Alfred Naaman

Comparison of Canal Transportation and Centering Ability of Twisted Files, Pathfile-ProTaper System, and Stainless Steel Hand K-Files by Using Computed Tomography

INTRODUCTION The purpose of this study was to compare canal transportation and centering ability of 2 rotary nickel-titanium (NiTi) systems (Twisted Files [TF] and Pathfile-ProTaper [PP]) with conventional stainless steel K-files. METHODS Ninety root canals with severe curvature and short radius were selected. Canals were divided randomly into 3 groups of 30 each. After preparation with TF, PP, and stainless steel files, the amount of transportation that occurred was assessed by using computed tomography. Three sections from apical, mid-root, and coronal levels of the canal were recorded. Amount of transportation and centering ability were assessed. The 3 groups were statistically compared with analysis of variance and Tukey honestly significant difference test. RESULTS Less transportation and better centering ability occurred with TF rotary instruments (P < .0001). K-files showed the highest transportation followed by PP system. PP system showed significant transportation when compared with TF (P < .0001). CONCLUSIONS The TF system was found to be the best for all variables measured in this study.

Cyclic fatigue analysis of twisted file rotary NiTi instruments used in reciprocating motion.

AIM To evaluate the cyclic fatigue fracture resistance of engine-driven twisted file (TF) instruments under reciprocating movement. METHODOLOGY A sample of 30 size 25, 0.08 taper NiTi TF instruments was tested in a simulated canal with 60˚ angle of curvature and a 3 mm radius. During mechanical testing, different movement kinematics were used at a constant speed, which resulted in three experimental groups (each group n = 10). The instruments from the first group (G1) were rotated until fracture occurred. The instruments in the second (G2) and third group (G3) were driven under reciprocating movement with different angles of reciprocation. The time of fracture for each instrument was measured, and statistical analysis was performed using one-way analysis of variance followed by Tukeys Honestly Significant Different test. RESULTS Reciprocating movement resulted in a significantly longer cyclic fatigue life (P < 0.0001) when compared with continuous rotation. No difference was found between reciprocation 150° clockwise/30° counterclockwise (CW/CCW) and 30° CW/150° CCW. CONCLUSIONS The reciprocating movement was associated with an extended cyclic fatigue life of the TF size 0.25, 0.08 taper instruments in comparison with conventional rotation.

Irrigant Flow beyond the Insertion Depth of an Ultrasonically Oscillating File in Straight and Curved Root Canals: Visualization and Cleaning Efficacy

INTRODUCTION The purpose of this study was to evaluate the influence of the insertion depth of an ultrasonically oscillating file on the ability to remove dentin debris from simulated canal irregularities in an extracted tooth model of a straight root canal and its influence on the flow of irrigant in both straight and curved canals. METHODS A tooth model with artificial depressions in 1 canal wall at 0.5, 2, 4, and 6 mm from the working length was used. Ultrasonic-activated irrigation was performed with the file inserted 1, 2, 3, 4, or 5 mm short of the working length. Dye penetration and high-speed recordings of the flow in straight and curved canals showed the static and dynamic behavior of the flow during ultrasonic activation. RESULTS The overall cleaning efficacy decreased with increasing distance between the file and the apex, with the depressions next to the file and within 3 mm in front of the file being the cleanest. The flow observed from the visualization experiments matched this distance, suggesting a direct relation between flow and cleaning. The observed flow depth increased with increasing power setting; the curvature of the root canal had no influence on the flow depth. High-speed imaging showed a start-up phase with deeper fluid activation than in the steady phase afterward. CONCLUSIONS The ultrasonically oscillating file could remove dentin debris up to 3 mm in front of the file tip, coinciding with the extent of the observed flow. The root canal curvature had no influence on the irrigant flow.

Properties of Tricalcium Silicate Sealers.

INTRODUCTION Sealers based on tricalcium silicate cement aim at an interaction of the sealer with the root canal wall, alkalinity with potential antimicrobial activity, and the ability to set in a wet field. The aim of this study was to characterize and investigate the properties of a new tricalcium silicate-based sealer and verify its compliance to ISO 6876 (2012). METHODS A new tricalcium silicate-based sealer (Bio MM; St Joseph University, Beirut, Lebanon), BioRoot RCS (Septodont, St Maure de Fosses, France), and AH Plus (Dentsply, DeTrey, Konstanz, Germany) were investigated. Characterization using scanning electron microscopy, energy-dispersive spectroscopy, and X-ray diffraction analysis was performed. Furthermore, sealer setting time, flow, film thickness, and radiopacity were performed following ISO specifications. pH and ion leaching in solution were assessed by pH analysis and inductively coupled plasma. RESULTS Bio MM and BioRoot RCS were both composed of tricalcium silicate and tantalum oxide in Bio MM and zirconium oxide in BioRoot RCS. In addition, the Bio MM contained calcium carbonate and a phosphate phase. The inorganic components of AH Plus were calcium tungstate and zirconium oxide. AH Plus complied with the ISO norms for both flow and film thickness. BioRoot RCS and Bio MM exhibited a lower flow and a higher film thickness than that specified for sealer cements in ISO 6876. All test sealers exhibited adequate radiopacity. CONCLUSIONS Bio MM interacted with physiologic solution, thus showing potential for bioactivity. Sealer properties were acceptable and comparable with other sealers available clinically.

Dentinal crack formation during root canal preparations by the twisted file adaptive, Reciproc and WaveOne instruments

Objective: This study aimed to compare the frequency of dentinal microcracks after root canal shaping with 2 reciprocating (Reciproc and WaveOne) and 1 combined continuous reciprocating motion twisted files adaptive (TFA) rotary system.Materials and Methods: Ninety molars were chosen and divided into three groups of 30 each. Root canal preparation was achieved by using Reciproc R25, Primary WaveOne and TFA systems. All the roots were horizontally sectioned at 15, 9, and 3 mm from the apex. The slices were then viewed each under a microscope at × 25 magnification to determine the presence of cracks. The absence/presence of cracks was recorded, and the data were analyzed with a Chi-square test. The significance level was set at P < 0.05. Results: Instrumentation with Reciproc produced significantly more complete cracks than WaveOne and TFA (P = 0.032). The TFA system produced significantly less cracks then the Reciproc and WaveOne systems apically (P = 0.004). Conclusions: Within the limits of this study, the TFA system caused less cracks then the full reciprocating system (Reciproc and WaveOne). Single-file reciprocating files produced significantly more incomplete dentinal cracks than full-sequence adaptive rotary motion.

Quantitative volumetric analysis of cross-linked gutta-percha obturators

AIM The purpose of this study was to evaluate the effects of technique on the filling quality of 2 recently introduced obturation systems comparatively with warm vertical compaction using micro-computed tomography. METHODS 36 single-rooted teeth were selected, root canals prepared, and assigned to 3 groups (n=12), according to the filling technique: warm vertical compaction technique WVC, GuttaCore (Dentsply Tulsa Dental Specialties, Tulsa, OK) and Gutta Fusion (VDW, Germany). Each specimen was scanned using a micro-CT. Percentage of voids was calculated and data statistically analyzed using Kruskal Wallis test with a significance level of 5%. RESULTS All obturations showed satisfactory similar results at the apical level. Differences between the three obturation methods were not significant at 1 mm (-p-value >0.05), 3 mm (-p-value >0.05) and 5 mm (-p-value >0.05). No root fillings were void-free. No significant difference was found between the WVC technique, the GuttaCore technique and the Gutta Fusion technique concerning percentage of apical voids regardless of canal level. CONCLUSION This study shows the efficiency of cross-linked obturators in filling root canals hermetically by comparing them to the warm vertical compaction technique. Results show that these obturation techniques were equally sufficient concerning apical adaptation making them appropriate to use in endodontic obturations.

Taper Preparation Variability Compared to Current Taper Standards Using Computed Tomography

Introduction. The purpose of this study was to compare the taper variation in root canal preparations among Twisted Files and PathFiles-ProTaper .08 tapered rotary files to current standards. Methods. 60 root canals with severe angle of curvature (between 25° and 35°) and short radius (r < 10 mm) were selected. The canals were divided randomly into two groups of 30 each. After preparation with Twisted Files and PathFiles-ProTaper to size 25 taper .08, the diameter was measured using computed tomography (CT) at 1, 3, and 16 mm. Canal taper preparation was calculated at the apical third and at the middle-cervical third. Results. Of the 2 file systems, both fell within the ±.05 taper variability. All preparations demonstrated variability when compared to the nominal taper .08. In the apical third, mean taper was significantly different between TF and PathFiles-ProTaper (P value < 0.0001; independent t-test). Mean Taper was significantly higher with PathFile-ProTaper. In the middle-cervical third, mean Taper was significantly higher with TF (P value = 0.015; independent t-test). Conclusion. Taper preparations of the investigated size 25 taper .08 were favorable but different from the nominal taper.