Evaluation of Root-End Preparation with Two Different Endodontic Microsurgery Ultrasonic Tips.

Paulo J Palma,Margarida Casau,André Santos,Rui I Falacho,Francisco Caramelo,João Miguel Santos,Joana A Marques

doi:10.3390/biomedicines8100383

Abstract

The aim of this study is to compare root-end preparation performed with two different ultrasonic tips—CVDentus and NSK—and respective time requirements. After root-end resection, 32 teeth were randomly divided in two groups, according to the ultrasonic tip used for root-end preparation. Preparation time was recorded. Photomicrographs were taken to assess the following parameters: root surface microcracking, marginal integrity and presence of debris. One ultrasonic tip from each group was analyzed through scanning electron microscopy before and after root-end preparation. The significance level was set at α = 0.05. Incidence of microcracks in both groups was 12.5%. Solely intracanal microcracking was found, consistently positioned within the widest side of the remaining dentine. No statistically significant differences were verified between both experimental groups regarding marginal integrity (p = 0.102) and preparation time (p = 0.780), whereas statistical differences (p = 0.003) were found concerning the presence of debris (the minimum registered score was mostly verified in CVDentus group). NSK tips showed major morphological changes, with extensive surface wear and noticeable loss of particles, which was not verified on CVDentus tips. Our findings suggest significant differences regarding root-end preparation walls quality, with CVDentus tips showing better results. Concerning microcracking, as well as preparation time and marginal integrity, both ultrasonic tips showed similar results. Qualitative analysis exposed NSK tips major morphological changes and wear after use, which was not verified on CVDentus tips.

Highlights

Apical periodontitis comprises the host’s response to pathogenic microorganisms colonizing the root canal system of the tooth [1,2]
Root surface microcracking was consistently positioned surface microcracking was consistently positioned within the widest side of the remaining dentine within the widest side of the remaining registering frequency
Since the the introduction introduction of of ultrasound ultrasound technology technology for root-end preparation preparation in in the the 1990s, 1990s, several several studies have confirmed it as a technical improvement with positive impact in the clinical outcome studies have confirmed it as a technical improvement with positive impact in the clinical outcome of of endodontic

Summary

Introduction

Apical periodontitis comprises the host’s response to pathogenic microorganisms colonizing the root canal system of the tooth [1,2]. The principal goal of conventional endodontic treatment is prevention and/or elimination of apical periodontitis [1,2]. The success rate of endodontic treatment stands between 85% and 95%, being frequently applied to treat irreversible inflammation or necrosis of the root canal content [3]. Periapical surgery facilitates complete debridement of the root canal and placement of a root-end filling to ensure adequate apical sealing. The surgical approach comprises several sequential procedures in order to fulfill the aforementioned goals: (a) periapical resection (apicoectomy), (b) preparation of the root-end cavity, and (c) sealing of the root canal system by means of a bioactive and biocompatible root-end filling material placement [4,5]

Objectives

Methods

Results

Discussion

Conclusion