XP-endo Shaper Research Articles

Comparison of Dentinal Defects Induced by Rotary, Reciprocating, and Hand Files in Oval Shaped Root Canal - An In-Vitro Study.

To evaluate and compare the formation of dentinal defects using hand Hedstrom files, XP-Shaper, TruNatomy, and Reciproc Blue file systems when used for oval shaped root canals. One hundred and five extracted human mandibular premolars with single root and oval canals were selected for the study. Twenty-one teeth were unprepared (control), and the remaining teeth were divided into the prepared groups (n = 21), that is, Group H-Files, Group XP-Shaper, Group TruNatomy, and Group Reciproc Blue. All selected teeth were de-coronated perpendicular to the long axis of the tooth by using a diamond-coated disk with water cooling, leaving root segments approximately 16 mm in length. Each group was prepared according to the above file system. Then all roots were sectioned perpendicular to their long axes at 3, 6, and 9 mm from the apex using a diamond-coated disk under a continuous water stream. Each specimen was then checked for the presence of dentinal defects/microcracks. The XP-Endo shaper group had the lowest number of defects (01/21 roots) 4.7%; TN (04/21) 19%, H-Files (04/21) 19%, and RC Blue (05/21) 23.8% had the highest incidence of defects. However, no significant difference was detected among these groups (P > 0.05). The motor-driven root canal instrumentation with rotary and reciprocating files and hand files may create microcracks in the radicular dentine, whereas the XP-Shaper file system produces minimal or less cracks compared to other tested rotary file systems and H-file instrumentation.

Shaping Ability of TRUShape and XP-endo Shaper in C-Shaped Canals Using 3D-Printed Replicas: A Micro-CT Study.

This study compared the shaping ability of TRUShape and XP-endo Shaper systems on C-shaped root canals replicas using microcomputed tomography (micro-CT). Thirty three-dimensional replicas based on a mandibular second molar classified as C1 type I C-shaped canal were randomly divided into two groups (n = 15): TRUShape (G.TRU) and XP-endo Shaper (G.XP) and instrumented with each system according to the manufacturer's instructions. Changes in volume and surface and the unprepared area of the root canal were measured by scanning on micro-CT before and after instrumentation. The unprepared areas were 39% in the G.TRU and 43% in the G.XP group with no significant difference between them (p > 0.05), but both the tested systems left a high percentage of unprepared root canal walls of C-shaped root canals. TRUShape and XP-endo Shaper showed a high rate of unprepared areas with similar results after C-shaped root canals replicas for root canal preparation.

Exploring the Efficacy of 6 Preparation Systems for Achieving Minimal Root Canal Transportation: A Micro-CT Investigation

IntroductionThis study aimed to assess the canal transportation with 6 preparation systems. MethodsSixty curved mesial roots of mandibular molars were scanned, and their root canals (n = 20 per group) were prepared with XP-endo Shaper, BioRace, ProTaper Next, Twisted File Adaptive, Reciproc, or Reciproc Blue systems. After preparation, a new scan was conducted, and transportation was determined by comparing the geometric center of the canal in 13,542 cross-sectional slices. The transport direction frequencies were recorded, and linear transport were compared using a Univariate GLM model and Tukey honestly significant difference tests (α = 5 %). ResultsTransportation was affected by the preparation system and root third (P < .05), with no significant effect observed for the root canal (P > .05). The Twisted File Adaptive had the highest transport (P < .05), and the lowest transports were observed with XP-endo Shaper, ProTaper Next, and BioRace (P < .05). Reciproc Blue and Reciproc showed intermediate results (P < .05). The apical and coronal third exhibited the lowest and highest transportation, respectively (P < .05). A significant interaction was observed between the preparation system and root third (P < .05). In the coronal third, transportation was mostly toward the disto-inside direction, whereas in the middle and apical thirds, transportation was predominantly toward the mesio-outside direction. ConclusionsXP-endo Shaper had the lowest mean linear transportation followed by the ProTaper Next, BioRace, Reciproc Blue, and Reciproc systems. The Twisted File Adaptive system had the worst performance. The direction of transportation was generally toward the inner aspect of the canal at the coronal third and toward the outer aspect of the curve at the middle and apical thirds.

Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study.

To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I-XP-endo Finisher; group II-EndoVac; group III-plastic finishing file; and group IV-standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.

Quasi-3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems.

The aim of this study is to compare the stress produced on the internal walls of simulated canals by nine rotary and four reciprocating systems. Sixty-five isotropic transparent blocks containing a 60° curved and tapered simulated canal were selected and distributed into 13 groups (n = 5) according to the preparation system: BioRace, HyFlex EDM, iRaCe, Mtwo, One RECI, ProTaper Next, RaCe EVO, Reciproc, Reciproc Blue, R-Motion, VDW.ROTATE, XP-Endo Rise Shaper, and XP-Endo Shaper. Each resin block was mounted in a vice and a digital camera recorded the entire sequence of each preparation system through a circular polariscope set for dark field analysis. The video frames when each instrument reached the end of the coronal, middle, and apical thirds of the canal were extracted from the recordings and analysed by two independent observers regarding the stress generated on the canal walls using a semi-quantitative evaluation on a 0-5 scale. Intra- and inter-observer agreement were subjected to the Cohen's Kappa coefficient test, whilst the experimental results were compared using Kruskal-Wallis test post hoc pairwise comparisons with Bonferroni correction (α = 5%). The inter- and intra-observer agreement were 0.98 and 1, respectively. Most instruments demonstrated acceptable performance (scores ≤ 2) in all thirds. Other instruments, such as the HyFlex EDM 25.12 (coronal and middle thirds), Reciproc Blue R25 and Reciproc R25 (coronal and apical thirds), R-Motion 30.04 (apical third), and VDW.ROTATE 20.05 (apical third) showed scores higher than 3. Statistical analysis revealed a significant difference amongst the tested systems at the coronal, middle, and apical thirds (p < .05). None of the canal instrumentation protocols were stress-free, showing varying levels of stress concentrations. Various factors seemed to influence the magnitude of stress and its distribution pattern on the canal walls. Overall, instruments characterized by a larger taper, lower speed, reciprocating motion, and made of heat-treated NiTi alloy exhibited higher patterns of stress distribution.

Farklı tek eğe sistemlerinin alt çene birinci büyük azı dişlerinin tehlike alanındaki dentin kalınlığına etkisi

Background: To compare the dentin thickness in the danger zone of mandibular molars after preparation with one rotating (XP-endo Shaper) and two reciprocating (One Reci and Reciproc Blue) single file systems using a cone beam computed tomography (CBCT).&#x0D; Materials and Methods: Thirty-six mesial roots of mandibular first molars having two independent canals were selected. After initial CBCT scans were provided, teeth were assigned into 3 groups related to the single file used: XP-Endo Shaper (XPS), One Reci (OR) and Reciproc Blue (RB). The roots were scanned again after preparation with respective single file systems. The minimum dentine thickness in the danger zone, at 4, 5, 6 and 7 mm below the furcation level, were measured in CBCT scans. Initial and final measurements were used to calculate the removed dentin thickness in the danger zone. Data was analyzed using Repeated-measures ANOVA (p=0.05).&#x0D; Results : No significant differences were found related with remaining and removed dentin thickness among single file systems at any level from the furcation (p&gt;0.05). &#x0D; Conclusions: The evaluated single file systems showed similar cutting efficiency in the danger zone of mandibular molars.

In-vitro comparison of TruNatomy and XP-endo Shaper on amount of dentin removal: A micro-computed tomography study

In-vitro comparison of TruNatomy and XP-endo Shaper on amount of dentin removal: A micro-computed tomography study

Disinfection and Shaping of Vertucci Class II Root Canals after Preparation with Two Instrument Systems and Supplementary Ultrasonic Activation of Sodium Hypochlorite

IntroductionThis study compared disinfection and shaping after root canal preparation with either XP-endo Shaper or TruNatomy instrument systems, supplemented by ultrasonic activation of sodium hypochlorite (NaOCl) with either stainless-steel (SS) or nickel-titanium (NiTi) inserts. MethodsMesial roots from mandibular molars with Vertucci class II configuration were divided into 2 groups (n = 24) based on anatomically paired micro-computed tomography (micro-CT) analyses. Pre and postpreparation micro-CT scans were obtained to evaluate the shaping performance. The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation with either XP-endo Shaper or TruNatomy instruments using NaOCl irrigation. Supplementary ultrasonic activation of NaOCl was conducted using either an SS (TruNatomy group) or NiTi (XP-endo Shaper group) insert. Bacteriological samples were taken from the canals before preparation (S1), after preparation (S2), and after the supplementary approach (S3). Bacterial reduction was evaluated using a quantitative real-time polymerase chain reaction. ResultsPreparation with both instrument systems significantly reduced bacterial counts (P < .01). After preparation, 36% (TruNatomy) and 35% (XP-endo Shaper) were negative for bacteria. These values increased to 59% and 65% after ultrasonic activation with the SS and NiTi inserts, respectively. The quantitative data in S2 showed that XP-endo Shaper promoted a significantly higher bacterial reduction than TruNatomy (P < .05). No significant intragroup differences were observed after ultrasonic activation (P > .05), probably because the SS insert promoted a significantly higher S2-to-S3 reduction than the NiTi insert (P < .01). Micro-CT analysis revealed no significant differences in the unprepared areas between the groups (P > .05). ConclusionsThe XP-endo Shaper caused a significantly higher bacterial reduction than TruNatomy in Vertucci class II canals. Better antibacterial results after ultrasonic activation were observed for the SS ultrasonic inserts than for the NiTi inserts.

Comparative Evaluation of Root Canal Transportation and Centering Ability in Curved Mesiobuccal Canals of Mandibular First Molars after Instrumentation with Different File Systems-An In vitro Study.

To assess the canal transportation and centering ability in the mandibular first molars' curved mesiobuccal canals after instrumentation with file systems XP endo Shaper, self-adjusting File (SAF), Hyflex EDM, Pro Taper NEXT, WaveOne Gold, and K files with the help of Cone-Beam Computed Tomography (CBCT). Ninety recently extracted mandibular first molars with mesiobuccal roots that had a 25-30 degree canal curvature were assessed. Following preoperative CBCT scans, teeth were allocated randomly to six experimental groups of fifteen. After preparation with XP endo Shaper, SAF, Hyflex EDM, Pro Taper Next, WaveOne Gold, and K files, post-instrumentation scans were taken using same parameters as pre operative scans. At 3 mm, 6 mm, and 9 mm from the apex, samples were assessed for canal transportation and centering ratio. Apical transportation was least for XP endo Shaper as compared to other groups except SAF and the results were statistically significant. K file showed the highest apical transportation toward the lateral wall of the root canal. XP endo Shaper was better in maintaining centering ability of middle and apical third of canal and SAF was better in maintaining centering ability of coronal third. In root canal preparation, least apical transportation and better centering ability with XP endo Shaper than other file systems compared. K file showed the highest transportation.

Evaluation of postoperative Pain after endodontic treatment using XP-endo shaper and Oneshape (A double-blind randomized study)

Evaluation of postoperative Pain after endodontic treatment using XP-endo shaper and Oneshape (A double-blind randomized study)

Cleaning and Disinfecting Oval-Shaped Root Canals: Ex Vivo Evaluation of Three Rotary Instrumentation Systems with Passive Ultrasonic Irrigation.

Background and Objectives: Successful root canal treatment depends on the thorough removal of biofilms through chemomechanical preparation. This study aimed to investigate and compare the cleaning and disinfecting efficiency of oval-shaped root canals using XP-endo Shaper (XPS), ProTaper Next (PTN), and HyFlex CM (HCM) in combination with passive ultrasonic irrigation (PUI). Materials and Methods: Ninety extracted teeth were contaminated and randomly divided into three groups: XPS, PTN, and HCM. Each group was assigned to three subgroups: subgroup A (sterile saline), subgroup B (3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid), and subgroup C (3% sodium hypochlorite, 17% ethylenediaminetetraacetic acid, and PUI). Bacterial sampling was conducted both from baseline samples and samples after chemomechanical preparation. Scanning electron microscopy (SEM) was used to evaluate the residue bacterial biofilms, hard tissue debris, and smear layers on the buccolingual walls of oval-shaped root canals. Results: When combined with sterile saline, XPS demonstrated a higher reduction of bacterial counts and was more effective in eradicating Enterococcus faecalis in the middle third of the canals compared to the other instruments (p < 0.05). Additionally, when used with antimicrobial irrigants, XPS was more effective in disinfecting the coronal third of the canals than the other instruments (p < 0.05). Furthermore, XPS reduced hard tissue debris more effectively in the middle third of canals than in the apical third (p < 0.05). Conclusions: XPS outperforms PTN and HCM in disinfecting oval-shaped root canals. Despite the fact that combining XPS and PUI improves cleaning and disinfecting, removing hard tissue debris from the critical apical area remains challenging.

Assessing Percentage of Touched Surfaces and Changes in Cross-sectional Area in Oval Shaped Root Canals after XP-endo Shaper, IRaCe and HyFlex CM Instrumentation Using AutoCAD Software

AIM: This study aimed to calculate the percentage of touched surfaces and changes in the cross-sectional area of oval-shaped root canals after preparation using (XP-endo Shaper, IRace, and HyFlex CM) rotary systems using AutoCAD software. MATERIALS AND METHODS: Sixty extracted single-rooted mandibular premolars were collected and divided into three main groups according to the rotary system used (n = 20). Each tooth was impeded in a resin block, coded, sectioned, and photographed under a stereomicroscope, before and after instrumentation. Microphotographs were analyzed using AutoCAD software. Two-way ANOVA was used to evaluate the mean percentage of the touched surface and mean cross- sectional area between the groups and tooth segments, followed by Tukey’s post hoc test for pair-wise comparisons. RESULTS: The percentage of touched canal walls was significantly different between IRace group and each of XP-endo Shaper and HyFlex CM groups (p &lt; 0.001). A statistically significant difference was recorded for the mean change in the cross-sectional areas of the root canal between IRace group and both HyFlex CM and XP-endo Shaper groups, respectively (p &lt; 0.001). For all groups, there was a significant difference in the change in the cross- sectional area between all segments (coronal, middle, and apical). CONCLUSIONS: Within the limitations of this study, the XP-endo Shaper and HyFlex CM files had a higher cutting efficiency and maintained better root stability than the IRaCe system by preserving the dentin of the oval root canal. This was observed at all the canal levels in the coronal, middle, and apical segments.

Efficiency of ProTaper Universal Retreatment, Reciproc Blue and XP-endo Shaper in the removal of a bioceramic-based root canal filling.

This in vitro study aimed to assess the performance of ProTaper Universal Retreatment (PTUR), Reciproc Blue (RB), and XP-endo Shaper (XPS) system in the removal of bioceramic root canal filling. Forty-five human single-rooted mandibular premolars were prepared up to 30/.04 and filled with Endosequence BC sealer and BC points before being assigned into three groups (n=15). The root canal fillings were removed until reaching predetermined working length (WL) with PTUR in group 1, RB in group 2, and XPS in group 3. During the removal of the filling material, apically extruded debris was collected in pre-weighed Eppendorf tubes, and operation time was recorded with a digital chronometer. Reaching the WL and maintaining apical patency were evaluated separately. The data were statistically analyzed using Kruskal Wallis and Mann Whitney U tests. The mean amount of extruded debris was highest in the PTUR group, although all instruments caused apical extrusion of debris. The mean time for reaching WL was longest for RB and shortest for XPS, with significant differences among the groups (p<0.05). Although the difference was not significant (p=0.799), in the PTUR group the WL was reached in 93.3% of the samples, which was higher than other groups (86.7%). All tested systems caused a certain amount of debris extrusion. XPS was associated with less extrusion while regaining more rapid access to the periapical area than PTUR and RB.

Smear Layer removal efficacy of different types of Irrigation Solutions with single file system: An in vitro SEM Study

Aim: To compare the effectiveness of three different irrigating solutions (NaOCl+ EDTA, REMIX 2 IN 1, TWIN KLEEN) on the removal of smear layer with the single file system (XP-Endo Shaper) in mandibular premolars using a scanning electron microscope. Materials and Methods: Thirty-three human single-rooted mandibular premolar teeth were selected and decoronated to a standardized length. Biomechanical preparation was done with a single file system (XP-Endo Shaper) using 3% NaOCl as an irrigant during instrumentation. Three experimental groups were formed by randomly dividing teeth, with eleven teeth in each Group (n=11), and final irrigation was carried out using the following solutions; Group I - (control group) 5.25% Sodium Hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic (EDTA), Group II - REMIX 2 IN 1 solution (Neelkanth healthcare, India), Group III - freshly prepared TWIN KLEEN (Maarc dental, India) solution. The teeth were separated into two halves and observed under a scanning electron microscope at 3mm, 6mm, and 9mm from the apex to analyze the amount smear layer in 1000X and were evaluated using a 5-grade scoring system. Kruskal–Wallis test and Mann–Whitney U test were used to analyze the data. Results: On comparing the three different irrigating solutions, no statistically significant difference was found in the ability to remove the smear layer from the coronal and middle third's (P&gt;0.05). Group I (1.14±0.68) and Group II (1.18±0.40) showed significantly higher removal of smear layer when compared to Group III (1.81±0.60) in the apical third. Conclusion: Sequential use of 5.25% NaOCl + 17% EDTA and REMIX 2 IN 1 solution were found to be the most efficient than TWIN KLEEN solution in removing the smear layer in the apical third of root canals instrumented with the single file system (XP-Endo Shaper).

Comparison of Postoperative Pain After the Utilization of Different File Systems in Single Visit Endodontics.

This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes. A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment. The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time. The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.

A Comparative Evaluation of Canal Transportation and Centering Ability with Three Different Retreatment File Systems– An In vitro CBCT Study

AIM: The study aimed to compare the canal transportation and centering ability of the three different retreatment file systems using cone-beam computed tomography imaging (CBCT).&#x0D; Methodology: Thirty three single-rooted, mandibular premolars were prepared up to ProTaper Gold size F2. Post intrumentation CBCT imaging was taken for all the samples. Obturation is done. The samples were randomly assigned to three different retreatment groups (n = 11), Group I: Pro Taper Universal retreatment kit, Group II: Mtwo R, and Group III: Xp endoshaper. Retreatment was done for all the samples using respective file systems followed by a Post-retreatment CBCT imaging. The two scans were compared both bucco-lingually and mesiodistally to determine canal transportation and centering ability at 3 mm, 6 mm, and 9 mm from the apex using DICOM Software. The results obtained were tabulated and statistically analyzed using One way Anova and Post hoc tukey test.&#x0D; Results: The mean canal transportation was least for Xp endoshaper (Group III). A Significant difference in canal transportation and centering ability was not observed at all three levels from the apex.&#x0D; Conclusion: Under in-vitro conditions, all three file systems have shown similar efficacy concerning canal transportation and centering ability. Based on mean values, canal transportation was higher for PTUR, followed by Mtwo R and Xp endo shaper in mesiodistal and buccolingual directions at 3, 6 and 9mm, and canal centering ability XP endo shaper stay centered followed by Mtwo R and PTUR in mesiodistal and buccolingual directions at 3, 6 and 9 mm.

Optimization of automated preparation of long oval-shaped root canals using supplementary instrumentation.

This study compared the preparation of long oval-shaped root canals using WaveOne Gold and XP-endo Shaper systems, both supplemented or not with manual instrumentation. Twenty-four long oval-shaped canals of mandibular incisors were distributed into two groups according to the instrumentation: WaveOne Gold Primary or XP-endo Shaper systems. All root canals were manually instrumented with a size 25 K-file after automated preparation. The specimens were scanned by using a micro-CT device (17.42 µm) before and after automated preparation and manual instrumentation. The increased surface of the root canal and the percentage of untouched areas were assessed. Both WaveOne Gold and XP-endo Shaper systems increased the root canal surface and had similar untouched areas (p>0.05). Supplementary instrumentation increased the surface of the root canal and decreased the untouched walls (p<0.05). WaveOne Gold and XP-endo Shaper systems provided a similar preparation of long oval-shaped canals and manual instrumentation improved their preparation.

Rotary Systems for Root Canal Gutta-percha Removal: A Review

Gaining a predictable outcome in endodontics is complicated by handling an endodontically treated. Compared to primary root canal therapy, non-surgical endodontic retreatment typically entails the removal of previous root filling materials. This process may be necessary to enable access to contaminated canal space for recleaning and to remove obturation materials that may have been contaminated by marginal penetration of microorganisms and microbial toxins. The achievement of patency at the canal terminus and the extension of cleaning as close as possible to the apical terminus have been identified as healing prognostic criteria. Gutta-percha (GP) is the current mainstay material utilised as an endodontic filling material, capable of performing comprehensive, three-dimensional sealing of the treated root canal system in a highly effective manner with considerable physical durability. Interestingly, since its initial discovery in the 17th century, GP remains to this day the ideal obturation material used across, in essence, all dental clinics globally due to its material properties and versatility for use in conjunction with sealer compounds. The development of GP removal systems that can manage to remove GP in its entirety from root canals during non-surgical retreatment procedures is currently highly desirable for dental practices. This literature review investigated this current research niche and scrutinised two prevalently utilised rotary systems – Edgefile-XR and the XP-Endo shaper systems.

Post-Instrumentation Dentinal Microcracks Induced by Two NiTi Rotary Systems with Increased Super Elasticity and Shape Memory: A MicroCT Comparative and Methodological Ex Vivo Study

This study aimed to determine the incidence of dentinal microcracks after instrumenting the root canals of maxillary premolars using two novel rotary instrumentation systems. Micro-computed tomography (microCT) scans and images generated by sectioning and observation with a stereomicroscope were used to assess the specimens. Twenty-two freshly extracted maxillary premolars were collected and the specimens were divided into two groups of eleven. The tested radicular shaping systems were XP-Endo shaper and TRUShape (i.e., single file). The specimens were scanned with microCT pre- and post-instrumentation, and the newly formed microcracks were detected. The post-instrumentation scans were also compared with images obtained by sectioning method and stereomicroscope inspection, comparing the incidence of microcracks in either microCT scans or images. The results identified an overall incidence of 0.49% of newly formed microcracks, with no statistically significant differences (p = 0.689) between the shaping systems (0.11% for TRUShape and 0.87% for XP-Endo shaper). There were statistically significant differences (p &lt; 0.001) between the microcracks incidence in microCT scans and the sectioning method (16.6% more for the latter). In conclusion, the results show that neither TRUShape nor XP-Endo shaper created dentinal microcracks during root canal instrumentation. The sectioning method with stereomicroscope evaluation overestimates the presence of microcracks with a statistically significant difference compared to microCT scans.

Incidence of Post-Operative Pain following a Single-Visit Pulpectomy in Primary Molars Employing Adaptive, Rotary, and Manual Instrumentation: A Randomized Clinical Trial.

Background and Objectives. To differentiate the intensity of postoperative pain after primary molar pulpectomy employing manual instrumentation versus two single-file systems with different kinetics (the XP-Endo shaper file with adaptive instrumentation vs. the Kedo-SG blue file with continuous rotation instrumentation). Materials and Methods. This three-arm, single-blind, randomized clinical trial included assessing 75 healthy children between 4 to 9 years who required pulpectomy for primary molars (mandibular first and second). The three groups each had an equal number of children. Children in Group 1 had their teeth instrumented with the XP-endo Shaper, children in Group 2 had their teeth instrumented with the Kedo-SG Blue file, and children in Group 3 had their teeth instrumented manually using K-files. The degree of postoperative pain was measured using a four-point pain scale at 6-, 12-, 24-, 48-, and 72-h following therapy. Each participant's parent received five flashcards with four faces and a word characterizing each face. The data were analyzed using Kruskal-Wallis and chi-square tests. The level of significance was set to 5%. Results. During the follow-up period, there was a significant difference in postoperative pain intensity between the three groups. The XP-endo shaper was associated with considerably decreased post operative at the 6- and 12-h interval followed by Kedo-SG. The highest post-operative discomfort across the groups was related to the patients who underwent manual instrumentation. Conclusion. In comparison to rotary and manual instrumentation, postoperative pain severity was reduced with adaptive instrumentation.