The effect of glide path preparation on the shaping ability of XP-endo® Shaper in simulated canals

Aims: To compare the shaping efficiency of the XP-endo Shaper with or without glide path preparation with sequenced Scout Race files in J-shaped resin blocks Material and Methods: Forty simulated J-shaped root canals were classified into two groups (n=20). While the root canals were shaped with XPS after a glide path was created with Scout Race files in Group 1, the same procedures were done without the glide path preparation in Group 2. The pre-and post-instrumentation images were taken and superimposed. Transportation value (TV), centering ability (CA) and the total amount of resin removed (TRR) was calculated by using the obtained images with Adobe Photoshop CS5 software. These parameters were calculated based on 18 reference points (9 inner/9 outer walls) with 1-mm intervals according to 3 sections (coronal, middle, and apical of the canals). The data were analyzed with Kruskal-Wallis and then Dunn's multiple comparison tests (p ≤ 0.05). Results: More resin was removed in Group 2 apical and coronal sections than in Group 1 (p=0.036). In Group 2, a higher transportation value was obtained in apical and middle sections compared to Group 1 (p<0.001). Group 1 showed a higher centering ratio in apical and middle sections than in Group 2 (p<0.001). The centering ability of the instruments was decreased in the curvature part (middle section) of the canals. Conclusions: Within the limits of this study, glide path preparation using Scout Race instruments improved the shaping ability of XPS instrument by leading to less transportation and maintaining centering ability.

Análisis Elemental de las Propiedades Morfológicas, Físicas y Químicas de Dos Instrumentos Rotatorios Protaper Universal

RESUMEN: Los instrumentos rotatorios utilizados en el tratamiento de conductos dentales necesitan cumplir con ciertas características físicas que le confieran un uso correcto, adecuado y seguro para su uso clínico. En el mercado comercial existen una serie de instrumentos importados que dejan en duda la autenticidad de estos debido a sus bajos costos. En este estudio evaluamos física, química y morfológicamente dos kits de instrumentos rotatorios Protaper universal (Dentsply) mediante análisis de MEB, EDX, microdureza y EDS. Uno de los kits (grupo 1) se adquirió directamente de la casa comercial y otro kit importado que a simple vista no parecía cumplir con los estándares de calidad de un correcto empaquetado (grupo 2). En el análisis de MEB se observaron características morfológicas muy diferentes entre ambos kits, el grupo 2 presentó diversas irregularidades en la superficie de las limas, sin embargo, en el EDS no se encontró diferencia alguna. En cuanto al análisis de microdureza se observó una estadística estadísticamente significativa y en el EDS se observaron mayores picos de intensidad en cuanto a la aleación de Ni-Ti en el grupo 2. Estos resultados sugieren que existen instrumentos rotatorios importados que a pesar de su bajo costo pueden presentar ciertas características muy similares a los kits auténticos, sin embargo, física y químicamente pueden resultar en un riesgo para su uso clínico debido a la diferencia entre estos.

ABSTRACT: Rotatory files are instruments used in the treatment of dental canals roots. These instruments need to comply with certain physical characteristics for a correct, adequate and safe use for clinical use. In the commercial market there are a series of imported instruments that cast doubt on their authenticity due to their low costs. In this study we physically, chemically and morphologically evaluated two Protaper universal rotary instrument kits (Dentsply) using SEM, EDX, microhardness and EDS analysis. One of the kits (group 1) was purchased directly from the commercial house and another imported kit that a simple view did not seem to meet the quality standards of a correct packaging (group 2). In the SEM analysis, very different morphological characteristics were observed between both kits, group 2 presented various irregularities on the surface of the files, however, no difference was found in the EDS. Regarding the microhardness analysis, a statistically significant statistic was observed and in the EDS, higher intensity peaks were observed in terms of the Ni-Ti alloy in group 2. These results suggest that there are imported rotary instruments that despite their low cost can present characteristics very similar to authentic kits, however, physically and chemically they can result in a risk for their clinical use due to the difference between them.

In Vitro Evaluation of a Recently Developed Rotary File: AF Rotary / Avaliação in vitro de um arquivo rotativo desenvolvido recentemente: AF Rotary

Objective: Aim of the present study is to evaluate mechanical properties of a newly developed rotary file, AF Rotary (Fanta Dental, Shanghai, China), and to compare these features with a worldwide spread rotary file, Protaper Gold F2 (PTG F2; Dentsply Maillefer, Ballaigues, Switzerland). Material and Methods: 60 AF Rotary 25.06 and 60 PTG F2 were divided in three groups of 20 files each. A group underwent to cyclic fatigue resistance tests, second group underwent to torsional resistance tests, third group underwent to bending tests. The statistical analysis was performed using t student test with significance level set at 95% (p < 0.05). Results: AF Rotary showed significantly higher torsional resistance and cyclic fatigue resistance (p < 0.05) when compared to the PTG F2. AF Rotary also showed significantly lower bending resistance (p < 0.05) when compared to the PTG F2. Conclusion: Therefore, within the limitations of this study, the results show better performances for AF Rotary compared to PTG F2 regarding the cyclic fatigue test, the torsional test and the bending test. Since the PTG F2 is a commonly used and widely investigated instrument it could be possible to state that the AF Rotary exhibits remarkable in vitro performances. (AU)

Objetivo: O objetivo do presente estudo é avaliar as propriedades mecânicas de uma lima rotativa recém-desenvolvida, AF Rotary (Fanta Dental, Shanghai, China), e comparar essas características com uma lima rotativa mundialmente difundida, Protaper Gold F2 (PTG F2; Dentsply Maillefer, Ballaigues, Suíça). Material e Métodos: 60 AF Rotary 25.06 e 60 PTG F2 foram divididos em três grupos de 20 arquivos cada. Um grupo foi submetido a testes de resistência à fadiga cíclica, o segundo grupo foi submetido a testes de resistência à torção, o terceiro grupo foi submetido a testes de flexão. A análise estatística foi realizada por meio do teste t student com nível de significância de 95% (p <0,05). Resultados: AF Rotary apresentou resistência torcional e resistência à fadiga cíclica significativamente maiores (p <0,05) quando comparado ao PTG F2. AF Rotary também apresentou resistência à flexão significativamente menor (p <0,05) quando comparado ao PTG F2. Conclusão: Portanto, dentro das limitações deste estudo, os resultados mostram melhores desempenhos do AF Rotary em relação ao PTG F2 no que diz respeito ao teste de fadiga cíclica, ao teste de torção e ao teste de flexão. Uma vez que o PTG F2 é um instrumento comumente usado e amplamente investigado, pode-se afirmar que o AF Rotary exibe desempenhos in vitro notáveis. (AU)

Antibacterial efficacy of synthetic and natural-derived novel endodontic irrigant solutions

Abstract The aim of this study was to compare the efficacy of grape seed extract (GSE), calcium hypochlorite [Ca(ClO)2], and sodium hypochlorite (NaOCl) irrigant solutions with rotary or reciprocating instrumentation for disinfection of root canals inoculated with Enterococcus faecalis. The mesiobuccal root canals of mandibular molars were prepared and inoculated with Enterococcus faecalis for 21 days. The roots were then randomly divided into the following eight experimental groups (n=11) according to the instrumentation technique and disinfection protocol: ProTaper Next or Reciproc R25 with sodium chloride (control group), 6% NaOCl, 6% Ca(ClO)2, or 50% GSE used for irrigation during instrumentation. The antimicrobial activity was determined on the basis of a reduction in colony-forming units (CFUs) counted on bacterial samples collected before and after root canal instrumentation and expressed as a percentage of reduction. Data were evaluated by two-way ANOVA followed by Tukey HSD post-hoc tests (p<0.05). No significant differences were observed in bacterial reduction between the ProTaper Next and Reciproc R25 systems (p>0.05), regardless of the irrigant solution used. Furthermore, all active solutions (6% NaOCl, 50% GSE, and 6% Ca(ClO)2) showed similar potential to reduce bacterial counts (p>0.05) and were significantly more effective than sodium chloride (control) (p<0.05). The results suggest that the GSE and Ca(ClO)2 have potential clinical application as irrigant solutions in endodontic therapy since they present bactericidal efficacy against Enterococcus faecalis.

Resumo O objetivo deste estudo foi comparar a eficácia do extrato de semente de uva (ESU), hipoclorito de cálcio [Ca(ClO)2] e hipoclorito de sódio (NaOCl) como soluções irrigadores quando utilizadas com instrumentos reciprocantes e rotatórios para desinfecção de canais radiculares infectados com Enterococcus faecalis. Raízes mesio-vestibulares de molares inferiores foram preparados e inoculados com E. faecalis por 21 dias. As raízes foram aleatoriamente divididas em 8 grupos (n=11) de acordo com a técnica de instrumentação e protocolo de irrigação: ProTaper Next ou Reciproc R25 associados com soro fisiológico (grupo controle), Ca(ClO)2 6%, NaOCl 6% ou ESU 50%. A atividade antimicrobiana foi determinada pela redução do número de Unidades Formadoras de Colonias (UFCs) coletadas antes e após a instrumentação e expressas em porcentagens de redução. Os dados foram analisados estatisticamente pelos testes ANOVA seguido pelo teste complementar de Tukey HSD (p<0,05). Não foi encontrado diferença estatisticamente significante na redução bacteriana entre os sistemas ProTaper Next e Reciproc R25 (p>0.05), independente da solução irrigadora usada. Além disso, todas as soluções ativas (NaOCl, ESU e Ca(ClO)2) mostraram similar potencial em reduzir a quantidade de bactérias (p>0.05) e foram significativamente mais efetivas que o soro fisiológico (p<0.05). Pode-se concluir que o ESU e o Ca(ClO)2 apresentam potencial para aplicação clínica como irrigantes endodônticos uma vez que apresentaram efetividade antimicrobiana contra o E. faecalis.

'In Vitro' Comparison of K3XF and TFA Cyclic Fatigue Resistance in Continuous Rotation and Adaptive Motion / Comparación In Vitro de resistencia a la fatiga cíclica de K3XF y TFA en rotación continua y movimiento adaptativo

Abstract: Among the most common problems within dental professionals, is the fracture of rotary instruments of nickel and titanium root canal files (NiTi), when performing a procedure on a patient. Therefore, the objective of this work is to compare the in vitro resistance to cyclic fatigue of K3XF and TFA rotatory instruments, in continuous rotation and adaptive motion. For this, a static and cyclic fracture test was used and a fracture pattern was searched. The numbers of cycles until the fracture and the length of the fragments were determined. Of all the groups evaluated, K3XF-A exhibited the best resistance to cyclic fatigue. In future research, it will be performed an autoclaving and immersion cycles in sodium hypochlorite to be able to determine the separation causes of the rotary instruments. As a recommendation, the operator could significantly influence the decrease in resistance to cyclic fatigue due to the misuse of rotary instruments.

Resumen: Entre los problemas más comunes entre los profesionistas dentales, es la fractura de los instrumentos rotatorios de limas de canales radiculares de níquel y titanio (NiTi), cuando se lleva a cabo el procedimiento al paciente. Es por eso, que el objetivo de este trabajo es el comparar la resistencia in vitro de la fractura cíclica entre los instrumentos rotatorios K3XF y TFA, en rotación continua y movimiento adaptativo. Para esto, se utilizó la prueba de fractura cíclica y estática y el patrón de fractura fue evaluado. El número de ciclos hasta la fractura y la longitud de los fragmentos fue determinado. De todos los grupos evaluados, K3XF-A presentó la mejor resistencia a la fractura cíclica. Como trabajo a futuro, se utilizará ciclos de inmersión en hipoclorito de sodio y autoclaveado, para ser capaces de determinar las causas de separación de los instrumentos rotarios. Como recomendación, el operador puede influenciar significativamente la disminución de la resistencia a la fractura cíclica utilizando de una manera errónea el dispositivo.

Automatic Electronic Device Used for the Evaluation of Cyclic-Fatigue Resistance of Nickel-Titanium Instruments

he aim of this study was to evaluate the cyclic-fatigue fracture of different Nickel-Titanium motor-driven rotary instruments (ProTaper® Universal, ProFile®, and Mtwo® systems) in artificial canals by means of an Automatic Electronic Device (AED). The study was performed using NickelTitanium instruments 25/0.06 evaluated in canals with a 45-degree curvature and 2-mm radius. The analyses evaluated two parameters: fracture by cyclic fatigue, and time of fracture; in addition, the length of separated fragment was evaluated. Medians and range values were calculated for each group. Data were analyzed by the Kruskall-Wallis and Mann-Whitney U tests to determine statistical difference. The ProFile motor-driven rotator system exhibited highest resistance to fracture due to cyclic fatigue and highest fracture time compared with the ProTaper and Mtwo systems (p <0.05). The equipment proposed in this study (AED) demonstrated efficiency for recording information, automation, scheduled work times and durations, cycle number, time of fracture, pressure changes and, principally control of the human factor.

l objetivo del presente estudio fue evaluar la fractura a la fatiga cíclica de diferentes instrumentos rotatorios de Niquel-Titanio (sistemas ProTaper® Universal, ProFile® y Mtwo®) en conductos artificiales por medio de un Dispositivo Electrónico Automático (DEA). Se usaron instrumentos de Niquel-Titanio 25/0.06, los cuales se evaluaron en conductos con una curvatura de 45 grados y 2 milímetros de radio. Se analizaron dos parámetros: Fractura a la fatiga cíclica y tiempo a la fractura; además se evaluó la longitud del fragmento separado. Medianas y rangos fueron calculados para cada uno de los grupos. Los resultados fueron analizados por las pruebas de Kruskall-Wallis y U de Mann-Whitney para determinar diferencias estadísticas. El Sistema ProFile mostró una mayor resistencia y tiempo a la fractura en comparación con los sistemas ProTaper y Mtwo (p <0.05). El equipo propuesto en este estudio (DEA) demostró eficiencia para el registro de la información, tiempos de trabajo y duración, número de ciclos, tiempo a la fractura, cambios en la presión y principalmente control del factor humano.

Comparison of Application Effect of NiTi Rotary Instruments and Hand NiTi Enlarging File in Children with Root Canal Therapy / 中山大学学报(医学科学版)

[Objective]To study effect of pain and stress response of NiTi rotary instrument for children with root canal therapy , and analyzed possible mechanisms.[Methods]60 cases(60 teeth)children with Dental pulp disease or root tip disease by root canal therapy from March 2015 to March 2017 were divided into observation group and control group. The control group used Hand NiTi en-larging file,observation group used NiTi rotary instruments,then root canal preparation,stress response,pain,filling effect and long-term efficacy were compared between two groups.[Result]The observation group root canal preparation time were significantly shorter than control group(P < 0.01),root canal deviation etc morphological changes(6.67%)was significantly lower than control group(26.67%,P < 0.05);gingival crevicular fluid TNF-α,IL-6,IL-1β were significantly lower than control group(P < 0.05, P < 0.01). In root canal preparation,after root canal preparation,pain rate were significantly lower than control group(10.00% vs 33.33%,3.33% vs 23.33%,P < 0.05);1 week after surgery,just fill rate(93.33%)was significantly higher than control group (70.00%,P<0.05). Followed up 6 months,root canal success rate(90.00%)was significantly higher than control group(66.67%, P<0.05).[Conclusion]NiTi rotary instruments help to reduce the pain in children with root canal,improve clinical efficacy,May be related to inhibition of surgical stress response.

In vitro evaluation of retreatment efficacy of Mtwo rotary instruments / 口腔疾病防治

Objective@# To evaluate the efficacy of Mtwo rotary instruments during root canal retreatment. @*Methods @#Thirty mandibular premolars with oval root canal were prepared with ProTaper rotary instruments and obturated with lateral condensation method. The samples were divided into 2 groups. In Mtwo group, the filling materials were removed with Mtwo retreatment system and Mtwo basic instruments. Inmanual stainless group, the filling material were removed with manual instruments. The percentage of residual filling material was measured with image proplus software and the operating time was recorded. @*Results@#The percentage of residual filling material in Mtwo group was significantly lower than manual group in middle third, but the opposite result can be found in the coronal third. In the whole canal, no significant difference was found between the two groups. The mean operating time in Mtwo group was significantly shorter than manual group. @*Conclusion @#Mtwo rotary instruments can shorten the time of retreatment, neither of the groups can remove the filling material in oval root canal completely.

Attitude among dental practioners towards use of rotary instruments and hand instruments for root canal treatment: a comparative study

Aim: The purpose of present study is to assess the attitude of general dental practioners towards use rotary instruments and hand instruments for root canal treatment. Material and Methods: It was a cross-sectional questionnaire study conducted in the private clinics in Lucknow city, Uttar Pradesh. A total of 400 clinics were visited and face to face interview schedule was conducted. Questionnaire consists of demographic details of dental professionals. Information regarding the years of experience, OPD details and number of root canal treatment done per week by dental professionals was obtained. Use of rotary and hand instruments by dental professionals was inquired. Years of experience with Rotary instruments, procedural problems with rotary instruments faced by dental professionals and reasons for not using the rotary instruments if any was also recorded. Results: 102 (33%) of the total study samples were using rotary instruments for root canal treatment and 100 (32%) using both rotary and hand instruments for root canal treatment. Dentists who are using rotary instruments are facing the procedural problem of file breakage {70 (36%)}. And those dental professionals using hand instruments are facing the problem of ledge formation {82(40%)}. Conclusions: The main procedural failure of the rotary instruments in root canal treatment, faced by dental professionals was file breakage and with hand instrument is ledge formation. Lack of expertise is the main reason which restricts dental professionals from using rotary instruments.

Sistema rotatório Mtwo para retratamento endodôntico: revisão de literatura / Rotary system Mtwo for endodontic retreatment: literature review

O retratamento endodôntico é sempre a primeira opção indicada para solucionar o fracasso do tratamento. Atualmente, o retratamento vem sofrendo grandes avanços, buscando técnicas e instrumentos que provoquem o mínimo de danos possíveis, com uma maior eficiência e em menor tempo. Dentre esses instrumentos, encontra-se o sistema Mtwo para retratamento (Mtwo-R), que é um sistema rotatório de níquel-titânio da nova geração o qual tem sido alvo de muitas pesquisas nos últimos anos. O objetivo deste trabalho foi realizar um levantamento da literatura com o intuito de ressaltar as vantagens e desvantagens do sistema rotatório Mtwo-R, quando comparado com outros tipos de sistemas rotatórios e com técnicas manuais.

Endodontic retreatment is always the first option to solve the failure of the previous root canal treatment. Currently, the retreatment has undergone great advances, developing techniques and instruments that cause the least possible damage, with greater efficiency and dispending less time. Among these instruments is the Mtwo system for retreatment (Mtwo-R), which is a new generation of nickel-titanium rotary system which has been extensively studied in recent years. The objective of this study was to survey the literature in order to highlight the advantages and disadvantages of rotary system Mtwo-R compared with other types of rotary systems and manual techniques.

Assessment of canal centering ability and topography of three nickel-titanium rotary systems / Avaliação da centralização do preparo e da topografia de três sistemas rotatórios de níquel-titânio

Objective: This study aimed to evaluate the canal cen-tering ability and topography of BioRaCeTM (BR), Wi-zard CD PlusTM (WP), and Wizard NavigatorTM (WN) instruments. Materials and method: mesiobuccal roots of upper first molars were selected and randomly dis-tributed in three groups (n=10), according to the rota-ry system used for instrumentation. Canal transporta-tion was assessed at 2, 4, 6, and 8 mm from the root apex, by subtracting cone bean computed tomography (CBCT) images taken before and after preparation. The root canal center was marked in pre- and post-prepa-ration images, and the distance between these points was measured in bucco-palatal (BP) and mesio-distal (MD) directions. New instruments were analyzed un-der scanning electron microscopy (SEM) regarding their surface finishing, topographical features, and surface defects. The SEM images were obtained at the tip of the instrument, and at 5 mm from the tip. Data of the canal centering ability were analyzed by two-way ANOVA (? = 0.05). Results: regardless of root level (2, 4, 6, and 8 mm), all groups presented canal transportation in both directions. Significant differences were not detected (p > 0.05). Surface finishing was regular in the BR group with rounded transitional angle. Cutting edges had a sharp angle in BR and WN groups, while WP instru-ments had a flattened angle. Conclusion: despite such topographical differences between the rotary instru-ments tested, none of them were able to exactly main-tain the original root canal center, and no significant differences were observed among groups.

Instrumentos rotatorios: su uso, separación y efecto en complicaciones endodónticas postoperatorias / Rotary instrumentation: usage, separation and effect on postoperative endodontic complications

El uso de instrumentos de níquel-titanio en el campo de la endodoncia ha permitido que el tratamiento de conductos se lleve a cabo de manera más predecible y eficiente. Sin embargo, a pesar de las mejoras que se han hecho en el diseño de las limas y en las aleaciones del metal, la fractura de los instrumentos rotatorios continúa siendo una complicación no deseada, problemática y frustrante. La separación de los instrumentos rotatorios se debe frecuentemente al uso incorrecto o excesivo de los mismos. Si la fractura ocurre, el paciente debe ser informado del incidente y se debe considerar el remover o no el fragmento del instrumento. El presente reporte describe un caso de seguimiento a cinco años en un molar mandibular con dos instrumentos endodónticos rotatorios separados en los conductos mesiovestibular y mesiolingual, que no afectaron de forma adversa el resultado del tratamiento.

Introduction of nickel-titanium instruments in the field of endodontics has made conventional root canal therapy more predictable and efficient. However, despite improvements in file designs and metal alloys, fracture of rotary instruments during endodontic treatment still represents a problematic, unwanted and frustrating complication. File separation often results from incorrect use or overuse of an endodontic instrument. If breakage occurs, patients should be informed about the incident and consideration should be given to whether or not to remove the fragment. This report describes a five year follow-up case of a mandibular molar with two separated endodontic rotary instruments lodged into the mesio-buccal and mesio-lingual canals which did not negatively affect the outcome of root canal treatment.

The Influence of Surface Roughness of Tooth Preparation and Cement Compatibility on the Adhesive Strength / 天津医药

Objective To investigate the influence of tooth preparation surface roughness and different dental ce-ments on adhesive strength, and provide some reference information on the selection of dental rotary instruments and dental cements. Methods Sixty dentin samples were prepared and randomly divided into 3 groups. Samples from group A, B and C were grinded by diamond burs with grit-sizes of 125μm, 60μm and 28μm respectively. Two samples selected randomly from each group were observed under scanning electron microscope (SEM) for the surface microprofile. The remaining 18 samples from each group were evenly divided into 3 subgroups. Each subgroup was teamed with one of 3 dental cements:zinc polycarboxylate cement (ZP), glass ionomer cement (GI) and resin-modified glass ionomer cement (RMGI). Co-Cr alloy casts were cemented onto the dentin samples, and the adhesive strength was tested. Meanwhile, the types of failure were re-corded for each sample. Results The surface roughness of tooth preparation samples showed a downward trend in group A, group B and group C. Among the involved 3 dental cements, RMGI exhibited the highest adhesive strength, and there was no significant difference in the adhesive strength between ZP and GI. Among different combination subgroups, A-RMGI had the highest adhesive strength, B-RMGI run the second place, while C-ZP and C-GI were proved the lowest. However, there was no interaction between the two factors. Furthermore, group A mainly showed failure typesⅠandⅡ, group B evenly showed all the failure types and group C mainly showed failure typesⅡandⅢ. Conclusion The adhesive strength is related to the surface roughness. RMGI exhibits the highest adhesive efficiency. There is no obvious compatibility in particular surface roughness and dental cements.

Performance of RaCe Instrumentation System in Curved Root Canals: A Comprehensive Analysis by Three Study Methods

In this study, curved maxillary molar root canals were instrumented with RaCe rotary system to evaluate: 1. the occurrence of canal transportation using a radiographic platform; 2. the action of the instruments on the dentin walls, centering ability and canal enlargement by analysis of digital images; and the percentage of regular dentin surfaces and debris within the canal by histological analysis. Ten mesiobuccal roots of extracted human maxillary molars were embedded in acrylic resin and sectioned at the middle and apical thirds. Root canal shaping was performed using the RaCe rotary system at 250 rpm and 1 Ncm torque. Each instrument set was used five times according to a crown-down technique in the following sequence: 40/0.10, 35/0.08, 25/0.06, 25/0.04, 25/0.02 (working length - WL), 30/0.02 (WL) and 35/0.02 (WL). Each instrument was inserted until resistance was felt and then pulled back, followed by brushing movements towards all canal walls. Each specimen was assessed by three study methods: radiographic platform, digitized image assessment and histological analysis. The radiographic platform showed lack of apical transportation. No statistically significant difference (Wilcoxon test, p>0.05) was found between the middle and apical thirds regarding instrument action on dentin walls, centering ability, area of root canal enlargement, percentage of regular dentin surfaces and debris within the root canal. It may be concluded that RaCe system is a suitable method for the preparation of curved root canals, regarding the maintenance of root canal original path, action on dentin walls, canal enlargement and removal of debris from the root canal lumen.

O objetivo do presente estudo foi verificar a presença de desvio apical por meio da plataforma radiográfica, avaliar a ação dos instrumentos, centralização do preparo e ampliação por meio de imagens digitais do canal e calcular a porcentagem de superfícies regulares e presença de debris por meio da análise histológica. Dez raízes mésiovestibulares de molares superiores extraídos foram incluídos em blocos de resina e seccionados no terço médio e apical. O preparo do canal foi feito empregando o sistema RaCe, a 250 rpm e torque de 1 Ncm. Cada sistema rotatório foi usado 5 vezes no sentido coroa-ápice na seguinte sequência: 40/0.10, 35/0.08, 25/0.06, 25/0.04, 25/0.02 (comprimento de trabalho - CT), 30/0/02 (CT) e 35/0/02 (CT). Cada amostra foi avaliada por 3 métodos de estudo: plataforma radiográfica, imagem digital e análise histológica. A plataforma radiográfica mostrou ausência de transporte apical. Em relação à ação dos instrumentos sobre as paredes dentinárias, centralização do preparo, ampliação, porcentagem de superfícies regulares e presença de debris, o teste estatístico de Wilcoxon não mostrou diferença significativa entre os terços apical e médio. O sistema RaCe se mostrou adequado para o preparo de canais radiculares curvos em relação à manutenção do trajeto original do canal, ação sobre as paredes dentinárias, ampliação e remoção de debris da luz do canal radicular.

Influence of ultrasonic cleaning time and disinfecting frequency on physical property of Ni- Ti root canal files / 中国实用护理杂志

Objective To investigate the influence of ultrasonic cleaning time and disinfecting frequency on physical property of Ni-Ti root canal files in order to understand the safety and feasibility of ultrasonic cleaning and high temperature and high pressure disinfection for Ni-Ti root canal files.Methods The Ni-Ti root canal files used in this study were ProTaper,Mtwo and Hero642,5 files were selected from each kind.After the ultrasonic cleaning and high temperature high pressure disinfection the files underwent breaking test,the breaking time was recorded.Unclean and non-sterile Ni-Ti root canal files were set as control.Results After different time of ultrasonic cleaning,ProTaper and Mtwo showed no difference in breaking time,but the result was opposite in Hero642.After different times of disinfection,Mtwo showed no difference in breaking time,but significant difference was seen in the other two kinds.Conclusions Ultrasonic cleaning time has no significant influence on physical property of ProTaper and Mtwo Ni- Ti root canal files,but the influence was significant for Hero642.Disinfection frequency had no significant influence on physical property of ProTaper and Hero642 Ni-Ti root canal files,but the influence was significant for Mtwo Ni-Ti root canal files.

Canal transportation in simulated root canals instrumented with one progressive taper and two constant taper nickel-titanium rotary systems

This study investigated the occurrence of canal transportation in the apical third of simulated root canals instrumented with progressive and constant taper shaft designed rotary instruments. Thirty simulated resin canals were prepared with progressive taper (ProTaper Universal) and constant taper (Hero 642 and K3) Ni-Ti rotary systems, with 10 canals per group. The pre and post-instrumentation images of the canals were superimposed and the composite images were analyzed with Image Pro Plus 5.0 software. Centering ability of the instruments was assessed by subtracting the amount of resin removed at the inner wall from that removed at the outer wall. Total amount (in mm) of resin removed was recorded by adding the amount of resin removed at the inner and outer walls, comparing the pre and post-preparation images. Data were analyzed statistically by Kruskal Wallis and Median tests (α=5%). There was statistically significant difference (p<0.05) among the groups. ProTaper produced the greatest canal transportation in the apical third. In conclusion, canal transportation occurred in all groups; the constant taper rotary instruments (Hero 642 and K3) presented greater centering ability towards the original canal curve and caused less canal transportation than the progressive taper instruments (ProTaper).

Este estudo investigou a ocorrência do transporte do canal no terço apical de canais simulados preparados com instrumentos rotatórios de conicidade progressiva e constante. Trinta canais simulados em blocos de resina foram preparados com sistemas rotatórios de Ni-Ti de conicidade progressiva (ProTaper Universal) e de conicidade constante (Hero 642 e K3), com 10 canais simulados por grupo. As imagens pré e pós-operatórias dos canais foram superpostas e analisadas com o Programa Image Pro Plus 5.0. A capacidade de manter a centralização do canal foi avaliada pela subtração da quantidade de resina removida da parede interna daquela removida na parede externa. A quantidade total de resina (em mm) removida foi obtida por meio da soma da resina removida das paredes internas e externas do canal, comparando as imagens pré e pós-operatórias. Os dados foram analisados estatisticamente pelo teste de Kruskal Wallis e Teste das medianas (α=5%). Houve diferença estatisticamente significativa (p<0.05) entre os grupos. O Sistema ProTaper produziu o maior transporte do canal no terço apical. Em conclusão, o transporte do canal ocorreu em todos os grupos; os intrumentos rotatórios de conicidade constante (Hero 642 e k3) apresentaram uma grande capacidade de manter o canal centrado e causaram menos transporte do canal do que os instrumentos de conicidade progressiva (ProTaper).

The influence of torque and manual glide path on the defect or separation rate of NiTi rotary instruments in root canal therapy.

Introduction: One of the effecting factors in prognosis of root canal therapy is accidental procedure as broken files that may be unpreventable. Many manufacturers have designed and marketed various electromotors that can control rotational speed and torque. On the other hand, some studies have recommended applying a manual glide path to diminish contact area between the file and canal walls. The purpose of this study was evaluation of the effect of torque and a manual glide path on defects as separation of Nickel-titanium (NiTi) rotary files. Materials and Methods: This ex vivo randomized controlled trial study was carried out on 160 canals of human's matured molars with mild curvature (15-338). After initial preparation of samples and checking for inclusion criteria, in first group, preparation was carried out with air-driven handpiece, and in group two, Endo IT was used as electromotor. In both groups, Mtwo files with simultaneous technique were used for preparation. Then all data were collected and analyzed with Mann Whitny, Mantel Cox, and t-test. Results: No significant differences between two groups (P < 0.05) were observed. Based on survival analysis, safety probability of files after preparation of nine canals is 64% in group one and 69.9% in group two. There was no significant differences between this safety probability in two groups (P = 0.272). Conclusion: Usage of torque control handpiece is not an important factor, comparing instrumentation technique.

Procedural errors during root canal preparation using rotary NiTi instruments detected by periapical radiography and cone beam computed tomography

This study detected procedural errors created by rotary nickel-titanium (NiTi) instruments during root canal preparation by two imaging methods. Forty extracted human maxillary and mandibular molars were divided randomly into two groups and treated by two endodontists (n=10) and two undergraduate dental students (n=10). The ProTaper UniversalTM Rotary System was used to shape the canals and then they were filled using AH PlusTM sealer and gutta-percha. Periapical radiographs (PR) and cone beam computed tomography (CBCT) images were obtained and two examiners, who evaluated them to verify the occurrence of procedural errors (fractured instruments, perforations, and canal transportation). The Chi-square test at 0.05 level of significance was used for statistical analyses. There were no significant differences (p>0.05) between the imaging methods. In the analysis of procedural errors, there was no significant difference (p>0.05) between the groups of operators (endodontists vs. students) nor between tooth groups (maxillary molars vs. mandibular molars). In view of the low incidence of procedural errors during root canal preparation performed by students the introduction of rotary NiTi instruments has potential in undergraduate teaching. PR and CBCT permitted the detection of procedural errors, but the CBCT images offer more recourse for diagnosis.

O objetivo deste estudo foi determinar erros de procedimentos ocorridos durante o preparo de canais radiculares após o uso de instrumentos de níquel-titânio (NiTi) acionados a motor, avaliados por dois métodos de exame por imagens. Quarenta molares humanos extraídos, superiores e inferiores, foram aleatoriamente divididos em dois grupos e tratados por dois especialistas em Endodontia (n=10) e dois estudantes de Odontologia (n=10). O sistema rotatório ProTaper UniversalTM foi usado para preparar os canais radiculares e, a seguir estes foram obturados com cimento AH PlusTM e guta percha. Radiografias periapicais (RP) e tomografia computadorizada de feixe cônico (TCFC) foram obtidas e avaliadas por dois examinadores para verificar a ocorrência de erros de procedimentos (instrumentos fraturados, perfurações e transporte apical). O teste do qui-quadrado com nível de significância de 0,05 foi usado para análise estatística. Frente a comparação dos métodos de exames por imagens não houve diferenças significantes (p>0,05). Na análise de erros de procedimentos (fraturas de instrumentos, perfurações e transportes apicais) não houve diferenças estatisticamente significantes nos níveis de operadores e nem entre grupos de dentes. Em vista da baixa incidência de erros de procedimentos durante o preparo de canais radiculares realizados por estudantes, a introdução de instrumentos de NiTi apresenta potencial no ensino da graduação. RP e TCFC permitiram detectar erros de procedimentos durante o preparo de canais radiculares, porém, a TCFC oferece maiores recursos para o diagnóstico.

Calcium hydroxide intracanal dressing removal with different rotary instruments and irrigating solutions: a scanning electron microscopy study

This study evaluated the efficacy of 2 types of rotary instruments employed in association with sodium hypochlorite (NaOCl) or EDTA in removing calcium hydroxide (CH) residues from root canals dentin walls. Forty-two mandibular human incisors were instrumented with the ProTaper System up to F2 instrument, irrigated with 2.5 percent NaOCl followed by 17 percent EDTA and filled with a CH intracanal dressing. After 7 days, the CH dressing was removed using 4 techniques: NiTi rotary instrument size 25, 0.06 taper (K3 Endo) and irrigation with 17 percent EDTA (Group 1), NiTi rotary F1 instrument (ProTaper) and irrigation with 17 percent EDTA (Group 2), NiTi rotary instrument size 25, 0.06 taper and irrigation with 2.5 percent NaOCl (Group 3) and NiTi rotary F1 instrument and irrigation with 2.5 percent NaOCl (Group 4). Two roots without intracanal dressing were used as negative controls. Teeth were evaluated by scanning electron microscopy, in the cervical and apical canal thirds. None of the techniques removed the CH dressing completely. In the apical and cervical thirds, F1 instrument was better than instrument size 25, 0.06 taper in removing CH residues (p<0.05), regardless of the final irrigating solution. No difference was found between the irrigating solutions in the groups of F1 instrument and of instrument size 25, 0.06 taper (p>0.05). The negative controls had no CH residues on the dentin walls. In conclusion, the ProTaper F1 instrument was better than K3 Endo instrument size 25, 0.06 taper in the removal of CH intracanal medication, regardless of irrigating solution used.

O objetivo deste estudo foi avaliar a eficácia de dois tipos de instrumentos rotatórios em associação à irrigação com hipoclorito de sódio (NaOCl) ou EDTA na remoção de resíduos de hidróxido de cálcio (HC) das paredes do canal radicular. Quarenta e dois incisivos inferiores de humanos foram instrumentados com o sistema ProTaper até o instrumento F2, irrigados com NaOCl a 2,5 por cento, seguido de EDTA a 17 por cento e preenchidos com medicação intracanal à base de HC. Após 7 dias, o HC foi removido utilizando 4 técnicas: instrumento 25/0.06 (K3 Endo) e irrigação com EDTA a 17 por cento (Grupo 1), instrumento F1 (ProTaper) e irrigação com EDTA a 17 por cento (Grupo 2), instrumento 25/0.06 e irrigação com NaOCl a 2,5 por cento (Grupo 3) e instrumento F1 e irrigação com NaOCl a 2,5 por cento (Grupo 4). Duas raízes que não receberam medicação intracanal foram utilizadas como controles negativo. Foram avaliados os terços cervical e apical dos canais radiculares por meio de microscopia eletrônica de varredura. Nenhuma das técnicas removeu completamente a medicação à base HC. Nos terços apical e cervical, o instrumento F1 foi melhor do que o instrumento 25/0.06 na remoção dos resíduos de HC (p<0,05), independentemente da solução irrigadora final. Não houve diferença entre as soluções irrigadoras nos grupos do instrumento F1 e do instrumento 25/0.06 (p>0,05). Os controles negativos não apresentaram resíduos de HC nas paredes dentinárias. Concluiu-se que o instrumento F1 do ProTaper foi melhor que o instrumento 25/0.06 do K3 Endo na remoção da medicação intracanal à base de HC, independentemente da solução irrigadora utilizada.

Assessment of canal walls after biomechanical preparation of root canals instrumented with protaper universalTM rotary system

OBJECTIVE: The aim of this study was to examine the instrumented walls of root canals prepared with the ProTaper UniversalTM rotary system. MATERIAL AND METHODS: Twenty mesiobuccal canals of human first mandibular molars were divided into 2 groups of 10 specimens each and embedded in a muffle system. The root canals were transversely sectioned 3 mm short of the apex before preparation and remounted in their molds. All root canals were prepared with ProTaper UniversalTM rotary system or with NitiflexTM files. The pre and postoperative images of the apical thirds viewed with a stereoscopic magnifier (X45) were captured digitally for further analysis. Data were analyzed statistically by Fisher's exact test and Chi-square test at 5 percent significance level. RESULTS: The differences observed between the instrumented and the noninstrumented walls were not statistically significant (p<0.05). CONCLUSIONS: The NitiflexTM files and the ProTaper UniversalTM rotary system failed to instrument all the root canal walls.