Root Canal Preparation Techniques Research Articles

Minimally invasive management of vital teeth requiring root canal therapy

The present study aimed to investigate the possible use of a non-instrumentation technique including blue light irradiation for root canal cleaning. Extracted human single rooted teeth were selected. Nine different groups included distilled water, NaOCl, intra-canal heated NaOCl, and NaOCl + EDTA irrigation after either instrumentation or non-instrumentation, and a laser application group following non-instrumentation technique. The chemical assessment of the root canal dentine was evaluated using energy dispersive spectroscopy (EDS) and Fourier transform infrared (FT-IR) spectroscopy. Surface microstructural analyses were performed by using scanning electron microscopy (SEM). The antimicrobial efficacy of different preparation techniques was evaluated using microbial tests. Light application didn’t change the calcium/phosphorus, carbonate/phosphate and amide I/phosphate ratios of the root canal dentin. The root canal dentin preserved its original chemistry and microstructure after light application. The instrumentation decreased the carbonate/phosphate and amide I/phosphate ratios of the root canal dentin regardless of the irrigation solution or technique (p < 0.05). The application of light could not provide antibacterial efficacy to match the NaOCl irrigation. The NaOCl irrigation both in the non-instrumentation and instrumentation groups significantly reduced the number of bacteria (p < 0.05). The use of minimally invasive root canal preparation techniques where the root canal is not instrumented and is disinfected by light followed by obturation with a hydraulic cement sealer reduced the microbial load and preserved the dentin thus may be an attractive treatment option for management of vital teeth needing root canal therapy.

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.

The Comparative Efficacy of Conventional and Crown-Down Root Canal Preparation Techniques in Relation to the Extrusion of Apical Debris

Numerous scientific investigations have been undertaken to assess the efficacy of standard root canal preparation methods and the crown-down procedure in mitigating the ejection of apical debris. The aforementioned research examines multiple facets, encompassing the efficacy of canal cleaning, the potential for debris extrusion, and their influence on the outcome of root canal therapy. The objective of this study is to evaluate the efficacy of conventional and crown-down root canal preparation methods in relation to the extrusion of apical debris. The literature search used a lot of different databases, like PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar, to look into how well traditional and crown-down root canal preparation methods work for getting debris out of the root canal. Traditional methods of root canal preparation have been extensively employed in the field of endodontics. While root canal cleaning and shaping techniques have demonstrated efficacy, there is still a potential danger of apical debris extrusion. Several factors contribute to the level of risk involved in dental procedures. These factors encompass the use of instruments, the amount of pressure applied during preparation, the effectiveness of irrigation, and the level of experience possessed by the dentist. In conclusion, the efficacy of both methodologies is contingent upon various aspects, including the level of expertise possessed by the dentist, the specific instruments employed, the irrigation technique employed, and the thoroughness of the case examination. The particulars of each case and the dentist's personal preference should guide the choice of either procedure.

Treatment Outcome and Root Canal Preparation Techniques: 5-Year Follow-Up

This study aims at comparing treatment outcome and tooth survival of root canal-filled teeth following manual vs rotary instrumentation techniques over a 5-year period. This was a single-centre study conducted as a follow-up to a short-term parallel-arm randomised controlled noninferiority trial in which root canal treatment was performed on teeth using either rotary or manual instrumentation. Patients were monitored at post 6-month, 1-year, 4-year, and 5-year review periods by blinded evaluators. Treatment outcome was categorised as favourable, uncertain, and unfavourable (employing European Society of Endodontology categorisation based on strict clinical and radiographic criteria), and 5-year tooth survival was determined by assessing whether tooth was in situ in the oral cavity or extracted. The Kaplan-Meier method and log rank test evaluated tooth survival. P value <.05 was considered statistically significant. Ninety of 120 treated teeth were assessed in 37 men and 40 women with mean age of 30.6 ± 10.99 years. Treatment outcome was significantly more favourable in the rotary group compared to the manual group at post 6-month (P=.021) and 1-year (P=.043) review periods. The differences in favourable outcome (P=.498) and tooth survival (P=.296) between the 2 groups were, however, not significant at the 5-year review period. The rotary instrumentation technique was shown to be more effective in resolving clinical symptoms and promoting periapical healing after the post 6-month and 1-year review compared to the manual instrumentation technique; however, both groups had similar favourable outcomes and survival rates after an extended 5-year review period.

Endodontic Flare-up Incidense in Irreversible Pulpitis in Universitas Airlangga Dental Hospital (RSKGMP Universitas Airlangga)

Background: Carious lesions that do not be treated, becomes infected and inflamed, leading to irreversible pulpitis. One of the treatments for irreversible pulpitis is root canal treatment. In root canal treatment can cause flare-ups. Purpose: Obtaining a data base on flare-ups with a diagnosis of irreversible pulpitis at RSKGMP and obtaining a picture of flare-ups in irreversible pulpitis based on root canal preparation techniques, root canal irrigation materials, root canal dressing materials, and root canal obturation techniques. Methods: The study used was a descriptive observational study with a study design cross sectional in patients with a diagnosis of irreversible pulpitis who had received root canal treatment at the UPF Dental Conservation RSKGMP University of Airlangga in 2018, 2019, and 2020. Results: A total of 14 patients (28%) of 50 patients experienced (flare-up). Conclusion: The incidence flare-ups of root canal treatment in irreversible pulpitis at RSKGMP University of Airlangga is 28%.

Endodontic flare-up incidence in pulp necrosis in Universitas Airlangga Dental Hospital (RSKGMP Universitas Airlangga)

Background : Dental caries occurs as a result of demineralization of the hard tissues of the teeth followed by the destruction of the organic matter, resulting in bacterial invasion and death of the pulp which can lead to pulp necrosis. One of the treatments for pulp necrosis is endodontic treatment. Endodontic treatment includes root canal preparation techniques, root canal irrigation materials, root canal dressing materials, and also root canal obturation techniques. In endodontic treatment can experience flare-ups. An endodontic flare-up is a pain or swelling after endodontic treatment that occurs in a relatively short time. Purpose : To describe the incidence of endodontic flare-ups in pulp necrosis at RSMKGP Universitas Airlangga. Methods : Conducted descriptive observasional research on patients who had endodontic treatment at UPF Dental Conservation, Dental and Oral Hospital, Faculty of Dental Medicine, Airlangga University in 2018, 2019, and 2020. Results : A total of 28 patients (30,1%) from 93 patients were experience pain or flare-ups after root canal treatment. Conclusion : From the result of this study, it can be concluded that there is still an incidence of endodontic flare-ups in pulp necrosis at RSKGMP Universitas Airlangga which is 30,1%.

Present status and future directions: Removal of fractured instruments.

The success rate of fractured instrument retrieval varies because it is dependent mainly on several factors including the visibility of the fractured instrument, the length of the fractured instrument in relation to the curvature of the canal and the techniques applied to each case. This review aims to update the present status on removal of fractured instruments to identify factors and variables that could affect the success of fractured instrument retrieval based on both the preparation techniques and the instrument retrieval techniques. On the other hand, future directions of fractured instrument retrieval should focus on management of nonvisible fractured instruments since the removal of those instruments is deemed unpredictable with the current techniques, whereas the removal of visible fractured instruments is considered predictable now. Another possible direction of it is that there might be no more instrument fracture due to possible significant changes in the root canal preparation technique which may dispense with the use of rotary instruments.

Apical transportation with different root canal preparation techniques using edgEEvolve rotary instruments

Apical transportation with different root canal preparation techniques using edgEEvolve rotary instruments

An Update on Root Canal Preparation Techniques and How to Avoid Procedural Errors in Endodontics

Background:Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors.Methods:A comprehensive search was carried out using multiple databases, PubMed, Medline, Google scholar, and Scopus, to identify relevant studies addressing the objective of this study and to summarize the current evidence to readers. Keywords,i.e., endodontics, root canal preparation, hand instrumentation, techniques and procedural errors, as well as, MeSH terms,i.e. “endodontics”, “instrumentation”, “root canal preparation” were used to conduct our comprehensive search.Results:The hybrid technique is a commonly-used approach that combines the benefits of both the crown-down and step-back techniques and was reported to be one of the best techniques to produce an optimal root canal preparation outcome. Hand-instrument manipulation using the balanced forced technique is also favoured as it rapidly and safely permits removal of canal contents allowing irrigants and medications to reach deep inside canal spaces.Conclusion:The use of hand files is still recommended for initial canal negotiation and preparation and is essential for the correction of procedural errors. This study provided an update on several hand instrumentation techniques commonly used in endodontics. The correct and safe application of these techniques can prevent iatrogenic procedural errors from occurring which optimizes the quality of treatment outcome.

The influence of different NiTi instrumentation techniques on postoperative pain after single-visit root canal treatment.

This study aimed to evaluate the effect of multi-file rotary (Protaper Universal) and reciprocating single-file (Reciproc Blue) root canal preparation techniques on the occurrence of postoperative pain in asymptomatic mandibular molar teeth with large periapical lesions in single-visit root canal treatment (RCT). A hundred and twenty teeth were randomly assigned to two groups: Protaper Universal (PTU) or Reciproc Blue (RB) instruments. Postoperative pain at 6, 12, 24, 48, 72 h and 7 days after obturation was measured. Mann-Whitney U-test was performed to compare the pain scores between the groups and to assess the relation of pain with patients' age and gender. Spearman's rank correlation was utilized to correlate the pain intensity and analgesic intake at different time points. There was no significant difference between the instrumentation techniques regarding postoperative pain at any time points evaluated (P > 0.05). There was a correlation between analgesic intake and intensity of pain (P < 0.05). No statistically significant difference was found among the groups assessed in the study in terms of analgesic intake (P > 0.05).

A Novel Root Canal Preparation Technique Hybridizing Heat-treated Nickel-Titanium Rotary Instruments

A Novel Root Canal Preparation Technique Hybridizing Heat-treated Nickel-Titanium Rotary Instruments

Root Microcracks Formation during Root Canal Instrumentation Using Reciprocating and Rotary Files

The aim of this study was to compare the formation of dentinal cracks with nickel-titanium (NiTi) instruments working in continuous rotation and reciprocating motion. One hundred sixty extracted human mandibular first molars were selected for the study. The mesial roots were resected and mounted in resin blocks with simulated periodontal ligaments. Those teeth were randomly assigned to five groups (n = 32 teeth/group). The first one was treated with K-files and served as control group, and the remaining 128 teeth were divided into 4 groups depending on the root canal preparation technique. Group 2 samples were prepared by sequential ProTaper Universal (PTU), group 3 samples with rotary ProTaper Universal (RPTU), group 4 achieved by the One Shape (OS), and group 5 with the WaveOne (WO) primary files. Roots were then horizontally sectioned at 3, 6, and 9 mm from the apex, and the slices were then observed under a stereomicroscope at ×40 magnification to determine the presence of internal dentinal microcracks. The presence or absence of dentinal defaults was recorded and the statistical analysis was performed by Pearson Chi-square test. The significance level was set at p < 0.05. The study was made in the oral biology and biotechnology research laboratory of the faculty of medical dentistry of Rabat, Morocco. No dentinal defect was seen with the stainless steel hand file (group 1). The manual PTU (group 2), the RPTU (group 3), the OS (group 4), and the WO (group 5) in reciprocating motion caused cracks in 15.6%, 12.4%, 21.9%, and 6.2% of samples, respectively. The highest percentage of dentinal defect was showed in group 4 but without significant difference with the other group (p > 0.05). Dentinal cracks are produced indifferently of motion kinematics. Within the limits of this study and the current literature, such incidence is less with instruments working in reciprocating motion compared with those working in continuous rotation. Manual and rotary NiTi sequential systems showed fewer microcracks than the single file system working by continuous rotation motion.

Development of apical root microcracks following different root canal preparation systems

Context: The most critical step in root canal therapy is cleaning and shaping of the root canal. A vast array of instruments both handheld and engine driven are available for root canal preparation. There are very few studies to compare the effect of different types of instruments on the development of apical root cracks. Hence, the aim of the study was to compare the development of apical root cracks following different root canal preparation techniques and instruments.Aims: The aim of this study is to compare the development of apical root cracks following different root canal preparation techniques and instruments.Settings and Design: This is an in vitro study.Subjects and Methods: Forty extracted mandibular premolar teeth were selected and mounted on resin blocks with simulated periodontal ligaments, after which the apex was exposed. All teeth were randomly divided into four groups; each group was earmarked for a specific technique and instrument used for root canal preparation. Digital images of external apical root surfaces of every tooth were taken before and after apical enlargement through optical microscope (×40). These images were compared, and the presence of cracks was evaluated.Statistical Analysis Used: Chi-square exact test was used to compare the four groups.Results: Overall P value was 0.167 which is not statistically significant and indicates that the proportion of teeth developing cracks was not statistically significant among the four groups.Conclusions: More cracks were developed with rotary system. However, the results were not statistically significant among the four groups.

Comparative Evaluation of Apical Extrusion Debris and Irrigant During Calcium Hydroxide Removal and Endodontic During Calcium Hydroxide Removal and Endodontic Instrumentation Using Three Types of Instrumentation Systems Instrumentation Using Three Types of Instrumentation Syste

Many root canal preparation techniques and instruments produce apically extruded materials to a certain extent depending on the preparation system adopted. The extrusion of debris from the apical foramen during chemomechanical preparation may cause postoperative pain and failure of endodontic treatment. Objective: This study evaluates the differences in the apical extrusion of debris and calcium hydroxide (CH) during endodontic instrumentation by using Reciproc Blue (RB), WaveOne Gold (WOG), and F6 Skytaper (F6). Methods: Six experimental study groups (n = 13) were established. The root canal procedures for all groups were prepared with different methods: Group I: One Shape (OS) instrumentation, CH filling for 21 days, removal of CH using RB; Group II: OS instrumentation, CH filling for 21 days, removal of CH using WOG; Group III: OS, CaOH filling for 21 days, removal of CH using F6; Group IV: root canal instrumentation using RB; Group V: root canal instrumentation using WOG; Group VI: root canal instrumentation using F6. Apically extruded debris was collected into preweighed Eppendorf tubes by using the Myers and Montgomery method. Data were statistically analyzed with one-way ANOVA and Kruskal–Wallis tests. Results: All the tested instruments caused the extrusion of debris and irrigant from the apical foramen. The difference among the six groups was not statistically significant (p &gt; 0.05). Conclusions: The tested instruments caused similar apical extrusions of debris and irrigant during CH removal or instrumentation procedures.

Influence of Root Canal Preparation on Formation of Dentinal Microcracks: A Systematic Review.

The effect of root canal preparation technique on microcrack initiation is a controversial issue. This systematic review aimed to assess the role of root canal preparation techniques with different kinematics (manual, rotary, reciprocating, adaptive, self-adjusting file) on microcrack initiation. In vitro and in situ studies comparing the influence of at least two different root canal preparation techniques on the initiation of dentin microcracks were searched in PubMed/MEDLINE and SCOPUS up to June 5, 2018 without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and the included studies were assessed for bias. Fifty-four (n=54) articles met the eligibility criteria. The results were classified according to the method used for microcrack evaluation, and most studies that used micro-computed tomography showed no formation of new cracks after root canal preparation. In general, the instrumentation techniques induced microcrack formation when the methods were destructive, irrespective of kinematics. In relation to the apex region, when the preparation working length was set as the root canal length subtracted of 1 mm, the risk of microcrack initiation reduces. The majority of the included studies had low risk of bias for all assessed domains. Our results seem to indicate that the various root canal preparation techniques considered in this study will not cause damage to the dental structure when adequately employed and the proper methodology is applied.

Comparison of Step-Down Versus Step-Back Hand Preparation Technique of Root Canals

Objective: The aim of this study was to compare the frequency of flare-up in terms of post-operative pain and/or swelling, after step down and step back root canal preparation technique.&#x0D; Methods: A randomized clinical trial was conducted from 28th October 2011 to 27th April 2012 in de'Montmorency College of Dentistry, Lahore.150 patients with irreversible pulpitis were randomly al- lotted in two equal groups (Group A and B) and root canals were prepared with step-down andstep- back technique respectively. Pain was recorded using visual analogue scale on 1st, 7th and 14th post-operative day. Data was analysed using SPSS version 17.0.&#x0D; Results: In Group A, 67 patients had no flare-up and 8 patients had flare-up on 14th postoperative day. In Group B, 57 patients had no flare-up and 18 patients had flare-up on 14th postoperative day. Out of 150 patients 26 (17.33%) showed flare-up and 124 (82.66%) showed no flare-up. The overall flare-up in Group A was 10.6% and in Group B was 24% after 14 days.&#x0D; Conclusions: Step-down technique is better for root canal preparation as evaluated by the comparison of flare-up by step-down and step-back techniques.

Effect of Root Canal Preparation Techniques on Crack Formation in Root Dentin

IntroductionThe aim of this study was to assess the frequency of root crack formation caused by the use of manual instrumentation, 2 rotary systems, and 1 reciprocating system using light-emitting diode transillumination. MethodsOne hundred fifty mandibular premolars were randomly divided into 5 groups (n = 30): control 1, no intervention; control 2, instrumented with hand files; group 3, instrumented with ProTaper Universal rotary files (Dentsply Maillefer, Ballaigues, Switzerland); group 4, instrumented with OneShape rotary files (Micro-Mega, Besancon, France); and group 5: instrumented with the WaveOne reciprocal system (Dentsply Maillefer, Ballaigues, Switzerland). After root canal preparations, the roots were sectioned at 3, 6, and 9 mm from the apex with water irrigation. The slices were inspected under a stereomicroscope with light-emitting diode transillumination from the buccal, lingual, mesial, and distal directions at ×40 magnification to determine the presence/absence of cracks (dentinal defects). The chi-square test was used to analyze the data. ResultsThere was a significant difference among the groups in crack frequency (P < .05). The 2 single systems had significantly higher cracks than the other 3 groups. At 3 mm from the apex, there were significantly more cracks in groups 4 and 5 than in groups 1, 2, and 3 (P < .05). At 6 mm from the apex, no significant difference was noted (P > .05). At 9 mm from the apex, the frequency of cracks in group 3 was significantly higher (P < .05). ConclusionsAccording to the results, using rotary instrumentation can result in some dentinal defects, and single-file systems, regardless of motion type, can cause significantly higher crack formation in the apical third of root canals.

A comparative evaluation of the shaping ability of different nickel-titanium rotary root canal preparation techniques performed by undergraduate students

A comparative evaluation of the shaping ability of different nickel-titanium rotary root canal preparation techniques performed by undergraduate students

Influence of size and taper of basic root canal preparation on root canal cleanliness: a scanning electron microscopy study.

To investigate whether a minimally invasive basic root canal preparation technique has an influence on root canal cleanliness in extracted mandibular molar teeth. A total of 80 root canals (40 mesio-buccal and 40 mesio-lingual) from 40 mandibular molars were included. The teeth were divided equally into four different experimental groups depending on the subsequently root canal preparation technique: Group 1: a basic preparation was performed up to size 20, .04 taper; Group 2: a basic preparation was performed up to size 2, .06 taper; Group 3: a basic preparation was performed up to size 25, .04 taper; and Group 4: a basic preparation was performed up to size 25, .06 taper. After the use of each instrument, each root canal was irrigated with 2.5mL of 6% sodium hypochlorite for 30s. Then, 1mL NaOCl was activated for 20s using an EDDY sonic tip. Final irrigation was performed using a total of 5mL of 17% EDTA solution. The roots were then split longitudinally and all root canal thirds were observed through scanning electron microscopy (SEM) to evaluate the presence of superficial debris and smear layer using a scoring system. Data were statistically analysed using the Kruskal-Wallis and Bonferroni tests with a level of significance set at P<0.05. In all groups, there was significantly more residual debris and smear layer in the apical third (P<0.05), with no differences between the middle and coronal thirds (P>0.05). For both the parameters analysed, there was no difference amongst the groups in the middle and coronal thirds (P>0.05), whilst in the apical third significantly less debris and smear layer was found in specimens from groups 3 and 4 than for groups 1 and 2 (P<0.05). All basic root canal preparation techniques were associated with less debris and smear layer on the canal walls in the middle and coronal thirds, without differences among them. Even though debris and smear layer were always present in the apical third, an apical size of 25 resulted in significantly cleaner canals walls compared to a size 20.

Assessment of Different Root Canal Preparation Techniques with Rotary Nickel-Titanium Instruments by Novice Students.

This study investigated which preparation strategy for root canals leads to the best technical preparation quality, and moreover, which is perceived to be performed best by novice students. Sixty-four students were recruited to prepare one simulated root canal with each of the following: FlexMaster files (F), Mtwo files (M), and Reciproc files (R). After preparation, the students assessed the different instrument systems through a questionnaire. The technical quality of the root canal preparations was evaluated by the centering ratio of the preparation. A total of 186 prepared root canals were submitted for evaluation. With R, significantly better centered preparations were achieved when compared to M and F (p < 0.001). The students evaluated R faster than M and F, and evaluated F significantly (p < 0.05) slower than R and M. M was rated as the easiest system to learn and to handle, as well as the best at reaching the working length; therefore, it was evaluated as the overall favorite of the students. A difference was found between the students’ perceptions and their achieved technical quality of root canal preparations.