A micro-computed tomography assessment of the efficacy of rotary and reciprocating techniques for filling material removal in root canal retreatment.

OBJECTIVES: The aim of this study was to compare the efficacy of rotary and reciprocating techniques for removing filling material from root canals, using micro-computed tomography (micro-CT) imaging. MATERIALS AND METHODS: The distal root canals of 42 human mandibular molars were instrumented with hand files up to size 40 according to a step-down technique and obturated with gutta-percha and an epoxy resin-based sealer using Tagger's hybrid technique. Teeth were divided into six groups (n = 7) according to the instruments used for removal of filling material: group PTUR (Protaper Universal Retreatment), group W40 (WaveOne 40.08), group R40 (Reciproc 40.06), group R50 (Reciproc 50.05), group W25/W40 (WaveOne 25.08/40.08), and group R25/R40/R50 (Reciproc 25.08/40.06/50.05). Teeth were scanned with a micro-CT device before and after use of the instruments to calculate the percentage of remaining filling material. Data were compared using one-way ANOVA and Fisher's LSD test at 5 % significance level. RESULTS: The mean percentage of remaining filling material was significantly lower when canals were retreated with the set of instruments R25/R40/R50 and single instruments W40 and R50 compared with the set of instruments W25/W40 (P < 0.05), which promoted material compaction in the apical region. CONCLUSION: None of the retreatment techniques removed the root fillings completely. PTUR instruments performed equally effective regarding filling removal compared with W40, R40, R50, W25/W40, and R25/R40/R50. For WaveOne, the use of a single instrument (size 40, taper 0.08) was more effective in removing filling material, while for Reciproc showed similar cleaning ability using single instrument or combination of instruments. CLINICAL RELEVANCE: The results of this in vitro study provide consistent information on filling material removal capacity of mechanized systems during retreatment at the different root canal thirds.

Micro-computed tomographic analysis of the root canal morphology of mandibular incisors.

INTRODUCTION: This study aimed to describe the anatomy of mandibular central and lateral incisors using micro-computed tomographic imaging. METHODS: One hundred mandibular incisors were scanned in a micro-computed tomographic device using an isotropic resolution of 22.9 µm. The anatomy of each tooth (length of the roots, presence and location of accessory canals and apical deltas, and number of canals) as well as the 2- and 3-dimensional morphologic aspects of the canal (area, roundness, diameter, volume, surface area, and structure model index) were evaluated. Data were statistically compared using the Student t test (alpha = 0.05). RESULTS: The mean lengths of the mandibular central and lateral incisors were 20.71 and 21.56 mm, respectively. Most of the central (60%) and lateral (74%) incisors had no accessory canals. An apical delta was observed in only 1 specimen. The cross-section analysis of the apical third showed the presence of 1, 2, or 3 canal orifices. No statistical difference was observed in the comparison of the 2- and 3-dimensional morphologic parameters between central and lateral incisors (P < .05). The qualitative analyses of the 3-dimensional models of the root canal systems of the central and lateral incisor teeth confirm that the most prevalent configurations were Vertucci's types I (50% and 62%, respectively) and III (28%). CONCLUSIONS: Overall, mandibular central and lateral incisors were similar in terms of the 2- and 3-dimensional analyzed parameters. Vertucci's types I and III were the most prevalent canal configurations of the mandibular incisors; however, 8 new types have also been described.

Orthodontic force increases interleukin-1ß and tumor necrosis factor-α expression and alveolar bone loss in periodontitis.

BACKGROUND: The present study aims to evaluate the effects of orthodontic movement (OM) on the periodontal tissues of rats with ligature-induced periodontal disease. METHODS: Eighty-eight rats were divided into four groups: 1) negative control (sham operated); 2) periodontal disease; 3) OM; and 4) periodontal disease followed by OM (OMP). Rats were sacrificed 3 hours or 1, 3, or 7 days after OM commencement. Bone volume fraction (BVF) and bone mineral density (BMD) were assessed in hemimaxillae by microcomputed tomography analysis. Expression of the proinflammatory cytokines interleukin (IL)-1ß and tumor necrosis factor (TNF)-α were evaluated in gingival samples by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, and in the furcation region by immunohistochemistry analysis (IHC). RESULTS: The OMP group had lower BVF and BMD levels compared to the other groups at day 7 (P <0.05). Maximum messenger ribonucleic acid expression of both cytokines was observed in the OMP group at day 1 (P <0.05). In the same period, all proteins were expressed in high levels for all test groups compared to the control group. The number of cells positive for IL-1ß and TNF-α by IHC was highest in the OMP group at day 1, with progressive reduction thereafter. CONCLUSION: The results suggest that OM acts synergistically with periodontal disease in periodontal breakdown through upregulation of proinflammatory cytokines.