Step-back Technique Research Articles

Evaluation of apically extruded debris from root canal filling removal of the mesiobuccal canal of maxillary molars using XP shaper and protaper with two different irrigation

ABSTRACT Background: Periapical extrusion of debris for root retreatment will effectively improve the posttreatment inflammation and pain. The aim of this study was to investigate the extruded debris for root retreatment using XP shaper and ProTaper files. Materials and Methods: In his experimental laboratory study, 40 extracted human maxillary molars were used in this laboratory study. After disinfection and equalization of length, the samples were treated with a passive step-back technique and dressed. The samples placed in the tubes for retreatment were divided into four groups: (1) XP shaper file and hypochlorite, (2) XP shaper file and ethylenediaminetetraacetic acid (EDTA), (3) ProTaper file and hypochlorite, and (4) ProTaper file and EDTA. Then, the teeth were taken out of the tubes, and cleaned to collect the remaining apical debris. The weight of the tube and the extruded debris was measured again. Data were analyzed using the Kruskal–Wallis test (α =0.05). Results: The highest average of extruded debris was related to the XP shaper file with EDTA solution, and the lowest average was related to the ProTaper file with hypochlorite solution. Between the two files used with EDTA and hypochlorite solution, the average debris extrusion of the XP shaper file with EDTA solution was significantly higher (P < 0.05) compared to the ProTaper and XP shaper files with hypochlorite solution (P < 0.05). Conclusion: Regardless of the type of irrigant material, the ProTaper file can be a more suitable option than the XP shaper file for retreatment of the tooth root canal with minimal debris extrusion.

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>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.

A comparison of spreader penetration depth and load required in curved canal using two types of spreaders

The aim of the present study was to compare nickel titanium and stainlesssteel spreaders penetration depth and load in lateral compaction. Thirty curved mesialcanals of extracted mandibular molars were used in the study. The canals wereprepared using step-back technique with Gates-Glidden. Afterward the teeth weredivided randomly into 2 groups. In part 1 of the study, the force required to inserteach spreader to within 1 mm of the working length in an empty canal was measured .In part 2, the force required to insert each spreader to within 2 mm of the workinglength was measured in canal containing a master cone. ln part 3, the depth ofpenetration of each spreader with a master cone in place using a 1.5 kg force wasmeasured. Using a t-test for paired samples, the results from pan 1 showed that nickeltitanium spreader required high significantly less force than stainless steels reader P<0.01 . ln part 2, a nickel titanium s reader re uired high si niticantl lessforce than a stainless steel spreader .As expected in part 3, a nickel titanium spreaderpenetrated to a significantly high depth than stainless steel spreader (P<0.0l

Centering ability of variety of instruments and techniques used to over-instrument simulated tiny curved canals.

Aim: To determine centering ability of variety of instruments and techniques used to over-instrument simulated tiny curved canals.
 Method: Standardized eighty blocks of clear resin, each had a canal of 20 mm in length, the straight portion was 17 mm in length, while the length of the curved apical portion was 3 mm, with a curvature of 20˚ and a radius of 4 mm, its size was equal to no.8 .02 ISO K-file, the resin blocks were divided into 8 groups, six of them were over instrumented by 1mm using hand SS K-files and Ni-Ti K-files in step back technique, Gates-Glidden drills and hand SS K-files and Ni-Ti K-files in hybrid technique, ProTaper and ProFile rotary file system in crown down technique, while two groups were under instrumented by 1 mm using hand SS K-files in step back technique and ProTaper rotary file system in crown down technique.
 Results: Regarding Centering ability for Over-instrumentation techniques, there was a significant difference at p < 0.05 in favor of crown down technique, in favor of Ni-Ti over the SS, and in favor of rotary instruments over the hand instruments. For under-instrumentation groups, there was a significant difference at p < 0.05 with in favor of hand SS instruments in step back technique over the rotary Ni-Ti instruments in crown down technique. Also there was a significant difference between the over and under instrumentation techniques at p < 0.05, with in favor of under instrumentation techniques.
 Conclusion: Within the limitations of this in vitro study, crown down technique gave better results than step back and hybrid technique, as well Ni-Ti instruments performed better than SS instruments. Rotary instruments had less deviation than the hand instruments when used inside simulated tiny curved resin canals.

In vitro apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc and Reciproc Blue instruments and a novel stainless steel rotary system (Gentlefile) versus manual instrumentation.

This study compared apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc, Reciproc Blue, and Gentlefile (GF) rotary instruments versus the manual step-back technique. This in vitro study was conducted on 80 extracted mandibular premolars with mature apices and a root curvature of<10°. The teeth were randomly assigned to 4 groups (n=20), standardized regarding working length, and placed in pre-weighed vials. The root canals were instrumented with Reciproc, Reciproc Blue, and GF systems and the manual step-back technique in the four groups. The vials containing the collected debris were then dried and weighed. The instrumentation time was also recorded for each group. Data were analyzed with one-way ANOVA and post hoc Games-Howell test (α=0.05). Minimum apical debris extrusion was noted in Reciproc, followed by Reciproc Blue, GF, and manual technique (P<0.05). Pairwise comparisons showed significantly lower apical extrusion of debris in the Reciproc compared with GF (P=0.015) and manual instrumentation (P=0.011) groups. The Reciproc system also had the shortest instrumentation time, followed by Reciproc Blue, GF, and manual instrumentation (P<0.05). Pairwise comparisons showed significant differences between all the systems (P<0.05) except between Reciproc and Reciproc Blue (P>0.05) in this respect. Although all systems caused apical extrusion of debris, manual instrumentation caused maximum extrusion of debris. In contrast, the Reciproc system was superior to others regarding minimal apical extrusion of debris and the shortest instrumentation time.

Influence of heat treated files on conserving the remaining dentin thickness during endodontic retreatment – An invitro CBCT study

ObjectivesNon-surgical endodontic retreatment is to be a conservative option over endodontic surgery in case of recurrent infections. Root canal retreatment procedures needs to be initiated faster and proficiently with proper root canal retreatment files. The main aim of this study is to evaluate the remaining root dentin thickness post Gutta Percha (GP) retrieval from the root canal after using two different rotary instruments. Materials and methodsA total of sixty extracted single rooted teeth were chosen. Shaping and Cleaning was done Step Back (Telescopic) technique with apical preparation ofsize 40 k File. Irrigation was carried out using NaOCl (3 %)and Ethyelenediamine tetraacetic acid (EDTA) to clear the smear layer. The canals were dried using paper points and obturation was completed using lateral compaction technique with AH plus resin sealer. Upon completing the obturation, it was categorized into two groups: Group I- ProTaper retreatment files (PTR) and Group II- Solite RS3(S-RS3) Retreatment files. Cone Beam Computed Tomography (CBCT) was used to assess the remaining dentin thickness post gutta-percha retrieval at 3,5 and 7 mm respectively. To test the significance between groups independent t test was used. ResultsIt can be noted from the results that more amount of remaining dentin thickness was seen after using Solite RS3 files at 3 mm, 5 mm and 7 mm on the mesial side compared to ProTaper retreatment files (p < 0.05). There is no statistically significant difference seen between the files at three levels on the distal side (p > 0.05). ConclusionWithin the limitations of the study, it can be concluded that Solite RS3 files have the potential to preserve the remaining dentin thickness. However, more studies including various other parameters should be performed to arrive at a definitive conclusion.

An Apprise on Root Canal Preparation Procedures and How to Evade Procedures Errors in Endodontics A New Assessment

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. Purpose: Purpose of this review was to provide an update on root canal hand instrumentation techniques commonly used in endodontics, including how to overcome iatrogenic errors and optimize the quality of endodontic treatment outcomes. 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. 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 favored as it rapidly and safely permits removal of canal contents allowing irritants 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.

Fracture load assessment of digitally fabricated post and prefabricated fibre post in endodontically treated teeth.

Endodontically treated teeth are structurally more susceptible to root fractures. Proper tooth restorations with digitally fabricated or fibre post following endodontic therapy is essential to restore function and esthetics. The aim of this in vitro study is to evaluate the fracture load of digitally fabricated and prefabricated fibre posts in endodontically treated teeth. Sixty extracted human single rooted teeth were selected. The crowns were sectioned at the cement-enamel junction to standardize the remaining root length at 15 mm from the apices. Cleaning, shaping and obturation was done using conventional step back technique to an ISO K-file size 40. The roots were divided into two groups of 30 samples each: Group S: teeth reinforced with digitally fabricated posts; Group F: teeth reinforced with fibre posts. Each group was further divided into three subgroups (S7, S9, S12, F7, F9, F12) based on lengths 7, 9 and 12 mm at which the posts were cemented. Composite resin core was fabricated and prepared to receive a complete metal crown. Universal testing machine was used to measure the compressive load required to fracture the teeth. The highest fracture resistance of 1532N was observed with fibre posts at 12 mm of post space length followed by digitally fabricated post 1398N at 12 mm, but the difference was not statistically significant. The highest fracture resistance was observed in the teeth restored with fibre posts with 12 mm length and the lowest with digitally fabricated post with 7 mm length. As the length of post increases irrespective of type of post fracture resistance increased.

Incidence and Intensity of Pain Following Endodontic Treatment by Different Instrumentation Techniques in Teeth With Periapical Lesion.

This study was carried out to compare the effectiveness of hand and rotary instrumentation techniques on postoperative pain in asymptomatic necrotic premolars with periapical lesions and instrumented by a modified step-back technique using a K file, crown down by continuous rotary motion technique using ProTaper Universal (Dentsply Mailefer, Ballaigues, Switzerland), and with the reciprocation technique using WaveOne (Dentsply Sirona, Charlotte, NC, USA). For this study, 66 premolars with single roots and canals were chosen. The procedure was completed in a single visit. Following access opening, the working length was initially determined using an apex locator and then confirmed after inserting K file #10 by radiograph. The canal was cleaned and shaped using a grouping system. After the masterapical preparation, the canal was dried by paper point and obturated with gutta-percha and AH plus sealer, an epoxide-amine resin pulp canal sealer. In order to confirm the obturation, a radiograph was taken. After that, a permanentrestoration material was used to seal the access cavity. Following that, patients to whom the visual analog scale (VAS) had already been explained were contacted by phone at six, 12, 24, and 48 hours. In this study, compared to a stainless steel instrumentation technique, WaveOne instrumentation caused more noticeable pain. The results of the current study showed that, on average, postoperative pain scores decreased over the course of the 12to 48-hour period, reaching a minimum or a maximum at 48 hours (p<0.01). Postoperative pain was produced by all instrumentation methods used in the study. In comparison to ProTaper and WaveOne, instrumentation using the modified step-back technique with K files caused less pain, especially over the course of a 24-hour period.

The Impact of Different Irrigation Regimens on the Chemical Structure and Cleanliness of Root Canal Dentin.

This in vitro study aimed to evaluate the effect of different irrigation regimens on the chemical composition and cleanliness of root canal dentin. Forty-eight extracted single-rooted permanent human teeth were collected. Root canals were instrumented using step-back technique up to master apical file size 60. Samples were divided into 3 groups (n=16) based on the type of the irrigant used. The irrigation solutions were 5.25% sodium hypochlorite, 2% chlorhexidine gluconate, and saline solution as a control. Root canal cleanliness was assessed using stereomicroscope and scanning electron microscope. Scanning electron microscope energy dispersive X-ray was used for the inorganic analysis. Fourier transform infrared spectrometer was used for the organic analysis. One-way analysis of variance (ANOVA) and multiple comparison post hoc test were used for comparison between the three groups. The highest mean percentage of remaining debris was in saline group followed by chlorhexidine gluconate group. Sodium hypochlorite group showed the lowest mean value of remaining debris. Furthermore, our results showed that canal irrigation with sodium hypochlorite affected the chemical structure of root canal dentin more than chlorhexidine gluconate. Based on the results, 5.25% sodium hypochlorite emerges as the preferred irrigant for root canal treatment. This research sheds light on the significance of irrigation regimens in endodontics and emphasizes the need for careful consideration of irrigant selection in clinical practice.

Comparison of fracture resistance of mandibular central incisors following the use of two different spreaders during lateral condensation obturation technique- An in vitro study

The lateral condensation is the most commonly practiced obturation technique during root canal treatment. In this method, the use of spreaders is instrumental in acheiving 3-D obturation. These spreaders can create an unnecessary stress during use, by means of wedging force that might lead to vertical root fracture, resulting in failure of root canal treatment. Sixty extracted mandibular central incisors were taken. All teeth were sectioned 2 mm coronal to CEJ and were wrapped in aluminium foil. The specimens were embedded in acrylic mould. Aluminium foil was scratched and the created space was filled with light body silicone impression material. Then, after working length determination, apical preparation was done with 40 no. K- file. Rest of the canal was prepared using step back technique. The samples were then randomly divided into 3 groups of 20 samples each. Group 1 No obturation (control group). Group 2 Obturation done using stainless steel finger spreaders. Group 3 Obturation done using nickel titanium finger spreaders. After the obturation, all samples were subjected to fracture using metal indenter on the universal testing machine. The load at which fracture occur was recorded. Data thus obtained was subjected to statistical analysis using ANOVA and TUKEY test. The mean fracture resistance of group 1 was highest followed by group 3 (NiTi spreader) and least in group 2 (SS spreader). NITI or SS spreaders can affect the fracture resistance of teeth during lateral condensation obturation technique.

Attitudes, techniques and trends in endodontic treatment by general dental practitioners in Benghazi- Libya

Introduction: The success of the root canal treatment depends on the attitudes, techniques and different approaches that carried out by the dental practitioners who made major impact on performing a high standard level of dental treatment to get a great quality of work. Aim: The objective of this research was to investigate the current trends and attitudes in endodontic treatment exhibited by general dental practitioners worked in private and public dental clinics in Benghazi- Libya.&#x0D; Materials and Methods: This study was accomplished in March 2017 included 170 general dental practitioners worked in private and public dental clinics in Benghazi Libya. Each participant received structured questionnaires to assist the attitudes, techniques, current trends, materials and new technology used in a daily endodontic practice. All returned forms were evaluated by a single operator. Descriptive statistics and frequency distribution were analyzed using SPSS version 21 and Chi-square test.&#x0D; Results: The respond of participants was 150 represent 88.23% response rates. The results showed that 78% (117) of the respondents they did not build up the tooth before starting RCT and the majority preferred multiple visits per endodontic treatment. The main isolation method was cotton roll with saliva suction (77.3%). About (43.3%) of the practitioners used step-back technique for canal preparation and the most common used hand instruments was a K-files in conjunction with hedstrom files (50%). The finding of this study indicated that (52.7%) of the practitioners took 0.5 mm working distance from the apex. Sodium hypochloride was the common irrigant (55.3%) and (38%) of respondents used calcium hydroxide as intracanal medicament. Lateral condensation was more common among the respondents (64%) and the zinc oxide-eugenol was the common type of sealer used among them (45.3%). The most common restorations were composite materials (34.7%). Conclusion: It was concluded that the general participant dentists in Benghazi city did not keep up with the newly introduced techniques in endodontic as they were used more conventional methods in their work which could be attributed to lack in expertise and recognition of new technology in a daily endodontic work.

A retrospective study of endodontic treatment among patients in Southwest Nigeria

Aims: To determine pattern of demand, reasons for root canal treatment (RCT) and survey routine practices of RCT in Lagos State University Teaching Hospital, Ikeja (LASUTH). Methods: A retrospective review of hospital records of patients who had done RCT in Endodontic Unit of Restorative clinic of LASUTH, Lagos State, Nigeria from January 2016 to December 2019. Information on age, gender, ethnicity, tooth treated, indications for treated tooth, obturation techniques, obturation materials, irrigants and intramedicaments used were obtained. Data were analyzed using SPSS Version 23. Results: A total of 231 patients’ records were retrieved. 220 records had complete data, of which 100 (45.4%) males and 120 (54.5%) females. Age range was 18–86 years while mean age was 38.6 ± 1.47. Highest incidence of RCT (24.1%) was found in 30–39 years age group. Commonest indication for RCT was apical periodontitis 145 (58.9%). Total number of teeth treated was 246. Upper central incisors were 56 (22.8%) which were treated most endodontically. More maxillary 176 (71.5%) teeth underwent RCT than 70 (28.5%) mandibular teeth. Step-back technique 226 (92.3%) was the commonest used. Irrigants frequently used were sodium hypochlorite alternating with normal saline 246 (100.0%). More of calcium hydroxide 201 (81.7%) was utilized as canal medicaments. Gutta-percha was solely used as obturation material and endoseal as sealant in this study. Conclusion: Most of endodontic practices done in this study used conventional preparations and obturation techniques. There was need for community dental awareness to prevent and treat early carious lesions.

Outcome of single- versus two-visit root canal retreatment in teeth with periapical lesions: A randomized clinical trial.

The aim of the study was to evaluate the clinical and radiographic outcome of single-visit root canal retreatment and compare the results with conventional two-visit root canal retreatment as control group. One hundred root canal-treated, single-rooted asymptomatic teeth with periapical lesion were retreated by one operator. Fifty of the teeth were randomly assigned to the single-visit group and the others were treated in two visits. In both groups, root canal filling material was removed, and re-instrumentation of the root canal was performed using step-back technique with hand files using 2.5% NaOCl and 5% EDTA as irrigants. In the single-visit group, 5ml 2% chlorhexidine (CHX) were applied as the final irrigation and in the two-visit group, calcium hydroxide paste was placed into the root canal as an interappointment dressing. All root canal obturations were performed with lateral compaction. All patients were followed up for 24 months. The success was determined depending on both healed and healing cases. The chi-square or Fisher's exact test was used to analyse the differences between the groups for success rates and the factors affecting the outcome. The recall rate was 89 (89%). At 24 months, 39 teeth (88.6%) were considered as healed, three teeth (6.8%) as healing, and two teeth (4.5%) were identified as failed in the single-visit group, while in the two-visit group 39 teeth (86.7%) had healed, two teeth (4.4%) were scored as healing, and four teeth (8.9%) as failed. There was no statistically significant difference in the success rates between the two groups (p > .05). Size of the lesion and the preoperative length of root canal filling had a statistically significant impact on the outcome (p < .05). No statistically significant difference was observed in terms of healing in 24-month follow-up of retreatments completed in single visit or two visits in asymptomatic teeth with periapical lesions. The size of the periapical lesion and initial apical level of root canal filling have affected the outcome of root canal retreatment.

Diagnosis of Vertical Root Fracture by Digital Radiography With and Without Unsharp Masking Filter: An In-vitro Study

Background and Objectives The digital radiography offers a variety of image processing techniques. Due to the importance of the accuracy of this method and its widespread applications, in this study we aim to investigate the diagnose of vertical root fracture (VRF) by conventional digital radiography with and without unsharp masking (UM) filter. Subjects and Methods Radiographs were taken from 24 extracted anterior teeth before and after VRF induction. The root canal was prepared with passive step-back technique, and then the teeth were divided into two halves buccolingually with a very thin disk. The two halves were re-attached to each other and mounted in a mixture of gypsum and sawdust. After processing by the UM filter, the radiographs were evaluated by two observers to detect the presence or absence of VRF. Results For the first observer, the sensitivity of both methods was the same, while the specificity of the UM filtering mode was higher. For the second observer, the sensitivity of the unfiltered mode was higher, while the specificity of the two methods was the same. Conclusion There is no significant difference between digital radiography with and without the UM filter in diagnosing VRF. Due to the high sensivity and specifity of the UM filtering method, the specialist can use this filter based on personal preferences.

Chemical changes in root canal dentin of primary teeth after endodontic irrigation

Background: The current root canal irrigants used in dentistry are either antibacterial or decalcifying agents or their combinations. These agents can alter the chemical structure of dentin as well as change its permeability and solubility characteristics. Aim: The aim of this study was to evaluate the mineral content of root canal dentin after irrigating with five different endodontic irrigation solutions Materials and Methods: Sixty primary anterior teeth were selected for the study. Cleaning and shaping was done by step-back technique and divided randomly into six groups (n = 10): BioPure™ MTAD (Group 1), QMix™ 2-in-1 solution (Group 2), 0.9% normal saline (Group 3), coconut water (Group 4), and 5.25% NaOCl (Group 5) and the uninstrumented ten teeth were grouped as Group 6. After irrigation with final irrigants, the teeth were longitudinally divided into two halves. The levels of six elements calcium, phosphorus, oxygen, carbon, arsenic, and fluoride at the coronal and middle third in each specimen was assessed using scanning electron microscopy and energy-dispersive X-ray analysis. Statistical analysis was done by SPSS version 20 using one-way analysis of variance, and the comparison of means was conducted using post hoc Tukey test. Results: There was a statistically significant reduction in the calcium level at the coronal third of radicular dentin after irrigating with five different irrigants when compared with the uninstrumented teeth group. The phosphate level at the coronal third of the radicular dentin significantly increased in all the groups except for the saline group. The other elements such as oxygen, fluoride, and arsenic also showed significant differences in the coronal and middle levels after the irrigation. Conclusion: The endodontic irrigation by various irrigants changed the mineral levels in primary tooth dentin

Management of radix entomolaris on permanent mandibular first molar complicated with ledge: a case report

Radix entomolaris is a supernumerary root located distolingually on permanent mandibular molars. It is considered as an anatomical variant and usually curved buccolingually. The presence of radix entomolaris can be endodontically challenging to treat and susceptible to endodontic mishaps such as ledge. This report describes the management of ledge in a radix entomolaris with type-3 curvature on tooth 46. Ledge was bypassed using pre-curved K-files #10, #15, and #20 sequentially and preparation was continued using step-back technique. Then, the root canal was obturated using gutta percha and root canal sealer. Diagnostic and clinical challenges in managing radix entomolaris, and prevention and management of ledge were also discussed.

Nonsurgical Retreatment of Mandibular Incisors with Periapical Lesions –A Case Report

The case demonstrates successful, nonsurgical retreatment of mandibular, central, and lateral incisors. Acute exacerbation was noted on previously root-filled mandibular incisors with periapical lesions and endodontic retreatment was arranged. Thorough root canal cleaning and shaping were done using the step back technique with hand files and obturation was completed using gutta-percha and AH plus sealer using the passive lateral compaction technique. An 18-month follow-up showed complete osseous healing.

The effect of root canal rinsing protocol on the push-out bond strength to the dentin cementation of the fiber post.

B a c k g r o u n d: Studies on the effect of root canal rinsing protocols on fiber post bonding to dentin are inconclusive. This study reports investigation of this topic. O b j e c t i v e s: to determine effects of irrigation protocol by means of a push-out test on the strength of adhesion between the post and dentin in an in vitro study. Materials and Method: Thirty human single-rooted teeth were prepared using hand instruments and the step-back technique, filled with gutta-percha, sealed with AH Plus (Dentsply), and divided into three groups: A: rinsed with NaCl; B: rinsed with 2% chlorhexidine (CHX); C: not rinsed before cementation of posts. The fiber posts were set using RelyX and Built-it. The tooth roots were sliced and the push-out test was performed. The area of contact between the post and dentin was calculated and the destroying force was established. The results were statistically analyzed. R e s u l t s: The mean adhesive strength was 10.69 MPa in group A, 16.33 MPa in group B, and 16.72 MPa in C. The adhesive strength in group B and C was statistically significantly higher than in group A (p = 0.0016, ANOVA). Conclusion: Rinsing root canals with CHX seems to be the most effective method prior to setting a fiber post.

RETRIEVING BROKEN INSTRUMENT IN HALF OF THE APIKAL ON CANINES TEETH WITH H-FILE BRAIDING TECHNIQUE

ABSTRACTBackground: Broken instruments affect the outcome and prognosis. A broken instrument will prevent the procedure of cleaning and shaping, irrigation and obturation of the root canal on the obstructed root section causing failure in endodontic treatment. There are some treatments for broken instrument including retrieving a broken fragment file and bypassing it on the root canal. the aim of the case report aims to provide an alternative for retrieving broken instruments using the H-file braiding technique. Method: A 38-year-old female patient came to the Dental Conservation Clinic RSGM Prof. Soedomo FKG UGM. A patient got a history of initial root canal treatment in a clinic, which ended with a separated file on canine teeth left upper. No complain pain, from the investigation radiographic there is an instrument broken in half apical. The teeth 23 seen temporary restoration cavity class I is still in good. Retrieving broken instruments using the H-file braiding technique, preparation with step back techniques, obturation with warm vertical condensation technique and class I composite resin restorations with fiber-reinforced retention. Result: No complain pain after 2 weeks retrieving broken instrument.Conclusion: The technique of the H-file braiding technique is one technique to retrieve a broken instrument, this procedure is simple, cost-effective, harmless to the teeth and gives root canal sealing.