Abstract
The aim of the present study was to prospectively assess the frequency of teeth in which the Reciproc instruments were able to reach the full working length (WL). This case series study enrolled 277 consecutive teeth requiring primary endodontic treatment performed with the Reciproc system (VDW) without a previous glide path by 3 experienced endodontists. Instruments R25, R40 or R50 were selected, respectively, for narrow, medium and large canals, according to the preoperative radiographs, as per manufacturer recommendation. Canals were instrumented and classified as reaching the full WL (RFWL) and not reaching the full WL (NRFWL), according to the ability of the Reciproc instrument to reach without a glide path the full electronically determined WL. Finally, canals were filled using a single matched cone technique. Pearson's squared-chi test compared the frequency distributions of canals classified as RFWL and NRFWL. From a total pool of 673 root canals, Reciproc instruments reached the FWL in 96.28% of cases and 3 fractures occurred. For narrow canals the percentage of RFWL was 95.37% with 3 fractures. For medium and large canals, the R40 or R50 instruments reached the FWL in 98.51% and 97.62% of the cases respectively, with no fracture. Enlarging of root canals using the Reciproc instruments up to the FWL without a glide path is successful in a great percentage of cases. This case series suggests the possibility of using a single instrument to enlarge the root canal space of teeth by a simpler approach without an a prioriglide path procedure.
Highlights
From an endodontic standpoint, reciprocation can be defined as the sequence of repetitive and imbalanced backand-forth movements [1], which mechanically drive a given instrument
Squared-chi tests showed that the observed frequencies of reaching the full WL (RFWL) and not reaching the full WL (NRFWL) canals were significantly different from the expected frequencies both to overall treated canals (p=0.000, χ2=584.89) and for canal classifications (p=0.000, χ2=381.87 for narrow canals; p=0.000, χ2=127.12 for medium canals and p=0.000, χ2=76.19 for large canals )
Medium / R40 135 133 (98.51%) 2 (1.48)%. This clinical study reports a high frequency of Reciproc instruments reaching the full working length (WL) without a glide path, more than 95% for overall root canals
Summary
Reciprocation can be defined as the sequence of repetitive and imbalanced backand-forth movements [1], which mechanically drive a given instrument. An interesting point addressed by one reciprocating system (Reciproc system, VDW, Munich, Germany) is the claim that it is able to prepare most root canals with no previous hand filing as, not rarely, the Reciproc file is able to swimmingly advance towards the apex (http://www.vdw-reciproc.de/en.html) This effortless and efficient inward advance toward the apex can be regarded as the result of the interplay between the instrument’s cross-sectional design and flexibility, as well as the features of the reciprocating movement itself. This means that the Reciproc system does not necessarily require the creation of a smooth and reproducible glide path for the majority of cases This is an innovative feature as creation of a glide path became a mandatory transoperative procedure due to its ability to minimize the risk of torsional fracture of NiTi rotary systems [11,12,13]
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