ABSTRACT
AIMS: Apical extrusion of infected debris to the periradicular tissues is one of the principal causes of postoperative pain and discomfort. Recent researches have shown that reciprocating instrumentation techniques seem to significantly increase the amount of debris extruded beyond the apex and, consequently, the risk of postoperative pain. The goal of the present study was to evaluate and compare postoperative pain using three different nickel-titanium instrumentation techniques: a rotary crown-down technique using TF instruments (SybronEndo, Orange, Ca), a reciprocating single-file technique using WaveOne instruments (Maillefer DEntsply, Baillagues, CH), and a novel instrumentation technique (TF Adaptive, SybronEndo, Orange, Ca), using a unique, proprietary movement, combining reciprocation and continuous rotation. METHODS: Ninety patients requiring endodontic treatment on permanent premolar and molar teeth with non vital pulps preoperatively were included in the study. The patients were assigned into three groups of 30 patients each, trying to make the groups very similar, concerning the number of root canals, presence of initial pain and periapical lesions. The teeth in group 1 (n = 30) were instrumented with a crown-down technique using TF instruments, whilst those in group 2 (n = 30) were instrumented with a single-file technique using Waveone 08 25. The third group (n = 30) used the 3-file Tf Adaprtive sequence. All techniques were performed following manufacturers' instructions and all canals were shaped, cleaned and obturated in a single-visit by the same operator. The assessment of postoperative pain was carried out at 3 days by using a visual analogue scale. VAS pain scores were compared using one-way ANOVA post hoc Tukey test. A value of p < 0.05 was required for statistical significance. RESULTS: Results for VAS pain scores showed a statistically significant difference was found between the WaveOne (p=0,021) technique and the other two techniques. No statistical significant differences were found between TF and TF Adaptive (p= 0,087). When evaluating patient experiencing sever pain the incidence of symptoms was significantly higher with the WaveOne technique. CONCLUSIONS: Since the incidence of preoperative pain, the type of tooth and the pulp and periodontal pathology were quite similar between the three tested groups, and all the other variables (operator, irrigation, obturation) were identical, we may conclude that the difference in postoperative pain can be mainly related to the different instrumentation techniques.
ABSTRACT
AIM: A new manufacturing method aiming at to producing more flexible and resistant NiTi endodontic instruments has been recently developed (Hyflex, produced with CM wire). The purpose of the study was to determine whether this new manufacturing method produces NiTi instruments (Hyflex) of superior flexibility and/or superior resistance to cyclic fatigue, when compared with instruments produced by a traditional manufacturing process or thermally treated NiTi alloy (M-wire). MATERIALS AND METHODS: Twelve .06 size 25 Hyflex instruments (Coltene, Allstatten, Switzerland), and twelve 06.25 Vortex instruments (Dentsply-Tulsa, OK, USA) and twelve 06.25 Endosequence instruments (Brasseler, Savannah, GA, USA) were initially evaluated for stiffness on bending, followed by a cyclic fatigue test. For the stiffness test test procedures strictly followed ISO 3630-1, and bending moment was measured when the instrument attained a 45 degrees bend. The cyclic fatigue test was performed in a customized artificial stainless steel canal (60° degree curvature with 5 mm radius). Instruments were rotated at 300 rpm until fracture. All data obtained were recorded and statistically analyzed using an ANOVA test. RESULTS: Statistical analysis of data showed that bending moments were significantly greater (P < .05) for Vortex and EndoSequence instruments (mean values 59.06 g/cm and 48,98 g/cm respectively), compared to the Hyflex instruments (mean value 35.60 g/cm). For the cyclic fatigue test Hyflex and Vortex were significantly more resistant than EndoSequence instruments (P < .05). CONCLUSIONS: Results of the present study demonstrate the ability of the new CM-wire manufacturing process to produce NiTi rotary instruments more flexible and more resistant to cyclic fatigue than instruments produced by a traditional manufacturing process or a thermally treated NiTi alloy (M-wire).
ABSTRACT
The purpose of this in vitro study was to evaluate the degree of smear layer removal after root canal preparation with TF(®) instruments, combined with two different irrigating solutions.For the present study twenty-two freshly extracted human roots were selected. All teeth had been extracted for periodontal purpose. Crown were cut off with a separating disk, so all roots were approximately 10-12 mm long.After having chosen the two control roots, the remaining ones were randomly divided into two groups each containing 10 roots. The two experimental groups were prepared as follows.A crown-down instrumentation technique was used, following TF(®) manufacturer's instructions.Irrigation of Group A consisted of 2 ml of solution: 6% sodium hypochlorite (Chlor-Extra(®), Vistadental Racine, Mi, USA) after each instrument followed at the end by a 17% EDTA minute (Smear Clear(®), SybronEndo, Orange, Ca) irrigation for 1 min. Both irrigants contain tensioactive agents.Group B specimens were irrigated with 2 ml of sterile saline solutions after each instrument. Two control roots were not instrumented and irrigated. Teeth were then examined by scanning electron microscopy.Values obtained were tabulated and statistical analyses were carried out using a non parametric tests.RESULTS SHOWS SIGNIFICANT DIFFERENCES IN THE MEAN SCORE BETWEEN THE TWO GROUPS: most experimental group A canals showed clean or minimal debris in the observed areas, especially in the coronal and middle thirds.
ABSTRACT
The goal of the study is to evaluate if the use of rotary nickel-titanium (RNT) instruments, as Hedstroem files, is safe. Twelve twisted files (TF) RNT instruments size 06-25 were selected and randomly divided in 2 groups of 6 instruments each. Group A (new instruments) were used as control. Group B (test) instruments were clinically used only as Hedstroem files in a canal that had been previously instrumented to the working length with other 06-25 RNT instruments. Group B instruments were used only in the straight portion of the canal (1 minute at 1000 rpm). A cyclic fatigue test was performed for each instrument of groups. Data were statistically analyzed (Student's t-test). Results showed no significant difference (P > 0.05) between groups A and B. Data confirmed that the use of TF instruments as Hedstroem files is a safe procedure. Cross section images and volumes of the same instrument, before and after cyclic fatigue testing, have been obtained by means of microtomographic analysis to evaluate possible microstructure alterations.
Subject(s)
Dental Instruments , Nickel , Titanium , Equipment Failure , Materials Testing , Mechanical Phenomena , Root Canal Preparation/instrumentation , SoftwareABSTRACT
Currently, although ultrasonics (US) is used in dentistry for therapeutic and diagnostic applications as well as for cleaning of instruments before sterilization, its main use is for scaling and root planing of teeth and in root canal therapy, both for orthograde and retrograde therapy. Both in conventional and surgical treatments, US in endodontics has enhanced quality of clinical procedures and represents an important adjunct in the treatment of difficult cases. More precisely it has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. This review of the literature aims at presenting the numerous advantages of US in surgical endodontics and emphasizes its application in a modern-day endodontic practice.
ABSTRACT
A new manufacturing method of twisting nickel titanium wire to produce rotary nickel titanium (RNT) files has recently been developed. The aim of the present study was to evaluate whether the new manufacturing process increased the angular deflection of RNT files, by comparing instruments produced using the new manufacturing method (Twisted Files) versus instruments produced with the traditional grinding process. Testing was performed on a total of 40 instruments of the following commercially available RNT files: Twisted Files (TF), Profile, K3 and M2 (NRT). All instruments tested had the same dimensions (taper 0.06 and tip size 25). Test procedures strictly followed ISO 3630-1. Data were collected and statistically analyzed by means ANOVA test. The results showed that TF demonstrated significantly higher average angular deflection levels (P<0.05), than RNT manufactured by a grinding process. Since angular deflection represent the amount of rotation (and consequently deformation) that a RNT file can withstand before torsional failure, such a significant improvement is a favorable property for the clinical use of the tested RNT files.
