Alfredo Iandolo

Thermafil: A New Clinical Approach Due to New Dimensional Evaluations

Background: There are a lot of techniques to obturate the root canals, but lateral condensation of gutta-percha is the most used one. An important aspect of thermafil is the error margin tolerated by the manufacturer in the production of plastic carriers. In literature, there is no evidence about discrepancy percentage between different carriers. It is demonstrated that the error margin of gutta-percha is 0.5% and is 0.2% for metal files (ISO standards). Objective: The aim of this study was to evaluate the real dimensions of thermafil plastic carriers observed by the stereo microscope measuring the dimensional discrepancy between them. Methods: For this study, 80 new thermafil (Dentsply Maillefer) have been selected. 40 thermafil 0.25 and 40 thermafil 0.30. Through 60X stereo microscope, the dimensions of the plastic carrier tips have been measured. The dimensions of the plastic carrier were also measured after a heating cycle. ZL GAL 11TUSM (Zetaline stereo evolution) microscope was used to observe the samples. Measurements were made through a dedicated software (Image Focus). All samples were analysed at 60X. Results: A non-parametric paired test (Wilcoxon test) was used to compare baseline and after heating values; p-values ≤ 0.05 were assumed to be statistically significant. Conclusion: The samples we measured showed a mean value of the diameters in Thermafil 25 that was 0.27 mm, for Thermafil 30 the mean value was 0.33 mm. We have measured a dimensional variable of 8% in the 25 group while in group 30 the maximum possible variation found was 4%, that’s why we propose a new protocol of obturation with thermafil. We can also conclude that a single heating process does not affect clinically the plastic carrier dimensions.

The IG- file use to Gauge the Apical Diameter in Endodontics: An In Vitro Study

Aim: The aim of this study was to evaluate the efficacy of the IG-file, a new instrument designed for apical diameter gauging. Materials and Methods: After shaping with F1 Universal Protaper, 60 roots were randomly divided into two groups and assigned to two operators, One Expert in Endodontics (EO) and One Unexpert (UO). In each sample, after canal curvatures have been detected, the apical diameters were measured with the IG-file and the K-NiTi. The results were compared with the reference value obtained by retrograde apical gauging. The data were statistically analyzed. Results: Among 60 samples, 10% of errors were recorded when the IG-files were used; in the K-NiTi group the incorrect measurements were 70%. In both groups (expert and unexpert) the IG-file measurements were more accurate than the K-NiTi (90 vs 33 and 90 vs 26,7). The differences were statistically significant. In curved canals, the difference between measurement rates performed with both instruments was statistically significant (85,7% IG-file vs 28,6% K-NiTi) as well as for the samples without curvatures (92,3% IG file vs 30,8% NiTi file). In root canals without curvatures overestimation errors in K-NiTi file group are more frequent than underestimation errors. This difference was statistically significant. Conclusion: A proper gauging of the apical diameter has a key role in endodontic therapy; an incorrect measurement can lead to clinical failures. This “in vitro” study highlights that IG-file improves measurement accuracy independently from clinician experience. Furthermore, in curved canals, the IG-file is more accurate than K-NiTi.

Evaluation of the Actual Chlorine Concentration and the Required Time for Pulp Dissolution Using Different Naocl Irrigating Solutions

1 Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples, Federico II, Naples, Italy 2 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences Section of Dentistry, Endodontic Unit, University of Pavia, Italy 3 Department of Medicine and Surgery, University of Salerno, Salerno, Italy 4 Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt

An in vitro evaluation of the degree of pulp tissue dissolution through different root canal irrigation protocols

Aim: The aim of this study is to evaluate in vitro, using artificial lateral canals, the rate of dissolution of the pulp tissue through different protocols of canal irrigation. Materials and Methods: One hundred artificial canals provided with lateral canals have been used. Each lateral canal was filled with pulp tissue and calibrated to 0.002 mg. All canals were irrigated using five different protocols. Five groups have been used for the experiment: Group A, distilled water (control); Group B, preheated NaOCl; Group C, NaOCl heated inside the canal; Group D, NaOCl ultrasonically activated; and Group E, NaOCl heated inside the canal with ultrasonic activation. All samples were weighed through professional microbalance in three different phases: before insertion of the pulp tissue into the lateral canal, after insertion of the pulp tissue and, finally, after different protocols of irrigation. A statistical analysis with Kruskal–Wallis test and Mann–Whitney test was performed. Results: The partial dissolution of the pulp tissue inside the artificial lateral canal occurs only using the protocol with NaOCl heated inside the canal with ultrasonic activation. Other irrigation protocols are not able to dissolve the pulp tissue. Discussion and Conclusions: The main objective of endodontic therapy is the removal of damaged tissues and bacteria. Modern literature highlights that it is impossible to remove all the pulp tissues and bacteria from the whole endodontic space. Hence, to achieve excellence and get positive results in the short and long term, it is necessary to use techniques and technologies that may increase the degree of root canal detersion.