Introduction of nickel titanium rotary instruments to undergraduate students

Many studies address the quality of root canal treatments, but few refer to endodontics using rotatory techniques performed by novice operators. This study evaluated the performance of undergraduates in their first contact with rotary root canal instrumentation concerning the findings of the final periapical radiograph, and the post endodontic treatment pain. A longitudinal observational study was performed on periapical radiographs of 491 teeth from 450 patients submitted to root canal treatment by undergraduate students from 2015 to 2018. The analysis of the length of root canal filling followed the criteria: (i) acceptable, if periapical radiograph presents root filling ending 0 - 1 mm short of radiographic apex; (ii) over, if periapical radiograph presents root filling ending beyond the radiographic apex; and (iii) under, if periapical radiograph presents root filling ending > 1 mm short of radiographic apex. Evaluation of postendodontic treatment pain was categorized into either absence or presence of pain. Adequate length root canal filling was observed in 65.9% of the cases (324 teeth). Periapical lesions presence and dimensions did not interfere to the obturation quality. Statistical relation was found between the pulp condition and postendodontic treatment pain. The presence of pain was observed in 4.7% of the vital teeth and 0.3% of non-vital teeth. The presence of periapical lesion did not influence postoperative pain. Adequate length root canal filling was observed in most cases and NitTi rotary instrumentation had applicability in undergraduate programs, even with novice operators. Besides that, pulp condition had an effect on postendodontic pain.

Treatment of anatomic canal variations in premolar teeth: Five case reports

Aim: The aim of this case report is to present a series of anatomical variations and endodontic treatments in four two-canal mandibular premolar teeth and three rooted three-canal maxillary second premolar teeth with root canal treatment indications identified via clinical and radiographic examinations. The success of root canal treatment is achieved with a thoroughly examined root canal morphology that has been accurately determined radiographically and clinically before adequate shaping, irrigation, and hermetic filling procedures. Root canals that are not found or not adequately disinfected can cause root canal treatment failure and complications, such as pain, swelling, or persistent fistula, also known as flare-up, after treatment. Canal variations in the teeth were detected via periapical radiographs during the root canal instrumentation stage. Methodology: The endodontic treatments of four two-canal mandibular premolar teeth and one triple-rooted three-canal maxillary second premolar with root canal treatment indications were described. Conclusion: To achieve full success in root canal treatment, anatomical variations should be examined in detail before and during treatment, and treatment should be completed with appropriate techniques. How to cite this article: Dinger E, Bodrumlu E. Treatment of anatomic canal variations in premolar teeth: Five case reports. Int Dent Res 2021;11(Suppl.1):279-84. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.41 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Rotary endodontic files versus manual files for root canal treatment

Many studies have been published to compare the efficacy of root canal filling with either rotary and manual instrumentation. The most commonly reported factors included instrumentation, obturation time and to obturation quality. Besides, the different studies in the literature have used different assessment tools and parameters of their outcomes. In addition, to using different rotary instrumentation techniques. In thisliterature review, we have formulated strong evidence regarding the effectiveness of rotary and manual instrumentation files for root canal filling based on the findings from the current studies in the literature. Our results indicate the effectiveness of rotary instrumentation in reducing the root canal instrumentation time and enhancing the obturation and filling quality as compared to the manual instrumentation techniques. Our findings also indicate the potential variability in the effectiveness between the different rotary instrumentation techniques. However, it was not an area of concentration among the different studies in the literature. Thus, to formulate such evidence, further relevant investigations to this topic might be required. Finally, we recommend that rotary endodontic files should be indicated for the root canal filling settings to obtain better outcomes and alleviate the associated quality of work.

Force and vibration analysis in biomechanical preparation of root canals using reciprocating endodontic file system: In vitro study

The shaping and cleaning of the root canal are very important in root canal treatment. The excessive force and vibration during biomechanical preparation of the root canal may result in failure of the endodontic file. In this study, force and vibration analysis was carried out during root canal preparation. The samples of human extracted (premolar) teeth were provided by the College of Dental Science and Hospital. Endodontic instruments for reciprocating motion, such as the WaveOne Gold file system, had been used for root canal preparation. Force and vibration signals were recorded by dynamometer and accelerometer, respectively. The acquired signals were denoised using the db4 (SWT denoising 1-D) wavelet. Four levels of decomposition were carried out for each signal. The signal denoising technique was used to remove unwanted noise from the acquired signal. FESEM analysis was used to visualize the levels of severity of endodontic files during the cleaning and shaping of the root canal. In most of the cases, the failure occurred due to the improper use of the root canal instrumentation. The optimum amount of force was used to avoid the file failure and provided the proper instrumentation. The curve fitting regression model was used to find the interdependency between force and vibration.

Comparison of the effect on postoperative pain between instrumentation with and without connected electronic apex locator: a randomized clinical trial

Background: The aim of the present study was to evaluate the postoperative pain between root canal instrumentation with unconnected electronic apex locator and instrumentation with connected electronic apex locator. Methods: Forty-two patients were randomly divided into two groups (n=21). Group 1 was treated using the traditional endodontic motor with unconnected electronic apex locator (EAL) and group 2 was treated using the endodontic motor with connected EAL. All teeth were treated in single-visit endodontic therapy. Postoperative pain levels at 6, 24, 48, 72 h and 1 week were recorded by patients. The data were collected and analyzed using the χ2, and Mann-Whitney U tests with significance at 0.05. Results: Postoperative pain levels were significantly reduced by half at 6 hours in both experimental groups; however, no significant differences were found in postoperative pain levels between the two groups at all considered times. The postoperative pain levels using a percussion test were reduced on day 7 in both groups, and there was no significant difference in this variable between two groups. Conclusions: Both groups have a similar effect on reduction of the postoperative pain for endodontic patients undergoing root canal.

The use of chelating agents with passive ultrasonic irrigation enhances root canal filling sealing ability

The aim of this study was to compare the influence of a final rinse with and without passive ultrasonic irrigation (PUI), using 17% ethylenediaminetetraacetic acid (EDTA) or 10% citric acid (CA), with 2.5% sodium hypochlorite (NaOCl) with PUI, on the sealing ability of root canal fillings. Root canal instrumentation was performed in single-rooted premolars using NaOCl as the irrigant. Subsequently, the roots were randomly allocated into four experimental groups (n=23): EDTA+PUI, EDTA, CA+PUI, CA and control group: NaOCl+PUI. The specimens were root-filled using gutta-percha with a resin-based sealer and inserted into a device to measure glucose leakage at 7 and 30 days. Kruskal-Wallis and Mann- Whitney tests were used to evaluate the differences between the solutions and with or without PUI. Friedman’s ANOVA was used to compare time points (P<0.05). PUI groups showed lower infiltration values (EDTA+PUI 0.74±0.77 and CA+PUI 5.32±1.45) when compared to the groups on which PUI was not performed (EDTA 7.20±2.18 and CA 20.73±4.70), this difference was significant for EDTA (P<0.01) and CA (P=0.000). Also, EDTA showed less glucose infiltration than CA, with or without PUI (P<0.005). NaOCl+PUI showed a higher cumulative glucose infiltration (22.92±9.71). A final rinse using EDTA or CA with PUI enhances the sealing of root canal fillings. EDTA showed less infiltration.

Dentinal Microcracks after Root Canal Instrumentation Using Instruments Manufactured with Different NiTi Alloys and the SAF System: A Systematic Review

Aim: The aim of this systematic analysis was to assess the prevalence of dentinal microcracks at various levels (3, 6, and 9mm from the apex) after using instruments made with conventional, R-Phase, and M-Wire NiTi alloys and the SAF system. Materials and Methods: Electronic searches were conducted in the databases Embase, Cochrane Library, Scopus, PubMed, and Web of Science. To arrange search methods, “MeSH” terms and/or keywords typically associated with the subject were paired with the Boolean operators “AND” and “OR.” Additional searches were conducted on the websites of four separate endodontic journals. After reading the titles and excluding duplicates, 1000 of the 1343 documents originally found were eliminated. Upon reviewing the abstracts, 310 of the remaining 343 experiments were also eliminated. Based on qualifying requirements, only 13 of the remaining 33 articles were included in the qualitative review. Results: All systems triggered dentinal microcracks; however, when chemo-mechanical preparation was performed using Self-Adjusting File (SAF) and systems manufactured with R-phase technology—K3XF and Twisted File Adaptive (TFA)—less of these defects were found when compared to those manufactured with traditional NiTi—ProTaper Universal and Mtwo—and with M-Wire—ProTaper Next, Reciproc, and WaveOne. Conclusions: A lower prevalence of dentinal microcracks was observed after using SAF and endodontic systems manufactured with R-phase.