Comparison of the Cleaning Efficacy of Self-Adjusting File and Rotary Systems in the Apical Third of Oval-shaped Canals (original) (raw)
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The Self-Adjusting File Optimizes Debridement Quality in Oval-shaped Root Canals
Journal of Endodontics, 2011
Introduction: Oval-shaped canals represent a challenge for rotary nickel-titanium (NiTi) files because buccal and/ or lingual recesses are commonly left uninstrumented. The aim of the present study was to evaluate the debridement quality of the Self-Adjusting File (SAF) system in oval canals and compare it with the debridement achieved by a commonly used NiTi rotary system. Methods: A careful specimen selection resulted in two equal groups each consisting of 12 extracted mandibular canines with oval canals that had vital pulps before extraction. All canals had a buccolingual diameter that was at least 2.5 times larger than that of the mesiodistal one as defined from radiographs. One group was subjected to the SAF protocol, whereas the other group underwent conventional protocol; the ProTaper system up to the F2 instrument was used with syringe and open end needle irrigation. Sodium hypochlorite (5.25%) was used as an irrigant for both groups. The roots were then histologically processed and 0.6-mmthick cross-sections were obtained every 0.5 mm from the 1-to 5-mm apical levels. Morphometric evaluation was performed on cross-sections to determine the amount of remaining pulp tissue as a percent of the root canal area. Results: The group-by-location interaction was not significant (P > .05), which means that the group comparisons were not dependent on the crosssectional level. There was significantly greater residual pulp tissue left after ProTaper system instrumentation versus SAF instrumentation (21.4% vs 9.3%, P < .05). Conclusions: The SAF protocol was significantly more efficient for debridement of oval root canals than the rotary ProTaper protocol. (J Endod 2011;37:701-705)
Brazilian Dental Journal, 2009
The aim of this study was to evaluate the cleaning capacity of Profile .04 files combined with different irrigating solutions in flattened root canals using histological, morphometrical and SEM analyses. Eighty human mandibular incisors were prepared with Profile .04 instruments and randomly divided into 4 groups according to the irrigating solutions used (n=20): G1: distilled water (control); G2: 1% sodium hypochlorite (NaOCl); G3: 1% NaOCl alternated with 17% EDTA, and G4: 1% NaOCl with RCPrep cream. Ten teeth of each group were evaluated with an optical microscope to determine the percentage of root canal debris. The remaining teeth were evaluated under scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test (α=0.01).There was a significant difference (p<0.001) among the groups regarding the percentage of debris left in the canals (distilled water: 18.82 ± 5.55; 1% NaOCl: 6.29 ± 5.55; 1% NaOCl + 17% EDTA: 12.47 ± 6.92; 1% NaOCl + RCPr...
Dental Research Journal, 2016
Background: The purpose of this study was to evaluate the canal cleaning ability of three novel endodontic rotary instruments and compare with ProTaper files as a control in apical third of root canals under scanning electron microscopy (SEM). Materials and Methods: Eighty freshly extracted mandibular premolars were selected according to inclusion criteria. Buccal cusp tips were ground to ensure having a flat coronal reference point with a total tooth length of 16 mm for all samples. Teeth were divided equally into four groups: Group I (ProTaper group), Group II (ProTaper next group), Group III (variable taper group), and Group IV (self-adjusting file [SAF] group). Using SEM, the dentinal surfaces were observed and rated at apical thirds with a magnification of ×1000 for the presence/absence of smear layer and debris. Descriptive analysis was performed, and analysis of variance with Bonferroni post hoc test was carried out for comparison between the groups, at a significance level of 0.05. Results: There was statistically significant difference between Group II and Group IV for debris (P = 0.047) and smear layer (P = 0.037). Conclusion: In apical third of root canal, SAF showed statistically significant canal cleaning ability due to combined effect of continuous streaming irrigation with effectively replacing the irrigant from the apical portion of the root canal, irrigants activation through the creation of turbulence, and its self-adapting design to root canal anatomy with a scrubbing motion on the canal walls.
Journal of Endodontics, 2014
We compared the effects of 6 different rotary systems on transportation, canal curvature, centering ratio, surface area, and volumetric changes of curved mesial root canals of mandibular molar via cone-beam computed tomographic (CBCT) imaging. Methods: Mesiobuccal root canals of 120 mandibular first molars with an angle of curvature ranging from 20 -40 were divided into 6 groups of 20 canals. Based on CBCT images taken before instrumentation, the groups were balanced with respect to the angle and radius of canal curvature. Root canals were shaped with the following systems with an apical size of 25: OneShape (OS) (MicroMega, Besancon, France), ProTaper Universal (PU) F2 (Dentsply Maillefer, Ballaigues, Switzerland), Pro-Taper Next X2 (Dentsply Maillefer), Reciproc (R) R25 (VDW, Munich, Germany), Twisted File Adaptive (TFA) SM2 (SybronEndo, Orange, CA), and WaveOne primary (Dentsply Tulsa Dental Specialties, Tulsa, OK). After root canal preparation, changes were assessed with CBCT imaging. The significance level was set at P = .05. Results: The R system removed a significantly higher amount of dentin than the OS, PU, and TFA systems (P < .05). There was no significant difference among the 6 groups in transportation, canal curvature, changes of surface area, and centering ratio after instrumentation. Conclusions: The 6 different file systems straightened root canal curvature similarly and produced similar canal transportation in the preparation of mesial canals of mandibular molars. R instrumentation exhibited superior performance compared with the OS, TFA, and PU systems with respect to volumetric change. (J Endod 2013;-:1-5)
2013
Objective: To assess the cleaning efficacy of the Mtwo rotary system, hand instrumentation and their combination in oval-shaped root canals. Methods: Thirty human mandibular incisors were divided into three groups (G): GMtwo – basic series (10.04, 15.05, 20.06, 25.6) and instruments 30.05, 35.04, 40.04 from complementary series; GMtwo + Hand – basic series of Mtwo followed by sizes 30 to 40 hand instruments; GHand – classic technique with sizes 15 to 40 hand instruments. Teeth were longitudinally sectioned and then the buccal and lingual root canal walls were observed by scanning electron microscopy (SEM). Central images of each canal third were obtained and classified into scores based on the amount of smear layer (SL) and organic debris (OD). Data were analyzed by Kruskal-Wallis and Friedman tests. Results: There was no significant difference between groups (P>0.05) regarding SL. The coronal third showed significantly lower scores than the other segments (P 0.05). Conclusion: N...
Restorative Dentistry & Endodontics
Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37°C. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.
The Journal of Contemporary Dental Practice, 2021
Aim and objective: The aim of this study was to evaluate the apical extrusion of debris during root canal preparation with the use of different Nickel-Titanium (Ni-Ti) file systems. Materials and methods: Totally 60 single-rooted human mandibular premolar teeth with fully formed roots were chosen for the study. The coronal access cavity and all other preparations were done with the use of an access cavity kit and then 60 samples were randomly separated into three investigational groups (n = 20); group I: self-adjusting file, group II: WaveOne Gold, and group III: Mtwo rotary system. After instrumentation, the teeth were taken out from the tube and the root surface-adherent debris was collected by washing off the apical area of the tooth with distilled water (1 ml) into a centrifuge tube. The centrifuge tube was kept for 5 days in an incubator at 70°C to permit evaporation of the moisture prior to weighing the dry debris with the aid of an electrical analytical balance. Results: The highest quantity of debris extruded was by the Mtwo rotary system (0.0394 ± 0.880) followed by WaveOne Gold (0.0247 ± 1.030) and self-adjusting file (0.0198 ± 0.102). A statistically significant difference (p < 0.001) was found between the various file systems. Conclusion: After considering the drawbacks of this study, apical debris extrusion could be found with all three groups. However, the selfadjusting file demonstrated a significantly reduced quantity of apical debris extrusion compared to the Mtwo rotary system and WaveOne Gold. Clinical significance: The chief step during the procedure of root canal treatment is the preparation of the infected root canals biomechanically. This preparation may lead to forcing the apical debris into the periapical space through the apical foramen, resulting in host-initiated immunological response which leads to postoperative discomfort and pain. This consequently leads to selection of a specific rotary system for endodontic treatment.
An in vitro comparison of root canal system prepared with either hand or rotary instruments
Iranian endodontic journal, 2010
The aim of the present study was to compare hand stainless steel K-files and Nickel-Titanium Profile 0.04 taper 29 series rotary instruments for their efficiency, procedural errors and time consumed in preparation of root canal system. A total of 46 maxillary and mandibular first premolars extracted for orthodontic purposes were collected (two contralateral teeth from each individual). The samples were divided into two groups of 34 canals each. Teeth in the first group were prepared with stainless steel hand K-files while the second groups were prepared with profile 0.04 taper series 29 rotary files. Preparation period was recorded for both groups. Impression material was introduced into the prepared canals so that the replica of prepared canals was achieved. These were assessed under stereomicroscope to assess the efficiency in preparing canals in respect to canal smoothness, ability of impression material to flow and quality of taper.Statistical analyses were performed using t-tes...
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2007
To determine whether the shaping of oval-shaped root canals using 2 different preparation techniques resulted in significant morphologic differences. Study design. Forty lower premolars with oval-shaped root canals were divided into group A, instrumented with the Anatomic Endodontic Technology (AET) system, and group B, treated with ProTaper instruments. A modified Bramante technique was used to analyze changes in root canal diameters (⌬D), changes in surface area (⌬A), and the change in buccolingual and mesiodistal ratio (⌬R). The data were subjected to a Student t test at a significance level of P Ͻ 0.05. Results. Statistically significant differences were found between the 2 groups at coronal and middle levels. There was no statistically significant difference at the apical level. Conclusions. The 2 techniques produced a significant difference in the ultimate shape of the coronal and middle portions of oval-shaped root canals, with the AET system removing more tooth structure at these levels. However, no differences were observed at the apical third.
Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review
Nickel-titanium rotary instruments are important adjuncts in endodontic therapy. This review attempts to identify factors that influence shaping outcomes with these files, such as preoperative root-canal anatomy and instrument tip design. Other, less significant factors include operator experience , rotational speed, and specific instrument sequence. Implications of various working length definitions and desired apical widths are correlated with clinical results. Despite the existence of one ever-present risk factor, dental anatomy, shaping outcomes with nickel-titanium rotary instruments are mostly predictable. Current evidence indicates that wider api-cal preparations are feasible. Nickel-titanium rotary instruments require a preclinical training period to minimize separation risks and should be used to case-related working lengths and apical widths. However, and despite superior in vitro results , randomized, clinical trials are required to evaluate outcomes when using nickel-titanium instruments.