Biomechanical Preparation Research Articles

Effectiveness of hand and rotary instrumentations during biomechanical preparation in primary teeth: an umbrella review with evidence stratification.

Biomechanical preparation (BMP) of primary teeth often involves using hand and rotary instruments. This study aimed to assess the effectiveness of hand and rotary instruments during BMP in primary teeth. A thorough search for relevant systematic reviews and meta-analyses (SRMAs) was conducted in four databases, including MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. The primary outcome assessed was the instrumentation time (IT) for BMP, and the identified SRMAs were qualitatively analysed using the ROBIS tool. Furthermore, quantitative analysis, evidence stratification, and GRADE analysis of eligible SRMAs were performed using the browser-based R package metaumbrella software. Six SRMAs addressing the research question were included, with five being evaluated as having a high risk of bias (ROB). The findings indicated that the IT required for BMP in primary teeth was 3.2 min less (95% CI = 1.52 to 4.93; I2 = 96%; P = < 0.001) using rotary instruments compared to hand instruments, with a 'class IV' evidence stratification and 'very low' class of evidence. Based on the existing evidence, it can be inferred that there is insufficient quality data to recommend the use of rotary instruments over hand instruments in primary teeth.

Comparative evaluation of fracture resistance of wide and flared endodontically treated teeth with new techniques of postplacement – An in vitro study

Aim: This study aims to compare and evaluate the fracture resistance of endodontically treated maxillary anterior teeth restored using new postplacement techniques. Methodology: Forty-five single-rooted maxillary anterior teeth (n = 15) were selected and decoronated at the cementoenamel junction. The working length was determined using a 15K file. Biomechanical preparation was done up to size 70 and the teeth were obturated. After 1 week, the root-filling material, gutta-percha, was removed, and postspace was prepared using a size 3 and 4 peeso reamer. The samples were divided into three groups (n = 15). Group I: Coltene Tenax fiber Post-reinforced with composite (anatomical post). Group II: Coltene Tenax fiber postreinforced with a leno-woven polyethylene; Ribbond fibers. Group III: Coltene Tenax fiber Post-luted with a dual cure cement. After postcementation, core buildup was done. Fracture resistance was measured using a universal testing machine. Results: Statistical analysis was done using one-way analysis of variance and Tukey’s post hoc tests. A statistically significant difference was seen in the mean maximum load (N) between the groups. Group I showed the highest mean maximum load (N), followed by Group II and Group III. A significant P value (P = 0.025) was noted. Conclusion: Coltene Tenax fiber postreinforced with composite (anatomical post) showed the highest fracture resistance in endodontically treated maxillary anteriors.

Comparative Evaluation of the Effectiveness of Rotary and Reciprocating Single File Systems on Postoperative Pain After Biomechanical Preparation in Patients With Chronic Apical Periodontitis: A Randomized Clinical Trial

Comparative Evaluation of the Effectiveness of Rotary and Reciprocating Single File Systems on Postoperative Pain After Biomechanical Preparation in Patients With Chronic Apical Periodontitis: A Randomized Clinical Trial

Volumetric analysis of Hand and Rotary instrumentation and Evaluation of Obturating material in Primary teeth using CBCT – A Clinical trial

Aims &amp; Background: The biomechanical preparation is considered a critical step in the Pulpectomy procedure. The goal is to remove the microbiological contents in the canal and protect tooth function. In-vitro studies demonstrate that the shape of the root canal is more conical, favouring higher obturation quality and thereby increasing success rate using rotary files. So, this clinical trial aims to compare the volume of root canals before and after root canal instrumentation using hand and rotary files and to evaluate the flow of obturating material using CBCT in primary molars. Materials and Methods: This trial was conducted in 20 primary molars which were assigned to Group 1 (Hand files) and Group 2 (Rotary files). A CBCT was taken at 3 different intervals i.e., Prior to the procedure, After BMP, After the procedure. The difference between the Pre-instrumentation and Post-instrumentation CBCT images reveals the 3D volume change measured using hand and rotary files. Post-instrumentation and Post-obturation CBCT scans display the flow of root canal filling material in primary molars. Results: There were statistically significant differences noticed within Group 1 (p value = 0.000); and pre-instrumentation and post-instrumentation, pre-instrumentation and post-obturation in Group 2 (p value = 0.000). No statistically significant difference seen between post-instrumentation and post-obturation values (p value = 0.076). Significant differences were found in post-instrumentation and post-obturation volumes between groups. Conclusion: This trial concluded that rotary files led to a more productive funnel-shaped canal preparation that resulted in better obturation quality with minimal voids than hand files. Clinical significance: Rotary files using 3D imaging allowed more conservative and efficient root canal preparation while maintaining anatomy, resulting in superior three-dimensional obturation than hand files.

A confocal laser scanning microscopic analysis of efficacy of different activated irrigants in the removal of calcium hydroxide medicament and subsequent penetrability of Bio-C sealer – An in vitro study

Abstract Aim: The aim of the study was to investigate the efficacy of different irrigants activated by pro-agitator tip system (PATS) Vario on the removal of calcium hydroxide medicament and subsequent penetration depth of Bio-C sealer. Materials and Methods: Fifty single-rooted mandibular premolars were selected. Access cavities were prepared; biomechanical preparation was done. Metapex that had been combined with rhodamine B dye was used to fill each sample. All the samples were divided into five groups (n = 10) – Group I: chitosan–citrate, Group II: intracanal heated sodium hypochlorite (NaOCl), Group III: phytic acid, Group IV: SmearClear, and Group V: saline. All samples were obturated using gutta-percha and Bio-C sealer (combined with fluorescein dye). Later, all samples were sectioned at 3, 6, and 9 mm from the apex and observed under a confocal microscope for residual Ca(OH)2 and sealer penetration into dentinal tubules. Results: The saline group exhibited the least amount of sealer penetration and high residual Ca(OH)2, both of which were statistically significant (P ≤ 0.05). Conclusion: The use of PATS Vario for irrigant activation enhanced the calcium hydroxide removal efficacy and penetration of Bio-C sealer into dentinal tubules. The elimination of calcium hydroxide and sealer penetration, from the apical region of the tooth, can be accelerated by intracanal heating of NaOCl.

Effectiveness of Chloroform and Orange Oil as Gutta-percha Solvents used in Endodontic Retreatment: An In Vitro Study

The aim of this study was to assess and compare the effectiveness of chloroform and orange oil to dissolve obturated materials during endodontic retreatment. Thirty extracted human permanent maxillary anterior teeth (10 central incisor, 10 lateral incisor and 10 canine) which fulfilled specific inclusion criteria were de-coronated and after biomechanical preparation using step-back technique obturated with gutta-percha and AH plus sealer and stored in 370C in 100% humidity for 2 weeks. Then the teeth were assigned into 2 groups randomly: Chloroform (n= 15) and Orange oil (n= 15). Solvents were applied to reservoir created on the coronal root third for 2 minutes. Then instrumentation was initiated to remove obturated materials using Hedstrom file until the master apical file size 40 for central incisor and canine and 35 for lateral incisor reach the working length. The time to reach the working length and the time to obtain the last debris were recorded. Data were collected and analyzed by using SPSS version 22. The results showed no statistically significant difference (P&gt;0.05) between two gutta-percha solvent groups in relation to time required to reach the working length by master apical file and time required to remove total obturated material from root canal. In conclusion, there was no statistically significant difference in effectiveness between chloroform and orange oil as gutta-percha solvent during retreatment procedure. So, orange oil can be used in retreatment procedure with the same efficacy of chloroform to dissolve obturated material in the root canal.

Comparative Evaluation of Effectiveness of Rotary and Hand File Systems in Terms of Quality of Obturation and Instrumentation Time among Primary Teeth: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

This systematic review and meta-analysis aimed to answer the following focused question: Are rotary file systems more effective than hand file systems in terms of the quality of obturation and instrumentation time among primary teeth? The inclusion criteria comprised studies that compared the effect on quality of obturation and instrumentation time among primary teeth after using rotary and hand file systems for biomechanical preparation of the root canals. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included Medline (via PubMed), EBSCO, and Google Scholar. Articles published from January 2000 to December 2021, but only in English, were included. The search resulted in 8,003 published studies. After the removal of duplicate studies and full-text analysis, 9 studies were selected for systematic review, and 8 were selected for meta-analysis. Overall, the results demonstrated the promising effects of rotary file systems in reducing instrumentation time and improving obturation quality compared to hand files. Within the limitations of this review, it can be asserted that rotary file systems are superior to hand files in primary teeth for pulpectomy procedures. Rotary files, a more recent technique, are more efficient than traditional hand files in lowering the time required for instrumentation. Additionally, they provide superior obturation quality in primary molars, making them particularly beneficial for pediatric patients. Gala UP, Kalaskar R, Vinay V, et al. Comparative Evaluation of Effectiveness of Rotary and Hand File Systems in Terms of Quality of Obturation and Instrumentation Time among Primary Teeth: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Int J Clin Pediatr Dent 2024;17(8):962-969.

To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy.

The introduction of the rotary file system for children was a revolution in the field of pediatric endodontics. These files are cost-effective and help in consistent obturations with shorter instrumentation time. The present randomized controlled trial (RCT) was planned for a comparative evaluation of rotary and manual techniques in biomechanical preparation of primary molars to determine their effect in terms of cleaning and shaping efficacy, working time, quality of obturation, and postoperative pain. A randomized clinical trial study was conducted in 75 children aged 5-9 years requiring pulpectomy. Each tooth was randomly assigned to one of the three treatment groups: Kedo-S files, rotary K-Flex files, and hand instruments group. It was observed that Kedo-S files and rotary K-Flex files were more effective in cleaning and shaping of root canals compared to hand H/K files. The postbacterial count for hand files was higher compared to rotary files. Shorter working time was seen with rotary files (3.88-5.04 minutes) compared to hand files (15.68 minutes). Rotary files showed a reduced number of voids, with Kedo-S files in 92% of cases and rotary K-Flex files in 80% of cases. Apical seal and extent of fill were maximum with rotary files, having a grade C rating in 92% of cases. Kedo-S files and rotary K-Flex files showed a significant reduction in postoperative pain compared to hand files. The present study showed a significant reduction in bacterial count, working time, quality of obturation, and postoperative pain with rotary files. Moudgalya MS, Tyagi P, Tiwari S, et al. To Compare and Evaluate Rotary and Manual Techniques in Biomechanical Preparation of Primary Molars to Know Their Effects in Terms of Cleaning and Shaping Efficacy. Int J Clin Pediatr Dent 2024;17(8):864-870.

Retrieval of Separated Endodontic Instrument

Endodontic instrument fracture is a procedural error that creates a significant barrier to routine root canal therapy. A separated instrument results in insufficient cleaning and shaping of the root canals. Inadequate biomechanical preparation has an impact on the result and outcome of root canal treatment. Therefore, retrieval of separated instruments should be considered important. There are many instrument retrieval kits and techniques available for this purpose. In this case report, a separated rotary file was successfully retrieved using a Masserann kit .

Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different endodontic sealers: A randomized controlled clinical trial.

A randomized controlled clinical trial to evaluate postoperative pain and investigate periapical healing after root canal treatment using eugenol, resin-based, and calcium silicate-based sealers (CSBSs) sealers. Sixty-three individuals diagnosed with apical periodontitis confirmed using cold test and electronic pulp tester, periapical pathology with periapical index score of 2 or more, previous endodontic treatment failure exhibiting a visual analog scale pain score of 3 or above, were enrolled in this investigation. The patients were randomly allocated into three groups and following biomechanical preparation, the canals were obturated using Meta CeraSeal, AH plus, and eugenol-based sealers. Postprocedural pain intensity was assessed at 24 h, 48 h, and 7 days, while periapical healing was evaluated at 3- and 6-month follow-ups. Statistical analysis was done using the Chi-square and Friedman's test. The mean of periapical lesions for Meta CeraSeal (4.7, 1.6), AH Plus (4.68, 3.19), 24 and eugenol-based (2.66, 1.75) at 3 months and 6 months, respectively. The mean & std. deviation of pain scores at 24 h for Meta CeraSeal (0.62 ± 1.857), AH Plus (1.62 ± 1.962), and eugenol-based (0.48 ± 1.250). At 48 h for Meta CeraSeal (0.33 ± 1.528), AH Plus (1.33 ± 1.798). On the 7th day, Meta CeraSeal (0.24 ± 1.091) and AH Plus (0.71 ± 1.384) for eugenol-based at 48 h, and on the 7th day, none of the patients had pain. Evaluation of the apical sealer puff displayed no suggestive variations (P = 0.634). Notably, no analgesics were taken. No suggestive dissimilarity was noted between eugenol, resin-based, and CSBSs sealers.

Comparative Evaluation of Apical Sealing Ability of Three Different Endodontic Sealer: An In Vitro Study

AIM : Comparative evaluation of apical sealing ability of three different endodontic sealers : An in vitro study Materials and Methods:- The study was conducted on 60 samples on single rooted teeth using three different sealers MTA fillapex, Apexit Plus, Bio C sealer. On the prepared samples access cavities and biomechanical preparation was performed using endodontic rotary system. The teeth were randomly divided into three groups of 15 each with control group having empty canal. All root surfaces except the apical 2 mm was covered with two layers of nail varnish and sticky wax and all samples were immersed in an aqueous solution of 2% methylene blue dye for 72 hours. Roots were longitudinally split using a diamond disc . STATISTICAL ANALYSIS : The data was statistically analysed with One way ANOVA test and post hoc tukey test to compare the apical sealing ability between the experimental groups RESULTS : In our study , least sealing ability was observed Apexit plus followed by MTA Fillapex and Bio C sealer.CONCLUSION : Bio C sealer showed considerably good results compared to MTA Fillapex and Bio C sealer

Major root endodontic treatments: a systematic review

Introduction: In the root canal treatment scenario, irrigation is one of the most important aspects of the biomechanical preparation of the root canal. A condition for successful endodontic retreatment is adequate cleaning of the root canals, therefore, special attention should be paid to the technique used to remove the filling material, the most commonly used being cement, pastes, and gutta-percha cones. Objective: This study aimed to present the main root endodontic treatments to analyze and compare the techniques for removing pulp tissue debris resulting from root preparation and microorganisms from the canals of the root canal system, seeking complete cleaning and asepsis. Methods: The PRISMA Platform systematic review rules were followed. The search was conducted from April to July 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 129 articles were found, 39 were evaluated and 21 were included in this systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 25 studies with a high risk of bias and 27 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =91.5% &gt;50%. It was concluded that the system of root canal instrumentation with rotary files maintains the quality of root preparation and, at the same time, reduces the number of files required to obtain a canal, which would consequently reduce the operative time and also considerably reduce the risk of torsion fracture within the root canal than with files. Irrigation plays a fundamental role in the success of endodontic treatment. Although hypochlorite is the most important irrigant solution, no irrigant can perform all the tasks required by irrigation. A detailed understanding of the mode of action of various solutions is important for optimal irrigation. Within the limitations of this study, the use of the self-adjusting file with the combination of EDTA and NaOCl improved Ca(OH)2 removal. Passive ultrasonic irrigation and the self-adjusting file were more effective in removing Ca(OH)2 from the lateral sulci in the apical parts of the root canal than the EndoVac and conventional syringe irrigation systems.

Comparative Evaluation of Different Methods of Activation of Chelating Solution for Smear Layer Removal in the Apical Portion of the Root Canal Using a Scanning Electron Microscopy: An In Vitro Study.

Background The smear layer has an adverse effect on the sealing of root canals during obturation, and it is the main reason for the failure of root canal treatment.Root canal irrigation using a conventional irrigation system is ineffective for smear layer removal, especially from the apical third region, where mostlateral canals are present. For successful endodontic treatment, the smear layer should be removed from the apical third region using an effective irrigation activation system. Aim This study aimed to compare smear layer removal by conventional irrigation, XP Endo Finisher (XPF), endoactivator (EA), passive ultrasonic activation, and root canal brushusing 17% ethylenediaminetetraacetic acid (EDTA) as a chelating solution and 5.25% sodium hypochlorite after chemomechanical preparation, using scanning electron microscopy (SEM). Method A total of 50 extracted human mandibular single canal premolars with mature roots were selected for this study. Samples were decoronated to obtain a standard working length (WL) of 15 mm. Canal patency was achieved using a 10 k file. Samples were sealed with sticky wax to obtain the vapor lock effect. Biomechanical preparation is done till F3. The samples were divided into five groups according to the final irrigation activation protocol: Group 1, control group; group 2, XPF; group 3, EA; group 4, passive ultrasonic irrigation (PUI); and group 5,, root canal brush. Samples were divided into two equal halves longitudinally. Each sample was analyzed for a smear layer under SEM at 2000x magnification. Statistical analysis was done using the one-way Anova "F" test and Tukey's post-hoc test. Results Group 3 showed the least presence of a smear layer, followed by groups 4, 2, 5, and 1. All the groups exhibited highly significant differences between each other (p < 0.001). Group B shows no significant difference with groups C, D, and E. Group C shows no significant difference with groups D and E. Group D shows no significant difference with group E. Conclusion The EA removes the smear layer effectively as compared with other groups. All the irrigation activation system shows the presence of smear layer. No activation systems were able to remove the smear layer completely.

Breakthrough in the Development of Endodontic Irrigants.

The three main components of endodontic success are three-dimensional obturation, pulp space sterilization, and biomechanical preparation. Instrumentation techniques are insufficient to accomplish complete disinfection of the pulp space. It is essential to use additional tools, such as endodontic irrigants. This review article aims to provide a general overview of the different root canal irrigants and their clinical uses. Endodontic treatment focuses more on removing infectious material from the root canal system to facilitate the healing of an existing periapical lesion or to prevent the periradicular tissues from being infected. It is important to note that instrumentation alone can reach every part of the root canal wall. Therefore, the irrigation procedure is a crucial aspect of endodontic therapy. Irrigation requires the application of various irrigants, like sodium and chlorhexidine, to get rid of debris, bacteria, and tissue leftovers. The accomplishment of root canal treatments counts heavily on the thoroughness of irrigation, contributing to optimal canal shaping and disinfection. Modern root canal irrigation systems incorporate syringes, needles, and advanced delivery mechanisms, including sonic and ultrasonic devices. These inventions aim to enhance the mechanical action of irrigants, reaching intricate canal anatomy more efficiently. Understanding the dynamics of root canal irrigation and staying abreast of technological advancements are essential for clinicians to achieve improved treatment outcomes in endodontic procedures.

Influence of Initial Root Canal Treatment on Intratubular Penetrability and Bond Strength of Nonsurgical Retreatment: An InVitro Study

IntroductionTo assess the effect of combinations of two different endodontic sealers used in initial and endodontic retreatment on the bond strength of the secondary obturation and the penetrability of the sealers. MethodsForty-eight mandibular premolars were used, receiving standardized endodontic access and biomechanical preparation. Twenty-four teeth received AH Plus sealer (AHP) in primary obturation and the others received Bio-C Sealer (BCS). Retreatment protocol was performed with an R50 instrument. The samples were further subdivided into four groups (n = 12) based on the combination of primary/secondary obturation sealers: AHP/AHP; AHP/BCS; BCS/AHP; and BCS/BCS. Four samples from each subgroup received the addition of fluorophores to the sealer for penetrability analysis using laser scanning confocal fluorescence microscopy. The root portion on the 8 push-out samples was sectioned into 6 slices of 1.0 mm. Bond strength (BS) was assessed using a universal testing machine until displacement of the filling mass. Failure pattern was evaluated under a stereomicroscope (20× magnification). BS data were analyzed using two-way analysis of variance followed by Tukey's test (P < .05), and the association between the failure pattern and BS value was assessed using the chi-square test (P < .05). Penetrability was qualitatively evaluated. ResultsThe highest BS values were observed in the AHP/AHP (4.54 ± 1.5 MPa) and BCS/AHP (5.00 ± 1.0 MPa) groups (P < .05), with a higher percentage of adhesive failures to the filling material for all groups. Laser scanning confocal fluorescence microscopy images indicated greater penetrability of AHP compared to BCS, both in initial treatment and retreatment. ConclusionAHP sealer exhibited higher BS and greater penetrability compared to BCS sealer.

Comparative evaluation of antimicrobial efficacy of various intracanal medicament in young permanent teeth: An in vivo study.

Bacteria and their byproducts are key contributors to the onset and perpetuation of pulpoperiapical pathosis. Intracanal medication is vital in achieving successful endodontic outcomes as it targets and eradicates remaining microorganisms following biomechanical preparation. The aim of the study was to compare and evaluate the antimicrobial efficacy of calcium hydroxide (CH) paste, triple antibiotic paste (TAP), and probiotics (PBs) as intracanal medicament in 12-17-year-old children undergoing root canal treatment for the management of infected pulpal tissues in young permanent teeth. A total of 30 patients aged 12-17 years indicated for endodontic therapy in maxillary incisors and with no systemic complications were selected. They were randomly divided into three groups, i.e., Group I - CH group, Group II - TAP, and Group III - PB allocating 10 teeth in each group. After access opening, the first sample (S1) was collected by inserting a paper point into the root canal, the second sample (S2) was collected immediately after biomechanical preparation, and the third sample (S3) was collected after 7 days, i.e., postintracanal medication. Samples were sent for microbiological analysis to assess the microbial count, and statistical analysis was done for the obtained data. The three intracanal medicaments were successful in reducing the microbial counts of Enterococcus faecalis in the infected root canals. However, according to the results of the study, the PB group demonstrated greater effectiveness against E. faecalis compared to the CH group and displayed similar antimicrobial efficacy as the TAP group. PB exhibited antimicrobial efficacy comparable to TAP but greater than Ca (OH) 2 paste. Hence, PB can be utilized as an intracanal medicament in young permanent teeth.

An in vitro comparative evaluation of efficiency of three rotary nickel-titanium file systems in terms of remaining dentin thickness using cone-beam computed tomography.

The objective of the present research was to assess and compare the residual dentin thickness after biomechanical preparation of teeth using three distinct rotary nickel-titanium (Ni-Ti) file systems. In the current experimental study, a total of 45 single-rooted teeth were selected for the analysis. The cementoenamel junction of each tooth was decoronated using a diamond disc. The teeth were randomly allocated to three groups, with each group representing a different rotary file system: Group 1: Hero GOLD (Micro Mega), Group 2: One Curve (Micro Mega), and Group 3: HyFlex electro-discharge machining (EDM) (Coltene-Whaledent, Altstatten, Switzerland). To evaluate the initial condition of the teeth, cone-beam computed tomography (CBCT) scans were conducted before the biomechanical preparation. The teeth were positioned on a modeling wax sheet, and the CBCT scans provided baseline measurements. The biomechanical preparation of the root canals followed the manufacturer's recommended guidelines for each file system. After the completion of the canal preparation, follow-up CBCT scans were conducted. The postprocedure CBCT scans were then compared with the initial scans to assess any changes in the residual thickness of dentin in the teeth. Post hoc Tukey analysis of variance tests was utilized to examine differences between the groups. A statistically significant result was defined as P = 0.05 or less for every test. The comparison of preinstrumentation and postinstrumentation CBCT images showed that the HyFlex EDM group removed less dentin clinically compared to the other two groups, i.e., Hero GOLD and One Curve. No significant statistical difference was found between Hero GOLD versus One Curve, One Curve versus HyFlex EDM, and Hero GOLD versus HyFlex EDM. Based on the results of this study, the HyFlex EDM file system exhibited superior cutting efficiency at various levels. Nonetheless, additional investigations are required to comprehensively assess the influence of Ni-Ti rotary file systems on the remaining dentin thickness.

Effect of Intracanal Cryotherapy and Curcuma Longa as a Final Irrigant in Reducing Post Operative Pain: An In-Vivo Study

ABSTRACT Aim: The point of search of present study was to assess intracanal viability of cold saline, curcumin as an irrigant, and ordinary saline as last irrigant in lessening post endodontic torment. Material and Method: In total, 60 individuals were chosen and divided into 3 groups: Group I: intracanal cryotherapy using 2.5°C cold saline, Group II: curcumin irrigant, and Group III: ordinary saline. After the biomechanical preparation, the above mentioned irrigant was used. On the visual analogue scale, participants were asked to rank the intensity of their discomfort following the procedure before, after 6 h and 24 h after the procedure. The outcomes were dissected utilizing ANOVA test. Result: Both the regimens were successful in reducing post endodontic soreness associated with infected teeth. Conclusion: Curcumin and cryotherapy both the regimens were successful in lessening post endodontic torment.

Effectiveness of EndoActivator, PATS Vario system, and XP-endo Finisher files on smear layer removal under scanning electron microscope: A comparative study.

The smear layer may harbor many bacteria; hence, alternative methods are used to disrupt and remove biofilm. The aim of the study was to compare the effectiveness of EndoActivator, PATS Vario System, and XP-endo Finisher files on smear layer removal using a scanning electron microscope. Sixty single-rooted extracted premolars with Vertucci Type 1 configuration were decoronated and divided into four groups. The groups were instrumented with the rotary ProTaper file system. All specimens were flushed with 1 ml of 3% sodium hypochlorite. Group 1 was irrigated with a conventional needle and syringe. In Group 2, the irrigant was activated with an EndoActivator. In Group 3, the irrigant was activated with PATS Vario system, and in Group 4, XP-endo Finisher files were used after biomechanical preparation to remove debris and smear layer. All specimens were finally rinsed with 3 ml of 3% sodium hypochlorite. The teeth underwent longitudinal splitting and grooving in the coronal, middle, and apical thirds, and then, the samples were taken for scanning electron microscopy to evaluate the amount of smear layer removal in each third. The middle and coronal thirds Showed that almost similar efficacy to remove smear layer in both Group II and Group III. At the apical third, Group III showed comparatively better results than Group I, II, and IV, respectively. Equal amount of smear layer was seen with EndoActivator and PATS Vario system when used as sonic irrigation devices.

Comparative evaluation of remaining dentin thickness using single file, two file, and multiple rotary file system - An in vitro CBCT study.

Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. This was an in vitro study, original research article. Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems.