample (IS: 21 days after contamination (control, b S1: after instrumentation, c S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. RESULTS AND CONCLUSIONS: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

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Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.

2014-01-01

Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p rotary instruments (52% against 28% with a manual one, p rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911

Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material.

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Marques da Silva, B; Baratto-Filho, F; Leonardi, D P; Henrique Borges, A; Volpato, L; Branco Barletta, F

2012-10-01

To assess the efficacy of different retreatment rotary files in removing gutta-percha and endodontic sealer from canals. Ninety straight single-rooted premolars were prepared up to a size 30 and filled with gutta-percha and sealer and then randomly assigned to six retreatment groups (n = 15). Groups I, III, and V were retreated using rotary systems ProTaper Universal Retreatment (PTUR), D-RaCe, and Mtwo Retreatment, respectively. Groups II, IV, and VI were retreated using the additional instruments F4, size 40, .04 taper RaCe, and size 40, .04 taper Mtwo, respectively. The roots were split vertically, and images of the halves were obtained using a high-resolution scanner and evaluated with AutoCAD software to calculate the percentage of residual material. Data were analyzed with Kruskal-Wallis and Student-Newman-Keuls tests using a 5% significance cutoff (P 0.05) between groups when additional instruments were used. The percentage of residual material was lowest in the PTUR group and was statistically significant only when compared to the D-RaCe system (P = 0.0038). All root canals had residual filling material after retreatment even when additional instruments were used. © 2012 International Endodontic Journal.

Incidence of apical root cracks and apical dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths.

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Liu, Rui; Kaiwar, Anjali; Shemesh, Hagay; Wesselink, Paul R; Hou, Benxiang; Wu, Min-Kai

2013-01-01

The aim of this study was to compare the incidence of apical root cracks and dentinal detachments after canal preparation with hand and rotary files at different instrumentation lengths. Two hundred forty mandibular incisors were mounted in resin blocks with simulated periodontal ligaments, and the apex was exposed. The root canals were instrumented with rotary and hand files, namely K3, ProTaper, and nickel-titanium Flex K files to the major apical foramen (AF), short AF, or beyond AF. Digital images of the apical surface of every tooth were taken during the apical enlargement at each file change. Development of dentinal defects was determined by comparing these images with the baseline image. Multinomial logistic regression test was performed to identify influencing factors. Apical crack developed in 1 of 80 teeth (1.3%) with hand files and 31 of 160 teeth (19.4%) with rotary files. Apical dentinal detachment developed in 2 of 80 teeth (2.5%) with hand files and 35 of 160 teeth (21.9%) with rotary files. Instrumentation with rotary files terminated 2 mm short of AF and did not cause any cracks. Significantly less cracks and detachments occurred when instrumentation with rotary files was terminated short of AF, as compared with that terminated at or beyond AF (P hand instruments; instrumentation short of AF reduced the risk of dentinal defects. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative evaluation of rotary ProTaper, Profile, and conventional stepback technique on reduction in Enterococcus faecalis colony-forming units and vertical root fracture resistance of root canals.

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Singla, Mamta; Aggarwal, Vivek; Logani, Ajay; Shah, Naseem

2010-03-01

The purpose of this in vitro study was to evaluate the effect of various root canal instrumentation techniques with different instrument tapers on cleaning efficacy and resultant vertical root fracture (VRF) strength of the roots. Fifty human mandibular first premolar roots were enlarged to ISO size 20, inoculated with Enterococcus faecalis [ATCC2912] for 72 hours and divided into 5 groups: group I: prepared with .02 taper hand instruments ISO size 40; group II: Profile .04 taper size 40; group III: Profile .06 taper size 40; group IV: ProTaper size F4; and group V (control group) further divided into: Va: with bacterial inoculation and no mechanical instrumentation; and Group Vb: neither bacterial inoculation nor mechanical instrumentation. Cleaning efficacy was evaluated in terms of reduction of colony forming units (CFUs). The VRF strength was evaluated using D11 spreader as wedge in an Instron testing machine. Root canals instrumented with ProTaper and 6% Profile instruments showed maximum reduction in CFUs, with statistically insignificant difference between them. The VRF resistance decreased in all instrumented groups. The difference of VRF between 2% and 4% taper Profile groups was statistically insignificant (P = .195). One-way analysis of variance showed that canals instrumented with ProTaper F4 showed maximum reduction in VRF resistance compared with control uninstrumented group. Profile 6% taper instruments offer the advantage of maximum debridement without significant reduction in root fracture resistance. Copyright 2010 Mosby, Inc. All rights reserved.

Root Canal Irrigation: Chemical Agents and Plant Extracts Against Enterococcus faecalis

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Borzini, Letizia; Condò, Roberta; De Dominicis, Paolo; Casaglia, Adriano; Cerroni, Loredana

2016-01-01

Background: There are various microorganisms related to intra and extra-radicular infections and many of these are involved in persistent infections. Bacterial elimination from the root canal is achieved by means of the mechanical action of instruments and irrigation as well as the antibacterial effects of the irrigating solutions. Enterococcus faecalis can frequently be isolated from root canals in cases of failed root canal treatments. Antimicrobial agents have often been developed and optimized for their activity against endodontic bacteria. An ideal root canal irrigant should be biocompatible, because of its close contact with the periodontal tissues during endodontic treatment. Sodium hypoclorite (NaOCl) is one of the most widely recommended and used endodontic irrigants but it is highly toxic to periapical tissues. Objectives: To analyze the literature on the chemotherapeutic agent and plant extracts studied as root canal irrigants. In particularly, the study is focused on their effect on Enterococcus faecalis. Method: Literature search was performed electronically in PubMed (PubMed Central, MEDLINE) for articles published in English from 1982 to April 2015. The searched keywords were “endodontic irrigants” and “Enterococcus faecalis” and “essential oil” and “plant extracts”. Results: Many of the studied chemotherapeutic agents and plant extracts have shown promising results in vitro. Conclusion: Some of the considered phytotherapic substances, could be a potential alternative to NaOCl for the biomechanical treatment of the endodontic space. PMID:28217184

Cleaning efficacy of reciprocal and rotary systems in the removal of root canal filling material

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Koçak, Mustafa Murat; Koçak, Sibel; Türker, Sevinç Aktemur; Sağlam, Baran Can

2016-01-01

Aim: The aim of this study was to compare the efficacy of hand file, nickel titanium rotary instrument, and two reciprocating instruments for removing gutta-percha and sealer from the root canals. Materials and Methods: Eighty-eight mandibular premolar teeth were used. The root canals were shaped and filled with gutta-percha and a resin-based sealer. The specimens were divided into four groups according to the technique by which the root filling material was removed: Group 1 — Wave One; Group 2 — Reciproc; Group 3 — ProTaper; and Group 4 — Gates-Glidden burs and stainless steel hand file. Then teeth were split longitudinally and photographed. The images were transferred to a computer. The ratio of remaining filling material to the root canal periphery was calculated with the aid of ImageJ software. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney tests. Results: A significant difference was found among all groups (P hand file. Conclusion: The reciprocating files were found to be significantly more effective in removing the filling material from the canal walls compared to the rotational file and hand file. PMID:27099429

21 CFR 872.3820 - Root canal filling resin.

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2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Root canal filling resin. 872.3820 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3820 Root canal filling resin. (a) Identification. A root canal filling resin is a device composed of material, such as methylmethacrylate, intended...

Cervical shaping in curved root canals: comparison of the efficiency of two endodontic instruments

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Busquim Sandra Soares Kühne

2002-01-01

Full Text Available The aim of this study was to determine the removal of dentin produced by number 25 (0.08 Flare files (Quantec Flare Series, Analytic Endodontics, Glendora, California, USA and number 1 e 2 Gates-Glidden burs (Dentsply - Maillefer, Ballaigues, Switzerland, in the mesio-buccal and mesio-lingual root canals, respectively, of extracted human permanent inferior molars, by means of measuring the width of dentinal walls prior and after instrumentation. The obtained values were compared. Due to the multiple analyses of data, a nonparametric test was used, and the Kruskal-Wallis test was chosen. There was no significant difference between the instruments as to the removal of dentin in the 1st and 2nd millimeters. However, when comparing the performances of the instruments in the 3rd millimeter, Flare files promoted a greater removal than Gates-Glidden drills (p > 0.05. The analysis revealed no significant differences as to mesial wear, which demonstrates the similar behavior of both instruments. Gates-Glidden drills produced an expressive mesial detour in the 2nd and 3rd millimeters, which was detected trough a statistically significant difference in the wear of this region (p > 0.05. There was no statistically significant difference between mesial and lateral wear when Flare instruments were employed.

Cervical shaping in curved root canals: comparison of the efficiency of two endodontic instruments.

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Busquim, Sandra Soares Kühne; dos Santos, Marcelo

2002-01-01

The aim of this study was to determine the removal of dentin produced by number 25 (0.08) Flare files (Quantec Flare Series, Analytic Endodontics, Glendora, California, USA) and number 1 e 2 Gates-Glidden burs (Dentsply - Maillefer, Ballaigues, Switzerland), in the mesio-buccal and mesio-lingual root canals, respectively, of extracted human permanent inferior molars, by means of measuring the width of dentinal walls prior and after instrumentation. The obtained values were compared. Due to the multiple analyses of data, a nonparametric test was used, and the Kruskal-Wallis test was chosen. There was no significant difference between the instruments as to the removal of dentin in the 1st and 2nd millimeters. However, when comparing the performances of the instruments in the 3rd millimeter, Flare files promoted a greater removal than Gates-Glidden drills (p > 0.05). The analysis revealed no significant differences as to mesial wear, which demonstrates the similar behavior of both instruments. Gates-Glidden drills produced an expressive mesial detour in the 2nd and 3rd millimeters, which was detected trough a statistically significant difference in the wear of this region (p > 0.05). There was no statistically significant difference between mesial and lateral wear when Flare instruments were employed.

Influence of operator's experience on root canal shaping ability with a rotary nickel-titanium single-file reciprocating motion system.

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Muñoz, Estefanía; Forner, Leopoldo; Llena, Carmen

2014-04-01

The aim of this study was to evaluate the influence of the operator's experience on the shaping of double-curvature simulated root canals with a nickel-titanium single-file reciprocating motion system. Sixty double-curvature root canals simulated in methacrylate blocks were prepared by 10 students without any experience in endodontics and by 10 professionals who had studied endodontics at the postgraduate level. The Reciproc-VDW system's R25 file was used in the root canal preparation. The blocks were photographed before and after the instrumentation, and the time of instrumentation was also evaluated. Changes in root canal dimensions were analyzed in 6 positions. Significant differences (P file reciprocating motion system Reciproc is not seen to be influenced by the operator's experience regarding the increase of the canal area. Previous training and the need to acquire experience are important in the use of this system, in spite of its apparent simplicity. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root canal adhesive filling in dogs' teeth with or without coronal restoration: a histopathological evaluation.

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Leonardo, Mario Roberto; Barnett, Frederick; Debelian, Gilberto J; de Pontes Lima, Regina Karla; Bezerra da Silva, Léa Assed

2007-11-01

The purpose of this study was to evaluate in vivo the response of the periradicular tissues after endodontic treatment and root filling with Epiphany/Resilon (Penntron Clinical Technologies, LLC, Wallingford, CT) or gutta percha and new Sealapex (SybronEndo, Glendora, CA) in dogs' teeth with or without coronal restoration. Teeth without coronal restorations were used to assess the influence of continuous exposure to the oral environment on the periradicular tissues. Sixty root canals with vital pulps in three dogs were instrumented and obturated in a single session and randomly assigned to one of four groups as follows. group 1: root canal filling with Epiphany/Resilon with coronal restoration, group 2: root canal filling with Sealapex sealer and gutta percha with restoration, group 3: root canal filling with Epiphany/Resilon without restoration, and group 4: root canal filling with Sealapex sealer and gutta percha without coronal restoration. After 90 days, the animals were euthanized, and the maxillas and mandibles were removed and submitted for histologic processing. Longitudinal sections were obtained and stained with hematoxylin and eosin, Mallory's trichrome, and Brown and Brenn stains and examined under light microscopy. There were significant differences found between the four groups (p < 0.05). The results showed that roots canals filled with Epiphany/Resilon, with coronal restoration, had significantly less periradicular inflammation than roots canals filled with gutta percha and Sealapex, with coronal restoration (p = 0.021). No significant difference was observed in the intensity of inflammation between roots canals filled with Epiphany/Resilon with no restoration and roots filled with gutta percha and Sealapex with restoration (p = 0.269). Roots canals filled with gutta percha and Sealapex sealer without coronal restoration showed the greatest degree of periradicular inflammation.

Microbiological examination of infected dental root canals.

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Gomes, B P F A; Pinheiro, E T; Gadê-Neto, C R; Sousa, E L R; Ferraz, C C R; Zaia, A A; Teixeira, F B; Souza-Filho, F J

2004-04-01

The aim of this study was to investigate the root canal microbiota of primary and secondary root-infected canals and the association of constituent species with specific endodontic signs and symptoms. Microbial samples were taken from 60 root canals, 41 with necrotic pulp tissues (primary infection) and 19 with failed endodontic treatment (secondary infection). Strict anaerobic techniques were used for serial dilution, plating, incubation and identification. A total of 224 cultivable isolates were recovered belonging to 56 different bacterial species. Individual root canals yielded a maximum of 10 bacterial species. Of the bacterial isolates, 70% were either strict anaerobes or microphilic. The anaerobes most frequently isolated were: Peptostreptococcus micros (35%), Fusobacterium necrophorum (23.3%), Fusobacterium nucleatum (11.7%), Prevotella intermedia/nigrescens (16.7%), Porphyromonas gingivalis (6.7%) and Porphyromonas endodontalis (5%). The root canal microflora of untreated teeth with apical periodontitis was found to be mixed, comprising gram-negative and gram-positive and mostly anaerobic microorganisms and usually containing more than 3 species per canal. On the other hand, facultative anaerobic and gram-positive bacteria predominated in canals with failed endodontic treatment, which harbored 1-2 species per canal. Suggested relationships were found between anaerobes, especially gram-negatives, and the presence or history of pain, tenderness to percussion and swelling (PEubacterium spp. (both Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp. (Pspp., P. micros, F. necrophorum (P<0.05). Our findings indicate potential complex interactions of species resulting in characteristic clinical pictures which cannot be achieved by individual species alone. They also indicate that the microbiota of primary infected canals with apical periodontitis differs in number and in species from the secondary infected canals by using the culture technique.

Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

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Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

2018-04-01

To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

Canal shaping of different single-file systems in curved root canals

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Maurizio D'Amario

2017-12-01

Full Text Available Background/Purpose: This study compared maintenance of canal anatomy, occurrence of apical transportation, and working time observed after instrumentation with One Shape New Generation rotary system (Micro-Mega, with those observed after instrumentation with Reciproc (VDW and WaveOne (Dentsply-Maillefer reciprocating systems. Materials and methods: The mesial canals of 45 mandibular molars (curvature angles between 35° and 45° were selected. Specimens were randomly divided into three groups, and canal preparations were performed using One Shape, Reciproc, or WaveOne systems (size #25. A digital double radiographic technique was used to determine apical transportation and change in angle of curvature. Also, working time and instrument failures were recorded. Data were statistically analyzed. Results: During preparation, no file fractured. No statistically significant differences were found among groups. No system showed a significantly faster preparation time than others (P>0.05. All instruments maintained the original canal curvature well and were safe to use. Conclusion: Both continuous rotary instrument and reciprocating systems did not have any influence on the presence of apical transportation or caused an alteration in angle of canal curvature. Keywords: canal curvature, canal straightening, endodontics, reciprocating motion, single file instrumentation

Comparison of air-driven vs electric torque control motors on canal centering ability by ProTaper NiTi rotary instruments.

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Zarei, Mina; Javidi, Maryam; Erfanian, Mahdi; Lomee, Mahdi; Afkhami, Farzaneh

2013-01-01

Cleaning and shaping is one of the most important phases in root canal therapy. Various rotary NiTi systems minimize accidents and facilitate the shaping process. Todays NiTi files are used with air-driven and electric handpieces. This study compared the canal centering after instrumentation using the ProTaper system using Endo IT, electric torque-control motor, and NSK air-driven handpiece. This ex vivo randomized controlled trial study involved 26 mesial mandibular root canals with 10 to 35° curvature. The roots were randomly divided into 2 groups of 13 canals each. The roots were mounted in an endodontic cube with acrylic resin, sectioned horizontally at 2, 6 and 10 mm from the apex and then reassembled. The canals were instrumented according to the manufacturer's instructions using ProTaper rotary files and electric torque-control motors (group 1) or air-driven handpieces (group 2). Photographs of the cross-sections included shots before and after instrumentation, and image analysis was performed using Photoshop software. The centering ability and canal transportation was also evaluated. Repeated measurement and independent t-test provided statistical analysis of canal transportation. The comparison of the rate of transportation toward internal or external walls between the two groups was not statistically significant (p = 0.62). Comparison of the rate of transportation of sections within one group was not significant (p = 0.28). Use of rotary NiTi file with either electric torquecontrol motor or air-driven handpiece had no effect on canal centering. NiTi rotary instruments can be used with air-driven motors without any considerable changes in root canal anatomy, however it needs the clinician to be expert.

Assessment of periapical health, quality of root canal filling, and ...

African Journals Online (AJOL)

Sixty three teeth were found to have short root canal fillings, whereas 74 teeth had adequate root canal fillings, and the remaining 10 teeth had over extended root canal filling. A significant correlation was observed between the length of root filling and apical periodontitis (P = 0,023). Inadequately dense root canal filling was ...

Newer Root Canal Irrigants in Horizon: A Review

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Sushma Jaju

2011-01-01

Full Text Available Sodium hypochloride is the most commonly used endodontic irrigant, despite limitations. None of the presently available root canal irrigants satisfy the requirements of ideal root canal irrigant. Newer root canal irrigants are studied for potential replacement of sodium hypochloride. This article reviews the potential irrigants with their advantages and limitations with their future in endodontic irrigation.

Effectiveness of castor oil extract on Escherichia coli and its endotoxins in root canals.

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Valera, Marcia Carneiro; Maekawa, Lilian Eiko; Chung, Adriana; de Oliveira, Luciane Dias; Carvalho, Claudio Antonio Talge; Koga-Ito, Cristiane Yumi; Jorge, Antonio Olavo Cardoso

2012-01-01

This in vitro study sought to evaluate the effectiveness of castor oil extract used as an irrigating solution on Escherichia coli and its endotoxins in root canals. Sixty single-rooted teeth were prepared (using castor oil extract as irrigating solution) and divided into five groups (n = 12): Group 1 samples were treated with calcium hydroxide (Ca(OH)2), Group 2 samples were treated with polymyxin B, Group 3 samples were treated with Ca(OH)2 and 2% chlorhexidine gel (CHX), and Group 4 samples were treated with castor oil extract. A control group used physiological saline solution as an irrigant. Canal content samples were collected at four different times: immediately after instrumentation, seven days after instrumentation, after 14 days of intracanal medication, and seven days after removal of intracanal medication. A plating method was used to assess antimicrobial activity and the quantification of endotoxins was evaluated by the chromogenic Limulus lysate assay. Data were submitted to ANOVA and a Dunn test (a = 5%). Irrigation with castor oil extract decreased E. coli counts but had no effect on the level of endotoxins. Samples taken seven days after removal of medication revealed a significant reduction in endotoxin levels in Groups 3 and 4. Compared to the saline solution irrigation, castor oil extract decreased microorganism counts in root canals immediately after canal preparation. None of the medications used completely eliminated endotoxins in the root canal.

Comparison of the effect of root canal preparation by using WaveOne and ProTaper on postoperative pain: a randomized clinical trial.

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Nekoofar, Mohammad H; Sheykhrezae, Mohammad S; Meraji, Naghmeh; Jamee, Azad; Shirvani, Armin; Jamee, Javid; Dummer, Paul M H

2015-05-01

WaveOne is a single-file reciprocating instrumentation system with the benefits of M-Wire alloy that has increased flexibility and improved resistance to cyclic fatigue over the conventional alloy. Root canal preparation techniques may cause postoperative pain. The goal of the present study was to compare the intensity and duration of postoperative pain when using WaveOne or ProTaper Universal systems for instrumentation of root canals. Forty-two patients who fulfilled specific inclusion criteria were assigned to 2 groups according to the root canal instrumentation technique used, WaveOne or ProTaper Universal. Root canal treatment was carried out in 2 appointments, and the severity of postoperative pain was assessed by numerical rating scale (NRS) score after each session until complete pain relief was achieved. Analgesic consumption, duration of pain, and root canal preparation time were also recorded. The mean NRS score and duration of pain after both appointments were significantly higher in the WaveOne group (P < .05); however, the mean analgesic consumption was only significantly higher in the WaveOne group after the first appointment (P < .05). In all groups the highest mean NRS score was seen 6 hours after each therapeutic appointment. Canal preparation time was significantly shorter in the WaveOne group (P < .001). Postoperative pain was significantly lower in patients undergoing canal instrumentation with ProTaper Universal rotary instruments compared with the WaveOne reciprocating single-file technique. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endodontic management of C-shaped root canal system of mandibular first molar by using a modified technique of self-adjusting file system.

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Helvacioglu-Yigit, Dilek

2015-01-01

C-shaped canal system is a seldom-found root canal anatomy which displays a challenge in all stages of endodontic treatment. According to the literature, this type of canal morphology is not a common finding in the mandibular first molar teeth. This case report presents endodontic management of a mandibular first molar with a C-shaped canal system. Root canal system was cleaned and shaped by nickel-titanium (NiTi) rotary instruments combined with self-adjusting file (SAF). Obturation was performed using warm, vertical condensation combined with the injection of warm gutta-percha. Follow-up examination 12 months later showed that the tooth was asymptomatic. The radiological findings presented no signs of periapical pathology. The clinician must be aware of the occurence and complexity of C-shaped canals in mandibular first molar teeth to perform a successful root canal treatment. The supplementary use of SAF after application of rotary instruments in C-shaped root canals might be a promising approach in endodontic treatment of this type of canal morphology.

Comparison of the rheological properties of four root canal sealers

Institute of Scientific and Technical Information of China (English)

Seok Woo Chang; Kwang Shik Bae; Young-Kyu Lee; Qiang Zhu; Won Jun Shon; Woo Cheol Lee; Kee Yeon Kum; Seung Ho Baek; In Bog Lee; Bum-Soon Lim

2015-01-01

The flowability of a root canal sealer is clinically important because it improves the penetration of the sealer into the complex root canal system. The purpose of this study was to compare the flowabilities of four root canal sealers, measured using the simple press method (ISO 6876), and their viscosities, measured using a strain-controlled rheometer. A newly developed, calcium phosphate-based root canal sealer (Capseal) and three commercial root canal sealers (AH Plus, Sealapex and Pulp Canal Sealer EWT) were used in this study. The flowabilities of the four root canal sealers were measured using the simple press method (n55) and their viscosities were measured using a strain-controlled rheometer (n55). The correlation between these two values was statistically analysed using Spearman’s correlation test. The flow diameters and the viscosities of the root canal sealers were strongly negatively correlated (r520.8618). The viscosity of Pulp Canal Sealer EWT was the lowest and increased in the following order:AH Plus,Sealapex,Capseal (P,0.05). All of the tested root canal sealers showed characteristic time-and temperature-dependent changes in their rheological properties. The viscosities measured using the strain-controlled rheometer were more precise than the flowabilities measured using the simple press method, suggesting that the rheometer can accurately measure the rheological properties of root canal sealers.

Optimizing the chemical aspect of root canal irrigation

OpenAIRE

de Macedo, R.G.

2013-01-01

Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that traditional endodontic therapy cannot make the root canal system completely free of bacteria. Moreover, it may not always result in complete healing of apical periodontitis, highlighting the need of optimizi...

A new anatomically based nomenclature for the roots and root canals-part 1: maxillary molars.

Science.gov (United States)

Kottoor, Jojo; Albuquerque, Denzil Valerian; Velmurugan, Natanasabapathy

2012-01-01

Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequently named based on definite sets of criteria. A new method for identification and naming of roots and root canal anatomy in maxillary molars, based on their root and canal relationship, was formulated and is presented in this paper. The nomenclature makes certain essential modifications to the traditional approach to accommodate naming of the various aberrations presented in the maxillary molars. A simple, yet extensive, nomenclature system has been proposed that appropriately names the internal and external morphology of maxillary molars.

Clinical significance of dental root canal microflora.

Science.gov (United States)

Gomes, B P; Lilley, J D; Drucker, D B

1996-01-01

Previous work by this group has shown that a significant association exists between pain and the presence of either Prevotella or Peptostreptococcus spp. in dental root canals. The aim of this study was to examine a more extensive series of canals microbiologically, to determine whether any other particular endodontic symptoms or clinical signs showed specific associations with individual bacterial species. Seventy root canals were examined microbiologically and clinical data collected to investigate in detail such associations. Of the canals studied, 37 were associated with pain, 49 with tenderness to percussion, 23 with swelling, six with purulent exudate and 57 presented with wet root canals. Anaerobes were isolated from 70.3% of painful canals and from 29.7% of pain-free canals. Significant associations were found between (a) pain and either Prevotella spp. or peptostreptococci, both with P spp. (P Eubacterium spp. (P spp. or Pstr. micros, both with P spp. (each P Eubacterium, Peptostreptococcus, Prevotella or Propionibacterium (each P < 0.05). It was concluded that several different endodontic clinical signs and symptoms are significantly associated with specific bacterial species.

Pulp revascularization after root canal decontamination with calcium hydroxide and 2% chlorhexidine gel.

Science.gov (United States)

Soares, Adriana de Jesus; Lins, Fernanda Freitas; Nagata, Juliana Yuri; Gomes, Brenda Paula Figueiredo de Almeida; Zaia, Alexandre Augusto; Ferraz, Caio Cezar Randi; de Almeida, José Flávio Affonso; de Souza-Filho, Francisco José

2013-03-01

Pulp revascularization may be considered a promising alternative for necrotic immature teeth. Many studies have accomplished passive decontamination associated with an antibiotic paste. To date, there is no report evaluating calcium hydroxide associated with 2% chlorhexidine gel for revascularization therapy. The aim of this case report was to describe a new proposal for pulp revascularization with mechanical decontamination and intracanal medication composed of calcium hydroxide and 2% chlorhexidine gel. The patient, a 9-year-old girl, suffered an intrusion associated with pulp exposure caused by an enamel-dentin fracture in her maxillary left central incisor. After diagnosis, treatment consisted of revascularization therapy with gentle manual instrumentation of the cervical and medium thirds of the root in addition to intracanal medication with calcium hydroxide and 2% chlorhexidine gel for 21 days. In the second session, a blood clot was stimulated up to the cervical third of the root canal. Mineral trioxide aggregate (MTA; Angelus, Londrina, Paraná, Brazil) was used for cervical sealing of the canal. Coronal sealing was performed with temporary filling material and composite resin. During the follow-up period, the root canal space showed a progressive decrease in width, mineralized tissue deposition on root canal walls, and apical closure. A cone-beam computed tomography scan taken at the 2-year follow-up confirmed these findings and did not show complete root canal calcification. This new proposal for revascularization therapy with 2% chlorhexidine gel may be used for the treatment of necrotic immature root canals. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Accuracy of two root canal length measurement devices integrated into rotary endodontic motors when removing gutta-percha from root-filled teeth.

Science.gov (United States)

Uzun, O; Topuz, O; Tinaz, C; Nekoofar, M H; Dummer, P M H

2008-09-01

To evaluate ex vivo the accuracy of the integrated electronic root canal length measurement devices within TCM Endo V and Tri Auto ZX motors whilst removing gutta-percha and sealer from filled root canals. Forty freshly extracted maxillary and mandibular incisor teeth with mature apices were selected. Following access cavity preparation, the length of the root canals were measured visually 0.5 mm short of the major foramen (TL). The canals were prepared using the HERO 642 system and then filled with gutta-percha and AH26 sealer using a lateral compaction technique. After 7 days the coronal temporary filling was removed and the roots mounted in an alginate experimental model. The roots were then randomly divided in two groups. The access cavities were filled with chloroform to soften the gutta-percha and allow its penetration using the Tri Auto ZX and the TCM Endo V devices in groups 1 and 2, respectively. The 'automatic apical reverse function' (ARL) of both devices was set to start at the 0.5 setting and the rotary instrument inserted inside the root canal until a beeping sound was heard and the rotation of the file stopped automatically. Once the auto reverse function had been initiated, the foot pedal of the motor was inactivated and the rubber stop placed against the reference point. The distance between the file tip and rubber stop was measured using a digital calliper to 0.01 mm accuracy (ARL). Then, a size 20, 0.02 taper instrument was attached to each device and inserted into the root canals without rotary motion until the integrated ERCLMDs positioned the instrument tips at the 0.5 setting as suggested by the devices. This length was again measured using a digital calliper (EL). The Mann-Whitney U-test was used to investigate statistical differences between the true canal length and those indicated by the two devices when used in 'automatic ARL and when inserted passively (EL). In the presence of gutta-percha, sealer and chloroform, the auto

[Endodontics in motion: new concepts, materials and techniques 3. The role of irrigants during root canal treatment].

Science.gov (United States)

van der Sluis, L W M

2015-10-01

The aims of root canal irrigation are the chemical dissolution or disruption and the mechanical detachment of pulp tissue, dentin debris and smear layer (instrumentation products), microorganisms (planktonic or biofilm) and their products from the root canal wall, their removal out of the root canal system and their chemical dissolution or disruption. Each of the endodontic irrigation systems has its own irrigant flow characteristics, which should fulfill these aims. Without flow (convection), the irrigant would have to be distributed through diffusion. This process is slow and depends on temperature and concentration gradients. On the other hand, convection is a faster and more efficient transport mechanism. During irrigant flow, frictional forces will occur, for example between the irrigant and the root canal wall (wall shear stress). These frictional forces have a mechanical cleaning effect on the root canal wall. These frictional forces are the result of the flow characteristics related to the different irrigation systems.

Mandibular molar with five root canals.

Science.gov (United States)

Barletta, Fernando Branco; Dotto, Sidney Ricardo; Reis, Magda de Sousa; Ferreira, Ronise; Travassos, Rosana Maria Coelho

2008-12-01

The purpose of this study was to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main causes of endodontic therapy failure. In this report, the authors describe the endodontic treatment of a mandibular first molar with five root canals, evaluate the rate of occurrence of this number of canals, and discuss the importance of their identification and treatment.

Ex Vivo Comparison of Mtwo and RaCe Rotary File Systems in Root Canal Deviation: One File Only versus the Conventional Method.

Science.gov (United States)

Aminsobhani, Mohsen; Razmi, Hasan; Nozari, Solmaz

2015-07-01

Cleaning and shaping of the root canal system is an important step in endodontic therapy. New instruments incorporate new preparation techniques that can improve the efficacy of cleaning and shaping. The aim of this study was to compare the efficacy of Mtwo and RaCe rotary file systems in straightening the canal curvature using only one file or the conventional method. Sixty mesial roots of extracted human mandibular molars were prepared by RaCe and Mtwo nickel-titanium (NiTi) rotary files using the conventional and only one rotary file methods. The working length was 18 mm and the curvatures of the root canals were between 15-45°. By superimposing x-ray images before and after the instrumentation, deviation of the canals was assessed using Adobe Photoshop CS3 software. Preparation time was recorded. Data were analyzed using three-way ANOVA and Tukey's post hoc test. There were no significant differences between RaCe and Mtwo or between the two root canal preparation methods in root canal deviation in buccolingual and mesiodistal radiographs (P>0.05). Changes of root canal curvature in >35° subgroups were significantly more than in other subgroups with smaller canal curvatures. Preparation time was shorter in one file only technique. According to the results, the two rotary systems and the two root canal preparation methods had equal efficacy in straightening the canals; but the preparation time was shorter in one file only group.

Single-rooted maxillary first molar with a single canal: endodontic retreatment.

Science.gov (United States)

de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

2008-12-01

This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

ROOT CANAL IRRIGANTS AND IRRIGATION TECHNIQUES: A REVIEW

OpenAIRE

Aniketh; Mohamed; Geeta; Nandakishore; Gourav Kumar; Patrick Timothy; Jayson Mathew; Sahle Abdul

2015-01-01

Root canal irrigation is not much emphasised in endodontic therapy. Most articles discussed are on root canal shaping and obturation not much emphasis is given for irrigation. There are many irrigation solutions which are introduced into market. The primary objective of root canal therapy is the ret ention of the pulpless or pulpally involved tooth with its associated periapical tissues in a healthy state. Achievement of this objective requires that the pulpal spaces and con...

Root canal treatment and special needs patients.

Science.gov (United States)

Yap, E; Parashos, P; Borromeo, G L

2015-04-01

To identify current trends of root canal treatment for patients with special needs. A postal questionnaire was sent to General Dentists in Victoria, Australia and Endodontists and Special Needs Dentists across Australia to determine the extent of root canal treatment performed on special needs patients. Over a four-month period, 1120 questionnaires were distributed with an overall response rate of 63.9% (n = 716). Response rates were 63.2% (n = 655), 68.5% (n = 50) and 100.0% (n = 11) amongst General Dentists, Endodontists and Special Needs Dentists, respectively. Endodontists (95.7%) and Special Needs Dentists (100.0%) performed significantly more root canal treatment on adult patients with special needs compared with 51.2% of General Dentists, (P special needs patients compared with only 29.7% of General Dentists (P special needs patients was more likely to be carried out by specialist dental practitioners who were more likely to utilize a pharmacological approach for behaviour guidance and to perform single-visit root canal treatment compared with General Dentists. A multidisciplinary approach for special needs patients who require root canal treatment provides an opportunity for these patients to retain their dentition. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

An endodontic management of mandibular third molar with five root canals

Directory of Open Access Journals (Sweden)

Dakshita Joy Sinha

2014-01-01

Full Text Available The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. This report highlights the importance of looking for additional roots and root canals so as to enable clinicians to treat a case successfully, which might have ended in failure.

Efficacy of Different Nickel-Titanium Instruments in Removing Gutta-percha during Root Canal Retreatment.

Science.gov (United States)

Özyürek, Taha; Demiryürek, Ebru Özsezer

2016-04-01

The aim of this study was to compare the cleanliness of root canal walls after retreatment using ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), Twisted File Adaptive (TFA; Axis/SybronEndo, Orange, CA), Reciproc (PRC; VDW, Munich, Germany), and ProTaper Universal retreatment (PTR, Dentsply Maillefer) nickel-titanium systems and the time required for gutta-percha and sealer removal. Eighty human maxillary central incisors with single and straight root canals were instrumented up to #40.02 with manual K-files (Dentsply Maillefer) and obturated using the continuous wave of condensation technique. Removal of the gutta-percha and sealer was performed using 1 of the following nickel-titanium systems: PTN, TFA, RPC, or PTR. The teeth were sectioned, and digital images were captured. The photographs were analyzed using AutoCAD software (Autodesk, San Rafael, CA). Also, the total time required for gutta-percha removal was calculated by a chronometer. The total retreatment time was significantly shorter in the PTR group compared with the other groups (P < .05). There was a significant difference between the groups according to the total residual gutta-percha and sealer (P < .05). The PTN and PTR groups left significantly less gutta-percha and sealer remnant than the TFA and RPC groups (P < .05). Within the limitations of this study, the PTN and the PTR groups showed less residual gutta-percha and sealer than the TFA and RPC groups. The time required for gutta-percha and sealer removal was similar for all the groups, except for the PTR group. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Micro-Computed Tomography Analysis of the Root Canal Morphology of Palatal Roots of Maxillary First Molars.

Science.gov (United States)

Marceliano-Alves, Marília; Alves, Flávio Rodrigues Ferreira; Mendes, Daniel de Melo; Provenzano, José Claudio

2016-02-01

A thorough knowledge of root canal anatomy is critical for successful root canal treatments. This study evaluated the internal anatomy of the palatal roots of maxillary first molars with micro-computed tomography (microCT). The palatal roots of extracted maxillary first molars (n = 169) were scanned with microCT to determine several anatomic parameters, including main canal classification, lateral canal occurrence and location, degree of curvature, main foramen position, apical constriction presence, diameters 1 and 2 mm from the apex and 1 mm from the foramen, minor dentin thickness in those regions, canal volume, surface area, and convexity. All canals were classified as Vertucci type I. The cross sections were oval in 61% of the canals. Lateral canals were found in 25% of the samples. The main foramen did not coincide with the root apex in 95% of the cases. Only 8% of the canals were classified as straight. Apical constriction was identified in 38% of the roots. The minor and major canal diameters and minor dentin thickness were decreased near the apex. The minor dentin thickness 1 mm from the foramen was 0.82 mm. The palatal canals exhibited a volume of 6.91 mm(3) and surface area of 55.31 mm(2) and were rod-shaped. The root canals of the palatal roots were classified as type I. However, some factors need to be considered during the treatment of these roots, including the frequent ocurrence of moderate/severe curvatures, oval-shaped cross-sections, and lateral canals, noncoincidence of the apical foramen with the root apex, and absence of apical constriction in most cases. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

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André PAGLIOSA

2015-01-01

Full Text Available Abstract : The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10, according to the biomechanical preparative system used: Hero 642 (HR, Liberator (LB, ProTaper (PT, and Twisted File (TF. The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05. The results demonstrated no significant difference (p > 0.05 in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR; -0.004 ± 0.044 mm (LB; -0.003 ± 0.064 mm (PT; -0.021 ± 0.064 mm (TF. The mean canal centering ability was: -0.093 ± 0.147 mm (HR; -0.001 ± 0.100 mm (LB; -0.002 ± 0.134 mm (PT; -0.033 ± 0.133 mm (TF. Also, there was no significant difference among the root segments (p > 0.05. It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

International Nuclear Information System (INIS)

Pagliosa, Andre; Raucci-Neto, Walter; Silva-Souza, Yara Teresinha Correa; Alfredo, Edson; Sousa-Neto, Manoel Damiao; Versiani, Marco Aurelio

2015-01-01

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape. (author)

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

Energy Technology Data Exchange (ETDEWEB)

Pagliosa, Andre; Raucci-Neto, Walter; Silva-Souza, Yara Teresinha Correa; Alfredo, Edson, E-mail: ysousa@unaerp.br [Universidade de Ribeirao Preto (UNAERP), SP (Brazil). Fac. de Odontologia; Sousa-Neto, Manoel Damiao; Versiani, Marco Aurelio [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odoentologia

2015-03-01

The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey’s tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape. (author)

Optimizing the chemical aspect of root canal irrigation

NARCIS (Netherlands)

de Macedo, R.G.

2013-01-01

Root canal treatment is aimed at the removal of inflamed and infected tissue present in the root canal system. It will prevent the entrance of new microorganisms or nutrients in order to maintain or create a healthy environment around the root. There is sufficient evidence that shows that

An endodontic management of mandibular third molar with five root canals

OpenAIRE

Dakshita Joy Sinha; Ashish Amit Sinha

2014-01-01

The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. Th...

Micro‐CT analyses of apical enlargement and molar root canal complexity

DEFF Research Database (Denmark)

Markvart, M.; Darvann, Tron Andre; Larsen, P.

2012-01-01

Markvart M, Darvann TA, Larsen P, Dalstra M, Kreiborg S, Bjørndal L. Micro‐CT analyses of apical enlargement and molar root canal complexity. International Endodontic Journal, 45, 273–281, 2012. Aim To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical...

Radiographic versus electronic root canal working length determination

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Lumnije Kqiku

2011-01-01

Conclusions: The present ex vivo study showed that electronic root canal working length determination is not superior to radiographic methods. Both methods provided a good performance in determining the root canal working length.

C-shaped root canal in a maxillary first molar: a case report.

Science.gov (United States)

Yilmaz, Z; Tuncel, B; Serper, A; Calt, S

2006-02-01

This case report presents an unusual C-shaped root canal system in a maxillary first molar tooth. Although C-shaped root canals are most frequently seen in the mandibular second molar, they may also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. The present case describes a C-shaped canal in the buccal root of a maxillary first molar. The endodontic access cavity displayed two canal orifices, one leading to the canal system in the buccal root, the other into the palatal root canal system. In the buccal root, what appeared to be the mesial and distal canals joined to form a single C-shaped canal. --Careful examination of radiographs and the internal anatomy of teeth is essential.-- The location and morphology of root canals should be identified at high magnification under the microscope.

Laser scanning dental probe for endodontic root canal treatment

Science.gov (United States)

Blank, Molly A. B.; Friedrich, Michal; Hamilton, Jeffrey D.; Lee, Peggy; Berg, Joel; Seibel, Eric J.

2011-03-01

Complications that arise during endodontic procedures pose serious threats to the long-term integrity and health of the tooth. Potential complexities of root canals include residual pulpal tissue, cracks, mesial-buccal 2 and accessory canals. In the case of a failed root canal, a successful apicoectomy can be jeopardized by isthmuses, accessory canals, and root microfracture. Confirming diagnosis using a small imaging probe would allow proper treatment and prevent retreatment of endodontic procedures. An ultrathin and flexible laser scanning endoscope of 1.2 to 1.6mm outer diameter was used in vitro to image extracted teeth with varied root configurations. Teeth were opened using a conventional bur and high speed drill. Imaging within the opened access cavity clarified the location of the roots where canal filing would initiate. Although radiographs are commonly used to determine the root canal size, position, and shape, the limited 2D image perspective leaves ambiguity that could be clarified if used in conjunction with a direct visual imaging tool. Direct visualization may avoid difficulties in locating the root canal and reduce the number of radiographs needed. A transillumination imaging device with the separated illumination and light collection functions rendered cracks visible in the prepared teeth that were otherwise indiscernible using reflected visible light. Our work demonstrates that a small diameter endoscope with high spatial resolution may significantly increase the efficiency and success of endodontic procedures.

Modificações da curvatura de canais simulados após emprego de instrumentos rotatórios Curvature modification of simulated root canals after use of rotary instruments

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Suely Maria Santos LAMARÃO

1999-01-01

Full Text Available É a partir da instrumentação que o canal radicular adquire a forma necessária à adaptação perfeita do material obturador. Durante essa fase, é necessário que ocorra uma interação entre instrumento e canal radicular com vistas a reduzir o número de alterações decorrentes desse passo improcedente. Neste estudo, procurou-se observar a ação de dois tipos de instrumentos endodônticos mecânico-rotatórios: as limas Quantec series 2000 tipo SC, com ponta cortante, e tipo LX, com ponta embotada, na instrumentação de canais simulados com curvaturas entre 20 e 35 graus, valendo-se da técnica Quantec Graduating TapersTM. Os resultados evidenciaram que a média de alteração da curvatura dos canais do Grupo I, que foram instrumentados com limas SC, foi 2,15%; para os canais do Grupo II, instrumentados com limas LX, foi de 2,61%. Embora tenha-se verificado que os canais do Grupo I apresentaram menor percentagem de alteração da curvatura, o teste estatístico pertinente de Mann-Whitney demonstrou não existir diferença significante para ± 5% entre os dois grupos experimentais.After instrumentation, the root canal acquires the necessary shape for a perfect adaptation of filling material. During this phase cutting end and LX type an interaction between instrument and root canal is necessary in order to reduce alterations that could occur at this point. This study evaluated the action of two mechanical-rotatory endodontic instruments, Quantec files 2000 serie type SC with blunt end, during the instrumentation of simulated canals curved between 20 and 35 degrees, using quantec graduating tapers. Results showed that the mean curvature alteration of group I canals that were instrumented with SC files, was 2,15%, and for group II instrumented with LX files, was 2,61%. Furthermore group I canals showed lower percentage of curvature alteration. Mann-Whitney tests showed no significant statistical difference at 5% between experimental groups.

Variations in the Root Form and Root Canal Morphology of Permanent Mandibular First Molars in a Sri Lankan Population

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Roshan Peiris

2015-01-01

Full Text Available The present study was conducted to determine the number of roots and morphology of the root canal system of permanent mandibular first molars (M1 in a Sri Lankan population. Sample of 529 M1 teeth was used. The number of roots was examined and the lengths of the mesial and distal roots were measured to the nearest 0.01 mm. Vacuum injection protocol was used to inject China ink into the root canal system, making it transparent. Root canal morphology was recorded using Vertucci’s classification. Presence of furcation canals, position of lateral canals, intercanal communications, level of bifurcation, and convergence of the root canal system were recorded. M1 showed three roots in 4.1% of the sample. Commonest root canal morphology of the mesial root was type IV and the distal root was type I. The level of bifurcation of the root canals was commonly observed in the cervical one-third of the root while convergence was observed in the apical one-third in both roots. Prevalence of three rooted mandibular first molars is less than 5%. Mesial root showed the most variable canal morphology. Prevalence of furcation canals was 1.5% while that of middle mesial canals was 0.2%.

Histological evaluation of the cleaning effectiveness of two reciprocating single-file systems in severely curved root canals: Reciproc versus WaveOne.

Science.gov (United States)

Carvalho, Maira de Souza; Junior, Emílio Carlos Sponchiado; Bitencourt Garrido, Angela Delfina; Roberti Garcia, Lucas da Fonseca; Franco Marques, André Augusto

2015-01-01

The aim of this study was to evaluate the cleaning effectiveness achieved with two reciprocating single-file systems in severely curved root canals: Reciproc and WaveOne. Twenty-five mesial roots of mandibular molars were randomly separated into two groups, according to the instrumentation system used. The negative control group consisted of five specimens that were not instrumented. The mesial canals (buccal and lingual) in Reciproc Group were instrumented with file R25 and the WaveOne group with the Primary file. The samples were submitted to histological processing and analyzed under a digital microscope. The WaveOne group presented a larger amount of debris than the Reciproc Group, however, without statistically significant difference (P > 0.05). A larger amount of debris in the control group was observed, with statistically significant difference to Reciproc and WaveOne groups (P file instrumentation systems presented similar effectiveness for root canal cleaning.

A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivo cone-beam computed tomographic analysis

Directory of Open Access Journals (Sweden)

Adrija Deka

2015-01-01

Full Text Available Background and Objectives: The present study was undertaken to compare and evaluate the area increase of root canals with ProTaper, iRaCe and Revo-S systems using cone beam computed tomography for analysis. Materials and Methodology: Forty five extracted human mandibular premolars having single canal and straight root were collected. Teeth were randomly assigned to three groups (n=15. Samples were decoronized by maintaining root length at 14 mm. Pre-instrumentation cone beam computed tomography scan was done after stabilizing the samples on wax blocks. The working length was determined at 1 mm short from the apical foramen by using a ISO 15 K-file tip protruding at apical foramen. Preparation was carried out according to the manufacturer′s instructions. Finally, canals were instrumented upto 30/.06 apically for each group. After each instrumentation, root canals were irrigated with 2ml of 3% sodium hypochlorite solution followed by 2 ml of 17% EDTA solution. Final irrigation was done with 5ml of saline. Post instrumentation cone beam computed tomography scans of all samples in the 3 groups were acquired. Results: Mean percentage of area increase in different thirds of the canal was highest for ProTaper followed by i-RaCe and Revo-s system which was statistically significant. Interpretation and Conclusion: Root canal area increase was highest for ProTaper followed by i-Race and Revo-S systems.

Maxillary second molar with four roots and five canals

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Xinjia Sha

2018-06-01

Full Text Available In this case report, we present a maxillary second molar variant, which had two palatal roots with two canals and two buccal roots with three canals, including a second mesiobuccal canal. A 44-year-old female patient complained about a tooth crown fracture and severe pain in her right maxillary second molar. A clinical intraoral inspection and radiography were carried out on the tooth, and a diagnosis of chronic apical periodontitis was made. Four roots (two buccal and two palatal and five canals (three buccal and two palatal were found. The anatomical variation of the tooth was further confirmed by cone-beam computed tomography, a cone-fit procedure, and a radiograph with a shifted projection angle. Root-canal treatment was performed under an endodontic microscope.

Comparison of effects of ProTaper, HeroShaper, and Gates Glidden Burs on cervical dentin thickness and root canal volume by using multislice computed tomography.

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Mahran, Abeer H; AboEl-Fotouh, Mona M

2008-10-01

The purpose of this study was to compare the effects of 3 different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multislice computed tomography. Mesiobuccal canals of 45 mandibular first molars with curvature between 30-40 degrees were divided into 3 equal groups: ProTaper, Hero Shaper, and Gates Glidden Bur with Flex-R hand file. Cervical dentin thickness and canal volume were measured before and after instrumentation by using multislice computed tomography and image analysis software. The results indicated that ProTaper removed significantly less cervical dentin from distal wall of the root (dangerous zone) than HeroShaper and Gates Glidden Bur (P ProTaper system (P < .05).

C-SHAPED CONFIGURATION OF THE ROOT CANAL SYSTEM – PROBLEMS AND SOLUTIONS.

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Janet Kirilova

2014-06-01

Full Text Available Introduction: The patients with C-shaped configuration of the root canal system are definitely a problem in the everyday dental practice. The C-shaped configuration of the root canal can be seen in the mandibular and maxillary molars. The treatment of these teeth is very difficult. Purpose: To trace the treatment of clinical cases with C-shaped configuration of the root canal system. Material and methods: There are some different cases that are described with a C-shaped configuration of the root canal system with one, two, three and four separate root canals. Careful exploration of the floor of the pulp chamber, inspection with magnification, use of ultrasonic irrigation and a modified filling technique are of particular use. Results and Discussion: Clinical cases of a C-shaped pulp chamber and root canal system shows that this root canal aberration occurs in a wide variety and variability with a single root canal up to two, three and four separate root canals. The diameter of the root canal themselves also varies from very wide to such with a small diameter. Conclusions: Knowledge of the different anatomical variations will improve the endododntic practice of the general dental practitioners.

The failures of root canal preparation with hand ProTaper

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Bătăiosu, Marilena; Diaconu, Oana; Moraru, Iren; Dăguci, C.; Ţuculină, Mihaela; Dăguci, Luminiţa; Gheorghiţă, Lelia

2012-01-01

The failures of root canal preparation are due to some anatomical deviation (canal in “C” or “S”) and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. Objectives: Our study was made on technique errors while preparing the canal roots with hand ProTaper. Methodology: Our study was made “in vitro” on 84 extracted teeth (molars, premolars, incisors and canines). The canal roo...

Three root canals in the maxillary second premolar

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de Almeida-Gomes Fabio

2009-01-01

Full Text Available In this study, we report an endodontic treatment of the maxillary second premolar with three root canals and distinct foramens. The possibility of three root canals in this tooth is quite small; however, it must be taken into account in clinical and radiographic evaluation during endodontic treatment. Many times, their presence is noticed only after canal treatment due to continuing post-operative discomfort.

Identification of dental root canals and their medial line from micro-CT and cone-beam CT records

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Benyó Balázs

2012-10-01

Full Text Available Abstract Background Shape of the dental root canal is highly patient specific. Automated identification methods of the medial line of dental root canals and the reproduction of their 3D shape can be beneficial for planning endodontic interventions as severely curved root canals or multi-rooted teeth may pose treatment challenges. Accurate shape information of the root canals may also be used by manufacturers of endodontic instruments in order to make more efficient clinical tools. Method Novel image processing procedures dedicated to the automated detection of the medial axis of the root canal from dental micro-CT and cone-beam CT records are developed. For micro-CT, the 3D model of the root canal is built up from several hundred parallel cross sections, using image enhancement, histogram based fuzzy c-means clustering, center point detection in the segmented slice, three dimensional inner surface reconstruction, and potential field driven curve skeleton extraction in three dimensions. Cone-beam CT records are processed with image enhancement filters and fuzzy chain based regional segmentation, followed by the reconstruction of the root canal surface and detecting its skeleton via a mesh contraction algorithm. Results The proposed medial line identification and root canal detection algorithms are validated on clinical data sets. 25 micro-CT and 36 cone-beam-CT records are used in the validation procedure. The overall success rate of the automatic dental root canal identification was about 92% in both procedures. The algorithms proved to be accurate enough for endodontic therapy planning. Conclusions Accurate medial line identification and shape detection algorithms of dental root canal have been developed. Different procedures are defined for micro-CT and cone-beam CT records. The automated execution of the subsequent processing steps allows easy application of the algorithms in the dental care. The output data of the image processing procedures

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

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Maryam Kuzekanani

2012-06-01

Full Text Available Background and aims. A through knowledge of the root canal morphology is required for successful endodontic therapy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a province in southeast of Iran. Materials and methods. One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing technique. Root number and morphology, number of canals per root, root canal configuration according to Vertucci classification, and incidence of dilacerated roots and C-shaped canals in mandibular third molars were evaluated under stereomicroscope with ×2 to ×3 magnifications. Results. From the total of 150 mandibular third molars studied, 21% had one root. The majority of teeth (73% had two roots. 5.5% of the teeth had three roots. The incidence of C-shaped canal was 3.5% in this study and 8% of the teeth had at least one dilacerated root. Conclusion. Although root canal anatomy and morphology of mandibular third molars is very variable having two roots seems to be the normal anatomy for these teeth.

A comparison of the shaping ability of reciprocating NiTi instruments in simulated curved canals

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Young-Sil Yoo

2011-11-01

Full Text Available Objectives The study was to compare the shaping ability of Reciproc (VDW and WaveOne (Dentsply Maillefer instruments compared with ProTaper, Profile and hand instrument during the preparation of simulated root canals. Materials and Methods Five groups (n = 5 were established. Reciproc, WaveOne, ProTaper, Profile and K file (K-flexo file were used to prepare the resin simulated canals. A series of preoperative and postoperative images were taken by a microscope and superimposed in 2 different layers. The amount of resin removed from both the inner and the outer sides of the canal was measured to the level of 10 mm from the apical tip, with a 1 mm increment. Results The mean of resin removal from the inner canal wall was not different from the outer canal wall for Reciproc and WaveOne groups at apical third (1 - 3 mm level. There was no difference in the change of working length and maintenance of canal curvature. NiTi instruments are superior to stainless-steel K file in their shaping ability. Conclusions Within the limitation of this present study, Reciproc and WaveOne instruments maintained the original canal curvature in curved canals better than ProTaper and Profile, which tend to transport towards the outer canal wall of the curve in the apical part of the canal.

Mandibular second premolar with three canals: Re-treatment of a case with unusual root canal anatomy

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Niranjan Desai

2011-01-01

Full Text Available A thorough knowledge of root canal anatomy along with the anatomical variations that may be present is essential for success of endodontic therapy. Unusual presentations in the number of the roots or the canals should be expected in every tooth. Mandibular second premolars are thought of as having a single root and canal. Studies have stated that the prevalence of three canals with three orifices in this tooth is 0.4%. The mandibular second premolar is particularly difficult to treat owing to the fact that a wide variation in the number, location and curvature of the roots and canals exist. Added to this is the fact that the access opening is restricted and location of the lingually placed orifices is difficult. This case report details the re-treatment of a mandibular second premolar with three canals and three separate orifices using the surgical microscope.

Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files

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Živković Slavoljub

2010-01-01

Full Text Available Introduction. Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. Objective. The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. Methods. The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. Results. The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GT and ProTaper files has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups shaped with different instruments. Conclusion. Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.

A micro-computed tomographic evaluation of dentinal microcrack alterations during root canal preparation using single-file Ni-Ti systems.

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Li, Mei-Lin; Liao, Wei-Li; Cai, Hua-Xiong

2018-01-01

The aim of the present study was to evaluate the length of dentinal microcracks observed prior to and following root canal preparation with different single-file nickel-titanium (Ni-Ti) systems using micro-computed tomography (micro-CT) analysis. A total of 80 mesial roots of mandibular first molars presenting with type II Vertucci canal configurations were scanned at an isotropic resolution of 7.4 µm. The samples were randomly assigned into four groups (n=20 per group) according to the system used for root canal preparation, including the WaveOne (WO), OneShape (OS), Reciproc (RE) and control groups. A second micro-CT scan was conducted after the root canals were prepared with size 25 instruments. Pre- and postoperative cross-section images of the roots (n=237,760) were then screened to identify the lengths of the microcracks. The results indicated that the microcrack lengths were notably increased following root canal preparation (Pfiles. Among the single-file Ni-Ti systems, WO and RE were not observed to cause notable microcracks, while the OS system resulted in evident microcracks.

Endodontic management of a mandibular first molar with six root canal systems.

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Jain, Dilip; Reddy, Smitha; Venigalla, Bhuvan Shome; Kamishetty, Shekhar

2015-01-01

Internal anatomy of pulp is complex. The first mandibular molars typically have two roots, one mesial with two root canals and another distal root, which contains one or two canals. A 20-year-old female patient reported with intermittent pain and incomplete root canal treatment in left lower back region since 1-week. Refined access cavity revealed initially two canals in mesial and two canals in the distal root. With operating microscope and cone beam computerized tomography, two additional canals (L-mesio-buccal and B-mesio-lingual) were identified in mesial root. One-year follow-up showed patient was asymptomatic and complete healing of periapical radiolucency.

Two-rooted maxillary first molars with two canals: a case series.

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Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.

Two-Rooted Maxillary First Molars with Two Canals: A Case Series

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Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal...

One-session root canal treatment with antimicrobial photodynamic therapy (aPDT): an in vivo study.

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Borsatto, M C; Correa-Afonso, A M; Lucisano, M P; Bezerra da Silva, R A; Paula-Silva, F W G; Nelson-Filho, P; Bezerra da Silva, L A

2016-06-01

To evaluate the response of the apical and periapical tissues of dog teeth with apical periodontitis after one-session root canal treatment with and without antimicrobial photodynamic therapy (aPDT) compared with the use of an intracanal dressing. Sixty root canals with an induced periapical lesion were instrumented and assigned to three groups: I, two-session root canal treatment using antibacterial dressing with calcium hydroxide-based paste; II, one-session root canal treatment using aPDT; and III, one-session root canal treatment in which the root canals were filled immediately after biomechanical preparation. The animals were euthanized after a 90-day experimental period. The maxillas and mandibles with teeth were submitted to histotechnical processing and haematoxylin-eosin staining. Descriptive microscopic analysis of the apical and periapical region characteristics was performed, as well as morphometric assessment of the periapical lesion areas in fluorescence microscopy. Quantitative data were analysed statistically by the nonparametric Kruskal-Wallis test and Dunn's post-test (α = 0.05). Group I was characterized by progressive repair, with the presence of fibres, cells and blood vessels. Group II had periodontal ligaments with the presence of collagen fibres and residual inflammatory cells. Group III had a dense inflammatory infiltrate with extensive oedematous areas and fibrillar dissociation, suggesting a persistent inflammatory and resorptive condition. Regarding periapical lesion size, group I had significantly smaller lesions (P session root canal treatment using a calcium hydroxide-based dressing was associated with significantly smaller periapical lesions at 90 days and characterized by progressive repair. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Quantitative three-dimensional analysis of root canal curvature in maxillary first molars using micro-computed tomography.

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Lee, Jong-Ki; Ha, Byung-Hyun; Choi, Jeong-Ho; Heo, Seok-Mo; Perinpanayagam, Hiran

2006-10-01

In endodontic therapy, access and instrumentation are strongly affected by root canal curvature. However, the few studies that have actually measured curvature are mostly from two-dimensional radiographs. The purpose of this study was to measure the three-dimensional (3D) canal curvature in maxillary first molars using micro-computed tomography (microCT) and mathematical modeling. Extracted maxillary first molars (46) were scanned by microCT (502 image slices/tooth, 1024 X 1024 pixels, voxel size of 19.5 x 19.5 x 39.0 microm) and their canals reconstructed by 3D modeling software. The intersection of major and minor axes in the canal space of each image slice were connected to create an imaginary central axis for each canal. The radius of curvature of the tangential circle was measured and inverted as a measure of curvature using custom-made mathematical modeling software. Root canal curvature was greatest in the apical third and least in the middle third for all canals. The greatest curvatures were in the mesiobuccal (MB) canal (0.76 +/- 0.48 mm(-1)) with abrupt curves, and the least curvatures were in the palatal (P) canal (0.38 +/- 0.34 mm(-1)) with a gradual curve. This study has measured the 3D curvature of root canals in maxillary first molars and reinforced the value of microCT with mathematical modeling.

Comparison of the effects of TripleGates and Gates-Glidden burs on cervical dentin thickness and root canal area by using cone beam computed tomography

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Kássio SOUSA

2015-04-01

Full Text Available The search for new instruments to promote an appropriate cervical preparation has led to the development of new rotary instruments such as TripleGates. However, to the best of the authors' knowledge, there is no study evaluating TripleGates effect on the “risk zone” of mandibular molars. Objectives : The aim of this study was to evaluate the effects of a crown-down sequence of Gates-Glidden and TripleGates burs on the remaining cervical dentin thickness and the total amount of dentin removed from the root canals during the instrumentation by using cone beam computed tomography. The number of separated instruments was also evaluated. Material and Methods : Mesial roots of 40 mandibular first molars were divided into 2 equal groups: crown-down sequence of Gates-Glidden (#3, #2, #1 and TripleGates burs. Cervical dentin thickness and canal area were measured before and after instrumentation by using cone beam computed tomography and image analysis software. Student’s t-test was used to determine significant differences at p0.05 were observed between the instruments, regarding the root canal area and dentin wall thickness. Conclusion : Both tested instruments used for cervical preparation were safe to be used in the mesial root canal of mandibular molars.

Effects of Diode Laser, Gaseous Ozone, and Medical Dressings on Enterococcus faecalis Biofilms in the Root Canal Ex Vivo

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Kerstin Bitter

2017-01-01

Full Text Available The objective was to compare the antibacterial effects of adjunctive disinfection using diode laser and gaseous ozone compared to the medical dressings calcium hydroxide (Ca(OH2 and chlorhexidine gel (CHX-Gel on Enterococcus faecalis biofilms in human root canals ex vivo. Root canals of 180 human extracted teeth were infected by E. faecalis and divided into 3 main groups (G: G1, control; G2, instrumentation and irrigation using 0.9% NaCl; G3, instrumentation and irrigation using 1% NaOCl. In each main group, the following treatments were applied: gaseous ozone, diode laser, and medical dressings of Ca(OH2 or CHX-Gel for 7 days (n=15. Reduction of colony forming units (CFUs inside the root canal of planktons and frequencies of adherent bacteria after treatment were calculated. Bacterial reduction was significantly affected by the irrigation protocol (p0.05; chi-square test. Instrumentation and irrigation using NaOCl combined with ozone or laser application resulted in comparable bacterial reduction on E. faecalis to the application of medical dressings.

Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers

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Moura-Netto, Cacio; Mello-Moura, Anna Carolina Volpi; Palo, Renato Miotto; Prokopowitsch, Igor; Pameijer, Cornelis H.; Marques, Marcia Martins

2015-03-01

This research analyzed the quality of resin-based sealer adaptation after intracanal laser irradiation. Extracted teeth (n=168) were root canal treated and divided into four groups, according to dentin surface treatment: no laser; Nd:YAG laser (1.5 W, 100 mJ, 15 Hz) diode laser (2.5 W in CW), and Er:YAG laser (1 W, 100 mJ, 10 Hz). The teeth were divided into four subgroups according to the sealer used: AH Plus, EndoREZ, Epiphany, and EpiphanySE. For testing the sealing after root canal obturation, the penetration of silver nitrate solution was measured, whereas to evaluate the adaptation and penetration of the sealer into the dentin, environmental scanning electron microscopy (ESEM) was used. The ESEM images were analyzed using a four-grade criteria score by three evaluators. The inter-examiner agreement was confirmed by Kappa test and the scores statistically compared by the Kruskal-Wallis' test (p<0.05). Both adaptation and sealer penetration in root canals were not affected by the laser irradiation. Nd:YAG and diode laser decreased the tracer penetration for AH Plus, whereas EndoREZ and EpiphanySE performances were affected by Nd:YAG irradiation (p<0.05). It can be concluded that intracanal laser irradiation can be used as an adjunct in endodontic treatment; however, the use of hydrophilic resin sealers should be avoided when root canals were irradiated with Nd:YAG laser.

Evaluation of apically extruded debris during root canal retreatment with several NiTi systems.

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Dincer, A N; Er, O; Canakci, B C

2015-12-01

To compare the amount of debris extruded apically during root canal retreatment using ProTaper, Mtwo and Reciproc instruments with hand H-files. In total, 60 freshly extracted human mandibular incisor teeth were used. All root canals were prepared with a Reciproc R25 file than filled with Gutta-percha and AH Plus sealer using cold lateral condensation before being assigned randomly to four groups (n = 15 each). In group 1, root fillings were removed with the Protaper Universal retreatment system; ProTaper Universal F3 and F4 instruments were used for the final preparation. In group 2, root fillings were removed with the Mtwo retreatment system; Mtwo size 30, .06 taper, size 35, .06 taper and size 40, .06 taper files were used for the final preparation. In group 3, root fillings were removed with Reciproc R25 instruments; Reciproc R40 instruments were used for the final preparation. In group 4, the root fillings were removed with Gates Glidden burs and sizes 35, 30 and 25 H-files; for final preparation, a size 40 H-file was used. Glass vials were used for debris collection. The vials were weighed before and after Gutta-percha removal. Additionally, the times required for the retreatment procedures were recorded. Data were analysed statistically using one-way analysis of variance. The Reciproc system produced significantly smaller amounts of apical extruded debris than the other groups (P ProTaper groups. The ProTaper and Reciproc groups required significantly less time than the Mtwo and H-file groups (P hand filing. Use of the ProTaper and Reciproc instruments required less time for retreatment procedures than use of the Mtwo or H-file. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Strategies of Coping With Stress During Root Canal Therapy

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Zare Jahromi

2015-12-01

Full Text Available Background Endodontic treatment is one of the stress producing situations. Objectives The purpose of this article was to determine the most stressful stage of root canal therapy among endodontists, endodontic residents, and undergraduate dental students and offering some strategies for reducing stress during this treatment. Patients and Methods This descriptive survey comprised three groups. Thirty-six endodontists, 41 endodontic residents, and 47 undergraduate dental students selected by convenience sampling. Participants were asked about age, sex, the most stressful stage of root canal therapy and stress reducing strategies during the procedure. Results The most stressful stage of root canal therapy was endodontic treatment for children in male endodontists and residents, preparing access cavity on crowns in female endodontists, obturation of apically root Resorped canals in female residents, obturation in female students, and preparing access cavity on molar teeth in male students. The most suggested strategy for reducing stress during root canal therapy was related to experience, knowledge, enough study, and technical mastery. Conclusions It is required to consider the strategies during student education in dental schools for both under and post-graduation dental students and better to follow them in workshops for other dentists and even endodontists.

Three-dimensional analysis of mesiobuccal root canal of Japanese maxillary first molar using Micro-CT

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Yamada, Masashi; Ide, Yoshinobu; Matsunaga, Satoru; Kato, Hiroshi; Nakagawa, Kan-Ichi

2011-01-01

The objective of this study was to three-dimensionally observe the morphological characteristics of mesiobuccal root canals of Japanese maxillary first molars using microcomputed tomography (Micro-CT) and classify root canal variations. This study used 90 maxillary first molars. Three-dimensional reconstruction was performed using data obtained by Micro-CT, and cross-sections of the root canals were observed. Moreover, the root canal morphology was classified by the configuration and root canal diameter, and was evaluated for occurrence using the classification by Weine et al. (1969) as a reference. Overall, single root canals were observed in 44.4%, incomplete separation root canals in 22.3%, and completely separate root canals (upper and lower separation root canals) in 33.3%. Mesiobuccal root canals often had intricate configurations, and accessory root canals (lateral canals and apical ramifications) were observed in most of the mesiobuccal root canals (76.7%), irrespective of whether there were ramifications of the main root canals. While there were no marked differences in the incidence of root canal ramifications between this study and earlier reports, the incidence of accessory root canals was higher in this study. This result may be explained by the far more superior visualization ability of Micro-CT than conventional methods, which allowed the detection of microscopic apical ramifications previously difficult to observe. (author)

Evaluation of debris extruded apically during the removal of root canal filling material using ProTaper, D-RaCe, and R-Endo rotary nickel-titanium retreatment instruments and hand files.

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Topçuoğlu, Hüseyin Sinan; Aktı, Ahmet; Tuncay, Öznur; Dinçer, Asiye Nur; Düzgün, Salih; Topçuoğlu, Gamze

2014-12-01

The aim of this study was to evaluate the amount of debris extruded apically during the removal of root canal filling material using ProTaper (Dentsply Maillefer, Ballaigues, Switzerland), D-RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland), and R-Endo (Micro-Mega, Besançon, France) nickel-titanium (NiTi) rotary retreatment instruments and hand files. Sixty extracted single-rooted mandibular premolar teeth were prepared with K-files and filled with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany). The teeth were then randomly assigned to 4 groups (n = 15 for each group) for retreatment. The removal of canal filling material was performed as follows: hand files, ProTaper, D-RaCe, and R-Endo retreatment instruments. Debris extruded apically during the removal of canal filling material was collected into preweighed Eppendorf tubes. The tubes were then stored in an incubator at 70°C for 5 days. The weight of the dry extruded debris was established by subtracting the preretreatment and postretreatment weight of the Eppendorf tubes for each group. The data obtained were analyzed using 1-way analysis of variance and Tukey post hoc tests. All retreatment techniques caused the apical extrusion of debris. Hand files produced significantly more debris when compared with ProTaper, D-RaCe, and R-Endo rotary systems (P ProTaper, D-RaCe, and R-Endo retreatment systems (P > .05). The findings showed that during the removal of root canal filling material, rotary NiTi retreatment instruments used in this study caused less apical extrusion of debris compared with hand files. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Root canal preparation with Er:YSGG laser

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Benthin, Hartmut; Ertl, Thomas P.; Onal, B.; Schruender, Stephan; Mueller, Gerhard J.

1994-12-01

The high level of efficiency of hard tissue ablation with Er:YAG and Er:YSGG lasers is well known. Of these lasers it is possible only to transmit Er:YSGG laser radiation with OH reduced quartz fibers. Most of the fibers we use in this study were prepared as hemispherical fiber tips. Fifty single rooted teeth were divided into ten groups (n equals 5). After conventional opening of the pulp chamber, root canal preparation was performed in five groups under water only using the laser. In the other five groups preparation with K-files to size 35 was performed before treatment with laser radiation. All teeth were axially separated with direct access to the root canal and examined in SEM investigations. The groups were compared by measuring the areas with patent dentin tubules. Representative areas were examined by TEM. The temperature at the root surface was measured during laser irradiation with thermocouples positioned at several points. The in-vitro study of the effect of the high delivered energy (50 - 100 mJ per pulse) in the root canal showed a good ablation effect. Most of the dentin tubules were opened. The increase in temperature at the root surface was tolerable.

Efficiency of final irrigation of root canal in removal of smear layer

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Mitić Aleksandar

2009-01-01

Full Text Available Introduction A smear layer forms on the root canal walls as the consequence of root instrumentation. The smear layer formed in such a way considerably influences the quality of root obturation and endodontic treatment outcome. Objective The aim of this study was to ultrastructurally analyze the surface of intracanal dentine after removal of the smear layer by the solution of doxycycline, citric acid and detergent Tween-80 (MTAD. Methods The study involved 60 single-rooted, extracted, human teeth divided into four groups. All samples were instrumented by a step-back technique and manual K-files, and rinsed during instrumentation by 2% CHX and H2O2. The first group of samples was exclusively rinsed by CHX and H2O2; in the second group, besides using CHX and H2O2, MTAD solution was used for the final irrigation. The samples which were rinsed by distilled water (+ control and the samples rinsed by 5.25% NaOCl and 17% Na EDTA (-control served as control groups. All samples were observed under the scanning electronic microscope JEOL-JSM-5300. The coronary, middle and apex thirds of the radix region were analyzed. Results The obtained results of the SEM analysis showed that the application of 2% chlorhexidine and hydrogen peroxide did not give clear dentine walls, and the smear layer could not be removed completely. The application of the same combination (CHX and H2O2, added by the final MTAD irrigation solution, led to the efficient removal of the smear layer, while the morphological structure of dentine surface remained unchanged. Statistical analysis showed that canal walls in the experimental group with MTAD as the final irrigation were significantly clearer compared to the control group (p<0.001. Conclusion Based on the obtained results, it can be concluded that MTAD is an efficient solution for the final irrigation of the canal system.

Endodontic Treatment of Maxillary Premolar with Three Root Canals Using Optical Microscope and NiTi Rotatory Files System.

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Relvas, João Bosco Formiga; de Carvalho, Fredsom Marcio Acris; Marques, André Augusto Franco; Sponchiado, Emílio Carlos; Garcia, Lucas da Fonseca Roberti

2013-01-01

The aim of the study was to report a clinical case of endodontic treatment of a maxillary first premolar with three root canals using an optical microscope and rotary instrumentation technique. The main complaint of the patient, a 16-year-old girl, was pain in tooth 14. After clinical and radiographic examination, irreversible pulpitis was diagnosed. An alteration in the middle third of the pulp chamber radiographically observed suggested the presence of three root canals. Pulp chamber access and initial catheterization using size number 10 K-files were performed. The optical microscope and radiographic examination were used to confirm the presence of three root canals. PathFiles #13, #16, and #19 were used to perform catheterization and ProTaper files S1 and S2 for cervical preparation. Apical preparation was performed using F1 file in the buccal canals and F2 in the palatal canal up to the working length. The root canals were filled with Endofill sealer by thermal compaction technique using McSpadden #50. The case has been receiving follow-up for 12 months and no painful symptomatology or periapical lesions have been found. The use of technological tools was able to assist the endodontic treatment of teeth with complex internal anatomy, such as three-canal premolars.

Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals.

Science.gov (United States)

Valera, Marcia C; Oliveira, Sarah Ac; Maekawa, Lilian E; Cardoso, Flávia Gr; Chung, Adriana; Silva, Stephanie Fp; Carvalho, Cláudio At

2016-02-01

The purpose of this in vitro study was to evaluate the antimicrobial activity of 2% chlorhexidine gel (CHX) as auxiliary chemical substance and intracanal medications on Candida albicans, Enterococcus faecalis, Escherichia coli, and their endotoxins in the root canals. The study was conducted on 48 single-rooted human teeth divided into four groups (n = 12), according to intracanal medications used: (1) Calcium hydroxide + apyrogenic saline solution (Ca(OH)2 + SS), (2) 20% ginger glycolic extract (GEN), (3) calcium hydroxide + 20% ginger glycolic extract (Ca(OH)2 + GEN), (4) apyrogenic SS (control). Collections were made from the root canal content before preparation (baseline-S1), immediately after instrumentation (S2), 7 days after instrumentation (S3), after 14 days the action of intracanal medication (S4), and 7 days after removal of the intracanal medication (S5). The antimicrobial activity and endotoxin content were analyzed for all collections. The results were statistically analyzed by the Kruskal-Wallis and Dunn tests at a significance level of 5%. After instrumentation with CHX, there was complete elimination of E. coli and C. albicans, except for E. faecalis, which was significantly reduced and then completely eliminated after intracanal medication. There was significant reduction of endotoxin after instrumentation. Comparison of collection after instrumentation and intracanal medication revealed reduction of endotoxins in all groups; this reduction was greater in group Ca(OH)2 followed by the group GEN. It was concluded that the instrumentation using CHX and intracanal medication used were able to eliminate the microorganisms from the root canal; the endotoxins were reduced, yet not completely eliminated. This study is important and relevant for searching alternatives during endodontic therapy, since it aims to study the effect of Zingiber officinale on microorganisms and endotoxins present in root canals.

ProTaper rotary instrument fracture during root canal preparation: a comparison between rotary and hybrid techniques.

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Farid, Huma; Khan, Farhan Raza; Rahman, Munawar

2013-03-01

This study aimed to compare the frequency of ProTaper rotary instrument fracture with rotary (conventional) and hybrid (rotary and hand files) canal preparation techniques. Secondary objectives were to determine whether there was an association of ProTaper file fracture with the canal curvature and to compare the mean time required for canal preparation in the two techniques. An in vitro experiment was conducted on 216 buccal canals of extracted maxillary and mandibular first molars. After creating an access cavity and a glide path for each canal, a periapical radiograph was taken and the canal curvature was measured with Schneider's technique. The canals were then randomly divided into Group A (rotary technique) and Group B (hybrid technique). The length of ProTaper files were measured before and after each canal preparation. Time taken for each canal preparation was recorded. A total of seven ProTaper files fractured in Group A (P=0.014) in canals with a curvature >25 degrees (PProTaper rotary files, although time consuming, was safer in canals having a curvature greater than 25 degrees.

Diagnosis and root canal treatment in a mandibular premolar with three canals.

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Soares, Lanuce Rosa; Arruda, Marcos; de Arruda, Marcos Pôrto; Rangel, Andréa Leão; Takano, Edson; de Carvalho Júnior, Jacy Ribeiro; Saquy, Paulo Cesar

2009-01-01

This paper presents a case report of a left mandibular second premolar with three canals and three different apical foramina. A 39-year-old male patient presented to our clinic with pain in the mandibular left second premolar. Initially, pain was caused by cold stimulus and later was spontaneously. The intraoral clinical examination revealed a fractured amalgam restoration with occlusal caries. Percussion and cold (Endo-Frost) tests were positive. The radiographic examination showed the presence of two roots. The probable diagnosis was an acute pulpitis. After access cavity, it was observed remaining roof of the pulp chamber and mild bleeding in the tooth lingual area, indicating the possible presence of a third canal. The endodontic treatment was completed in a single session using Root ZX apex locator and K3 NiTi rotary system with surgical diameter corresponding to a .02/45 file in the three canals and irrigation with 1% sodium hypochlorite. The canals were obtured with gutta-percha cones and Sealer 26 using the lateral condensation technique. After 1 year of follow-up, the tooth was asymptomatic and periapical repair was observed radiographically. Internal alterations should be considered during the endodontic treatment of mandibular second premolars. The correct diagnosis of these alterations by the analysis of preoperative radiographs can help the location of two or more canals, thereby avoiding root therapy failure.

Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment.

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Tanalp, J; Güngör, T

2014-03-01

Extrusion of intracanal debris as well as irrigants is a common occurrence during root canal treatment, and no instrument or technique has thoroughly solved this problem. Because flare-ups may arise with any irritation directed towards periapical tissues, a shaping or irrigation technique should minimize the risk of apical extrusion, even though it may not be prevented. There has been a rapid evolution of root canal instruments and irrigation systems through the last decade, and many have been assessed for their debris extrusion potential. The purpose of this review was to identify publications regarding the evaluation of debris, bacteria and irrigant extrusion during root canal treatment. A PubMed, Ovid and MEDLINE search was conducted using the keywords "apical extrusion", "debris extrusion" and "endodontic treatment". The literature search extended over a period of more than 30 years up to 2012. Content of the review was limited to apical extrusion of debris and irrigants, extrusion of liquid by irrigation methods and bacterial extrusion. Issues relevant to apical extrusion were obtained by further search in the reference sections of the retrieved articles. The review provides an update on the current status of apical extrusion. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Comparative study of root-canal shaping with stainless steel and rotary NiTi files performed by preclinical dental students.

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Alrahabi, Mothanna

2015-01-01

We evaluated the use of NiTi rotary and stainless steel endodontic instruments for canal shaping by undergraduate students. We also assessed the quality of root canal preparation as well as the occurrence of iatrogenic events during instrumentation. In total, 30 third-year dental students attending Taibah University Dental College prepared 180 simulated canals in resin blocks with NiTi rotary instruments and stainless steel hand files. Superimposed images were prepared to measure the removal of material at different levels from apical termination using the GSA image analysis software. Preparation time, procedural accidents, and canal shape after preparation were analyzed using χ 2 and t-tests. The statistical significance level was set at P instruments and stainless steel files; the former was associated with shorter preparation time, less ledge formation (1.1% vs. 14.4%), and greater instrument fracture (5.56% vs. 1.1%). These results indicate that NiTi rotary instruments result in better canal geometry and cause less canal transportation. Manual instrumentation using stainless steel files is safer than rotary instrumentation for inexperienced students. Intensive preclinical training is a prerequisite for using NiTi rotary instruments. These results prompted us to reconsider theoretical and practical coursework when teaching endodontics.

Three distal root canals in mandibular first molar with different canal configurations: Report of two cases and literature review

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Parul Bansal

2015-01-01

Full Text Available With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of three distal canals in distal roots of mandibular first molar is rare. This article reports endodontic management of two mandibular first molars presented with three distal canals present in a single distal root (Sert and Bayirli type XVIII and distal and distolingual root.

Apical instrumentation in endodontic therapy

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Kurniasri Darliana

2007-07-01

Full Text Available Cleaning and shaping of the root canal as the foundation for successful endodontic therapy. Cleaning of the root canal as the removal of all the contents of the root canal systems before and during shaping. Mechanical cleaning as the most important part of the root canal therapy. Instrumentation of the apical region has long been considered to be an essential component in the cleaning and shaping process. The apical area as the critical zone for instrumentation. The apical portion of the root canal system can retain microorganisms that could potentially cause periradicular inflammation. The nickel-titanium rotary instrumentation system to facilitate the cleaning and shaping process. Larger instrumentation sizes not only allow proper irrigation but also significantly decrease remaining bacteria in the canal system. How the larger apical sizes preparation must be achieved to clinical success. This paper will describe the major factors impacting the selection of final apical size, the factors are the anatomy of the apical constriction, root canal diameter, apical instrumentation, and bacteria in dentin tubuli.

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

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Singbal, Kiran; Jain, Disha; Raja, Kranthi; Hoe, Tan Ming

2017-01-01

Apical extrusion of debris during instrumentation is detrimental to the patient. 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. 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. The difference between pre- and post-weights was significantly greater for the One Shape system. The Neolix Niti single file was associated with less extrusion compared to One Shape single file system.

Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review.

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de Pablo, Oliver Valencia; Estevez, Roberto; Péix Sánchez, Manuel; Heilborn, Carlos; Cohenca, Nestor

2010-12-01

The main goal of endodontic therapy is to prevent or heal apical periodontitis. However, root canal anatomy might present a clinical challenge directly related to the treatment outcome. The purpose of this study was to review published literature related to root anatomy and root canal configuration of the permanent mandibular first molar. An exhaustive search was undertaken to identify published literature related to the root anatomy and root canal morphology of the permanent mandibular first molar by using key words. The search of the MEDLINE database included all publications from 1966-May 2010. Selected articles were then obtained and reviewed. Data evaluated and summarized in the data sheet included methodology, population, number of teeth per study (power), number of root canals, type of root canal configuration, and identification of number of apical foramina. Forty-one studies were identified including a total of 18,781 teeth. The incidence of a third root was 13% and was strongly correlated with the ethnicity of the studied population. Three canals were present in 61.3%, 4 canals in 35.7%, and 5 canals in approximately 1%. Root canal configuration of the mesial root revealed 2 canals in 94.4% and 3 canals in 2.3%. The most common canal system configuration was Vertucci type IV (52.3%), followed by type II (35%). Root canal configuration of the distal root revealed type I configuration in 62.7%, followed by types II (14.5%) and IV (12.4%). The presence of isthmus communications averaged 54.8% on the mesial and 20.2% on the distal root. The number of roots on the mandibular first molar is directly related to ethnicity. Root canal morphology and configuration might present the clinician with a complex anatomy requiring more diagnostic approaches, access modifications, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system. Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

[Continuous observation of canal aberrations in S-shaped simulated root canal prepared by hand-used ProTaper files].

Science.gov (United States)

Xia, Ling-yun; Leng, Wei-dong; Mao, Min; Yang, Guo-biao; Xiang, Yong-gang; Chen, Xin-mei

2009-08-01

To observe the formation of canal aberrations in S-shaped root canals prepared by every file of hand-used ProTaper. Fifteen S-shaped simulated resin root canals were selected. Each root canal was prepared by every file of hand-used ProTaper following the manufacturer instruction. The images of canals prepared by S1, S2, F1, F2 and F3 were taken and stored, which were divided into group S1, S2, F1, F2 and F3. One image of canal unprepared was superposed with the images of the same root canal in these five groups respectively to observe the types and number of canal aberrations, which included unprepared area, danger zone, ledge, elbow, zip and perforation. SPSS12.0 software pakage was used for Fisher's exact probabilities in 2x2 table. Unprepared area decreased following preparation by every file of ProTaper, but it still existed when the canal preparation was finished. The incidence of danger zone, elbow and zip in group F1 was 15/15, 11/15, 4/15, respectively, which was significantly higher than that in group S2(2/15,0,0) (PProTaper.The presence of unprepared area suggests that it is essential to rinse canal abundantly during complicated canal preparation and canal antisepsis after preparation.

Root canal morphology of primary molars: a micro-computed tomography study.

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Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

2014-10-01

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

Evaluation of apical canal shapes produced sequentially during instrumentation with stainless steel hand and Ni-Ti rotary instruments using Micro-computed tomography

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Woo-Jin Lee

2011-05-01

Full Text Available Objectives The purpose of this study was to determine the optimal master apical file size with minimal transportation and optimal efficiency in removing infected dentin. We evaluated the transportation of the canal center and the change in untouched areas after sequential preparation with a #25 to #40 file using 3 different instruments: stainless steel K-type (SS K-file hand file, ProFile and LightSpeed using microcomputed tomography (MCT. Materials and Methods Thirty extracted human mandibular molars with separated orifices and apical foramens on mesial canals were used. Teeth were randomly divided into three groups: SS K-file, Profile, LightSpeed and the root canals were instrumented using corresponding instruments from #20 to #40. All teeth were scanned with MCT before and after instrumentation. Cross section images were used to evaluate canal transportation and untouched area at 1- , 2- , 3- , and 5- mm level from the apex. Data were statistically analyzed according to' repeated nested design'and Mann-Whitney test (p = 0.05. Results In SS K-file group, canal transportation was significantly increased over #30 instrument. In the ProFile group, canal transportation was significantly increased after preparation with the #40 instrument at the 1- and 2- mm levels. LightSpeed group showed better centering ability than ProFile group after preparation with the #40 instrument at the 1 and 2 mm levels. Conclusions SS K-file, Profile, and LightSpeed showed differences in the degree of apical transportation depending on the size of the master apical file.

Root canal filling using Resilon: a review.

LENUS (Irish Health Repository)

Shanahan, D J

2011-07-01

Root canal treatment is achieved by chemo-mechanical debridement of the root canal system followed by filling. The filling material \\'entombs\\' residual bacteria and acts as a barrier which prevents the entrance of oral microorganisms and reinfection of the root canal system through microleakage. However, filling with contemporary root filling materials such as gutta-percha offers limited long-term resistance to microorganisms; as a result other materials such as Resilon have been investigated as alternatives. The aim of this review was to analyse the literature to consider whether Resilon is a suitable root canal filling material. A MEDLINE and Cochrane library search including various keyword searches identified several papers which investigated or discussed Resilon or RealSeal\\/Epiphany. Analysis of the literature demonstrated that the bulk of the literature is in vitro in nature, based largely on leakage-type studies, and demonstrates a wide variety of methodologies with conflicting findings; as a result meaningful conclusions are difficult. Within the limit of these in vitro studies Resilon appears to perform adequately in comparison to gutta-percha, however, as a result of the questionable merit of such studies, it cannot presently be considered an evidence-based alternative to the current gold standard gutta-percha. It is imperative that before Resilon is considered as a replacement material, a better understanding of the physical properties of the resin sealer and the reality of the adhesive \\'monoblock\\' are elucidated. The literature also demonstrates a paucity of quality long-term clinical outcome studies which will need to be addressed before firm conclusions can be reached.

Maxillary lateral incisors with two canals and two separate curved roots

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Ajit George Mohan

2012-01-01

Full Text Available Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.

Effects of canal enlargement and irrigation needle depth on the cleaning of the root canal system at 3 mm from the apex

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Ho-Jin Moon

2012-02-01

Full Text Available Objectives The aim of this study was to test the hypothesis, that the effectiveness of irrigation in removing smear layer in the apical third of root canal system is dependent on the depth of placement of the irrigation needle into the root canal and the enlargement size of the canal. Materials and Methods Eighty sound human lower incisors were divided into eight groups according to the enlargement size (#25, #30, #35 and #40 and the needle penetration depth (3 mm from working length, WL-3 mm and 9 mm from working length, WL-9 mm. Each canal was enlarged to working length with Profile.06 Rotary Ni-Ti files and irrigated with 5.25% NaOCl. Then, each canal received a final irrigation with 3 mL of 3% EDTA for 4 min, followed by 5 mL of 5.25% NaOCl at different level (WL-3 mm and WL-9 mm from working length. Each specimen was prepared for the scanning electron microscope (SEM. Photographs of the 3mm area from the apical constriction of each canal with a magnification of ×250, ×500, ×1,000, ×2,500 were taken for the final evaluation. Results Removal of smear layer in WL-3 mm group showed a significantly different effect when the canal was enlarged to larger than #30. There was a significant difference in removing apical smear layer between the needle penetration depth of WL-3 mm and WL-9 mm. Conclusions Removal of smear layer from the apical portion of root canals was effectively accomplished with apical instrumentation to #35/40 06 taper file and 3 mm needle penetration from the working length.

Efficacy of protaper next and protaper universal retreatment systems in removing gutta-percha in curved root canals during root canal retreatment.

Science.gov (United States)

Ozyurek, Taha; Ozsezer-Demiryurek, Ebru

2017-01-01

The aim of this study was to compare the cleanliness of root canal walls after retreatment using ProTaper Next (PTN), ProTaper Universal Retreatment (PTR) nickel-titanium (NiTi) systems and Hedström hand files in curved mesial canals of mandibular molar teeth and the time required for gutta-percha and sealer removal. Ninety mandibular molar teeth with curved mesial roots were instrumented up to #35.04 with Mtwo NiTi rotary instruments and obturated using the continuous wave of condensation technique. Removal of gutta-percha and sealer was performed using one of the following: PTN and PTR NiTi systems and Hedström hand files. Samples were placed on the VistaScan phosphor plates in the mesio-distal direction and the radiographs were taken. The digital radiographs were analyzed using AutoCAD software. Also, the total time required for gutta-percha removal was calculated by a chronometer. The total retreatment time was significantly shorter in the PTN and PTR groups compared with the manual group (p<0.05). There was a significant difference between the groups according to the total residual gutta-percha and sealer (p<0.05). The PTN and PTR groups left significantly less gutta-percha and sealer remnant than the manual group (p<0.001). Within the limitations of this study, the PTN and PTR groups showed less residual gutta-percha and sealer than the manual group. The NiTi rotary systems were significantly faster than the manual group in the time required for gutta-percha and sealer removal.

Classification of root canal microorganisms using electronic-nose and discriminant analysis

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Özbilge Hatice

2010-11-01

Full Text Available Abstract Background Root canal treatment is a debridement process which disrupts and removes entire microorganisms from the root canal system. Identification of microorganisms may help clinicians decide on treatment alternatives such as using different irrigants, intracanal medicaments and antibiotics. However, the difficulty in cultivation and the complexity in isolation of predominant anaerobic microorganisms make clinicians resort to empirical medical treatments. For this reason, identification of microorganisms is not a routinely used procedure in root canal treatment. In this study, we aimed at classifying 7 different standard microorganism strains which are frequently seen in root canal infections, using odor data collected using an electronic nose instrument. Method Our microorganism odor data set consisted of 5 repeated samples from 7 different classes at 4 concentration levels. For each concentration, 35 samples were classified using 3 different discriminant analysis methods. In order to determine an optimal setting for using electronic-nose in such an application, we have tried 3 different approaches in evaluating sensor responses. Moreover, we have used 3 different sensor baseline values in normalizing sensor responses. Since the number of sensors is relatively large compared to sample size, we have also investigated the influence of two different dimension reduction methods on classification performance. Results We have found that quadratic type dicriminant analysis outperforms other varieties of this method. We have also observed that classification performance decreases as the concentration decreases. Among different baseline values used for pre-processing the sensor responses, the model where the minimum values of sensor readings in the sample were accepted as the baseline yields better classification performance. Corresponding to this optimal choice of baseline value, we have noted that among different sensor response model and

Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

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Kurniasri Amas Achiar

2009-07-01

Full Text Available One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gutta-percha, or through voids within the sealer. Hence, the sealing quality of root canal filling depends much on the sealing ability of the sealer. Therefore, anything that may influence the adaptation of the root filling to the canal wall is can determine the degree and the extent of leakage, and ultimately the prognosis of the endodontic therapy. In endodontic therapy, the smear layer formation results from root canal preparation and may influence the effective seal of the root canal system. The smear layer formation is mainly composed of inorganic components (dentin debris and organic materials, such as pulp tissue remnant, bacteria, and blood cells. Removal of the smear layer from the root canal walls before the obturation can reduce the leakage of root canal sealer. To remove the smear layer use 10 ml 17% EDTA followed by 10 ml of 5.25% NaOCl as irrigating solution. This paper discribe about how the effectivity of EDTA as irigating solution to remove the smear layer especially in the apical root canal with many lateral canal to reduce the apical leakage.

Efficiency of a semiconductor diode laser in disinfection of the root canal system in endodontics: An in vitro study

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Mithra N Hegde

2015-01-01

Full Text Available Context: The success of endodontic treatment depends on the eradication of microbes from the rootcanal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root canal space. The main goal of instrumentation is to facilitate effective irrigation, disinfection, and filling. Throughout the history of endodontics, endeavors have continuously been made to develop more effective irrigant delivery and agitation systems for root canal irrigation. Aim: The purpose of this study was to evaluate the efficacy of three different newer irrigation delivery techniques; namely Endovac, Stropko Irrigator, and laser disinfection with 5.25% sodium hypochlorite. Materials and Methods: Forty teeth after disinfection by Occupational Safety and Health Administration (OSHA regulations were instrumented and inoculated with bacterial strains of Enterococcusfaecalis. The teeth were divided into four groups, in the experimental group, the irrigants were delivered with the Endovac, Stropko Irrigator, and laser irradiation and the control group which received no irrigation. The samples were incubated in Muller-Hilton media plates and incubated for 24 h. Statistical analysis used: The colony forming units were determined and statistically analyzed using the chi-square test. Results: According to the results obtained, laser irradiation resulted in complete disinfection of the root canal system. The Endovac system resulted in significant disinfection as compared to the Stropko Irrigator system. Conclusion: Laser irradiation resulted in significantly higher antimicrobial effects compared with the Endovac and Stropko irrigation groups when in conjunction with sodium hypochlorite

Scanning electron microscopic evaluation of the influence of manual and mechanical glide path on the surface of nickel-titanium rotary instruments in moderately curved root canals: An in-vivo study

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Patel, Dishant; Bashetty, Kusum; Srirekha, A.; Archana, S.; Savitha, B.; Vijay, R.

2016-01-01

Aim: The aim of this study was to evaluate the influence of manual versus mechanical glide path (GP) on the surface changes of two different nickel-titanium rotary instruments used during root canal therapy in a moderately curved root canal. Materials and Methods: Sixty systemically healthy controls were selected for the study. Controls were divided randomly into four groups: Group 1: Manual GP followed by RaCe rotary instruments, Group 2: Manual GP followed by HyFlex rotary instruments, Group 3: Mechanical GP followed by RaCe rotary instruments, Group 4: Mechanical GP followed by HyFlex rotary instruments. After access opening, GP was prepared and rotary instruments were used according to manufacturer's instructions. All instruments were evaluated for defects under standard error mean before their use and after a single use. The scorings for the files were given at apical and middle third. Statistical Analysis Used: Chi-squared test was used. Results: The results showed that there is no statistical difference between any of the groups. Irrespective of the GP and rotary files used, more defects were present in the apical third when compared to middle third of the rotary instrument. Conclusion: Within the limitations of this study, it can be concluded that there was no effect of manual or mechanical GP on surface defects of subsequent rotary file system used. PMID:27994317

Effects of irrigation solutions and Calcium hydroxide dressing on root canal treatments of periapical lesions

OpenAIRE

Nirmala, Vita

2006-01-01

The preparation of root canal in endodontic treatment plays an important role in treating non vital teeth with periapical lesion. Some factors influence the success of root canal treatment in short and long terms are the irrigation of root canal using antiseptic solution and the use of root canal medicament. The aim of this literature study is to determined the effect of irrigation solution and Calcium hydroxide dressing in root canal treatment of periapical lesions. The use of root canal med...

Technical quality of root canal treatment of posterior teeth after rotary or hand preparation by fifth year undergraduate students, The University of Jordan.

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Abu-Tahun, Ibrahim; Al-Rabab'ah, Mohammad A; Hammad, Mohammad; Khraisat, Ameen

2014-12-01

The aim of this study was to investigate the technical quality of root canal treatment provided by the undergraduate students as their first experience in molar endodontics using nickel-titanium (NiTi) files in a crown-down approach compared with stainless steel standard technique. This study was carried out by the fifth year undergraduate students attending peer review sessions as a part of their training programme, using two different questionnaires to assess the overall technical quality and potential problems regarding endodontic complications after root canal preparation with these two techniques. The overall results indicated a statistically significant difference in the performance of the two instrument techniques in difficult cases showing better performance of the NiTi system and mean rotary preparation time (P ProTaper rotary files, were able to prepare root canals faster with more preparation accuracy compared with canals of same teeth prepared with hand instruments. © 2014 Australian Society of Endodontology.

Retention of Root Canal Posts

DEFF Research Database (Denmark)

Sahafi, A; Benetti, Ana Raquel; Flury, S

2015-01-01

The aim of this study was to investigate the effect of the cement film thickness of a zinc phosphate or a resin cement on retention of untreated and pretreated root canal posts. Prefabricated zirconia posts (CosmoPost: 1.4 mm) and two types of luting cements (a zinc phosphate cement [DeTrey Zinc...... received tribochemical silicate coating according to the manufacturer's instructions. Posts were then luted in the prepared root canals (n=30 per group). Following water storage at 37°C for seven days, retention of the posts was determined by the pull-out method. Irrespective of the luting cement......, pretreatment with tribochemical silicate coating significantly increased retention of the posts. Increased cement film thickness resulted in decreased retention of untreated posts and of pretreated posts luted with zinc phosphate cement. Increased cement film thickness had no influence on retention...

Thermal analysis of different application techniques on Nd:YAG laser after root canal preparation of single-rooted teeth

International Nuclear Information System (INIS)

Archilla, Jose Ricardo de F.

2001-01-01

The experiment objective is to analyze temperature variation, by means of three different application techniques of Nd:YAG laser in the root canals of singlerooted anterior teeth. Three root canals were instrumented, irrigated, X-rayed to measure the remaining dentin in the apical area and submitted to laser irradiation techniques used by Gutknecht, Matsumoto and a new technique with oscillatory movement. The used laser parameters were: pulse energy 250 mJ, frequency 5 Hz, pulse fluency 354 J/cm 2 , average potency 1,25 W, pulse width 300 μs, fiber core diameter 300 μs and interval of thermal relaxation of 20 s. After temperature evaluation and interpretation of the obtained data, it was concluded: 1) the oscillatory technique provided a better heat distribution during the laser application, when analyzing the graphs separately; 2) all the used techniques are within a pattern of safety, analyzing the average and highest temperatures of the apical area and the middle third, even so, disrespecting the last application day and the middle third of root 'C'.(author)

Endodontic management of permanent mandibular molars with 6 root canals: report of 3 cases.

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Malhotra, Amit; Ahlawat, Jyoti; Bansal, Chirag; Tahiliani, Divya

2016-01-01

Aberrations in the internal dental anatomy present challenges for clinicians performing endodontic therapy. These challenges have been partly resolved in recent years by a more comprehensive knowledge of root canal anatomy as well as advancements in the endodontic armamentarium. The aim of this case series is to describe successful root canal treatment, under magnification, in 3 cases of mandibular first molars with 6 root canals. Two of these teeth had 2 roots (mesial and distal) with 3 canals in each root; the third tooth had 3 root canals located mesially and 3 present distally as well as a radix entomolaris. A distal root with 3 canals is rare; however, it is important to look for such anatomical variations to ensure successful endodontic therapy.

Marginal adaptation of newer root canal sealers to dentin: A SEM study.

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Polineni, Swapnika; Bolla, Nagesh; Mandava, Pragna; Vemuri, Sayesh; Mallela, Madhusudana; Gandham, Vijaya Madhuri

2016-01-01

This in vitro study evaluated and compared the marginal adaptation of three newer root canal sealers to root dentin. Thirty freshly extracted human single-rooted teeth with completely formed apices were taken. Teeth were decoronated, and root canals were instrumented. The specimens were randomly divided into three groups (n = 10) based upon the sealer used. Group 1 - teeth were obturated with epoxy resin sealer (MM-Seal). Group 2 - teeth were obturated with mineral trioxide aggregate (MTA) based sealer (MTA Fillapex), Group 3 - teeth were obturated with bioceramic sealer (EndoSequence BC sealer). Later samples were vertically sectioned using hard tissue microtome and marginal adaptation of sealers to root dentin was evaluated under coronal and apical halves using scanning electron microscopy (SEM) and marginal gap values were recorded. The data were statistically analyzed by two-way ANOVA and Tukey's multiple post hoc test. The highest marginal gap was seen in Group 2 (apical-16680.00 nm, coronal-10796 nm) and the lowest marginal gap was observed in Group 1 (apical-599.42 nm, coronal-522.72 nm). Coronal halves showed superior adaptation compared to apical halves in all the groups under SEM. Within the limitations of this study epoxy resin-based MM-Seal showed good marginal adaptation than other materials tested.

Comparison of Dentinal Crack Formation With Reciproc, Mtwo and ProTaper Root Canal Preparation Systems

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Nazari Moghaddam

2016-06-01

Full Text Available Background Instrumentation with rotary instruments could potentially cause dentinal cracks possibly leading to tooth fracture. Reciproc files require a single file to finalize the root canal preparation and the effect of this procedure has not been compared with other systems. Objectives The aim of this study was to compare the incidence of dentinal micro-cracks following root canal preparations with ProTaper, Mtwo and Reciproc files. Materials and Methods In an experimental in vitro trial, 80 maxillary and mandibular first molars were selected and their crowns and distal roots were cut. The roots were then examined to remove any previous cracks and defects. An impression polyether material was used to simulate teeth periodontal ligament (PDL. The teeth were divided to four experimental groups (n = 20 and prepared using Reciproc, Mtwo and ProTaper or remained unprepared as a control group. The specimens were then sectioned horizontally on 3, 5 and 9 mm from the apex and number of micro-cracks was determined by stereomicroscope. The incidence of dentinal cracks on different systems or sections were statistically analyzed by means of the chi-square test. Results Dentinal defects on 3-mm, 5-mm and 9-mm sections from the apex were noted in 10 (5.6%; 7 (3.9% and 9 (5.0% samples of all, respectively. Following canal preparation using Reciproc, ProTaper and Mtwo systems, the defects were observed in 7 (3.9%, 12 (6.7% and 7 (3.9% the sections, respectively. No significant differences were observed regarding the defect incidence on the studied instrumentation files or sections. Conclusions Regarding the study limitations, dentinal cracks were observed in all files and distances from the apex. Although there was more crack incidence in ProTaper files, no significant differences were noted regarding the studied systems and sections from the apex.

Comparative evaluation of apically extruded debris during root canal preparation using ProTaper™, Hyflex™ and Waveone™ rotary systems

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Surakanti, Jayaprada Reddy; Venkata, Ravi Chandra Polavarapu; Vemisetty, Hari Kumar; Dandolu, Ram Kiran; Jaya, Nagendra Krishna Muppalla; Thota, Shirisha

2014-01-01

Background and Aims: Extrusion of any debris during endodontic treatment may potentially cause post-operative complications such as flare-ups. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. Materials and Methods: In this study, 60 human mandibular first premolars were randomly assigned to 3 groups (n = 20 teeth/group). The root canals were instrumented according to the manufacturers’ instructions using the Reciprocating single-file system WaveOne™ (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence rotary Hyflex CM™ (Coltene Whaledent, Allstetten, Switzerland) and ProTaper™ (Dentsply Maillefer, Ballaigues, Switzerland) instruments. The canals were then irrigated using bidistilled water. The debris that was extruded apically was collected in preweighed eppendorf tubes and assessed with an electronic balance and compared. Statistical Analysis Used: The debris extrusion was compared and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. Results: The WaveOne™ and ProTaper™ rotary instruments produced significantly more debris compared with Hyflex CM™ rotary instruments (P < 0.05). Conclusions: Under the conditions of this study, all systems that were used resulted in extrusion of apical debris. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems. PMID:24778507

The effect of four different irrigation systems in the removal of a root canal sealer.

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Grischke, J; Müller-Heine, A; Hülsmann, M

2014-09-01

The aim of this study was to compare the efficiency of sonic, ultrasonic, and hydrodynamic devices in the removal of a root canal sealer from the surface and from simulated irregularities of root canals. Fifty-three root canals with two standardized grooves in the apical and coronal parts of longitudinally split roots were covered with AH Plus root canal sealer. Compared were the effects of (control) syringe irrigation, (1) CanalBrush, (2) passive ultrasonic irrigation, (3) EndoActivator, and (4) RinsEndo on the removal of the sealer. The specimens were divided into four groups (N = 12) and one control group (N = 5) via randomization. The amount of remaining sealer in the root canal irregularities was evaluated under a microscope using a 4-grade scoring system, whereas the remaining sealer on the root canal surface was evaluated with a 7-grade scoring system. Passive ultrasonic irrigation is more effective than the other tested irrigation systems or syringe irrigation in removing sealer from root canal walls (p irrigation shows a superior effect on sealer removal from the root canal surface during endodontic retreatment. Cleaning of lateral grooves seems not to be possible with one of the techniques investigated. Incomplete removal of root canal sealer during re-treatment may cause treatment failure. Passive Ultrasonic irrigation seems to be the most effective system to remove sealer from a root canal.

The Use of a Novel Approach for the Instrumentation of a Cone-beam Computed Tomography-discernible Lateral Canal in an Unusual Maxillary Incisor: Case Report.

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Chaniotis, Antonis; Filippatos, Christos G

2017-06-01

Lateral and apical ramifications of the main root canal create potential pathways through which bacteria can spread and remain unaffected by treatment procedures. It is a challenge for the specialty to find techniques that can predictably reach, disinfect, and obturate these ramifications. Here, we report the use of a novel instrumentation approach to aid in the negotiation and management of a lateral canal discernible on cone-beam computed tomography (CBCT) in an unusual maxillary central incisor. A 23-year-old female patient was referred for evaluation and possible treatment of tooth 9. The periapical radiographic examination revealed pulp chamber obliteration, existence of a lateral lesion, and a possible complex internal root canal anatomy. The CBCT evaluation revealed the existence of a lateral lesion, a periapical lesion, an additional distopalatal canal, and a lateral canal exiting at the lateral lesion. The diagnosis of asymptomatic apical and lateral periodontitis of tooth 9 was reached. CBCT-aided access cavity preparation and scouting resulted in the successful negotiation of all canals, main and lateral. A novel instrumentation technique with precurved controlled memory files was used for the mechanical preparation of the lateral canal to a 25/04 enlargement. Obturaton of the lateral canal was achieved with a single gutta-percha cone and AH Plus Root Canal Sealer. At the 2-year follow-up, the patient was asymptomatic, and the 2-dimensional radiographic examinations revealed resolution of both the periapical and the lateral lesions. This case report describes the application of a novel instrumentation technique for the mechanical debridement of an infected lateral canal discernible on CBCT and reinforces the importance of treating the root canals as systems that possesses anatomic intricacies that need to be addressed. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Adaptation and penetration of resin-based root canal sealers in root canals irradiated with high-intensity lasers.

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Moura-Netto, Cacio; Mello-Moura, Anna Carolina Volpi; Palo, Renato Miotto; Prokopowitsch, Igor; Pameijer, Cornelis H; Marques, Marcia Martins

2015-03-01

This research analyzed the quality of resin-based sealer adaptation after intracanal laser irradiation. Extracted teeth (n = 168) were root canal treated and divided into four groups, according to dentin surface treatment: no laser; Nd:YAG laser (1.5 W, 100 mJ, 15 Hz); diode laser (2.5 W in CW), and Er:YAG laser (1 W, 100 mJ, 10 Hz). The teeth were divided into four subgroups according to the sealer used: AH Plus, EndoREZ, Epiphany, and EpiphanySE. For testing the sealing after root canal obturation, the penetration of silver nitrate solution was measured, whereas to evaluate the adaptation and penetration of the sealer into the dentin, environmental scanning electron microscopy (ESEM) was used. The ESEM images were analyzed using a four-grade criteria score by three evaluators. The inter-examiner agreement was confirmed by Kappa test and the scores statistically compared by the Kruskal-Wallis' test (p laser irradiation. Nd:YAG and diode laser decreased the tracer penetration for AH Plus, whereas EndoREZ and EpiphanySE performances were affected by Nd:YAG irradiation (p laser irradiation can be used as an adjunct in endodontic treatment; however, the use of hydrophilic resin sealers should be avoided when root canals were irradiated with Nd:YAG laser.

Root Canal Configuration of Mandibular First and Second Premolars in an Iranian Population

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Nemat Eskandarzadeh

2007-08-01

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Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The aim of this study was to determine the canal configuration and the prevalence of C-shaped canals in mandibular first and second premolars in a North-Western Iranian population.

Materials and methods. A total of 163 extracted mandibular first and 103 mandibular second premolars were injected with India ink and demineralized . They were made clear and transparent with methyl salicylate and the anatomy of their canal(s was studied.

Results. The results showed that 98% of mandibular first premolars had one root, 2% had two roots, 70.6% had one canal, 27.8% had two canals, 1.2% had three canals and the prevalence of C-shaped canals was 2.4%. All mandibular second premolars had one root, 80.5% had one canal, 17.5% had two canals and the prevalence of C-shaped canals was 2%.

Conclusion. It is important that clinicians, before treatment of mandibular first and second premolars, pay complete attention to radiographs, have a true concept of the number of root(s and canal(s, and prepare a correct access cavitiy.

Additional disinfection with a modified salt solution in a root canal model.

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van der Waal, Suzette V; Oonk, Charlotte A M; Nieman, Selma H; Wesselink, Paul R; de Soet, Johannes J; Crielaard, Wim

2015-10-01

The aim of this study is to investigate the disinfecting properties of a modified salt solution (MSS) and calcium hydroxide (Ca(OH)2) in a non-direct-contact ex-vivo model. Seventy-four single-canal roots infected with Enterococcus faecalis were treated with 1% sodium hypochlorite (NaOCl) irrigation or with NaOCl irrigation with subsequent dressing with MSS or Ca(OH)2. After removal of the dressings, the roots were filled with bacterial growth medium and incubated for seven days to enable the surviving bacteria to repopulate the root canal lumen. Growth was determined by sampling the root canals with paper points before treatment (S1), after treatment (S2) and incubation after treatment (S3). The colony forming units were counted at S1 and S2. At S3, growth was determined as no/yes regrowth. The Kruskal-Wallis, McNemar and χ(2) test were used for statistical analyses. At S2, in the NaOCl group, growth was found in 5 of 19 root canals. After the removal of MSS or Ca(OH)2 bacteria were retrieved from one root canal in both groups. At S3, repopulation of the root canals had occurred in 14 of 19 roots after sole NaOCl irrigation, 6 of 20 roots after MSS-dressing and in 14 of 20 roots after Ca(OH)2-dressing. MSS was more effective in preventing regrowth than Ca(OH)2 (P=0.009). The modified salt solution prevented regrowth in roots which indicates that it can eliminate persistent bacteria. Dressing the root canals with Ca(OH)2 did not provide additional disinfection after NaOCl irrigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Geometric analysis of root canals prepared by four rotary NiTi shaping systems.

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Hashem, Ahmed Abdel Rahman; Ghoneim, Angie Galal; Lutfy, Reem Ahmed; Foda, Manar Yehia; Omar, Gihan Abdel Fatah

2012-07-01

A great number of nickel-titanium (NiTi) rotary systems with noncutting tips, different cross-sections, superior resistance to torsional fracture, varying tapers, and manufacturing method have been introduced to the market. The purpose of this study was to evaluate and compare the effect of 4 rotary NiTi preparation systems, Revo-S (RS; Micro-Mega, Besancon Cedex, France), Twisted file (TF; SybronEndo, Amersfoort, The Netherlands), ProFile GT Series X (GTX; Dentsply, Tulsa Dental Specialties, Tulsa, OK), and ProTaper (PT; Dentsply Maillefer, Ballaigues, Switzerland), on volumetric changes and transportation of curved root canals. Forty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 25° to 40° were divided according to the instrument used in canal preparation into 4 groups of 10 samples each: group RS, group TF, group GTX, and group PT. Canals were scanned using an i-CAT CBCT scanner (Imaging Science International, Hatfield, PA) before and after preparation to evaluate the volumetric changes. Root canal transportation and centering ratio were evaluated at 1.3, 2.6, 5.2, and 7.8 mm from the apex. The significance level was set at P ≤ .05. The PT system removed a significantly higher amount of dentin than the other systems (P = .025). At the 1.3-mm level, there was no significant difference in canal transportation and centering ratio among the groups. However, at the other levels, TF maintained the original canal curvature recording significantly the least degree of canal transportation as well as the highest mean centering ratio. The TF system showed superior shaping ability in curved canals. Revo-S and GTX were better than ProTaper regarding both canal transportation and centering ability. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Evaluation of surface preparation and maintenance of canal curvature following instrumentation with hand ′K′ file and three different Ni-Ti rotary systems: A radiographic and SEM study

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Namrata Bhatti

2010-01-01

Full Text Available Aim: To determine the shaping ability and cleaning efficiency of hand K-flexofiles, ProTaper, LightSpeed and Mtwo instruments during the preparation of curved root canals in extracted human teeth. Materials and Methods: A total of 120 root canals of mandibular and maxillary molars with curvature more than 20° were divided into four groups of 30 each. In group A, canals were prepared using hand K-flexofiles following the crown down technique. In group B LightSpeed, in group C ProTaper, and in group D Mtwo rotary instruments were used to prepare the root canals. Using pre- and post-instrumentation radiographs, straightening of the canal curvature was determined with Corel Draw 9.0 software tools. The amount of debris and smear layer were quantified at three different areas (coronal, middle, and apical thirds of root canal using SEM. The collected data were analyzed statistically using Student′s paired ′t′ test. Results: The mean change in curvature for hand K-files was 7.71°, for ProTaper files 6.03°, for Mtwo 5.43°, and for LightSpeed instruments were found to be 4.57°. The percentage change in the curvature for all the four groups was statistically highly significant (P< 0.01. LightSpeed instruments maintained the original canal curvature significantly (P< 0.01 better than the other instruments. For leftover debris, the minimum percentage was found to be associated with ProTaper (65.48% followed by Mtwo (66.22%, LightSpeed (71.67% and the maximum with hand K-files (74.16%. However, the difference in mean leftover debris between ProTaper and Mtwo was not significant. Conclusion: ProTaper and Mtwo resulted in good cleaning, and LightSpeed maintained the original canal curvature better than the ProTaper, Mtwo, or Hand K-files.

The Use of Lasers in Disinfection and Cleaning of Root Canals: a Review

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Ivica Anić

2014-01-01

Full Text Available The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure. Due to high energy content and specific characteristics of laser light, laser treatment has been proposed for cleaning and disinfecting the root canal system. This paper reviews the literature covering the effect of Er:YAG, Er,Cr:YSGG, Nd:YAG and diode laser on the root canal wall in the removal of smear layer and against intracanal bacteria. Recently, the use of laser energy to induce cavitation and acoustic streaming of intracanal irrigants has been investigated. Based on recent literature, it can be concluded that lasers have bactericidal effects. However, they still cannot replace sodium hypochlorite and should be considered as an adjunct to the current chemical root canal disinfection protocols. Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall. Unfortunately, there have not been enough randomized clinical studies evaluating endodontic treatment outcome following the use of laser.

The difference of 17% ethylenediaminetetraacetic acid irrigation material contact time of 60 seconds and 30 seconds toward of cleanliness of apical third root canal wall

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Yunita Wijaya

2011-11-01

Full Text Available Root canal preparation is one important step in endodontic treatment, involves the cleaning and the shaping of the root canal debris. Root canal cleaning effectiveness depends on the preparation bio-mechanical and irrigation. Purpose of this study was to evaluate the cleanliness of apical third of root canal wall from of debris, with the contact time of 17% EDTA irrigation material for 60 seconds and 30 seconds after root canal preparation using rotary NiTi instruments. This quasi-experimental study was carried out invitro, with random sampling technique. The sample used was 20 central maxillary incisors that have been extracted and divided into two experimental groups of 10 teeth each. The results were analyzed using student t statistics, showed that the average value of the debris of the two groups differed significantly. The contact time of 60 seconds of 17% EDTA showed cleaner root canal than the 30 seconds. The conclusion of this study was there were the differences of the cleanliness of apical third of the root canal with the 60 seconds contact time of 17% EDTA irrigation materials than 30 seconds contact time.

Comparative evaluation of dentinal crack formation after root canal preparation using ProTaper Next, OneShape, and Hyflex EDM.

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Das, Sanjib; Pradhan, Prasanti Kumari; Lata, S; Sinha, Sachidananda Prasad

2018-01-01

The purpose of this study was to compare the incidence of dentinal crack formation after root canal preparation using ProTaper Next, OneShape, and Hyflex electrodischarge machining (HEDM). A total of 75 extracted mandibular premolars were selected. The root canals were instrumented using ProTaper Next, OneShape, and HEDM rotary files. All roots were horizontally sectioned at 3, 6, and 9 mm from apex with slow-speed saw under water cooling. The sections were observed under a stereomicroscope at ×25 to determine the absence or presence of crack. Data were analyzed using post hoc test and one-way ANOVA. ProTaper Next and HEDM produced significantly less cracks than OneShape. Within the limitation of this in vitro study, it can be concluded that nickel-titanium instruments may cause cracks on the root surface. ProTaper Next and HEDM tend to produce less number of cracks as compared to OneShape.

EFFICACY OF PROTAPER NEXT AND PROTAPER UNIVERSAL RETREATMENT SYSTEMS IN REMOVING GUTTA-PERCHA IN CURVED ROOT CANALS DURING ROOT CANAL RETREATMENT

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Taha ÖZYÜREK

2017-04-01

Full Text Available Purpose: The aim of this study was to compare the cleanliness of root canal walls after retreatment using ProTaper Next (PTN, ProTaper Universal Retreatment (PTR nickel-titanium (NiTi systems and Hedström hand files in curved mesial canals of mandibular molar teeth and the time required for gutta-percha and sealer removal. Materials and Methods: Ninety mandibular molar teeth with curved mesial roots were instrumented up to #35.04 with Mtwo NiTi rotary instruments and obturated using the continuous wave of condensation technique. Removal of gutta-percha and sealer was performed using one of the following: PTN and PTR NiTi systems and Hedström hand files. Samples were placed on the VistaScan phosphor plates in the mesio-distal direction and the radiographs were taken. The digital radiographs were analyzed using AutoCAD software. Also, the total time required for gutta-percha removal was calculated by a chronometer. Results: The total retreatment time was significantly shorter in the PTN and PTR groups compared with the manual group (p<0.05. There was a significant difference between the groups according to the total residual gutta-percha and sealer (p<0.05. The PTN and PTR groups left significantly less gutta-percha and sealer remnant than the manual group (p<0.001. Conclusion: Within the limitations of this study, the PTN and PTR groups showed less residual gutta-percha and sealer than the manual group. The NiTi rotary systems were significantly faster than the manual group in the time required for gutta-percha and sealer removal.

[Deformations occurring in the apical third of curved root canals during biomechanical preparation using manual impulsion-traction techniques].

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Roig Cayón, M; Basilio Monné, J; Canalda Sahli, C

1990-01-01

Apical deformations, specially zips and elbows, during instrumentation of the root canals, are studied. The authors study why do they appear, their effect on endodontic therapy, and the way of avoiding them.

Effectiveness of Various Irrigation Protocols in Removing Calcium Hydroxide from Root Canals

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Hakan Göktürk

2018-04-01

Full Text Available Objective: The purpose of this study was to investigate the removal efficiency of calcium hydroxide (CH by CanalBrush, Vibringe, laser-activated irrigation (LAI, conventional syringe irrigation (CSI, XP-endo Finisher, and passive ultrasonic irrigation (PUI in the root canal walls. Materials and Methods: Ninety-eight human mandibular premolar teeth were prepared. Root canals were filled with CH. The roots were divided into six experimental groups (n=15/group according to the irrigation protocol used: group 1 (CSI, group 2 (Vibringe, group 3 (CanalBrush, group 4 (XP-endo Finisher, group 5 (PUI, and group 6 (LAI. The amount of residual CH in the canal walls for each canal third was scored. Data were analysed by using Kruskal-Wallis and Bonferroni-correction Mann-Whitney U tests. Results: None of the investigated protocols renders the root canal walls free of CH remnants. Significant differences were found between tooth regions in terms of CH removal (p<0.05, and all groups except group 6 (LAI showed more residual CH in the apical region. PUI and LAI eliminated significantly more CH than CSI from the middle and apical thirds of the root canal, respectively. Conclusion: The activation of sodium hypochlorite with various devices increased CH removal at the apical and middle part of the canal. LAI and PUI produce better results in the apical and middle thirds, respectively.

Research progress of antagonistic interactions among root canal irrigations disease

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Chen QU

2013-07-01

Full Text Available Root canal therapy is the most effective way to treat various pulposis and periapical disease. Simple mechanical apparatus can not clean root canal thoroughly, but may affect tight filling instead. It can achieve a satisfactory cleansing effect only when it is combined with a chemical solution. Irrigation fluid for root canal should possess the properties of tissue dissolution, antimicrobial, lubrication, and removal of smear layer. So far, no solution is able to fulfill all these functions. Therefore, a combined use of multiple irrigation solutions is suggested. It can not only achieve good effect in cleaning and disinfection, also it can lower the concentration of different solutions, thus reducing the side effects. Nevertheless, some experiments proved that antagonism existed among the chemicals used for irrigations. The purpose of present article is to review the antagonistic effect among the chemicals used for irrigation when they are used together for root canal treatment.

Evaluation of surface preparation and maintenance of canal curvature following instrumentation with hand 'K' file and three different Ni-Ti rotary systems: A radiographic and SEM study.

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Bhatti, Namrata; Sroa, Renu; Sikri, Vimal K

2010-04-01

To determine the shaping ability and cleaning efficiency of hand K-flexofiles, ProTaper, LightSpeed and Mtwo instruments during the preparation of curved root canals in extracted human teeth. A total of 120 root canals of mandibular and maxillary molars with curvature more than 20° were divided into four groups of 30 each. In group A, canals were prepared using hand K-flexofiles following the crown down technique. In group B LightSpeed, in group C ProTaper, and in group D Mtwo rotary instruments were used to prepare the root canals. Using pre- and post-instrumentation radiographs, straightening of the canal curvature was determined with Corel Draw 9.0 software tools. The amount of debris and smear layer were quantified at three different areas (coronal, middle, and apical thirds) of root canal using SEM. The collected data were analyzed statistically using Student's paired 't' test. The mean change in curvature for hand K-files was 7.71°, for ProTaper files 6.03°, for Mtwo 5.43°, and for LightSpeed instruments were found to be 4.57°. The percentage change in the curvature for all the four groups was statistically highly significant (PProTaper (65.48%) followed by Mtwo (66.22%), LightSpeed (71.67%) and the maximum with hand K-files (74.16%). However, the difference in mean leftover debris between ProTaper and Mtwo was not significant. ProTaper and Mtwo resulted in good cleaning, and LightSpeed maintained the original canal curvature better than the ProTaper, Mtwo, or Hand K-files.

Premolar root and canal variation in extant non-human hominoidea.

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Moore, N Collin; Hublin, Jean-Jacques; Skinner, Matthew M

2015-08-11

The premolar sub-cervical region in four non-human extant ape genera are examined to: 1) define a classification scheme for the premolar root system in order to rigorously characterize, quantify and document variation in root and canal, form, number and configuration; 2) compare this variation within and between genera; and 3) test the hypotheses that sex and size (i.e., the "size/number continuum," Shields, ) of the premolar are determinants of root/canal form and/or number. Microtomography and 3D visualization software are utilized to examine a large sample of Hylobates, Pan, Gorilla, and Pongo (n = 951 teeth). Each premolar root system is examined to ascertain the expected level of variability for each taxon. Cervical surface area (mm 2 ) serves as a metric proxy for tooth size. A Chi-square test of independence is used to assess for variability differences between and within each taxon, and Mann-Whitney U tests are employed to assess the predicted relationship between tooth size and variation within each taxon. Our findings indicate that root and canal configurations, non-metric root traits and tooth size can distinguish between extant ape genera. Within the four ape taxa, premolar size variation is generally, but not always, correlated with canal/root number. Our results indicate that males and females within genera differ in tooth size but not in canal/root form and number. We report previously undocumented variation in the study taxa. Our results are discussed within the context of Miocene Apes as well as the developmental and systematic implications. Am J Phys Anthropol, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Post endodontic pain following single-visit root canal preparation with rotary vs reciprocating instruments: a meta-analysis of randomized clinical trials.

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Hou, Xiao-Mei; Su, Zheng; Hou, Ben-Xiang

2017-05-25

In endodontic therapy, continuous rotary instrumentation reduced debris compared to reciprocal instrumentation, which might affect the incidence of post-endodontic pain (PP). The aim of our study was to assess whether PP incidence and levels were influenced by the choice of rotary or reciprocal instruments. In this meta-analysis the Pubmed and EM databases were searched for prospective clinical randomized trials published before April 20, 2016, using combinations of the keywords: root canal preparation/instrumentation/treatment/therapy; post-operative/endodontic pain; reciprocal and rotary instruments. Three studies were included, involving a total of 1,317 patients, 659 treated with reciprocating instruments and 658 treated with rotary instruments. PP was reported in 139 patients in the reciprocating group and 172 in the rotary group. The PP incidence odds ratio was 1.27 with 95% confidence interval (CI) (0.25, 6.52) favoring rotary instruments. The mild, moderate and severe PP levels odds ratios were 0.31 (0.11, 0.84), 2.24 (0.66, 7.59) and 11.71 (0.63, 218.15), respectively. No evidence of publication bias was found. Rotary instrument choice in endodontic therapy is associated with a lower incidence of PP than reciprocating instruments, while reciprocating instruments are associated with less mild PP incidence.

Management of foreign object in the root canal of central incisor tooth

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Mothanna Alrahabi

2014-01-01

Full Text Available There are several reports describing the impaction of foreign objects into the exposed pulp chambers and canals by patients, especially children as they often have the habit of inserting foreign objects in the oral cavity. These objects will become a potent source of infection.This case report describes the retrieval of a foreign object impacted into the root canal of a 12-year-old male patient who was referred to the endodontic specialty clinic at Taibah University College of Dentistry. The patient′s chief complaint was a pain in the upper left central tooth. Clinical examination revealed a complicated enamel-dentin fracture with a large caries cavity. A periapical radiographic image showed a radiopaque object in the root canal system. Stainless steel Hedstrom files were used to retrieve the object from the canal. Following a proper cleaning and shaping of the root canal system, an intra-canal calcium hydroxide dressing was placed for 1 week. The root canal system was then filled with sealer and gutta-percha using the lateral compaction technique and the tooth received an aesthetic restoration.

Chelation in root canal therapy reconsidered.

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Zehnder, Matthias; Schmidlin, Patrick; Sener, Beatrice; Waltimo, Tuomas

2005-11-01

The aim of this study was to assess interactions of EDTA and citric acid (CA) with sodium hypochlorite (NaOCl), the indispensable endodontic irrigant. Other chelators were simultaneously evaluated as possible alternatives: sodium triphosphate (STP), amino tris methylenephosphonic acid (ATMA), and 1- hydroxyethylidene-1, 1-bisphosphonate (HEBP). Available chlorine was titrated in chelator-NaOCl solutions. All chelators other than HEBP and STP caused an almost complete, immediate loss of available chlorine in solution. Atomic absorbtion spectrometry and SEM evaluation of root canal walls of instrumented teeth indicated that NaOCl had no negative effect on calcium-complexing ability of chelators. STP was too weak a complexing agent to warrant further studies. Finally, CA-, EDTA-, and HEBP-NaOCl mixtures were evaluated for their antimicrobial capacity. Again, EDTA and CA negatively interfered with NaOCl, while HEBP did not.

To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment.

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Shivanand, Sunita; Patil, Chetan R; Thangala, Venugopal; Kumar, Pabbati Ravi; Sachdeva, Jyoti; Krishna, Akash

2013-05-01

To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment. Sixty extracted premolars were retreated with following systems: Group -ProTaper Universal retreatment files, Group 2-ProFile system, Group 3-H-file. Specimens were split longitudinally and amount of remaining gutta-percha on the canal walls was assessed using direct visual scoring with the aid of stereomicroscope. Results were statistically analyzed using ANOVA test. Completely clean root canal walls were not achieved with any of the techniques investigated. However, all three systems proved to be effective for gutta-percha removal. Significant difference was found between ProTaper universal retreatment file and H-file, and also between ProFile and H-file. Under the conditions of the present study, ProTaper Universal retreatment files left significantly less guttapercha and sealer than ProFile and H-file. Rotary systems in combination with gutta-percha solvents can perform superiorly as compared to the time tested traditional hand instrumentation in root canal retreatment.

Apical Root Canal Morphology of Mesial Roots of Mandibular First Molar Teeth with Vertucci Type II Configuration by Means of Micro-Computed Tomography.

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Keleş, Ali; Keskin, Cangül

2017-03-01

The aim of this study was to assess the features of the apical root canal anatomy and its relation to the level at which 2 separate root canals merge in the mesial roots of the mandibular first molars with Vertucci type II canal configuration by using micro-computed tomography analysis. The anatomic features of the apical 3 mm of root canals in 83 mesial roots of mandibular first molar teeth were investigated by micro-computed tomography and software imaging according to the level at which 2 separate root canals merge. The most apical slice where a visible root canal was detectable was recorded as 0 level. The specimens from where 2 root canals rejoin at within 3 mm from the 0 level were then assigned to group 1 (n = 37), whereas the specimens from where root canals rejoin 3-9 mm from the 0 level were assigned to group 2 (n = 46). Data were presented by using descriptive statistics and Mann-Whitney U tests, with the significance level set at 5%. In all specimens the long oval type of cross-sectional shape increased from 50.9% at 1 mm to 80.5% at 3 mm. Group 1 presented significantly higher major diameter values compared with group 2 (P  .05) between groups. Group 2 displayed significantly higher roundness values than group 1 (P < .05). A long oval root cross section of apical root canal anatomy is more prevalent in roots for which 2 root canals merge within apical 3 mm of root canals. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Comparative analysis of efficacy and cleaning ability of hand and rotary devices for gutta-percha removal in root canal retreatment: an in vitro study.

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Reddy, Narender; Admala, Shilpa Reddy; Dinapadu, Sainath; Pasari, Srikanth; Reddy, Manoranjan P; Rao, M S Rama

2013-07-01

To evaluate the efficacy and cleaning ability of Hedstrom files, and ProTaper retreatment instruments in removing gutta-percha from root canals with and without xylene as solvent. Sixty extracted single rooted human teeth were selected and decoronated, straight access established working length determined 1 mm short of canal, chemomechanical preparation done and obturated with guttapercha and AH plus sealer. Samples were stored for 1 week in humidifier divided into four groups of 15 teeth each. • Group I: Hedstrom files without xylene. • Group II: Hedstrom files with xylene. • Group III: ProTaper retreatment instruments without xylene. • Group IV: ProTaper retreatment instruments with xylene. and the following criteria were assessed - Time taken for initial plunge of instrument into guttapercha. - Time taken for complete removal of gutta-percha to reach working length - Ability of H files and ProTaper retreatment files with/ without xylene to remove gutta-percha in coronal, middle and apical 1/3 of canal. The teeth were grooved in labiolingual cross section, observed under a steromicroscope and scored according to gutta-percha debris left in the canal. Results were evaluated using ANOVA test and multiple comparisons done using Scheffe test. The least time to reach working length was found with group IV followed by groups III, II and group I respectively. Also the fastest way to remove maximum gutta-percha was group IV followed by groups III, II, and I respectively with a statistically significant difference among all groups. Apical 1/3 has more amount of remaining gutta-percha debris than middle and coronal 1/3 in all groups. The amount of gutta-percha debris in apical 1/3 was least in group IV followed by groups III, II and I respectively. The better performance of ProTaper rotary instruments has been attributed to their special flute design which tends to pull gutta-percha coronally directing it toward orifice. Also the movements of engine driven

Comparison of the root canal debridement ability of two single file systems with a conventional multiple rotary system in long oval-shaped root canals: In vitro study.

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Khoshbin, Elham; Shokri, Abbas; Donyavi, Zakieh; Shahriari, Shahriar; Salehimehr, Golsa; Farhadian, Maryam; Kavandi, Zeinab

2017-08-01

This study sought to compare the root canal debridement ability of Neolix, Reciproc and ProTaper rotary systems in long oval-shaped root canals. Eighty five extracted single-rooted human teeth with long oval-shaped single root canals were selected and divided into three experimental groups(n=25) and one control group (n= 10). Root canals were filled with Vitapex radiopaque contrast medium and prepared with Neolix, Reciproc or ProTaper systems. The control group only received irrigation. Digital radiographs were obtained at baseline and postoperatively and subjected to digital subtraction. The percentage of reduction in contrast medium was quantified at 0-5 mm and 5-10 mm distances from the apex. The data were analyzed using one-way ANOVA and t-test. The mean percentage of the contrast medium removed was not significantly different in the 0-5mm segment among the three groups ( P =0.6). In the 5-10mm segment a significant difference was found in this regard among the ProTaper and Reciproc groups ( P =0.02) and the highest mean percentage of contrast medium was removed by ProTaper. But, difference between ProTaper and Neolix as well as Neolix and Reciproc was not significant. In Neolix ( P =0.024) and Reciproc ( P =0.002) systems, the mean percentage of the contrast medium removed from the 0-5mm segment was significantly greater than that in 5-10mm segment; however, this difference was not significant in ProTaper group ( P =0.069). Neolix single-file system may be a suitable alternative to ProTaper multiple-file system in debridement of long oval shaped canals. Key words: Root Canal Preparation, Debridement, Root Canal Therapy.

Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a meta-analysis.

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Ribeiro, D M; Réus, J C; Felippe, W T; Pacheco-Pereira, C; Dutra, K L; Santos, J N; Porporatti, A L; De Luca Canto, G

2018-03-01

The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic review was to answer the following focused questions: (i) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? (ii) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data were collected based on predetermined criteria. The key features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality, and a meta-analysis on all studies was conducted. At the end of the screening, 24 articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior teeth, 49% to premolars and 26% to molars. The main procedural errors reported were ledge formation, furcation perforation, apical transportation and apical perforation. The heterogeneity amongst the studies was high (84-99%). Five studies had a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

A comparison of instrumentation using Naviflex and Profile nickel-titanium engine-driven rotary instruments.

Science.gov (United States)

Ottosen, S R; Nicholls, J I; Steiner, J C

1999-06-01

This study was designed to compare the changes in canal configuration resulting from instrumentation by either Profile or Naviflex instruments. Forty mesial canals in extracted human molar teeth were embedded and sectioned at two root levels. Reassembled teeth were instrumented with a modified crown-down technique as described in the Profile training video for Profile files and in a similar manner for Naviflex instruments. Superimposed pre- and postinstrumented cross-sectional root images were projected, traced, and scanned into a computer for analysis. Canal movement, in relation to the furca, and canal area change were recorded. The results showed no significant difference in canal center movement or canal area change between the Profile or Naviflex groups. The degree of canal curvature had no effect on canal center movement or canal area change.

Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

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Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena

2016-01-01

Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

Comparison of antimicrobial activity of traditional and new developed root sealers against pathogens related root canal

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Joo-Hee Shin

2018-03-01

Full Text Available Background/purpose: Bacterial infection is closely associated with the failure of endodontic treatment, and use of endodontic sealer with antimicrobial activity and biological compatibility is necessary for the success of root canal treatment. The purpose of this study was to investigate and to compare the antibacterial effect of two calcium silicate-based root canal sealers (Endoseal and EndoSequence BC sealer as recent development sealers and with three conventional root canal sealers (AH Plus, Sealapex, and Tubli-Seal, before or after setting, on Porphyromonas endodontalis, Porphyromonas gingivalis, and Enterococcus faecalis. Materials and methods: The sealers were soaked in phosphate buffered saline to elute its compositions after and before setting, and the elutes were performed the antimicrobial assay. Also, X-ray fluorescence analysis was carried out to compare compositions of two calcium silicate-based sealers. Results: The conventional root canal sealers have strong antibacterial activity against the Gram-negative bacteria, P. endodontalis and P. gingivalis. Endoseal sealer showed antibacterial activity against not only the Gram-negative bacteria, but also against the Gram-positive bacteria, E. faecalis. However, Endosequence BC sealer exhibited a weak antibacterial effect on all bacteria in this study. X-ray fluorescence analysis exhibited that Endoseal contained more types and more amount of the oxide compound known to have strong antimicrobial activity such as Al2O3, Fe2O3, MgO, Na2O, NiO, and SO2 than Endoseqeunce BC. Conclusion: Endoseal, which contains various types of oxide compounds, seems to be a suitable sealer for preventing bacterial infection in both treated and untreated root canals. Keywords: Root canal sealer, Antimicrobial activity, Oxide compound, E. faecalis

Efficiency of the Self Adjusting File, WaveOne, Reciproc, ProTaper and hand files in root canal debridement.

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Topcu, K Meltem; Karatas, Ertugrul; Ozsu, Damla; Ersoy, Ibrahim

2014-07-01

The aim of this study was to compare the canal debridement capabilities of three single file systems, ProTaper, and K-files in oval-shaped canals. Seventy-five extracted human mandibular central incisors with oval-shaped root canals were selected. A radiopaque contrast medium (Metapex; Meta Biomed Co. Ltd., Chungcheongbuk-do, Korea) was introduced into the canal systems and the self-adjusting file (SAF), WaveOne, Reciproc, ProTaper, and K-files were used for the instrumentation of the canals. The percentage of removed contrast medium was calculated using pre- and post-operative radiographs. An overall comparison between the groups revealed that the hand file (HF) and SAF groups presented the lowest percentage of removed contrast medium, whereas the WaveOne group showed the highest percentage (P ProTaper group removed more contrast medium than the SAF and HF groups (P < 0.05). None of the instruments was able to remove the contrast medium completely. WaveOne performed significantly better than other groups.

Dynamic Torque and Vertical Force Analysis during Nickel-titanium Rotary Root Canal Preparation with Different Modes of Reciprocal Rotation.

Science.gov (United States)

Tokita, Daisuke; Ebihara, Arata; Nishijo, Miki; Miyara, Kana; Okiji, Takashi

2017-10-01

The purpose of the present study was to compare 2 modes of reciprocal movement (torque-sensitive and time-dependent reciprocal rotation) with continuous rotation in terms of torque and apical force generation during nickel-titanium rotary root canal instrumentation. A custom-made automated root canal instrumentation and torque/force analyzing device was used to prepare simulated canals in resin blocks and monitor the torque and apical force generated in the blocks during preparation. Experimental groups (n = 7, each) consisted of (1) torque-sensitive reciprocal rotation with torque-sensitive vertical movement (group TqR), (2) time-dependent reciprocal rotation with time-dependent vertical movement (group TmR), and (3) continuous rotation with time-dependent vertical movement (group CR). The canals were instrumented with TF Adaptive SM1 and SM2 rotary files (SybronEndo, Orange, CA), and the torque and apical force were measured during instrumentation with SM2. The mean and maximum torque and apical force values were statistically analyzed using 1-way analysis of variance and the Tukey test (α = 0.05). The recordings showed intermittent increases of upward apical force and clockwise torque, indicating the generation and release of screw-in forces. The maximum upward apical force values in group TmR were significantly smaller than those in group CR (P forces when compared with continuous rotation. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Ex vivo analysis of root canal cleaning using Endo-PTC associated to NaOCl and different irrigant solutions

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Andrea Kanako Yamazaki

2010-03-01

Full Text Available The aim of this study was to assess qualitatively, by means of SEM images, the cleaning of the dentin walls of root canals after chemical-surgical preparation using Endo-PTC cream with 0.5% and 1% sodium hypochlorite and different final irrigating solutions. Seventy-two single-rooted human teeth were divided into eight groups and prepared using Endo-PTC cream with sodium hypochlorite (NaOCl at different concentrations, and irrigated with NaOCl at different concentrations. Final irrigation was performed with either EDTA-T or EDTA-C. The best results were obtained with Group 1, followed by Groups 5, 2, 7, 8, 3, 6 and 4. We can conclude that the use of 0.5% NaOCl during instrumentation and final flush of the root canals was more efficient in cleaning than was 1% sodium hypochlorite. EDTA-T was more efficient in removing smear layer than EDTA-C, and the cervical third presented better cleaning of the root canal walls than did the middle third, which showed cleaner dentin walls than the apical third.

Evaluation of Root and Canal Morphology of Mandibular First Molars: A Clearing Method in an Iranian Population

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Shirkavand

2016-07-01

Full Text Available Background Successful endodontic treatment is dependent on the knowledge of root canal anatomy. Objectives This study aims to investigate the root canal anatomy of mandibular first molars in an Iranian population. Materials and Methods One hundred human mandibular first molars were collected and stored in 5.25% NaOCl. Radiographic images of the teeth were taken in mesial, distal, and buccal aspects using digital radiography. The root numbers were recorded, and the teeth were covered with lacquer. Access cavities were prepared, pulp tissue was dissolved, the apex was covered with liquid glue, and the root canals were injected with methylene blue. Decalcification of the teeth meant they were kept in 10% nitric acid, and final dehydration meant they were kept in 100% Isopropyl alcohol for 72 hours and rendered clear by immersion in methyl salicylate. The number of root canals per tooth, the number of canals per root, and canal configuration in each tooth were recorded. Results Ninety-nine of the 100 teeth had two roots and the other had three roots. The teeth were classified based on the number of canals; there were 2% with two canals, 59% with three canals, and 39% with four canals. Based on the Vertucci classification, the most prevalent canal configurations in the mesial root were types II and IV, and type I in the distal root. Conclusions The most common root morphology is the two rooted morphology with three canals. Both the mesial and distal roots show wide variations in canal anatomy with type IV and type I canal configuration predominating in the mesial and distal roots, respectively. Iranian mandibular first molar teeth exhibit features close to the average Caucasian, Jordanian, and Kuwaiti’s root and canal morphology.

Mineral content analysis of root canal dentin using laser-induced breakdown spectroscopy

Science.gov (United States)

2018-01-01

Objectives This study aimed to introduce the use of laser-induced breakdown spectroscopy (LIBS) for evaluation of the mineral content of root canal dentin, and to assess whether a correlation exists between LIBS and scanning electron microscopy/energy dispersive spectroscopy (SEM/EDS) methods by comparing the effects of irrigation solutions on the mineral content change of root canal dentin. Materials and Methods Forty teeth with a single root canal were decoronated and longitudinally sectioned to expose the canals. The root halves were divided into 4 groups (n = 10) according to the solution applied: group NaOCl, 5.25% sodium hypochlorite (NaOCl) for 1 hour; group EDTA, 17% ethylenediaminetetraacetic acid (EDTA) for 2 minutes; group NaOCl+EDTA, 5.25% NaOCl for 1 hour and 17% EDTA for 2 minutes; a control group. Each root half belonging to the same root was evaluated for mineral content with either LIBS or SEM/EDS methods. The data were analyzed statistically. Results In groups NaOCl and NaOCl+EDTA, the calcium (Ca)/phosphorus (P) ratio decreased while the sodium (Na) level increased compared with the other groups (p LIBS and SEM/EDS analyses (r = 0.84, p LIBS method proved to be reliable while providing data for the elemental composition of root canal dentin. PMID:29487841

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Khan, I.; Shan, T.; Manzoor, M.A.

2015-01-01

To compare the frequency of E. faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure in the same patient. Study Design: Cross-sectional comparative study. Place and Duration of Study: Samples were collected from Operative Dentistry Department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Study duration was one year. Patients and Methods: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-37 degree C for 48 hrs. E. faecalis colonies were identified by colony morphology, gramstain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E. faecalis in saliva was 34% and in root canal it was 58%. Frequency between the presence of E. faecalis in root canals and saliva was found to be statistically different (p = 0.001). Conclusion: The presence of E. faecalis in root canal was not associated with their presence in saliva. (author)

Frequency of enterococcus faecalis in saliva and root canals with treatment failure

International Nuclear Information System (INIS)

Shan, T.; Manzoor, M.A.; Hussain, W.

2014-01-01

To compare the frequency of E.faecalis in the saliva and root canals of teeth associated with apical periodontitis due to endodontic treatment failure Study. Design: Cross-sectional comparative. Place and Duration of Study: Samples were collected from Operative Dentistry department, AFID, while laboratory processing was done at AFIP, Rawalpindi. Duration of this study was one year. Patients and Method: Fifty patients, both males and females with failed endodontic treatment were selected. Saliva and root canal samples were collected from each patient, inoculated on MacKonkey agar plate and incubated at 35-370 C for 48 hours. E.faecalis colonies were identified by colony morphology, Gram stain, catalase, bile asculin test, arabinose fermentation and growth in 6% NaCl nutrient broth. Results: The frequency of E.faecalis in saliva was 34% and 58% in root canal samples. Frequency of the presence of E.faecalis in root canals and saliva was found to be statistically different (p=0.000). Conclusion: The presence of E.faecalis in root canal was not associated with their presence in saliva. (author)

The cleanliness differences of root canal walls after irrigated with East Java propolis extract and sodium hypoclorite solutions

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Tamara Yuanita

2017-03-01

(n=10. The specimens were prepared with ProTaper. During instrumentation, the root canals were irrigated with different solutions: Control Group irrigated with aquadest; Group 1 irrigated with 8% East Java propolis extract; Group 2 irrigated with 2.5% NaOCl and Group 3 irrigated with 5% NaOCl. The root canals were cut at apical third and SEM scores were tested by using Mann-Whitney test at the significance level of p=0.05 and Median Control test. Result: The results of Mann-Whitney Test, there were significant differences between control group with Group 1, 2 and 3 (p<0.05. Based on the Median Control test, the value of 8% East Java propolis extracts was 1,000, which was the best value compared to 2.5% NaOCl, 5% NaOCl and aquadest. Conclusion: It can be concluded that 8% East Java propolis extract is the most effective solution for cleaning root canal walls compared with 2.5% NaOCl and 5% NaOCl.

Effectiveness of EDTA as the irrigation solution to remove smear layer in root canal

OpenAIRE

Kurniasri Amas Achiar; Endang Sukartini

2009-01-01

One of the objectives of successful endodontic treatment is the hermetic obturation of the root canal system. To achieve this, the root canal filling must seal the canal space both apically and coronally to prevent the ingress of microorganisms or tissue fluids into the canal space. Apical leakage is reported a common reason for the clinical failure of endodontic therapy. Leakage through an obturated root canal is expected to take place at interfaces between sealer and dentin or sealer and gu...

[Bond strengths of absorbable polylactic acid root canal post with three different adhesives].

Science.gov (United States)

Pan, Hui; Cheng, Can; Hu, Jia; Liu, He; Sun, Zhi-hui

2015-12-18

To find absorbable adhesives with suitable bonding properties for the absorbable polylactic acid root canal post. To test and compare the bond strengths of absorbable polylactic acid root canal post with three different adhesives. The absorbable polylactic acid root canal posts were used to restore the extracted teeth, using 3 different adhesives: cyanoacrylates, fibrin sealant and glass ionomer cement. The teeth were prepared into slices for micro-push-out test. The bond strength was statistically analyzed using ANOVA. The specimens were examined using microscope and the failure mode was divided into four categories: cohesive failure between absorbable polylactic acid root canal posts and adhesives, cohesive failure between dentin and adhesives, failure within the adhesives and failure within the absorbable polylactic acid root canal posts. The bond strength of cyanoacrylates [(16.83 ± 6.97) MPa] and glass ionomer cement [(12.10 ± 5.09) MPa] were significantly higher than fibrin sealant [(1.17 ± 0.50) MPa], Padhesives was 25.0%, the cohesive failure between the dentin and the adhesives was 16.7%, the failure within the adhesives was 33.3%, and the failure within the absorbable polylactic acid root canal posts was 25.0%. In the group of fibrin sealant, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 66.7%, the cohesive failure between the dentin and the adhesives was 22.2%, the failure within the adhesives was 11.1%. In the group of glass ionomer cement, the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives was 87.5%, the failure within the adhesives was 12.5%. The major failure mode in fibrin sealant and glass ionomer cement was the cohesive failure between the absorbable polylactic acid root canal posts and the adhesives. No major failure modes were found in the group of cyanoacrylates. The bond strength of fibrin sealant is low, which cannot meet the requirement of

The cleanliness differences of root canal irrigated with 0.002% saponin of mangosteen peel extract and 2.5% NaOCl

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Anis Sakinah

2015-06-01

Full Text Available Background: Root canal treatment consists of preparation, sterilization, and obturation. During root canal preparation, debris is smeared over the dentinal surface forming a smear layer. Smear layer will reduce the attachment of root canal filling materials. Organic material in smear layer can be substrated for microorganism. Preparation of root canal should be followed by irrigation. NaOCl is common irrigation solution in endodontics. It has been very effective for their disinfecting and tissue-dissolving properties, but it is incapable of removing the smear layer. On the other hand, saponin of mangosteen peel extract has an ability as a surfactant to lower the surface tension, and it can dissolve debris containing of anorganic and organic materials. Purpose: This study aims to know the differences between 2.5% NaOCl and 0.002% saponin of mangosteen peel extract in removing the debris in the root canal after the preparation procedure. Method: Three groups of teeth (7 teeth in each were instrumented with K-file and irrigated as follow: group 1 (control with aquadest; group 2 with 2.5% NaOCl; and group 3 with 0.002% saponin of mangosteen peel extract. Furthermore, those teeth were split horizontally and longitudinally 4mm above the apical. The apical third of root canal walls was observed by a scanning electron microscope (SEM. Result: There were significant differences between each group (p<0.05. Median value of the group 3 was score 1 considered as the smallest value. It indicates that Group 3 with 0.002% saponin of mangosteen peel extract was the cleanest group. Conclusion:It can be concluded that 0.002% saponin of mangosteen peel extract can clean the smear layer of the root canal better than 2.5% NaOCl.

Role of the confinement of a root canal on jet impingement during endodontic irrigation

NARCIS (Netherlands)

Verhaagen, B.; Boutsioukis, C.; Heijnen, G. L.; van der Sluis, L. W. M.; Versluis, M.

2012-01-01

During a root canal treatment the root canal is irrigated with an antimicrobial fluid, commonly performed with a needle and a syringe. Irrigation of a root canal with two different types of needles can be modeled as an impinging axisymmetric or non-axisymmetric jet. These jets are investigated

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

OpenAIRE

Maryam Kuzekanani; Jahangir Haghani; Hossein Nosrati

2012-01-01

Background and aims A through knowledge of the root canal morphology is required for successful endodontic ther-apy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a prov-ince in southeast of Iran. Materials and methods One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing tech-ni...

Canal preparation with nickel-titanium or stainless steel instruments without the risk of instrument fracture: preliminary observations

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Ghassan Yared

2015-02-01

Full Text Available This report introduces a novel technique that allows a safe and predictable canal negotiation, creation of a glide path and canal preparation with reciprocating nickel-titanium or stainless steel engine-driven instruments in canals where the use of rotary and the newly developed reciprocating instruments is contraindicated. In this novel technique, the instruments are used in reciprocating motion with very small angles. Hand files are not used regardless of the complexity of the canal anatomy. It also allows achieving predictable results in canal negotiation and glide path creation in challenging canals without the risk of instrument fracture.

Root Canal Configuration of Maxillary First Permanent Molars in an Iranian Population

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Saeed Rahimi

2007-06-01

Full Text Available

Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The purpose of this study was to investigate variations in the root canal system of maxillary first permanent molars in an Iranian population.

Materials and methods. In this study, 137 maxillary first molars were decalcified, dye-injected, cleared and studied.

Results. The results demonstrated that 37.96% of the maxillary first molars under study had three canals, 58.4% had four canals and 3.64% had five canals.

Conclusion. According to the results of this study and considering variations in the root canal systems of maxillary first molars, it seems that great care should be taken in the root canal treatment of these teeth.

Shaping ability of several nickel–titanium systems in double-curved simulated canals

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Mothanna Alrahabi

2017-06-01

Conclusion: The iRaCe, ProTaper Next, Wave One, and TF systems preserved the original shape of the double-curved (S-shaped canal with minimum root canal transportation. These systems produced satisfactory root canal instrumentation in S-shaped canals.

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

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Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de, E-mail: sousanet@forp.usp.br [Universidade de São Paulo (USP), Ribeirao Preto, SP (Brazil). Departamento de Odontologia Restauradora; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi [Universidade de Ribeirão Preto (UNAERP), Ribeirão Preto, SP (Brazil). Departmento de Endodontia

2017-09-15

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm{sup 3}, 58.51 mm{sup 2}, and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

International Nuclear Information System (INIS)

Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi

2017-01-01

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm 3 , 58.51 mm 2 , and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

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Evaldo Rodrigues

2017-02-01

Full Text Available Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3, two distobuccal (DB1 and DB2, and two palatal (P1 and P2. Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

Apical extrusion of debris in primary molar root canals using mechanical and manual systems.

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Buldur, B; Hascizmeci, C; Aksoy, S; Nur Aydin, M; Guvendi, O N

2018-03-01

Apical extrusion of debris in primary root canal treatment has not been well elucidated. The purpose of this study is to compare the amount of apically extruded debris during the preparation of primary molar root canals using ProTaper, ProTaper Next, Self-adjusting File (SAF) and hand files. One hundred sixty extracted primary mandibular molar teeth were assigned to 2 groups: Group 1: Resorbed (n=80) and Group 2: Non-resorbed (n=80) and randomly to four subgroups (n=20 teeth for each subgroup) according to the instruments used, ProTaper, ProTaper Next, SAF, and hand file. The apically extruded debris was collected and dried in preweighed Eppendof tubes. The dry weight was calculated by subtracting the preoperative weight from the postoperative weight. Data were analysed statistically using the ANOVA and the Bonferroni post hoc t-test. The amount of apically extruded debris was significantly less for the non-resorbed group compared to the resorbed group (PProTaper Next and SAF extruded significantly less debris than did the ProTaper and hand files (PProTaper Next and SAF (P>0.05). All instruments caused apically extruded debris in primary teeth.

Application of microcomputed tomography for quantitative analysis of dental root canal obturations

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Anna Kierklo

2014-03-01

Full Text Available Introduction: The aim of the study was to apply microcomputed tomography to quantitative evaluation of voids and to test any specific location of voids in tooth’s root canal obturations. Materials and Methods: Twenty root canals were prepared and obturated with gutta-percha and Tubli-Seal sealer using the thermoplastic compaction method (System B + Obtura II. Roots were scanned and three-dimensional visualization was obtained. The volume and Feret’s diameter of I-voids (at the filling/dentine interface and S-voids (surrounded by filling material were measured.Results: The results revealed that none of the scanned root canal fillings were void-free. For I-voids, the volume fraction was significantly larger, but their number was lower (P = 0.0007, than for S-voids. Both types of voids occurred in characteristic regions (P < 0.001. I-voids occurred mainly in the apical third, while S-voids in the coronal third of the canal filling.Conclusions: Within the limitations of this study, our results indicate that microtomography, with proposed semi-automatic algorithm, is a useful tools for three-dimensional quantitative evaluation of dental root canal fillings. In canals filled with thermoplastic gutta-percha and Tubli-Seal, voids at the interface between the filling and canal dentine deserve special attention due to of their periapical location, which might promote apical microleakage. Further studies might help to elucidate the clinical relevance of these results.

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Özok, A.R.; van der Sluis, L.W.M.; Wu, M.K.; Wesselink, P.R.

2008-01-01

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Ozok, Ahmet R.; van der Sluis, Lucas W. M.; Wu, Min-Kai; Wesselink, Paul R.

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

Type III apical transportation of root canal

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Shiv P Mantri

2012-01-01

Full Text Available Procedural accidents leading to complications such as canal transportation have been ascribed to inapt cleaning and shaping concepts. Canal transportation is an undesirable deviation from the natural canal path. Herewith a case of apical transportation of root canal resulting in endodontic retreatment failure and its management is presented. A healthy 21-year-old young male presented discomfort and swelling associated with painful endodontically retreated maxillary incisor. Radiograph revealed periradicular radiolucency involving underfilled 11 and overfilled 12. Insufficiently obturated 11 exhibited apical transportation of canal. This type III transportation was treated by periradicular surgery and repair using white mineral trioxide aggregate (MTA. Comfortable asymptomatic patient presented uneventful healing at third and fourth month recall visits. A decrease in the size of radiolucency in radiograph supported the clinical finding. In the present case, MTA is useful in repairing the transportation defect. The result of these procedures is predictable and successful.

Effectiveness of four different final irrigation activation techniques on smear layer removal in curved root canals : a scanning electron microscopy study.

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Puneet Ahuja

2014-02-01

Full Text Available The aim of this study was to assess the efficacy of apical negative pressure (ANP, manual dynamic agitation (MDA, passive ultrasonic irrigation (PUI and needle irrigation (NI as final irrigation activation techniques for smear layer removal in curved root canals.Mesiobuccal root canals of 80 freshly extracted maxillary first molars with curvatures ranging between 25° and 35° were used. A glide path with #08-15 K files was established before cleaning and shaping with Mtwo rotary instruments (VDW, Munich, Germany up to size 35/0.04 taper. During instrumentation, 1 ml of 2.5% NaOCl was used at each change of file. Samples were divided into 4 equal groups (n=20 according to the final irrigation activation technique: group 1, apical negative pressure (ANP (EndoVac; group 2, manual dynamic agitation (MDA; group 3, passive ultrasonic irrigation (PUI; and group 4, needle irrigation (NI. Root canals were split longitudinally and subjected to scanning electron microscopy. The presence of smear layer at coronal, middle and apical levels was evaluated by superimposing 300-μm square grid over the obtained photomicrographs using a four-score scale with X1,000 magnification.Amongst all the groups tested, ANP showed the overall best smear layer removal efficacy (p < 0.05. Removal of smear layer was least effective with the NI technique.ANP (EndoVac system can be used as the final irrigation activation technique for effective smear layer removal in curved root canals.

Retreatment of a mandibular second premolar with two canals in two roots

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Chiara Fossati

2018-06-01

Full Text Available Aim: To present a case of retreatment in mandibular second premolar with two canals in two roots. Summary: Locating, cleaning and shaping the entire root canal system may represent a difficult challenge particularly in mandibular premolars, because of their complex canal systems.For this reason mandibular premolars are often considered the most difficult of all teeth on which to perform successful endodontic treatment. Vertucci stated that the second premolar has one root canal at the apex in 97.5% of the teeth studied and two canals in only 2.5%.1 The following case report describes the diagnosis and retreatment of a second premolar with two canal in two roots.Key learning points: (1 The major cause of failure in root canal therapy is the inability to localize and treat all of the canals of the root canal system. (2 Mandibular premolars have complex canal systems. (3 Mandibular premolars have a high risk of missed anatomy. (4 Preoperative radiograph interpretation is essential to evaluate and detect uncommon anatomies. (5 The operating microscope and CBCT interpretation are fundamental in confirming and preventing mistakes about the configuration of mandibular premolars. Riassunto: Obiettivi: Presentare un caso clinico di ritrattamento canalare di un secondo premolare mandibolare con due canali e due radici. Riassunto: Individuare, sagomare, detergere l’intero sistema radicolare presenta una sfida difficile in ambito endodontico e in particolar modo nei premolari mandibolari per il loro complesso sistema canalare. I premolari mandibolari sono spesso considerati i denti più difficili in cui effettuare una terapia endodontica.Vertucci riscontrò che i secondi premolari mandibolari hanno una radice e un canale nel 97.5% e due canali in solo il 2.5%.1Il case report seguente descrive la diagnosi e il ritrattamento di un secondo premolare con due canali in due radici.Punti chiave di apprendimento: 1. La maggior causa di fallimento endodontico �

Effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin

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Flávia Emi Razera BALDASSO

2017-05-01

Full Text Available Abstract This study aimed to evaluate the effect of final irrigation protocols on microhardness reduction and erosion of root canal dentin. Sixty root canals from mandibular incisors were instrumented and randomly divided into six groups (n = 10 according to the irrigant used: QMiX, 17% EDTA, 10% citric acid (CA, 1% peracetic acid (PA, 2.5% NaOCl (solution control, and distilled water (negative control. The chelating solutions were used to irrigate the canal followed by 2.5% NaOCl as a final flush. After the irrigation protocols, all specimens were rinsed with 10 mL of distilled water to remove any residue of the chemical solutions. Before and after the final irrigation protocols, dentin microhardness was measured with a Knoop indenter. Three indentations were made at 100 µm and 500 µm from the root canal lumen. Afterwards, the specimens were prepared for scanning electron microscopic analysis and the amount of dentin erosion was examined. Wilcoxon and Kruskal-Wallis tests were used to analyze the results with a significance level set at 5%. At 100 µm, all protocols significantly reduced dentin microhardness (p < .05, while at 500 µm, this effect was detected only in the EDTA and QMiX groups (p < .05. CA was the irrigant that caused more extensive erosion in dentinal tubules, followed by PA and EDTA. QMiX opened dentinal tubules, but did not cause dentin erosion. Results suggest that QMiX and 17% EDTA reduced dentin microhardness at a greater depth. Additionally, QMiX did not cause dentin erosion.

Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

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Bonny Paul

2014-01-01

Full Text Available Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth.

Science.gov (United States)

Bodanezi, Augusto; Munhoz, Etiene Andrade; Capelozza, Ana Lúcia Álvares; Bernardineli, Norberti; Moraes, Ivaldo Gomes de; Garcia, Roberto Brandão; Bramante, Clovis Monteiro

2012-01-01

This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05). Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings. The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

Comparative evaluation of cyclic fatigue resistance of D-RaCe and ProTaper retreatment instruments in curved artificial canals.

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Topçuoğlu, H S; Topçuoğlu, G; Aktı, A

2016-06-01

To compare the cyclic fatigue resistance of D-RaCe and ProTaper rotary nickel-titanium (NiTi) retreatment files when used in curved artificial canals. A total of 120 new D-RaCe DR2 and ProTaper D3 retreatment files were tested in stainless steel artificial canals having 45° and 60° angles of curvature. Thirty instruments of each of the file systems were tested in both angles of curvature (n = 30). The retreatment instruments were rotated until fracture to calculate the number of cycles to failure. The length of each fractured fragment was recorded. Data were analysed by independent sample t-test. Fractured surfaces of the instruments were analysed by scanning electron microscopy. In the canal with 45° angle of curvature, no significant difference was observed between the retreatment systems (P > 0.05); on the other hand, in the canal with 60° angle of curvature, D-RaCe DR2 instruments had greater cyclic fatigue resistance than ProTaper D3 (P  0.05). The fracture surfaces of the instruments had morphologic characteristics of ductile fracture. D-RaCe DR2 instrument exhibited greater cyclic fatigue resistance than ProTaper D3 only in root canals with 60° angle of curvature. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Highly concentrated EDTA gel improves cleaning efficiency of root canal preparation in vitro.

Science.gov (United States)

Putzer, P; Hoy, L; Günay, H

2008-12-01

Debris and smear layer, as a product of mechanical root canal instrumentation, reduce the effectiveness of pharmacological substances to prevent post-treatment diseases and impair direct contact of filling materials with a clean dentinal surface. The aim of this in vitro study was to investigate the presence and localization of debris and smear layer via scanning electron microscope analysis after standardized root canal preparation with different chelating agents. Dentin surfaces received treatment with: (1) 15% ethylenediaminetetraacetic acid (EDTA), (2) 18.6% EDTA (3) and 24% EDTA or without any demineralizing chemicals as control. Forty vertically split human premolars were sputtered and divided into coronal, middle, and apical sections, followed by a randomized, blinded score evaluation using five scores. Pairwise comparisons of all treatment groups against a control group have been performed by Mann-Whitney U test and the Kruskal-Wallis test. Debris grades showed no significant difference between the three regions of the root canals, except for 18.6% EDTA in the central third. Smear layer and smear plug removal was concentration-dependent. Removal of the smear layer in the three areas showed that there was a statistically significant difference between all parts when using 18.6% and 24% EDTA concentrations compared with the control. The best smear layer removal in the apical region was observed using a 24% EDTA gel as chelating agent and lubricant. The usage of EDTA gel >/=18.6% presented a better cleaning regime when compared to the control group.