Evaluation of the efficacy of rotary and reciprocating systems for the removal of filling material for various root canal filling techniques.

Background: This study aimed to evaluate the efficacy of various filling and retreatment techniques for oval-shaped root canals. Methods: Sixty distal roots of mandibular molar teeth were included in the study. The roots were prepared using the ProTaper Next (PTN) X4 rotary system and irrigation with 2.5% NaOCl. The roots were then divided into three groups and filled with Total Fill BC Sealer (FKG Dentaire) using three different techniques (n=20): single cone (SC), GuttaCore (GC), and warm vertical condensation (WVC). The retreatment procedure was performed using two different instrumentation techniques: Reciproc 50 (R50) and PTN X5 (n=10). To analyze the remaining filling material, the roots were divided buccolingually in two parts with the help of diamond separators, and photographs were taken at x16 magnification using a dental operating microscope (DOM). The ratio of the remaining filling materials was calculated using image analysis software and statistically evaluated using the Kruskal-Wallis test. Results: None of the assessed retreatment procedures completely removed the filling materials from the root canals. For both instrumentation techniques, more root canal filling material remained in the WVC group (P<0.05). Conclusion: The GC filling technique had a higher cleaning percentage than the WVC and SC techniques in the coronal region. The R50 system was found to be superior to the PTN X5 system for retreatment, and the root canal fillings applied using the WVC technique were more difficult to remove than the fillings applied using the other techniques.

Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration.

The aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency (n = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI (p > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level (p > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage (p < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.

Effect of EDDY and manual dynamic activation techniques on postoperative pain in non-surgical retreatment: a randomized controlled trial.

BACKGROUND: During non-surgical retreatment process, the products such as dentin debris, root canal fillings, irrigation solutions, microorganisms and remaining pulp tissues can extrude to the apical area and can cause the postoperative pain and flare-up. Thus, the aim of this study was to evaluatethe effect of EDDY and manual dynamic activation (MDA) techniques on postoperative pain (PP) associated with retreatment. METHODS: Ninety patients scheduled for retreatment were treated at a single visit. Non-vital mandibular premolar teeth diagnosed with asymptomatic apical periodontitis were included in this study. The patients were divided into two groups (n = 45) on the basis of the need for additional irrigation activation procedures (EDDY and MDA). The patients' post-treatment pain levels were asked to rate the intensity of their pain on a 10-point numerical rating scale (NRS) at the 12th, 24th, 48th, and 72nd h and 7 days.The data were analyzed using the chi-square and Wilcoxon signed-rank test was used for within-group comparisons and Mann Whitney U test was used to compare the groups by time period. RESULTS: The difference in postoperative pain intensity between two groups was statistically significant at 12, 24, 48, and 72 h (p < 0.05). There was no significant difference at 7 days. Moreover, no statistically significant difference was found between the two groups in terms of gender and analgesic medication intake (p > 0.05). Pain intensity after the treatment was lesser in the MDA groupthanin the EDDY group at 12, 24, 48, and 72 h. CONCLUSION: This study could lead us to conclude that the two activation systems can be used during endodontic retreatment with no difference at PP 7 days later. However, a comparison of the groups indicated that the EDDY resulted in significantly more PP at 12, 24, 48, and 72 h. Trial registration ClinicalTrials.gov Identifier: NCT04726670.

Evaluation of dentinal tubule penetration of Irritrol and chlorhexidine irrigating solutions activated using EDDY and photon-initiated photoacoustic streaming.

The aim of the study was to compare the penetration depth and percentage of Irritrol and chlorhexidine (CHX) solutions into dentinal tubules using conventional needle irrigation (CI), EDDY, and photon-induced photoacoustic streaming (PIPS). Sixty oval shaped mandibular premolar teeth were divided into two main groups according to the irrigating solutions as follows; Irritrol and CHX, which were later randomly divided into three subgroups according to the activation technique; CI, EDDY and PIPS (n = 10). Following the irrigation activation procedures, all roots were horizontally sectioned at 3 (apical), 8 (middle), and 13 (coronal) mm from the root apex and then examined with confocal laser scanning microscope (CLSM). Penetration depth (µm) and penetration percentage (%) as determined from the images were analyzed using LSM Image Browser software (Zeiss) and Image J analysis software (V. 1.44p; National Institutes of Health, Bethesda, MD), respectively. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests were performed for multiple comparisons. In both Irritrol and CHX groups, the PIPS activation system demonstrated the highest values for irrigant penetration depth and penetration percentage compared with the other activation methods. Activation of the CHX and Irritrol the final irrigating solutions with PIPS activation technique improved the penetration depth and percentage solutions into the dentinal tubules.

Comparison of apical debris extrusion using EDDY, passive ultrasonic activation and photon-initiated photoacoustic streaming irrigation activation devices.

The study aimed to determine the effect of different irrigation activation systems on the amount of apical debris extrusion in mandibular molar teeth with curved root canals. Sixty extracted mandibular molar teeth were instrumented with HyFlex EDM system and divided into four groups according to irrigation techniques: passive ultrasonic irrigation (PUI), EDDY, photon-initiated photoacoustic streaming (PIPS) and manual irrigation (MI). After the final irrigation, the extruded irrigants were collected into Eppendorf tubes of known weights. The amount of extruded debris was obtained by subtracting the weight from the initial weight of the tube. The Kruskal-Wallis test was used for statistical analysis. EDDY caused significantly more debris extrusion than the other irrigation activation systems (P < 0.001). PUI caused less apical debris extrusion but there was no statistical difference between PUI, PIPS and MI (P > 0.05). The EDDY activation system was associated with the highest amount of debris extrusion in curved root canals.

Microcomputed Assessment of Transportation, Centering Ratio, Canal Area, and Volume Increase after Single-file Rotary and Reciprocating Glide Path Instrumentation in Curved Root Canals: A Laboratory Study.

INTRODUCTION: The aim of this study was to compare the transportation and centering abilities of the ProGlider (PG; Dentsply-Sirona, Ballaigues, Switzerland), WaveOne Gold Glider (WOGG; Dentsply-Sirona), and R-Pilot (RP; VDW, Munich, Germany) file systems and the changes in the structure model index (SMI), surface area, and root canal volume (after creating the glide path in the mandibular first molar teeth's mesial canals with moderate curvature) using the micro-computed tomographic (micro-CT) method. METHODS: In the present study, 24 mandibular first molar teeth with 2 separate mesial canals and moderate (10°-20°) curvature were used. After scanning with micro-CT imaging before the procedure, the teeth were divided into 3 groups, PG, WOGG, and RP (n = 10/each group), followed by the glide path procedure. After the root canal preparation, changes in the root canals regarding the volume, surface area, SMI, transportation made by the files, and the change of their centering ability in the apical, middle, and coronal third were analyzed by micro-CT imaging. The data were statistically evaluated using 1-way analysis of variance and the Kruskal-Wallis test with a significance level set at 5% (P < .05). RESULTS: The WOGG and RP file systems showed better centering abilities at all thirds compared with the PG file system (P < .05). No significant difference was found in the apical third between the groups in terms of canal transportation degree (P > .05). However, in the WOGG and RP groups, less transportation was observed in the middle and coronal thirds compared with the PG group (P < .05). When the SMI changed, after the root canal preparation was compared, no significant differences were found between the groups (P > .05). Nevertheless, the changes in volume and surface area of the root canal in the WOGG and RP groups were significantly lower than in the PG group (P < .05). CONCLUSIONS: The WOGG and RP file systems caused similar levels of change in the root canal systems based on all parameters. Moreover, it was determined that the PG file system caused a significantly higher volume and surface area increase than the WOGG and RP file systems.

Effect of Reciproc blue, XP-endo shaper, and WaveOne gold instruments on dentinal microcrack formation: A micro-computed tomographic evaluation.

The purpose of this study was to evaluate and compare the effect of Reciproc Blue (RPCB), XP-endo Shaper (XPS), and WaveOne Gold (WOG) single-files on dentinal microcrack formation using micro-computed tomography (micro-CT). Twenty-four mesial roots (24 mesio-buccal and 24 mesio-lingual canals) of mandibular molar teeth were prepared using RPCB, XPS, and WOG files (n = 8/each group). The samples were scanned with micro-CT in the pre- and post-preparation. Then, before preparation and after preparation cross-sectional images of the teeth were evaluated to detect the presence of microcracks. For each group, the number of microcracks was calculated as a percentage rate. The data were statistically analyzed using McNemar at 5% significance level (p < .05). Dentinal microcracks were observed in 25.99% (2,103 of 7,813), 31.99% (2,482 of 7,758), and 36.66% (2,836 of 7,731) of cross-sectional images of the XPS, WOG, and RPCB groups, respectively. In all the groups, all the dentinal microcracks seen in the post-treatment cross-sectional images were present in the corresponding pre-treatment images. Within the limitations of this study, the XPS, WOG, and RPCB files did not cause new dentinal microcrack formation or propagation of existing dentinal microcracks.

Comparison of cyclic fatigue life of nickel-titanium files: an examination using high-speed camera.

OBJECTIVES: To determine the actual revolutions per minute (rpm) values and compare the cyclic fatigue life of Reciproc (RPC, VDW GmbH), WaveOne (WO, Dentsply Maillefer), and TF Adaptive (TFA, Axis/SybronEndo) nickel-titanium (NiTi) file systems using high-speed camera. MATERIALS AND METHODS: Twenty RPC R25 (25/0.08), 20 WO Primary (25/0.08), and 20 TFA ML 1 (25/0.08) files were employed in the present study. The cyclic fatigue tests were performed using a dynamic cyclic fatigue testing device, which has an artificial stainless steel canal with a 60° angle of curvature and a 5-mm radius of curvature. The files were divided into 3 groups (group 1, RPC R25 [RPC]; group 2, WO Primary [WO]; group 3, TF Adaptive ML 1 [TFA]). All the instruments were rotated until fracture during the cyclic fatigue test and slow-motion videos were captured using high-speed camera. The number of cycles to failure (NCF) was calculated. The data were analyzed statistically using one-way analysis of variance (ANOVA, p < 0.05). RESULTS: The slow-motion videos were indicated that rpm values of the RPC, WO, and TFA groups were 180, 210, and 425, respectively. RPC (3,464.45 ± 487.58) and WO (3,257.63 ± 556.39) groups had significantly longer cyclic fatigue life compared with TFA (1,634.46 ± 300.03) group (p < 0.05). There was no significant difference in the mean length of the fractured fragments. CONCLUSIONS: Within the limitation of the present study, RPC and WO NiTi files showed significantly longer cyclic fatigue life than TFA NiTi file.

Comparison of treatment choices among endodontists, postgraduate students, undergraduate students and general dentists for endodontically treated teeth.

OBJECTIVES: To compare the decision-making choices among Turkish dentists with different educational backgrounds. METHODS: Eighty endodontically treated teeth were selected from the authors' private archives and placed into four case groups of equal size: case-group 1, symptom/periapical lesion (n = 20); case-group 2, symptom/no periapical lesion (n = 20); case-group 3, no symptom/periapical lesion (n = 20); and case-group 4, no symptom/no periapical lesion (n = 20). The respective periapical radiograph of each tooth was scanned and, together with a leaflet containing relevant information, was distributed to the participants. Participants comprised undergraduate students (n = 20), general dentists (n = 20), endodontic postgraduate students (n = 20) and endodontists (n = 20). Each participant was requested to choose only one option, from five previously determined treatment alternatives, for each tooth: no treatment, wait and see; non-surgical root canal treatment; only apical surgery (apical resection and retrofilling or only apical curettage); retreatment and apical surgery; or extraction. The results were expressed as frequency and percentage. Kendall's W test was used to determine the differences among the participant groups. RESULTS: There was a statistically significant difference among the practitioners in the preferred treatment options for different case-groups (P < 0.05). For case-groups 1, 2 and 3, the postgraduate students and endodontists preferred non-surgical retreatment more frequently than did the undergraduate students and general dentists. However, in case-group 4, all participants suggested the first treatment option, 'no treatment, wait and see' more frequently than the other treatment options. CONCLUSIONS: Within the limitations of this survey study it was concluded that endodontists and graduate programme students tend more towards conservative treatment (retreatment) compared with general dentists and undergraduate students.