ProTaper Next Research Articles

Root canal transportation with ProTaper Next and WaveOne Gold: A systematic review

Root canal transportation is a significant concern in endodontic therapy, impacting treatment outcomes. ProTaper Next (PTN) and WaveOne Gold (WOG) are popular endodontic instrumentation systems used to shape root canals. This systematic review aimed to evaluate the literature on root canal transport with PTN and WOG. Fourteen studies were analyzed, highlighting the overall effectiveness of both systems. The PTN showed potential advantages in minimizing canal transport, while the WOG preserved the original canal shape. Operator experience and canal curvature influence performance. This review provides evidence-based insights to aid endodontic practitioners in making informed decisions for successful root canal treatments. The aim of this systematic review was to evaluate and synthesize the literature on root canal transportation with ProTaper Next (PTN) and WaveOne Gold (WOG) instrumentation systems in endodontic therapy. A comprehensive literature search was conducted using the PubMed Central, Scopus, EBSCO, Embase and Web of Science databases from 2000 to 2022. Studies that met the predefined inclusion and exclusion criteria were selected for analysis. Data on study design, participant characteristics, intervention details, comparison groups, outcomes, and results were extracted from the included studies. The methodological quality of the studies was assessed using appropriate tools, and the findings were synthesized qualitatively. A total of 14 studies were included in the systematic review. The analysis revealed that both the PTN and WOG systems demonstrated overall effectiveness in root canal preparation. PTN rotary files performed adequately with inexperienced operators and showed potential advantages in minimizing canal transportation. On the other hand, WOG files exhibited a conservative approach, preserving the original canal shape. However, variations in performance were observed depending on the instrumentation method, operator experience, and canal curvature. This systematic review provides valuable insights into the ability of the PTN and WOG to manage root canal transport. Both systems demonstrated satisfactory outcomes, with WOG often preserving the natural canal anatomy. The findings suggest that proper operator training and technique play vital roles in achieving optimal results. Clinicians should consider the unique characteristics of each system when selecting instrumentation for root canal treatments. Nonetheless, it is crucial to acknowledge the limitations of the included studies, such as variations in sample sizes and operator experience, which may impact the interpretability of the findings. Future research should address these limitations and further explore the efficacy of these instrumentation systems in various clinical settings. The evidence derived from this systematic review can aid endodontic practitioners in making evidence-based decisions for successful root canal procedures.

Evaluation of the shaping ability of different rotary file systems in severely and abruptly curved root canals using cone beam computed tomography

BackgroundWhen selecting an instrument for canal preparation, it is important to consider several parameters that influence the shaping efficiency, including instrument design, metallurgy, and operating motion. This study aimed to evaluate the shaping ability of the ProTaper Next (PTN), WaveOne Gold (WOG), and XP-endo Rise Shaper (XPRS) rotary systems in severely and abruptly curved root canals using cone beam computed tomography (CBCT) and ImageJ software. Materials and MethodsForty-eight mesial root canals of the mandibular first molars were assigned equally to three groups: PTN, WOG, and XPRS. Using ImageJ software, CBCT images were acquired pre- and post-instrumentation to assess dentin removal, remaining dentin thickness (RDT), canal transportation, and centering ratio at the coronal, middle, and apical levels. Statistical analyses were conducted on all numerical data. ResultsAll rotary systems removed significantly more distocoronal dentin in the danger zone (DZ), than the mesiocoronal area. PTN removed significantly more dentin and caused less RDT than XPRS (p < 0.05). However, there were no significant differences between PTN-WOG and WOG-XPRS. In the DZ, the highest percentage of specimens with an RDT < 0.5 mm was observed when using PTN (50%), followed by WOG (31.3%), and XPRS (6.3%). Compared with PTN and WOG, XPRS demonstrated less coronal transportation. Among all rotary systems, there was no significant difference in apical transportation or centering ratio. ConclusionsBased on our observations, all rotary instruments exhibited a tendency to remove dentin in the DZ, but to different degrees. XPRS demonstrated better results in terms of coronal transportation and dentin thickness in the DZ. Comparable centering abilities and minimal apical transportation were demonstrated using all rotary instruments.

Assessment of Vertical Force Generated with Single File Systems during Shaping of Constricted Root Canals.

This study aimed to evaluate the shaping force generated with OneShape (OS) and HyFlex EDM (HEDM) systems designed for single file shaping, in comparison with ProTaper Next (PTN). Maxillary premolar teeth received access cavity preparation and their canals were shaped with OS, HEDM, or PTN to size 25 according to manufacturer's instructions with consistent pressure on the files to give a gentle "in-and-out" movements of 2 mm amplitude. The canal shaping was completed with a total of three insertions. After each insertion, 1% NaOCl irrigation and recapitulation with K-file size 15 were performed. The vertical shaping force was measured using a force gauge (M5-20 Advanced Digital Force Gauge; Mark-10 Corporation, NY). The shaping time was analyzed by using a one-way analysis of variance (ANOVA) test and differences between the mean apical and coronal maximum force values were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. The level of significance was set as 0.05. The magnitude of the vertical forces increased with successive advancements of the instruments within the canal. During canal shaping procedures in all groups, the apical and coronal maximum force values of the OS and HEDM ranged from 2.5 to 7.2 N and 1.3 to 2.9 N, respectively. PTN generated the lowest maximum apical forces during the second and third insertions (p < 0.05). HEDM generated significantly less maximum coronal forces than both OS and PTN during the first insertion while the use of OS was associated with the highest amount of force values in the second and third insertions (p < 0.05). In terms of shaping time, no significant differences were detected among the three tested systems (p = 0.606). The tested single file systems were associated with higher shaping forces in the apical direction that were significant in the second and third insertions.

Comparison of the Amount of Debris Extruded From the Apex During Retreatment Procedures Using Several File Systems and to Gauge the Effect of Same and Different Taper on the Debris Extrusion: An In Vitro Study.

To determine the amount of apical extrusion between various file systems during the retreatment procedure and to determine the effect of taper on the same. Seventy mandibular extracted premolars were taken, and preparation was performed using a Woodpecker file (Woodpecker Medical Instrument Co., Ltd., Guilin, China) (25/0.06). The gutta-percha (GP) was removed from each specimen with H file (#40/0.02) to simulate retreatment in seven groups (n = 10) using ProTaper Next (PTN;Dentsply, Maillefer, Ballaigues, Switzerland) (PTN) (30/0.07), Reciproc (25/0.08), Hyflex CM (30/0.06), Mtwo (30/0.05), Neoendo flex (30/0.04), Neoendo hybrid (30/0.04), and Flexicon file (30/0.06). The specimens were held with the help of a rubber stopper and put in the Eppendorf tube of volume 4 mL (pre-weighed before retreatment). The debris that was on the root surface of the specimen was washed with distilled water with 1 mL volume, kept in the oven, and then again weighed after 7 days. Apical extrusion was found in the following order: HYFLEX CM (LEAST) < FLEXICON < PROTAPER NEXT < RECIPROC < NEOENDO FLEX < NEOENDO HYBRID < MTWO (HIGHEST). W Hyflex CM and Flexicon files showed lesser extrusion of debris than others.

Confocal laser scanning evaluation of the influence of ledges on root canal disinfection

AbstractThe aim was to analyse the influence of an apical ledge on root canal disinfection. Forty‐four single‐rooted teeth were micro‐CT scanned and inoculated with Enterococcus faecalis. In Group S shaping was performed with ProTaper Next (PTN) up to X3 at working length (WL). In Group L an apical ledge was created with K‐Files #40 and shaping completed up to PTN X3. NaOCl 5% and EDTA 10% irrigant solutions were alternated. Confocal laser scanning microscope (CLSM) and viability staining were used to analyse the proportions of dead (red) and live (green) bacteria and penetration ability inside dentinal tubules. Data were analysed with the Mann–Whitney test with Bonferroni correction (p &lt; 0.05). In Group L the amount of red fluorescence resulted significantly lower, and penetration ability was decreased in the apical and middle portion (p &lt; 0.05). The presence of an apical ledge may negatively influence the disinfection both in the apical and middle third.

CBCT Assessment of Effectiveness of ProTaper Next and WaveOne file Systems on Remaining Dentin Thickness.

Obturation of the canal space, efficient disinfection, and thorough canal debridement are essential components of endodontic therapy success. A crucial first step is biomechanical preparation. This study set out to assess various file systems' cleaning efficacy in terms of the thickness of dentin that remained after cleaning. Twenty permanently removed anterior teeth were used in the investigation, and they were split into two groups: Group B used reciprocating WaveOne file systems, and Group A used ProTaper Next (PTN). After obtaining a pre-CBCT scan, the corresponding file groups proceeded with biomechanical preparation. A post-CBCT scan was obtained, and the dentin thickness remaining was compared between the pre- and post-CBCT scans. Statistics were used to analyze the data. Dentin thickness decrease was shown to be minimal for ProTaper Next (PTN) and maximal for WaveOne; nonetheless, the intergroup comparison was deemed to be highly inconsequential. After biomechanical preparation, WaveOne is a highly recommended rotary endodontic device that does not significantly reduce the residual dentin thickness.

Correlation between pulp sensibility and magnetic resonance signal intensity following regenerative endodontic procedures in mature necrotic teeth- a retrospective cohort study

BackgroundWith increasing studies being published on regenerative endodontic procedures (REPs) as a treatment modality for mature necrotic teeth, the assessment of outcomes following regenerative endodontic procedures has become more challenging and the demand for a better understanding of the regenerated tissues following this treatment is rising. The study aimed to correlate cold, electric pulp testing (EPT), and magnetic resonance imaging (MRI) signal intensity (SI) in mature necrotic teeth treated with regenerative endodontic procedures.MethodologyThis retrospective cohort study included eighteen adult patients who experienced tooth necrosis in mature maxillary anterior teeth recruited from the outpatient clinic, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt from July 2017 until December 2018 with 12 months of follow-up. regenerative endodontic procedures via blood clot were performed. The canals were instrumented by ProTaper Next (PTN) files until final sizes X3 or X5. Biodentine was used as cervical plug material. Pre and post-operative clinical follow-up was done where the patients’ responses to cold and electric pulp testing were given a scoring system and were compared to the normal contralateral tooth. Pre and post-operative magnetic resonance imaging signal intensity of both the involved tooth and its contralateral at the middle and the apical thirds of the root canals were assessed after 3, 6, and 12 months. Data was analyzed using the ANOVA, Friedman and Bonferroni tests. Significance was set at a p-value < 0.05.ResultsAll 18 teeth scored a baseline score of “2” for cold and electric pulp testing. There was a significant difference between scores of the cold test at baseline and 12-month follow-up (p < 0.001). There was a significant difference between scores of the electric pulp testing of baseline and 12-month follow-up (p < 0.001). There was a moderately significant indirect (inverse) correlation between magnetic resonance imaging signal intensity and cold test in both the middle and apical thirds at 12 months. No significant correlations were detected between magnetic resonance imaging signal intensity and electric pulp testingat any of the time intervals (p > 0.05).ConclusionMagnetic resonance imaging is a successful non-invasive method to assess outcomes of regenerative endodontic procedures and correlating it with another reliable method of assessing pulpal responses, cold test, could validate these outcomes.Clinical trial registrationThe study was registered with ClinicalTrials.gov (ID: NCT03804450).

Evaluation of Cyclic Fatigue Resistance of Novel Replica-Like Instruments in Static Test Model.

The aim of our study is to comparatively analyze the canal cyclic fatigue resistance of widely used rotary file systems, including EndoArt Touch Gold (ETG), Perfect MTF Plus Gold (PPG), Fanta V-Taper Gold (FVG), and ProTaper Next (PTN). Stainless steel canals with a 60° angle and a 3-mm curvature radius were specially prepared. The canals were shaped with each rotary file system and tested for resistance using a cyclic fatigue testing apparatus. The number of fracture cycles (NFC; K file tip separation) was measured. Data were analysed by one-way ANOVA and post hoc LSD tests. PTN and PPG rotary file systems exhibited the highest NFC. The NFC value for PTN was 589 ± 63, and for PPG, it was 507 ± 51. The results of this study demonstrate that rotary file systems such as PTN and PPG exhibit higher cyclic fatigue resistance. ETG and FVG rotary file systems also possess generally acceptable cyclic fatigue resistance levels.

Comparison and analysis of ProTaper, ProTaper Next, and ProTaper Gold using finite element analysis

Aim: The aim of this study is to compare three endodontic files: ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG) under bending forces using finite element analysis. Methods: This study utilizes finite element analysis conducted with ANSYS software. 3D models of the three endodontic files were prepared using ANSYS. A non-linear material model was applied, idealizing the stress-strain curve for Nickel-Titanium alloy (NiTi), the material of these endodontic files. Static and transient analyses were performed to identify three different material phases: austenitic phase, transition phase, and martensitic phase. Results: Finite element analysis reveals that the PTU file exhibited a maximum von Mises stress magnitude of 1249.7 MPa, PTN showed a maximum von Mises stress magnitude of 798.16 MPa, whereas the PTG file showed a minimum von Mises stress magnitude of 465.68 MPa. PTN showed more bending compared to the other file models for the same load magnitude. PTN remained in the austenitic phase until a tip displacement of 7.3657 mm, while PTU reached a maximum displacement of 4.5633 mm in the austenitic phase. Conclusion: The study concludes that the PTU file is the most rigid among the three file models. PTU generates higher stress magnitudes compared to the other files; thus, it is more likely to fracture under lesser bending forces. The study also concludes that PTG exhibits higher displacement with the lowest von-Mises stresses, making it the most flexible file among the three models.

Residual dentin thickness of root canal transportation by various metallurgical rotary systems: An in vitro study

Introduction: Numerous nickel–titanium (NiTi) rotary systems have been released on the market with noncutting tips, various cross sections, and production techniques. This research was carried out to assess the quantity of remaining dentin thickness of mandibular first molar root canal at 3, 6, and 9 mm far from the anatomic peak that prepared through contemporary rotating systems with different metallurgical properties with a cone-beam computed tomography (CBCT). Materials and Methods: In this investigation, 45 human mandibular first molars that had been extracted were employed. Teeth were accordingly divided into three main groups through the NiTi rotary system that was utilized in canal instrumentation (15 teeth each), such that all ranges of curvatures were equally represented in each group – Group A: EdgeFile X3 rotating system, Group B: ProTaper Next (PTN) rotating system, and Group C: ProTaper (PT) rotating system. The samples were scanned before and after instrumentation using CBCT, and by deducing the instrumented canals from the uninstrumented counterpart, the remaining dentin thickness for each root canal is calculated at three levels of each root (3, 6, and 9 mm away from the root end). Data were statistically analyzed. Results: A significantly higher mean value was scored in PT, followed by PTN, and the lowest value was found in X3 of canal transportation at the level of 3 mm (P &lt; 0.001), whereas at the 6- and 9-mm levels, there was no substantial difference statistically through the levels. Conclusion: The EdgeFile X3 showed the lowest canal transportation at a 3-mm level from the apex in comparison to the other tested files.

Using manual versus mechanized glide path instruments and ProTaper Gold versus ProTaper Next systems in curved canals: micro-CT study.

The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.

Effect of preset torque setting on torque/force generation, shaping ability and surface changes of nickel titanium rotary instrument in different root canal curvature locations: An ex vivo study.

The aim of this study was to evaluate how preset torque settings influence the torque, vertical force, and root canal-centering ability of ProGlider and ProTaper NEXT nickel-titanium rotary instruments in canals with different curvature locations. Based on micro-computed tomography, mesial roots of human mandibular molars (25°-40° curvature) were allocated to the apical curvature (apical 1-5 mm) or the middle curvature (apical 5-9 mm) groups, and mandibular incisors (curvature <5°) to the straight canal group. Each group was subjected to automated instrumentation and torque/force measurement with the preset torque of 1, 2.5, or 5 N•cm. Canal-centering ratios were determined with micro-computed tomography. Instrument fracture occurred only in the 2.5 and 5 N•cm groups in curved canals. The preset torque setting and curvature location did not influence canal shaping ability.

Evaluation of apically extruded debris using protaper universal, protaper next, one curve, Xp shaper, and edge file: An in vitro study

Introduction: Effective chemo-mechanical debridement is essential for a successful endodontic treatment. The present study aimed to determine the quantity of apical extruded debris during instrumentation by Protaper Universal (PTU), Protaper Next (PTN), One Curve, Xp Shaper, and Edge file systems. Materials and Methods: Fifty human maxillary first molars were chosen for this study. The palatal roots of teeth were decoronated using a diamond disk at length 13 mm, Then 50 samples were randomly divided to five groups (n = 10) (Group I: PTU file; Group II: PTN file; Group III: One Curve file; Group IV: XP Shaper file; and Group V: Edge file). After instrumentation, the root-cap assembly was detached from the glass vial. After that, the outer surface of the root was rinsed in the vial by 2 mL of normal saline to eliminate any debris that could have attached to it. The samples’ vials were stored in a hot air oven for 2 h at 100°C to allow moisture to evaporate before the debris was weighed with an electronic balance that had a 0.0001 g precision. Results: The data were statistically analyzed, and the greatest amount of extruded debris was in the PTU file (mean = 1.596), which had a statistically significant difference (P &lt; 0.05) with all other groups. Conclusion: Even after taking the study’s limitations into account, apical debris extrusion was observed in all groups. In contrast to the PTU file system, which exhibited the greatest value, the One Curve file system showed the lowest mean value of apical extrusion debris.

Evaluation of efficacy of photodynamic disinfection against enterococcus faecalis and compare it with the effect of different endodontic irrigant activation techniques.

Background and objective: The aim of this in vitro study was to assess the efficacy of photodynamic disinfection against Enterococcus faecalis, and compare it with the effect of different endodontic irrigant activation techniques. Methods: Fifty single-rooted premolars with single canals were chosen for the study. Five teeth were chosen to serve as the negative control group. The remaining samples were infected with normal Enterococcus faecalis strains. They were then randomly separated into five groups, with nine teeth serving as a positive control group (E. Cont.). Each group consisted of 9 samples based on the kind of irrigant activation: E.A (Diode laser), E.B (Ultrasonic), E.C (conventional), and E.D (FotoSan). The ProTaper NEXT rotary system up to model X3 was used to prepare all samples. For each group, 5.25% NaOCl was injected as an initial irrigant with a 30G double-side vented syringe needle, followed by 17% EDTA, then activated with NaOCl as a final irrigant. CFU of each sample was counted before and after irrigation regime, and they were compared to the control group. The efficiency of the disinfection techniques was determined using scanning electron microscopes (SEM). Result: The quantity of bacterial colony counting revealed that the control group had the largest mean of a bacterial colony (135.56±50.58); while the FotoSan group had the lowest colony mean number (23.11±9.82). SEM results indicated that the FotoSan group (5.56±3.16) and Diode laser (5.56±3.57) had the lowest surviving colony mean number. Conclusion: As an additional method, photodynamic therapy may increase the disinfection capacity of traditional endodontic treatment against E. faecalis in the root canal. Keywords:photodynamic disinfection, enterococcus faecalis, endodontic irrigant activation

Instrumentation time and effectiveness of hand and rotary files in a prototyped second mandibular primary molar: A micro-CT study.

Eccentric instruments have been proposed as more effective and less time-consuming for endodontic instrumentation. To compare biomechanical outcomes of different instrumentation systems and time undertaken for instrumentation in resin prototypes. Sixty standardized prototypes of mandibular second primary molars were instrumented according to the following systems: K-files, ProTaper Next (PTN), XP-endo Shaper (XPS), XP-endo Finisher (XPF), XP-Clean (XPC), and Sequence Baby File (SBF; n = 10/each). Irrigation was performed with saline with simultaneous aspiration, and time spent was recorded. The prototypes were micro-CT-scanned before and after the instrumentation, and image sets were reconstructed and registered. Non-instrumented areas, accumulated debris, removed root material volume, and canal transportation were quantified. Data were analyzed through ANOVA, the Kruskal-Wallis test, and the Wilcoxon signed-rank test (α = 5%). K-files and SBF resulted in more instrumentation time (p < .05). SBF, XPC and PTN removed less root dentine (p < .05), but PTN left more untouched areas (p < .05). Accumulated debris were lower for XPC and SBF (p < .05). Canal transportation was similar among the groups. Rotary systems reduced instrumentation time, whereas SBF and XPC resulted in more conservative instrumentation, with less debris accumulation and non-instrumented areas. A dedicated paediatric endodontic system (SBF) outperformed eccentric instruments in terms of effectiveness.

Efficiency and complications in root canal retreatment using nickel titanium rotary file with continuous rotation, reciprocating, or adaptive motion in curved root canals: a laboratory investigation

BackgroundIt is currently unknown whether rotary file motion affects the best outcome of root canal retreatment. This experimental study compared the efficacy, efficiency, and complications of single-use NiTi rotary files using continuous rotation, reciprocating, and adaptive motions in root canal filling removal in curved root canals. Reciproc blue R25 was used with reciprocating motion (RB), VDW.ROTATE retreatment files with continuous rotation (VR), and ProTaper NEXT X2 with continuous rotation (PTNc) or adaptive motion (PTNa).MethodsForty mesial root canals of extracted mandibular first and second molars with an angle of curvature between 20°–40° and a radius of curvature between 5 and 10 mm were collected. The specimens were instrumented and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. The specimens were randomly divided into 4 retreatment groups (n = 10), RB, VR, PTNc, and PTNa. The percentage of root canal filling removal in each group was analyzed using Micro-Computed Tomography (µCT). The motor running time, total time, root canal complication, and instrument complication were recorded and statistically analyzed (p-value < 0.05).ResultsThe pre-operative root canal curvature and root canal filling volume were comparable among groups. The percentage of root canal filling removal from the whole canal in the PTNc, RB, PTNa, and VR group was 98%, 96%, 95%, and 93%, respectively. A significant difference was observed between the PTNc and VR groups for the whole canal and the apical-third part. The motor running time and total time were significantly different between the groups. Instrument fracture was observed at 40% in the VR and 20% in the PTNa group, but none in the RB and PTNc groups.ConclusionsThe ProTaper NEXT X2 with continuous rotation and RB files can be used with high efficacy and efficiency in curved root canal retreatment. Continuous rotation is more efficacious and efficient than adaptive motion when using the NiTi rotary file. Single file retreatment can be used in small canals with high efficacy, cost-effectiveness, and less time consumption.

The effect of various file systems on postoperative pain in primary Tooth Root Canal treatments: A randomized controlled clinical trial

Objective: All root canal preparation techniques can potentially result in debris protruding apically, leading to postoperative pain. This study aimed to assess the effects of different file systems on postoperative pain in root canal treatments performed on primary molar teeth. Material and Methods: The study included 100 patients aged 5-8 years. NiTi K-type hand files (NTK), rotary file systems ProTaper Next (PTN), AF Baby (AFB), EndoArt Niti Pedo Gold (EAN), and reciprocal file system WaveOne Gold (WOG) were employed in the canal treatment of mandibular primary molars. Postoperative pain was assessed using the Visual Analog Scale (VAS) at the 6th, 12th, 18th, 24th, 48th, 72nd hour, and 1st week following treatment, and the collected data were evaluated statistically. Results: When considering time as a factor, the postoperative pain values among the groups were compared using the Kruskal-Wallis H test, and no statistically significant differences were observed (p = 0.007). In numerical terms, the group using NTK, EAN, AFB, and PTN exhibited the highest average postoperative pain, while the group using WOG, a reciprocal system, had the lowest pain. Conclusion: In conclusion, the choice of file used impacts postoperative pain. There was no statistically significant difference in time-independent postoperative pain values between rotary files designed for primary teeth and those intended for permanent teeth. However, using files specifically designed for primary teeth is recommended, considering factors such as working comfort and suitability for working length.

Cytokine expression of IL-8 before and after root canal treatment in patients with symptomatic apical periodontitis: A clinical trial.

Thirty-six patients were allocated according to their pulp status into two experimental groups (n = 18) receiving the same treatment protocol; group 1: Vital pulps with SAP, and group 2: non-vital pulps with SAP. Conventional endodontic treatment was done on two visits; isolation and disinfection of the operative field were undertaken, and two-stage access cavity preparation was implemented. The first pre-instrumentation peri-apical sample (S1) was collected prior to cleaning and shaping procedures. A 2.5% NaOCl irrigation was used to thoroughly irrigate the canal after performing root canal preparation utilising the ProTaper Next (PTN) rotary system. After 1 week, the second post-instrumentation peri-apical sample (S2) was collected. Using an ELISA kit, the quantity of IL-8 was evaluated following the collection of all samples. In all pre-instrumentation samples, IL-8 was detected (100%). The level of IL-8 expression was significantly decreased from the S1 to S2 of all samples (p < 0.001). The intra-group comparison showed a statistically significant reduction in the level of IL-8 expression between S1 and S2 in both vital and non-vital groups where p < 0.001* in both groups. The inter-group comparison of levels of IL-8 expression (vital and non-vital) revealed a significant difference between both groups regarding the pretreatment sample with the higher levels of IL-8 shown in the non-vital group (p < 0.001). While in the post-treatment sample, both groups showed a significant reduction in the level of IL-8 expression but the difference between them was not statistically significant (p = 0.226). Root canal instrumentation seems to be efficient in decreasing the levels of anti-inflammatory cytokines, namely IL-8. Further research should clarify how intra-canal medicaments affect inflammatory mediator levels.

Apical extrusion of debris when using OneCurve, ProTaper Next and TruNatomy in curved canals.

The extrusion of apical debris is related to various factors, and may be affected by variations in technique or instrumentation system. Although the extrusion cannot be completely prevented, it is crucial to minimize the amount of extruded material. The present study aimed to compare apical debris extrusion by the novel TruNatomy (TRN), OneCurve (OC) and ProTaper Next (PTN) instruments in curved root canals. A total of 60 multi-rooted human mandibular molar teeth with moderate and severe curvature were selected and randomly divided into 3 groups. The root canals were prepared with the OC, TRN and PTN files. For collecting the debris extruded through the apical foramen, Eppendorf tubes were used. After the vaporizing period, the tubes were re-weighed, and the amount of the extruded debris was calculated by subtracting the initial weight from the final weight. Statistical analysis was performed with the Shapiro-Wilk and Kruskal-Wallis tests. The statistical significance level was set at p < 0.05. The least amount of debris was extruded with TRN and the greatest with PTN, but the difference between the groups was not significant (p = 0.257). All instrumentation systems were associated with debris extrusion. The tested file systems presented similar results in terms of apical debris extrusion in curved canals. The novel TRN system demonstrated promising results, comparable to OC and PTN.

Impact of cooling on shaping ability of thermally treated files in canal models with double curvature.

This study compared the ability of thermally treated files in shaping simulated canals with double curvature. Fifty-six canals were enlarged to a final size of 25 with ProTaper Next (PTN) or ZenFlex (ZF). Half of the samples were shaped with cooled files (n=14 each). The amount of removed resin was measured and canal deviation was determined at eight levels. Shaping time and maximum shaping torque values were also recorded. Data were statistically analyzed using analysis of variance and LSD, Kruskal-Wallis, and chi-square tests at a 0.05 significance level. Compared to PTN and cooled PTN, ZF and cooled ZF required lesser time to shape the canals. The maximum torques were found comparable between the groups. All the groups generated negligible deviations at every canal level evaluated and maintained the canal geometry. Although not significant, the cooled PTN and ZF files exhibited lesser canal deviations than their counterparts. All groups demonstrated similar shaping ability whilst maintaining the original curvature of the canal in simulated canals with double curvature. However, ZF groups were able to shape the canals faster than PTN groups. There was a trend that cooled files made lesser canal deviations compared to their counterparts.