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Effect of post space preparation drills on the incidence of root dentin defects
Thaíse Ayres Bezerra Zuli, Orlando Aguirre Guedes, Gislaine Figueiredo Zarza Arguello Gonçalves, Aurélio Rosa da Silva Júnior, Álvaro Henrique Borges, Andreza Maria Fábio Aranha
Restor Dent Endod 2020;45(4):e53.   Published online October 16, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e53
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills.

Materials and Methods

Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance.

Results

Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05).

Conclusions

PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

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Dentinal defects induced by 6 different endodontic files when used for oval root canals: an in vitro comparative study
Ajinkya M Pawar, Bhagyashree Thakur, Anda Kfir, Hyeon-Cheol Kim
Restor Dent Endod 2019;44(3):e31.   Published online July 29, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e31
AbstractAbstract PDFPubReaderePub
Objectives

To compare the formation of dentinal defects using stainless-steel hand K-files (HFs), rotary files, reciprocating files, and Self-Adjusting File (SAF), when used for oval root canals.

Materials and Methods

One hundred and forty extracted human mandibular premolar with single root and oval canal were selected for this study. Oval canals were confirmed by exposing to mesio-distal and bucco-lingual radiographs. Teeth with open apices or anatomic irregularities were excluded. All selected teeth were de-coronated perpendicular to the long axis of the tooth, leaving roots segments approximately of 16 mm in length. Twenty teeth were left unprepared (control), and the remaining 120 teeth were divided into 6 groups (n = 20) and instrumented using HF (size 40/0.02), Revo-S (RS; size 40/0.06), ProTaper NEXT (PTN; size 40/0.06), WaveOne (WO; size 40/0.09), RECIPROC (RC; size 40/0.06), and the SAF (2 mm). Roots were then sectioned 3, 6, and 9 mm from the apex, and observed under stereomicroscope, for presence of dentinal defects. “No defect” was defined as root dentin that presented with no visible microcracks or fractures. “Defect” was defined by microcracks or fractures in the root dentin.

Results

The control, HF, and SAF did not exhibit any dentinal defects. In roots instrumented by RS, PTN, WO, and RC files exhibited microcracks (incomplete or complete) in 40%, 30%, 55%, and 50%, respectively.

Conclusions

The motor-driven root canal instrumentation with rotary and reciprocating files may create microcracks in radicular dentine, whereas the stainless-steel hand file instrumentation, and the SAF produce minimal or less cracks.

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Incidence of apical crack formation and propagation during removal of root canal filling materials with different engine driven nickel-titanium instruments
Taha Özyürek, Vildan Tek, Koray Yılmaz, Gülşah Uslu
Restor Dent Endod 2017;42(4):332-341.   Published online November 4, 2017
DOI: https://doi.org/10.5395/rde.2017.42.4.332
AbstractAbstract PDFPubReaderePub
Objectives

To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems.

Materials and Methods

The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with χ2 tests using SPSS 21.0 software.

Results

New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage.

Conclusions

This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

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Light-emitting diode assessment of dentinal defects: the role of presumed extraction forces
Marcelo Santos Coelho, Steven J. Card, Peter Z. Tawil
Restor Dent Endod 2017;42(3):232-239.   Published online July 24, 2017
DOI: https://doi.org/10.5395/rde.2017.42.3.232
AbstractAbstract PDFPubReaderePub
Objectives

The evaluation of iatrogenic dentinal defects in extracted teeth may be influenced by extraction forces and prolonged dry times. The purpose of this study was to compare the presence of dentinal defects in freshly extracted, periodontally compromised teeth with those in a group of teeth with uncontrolled extraction forces and storage time.

Materials and Methods

The experimental group consisted of eighteen roots obtained from teeth extracted due to periodontal reasons with class II or III mobility. They were kept in saline and sectioned within 1 hour following extraction. The control group consisted of matched root types obtained from an anonymous tooth collection, consistent with previous dentinal defect studies. The slices were obtained at 3, 6, and 9 mm from the apex. The imaging process exposed all specimens to no more than 60 seconds of dry time. The × 12.8 magnification was used for the 9 mm slices and × 19.2 magnification for the 3 mm and 6 mm slices under light-emitting diode (LED) transillumination. The root canal spaces and periodontal tissues were masked to minimize extraneous factors that might influence the evaluators. Chi-square test was used for statistical analysis.

Results

Dentinal defects were detected in 17% of the experimental group teeth, compared to 61% of control teeth (p = 0.015).

Conclusions

LED transillumination assessment of freshly extracted roots with class II or III mobility showed smaller number of dentinal defects than roots with uncontrolled storage time and extraction forces. The use of freshly extracted roots with mobility should be considered for future dental defect assessment studies.

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Cutting efficiency of apical preparation using ultrasonic tips with microprojections: confocal laser scanning microscopy study
Sang-Won Kwak, Young-Mi Moon, Yeon-Jee Yoo, Seung-Ho Baek, WooCheol Lee, Hyeon-Cheol Kim
Restor Dent Endod 2014;39(4):276-281.   Published online July 22, 2014
DOI: https://doi.org/10.5395/rde.2014.39.4.276
AbstractAbstract PDFPubReaderePub
Objectives

The purpose of this study was to compare the cutting efficiency of a newly developed microprojection tip and a diamond-coated tip under two different engine powers.

Materials and Methods

The apical 3-mm of each root was resected, and root-end preparation was performed with upward and downward pressure using one of the ultrasonic tips, KIS-1D (Obtura Spartan) or JT-5B (B&L Biotech Ltd.). The ultrasonic engine was set to power-1 or -4. Forty teeth were randomly divided into four groups: K1 (KIS-1D / Power-1), J1 (JT-5B / Power-1), K4 (KIS-1D / Power-4), and J4 (JT-5B / Power-4). The total time required for root-end preparation was recorded. All teeth were resected and the apical parts were evaluated for the number and length of cracks using a confocal scanning micrscope. The size of the root-end cavity and the width of the remaining dentin were recorded. The data were statistically analyzed using two-way analysis of variance and a Mann-Whitney test.

Results

There was no significant difference in the time required between the instrument groups, but the power-4 groups showed reduced preparation time for both instrument groups (p < 0.05). The K4 and J4 groups with a power-4 showed a significantly higher crack formation and a longer crack irrespective of the instruments. There was no significant difference in the remaining dentin thickness or any of the parameters after preparation.

Conclusions

Ultrasonic tips with microprojections would be an option to substitute for the conventional ultrasonic tips with a diamond coating with the same clinical efficiency.

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