WaveOne Gold Research Articles

Quantitative evaluation of apically extruded debris using TRUShape, TruNatomy, and WaveOne Gold in curved canals

ObjectiveThis study compared the quantity of extruded debris after instrumentation with TRUShape 3D Conforming files, TruNatomy files, and the WaveOne Gold reciprocating system.Materials and methodsFifty-one mesiobuccal canals with severe curvatures (25–40°) were assigned to three equal groups according to the rotary system used for preparation, either TRUShape, TruNatomy, or WaveOne Gold files. The extruded debris was collected in pre-weighed glass vials. The data were statistically analyzed using a one-way ANOVA test and Tukey’s post hoc test.ResultsThe least extruded debris was obtained with the WaveOne Gold instruments compared to the TRUShape and TruNatomy files (p < 0.001).ConclusionsDebris extrusion occurs independently of the motion or design of the instrument. The WaveOne Gold system outperformed TRUShape and TruNatomy files in this study.

Shaping ability of rotary and reciprocating single-file systems in combination with and without different glide path techniques in simulated curved canals

Background/purposeGlide path management (GPM) is a consequential clinical step that serves to influence predictably successful root canal therapy. However, the effect of GPM on the shaping ability of single-file system remains controversial. This study compared the performance of rotary single-file One Curve (OC) and reciprocating single-file Reciproc Blue (RCB) in combination with/without different glide path techniques: no glide path preparation (NG), PathFile (PF), ProGlider (PG) and WaveOne Gold Glider (WOGG), respectively. Materials and methods80 simulated curved canals (n = 10 canals/per group) were instrumented to an apical size of 0.25 mm using OC and RCB in combination with/without different glide path techniques, respectively. The amount of resin removal, canal transportation, and the degree of canal straightening were measured in Photoshop CS6 software. Statistical analysis of the data was performed by using Kruskal–Wallis test, followed by Dunn's post hoc test with Bonferroni correction (α = 0.05). ResultsPost–glide path analysis found that WOGG and PG produced less canal transportation and curvature straightening than PF (P < 0.05). Post-shaping analysis showed that OC groups removed significantly less resin than RCB groups (P < 0.05). The PG and WOGG subgroups in both OC groups and RCB groups produced less transportation and curvature straightening than NG and PF subgroups (P < 0.05). OC + PG subgroup and OC + WOGG subgroup yielded the least canal transportation and curvature straightening (P < 0.05). ConclusionPG and WOGG can improve the shaping ability of OC and RCB instrument. OC, especially when combined with PG and WOGG, has a less aggressive dentin cutting and more centered preparation than the RCB instrument.

Postoperative pain after primary molar pulpectomy using rotary or reciprocating single files: A superior, parallel, randomized clinical trial.

To compare postoperative pain intensity between two single-file systems with different kinetics (the OneShape file with continuous rotation vs. the WaveOne Gold file with reciprocation movement) after primary molar pulpectomy. This superiority, parallel, randomized clinical trial included 164 healthy children aged 6 to 8years with asymptomatic, necrotic, maxillary primary second molars due to caries. An equal number of children were assigned to the two groups. The teeth of children in Group 1 were instrumented with the OneShape rotary system (Micro-Mega), whereas teeth of children in Group 2 were instrumented with the WaveOne Gold reciprocating system (Dentsply Maillefer). Postoperative pain intensity was assessed using a 4-point pain scale at 6, 12, 24, 48 and 72h and 1week after treatment. The parent of each participant received 6 flashcards that included four faces and a word describing each face. A chi-square test was used to compare postoperative pain intensity. The level of significance was set to 5%. Over the follow-up period, no significant difference in postoperative pain intensity was found between the two groups (p>.05). Although the absolute risk reduction maximum limit of 95% CI equal or exceeded the predetermined proportional difference of 0.15, pain intensity was inconclusive at 6, 24, and 48 hours denoting that the superiority of the OneShape single-file over the WaveOne Gold single-file could not be declared. Postoperative pain intensity associated with a rotary vs. reciprocating file system was nearly similar.

Comparison of postoperative pain after the use of different nickel titanium instrumentation systems: a randomized clinical trial.

Postoperative pain is a common complication in endodontics contributed by multiple etiological factors, which consist canal preparation instruments and kinematics. The aim of this randomized clinical trial compare the postoperative pain in terms of intensity and incidence after the use of different nickel titanium (NiTi) file systems. In this randomized clinical trial (NCT03791762), a total of 150 patients were root canal treated by 2 experienced endodontists according to a standardised protocol. The subjects were randomly assigned to 1 of the 3 groups according to preparation instrument used: ProTaper Next (Dentsply Sirona, Ballaigues, Switzerland), Reciproc Blue (VDW, Munich, Germany) and WaveOne Gold (Dentsply Sirona). Following preparation the teeth underwent standardized root canal treatment procedures in a single visit. The patients were contacted to gather information about the incidence of pain and intensity at 6th, 12th, 18th, 24th, 48th, and 72nd hours postoperatively. The data were analysed using chi-square, one-way analysis of variance and post hoc Tukey tests and logistic regression analysis with 5% significance threshold. No significant difference was found among preparation groups in relation to the intensity of postoperative pain. The incidence of postoperative pain was significantly linked with the preoperative pain presence with odds ratio values ranging between 2.06 and 4.08 irrespective of the preparation technique (P<0.05). The effects of reciprocating and the continuous rotary systems on the intensity and incidence of postoperative pain were found to be similar.

Final irrigation protocols affect radicular dentin DMP1-CT expression, microhardness, and biochemical composition.

To evaluate the effect of several final irrigation protocols on radicular dentin microhardness, biochemical composition, and DMP1-CT expression. A total of 140 single-rooted human teeth were prepared with WaveOne Gold files and randomly distributed into 7 groups (n = 20) according to the final irrigation protocol: distilled water (DW); sodium hypochlorite-EDTA (NaOCl-EDTA); EDTA (EDTA); EDTA-NaOCl (EDTA-NaOCl); EDTA-chlorhexidine (EDTA-CHX); passive ultrasonic irrigation (PUI:NaOCl-EDTA); and PUI:NaOCl-EDTA-NaOCl. Dentin microhardness (n = 10) was evaluated in the root canal lumen using Vickers hardness tester. Immunohistochemical analysis (n = 5) was used to evaluate DMP1-CT expression. Dentin ultrastructure and biochemical composition were evaluated by using Raman and energy dispersive X-ray analysis (EDAX) (n = 5) with a scanning electron microscope (SEM). Analysis of variance (ANOVA) and Tukey test were performed (p˂0.05). Raman spectra of the organic content and DMP1-CT expression were lower at the lumen canal in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl when compared to control (p < 0.05). EDAX showed reduced values for calcium and phosphorus in EDTA-NaOCl, PUI:NaOCl-EDTA, and PUI:NaOCl-EDTA-NaOCl. SEM microphotography's showed completely cleaned dentin, permeable tubules, and dentin erosion, mainly when PUI was used. NaOCl-EDTA presented significantly higher microhardness values than PUI:NaOCl-EDTA-NaOCl (p < 0.05). PUI:NaOCl-EDTA-NaOCl exhibited the lowest Vickers hardness values of all groups. The final irrigation protocols that used a final rinse with NaOCl and PUI showed a detrimental effect on radicular dentin DMP1-CT expression, biochemical composition, and microhardness. The adequate irrigation protocol could be advantageous to preserve the radicular dentin ultrastructure, promote adequate adhesion, and sustain favorable conditions for biomineralization and regeneration.

Ability of two reciprocating Nickel-Titanium instruments for guttapercha/ sealer removal in simulated curved root canals.

The aim of this study was to compare the capacity of two reciprocating NiTi instruments in removing gutta-percha/sealer material from simulated curved root canals (SCRC). The time required for filling material removal was also recorded. Twenty SCRCs were divided into two groups of 10 (n=10) samples each. In Group 1, the SCRC were prepared to a R25 Reciproc Blue instrument (RCPB; VDW, Munich, Germany). In Group 2 the SCRC were prepared to a Primary WaveOne Gold instrument (PWOG; Dentsply, Ballaigues, Switzerland). In both groups, the canals were filled with matched-taper single gutta-percha cones and AH Plus sealer. Filling materials were removed with R25 RCPB (Group 1) and PWOG (Group 2). The amount of remaining gutta-percha/sealer was calculated at three predetermined levels of evaluation located at 2, 6 and 10 mm from the WL and expressed in percentages. Canals re-treated with RCPB contained significantly less remaining gutta-percha/sealer compared tocanalspreparedwith PWOG (P=0.02). The RCPB instruments required significantly less time to complete the retreatment procedures (P<0.01). No unwinding or instrument separation was noted. RCPB instruments removed significantly more gutta-percha/sealer from simulated curved root canals than PWOG. However, neither of the tested instruments completely removed all filling materials.

Micro-CT assessment of gap-containing areas along the gutta-percha-sealer interface in oval-shaped canals.

To assess the interfacial adaptation (gap-containing areas) of two root canal sealers (EndoSequence BC Sealer and AH Plus) to a conventional gutta-percha (GP) cone (GP-sealer interface) in oval-shaped canals filled using the single cone technique. Sixteen teeth with oval-shaped canals were selected, scanned in a micro-computed tomographic device, and pair-matched according to the volume, aspect ratio and configuration of root canals. Root canals were then sequentially prepared with WaveOne Gold Primary and Large instruments, followed by filling with WaveOne Large GP points associated with either the premixed calcium-silicate EndoSequence BC Sealer or the epoxy resin-based AH Plus sealer (n=8 per group) using the single cone technique. After 7days stored in phosphate-buffered saline solution at 37°C, the specimens were rescanned and the reconstructed images segmented in order to differentiate the filling materials (sealer and GP cone) to the dentine. A total of 453 cross-sectional slices were assessed and categorized according to the presence or absence of gaps at the GP-sealer interface. Mann-Whitney U-test verified the differences between groups and were considered significant at alpha=5%. Gaps were non-homogenously distributed in two-dimensional axial cross-section images and none of the specimens showed completely gap-free areas along the entire GP-sealer interface. Root canals filled with EndoSequence BC Sealer and AH Plus displayed 171 (37.75%) and 136 (30.02%) slices with gaps in the GP-sealer interface and these frequencies were statistically significant (p=.000). Although none of the specimens had a gap-free area along the entire GP-sealer interface, oval canals filled with AH Plus showed less gaps than the ones filled with EndoSequence BC Sealer.

Comparative Assessment of the Shaping Ability of Reciproc Blue, WaveOne Gold, and ProTaper Gold in Simulated Root Canals.

Maintaining the original trajectory of the root canal is a major challenge in endodontic therapy, especially in narrow and curved root canals. The present study aims to assess the shaping capacity of three endodontic systems made of different nickel–titanium alloys on simulated curved root canals. Thirty-six endodontic resin blocks (Ref. V040245, VDW) divided into three groups, each of twelve blocks (n = 12), were shaped, photographed, and analyzed: Group 1-Protaper Gold (PTG) (Dentsply Maillefer, Ballaigues, Switzerland) F2 25/08; Group 2-Reciproc Blue (RB), RB 25/08 (VDW, Munich, Germany); Group 3-WaveOne Gold (WOG) (Dentsply Maillefer), WOG 25/07. Each block was standardized and photographed before and after shaping in the same position, with the foramen oriented to the left. Post-shaping images were superimposed onto the initial ones. Thirteen measurement points were used for evaluation, spaced with 1 mm distance from one another, from level 0, apical foramen, to level 12, coronal orifice. The amount of removed resin from inner (X1) and outer (X2) walls, the direction of transportation (X1 − X2), and the centering ability (X1 − X2)/Y were measured, calculated, and comparatively analyzed. Statistical differences (p < 0.05) were observed between the shaping capacity of the considered systems in the middle and coronal thirds. PTG had a better centering ability than WOG and RB in the coronal third, while RB was more centered in the middle third in comparison to both WOG and PTG. In the apical third, the centering capacity of WOG was higher, without being statistically significant. WOG 25/07 and PTG 25/08 tend to cut more on the inner wall of the root canals, and RB 25/08 on the external one.

Comparison of Cleaning Efficiency of Root Canal Using Different Rotary NiTi Instrumentation System: A Scanning Electron Microscopic Study.

Background: To ensure that endodontic treatment is as effective as possible, it is important to remove any smear layer that forms as part of the instrumentation procedure. This layer might reduce the overall effectiveness of endodontic therapy.Aim of the study: For this research, two distinct types of rotary NiTi files were compared: WaveOne Gold (WOG) (Dentsply Maillefer, Ballaigues, Switzerland) and F360 (Komet Brasseler GmbH & Co., Lemgo, Germany) for its capacity to eliminate trash and the smear layer.Materials and methods: Two groups (n=20 each) of 40 mandibular second premolar teeth were employed in this investigation, with each group receiving a random allocation of teeth. The F360 system and the WaveOne Gold system are two sets of instruments. The samples were irrigated with a mixture of sodium hypochlorite (NaOCl) (5.25%) and citric acid (40%). Finally, all samples in the centre of the coronal, middle, and apical thirds were examined by scanning electron microscopy (SEM). Mann-Whitney U tests were used to analyse the data.Results: F360 instrument showed a statistically significant difference for smear layer removal among all thirds of the root canal whereas WOG resulted in a significant difference when the apical third was compared to the middle and coronal third. Significant differences were found in the middle and apical third in terms of smear layer removal between the two groups.Both F360 and WOG instruments showed statistically significant differences for debris removal among all thirds of the root canal. No significant differences were found in the coronal, middle, and apical third in terms of debris removal between the two groups.Conclusion: WOG resulted in cleaner canals compared to the F360 file system at coronal, middle, and apical third.

The Effect of Different Molar Access Cavity Designs on Root Canal Shaping Times Using Rotation and Reciprocation Instruments in Mandibular First Molars

IntroductionThe aim was to compare the glide path and final preparation times of WaveOne Gold and TruNatomy in conjunction with two different endodontic access cavity designs in extracted human molar teeth. Methods60 extracted human mandibular molars with mesiobuccal canals were selected and randomly divided into two different access cavity design preparation groups (n = 30). Traditional access cavities (TAC) and conservative access cavities (CAC). Within each cavity design group, the 30 teeth were divided in to two instrumentation groups (WaveOne Gold Primary (n = 15) and TruNatomy Prime (n = 15)). Group 1: TAC, #10 stainless steel manual K-file followed by WaveOne Gold Glider and WaveOne Gold Primary. Group 2: CAC, #10 stainless steel manual K-file followed by WaveOne Gold Glider and WaveOne Gold Primary. Group 3: TAC, #10 stainless steel manual K-file followed by TruNatomy Orifice Modifier and Glider and TruNatomy Prime. Group 4: CAC, #10 stainless steel manual K-file followed by TruNatomy Glider and TruNatomy Prime. Glide path and final preparation times were recorded. ResultsShaping time with TruNatomy Glider in combination with TruNatomy Prime instruments were faster compared to the WaveOne Gold Glider/ WaveOne Gold Primary instruments regardless of the type of access cavity preparation. TAC design yielded faster preparation time (38.2 ± 4.57 seconds) compared to the CAC (55.6 ± 6.91 seconds) in the WaveOne Gold Glider/ WaveOne Gold Primary instrumentation group. No difference was found between the different access cavity design groups in combination with TruNatomy Glider/TruNatomy Prime preparation. ConclusionPreparation time with TruNatomy Glider and Prime instruments was significantly faster than WaveOne Gold Glider/WaveOne Gold Primary, regardless of the access cavity design. TAC design in combination with WaveOne Gold Glider/ WaveOne Gold Primary instrumentation resulted in faster preparation time compared to WaveOne Gold Glider/WaveOne Gold in combination with the CAC design.

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study.

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Several Shaping Characteristics of OneCurve Continuously Rotating System versus Three Different Kinematic Systems: ProTaper Universal, Twisted File Adaptive and WaveOne Gold

Several Shaping Characteristics of OneCurve Continuously Rotating System versus Three Different Kinematic Systems: ProTaper Universal, Twisted File Adaptive and WaveOne Gold

Shaping ability of WaveOne Gold reciprocating instruments compared to two analogous counterparts

The aim of this study was to evaluate and compare canalcentering ability and transportation of three analogous reciprocating shaping instruments after glide path preparation. Radiographs were used to select sixty untreated mesiobuccal canals with curvatures of 25° to 35° from extracted, human, mandibular molars. The canals were randomly divided into three groups for glide path preparation and shaping (n = 20): Group TWOG (WaveOne Gold Glider + Primary WaveOne Gold); Group TEF (Edge GlidePath + Primary EdgeOne Fire); and Group TOFG (One File G Reciprocating Glide Path File + Primary Shaping file). Pre- and post-preparation micro-CT scans were compared at levels 7 mm (coronal), 5 mm (midroot), and 3 mm (apical) from the apex to evaluate transportation and centering ratios. There were no significant differences in centering ratios at the coronal and midroot levels (P &gt; 0.05). Transportation values were similar at the coronal level and for the combined mean values (P &gt; 0.05). Transportation values for TEF and TWOG were similar (P = 0.98) at the midroot level but significantly lower than TOFG (P = 0.04). Apically, TEF remained significantly more centered with significantly lower transportation values than TWOG and TOFG (P &lt; 0.05). Combined results showed that TEF was significantly more centered than TWOG but similar to TOFG (P = 0.017). Centering ratios and transportation values were more favorable in the apical region after use of TEF. All three groups evaluated in this study proved to be safe for the preparation of moderately curved root canals.

Shaping ability of non-adaptive and adaptive core nickel-titanium single-file systems with supplementary file in ribbon-shaped canals analysed by micro-computed tomography.

This study compared shaping ability between two single-file systems and before/after using supplementary file in untouched area, volume of removed dentin, maximum cut depth (the highest cut depth by main file) and remaining thinnest dentin (the thinnest root dentin after preparation). Ribbon-shaped distal canals of mandibular molars were prepared with non-adaptive core (WaveOne Gold) or adaptive core (XP-endo Shaper) files (n=15/group) and additionally prepared with a supplementary file (XP-endo Finisher), and the shaping ability was investigated using micro-computed tomography. XP-endo Shaper group demonstrated significantly less overall untouched area than WaveOne Gold group (38.21±6.98% vs. 47.68±9.16%) (p<0.05). No significant difference was detected between XP-endo Shaper and WaveOne Gold groups in volume of removed dentin (1.85±0.53 vs. 1.66±0.33mm3 ), maximum cut depth (0.10-0.28 vs. 0.10-0.29mm) and remaining thinnest dentin (0.66-0.80 vs. 0.78-0.88mm). Supplementary XP-endo Finisher treatment significantly decreased untouched area (11%-23% reduction) (p<0.05) with minimally cut root dentin (0.01-0.02mm).

Effect of Access Cavity Preparation on Dentin Preservation, Biomechanical Property, and Instrumentation Efficacy: A Micro–Computed Tomographic Study

IntroductionThe purpose of this study was to evaluate the influence of a contracted endodontic cavity (CEC) on dentin preservation, biomechanical property, and instrumentation efficacy of first permanent molars in comparison with a traditional endodontic cavity (TEC). MethodsForty-eight extracted intact maxillary and mandibular first molars were selected and scanned by micro–computed tomographic (micro-CT) imaging. Each tooth type was anatomically matched and assigned to the CEC group or the TEC group (n = 12). After root canal instrumentation with the ProGlider (Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Gold (Dentsply Maillefer), the specimens were scanned by micro-CT again. Pre- and postpreparation micro-CT imaging was used to evaluate the dentin preservation and instrumentation efficacy. The results on volume and thickness reduction in the coronal dentin and pericervical dentin (PCD), root canal volume and surface area, percentage of unprepared surface area, canal transportation and centering ratio, and canal wall thickness in the “danger zone” were measured and analyzed with the Shapiro-Wilk and independent sample t tests. Based on micro-CT imaging of maxillary and mandibular first molars, CEC and TEC models were constructed on the intact tooth, and 2 different static loads were applied to the occlusal load points. The stress distribution patterns and von Mises stress on the occlusal surface and cervical region were assessed by 3-dimensional finite element analysis. ResultsThe CEC had a significantly lower volume and thickness reduction of coronal dentin and PCD above the alveolar crest compared with the TEC group (P < .05), whereas no difference was observed in PCD below the alveolar crest between the 2 groups (P > .05). There was no difference regarding all instrumentation efficacy outcomes (root canal volume and surface area, percentage of unprepared surface area, canal transportation and centering ratio, and canal wall thickness) in the danger zone between the 2 groups (P > .05). The CEC effectively reduced the maximum von Mises stress and stress concentration area on the occlusal surface and cervical region compared with the TEC. ConclusionsThe CEC preserved more coronal dentin and PCD above the alveolar crest and thus reduced stress concentration on the occlusal surface and cervical region. The CEC had no significant adverse effects on the instrumentation efficacy compared with the TEC given that the instrumentation procedures were performed with ProGlider and WaveOne Gold files.

Evaluation of Foraminal Enlargement with Thermally Treated Nickel–Titanium Systems

To evaluate morphologic changes in the main foramen after enlargement with four different systems. One hundred and twenty canals (buccal of maxillary molars and mesial of mandibular molars) with patency and apical foramen ≤200 µm were included. These apical foramina were photographed and then randomly divided into four experimental groups, according to the ProDesign Logic (PDL), ProDesign R (PDR), twisted file adaptive (TFA), and WaveOne Gold (WOG) systems, all of which were composed of three sequential instruments (Glidepath, #25 and #35). Root canals were prepared 1 mm beyond the main foramen (n = 30). The specimens were photographed again to capture intermediate (#25) and final enlargement (#35) images. These were analyzed using an image software that allowed comparison of the enlarged area and shape of the main foramen. In the Intragroup comparison, the Friedman's test showed a statistical difference between each phase of foramen enlargement (p <0.05). In the intergroup comparison, the percentage of foramen enlargement showed statistically significant difference between Groups PDR and TFA only in the analysis from #25 to #35, with 42.88 and 67.34% of foramen area widening, respectively. Relative to the final foramen shape, 81.7% were observed to be circular, 17.5% oval, and 0.8% flattened. Our results showed that foramen enlargement allowed an increase in area, maintained the circular shape of the foramen in the majority of cases, irrespective of the system used, and was a feasible option for use during preparation of the root canal system.

Apically Extruded Debris during Instrumentation using Different Engine Driven File Systems: A Comparative In Vitro Study

AIM: The aim of the present study was to evaluate and compare the amount of apically extruded debris using three engine driven systems. METHODS: Sixty mandibular premolars with single root were used. The samples were divided into three groups with 20 teeth for each group: group 1 Neolix Neoniti A1 (25, 0.08), group 2 WaveOne GOLD Primary (25.07, red), and group 3 Protaper Next (PTN), using X1 (017/0.04), X2 (025/0.06) files. All files were used to prepare the root canals according to manufacturer instruction. Root canal preparation for each group was done according to manufacturer instructions using 16:1 gear reduction hand piece powered by a torque controlled electric motor. Debris collection was made using apparatus described by Myers and Montgomery. The extruded debris weight was measured by subtracting the weight of the empty Eppendorf tubes from the weight of the debris containing tubes results were statistically analyzed. RESULTS: One-way analysis of variance test revealed that there was statistically significant differences between all the three groups being tested (p &lt; 0.001) showed that apical extrusion of the debris of WaveOne Gold was the least followed by Neolix Neoniti and finally PTN which showed the most apical extrusion of debris with a significant difference between all groups. CONCLUSIONS: WaveOne Gold was found to be the least apical extruded debris system among all groups.

Impact of Different Access Cavity Designs and Ni–Ti Files on the Elimination of Enterococcus faecalis from the Root Canal System: An In Vitro Study

The present research aimed to reveal the in vitro effects of different endodontic file systems utilizing different endodontic access cavity designs on the elimination of Enterococcus faecalis from root canal systems. One hundred and fifty mandibular molar teeth were separated into three groups with respect to the access cavity design: traditional endodontic cavity (TEC), conservative endodontic cavity (CEC), and truss access cavity (TAC) (n = 50). After access cavity preparation, inolulation of teeth with E. faecalis was undertaken for 21 days. Following the first sampling (S1), further division of the groups into five subgroups (n = 10) was performed: ProTaper Gold, 2Shape, TruNatomy, Reciproc Blue, and WaveOne Gold. After instrumentation, bacterial sampling (S2) was performed. Bacterial reduction was evaluated in colony-forming units/mL, and statistical analysis was carried out. The E. faecalis count decreased significantly in all groups (p &lt; 0.05). The range of mean values for a decrease in E. faecalis in log numbers was lowest in the TAC and Reciproc Blue groups, while the highest values of bacterial reduction were detected in the TEC and ProTaper Gold groups. The highest level of antibacterial action was obtained with the use of ProTaper Gold compared to the other file systems tested.

Instrumentation kinematics does not affect bacterial reduction, post-operative pain, and flare-ups: A randomized clinical trial.

This randomized clinical trial aimed to assess the effect of instrumentation kinematics (reciprocation or continuous rotation) on bacterial reduction, post-operative pain, and incidence of flare-ups after root canal treatment of single-rooted mandibular premolars with asymptomatic apical periodontitis. Sixty-six patients were included in this prospective, parallel, randomized clinical trial. Patients were randomly allocated into two groups (N=33) according to the kinematics of the shaping instrument: WaveOne Gold (WO) used in reciprocation or One Shape (OS) used in continuous rotation. Under complete asepsis, bacterial samples were taken before (S1) and after (S2) a standard cleaning and shaping protocol. Evaluation of bacterial reduction was done by both culture technique and quantitative real-time polymerase chain reaction (qPCR) analysis. Post-operative pain was evaluated using the visual analogue scale (VAS) after 24, 48, and 72h following treatment, while flare-ups were recorded as a binary outcome (Yes/No). Independent and paired t-tests were used for inter- and intra-group comparisons for bacterial count data, respectively. For post-operative pain score, inter-group comparisons were analyzed using the Mann-Whitney U-test while intra-group comparisons were analyzed using Friedman test followed by pairwise comparisons utilizing the Wilcoxon signed rank test with Bonferroni correction. The significance level was set at p≤.05 within all tests. All the allocated participants received the intervention and were analysed. The comparison between culture and qPCR methods showed that qPCR analysis demonstrated significantly higher pre-instrumentation baseline bacterial count (p<.05). The percentage of bacterial reduction, detected by either method, significantly decreased after instrumentation using either rotation or reciprocation kinematics (p<.05). However, the difference between the WOG or OS files was statistically non-significant (p>.05). The intra-group comparisons showed a significant reduction in post-operative pain with time (p<.05) for both groups. However, the inter-group comparison demonstrated that the difference in post-operative pain after the use of either WOG or OS was statistically non-significant (p>.05). The incidence of flare-ups between both groups was also not-significant (p=1). Shaping kinematics, either rotation or reciprocation motions, had no impact on bacterial reduction and the incidence of post-operative pain and flare-ups after root canal preparation of single-rooted premolars with asymptomatic apical periodontitis.

Debridement Ability of TruNatomy, S-One Plus, and Other Single File Systems

BACKGROUND: Rotary nickel titanium instrument are an essential part of endodontic treatment, it is important to compare the root canal cleaning ability of these instruments. AIM: This study aimed to compare the amount of smear and debris layer remained following the use of four rotary instruments with an irrigant solution: TruNatomy (TRN), Protaper Next (PTN), S-One Plus and Wave One Gold (WOG). METHODS: A total of 80 extracted mandibular premolars were used and decoronated to the cemento-enamel junction. The roots were randomly divided into four groups of 20 specimens each. The roots were instrumented according to the manufacturer’s instructions of each file, the root canals were irrigated with sodium hypochlorite (NaOCl), Ethylene-diaminete-traacetic acid (EDTA) and Normal saline with each file use, two grooves were prepared on the buccal and lingual surfaces by disc to facilitate vertical splitting with a chisel. The presence of the smear layer and the debris layer were evaluated under Scanning Electron Microscope. RESULTS: Trunatomy remove the smear layer substantially better than PTN and S-one Plus. Wave one gold significantly removes smear layer better PTN. The amount of debris remained in TruNatomy group was significantly lower than other groups, all experimental files significantly removes the smear layer and debris layer better in the middle and coronal thirds compared to apical third. CONCLUSION: TruNatomy showed better cleaning capacity than all other experimental groups and all experimental groups demonstrated better cleanliness at the coronal and middle third of the roots.