ProTaper Technique Research Articles

Effectiveness of calcium hydroxide removal with irrigation techniques using ProTaper and ultrasonic activation: an in vitro study

Background: Residual calcium hydroxide might adversely affect the outcome of endodontic treatment results. Calcium hydroxide affect the adhesion of endodontic sealers to the canal walls and interfere with sealing ability of endodontic sealers. To remove this intracanal medicament, there are various irrigation techniques have developed. The aim of this study was to evaluate the effectiveness of different techniques in removing calcium hydroxide from the root canal. Materials and methods: Thirty extracted single-rooted mandibular premolar were instrumented and filled with calcium hydroxide and divided into three groups (n = 10/group). After 7 days, calcium hydroxide was removed. All root canals were received 2.5% NaOCl, followed by 17% EDTA and a final flush with 2.5% NaOCl. In group I, no additional agitation of the irrigant was performed. In group II, agitation was done for 20 s between irrigants with a size of F2 ProTaper rotary file. In group III, an ultrasonic activation was delivered for 20 s between irrigants. Finally, the roots were grooved longitudinally and split in two halves. Selected half of each tooth was observed under a stereomicroscope at 30x magnification. Results: In groups needle irrigation and ProTaper technique, score of residual calcium hydroxide in apical third is higher than cervical and middle thirds (p < 0.05). Needle groups demonstrated the significantly higher score of residual calcium hydroxide than ProTaper and ultrasonic groups (p < 0.05). Conclusion: None of irrigation techniques could remove all calcium hydroxide completely. Ultrasonic irrigation and ProTaper irrigation was more effective in removing calcium hydroxide than needle irrigation. Key words: calcium hydroxide, irrigation solution, ultrasonic irrigation.

Effect of Multilayering Incremental Technique on the Microleakage of High-viscosity Bulk-fill Composite Restorations in Endodontically Treated Teeth

The aim of this study is to evaluate the effect of multilayering incremental technique on the microleakage of high-viscosity bulk-fill composite restorations in endodontically treated teeth. A total of 60 human mandibular premolar teeth were divided into four groups after standardized access preparation with a protaper technique followed by single-cone obturation to receive the following restorations for the access preparations. Group I (n = 20): bulk-fill composite (Filtek™ Bulk fill) using a bulk technique, group II (n = 20): bulk-fill composite (Filtek™ Bulk fill) using an incremental layering technique, group III (negative control) (n = 10): gutta-percha was kept intact at the access orifice and covered with a nail polish, and group IV (positive control) (n = 10): gutta-percha was kept intact at the orifice. The samples were thermocycled at 5°C and 55°C for 500 cycles followed by dye penetration with 2% methylene blue and then the scoring was done under a stereomicroscope at 10× magnification. The data so obtained were compared for microleakage using a Chi-square test. There was a significant difference among all the groups except groups II and III. Bulk-fill composites used with an incremental layering technique sealed significantly better than the other groups followed by bulk-fill composite in the bulk technique. Within the limitations of the present study, it can be concluded that the incremental layering technique with bulk-fill composites significantly decreases microleakage in the restored access preparations of endodontically treated teeth.

Influence of Different Irrigation Solutions and Instrumentation Techniques on the Amount of Apically Extruded Debris.

Objective:The objective of the present study was to evaluate the influence of different irrigation solutions on the amount of extruded residues apically, varying the instrumentation technique in manual, continuous rotation, or reciprocation motions. The amounts of residue for each irrigation solution was also assessed.Methods:Two tests were performed. In the first test, 90 mandibular premolars were divided into nine groups (n=10). Each group was subjected to a different technique: ProTaper Universal, WaveOne Gold, or manual instruments, with different irrigation solutions [2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gel, or distilled water]. During the preparation of the root canal, the apically extruded material was collected in previously weighed glass vials. In the second test, irrigation solutions were weighed separately with the same weighing method. Data were analyzed using the Kolmogorov–Smirnov, one-way and two-way ANOVA, Levene, Tukey, and Games–Howell tests.Results:Apically extruded debris was observed in all groups. ProTaper Universal with continuous rotation using 2% CHX gel resulted in the greatest amount of debris (P<0.001). There were significant differences in the amounts of residue among the different groups (P<0.001). Moreover, when the weighing of the irrigation solutions was tested, the 2.5% NaOCl solution produced the greatest amount of residues compared with other irrigation solutions.Conclusion:Different irrigation solutions influenced the amount of apically extruded debris during the preparation of the canal among the different instrumentation techniques. The ProTaper technique using 2% CHX gel resulted in the greatest amount of apically extruded debris.

The incidence of dentinal cracks during root canal preparations with reciprocating single-file and rotary-file systems: A meta-analysis.

As a dangerous factor in vertical root fracture, dentinal crack formation is often associated with root canal instruments. We conducted this meta-analysis to compare the influence of two types of nickel titanium (NiTi) instruments that have different movements (reciprocating single-file versus full-sequence rotary file systems) on dentinal cracks formation during root canal preparation. Searches were conducted in PubMed, ISI Web of Knowledge, Embase and Cochrane Library using a combination of keywords. Titles and abstracts of all articles were independently assessed by two reviewers in accordance with the predefined inclusion criteria. Relevant studies were acquired in full-text form. Data in these articles were independently extracted. A meta-analysis was conducted using Review Manager 5.3. The results showed that the WaveOne and Reciproc files with a reciprocating motion produced significantly fewer dentinal cracks than the conventional rotational ProTaper technique.

Comparative Evaluation of Smear Layer and Debris on the Canal Walls prepared with a Combination of Hand and Rotary ProTaper Technique using Scanning Electron Microscope

The effect of smear layer and debris on the success rate of endodontic treatment has not yet been definitely determined. So the present study was aimed to evaluate the amount of smear layer and debris on the canal walls prepared with a combination of hand and rotary ProTaper technique using NaOCl and ethylenediaminetetraacetic acid (EDTA) alternately as root canal irrigants using scanning electron microscope (SEM). Eighty intact freshly extracted human permanent mandibular premolar teeth were collected and randomly divided equally into four groups. In group I canals were prepared with hand K-Flexofiles; group II with rotary ProTaper instruments; group III with rotary ProTaper instruments and final instrumentation was done with hand K-Flexofile; group IV with rotary ProTaper instruments and final instrumentation was done with RC-Prep and irrigated with 1 mL of normal saline. In all groups canals were irrigated using NaOCl and EDTA alternately. After instrumentation, the teeth were prepared for SEM examination using five-score indices for debris and smear layer at coronal, middle, and apical third levels. Statistical analysis was performed using chi-square test (p < 0.05) and Kruskal-Wallis test (p < 0.05). Statistically significant difference was observed between the groups in cleaning the apical third. Groups I and III showed better canal cleanliness compared to group II. The use of EDTA and NaOCl in group III was more effective in removing debris and smear layer compared to EDTA and normal saline in group IV. Regardless of the instrumentation technique employed and the irrigant used, the cleaning ability decreased in the apical third, resulting in higher debris and smear layer scores compared to coronal and middle third levels. None of the instrumentation techniques in the present study could completely eliminate the smear layer and debris from the canal walls. Instrumentation of the canals with hand files after automated rotary preparation could result in cleaner canal walls. Alternate irrigation with NaOCl and EDTA is effective in the removal of debris and smear layer in the coronal and middle level, but the effectiveness in the apical third is less.

Microtomography-based Comparison of Reciprocating Single-File F2 ProTaper Technique versus Rotary Full Sequence

Introduction A preparation technique with only 1 single instrument was proposed on the basis of the reciprocating movement of the F2 ProTaper instrument. The present study was designed to quantitatively assess canal preparation outcomes achieved by this technique. Methods Twenty-five extracted human mandibular first molars with 2 separate mesial root canals were selected. Canals were randomly assigned to 1 of the 2 experimental groups: group 1, rotary conventional preparation by using ProTaper, and group 2, reciprocate instrumentation with 1 single ProTaper F2 instrument. Specimens were scanned initially and after root canal preparation with an isotropic resolution of 20 μm by using a micro–computed tomography system. The following parameters were assessed: changes in dentin volume, percentage of shaped canal walls, and degree of canal transportation. In addition, the time required to reach working length with the F2 instrument was recorded. Results Preoperatively, there were no differences regarding root canal curvature and volume between experimental groups. Overall, instrumentation led to enlarged canal shapes with no evidence of preparation errors. There were no statistical differences between the 2 preparation techniques in the anatomical parameters assessed ( P > .01), except for a significantly higher canal transportation caused by the reciprocating file in the coronal canal third. On the other hand, preparation was faster by using the single-file technique ( P < .01). Conclusions Shaping outcomes with the single-file F2 ProTaper technique and conventional ProTaper full-sequence rotary approach were similar. However, the single-file F2 ProTaper technique was markedly faster in reaching working length.

Suboptimal Debridement Quality Produced by the Single-file F2 Protaper Technique in Oval-shaped Canals

Introduction The aim of this study was to determine whether the debridement quality of the single-file F2 ProTaper instrumentation technique is comparable to a full conventional ProTaper sequence in both round and oval-shaped root canals. Methods Fifty-four recently extracted vital lower incisors were instrumented with either a full range of ProTaper Universal instruments in rotary motion (group 1) or with the single-file F2 ProTaper technique in reciprocating motion (group 2). Teeth were previously classified as round or oval-shaped by means of bidirectional radiographs, resulting in 24 round canals, 24 oval canals, and 12 controls. After instrumentation, the roots were demineralized, and the apical 3 mm was multi-sliced and processed for histologic examination. The percentage of residual pulp tissue (PRPT) was calculated with the aid of image analysis software. Univariate analysis of variance was used to verify the variables influencing PRPT. Results Both canal shape and technique significantly influenced PRPT ( P < .05). Oval-shaped canals displayed much more PRPT than round canals in both techniques ( P < .05). The difference in PRPT between the techniques depended on the root canal shape, since a significant interaction between canal shape and technique was observed ( P < .05). Group 1 displayed considerably less PRPT in oval canals than group 2 ( P < .05), whereas in round canals no significant difference was found between the 2 techniques ( P > .05). Conclusions The single-file F2 ProTaper technique displayed similar PRPT to the full range of ProTaper instruments in round canals. However, the debridement quality of the single-file F2 ProTaper technique was suboptimal in oval canals.

CT evaluation of canal preparation using rotary and hand NI-TI instruments: Anin vitrostudy

Background:Controlled, uniformly tapered radicular preparation is a great challenge in endodontics. Improper preparation can lead to procedural errors like transportation of foramen, uneven dentine thickness, stripping of root canal, formation of ledge, zip, and elbow in curved canals. These procedural errors and their sequel can adversely affect the prognosis of treatment.Aim/Objectives:The present in vitro study aims to evaluate canal preparation based on the following factors: canal transportation, remaining dentine thickness and comparing centering ability between hand Ni-Ti K files and ProTaper rotary Ni-Ti instruments using computed tomography (CT).Materials and Methods:For evaluation, 30 mesiobuccal roots of maxillary molars were selected. Of these, 15 roots were distributed into two groups where Group 1 included hand instrumentation with Ni-Ti K-files; and Group 2 comprised ProTaper NiTi rotary system. Pre instrumentation and post instrumentation three-dimensional CT images were obtained from root cross-sections that were 1 mm thick from apex to the canal orifice; scanned images were then superimposed and compared.Result:It was observed that the manual technique using hand Ni-Ti K-file produced lesser canal transportation and maintained greater dentine thickness than the rotary ProTaper technique at middle and coronal third and this difference was statistically significant. No significant difference was seen with regard to canal transportation and remaining root dentine at apical levels. With regard to centering ratio, no significant difference was seen between both the groups at all levels.Conclusion:ProTaper should be used judiciously, especially in curved canals, as it causes higher canal transportation and thinning of root dentine at middle and coronal levels. None of the groups showed optimal centering ability.

Microbial Leakage of Gutta-percha and Resilon™ Root Canal Filling Material: A Comparative Study Using a new Homogeneous Assay for Sequence Detection

The sealing ability of gutta-percha/sealer root canal filling was compared to a new thermoplastic synthetic polymer-based obturation material (Resilon), using a microleakage model and a new sequence detection assay One Cut Event AmplificatioN (OCEAN). Eighty-eight extracted human teeth, shaped with K-Files and the ProTaper Technique, were randomly assigned to four groups (n = 22) and obturated in the apical 5 mm. Group R were obturated with the Resilon/Epiphany technique; group GP were obturated with gutta-percha and Zinc oxide eugenoe sealer; group RCH and GPCH received calcium hydroxide intracanal medication before being obturated. Sterilized specimens were inoculated with Enterococcus faecalis and incubated in sterile medium for 47 days. DNA extracted from the specimens was amplified by PCR and then identified by the OCEAN technique. Samples obturated with Resilon root canal filling material showed a greater number of microleakage events than the other groups (p = 0.036). Calcium hydroxide medication did not have a relevant impact on the quality of the apical seal (p = 0.044).

The ProTaper technique

Endodontic TopicsVolume 10, Issue 1 p. 187-190 The ProTaper technique Clifford J. Ruddle, Clifford J. RuddleSearch for more papers by this author Clifford J. Ruddle, Clifford J. RuddleSearch for more papers by this author First published: 18 August 2005 https://doi.org/10.1111/j.1601-1546.2005.00115.xCitations: 28Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume10, Issue1March 2005Pages 187-190 RelatedInformation