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The potential effect of instrumentation with different nickel titanium rotary systems on dentinal crack formation-An in vitro study.

ABSTRACT: The potential mechanical impact of different rotary systems used for root canal preparation has been a matter of debate for long. The aim of this study was to explore the incidence of dentinal cracks after root canal instrumentation with various rotary systems, in vitro. One hundred and eighty intact lower central incisors were selected and randomly divided into fourteen treatment groups (n = 12/group) and a control group (n = 12). After decoronation, the root canals were instrumented with fourteen different rotary systems (E3, E3 azure, NT2, Hyflex CM, Hyflex EDM, 2Shape, OneCurve, ProTaper Next, ProTaper Gold, WaveOne Gold, Mtwo, Reciproc Blue, TF adaptive, K3XF). All roots were horizontally sectioned at 3, 6, and 9 mm from the apex with a low-speed saw under water-cooling. The slices were then examined under stereomicroscope for dentinal cracks. No cracks were found in the control group. Cracks were found in all treatment groups, predominantly in the 3 mm slices. There was no statistically significant difference in the number of cracks when comparing the different systems to each other at any section level. At 3 mm, however, five of the studied systems, namely K3XF (p = 0.004), Protaper Next (p = 0.001), Reciproc Blue (p<0.001), TF adaptive (p = 0.050), and 2Shape (p = 0.009) presented a significantly higher number of cracks than the control group. Within the limitations of this study, instrumented canals presented dentinal cracks, while uninstrumented ones presented no cracks after sectioning. There seems to be no significant difference among the tested systems regarding crack formation in the instrumented root canal wall. Crack formation occurred irrespective of the motion of the rotary system (rotational or reciprocation). Further studies are needed to clarify the factors that contribute to crack formation in the case of each individual rotary system.

SUBMITTER: Frater M

PROVIDER: S-EPMC7480847 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The potential effect of instrumentation with different nickel titanium rotary systems on dentinal crack formation-An in vitro study.

Fráter Márk M Jakab András A Braunitzer Gábor G Tóth Zsolt Z Nagy Katalin K

PloS one 20200909 9

The potential mechanical impact of different rotary systems used for root canal preparation has been a matter of debate for long. The aim of this study was to explore the incidence of dentinal cracks after root canal instrumentation with various rotary systems, in vitro. One hundred and eighty intact lower central incisors were selected and randomly divided into fourteen treatment groups (n = 12/group) and a control group (n = 12). After decoronation, the root canals were instrumented with fourt ...[more]

PMID: 32903275

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Project description:IntroductionRoot canal treatment is one of the oldest dental procedures for the treatment of endodontic infection. Extrusion of debris beyond the root apex during root canal instrumentation and subsequent persistence of pain are common complications. A systematic review of the evidence on reciprocating single-file instrumentation systems and their comparison with rotary single-file systems, with apical extrusion of debris as primary outcome, will be done through this study.Methods and analysisPublished ex vivo and in vitro studies with no language restriction will be included. We will search MEDLINE (Ovid), EMBASE (Ovid), Web of Science, Cochrane and Google Scholar. Strategies will be incorporated to search grey literature also. Thorough evaluation of search results, completion of data abstraction and assessment of quality will be done by two reviewers independent from each other. Assessment of included studies will be done by utilising an evidence model developed on the basis of standards of quality reported in guidelines to document ex vivo and in vitro studies regarding dental materials and pertained for extrusion of debris apically and has been already used in quality assessment of studies involving quantification of debris extrusion apically. We will calculate the standardised mean differences for apically extruded debris, with congruent 95% CIs. We will measure the statistical heterogeneity by applying the Cochrane Q test and quantify using the I2 statistic. Existence of covariates and any potential heterogeneity will be explored through prespecified subgroup and sensitivity analyses.Ethics and disseminationApproval from an ethical research committee is not required because it will be done using data that have been already published and have no concerns related to the privacy of patients. Extensive dissemination of results from this review will be done through submission to a peer-reviewed journal for publication and conferences.Prospero registration numberCRD42019151804.

Project description:BackgroundTo investigate the complications associated with the use of nickel titanium rotary instruments (NiTi-RIs) for root canal treatments (RCTs), in Saudi Arabia dental practice, and to explore the influencing factors.MethodsAfter obtaining an ethical approval, two pilot studies were conducted to formulate the final questionnaire. The sample size was measured taking into consideration 60% expected response rates and confidence level of 99.9%. The questionnaire was emailed to 600 general dentists (GDs) randomly selected from the dental register and all of the endodontists (175). The email's introduction clarified objectives of the study and guaranteed that all of the collected information would remain confidential. A reminder was sent after 10?weeks. The data were collected and analyzed using the chi-squared test at a 0.05 significance level.ResultsWith a 51% overall response rate, 71.9% off the respondents used NiTi-RIs. The majority (83.1%) experienced complications while using NiTi-RIs; with the instruments' fracture being significantly the most common complication (52.7%) (p?<?0.001). The majority (87.7%) experienced NiTi-RIs' fracture at least once; with more endodontists (94.3%) than GDs (83.3%) (p?<?0.001). The greater the number of weekly performed RCTs and participants' experiences, the more NiTi-RIs fractures and the greater the number of fracture incidents (p?<?0.001). While 60% of those who performed 1-3 RCTs per week experienced NiTi-RIs fractures, 100% of those who performed more than 12 RCTs per week did so. The highest percentage of those who experienced more than 10 fractured NiTi-RIs (60%) was within the group who performed more than 12 RCTs per week. Although fracture incidents decreased with a smaller number of reuses, there was no significant correlation between the number of fractured instruments and NiTi-RIs discard strategy (p???0.05).ConclusionFracture incidence was the most common complication while using NiTi-RIs, regardless of the clinicians' experiences and skills. While the single use may reduce NiTi-RIs fractures, to some extent, the greater number of RCTs performed per week was the most influential factor.

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The potential effect of instrumentation with different nickel titanium rotary systems on dentinal crack formation-An in vitro study.

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The potential effect of instrumentation with different nickel titanium rotary systems on dentinal crack formation-An in vitro study.

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