Comparative Analysis of Ease of Removal of Fractured NiTi Endodontic Rotary Files from the Root Canal System-An In Vitro Study.

Vicente Faus-Matoses,Eva Burgos Ibáñez,Álvaro Zubizarreta-Macho,Celia Ruiz-Sánchez,Ignacio Faus-Matoses,Vicente Faus-Llácer

doi:10.3390/ijerph19020718

Abstract

This study aimed at analyzing and comparing the ease of removal of fractured nickel–titanium (NiTi) endodontic rotary files from the root canal system between the ultrasonic tips and the Endo Rescue appliance removal systems, as well as comparing the volume of dentin removed between ultrasonic tips and the Endo Rescue appliance using a micro-computed tomography (micro-CT) scan. Material and Methods: Forty NiTi endodontic rotary files were intentionally fractured in 40 root canal systems of 20 lower first molar teeth and distributed into the following study groups: A: Ultrasonic tips (n = 20) (US) and B: Endo Rescue device (n = 20) (ER). Preoperative and postoperative micro-CT scans were uploaded into image processing software to analyze the volumetric variations of dentin using an algorithm that enables progressive differentiation between neighboring pixels after defining and segmenting the fractured NiTi endodontic rotary files and the root canal systems in both micro-CT scans. A non-parametric Mann–Whitney–Wilcoxon test or t-test for independent samples was used to analyze the results. Results: The US and ES study groups saw 8 (1 mesiobuccal and 7 distal root canal system) and 3 (distal root canal system) fractured NiTi endodontic rotary files removed, respectively. No statistically significant differences were found in the amount of dentin removed between the US and ER study groups at the mesiobuccal (p = 0.9109) and distal root canal system (p = 0.8669). Conclusions: Ultrasonic tips enable greater ease of removal of NiTi endodontic rotary files from the root canal system, with similar amounts of dentin removal between the two methods.

Highlights

Nickel–titanium (NiTi) alloy endodontic rotary files are widely used to clean and shape the root canal system because they have been shown to significantly increase the success rate of root canal treatments [1]
Other techniques have been proposed for the removal of fractured NiTi alloy endodontic rotary files, including the wire loop technique [9], spinal tap needle-and-Hedstrom file technique [10], Cancelliers [11], Tube-and-Hedstrom file technique [12], hypodermic needle [13], blunt needle and core paste technique [14], and the
The objective of the present study was to assess and compare the ease of removal of fractured NiTi alloy endodontic rotary files from the root canal system between the ultrasonic tips and Endo Rescue appliance removal systems, as well as to compare the volume of dentin removed between ultrasonic tips and Endo Rescue appliance using a micro-CT

Summary

Introduction

Nickel–titanium (NiTi) alloy endodontic rotary files are widely used to clean and shape the root canal system because they have been shown to significantly increase the success rate of root canal treatments [1]. Several procedures can be used to remove fractured instruments [6], including the Masseran kit [6], Endo Safety System [7], and Endo Extractor [8]. Other techniques have been proposed for the removal of fractured NiTi alloy endodontic rotary files, including the wire loop technique [9], spinal tap needle-and-Hedstrom file technique [10], Cancelliers [11], Tube-and-Hedstrom file technique [12], hypodermic needle [13], blunt needle and core paste technique [14], and the.

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Methods

Discussion

Conclusion