Abstract
BackgroundReciproc instruments are the only contemporary root canal instruments where glide path preparation is no longer strictly demanded by the manufacturer. As the complete preparation of root canals is associated with success in endodontic treatment we wanted to assess the ability and find predictors for Reciproc instruments to reach full working length (RFWL) in root canals of maxillary molars in primary root canal treatment (1°RCTx) and retreatment (2°RCTx) cases.MethodsThis retrospective study evaluated 255 endodontic treatment cases of maxillary molars. 180 were 1°RCTx and 75 2°RCTx. All root canals were prepared with Reciproc instruments. The groups were compared and in a binary logistic regression model predictors for RFWL were evaluated.ResultsA total of 926 root canals were treated with Reciproc without glide path preparation. This was possible in 885 canals (95.6%). In 1°RCTx cases 625 of 649 (96.3%) canals were RFWL and in 2°RCTx cases 260 of 277 (93.9%). In second and third mesiobuccal canals (MB2/3) 90 out of 101 (89.1%) were RFWL with Reciproc in 1°RCTx and in the 2°RCTx treatment group 49 out of 51 cases (96.1%). In mesio-buccal (MB1) canals “2°RCTx” was identified as negative predictor for RFWL (OR 0.24 (CI [0.08–0.77])). In MB2/3 canals full working length was reached less often (OR 0.04 (CI [0.01–0.31])) if the tooth was constricted and more often if MB2/3 and MB1 canals were convergent (OR 4.60 (CI [1.07–19.61])).DiscussionUsing Reciproc instruments, the vast majority of root canals in primary treatment and retreatment cases can be prepared without glide path preparation.
Highlights
Preparation of root canals in a way that they can be completely disinfected is a big challenge in endodontic treatment and retreatment
The following information was collected from the medical records for every individual case: gender of the patient, tooth number, quantity of root canals, type of treatment (1◦RCTx/2◦RCTx), constricted root canal separately for every canal (first mesiobuccal (MB1), second/third mesiobuccal (MB2/3), distobuccal (DB) and palatal (P)), reaching full working length (RFWL) or not reaching full working length (NRFWL) separately for every canal, a glide path was prepared separately for every canal, MB2/3 and MB1 canals convergent, apical perforation, Forfenan retreatment case, Reciproc instrument fracture and apicoectomy after orthogradetreatment
For MB2 canals we found a significant influence to reach full working length (RFWL) of the covariates ‘‘constricted root canal’’ and ‘‘MB2/3 and MB1 convergent’’
Summary
Preparation of root canals in a way that they can be completely disinfected is a big challenge in endodontic treatment and retreatment. With the introduction of single-file and single-use Reciproc instruments (VDW, Munich, Germany) the manufacturer claimed that the glide path preparation with these instruments generally is no longer mandatory (Yared, 2011) even not in calcified MB2 canals (Yared, 2013a). This was explained by the special reciprocating movement of the instruments meaning that the instruments cut dentine in a counter-clockwise (CCW) direction and are immediately released in a clockwise (CW) motion. We sought to answer the question if in primary and in retreatment cases the technical root canal preparation can be carried out with Reciproc instruments without glide path preparation to the full working length. Our hypothesis was that the type of treatment (primary vs. retreatment cases), constricted root canals and convergent MB2/3 and MB1 canals are predictors for reaching full working length with Reciproc instruments
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