Optimizing Root Canal Therapy: An In Vitro Comparative Study of Innovative File Systems on Mandibular Premolar Fracture Resistance.

INTRODUCTION AND AIM:  Root canal therapy is a vital procedure for saving teeth by removing infection and cleaning the complex root canal system. However, a delicate balance exists between thorough cleaning and preserving tooth strength. The study aims to evaluate the instrumentation effect of three innovative file systems, XP-endo® shaper, Reciproc®, and Self-adjusting file (SAF) on fracture resistance of mandibular premolars. MATERIALS AND METHODS: Thirty single-rooted mandibular premolars were collected; a standard access cavity was prepared and the working length was established 1 mm short of the apex. The teeth were randomly divided into three groups(n=10). In Group 1, the shaping of the specimens was achieved using XP-endo® shaper; in Group 2, it was instrumented using Reciproc® file; and in Group 3, it was instrumented using SAF. All samples were decoronated and the roots were mounted vertically in acrylic resin and subjected to fracture resistance under a universal testing machine. RESULTS: Intergroup analysis was done by one-way ANOVA followed by Bonferroni post hoc test, which did not report a statistically significant difference (p>0.05). CONCLUSION: All three tested file systems were similar in fracture resistance. XP-endo® shaper exhibited better fracture resistance on root canal instrumentation when compared to Reciproc® and SAF although they are not statistically significant.

Canal-Centering and Apical Transportation Ability of Similar Cross-Section NiTi Instruments Working with Different Kinematics-Micro-CT-based In Vitro Analysis.

Objective: Evaluating the canal-centering and apical transportation ability of endodontic file systems working with different kinematics but of similar cross section. Materials and Methods: Sixty human maxillary first molar mesiobuccal (MB) roots were assigned to three experimental groups based on instrumentation techniques: Reciproc Blue (RB), Mtwo (M2), and OneShape (OS). Pre- and post-instrumentation micro-computed tomographic analysis was performed. Centering ability and apical transportation were analyzed at 3 mm, 6 mm, and 9 mm short of the apex. Statistical analysis was conducted using Mann-Whitney U test and Kruskal-Wallis test. Results: OS showed better canal-centering ability than RB and M2 at 3 mm, 6 mm, and 9 mm. No significant difference among the tested groups was observed during the assessment of apical transportation (P < 0.05). Conclusion: The systems evaluated safely prepared curved MB canals with minimal canal transportation. OS showed superior canal-centering ability compared to the other two groups.

To Evaluate Different Endodontic Instrumentation Systems Regarding Post-Operative Pain After Endodontic Therapy: A Clinical Study.

BACKGROUND: Despite substantial breakthroughs in instrumentation systems and pharmaceutical interventions, pain following endodontic therapy remains a serious concern. The effect of the type of endodontic instrumentation system in post-operative pain after endodontic therapy has been a matter of debate. AIM: To evaluate different endodontic instrumentation systems, namely Reciproc (GmbH, Munich), OneShape® (MicroMega, France), Protaper Gold (Dentsply Sirona, USA), and Hyflex® EDM (Coltène/Whaledent Inc., USA) file systems, regarding post-operative pain after endodontic therapy Methods and materials: The endodontic department treated healthy patients aged 20 to 50 years who were experiencing symptoms of irreparable pulpitis in one or more maxillary molars or mandibular molars. Five hundred was the determined size of the sample. The study participants were divided into five categories, each comprising 100 participants. These categories were: Category 1: Reciproc instrumentation system. Category 2: OneShape® instrumentation system. Category 3: ProtaperGold instrumentation system. Category 4: HyFlex® EDM instrumentation system. Category 5: Control (stainless steel K-files). Following endodontic therapy, these scores were recorded at 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours using the VAS scale. RESULTS: The visual analog scale (VAS) score (mean±SD) in the control group was 0.73± 0.40 (<0.001). The VAS score in the Reciproc group was 0.43± 0.05 (<0.001). The VAS score in the OneShape® group was 0.36±0.09 (<0.001). The VAS score in the Protaper Gold group was 0.41 ±0.08 (<0.001). The VAS score in the HyFlex® EDM group was 0.55 ±0.02 (<0.001). The VAS score in all instrumentation techniques at 72 hours follow-up was lesser in comparison to a control group with meaningful statistical significance (<0.001). However, the post-operative pain among the Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM instrumentation systems was not different clinically when compared among themselves. However, VAS values were greater in OneShape® and HyFlex® EDM compared to Reciproc and Protaper Gold, showing increased post-operative pain in OneShape and HyFlex® EDM compared to Reciproc and Protaper Gold. It was also observed that there was a decline in the VAS score in all instrumentation systems as the follow-up period increased from 6 hours to 72 hours, with maximum post-operative pain at 6 hours of follow-up and minimum post-operative pain at 72 hours of follow-up. However, the decline was lesser in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold, with increased post-operative pain in OneShape® and HyFlex® EDM in comparison to Reciproc and Protaper Gold. CONCLUSION: Post-operative pain at all follow-ups of endodontic procedures was less in Reciproc, OneShape®, Protaper Gold, and HyFlex® EDM than in the control group. VAS scores were higher in the OneShape® and HyFlex® EDM groups compared to the Reciproc and Protaper Gold groups, indicating increased post-operative pain with OneShape® and HyFlex® EDM instruments in comparison to Reciproc and Protaper Gold.

Efficiency of ProTaper Universal Retreatment, Reciproc Blue and XP-endo Shaper in the removal of a bioceramic-based root canal filling.

Purpose: This in vitro study aimed to assess the performance of ProTaper Universal Retreatment (PTUR), Reciproc Blue (RB), and XP-endo Shaper (XPS) system in the removal of bioceramic root canal filling. Materials and methods: Forty-five human single-rooted mandibular premolars were prepared up to 30/.04 and filled with Endosequence BC sealer and BC points before being assigned into three groups (n=15). The root canal fillings were removed until reaching predetermined working length (WL) with PTUR in group 1, RB in group 2, and XPS in group 3. During the removal of the filling material, apically extruded debris was collected in pre-weighed Eppendorf tubes, and operation time was recorded with a digital chronometer. Reaching the WL and maintaining apical patency were evaluated separately. The data were statistically analyzed using Kruskal Wallis and Mann Whitney U tests. Results: The mean amount of extruded debris was highest in the PTUR group, although all instruments caused apical extrusion of debris. The mean time for reaching WL was longest for RB and shortest for XPS, with significant differences among the groups (p<0.05). Although the difference was not significant (p=0.799), in the PTUR group the WL was reached in 93.3% of the samples, which was higher than other groups (86.7%). Conclusion: All tested systems caused a certain amount of debris extrusion. XPS was associated with less extrusion while regaining more rapid access to the periapical area than PTUR and RB.

In vitro evaluation of filling material removal and apical debris extrusion after retreatment using Reciproc blue, Hyflex EDM and ProTaper retreatment files.

OBJECTIVES: To evaluate the amount of remaining filing material and apical debris extrusion after retreatment using Reciproc Blue, Hyflex EDM and ProTaper Retreatment Files. MATERIALS AND METHODS: Thirty-six extracted permanent mandibular first molars with moderately curved mesial roots were selected. Mesiobuccal canals were prepared using the ProTaper Next system up to size X2 and filled using gutta-percha and Adseal sealer via cold lateral compaction. Teeth were randomly divided into three equal groups (n = 12): Group 1: Reciproc Blue (RB)(VDW, Germany), Group 2: Hyflex EDM (HEDM)(Coltene/Whaledent, Switzerland), Group 3: ProTaper Universal Retreatment file system + ProTaper Next file system (PTUR + PTN)( Dentsply Maillefer, Switzerland). Eppendorf tubes were used to collect the apically extruded debris. Cone-beam computed tomographic scans were taken prior to and after retreatment and the volume of remaining filling material was assessed at the coronal, middle and apical levels. Statistical analysis was performed using the Kruskal-Wallis test, Friedman's test and Wilcoxon Sign Rank test. Significance level was set at p value 0.05. RESULTS: There were no statistically significant differences among the three groups in the reduction of the volume of the filling material or in the amount of apically extruded debris. CONCLUSION: All the tested filing systems showed similar efficacy in removing the filling material, however, none of them could achieve its complete removal. Apical extrusion of debris occurred with all the systems used with no significant difference between the three groups.

Shaping outcomes of Reciproc Blue and Rotate in roots canals with band-shaped isthmuses: micro-CT study.

OBJECTIVE: This study assessed the outcome of shaping the mesial roots of mandibular first molars containing band-shaped isthmuses with an isthmus floor located at the apical third with Reciproc Blue and Rotate instruments in terms of canal transportation, canal aberrations and unprepared apical canals. MATERIALS AND METHODS: Pair-matched mesial roots of mandibular first molars according to their isthmus location (distance from apical foramina) and size were constructed based on quantitative measurements (length, major and minor diameter at isthmus roof and floor) on preoperative micro-CT scanning (n = 10). The pair-matched specimens were prepared either using Reciproc Blue R25 (25.08v) or Rotate (15.04, 20.05, 25.06) instruments and then subjected to a second micro-CT scanning. Micro-CT scans were analysed to evaluate the canal transportation at the apical foramen and isthmus floor levels and the frequency of procedural errors (separated instruments, artificial canal preparation, cross shaping and unprepared apical canals). Canal transportation values were compared using Mann-Whitney U, and the distribution of procedural errors was compared with chi-square tests with a 5% significance threshold. RESULTS: Greater transportation values were detected in the apical foramen level compared to the isthmus floor in both groups. No significant difference was detected between Rotate and Reciproc Blue groups in terms of absolute transportation values and the incidence of procedural errors (p > .05). CONCLUSION: Preparation of mesial root canals containing a band-shaped isthmus at the apical portion with Reciproc Blue and Rotate instruments caused transportation of the original canal position at the isthmus floor and the apical foramen levels and resulted in procedural errors. CLINICAL RELEVANCE: This ex vivo micro-CT study using controlled pair-matched specimens showed that presence of a band-shaped isthmus complicates canal preparation procedure irrespective of the preparation systems.

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.

Elimination of E. faecalis and C. albicans Biofilm: A comparison between single and multiple file systems in an Ex Vivo study

To evaluate whether the WaveOne Gold and Reciproc single file instrumentation systems, are effective in reducing the microbial load of a mixed biofilm and the cleaning of apical third compared to the Twisted File Adaptive system (multiple- file system). Seventy mesial roots of the first and second molars were included and randomly divided into three experimental groups (n=20, n=10 controls). Biofilms were formed inside canals over 31 days. After instrumentation with the unique file systems, WaveOne Gold and Reciproc and the multiple file system Twisted File Adaptive, using 2.25% sodium hypochlorite as an irrigant in all cases, a count of colony forming units was performed using serial dilutions, cleaning of the apical third was evaluated using scanning electron microscopy. Comparisons amongst groups were made by using parametric and non-parametric statistics, according to a normal or non-normal data distribution, respectively. No significant differences in the reduction of the microbial load after employing a single-file system in comparison to the multiple-file system were found; in addition, the cleaning of the apical third was similar for the three different instrumentation systems. The single-file system is equal in effectiveness compared with the multiple-file system in reducing the microbial load.

Evaluar si los sistemas de instrumentación de lima única, como WaveOne Gold y Reciproc son efectivos para reducir la carga microbiana de un biofilm mixto y la limpieza del tercio apical, comparado con los sistemas de limas múltiples, como Twisted File Adaptive. Setenta raíces mesiales de primeros y segundos molares fueron incluidos y divididos de forma aleatoria en tres grupos experimentales (n=20, n=10 controles). El biofilm fue formado en el interior de los conductos durante 31 días. Después se instrumentó con los sistemas de lima única (WaveOne Gold y Reciproc) y el sistema de limas múltiples Twisted File Adaptive, usando hipoclorito de sodio al 2.5% en todos los casos. El conteo de unidades formadoras de colonias se realizó usando diluciones seriales, la limpieza del tercio apical se evaluó empleando el microscopio electrónico de barrido. La comparación entre grupos se realizó con pruebas paramétricas y no paramétricas, de acuerdo con la distribución normal y no normal de los datos, respectivamente. No hubo una diferencia significativa en la reducción de la carga microbiana después de emplear los sistemas de lima única en comparación a los de limas múltiples, además, la limpieza del tercio apical fue similar en los 3 diferentes sistemas de instrumentación. Los sistemas de lima única son igual de efectivos para reducir la carga microbiana comparados con los sistemas de limas múltiples.

Evaluation of Apically Extruded Debris During Retreatment Procedures Using Various File Systems in Teeth With Simulated Apical Root Resorption: An In Vitro Study.

Aim The aim of this study was to compare the amount of debris produced apically during the removal of root canal obturating material by using various files in extracted teeth with simulated apical root resorption. Materials and methods An in vitro study was conducted in the root canals of 90 extracted mandibular premolar teeth that were prepared with a ProTaper Gold rotary file (Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and an AH Plus sealer (Dentsply Maillefer, Ballaigues, Switzerland) using a cold lateral compaction technique. A total of 45 mandibular premolar teeth were randomly assigned to three control groups (i.e., the ProTaper Universal retreatment file (Dentsply Maillefer), the Reciproc Blue file (VDW, Munich, Germany), and the HyFlex Remover file (Coltene/Whaledent, Altstatten, Switzerland) for the removal of root canal filling material, whereas the remaining 45 teeth were treated as the experimental group and their apical portion was modified to simulate apical root resorption. The teeth of this experimental group were randomly divided into three subgroups according to the same three techniques used with the control groups for the removal of root canal filling materials. The apically extruded debris was collected into pre-weighed borosilicate glass tubes and then dried. The mean weight of the apically extruded debris was assessed using an analytical balance to an accuracy of 10-4 g. Further, the data were analyzed using the Kruskal-Wallis test and Tukey's post hoc test. Results In the simulated apical root resorption groups, all file systems were associated with significantly more debris extrusion than the groups without simulated root resorption (a < 0.05). In both the control groups and experimental groups, the ProTaper Universal retreatment file was associated with the least weight of the apically extruded debris (a < 0.05), followed by the Reciproc Blue file and the HyFlex Remover file. Conclusion The amount of debris extruded apically was significantly greater in the teeth with simulated apical root resorption than in those without it. Further, during the removal of the root canal filling materials, HyFlex Remover was associated with significantly more apically extruded debris in all groups.

Removal of Thermafil Obturators Using 2 Different Techniques: A Comparative Ex Vivo Study.

INTRODUCTION: The aim of this ex vivo study was to compare 2 techniques for removal of Thermafil obturators from curved root canals in mandibular molars. METHODS: Sixty mesial root canals in extracted mandibular molars were distributed into matched pairs according to degree and radius of curvature and were prepared to size 35/.04 and obturated with Thermafil obturators size 35. Each tooth was embedded in resin, mounted in a mannequin head, and isolated with rubber dam to simulate clinical conditions. Removal of obturators was undertaken under a dental operating microscope by an experienced endodontist using either the FragRemover loop device, or reciprocating NiTi instruments. Pre- and postoperative micro-CT scans were taken to compare the amount of remaining filling material and of removed dentin. Eventual problems during removal attempts were recorded. RESULTS: Using Reciproc, 24 carriers (80%) were removed, 16 in one piece, 8 in small pieces, and in 6 cases removal failed. The FragRemover removed 12 carriers (40%), all of these completely, but in 18 cases removal failed (P < .05). Reciproc left less remaining filling material than the FragRemover (P < .05) but removed significantly more dentin in the apical part of the root canal (P < .01). There was no significant difference concerning the total amount of removed dentin (P > .05) between both groups. Seven complications occurred in the Reciproc group. In 5 teeth, working length could not be reached; in 2 teeth, a Reciproc file R25 fractured. With the FragRemover, 64 complications occurred, in 36 cases, including second removal attempts, the loop slipped over the carrier, in 24 cases the top of the carrier was sheared off. In 9 cases, separation of the core occurred too far apically, not allowing further use of the FragRemover. In 4 cases, the wire loop tore. CONCLUSIONS: Reciproc was more effective in removal of Thermafil carriers, whereas when using the FragRemover less dentin was removed in the apical part of the root canal and more obturation material was left.

Evaluación de la capacidad de centrado y transporte apical de los sistemas Reciproc Blue y XP-endo Shaper / Evaluation of the centering and apical transport capacity of Reciproc Blue and XP-endo Shaper systems

Resumen Objetivo: Comparar la capacidad de centrado y el transporte apical de los sistemas Reciproc Blue y XP-endo Shaper en bloques de resina con fotografías pre y posoperatorias yuxtapuestas, mediante un programa de análisis de imágenes. Materiales y Métodos: Se dividieron al azar 20 tacos de resina en dos grupos (n=10) preparados con XP-endo Sha- per y Reciproc Blue respectivamente. Se tomaron fotografías digitales de los tacos, antes y después de la preparación con cada sistema en una misma posición. Luego las fotografías obtenidas fueron yuxtapuestas mediante el software Photo shop. Se midieron las desviaciones del centro del conducto con respecto a la pared interna y externa del mismo en diversos puntos de referencia preestablecidos. Estos datos fueron analizados estadísticamente con el test de ANOVA. Resultados: Ambos sistemas produjeron transporte y desviación respecto a la trayectoria original del conducto radicular, pero el análisis estadístico (ANOVA Factorial 2x8) no cuantificó diferencias significativas entre ambos sistemas (p=0,4044) Conclusiones: Bajo las condiciones de este trabajo, ambos sistemas producen transporte y desviación respecto a la trayectoria original del conducto radicular.

Abstract Aim: To compare the centering capacity and apical transport of the Reciproc Blue and X-Pendo Shaper system in resin blocks with juxtaposed pre and postoperative photographs, using the Photoshop software. Materials and methods: 20 resin plugs were randomly divided into two groups (n=10) that were prepared with XP-endo Shaper and Reciproc Blue respectively. Digital photographs of the blocks were taken, before and after preparation, with each system in the same position. Then the obtained photographs were juxtaposed using Photoshop software. The deviations of the center of the canal, with respect to its inter nal and external wall, were measured at various pre-established reference points. These data were statistically analysed with the ANOVA test. Results: Both systems produced transport and deviation from the original trajectory of the root canal, but the statistical analysis (2x8 Factorial ANOVA) did not quantify significant differences between both systems (p=0.4044) Conclusions: Under the conditions of this work, both systems produce transport and deviation with respect to the original trajectory of the root canal.

Negotiating the second mesiobuccal canal: A comparison of nickel titanium files through the experience of undergraduate dental students.

OBJECTIVES: The aim of this study was to compare the ability of undergraduate students to reach working length (WL) in second mesiobuccal root canals (MB2) of maxillary first molars (n = 210) by using Reciproc Blue without glide path preparation, and One Curve with glide path preparation. METHODS: The students (n = 105) attended theoretical and practical courses. The first group (n = 53) shaped MB2 root canals using the One Curve system and then Reciproc Blue; the second group (n = 52) shaped MB2 root canals following the reverse sequence. Participants completed a questionnaire. The chi-square and Mann-Whitney U test were used for statistical analysis using significance of p < 0.05. RESULTS: The full WL was reached and shaping procedures were completed without complications in Reciproc Blue and One Curve groups at rates of 86.67% and 82.85%, respectively (p > 0.05). Treatment time was shorter in Reciproc Blue (p < 0.05). More (62.9%) students felt the One Curve system safer, while 61% felt the Reciproc Blue system faster. CONCLUSIONS: Within the limitations of this study, instrument kinematics and glide path preparation did not interfere with undergraduate students' ability to achieve the WL in MB2 root canals.

Apical transportation using Mtwo or Reciproc retreatment systems in severely curved canals: a micro-computed tomographic study.

OBJECTIVE: To assess apical root canal transportation using Mtwo or Reciproc during retreatment of severely curved canals, using a multi-analytical approach. METHODS: Forty mesial canals from mandibular molars (Vertucci type IV) were evaluated before and after endodontic retreatment to compare apical transportation with Mtwo retreatment or Reciproc. The systems were used on the same root but alternating the mesial canals. The analyses were performed by micro-computed tomography. Four evaluations were performed: (a) longitudinal transportation, (b) horizontal transportation, (c) variation in the angle of curvature of the canal, and (d) canal-root width ratio. Horizontal transportation and canal-root width ratio were evaluated in 1-, 3-, and 5-mm levels. RESULTS: Longitudinal transportation occurred in all samples, with a mean of 0.13 mm for Mtwo and 0.17 mm for Reciproc. Horizontal transportation increased as distant from the apex was the evaluated level, in mean. However, the transport was not observed in all samples. The mean angle of curvature was 4.16 for Mtwo and 3.03 for Reciproc. Canal-root width decreased as distant from the apex was the evaluated level. No significant differences were observed considering all tested variables, independently of the retreatment system or evaluated level (p > 0.05). CONCLUSION: Mtwo retreatment and Reciproc presented similar apical transportation (horizontal or vertical). CLINICAL RELEVANCE: Both Mtwo retreatment and Reciproc systems could be considered safe regarding apical transportation.

The Comparative Evaluation of Postoperative Pain After the Use of WaveOne Gold and TruNatomy Filing Systems in a Tooth With Irreversible Pulpitis: An Observational Study.

Introduction The present study aimed to clinically compare the incidence of postoperative pain after the endodontic treatment of posterior teeth using the WaveOne Gold (WOG) and TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) filing systems. The study gives a better understanding of the association of postoperative pain and filing systems used. The patients were selected in such a manner that they have a similar diagnosis before the initiation of treatment. It also helps to understand if the postoperative pain is dependent or independent of the filing system used. Methods In the study, 32 vital teeth with irreversible pulpitis with no periapical lesion were selected for the study. The patients were divided into two groups (n=16) according to the instrumentation system used (WaveOne Gold group and TruNatomy group). The treatments were performed in a single session. The participants were asked to rate the intensity of postoperative pain on a visual analog scale (VAS) (no pain, mild pain, moderate pain, and severe pain) after 24 hours, 72 hours, and seven days; the tests of significance used are Friedman test or Mann-Whitney test. Results The incidence of postoperative pain is comparatively less in WaveOne Gold group after 24 and 72 hours compared with those in the TruNatomy group. No postoperative pain is experienced after seven days by the participants of both groups. Conclusions Postoperative pain is expected more after the preparation of the root canal system with the TruNatomy as compared to WaveOne Gold.

The Efficacy of Three Rotary Systems (Reciproc Blue, WaveOne Gold, and AF Blue R3) in Preparing Simulated, Highly Curved Root Canals: An In Vitro Study.

Purpose This study aimed to evaluate the effectiveness of three rotary, single-file, and reciprocating systems in terms of preparation time and canal centralization in simulated highly curved root canal preparation. Materials and methods The study sample consisted of 45 simulated canals with a curvature of 40°. They were randomly distributed into three experimental groups: Group 1-Reciproc Blue; Group 2-WaveOne Gold; and Group 3-AF Blue R3. A glide path was established by #10 hand K-file, then red dye was colored on the simulated canals, and photographs of the sample were taken before preparation. Then, the canals of each group were prepared, and other photographs were taken after preparation. The images of the two phases were combined using AutoCAD, where the canal was divided into three parts and the preparation area was measured from the right and left sides of each part of the canal. The preparation time for each system was also measured. Results While there were no statistically significant differences in the rate of preserving canal centralization in the middle and apical thirds between preparation groups, a statistically significant difference was found in the coronal third, as the Reciproc Blue and WaveOne Gold systems have a greater ability to maintain the centrality of the canal compared to the AF Blue R3 system. While there were no statistically significant differences between the Reciproc Blue and WaveOne Gold systems in the coronal third, as for the preparation time, it was found that there were statistically significant differences in the preparation time between the groups in favor of the WaveOne Gold system. Conclusion Both preparation systems (Reciproc Blue and WaveOne Gold) maintained the anatomical shape and canal centrality, with more cons for WaveOne Gold compared to the Reciproc Blue system. Regarding the volumetric changes, AF Blue R3 had the greatest changes compared to the Reciproc Blue and WaveOne Gold systems. WaveOne Gold Group, in terms of canal preparation time, showed the least time among the investigated groups.

Comparison of postoperative pain after the use of different nickel titanium instrumentation systems: a randomized clinical trial.

Purpose: Postoperative pain is a common complication in endodontics contributed by multiple etiological factors, which consist canal preparation instruments and kinematics. The aim of this randomized clinical trial compare the postoperative pain in terms of intensity and incidence after the use of different nickel titanium (NiTi) file systems. Patients and methods: In this randomized clinical trial (NCT03791762), a total of 150 patients were root canal treated by 2 experienced endodontists according to a standardised protocol. The subjects were randomly assigned to 1 of the 3 groups according to preparation instrument used: ProTaper Next (Dentsply Sirona, Ballaigues, Switzerland), Reciproc Blue (VDW, Munich, Germany) and WaveOne Gold (Dentsply Sirona). Following preparation the teeth underwent standardized root canal treatment procedures in a single visit. The patients were contacted to gather information about the incidence of pain and intensity at 6th, 12th, 18th, 24th, 48th, and 72nd hours postoperatively. The data were analysed using chi-square, one-way analysis of variance and post hoc Tukey tests and logistic regression analysis with 5% significance threshold. Results: No significant difference was found among preparation groups in relation to the intensity of postoperative pain. The incidence of postoperative pain was significantly linked with the preoperative pain presence with odds ratio values ranging between 2.06 and 4.08 irrespective of the preparation technique (P<0.05). Conclusion: The effects of reciprocating and the continuous rotary systems on the intensity and incidence of postoperative pain were found to be similar.

Shaping Ability of Reciproc Blue Versus One Curve in Curved Canal: An In-Vitro Study.

The introduction of nickel-titanium (NiTi) rotary instruments improved the root canal preparation of the narrow and curved root canals, especially after the introduction of thermomechanical treated (NiTi) alloys that have a high flexibility to prepare the curved canal reducing the common clinical complication, such as fracture, the change of the original shape of the root canal as a result of the change in the curvature of the curved root canal, the change of the working length which caused by the creation of the ledges, canal transporting and zipping especially in medium and highly curved canal. This study aimed to compare the shaping ability of two heat-treated nickel-titanium single file systems using reciprocation motion and rotary motion in curved canals. Materials and methods Thirty extracted human teeth with one curved root at 25 to 56 degrees were used, two NiTi single file systems were used to prepare the curved root canal in two groups: Reciproc R25 (Munich, Germany: VDW) group (n=15) and One Curve (Besancon, France: Micro-Mega) group (n=15). Curved root canal instrumentation outcomes were evaluated using cone-beam computed tomography (CBCT). Kruskal-Wallis with Bonferroni post hoc test was used to assess differences between working length, the angle and radius of curvature after instrumentation. Results There was a significant difference in angle and radius of curvature (-1.83° One Curve, -2.25° Reciproc blue and -0.18 mm One Curve, -0.19 mm Reciproc blue, respectively) (p<0.05) after instrumentation for both One Curve and Reciproc blue groups, and there was no significant difference in working length change (-0.16 mm One Curve, -0.32 mm Reciproc blue) after instrumentation of both One Curve and Reciproc blue groups (p>0.05). Conclusion The Reciproc blue single file system with reciprocation movement and One Curve with continuous movement cause a significant difference in curvature and radius of curved root canal affecting the original shape of the root canal with no significant difference in working length of the curved root canal.

Comparison of apical debris extrusion during root canal preparation in primary molars using different file systems: an in vitro study.

This study aimed to compare the amount of debris extrusion of four endodontic systems made of Nickle-Titanium alloy. This in vitro study was done on 80 extracted primary molars. They were selected by cone-beam computed tomography and randomly divided into four groups (n = 20) to be prepared to the apical size of 25 by one of the systems: Reciproc, Protaper Universal, Neolix, or Hyflex CM. Debris was collected into Eppendorf microtubes and placed in an incubator to evaporate the washing solution. Debris was weighed by a digital scale of 0.01 g precision. Data were statistically analysed using SPSS software. Tukey's comparison was used to determine the difference between the four file systems (α = 0.05). Debris extrusion after Reciproc preparation (0.00320) was significantly higher than the other (P < 0.05), with no significant difference having been observed among the other systems (P > 0.05). It can be concluded that all systems under investigation exhibited debris extrusion.

Efficacy of Reciprocating Instruments in Retreatment of Bioactive and Resin-Based Root Canal Sealers.

Objective: To compare the effectiveness of reciprocating instruments in removing gutta-percha and bioactive-based (BioRoot RCS and MTA Fillapex) and epoxy resin-based (AH Plus) sealers from root canals based on filling residues and the time required for root canal revision. Material and methods: Root canals of 90 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and with one of the selected sealers. Samples with oval, straight canals were used and randomly divided into three groups: (i) filled with AH Plus sealer and gutta-percha (n=30); (ii) filled with MTA Fillapex and gutta-percha (n=30); (iii) filled with BioRoot RCS and gutta-percha (n=30). Each group was divided into two subgroups (n=15) according to the retreatment instrument used (Reciproc M-Wire R25/R40 or Reciproc blue RB25/RB40). Root canals were longitudinally split and analyzed with a stereomicroscope at 15 × magnifications in the coronal, middle, and apical third. Computational analyses were performed with the Image J software. Data were compared using the Kruskal-Wallis test and Mann-Whitney U test. Results: While no statistically significant differences in the residual material surface were found for Reciproc Blue, Reciproc M-Wire showed significantly higher residual material surface for AH Plus and MTA Fillapex compared to BioRoot RCS. For AH plus. Residual material surface was significantly lower for Reciproc Blue than for Reciproc M-Wire. In contrast, BioRoot RCS showed a significantly higher residual material surface for Reciproc Blue. Conclusions: Calcium silicate-containing sealers were more retrievable compared to AH Plus, with fewer sealer remnants and shorter retreatment time. Retreatment with Reciproc M-Wire instruments was superior to Reciproc blue instruments in retreatment of BioRoot RCS. However, none of the sealers were removed completely.

An Appraisal on Newer Endodontic File Systems: A Narrative Review.

AIM: This narrative review aims to explore and elicit the newer endodontic file systems used for root canal treatments. BACKGROUND: The primary goals of endodontic therapy continue to be the mechanical enlargement and shaping of the intricate endodontic root canal systems to aid in disinfection. Nowadays endodontists have access to a wide range of endodontic file systems for root canal preparations with various design characteristics and benefits. REVIEW RESULTS: ProTaper Ultimate (PTU) files' tip have a triangular convex cross-section, an offset mass of rotating design, a maximum flute diameter of 1.0 mm, and are constructed of gold wire, hence, commonly applied in conditions with restricted accessibility or an extremely curved canal. TruNatomyhas advantages over other cutting-edge file systems like maximum flute diameter of the corona, reduced distance between active cutting flutes, and shorter handles in comparison to SX instruments. In comparison to PTU files, ProTaper Gold (PTG) files are noticeably more elastic and fatigue-resistant. Compared to files in the F1-F3 range, size S1 and S2 files have a significantly longer fatigue life. MicroMega One RECI is more resistant to cyclic fatigue because of its heat treatment and reciprocating action and the C-wire heat treatment of the former gives it flexibility and controlled memory, enabling the prebending of the file. The RECIPROC blue demonstrated enhanced flexibility, increased fatigue resistance, and lower microhardness while maintaining the same surface qualities. CONCLUSION: As per the necessity and requirement on case to case basis, every endodontic file system has advantages and disadvantages as mentioned in this narrative review. According to the need, an endodontist can select the file system which is required specifically. Although several studies are comparing these various systems in the literature, this narrative review aims to give the clinician a summary of some recently launched endodontic rotary file systems available in the market and their clinical uses. CLINICAL SIGNIFICANCE: As per the priority and need of the case, whether removal and extrusion of debris, reduction of micro-organisms, keeping canal anatomy, and cutting efficiency, a specific required file system can be utilized.