Displaying publications 1 - 20 of 31 in total

  1. Ahmed HM
    Int Endod J, 2013 Nov;46(11):1011-22.
    PMID: 23711096 DOI: 10.1111/iej.12134
    Paediatric endodontics is an integral part of dental practice that aims to preserve fully functional primary teeth in the dental arch. Pulpectomy of primary molars presents a unique challenge for dental practitioners. Negotiation and thorough instrumentation of bizarre and tortuous canals encased in roots programmed for physiological resorption are the main challenges for this treatment approach. Consequently, numerous in vitro and in vivo studies have been conducted to validate the application of some contemporary endodontic armamentarium for effective treatment in primary molars whilst maintaining favourable clinical outcomes. Electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the forefront of endodontic armamentarium in paediatric dentistry. Hence, this review aims to map out the root and root canal morphology of primary molars, to discuss the application of electronic apex locators in primary molars and to provide an update on the preparation of their root canal systems.
    Matched MeSH terms: Root Canal Preparation*
  2. Neelakantan P, Ahmed HMA, Chang JWW, Nabhan MS, Wei X, Cheung GSP, et al.
    Aust Endod J, 2019 Dec;45(3):407-413.
    PMID: 30520194 DOI: 10.1111/aej.12333
    This systematic review assessed the effect of different root canal instrumentation systems on endotoxin reduction from the root canal system. The literature search was conducted in two electronic databases (PubMed and Scopus) using specific key words. The search strategy followed the PRISMA guidelines. Qualitative synthesis and quantitative synthesis of the data were performed and data interpretation was done based on the guidelines in the Cochrane Handbook. The risk of bias was assessed using Cochrane criteria. The initial search yielded 600 citations, of which three papers met the criteria for inclusion in this review. Studies showed a significant reduction in endotoxin following rotary and reciprocating instrumentation, with no significant differences between them. The meta-analysis showed no statistical significant difference between reciprocation and rotary files (P > 0.05). In conclusion, the instrumentation techniques compared in this review decrease endotoxin content from root canals, with no significant difference between them.
    Matched MeSH terms: Root Canal Preparation*
  3. Plotino G, Nagendrababu V, Bukiet F, Grande NM, Veettil SK, De-Deus G, et al.
    J Endod, 2020 Jun;46(6):707-729.
    PMID: 32334856 DOI: 10.1016/j.joen.2020.01.023
    INTRODUCTION: Negotiation, glide path, and preflaring are essential steps in root canal shaping procedures. This report aimed to discuss the terminology, basic concepts, and clinical considerations of negotiation, glide path, and preflaring procedures and the influence of these steps on root canal shaping.

    METHODS: This systematic review was undertaken following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol has been registered with the International Prospective Register of Systematic Reviews (number CRD42019127021). A comprehensive literature search was performed by 2 independent reviewers using a selected search strategy in 2 electronic databases (PubMed and Scopus) until January 28, 2019. A further search was performed manually in endodontic journals. Studies investigating or comparing at least 1 shaping property resulting from root canal instrumentation with a glide path or preflaring in human extracted teeth or clinical studies were included.

    RESULTS: The literature shows that the definition of glide path and preflaring procedures remains controversial, which requires an elaboration in the American Association of Endodontists' Glossary of Endodontic Terms. After the removal of irrelevant and duplicated articles, 98 articles were included. The impact of glide path preparation and preflaring on working length determination, apical file size determination, canal transportation, separation of endodontic files, shaping time, dentinal microcrack formation, and extrusion of debris was discussed. Because of heterogeneity among the included studies, quantitative synthesis was not performed for most of the parameters.

    CONCLUSIONS: An evidence-based guideline is needed to define and correlate the basic concepts and current applications of each step of contemporary advancements in root canal instruments. Glide path preparation reduces the risk of debris extrusion, has no influence on the incidence of dentinal crack formation, and improves the preservation of the original canal anatomy. The creation of a glide path may have no impact on Reciproc files (VDW, Munich, Germany) in reaching the full working length. Preflaring increases the accuracy of working length determination. Further randomized clinical trials are required to evaluate the effect of a glide path and preflaring on root canal treatment outcomes.

    Matched MeSH terms: Root Canal Preparation*
  4. Western JS, Dicksit DD
    J Conserv Dent, 2017 Jan-Feb;20(1):30-36.
    PMID: 28761250 DOI: 10.4103/0972-0707.209066
    BACKGROUND: All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing.

    OBJECTIVES: Of this meta-analysis was to collect and analyze in vitro studies quantifying apically extruded debris while using Hand ProTaper (manual), ProTaper Universal (rotary), Wave One (reciprocating), and self-adjusting file (SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically.

    METHODOLOGY: An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms "Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems." A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris.

    RESULTS: Statistically significant difference was seen in the following comparisons: SAF < Wave One, SAF < Rotary ProTaper.

    CONCLUSIONS: Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.
    Matched MeSH terms: Root Canal Preparation
  5. Al-Afifi NA, Abdullah M, Al-Amery SM, Abdulmunem M
    J Appl Biomater Funct Mater, 2016 Jul 26;14(3):e307-13.
    PMID: 27149939 DOI: 10.5301/jabfm.5000273
    BACKGROUND: The aim of this study was to evaluate and compare the obturation quality between canals obturated with gutta-percha/AH Plus sealer (GP group) and resin-coated GP/EndoREZ® sealer (ER group).

    METHODS: A total sample of 90 mandibular premolar teeth was divided into 2 groups (2 × 45 canals): the GP group and ER group. Each group was further divided into 3 subgroups (n = 15): cold lateral compaction (CLC), warm lateral compaction (WLC) and single cone (SC). The teeth were subsequently embedded in resin and sectioned horizontally at 1, 3, 6 and 9 mm. All sections were then viewed with a stereomicroscope at ×40 magnification. The area occupied by core filling materials was determined using Cell^D software.

    RESULTS: With CLC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at the 1- and 3-mm levels. Similarly, with WLC, the percentage of core filling material in the ER group was significantly higher than in the GP group at the 1-, 3- and 9-mm levels. With SC, the percentage of core filling materials in the ER group was significantly higher than in the GP group at all levels.

    CONCLUSIONS: It can be concluded that the resin-coated GP/EndoREZ® sealer is superior to the gutta-percha/AH Plus in the percentage of core filling material.

    Matched MeSH terms: Root Canal Preparation*
  6. Guivarc'h M, Ordioni U, Ahmed HM, Cohen S, Catherine JH, Bukiet F
    J Endod, 2017 Jan;43(1):16-24.
    PMID: 27986099 DOI: 10.1016/j.joen.2016.09.023
    INTRODUCTION: Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series.

    METHODS: A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search.

    RESULTS: Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing.

    CONCLUSIONS: A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective.

    Matched MeSH terms: Root Canal Preparation/adverse effects*
  7. Mohd Sulong MZ, Abu-Hassan MI, Abdul Razak AA, Embong A
    Singapore Dent J, 1996 Jul;21(1):31-5.
    PMID: 10597181
    Records of 302 root-filled teeth treated by dental undergraduates were reviewed by four lecturers in the Department of Conservative Dentistry, University of Malaya. Preoperative and operative factors were evaluated for their association with postoperative pain experience of patients during the visit immediately after completion of biomechanical preparation. Eighty four percent of patients did not experience any pain after biomechanical preparation whilst the remaining 16 percent only complained of slight or moderate pain. The incidence of pain after biomechanical preparation is not high even when performed by inexperienced undergraduates. Teeth with a pre-existing painful condition had a higher chances of postoperative of pain. The incidence of postoperative pain was halved when teeth were associated with a sinus tract.
    Matched MeSH terms: Root Canal Preparation/adverse effects*; Root Canal Preparation/statistics & numerical data
  8. Daood U, Parolia A, Matinlinna J, Yiu C, Ahmed HMA, Fawzy A
    Dent Mater, 2020 12;36(12):e386-e402.
    PMID: 33010944 DOI: 10.1016/j.dental.2020.09.008
    OBJECTIVES: Evaluate a new modified quaternary ammonium silane irrigant solution for its antimicrobial, cytotoxic and mechanical properties of dentine substrate.

    METHODS: Root canal preparation was performed using stainless steel K-files™ and F4 size protaper with irrigation protocols of 6% NaOCl + 2% CHX; 3.5% QIS; 2% QIS and sterile saline. Biofilms were prepared using E. faecalis adjusted and allowed to grow for 3 days, treated with irrigants, and allowed to grow for 7 days. AFM was performed and surface free energy calculated. MC3T3 cells were infected with endo irrigant treated E. faecalis biofilms. Raman spectroscopy of biofilms were performed after bacterial re-growth on root dentine and exposed to different irrigation protocols and collagen fibers analysed collagen fibers using TEM. Antimicrobial potency against E. faecalis biofilms and cytoxicity against 3T3 NIH cells were also. Resin penetration and MitoTracker green were also evaluated for sealer penetration and mitochondrial viability. Data were analysed using One-way ANOVA, principal component analysis and post-hoc Fisher's least-significant difference.

    RESULTS: Elastic moduli were maintained amongst control (5.5 ± 0.9) and 3.5% QIS (4.4 ± 1.1) specimens with surface free energy higher in QIS specimens. MC3T3 cells showed reduced viability in 6%NaOCl+2%CHX specimens compared to QIS specimens. DNA/purine were expressed in increased intensities in control and 6% NaOCl + 2% CHX specimens with bands around 480-490 cm-1 reduced in QIS specimens. 3.5% QIS specimens showed intact collagen fibrillar network and predominantly dead bacterial cells in confocal microscopy. 3.5% QIS irrigant formed a thin crust-type surface layer with cytoplasmic extensions of 3T3NIH spread over root dentine. Experiments confirmed MitoTracker accumulation in 3.5% treated cells.

    SIGNIFICANCE: Novel QIS root canal irrigant achieved optimum antimicrobial protection inside the root canals facilitating a toxic effect against the Enterococcus faecalis biofilm. Root dentine substrates exhibited optimum mechanical properties and there was viability of fibroblastic mitochondria.

    Matched MeSH terms: Root Canal Preparation
  9. Wan Noorina Wan Ahmad, Dalia Abdullah, Kanagasingam, Shalini, Safura Anita Baharin, Jasmina Qamaruz zaman
    Malaysian Dental Journal, 2010;31(2):90-93.
    This study aims to determine the prevalence of hand-held ProTaper® files system among UKM final year dental undergraduates and to assess their perception in performing endodontic treatments.

    Methods: 85 final year dental students from 2006/2007 academic session participated in the questionnaire survey. All students underwent didactic endodontic teaching of conventional stainless steel files throughout a 2-year course and a 2-day ProTaper® hand files seminar on canal preparation. Each student had a total of 6 months clinical period before the survey was distributed to the subjects and returned for data analysis.

    Results: A 100% response rate was received. About 58.8% (n=50) used hand ProTaper routinely while 41.2% claimed themselves as non-users. Amongst the users, 52.5% were moderate users and about 33.6% were frequent users. Tooth type and size of canals were the selected criteria for file use. Majority of users used ProTaper® hand for posterior teeth and regarded it as user friendly. Although almost all users expressed concern of instrument fracture during use, very few did break. Procedural errors were not experienced by 51.3% users.

    Conclusion: About 2/3rd majority of UKM undergraduate dental students use ProTaper® hand-held system as an alternative for canal preparation. Procedural errors were perceived to occur much less when using the NiTi files. The system can be initiated to novice users and can be taught as part of endodontic curricula.
    Matched MeSH terms: Root Canal Preparation
  10. Pai ARV
    Br Dent J, 2023 Apr;234(7):488.
    PMID: 37059753 DOI: 10.1038/s41415-023-5755-3
    Matched MeSH terms: Root Canal Preparation
  11. Sidhu P, Shankargouda S, Dicksit DD, Mahdey HM, Muzaffar D, Arora S
    J Endod, 2016 Apr;42(4):622-5.
    PMID: 26850688 DOI: 10.1016/j.joen.2015.12.027
    INTRODUCTION: Use of mobile phone has been prohibited in many hospitals to prevent interference with medical devices. Electromagnetic radiation emitted from cellular phones might interfere with electronic working length determination. The purpose of this in vitro study was to evaluate the effect of a smart phone (Samsung Galaxy Note Edge) on working length determination of electronic apex locators (EALs) Propex II and Rootor.

    METHODS: Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance.

    RESULTS: The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions.

    CONCLUSIONS: Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.

    Matched MeSH terms: Root Canal Preparation/instrumentation*
  12. Reddy KB, Dash S, Kallepalli S, Vallikanthan S, Chakrapani N, Kalepu V
    J Contemp Dent Pract, 2013 Nov 1;14(6):1028-35.
    PMID: 24858745
    The present study was conducted to compare the cleaning efficacy (debris and smear layer removal) of hand and two NiTi rotary instrumentation systems (K3 and ProTaper).
    Matched MeSH terms: Root Canal Preparation/instrumentation*; Root Canal Preparation/methods
  13. Decurcio DA, Rossi-Fedele G, Estrela C, Pulikkotil SJ, Nagendrababu V
    J Endod, 2019 Apr;45(4):387-393.e2.
    PMID: 30833095 DOI: 10.1016/j.joen.2019.01.013
    INTRODUCTION: This systematic review and meta-analysis aimed to assess whether machine-assisted agitation resulted in less postoperative pain (PP) compared with syringe irrigation with needle alone in adult patients undergoing root canal treatment.

    METHODS: A literature search was performed in 3 electronic databases for articles published before August 2018. Randomized clinical trials published in English that compared PP between machine-assisted agitation and syringe irrigation with needles as part of nonsurgical root canal treatment were included. Two authors were independently involved in the article selection process, data extraction, and assessment of the quality of included studies using the revised Cochrane risk of bias tool. The pooled effect estimates of the standardized mean difference (SMD) between machine-assisted agitation and syringe irrigation with needle was calculated by a random effects-modeled meta-analysis. A subgroup meta-analysis was performed. The quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development and Evaluations approach.

    RESULTS: Six studies were included for systematic review. Meta-analysis was performed using 3 studies and showed that machine-assisted agitation resulted in less PP compared with syringe irrigation with needle at 24 hours (SMD = -0.73; 95% confidence interval, -1.04 to -0.42; I2 = 30.6%) and 48 hours (SMD = -0.60; 95% CI, -0.85 to -0.35; I2 = 0%). The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the PP outcomes (24 hours and 48 hours) was graded as "moderate" quality.

    CONCLUSIONS: Machine-assisted agitation reduced PP compared with syringe irrigation with needles in nonsurgical root canal treatment. Future clinical trials are needed to support the result of this review.

    Matched MeSH terms: Root Canal Preparation/instrumentation*; Root Canal Preparation/methods*
  14. Mali S, Singla S, Tyagi P, Sharma A, Talreja N, Gautam A
    J Indian Soc Pedod Prev Dent, 2021 1 7;38(4):374-380.
    PMID: 33402620 DOI: 10.4103/JISPPD.JISPPD_315_20
    Aim and Objectives: The aim and objectives of this study are to evaluate and compare the effectiveness of Myristica fragrans - Nutmeg, Terminalia chebula - Myrobolan, Ocimum sanctum-tulsi, and 2.5% sodium hypochlorite (NaOCl) on the removal of the smear layer by the scanning electron microscope (SEM).

    Settings and Design: Endodontic treatment aims at disinfection and then obturation of root canal system in to prevent re-infection. Root canal irrigants play a pivotal role in the disinfection process. One of the important properties of an irrigant is the removal of complete smear layer and debris. Smear layer has the potential to protect bacteria within the dentinal tubules; therefore removal may be prudent. Smear layer removal increases the bond strength of resin sealers which results in better apical seal.

    Materials and Methods: Forty extracted single-rooted, primary teeth were allocated randomly into four groups of ten each: Group 1 - NaOCl, Group 2 - Nutmeg, Group 3 - Myrobolan, and Group 4 - Tulsi. Samples were stored in sterile saline (0.9% NaCl) and then decoronated at the level of the cementoenamel junction. Working length was determined followed by appropriate irrigation. The roots were split into two halves with a chisel and were stored in 2.5% glutaraldehyde solution for 24 h. After fixation, the samples were dehydrated in ethanol series (70, 90, and 95 and twice at 100%). Each specimen was mounted on Al stub and sputter coated with a 20 nm layer of gold. Samples were then examined using a SEM quantum 60 at magnification of ×2000.

    Results: Tulsi demonstrated the most statistically significant results followed by myrobolan and nutmeg extract. All herbal extracts were found to be significantly effective than 2.5% NaOCl.

    Conclusion: Tulsi, nutmeg and myrobolan can be effectively used as an irrigant in primary teeth.

    Matched MeSH terms: Root Canal Preparation
  15. Lin GSS, Ghani NRNA, Noorani TY
    Odontology, 2021 Jul;109(3):672-678.
    PMID: 33458795 DOI: 10.1007/s10266-021-00589-1
    To compare the microhardness and crack formation in root dentine presented with butterfly effect in lower premolars. Sixty mature lower premolars were selected and divided into the control and experimental groups. Teeth in the experimental group were instrumented up to size 30/.04. The roots were cut horizontally into twelve parts of 1-mm-thick cross-section and were numbered accordingly. They were divided into coronal, middle, and apical root sections. Sections were then viewed under a microscope to determine the presence of butterfly effect and subsequently scored. 8 teeth from both control and experimental groups with the highest and lowest score were selected. Crack formation was inspected and classified into four different types of cracks. Microhardness test was performed using a Vickers hardness test. Higher frequency of butterfly effect was found in the apical root section and root dentine with butterfly effect were harder mesiodistally. The middle and apical root sections with butterfly effect were harder than the coronal section. No significant difference of dentine hardness between the control and experimental groups. Cracks only occurred in the experimental group and presented in buccolingual direction with a higher rate of Type 1 and Type 2 cracks. Prevalence of butterfly effect in lower premolars increased from coronal to apical with increased hardness mesiodistally. More buccolingual cracks were found in radicular dentine with butterfly effect and most of them exhibited Type 1 and Type 2 cracks. Roots of lower premolar with butterfly effect may be susceptible to a higher rate of vertical root fracture in buccolingual direction, especially after root canal treatment. Thus, special attention should be given not to overload instruments during root canal preparation.
    Matched MeSH terms: Root Canal Preparation
  16. Che Ab Aziz, Z.A., Abdullah, M., Vello, C.D.S., Thangavelu, K.
    Ann Dent, 2006;13(1):12-17.
    Background: Majority of root canal treatment in Malaysia was provided by general dental practitioner. The purpose of this study was to evaluate the knowledge and practice (canal’s preparation, use of materials) by them. Methods: A questionnaire was structured and distributed to 120 registered general dental practitioners in selected areas in Perak, Johor and Klang Valley regarding the provision of root canal therapy in their practices. The questionnaires were hand delivered and collected after 1 to 2 weeks. Results: Reply rate was 95% (n=114). The result demonstrated that 62% respondents indicated that they performed the root canal therapy (RCT) themselves. Out of these only 26% included molars in the treatment. Three quarters of them (77%) used step-back technique and 54% used stainless steel instruments to prepare the canals. The majority of the respondents (69%) used calcium hydroxide as intracanal medicaments. Only 30% used rubber dam for isolation whereas the rest used cotton rolls. The numbers of routine radiographs taken were two for anterior teeth and three for molar. Half of the respondents indicated that they usually completed the RCT for the anterior tooth within two visits whereas three visits were needed for the molar tooth. The results were analyzed descriptively. Conclusions: This study indicates that most of the general dental practitioners’ do not comply with quality standards guidelines such as use of rubber dam as isolation. Cotton roll was the most popular isolation method. In spite of this, most of the respondents tend to update their knowledge and practices with current techniques and materials.
    Matched MeSH terms: Root Canal Preparation
  17. Ballester B, Giraud T, Ahmed HMA, Nabhan MS, Bukiet F, Guivarc'h M
    Clin Oral Investig, 2021 Nov;25(11):6027-6044.
    PMID: 34623506 DOI: 10.1007/s00784-021-04080-7
    OBJECTIVES: To assess related studies and discuss the clinical implications of endodontic access cavity (AC) designs.

    MATERIALS AND METHODS: A systematic review of studies comparing the fracture resistance and/or endodontic outcomes between different AC designs was conducted in two electronic search databases (PubMed and Web of Science) following the PRISMA guidelines. Study selection, data extraction, and quality assessment were performed. Meta-analyses were undertaken for fracture resistance and root canal detection, with the level of significance set at 0.05 (P = 0.05).

    RESULTS: A total of 33 articles were included in this systematic review. The global evaluation of the risk of bias in the included studies was assessed as moderate, and the level of evidence was rated as low. Four types of AC designs were categorized: traditional (TradAC), conservative (ConsAC), ultraconservative (UltraAC), and truss (TrussAC). Their impact on fracture resistance, cleaning/disinfection, procedural errors, root canal detection, treatment time, apical debris extrusion, and root canal filling was discussed. Meta-analysis showed that compared to TradAC, (i) there is a significant higher fracture resistance of teeth with ConsAC, TrussAC, or ConsAC/TrussAC when all marginal ridges are preserved (P  0.05), and (iii) there is a significantly higher risk of undetected canals with ConsAC if not assisted by dental operating microscope and ultrasonic troughing (P root canal treatment quality remains a pragmatic recommendation. Different criteria can guide the practitioner for the optimal extent of AC outline form which varies from case to case.

    Matched MeSH terms: Root Canal Preparation
  18. Lin GSS, Singbal KP, Noorani TY, Penukonda R
    Odontology, 2022 Jan;110(1):106-112.
    PMID: 34269933 DOI: 10.1007/s10266-021-00643-y
    To compare the vertical root fracture (VRF) resistance of root canal-treated teeth instrumented with four different nickel-titanium (NiTi) rotary file systems and examine the dentinal crack pattern and direction using a new classification. Eighty mature mandibular premolars were selected and decoronated, leaving 13 mm of the root. The root samples were mounted in acrylic resin and divided randomly into five groups of different NiTi file systems: Group 1-control, Group 2-T-Pro, Group 3-HyFlex CM, Group 4-TG6 and lastly Group 5-ZenFlex. Samples in Group 2 and Group 3 were instrumented up to size 25/0.04, whereas Group 4 and Group 5 were instrumented up to size 25/0.06. Obturation was performed with AH Plus sealer and gutta-percha using single cone technique. Subsequently, all samples were subjected to occlusal compressive force until they were fractured. The force (N) needed to cause root fracture was recorded. The crack patterns and directions were also inspected under magnification and classified using a new and simple classification. The highest (VRF) resistance was noted in the control group (453.15 ± 92.23 N), followed by T-Pro (387.43 ± 76.81 N), HyFlex CM (381.88 ± 52.73 N), ZenFlex (369.15 ± 89.41 N) and finally TG6 (346.05 ± 72.08 N), but there was no significant difference between T-Pro and HyFlex (P = 0.438). A significantly higher prevalence (P = 0.001) of Type 1 crack pattern was observed, especially in samples instrumented with TG6. Majority of the cracks ran buccolingually except in some samples instrumented with ZenFlex (P = 0.898). Smaller file taper increased the VRF resistance of root canal-treated teeth. Majority of the dentinal crack exhibited Type 1 pattern and ran buccolingually.
    Matched MeSH terms: Root Canal Preparation
  19. Ngeow WC, Thong YL
    Int Endod J, 1998 Sep;31(5):367-71.
    PMID: 9823142
    Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.
    Matched MeSH terms: Root Canal Preparation/methods*
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