Arata Ebihara

Phase transformation behaviour and bending property of twisted nickel-titanium endodontic instruments.

AIM To investigate the relationship between phase transformation behaviour and bending property of nickel-titanium endodontic instruments manufactured by a twisting process. METHODOLOGY The phase transformation behaviour and bending property of Twisted Files (TF; SybronEndo, Orange, CA, USA) and K3 (SybronEndo) with.06 taper and size 30 tip were investigated. K3 was used as control group. Phase transformation behaviour was estimated by differential scanning calorimetry (DSC). Transformation temperatures were calculated from the DSC curve. Bending load of the instruments was measured by cantilever-bending test at 37°C. Data were analysed by Students t-test and Mann-Whitney U-test. RESULTS The phase transformation temperatures of TF were significantly higher (P<0.05) than those of K3. The bending load values were significantly lower for TF than that of K3 (P<0.05), both in the elastic and super-elastic ranges. CONCLUSIONS The new method of manufacturing NiTi instruments by twisting coupled with heat treatment might contribute to the increased phase transformation temperatures and superior flexibility.

Effect of heat treatment on transformation temperatures and bending properties of nickel–titanium endodontic instruments

AIM To investigate the effect of heat treatment on the bending properties of nickel-titanium endodontic instruments in relation to their transformation behaviour. METHODOLOGY Nickel-titanium super-elastic alloy wire (1.00 mm Ø) was processed into a conical shape with a 0.30 mm diameter tip and 0.06 taper. The heat treatment temperature was set at 440 or 500 degrees C for a period of 10 or 30 min. Nonheat-treated specimens were used as controls. The phase transformation behaviour was examined using differential scanning calorimetry. A cantilever-bending test was used to evaluate the bending properties of the specimens. Data were analyzed by ANOVA and the Tukey-Kramer test (P = 0.05). RESULTS The transformation temperature was higher for each heat treatment condition compared with the control. Two clear thermal peaks were observed for the heat treatment at 440 degrees C. The specimen heated at 440 degrees C for 30 min exhibited the highest temperatures for M(s) and A(f), with subsequently lower temperatures observed for specimens heated at 440 degrees C for 10 min, 500 degrees C for 30 min, 500 degrees C for 10 min, and control specimens. The sample heated at 440 degrees C for 30 min had the lowest bending load values (P < 0.05), both in the elastic range (0.5 mm deflection) and in the super-elastic range (2.0 mm deflection). The influence of heat treatment time was less than that of heat treatment temperature. CONCLUSIONS Change in the transformation behaviour by heat treatment may be effective in increasing the flexibility of nickel-titanium endodontic instruments.

Pulpal blood flow assessed by laser Doppler flowmetry in a tooth with a horizontal root fracture

Horizontal root fractures of both maxillary central incisors were diagnosed radiographically; neither responded to electric pulp testing nor to cold testing. The pulp of the right incisor was necrotic, whereas the pulpal status of the left incisor was uncertain. Pulpal blood flow of the teeth was measured with laser Doppler flowmetry. The blood flow of the left central incisor was 4.0. Eight months after the injury, a local anesthetic with a vasoconstrictor was administered to confirm pulp vitality. The blood flow of the tooth was decreased to 51% of the preanesthesia value after the local anesthesia. At 19 months after the injury, it responded to both the electric pulp test and cold test. Laser Doppler flowmetry is a noninvasive method of evaluating the blood flow status in human teeth, and it may provide a clinically reliable method of assessing pulpal vitality.

Heat treatment of nickel-titanium rotary endodontic instruments: effects on bending properties and shaping abilities.

AIM To evaluate the bending properties and shaping abilities of nickel-titanium endodontic instruments processed by heat treatment. METHODOLOGY K3 files were heated for 30 min at 400 °C (group 400), 450 °C (group 450) and 500 °C (group 500). Files that were not heat treated served as controls. A cantilever-bending test was used to evaluate changes in specimen flexibility caused by heat treatment. Curved root canal models were prepared. The times required for preparation, deformation and fracture were recorded. Pre- and postoperative images were superimposed. The amounts of resin removed from both the inner and the outer sides of the curvature in the apical 6 mm were determined. RESULTS In the cantilever-bending test, load values of the control group and group 500 were higher than those of groups 400 and 450 at the elastic range (P<0.05). At the superelastic range, the bending load of the control group was the highest amongst all groups (P<0.05). Regarding shaping ability, in the control group, root canals at the apex were transported more to the outer side of the curvature compared with those of all heat-treated groups (P<0.05). Root canals of group 400 at 3 mm from the apex were transported less compared with those of other groups (P<0.05). No significant difference was found in working time amongst the groups. In group 450, there was no plastic deformation or fracture of the file. CONCLUSIONS Heat treatment of files might improve their flexibility, making them more effective for preparation of curved canals.

Detection of a second mesiobuccal canal in maxillary molars by swept-source optical coherence tomography.

INTRODUCTION The purpose of this study was to investigate the ability of swept-source optical coherence tomographic (SS-OCT) imaging to detect a second mesiobuccal canal (MB2) in maxillary molars compared with visual inspection (VI) and dental operating microscopy (DOM). METHODS Forty extracted human maxillary molars were examined. After the removal of half the crown and access cavity preparation, the existence of MB2 canals was confirmed based on cross-sectional images of each tooth obtained by micro-computed tomographic scanning as the reference standard. Then, the pulp chamber floor was scanned by SS-OCT imaging. Three dentists independently evaluated the SS-OCT images and the pulp chamber floor under VI and DOM for the presence of MB2 canals. The detection rate of MB2 canals for SS-OCT imaging, VI, and DOM was calculated, and statistical analysis was performed. RESULTS MB2 canals existed in 19 of 40 teeth (47.5%) using micro-CT imaging. Sensitivity of DOM (0.947) was significantly higher than that of SS-OCT imaging (0.632). Specificity of SS-OCT imaging (0.714) was significantly higher than that of DOM (0.333). No statistically significant differences were found for accuracy among the 3 methods. Kappa values of SS-OCT, VI, and DOM were 0.526, 0.417, and 0.326, respectively. CONCLUSIONS SS-OCT imaging is noninvasive, involves no ionizing radiation, and is accurate for the detection of MB2 canals.

Detection of root surface fractures with swept-source optical coherence tomography (SS-OCT).

OBJECTIVE The purpose of this study was to compare optical coherence tomography (OCT) with the existing technologies, to assess its accuracy and utility in detecting vertical root fractures of extracted human teeth. BACKGROUND DATA The detection of root fractures in teeth that have undergone root canal treatment is challenging because of the great difficulty in differentiating these fractures from morphologic or radiographic anomalies. OCT methods are based on depth-resolved optical reflectivity and have been developed to reduce the invasiveness and radiation exposure inherent to other techniques. METHODS Twelve extracted human mandibular teeth (totaling 25 roots) that were free of caries, calculus, and root treatment were used, and assessed by microfocus computed tomography, the current gold standard for fracture detection. The ability of appropriately trained observers to detect root fractures using visual, microscopic, and swept-source OCT (SS-OCT) techniques were compared. micro-CT and SS-OCT produce three-dimensional images of the tooth from which to diagnose fractures, but CT scanning involves radiation exposure that is not required in SS-OCT. RESULTS Seventeen of the 25 roots were found to have fractures by microfocus CT. These findings were replicated by SS-OCT, which revealed fractures exhibiting identical origin, size, and angulation within the root. We found that SS-OCT gave results compatible to the gold standard technique, and that SS-OCT and microscopy were more effective for identifying root fractures than was visual observation alone. CONCLUSIONS SS-OCT may represent a novel, noninvasive, noncontact and nonexposure alternative to the conventional methods used for assessing root fractures in teeth.

Nano-indentation testing of new and fractured nickel-titanium endodontic instruments

AIM To investigate the effect of cyclic fatigue on nickel-titanium (NiTi) endodontic instruments using a nano-indentation test. METHODOLOGY Eight ProFile NiTi rotary instruments (size 30, taper 0.06; Dentsply Maillefer, Ballaigues, Switzerland) were tested using a cyclic fatigue set-up until fracture. The fractured instruments and eight new NiTi instruments of the same size and taper were used for a nano-indentation test on the internal surfaces of a NiTi instruments in the region just adjacent to their fractured edge (group I) and in the same region of the new group (group II), and the cutting part beside the shaft for both instruments [group III (fractured) and group IV (new)]. Data were statistically analyzed using one-way analysis of variance and Games-Howell post hoc test. The alpha-type error was set at 0.05. RESULTS Significant differences in terms of hardness and elastic modulus for each group (P < 0.05) were found, with group I having the lowest mean values followed by group III. Additionally, standard deviations increased remarkably after failure, as represented by groups I and III. CONCLUSION The nano-indentation technique can be applied to determine the performance and the failure mechanism of NiTi instruments. The fatigue process revealed a significant decrease in the hardness and elastic modulus of the NiTi instrument. As indicated by the low hardness, the fatigue process did not result in work hardening but rather work softening.

Shaping ability of ProTaper NEXT, ProTaper Universal and iRace files in simulated S‐shaped canals

The aim of this study was to determine the shaping ability of three nickel-titanium endodontic file systems by comparing three parameters: canal deviation, apical foramen position and instrumentation time. A glide path was established in 30 simulated S-shaped canal blocks that were randomly assigned into three groups (n = 10): ProTaper Universal, ProTaper NEXT and iRace. Each group was instrumented per its manufacturers directions. Pre- and postoperative images were superimposed to determine any canal deviation or change in apical foramen position. The instrumentation times were recorded. The iRace system resulted in the least mean canal deviation. The apical foramen position was least shifted by the iRace system. The iRace system also required the least instrumentation time. The iRace system demonstrated the most favourable shaping ability in all three parameters.

Application of optical coherence tomography to identify pulp exposure during access cavity preparation using an Er:YAG laser.

OBJECTIVE The study aimed to evaluate the ability of optical coherence tomography (OCT) to guide and identify pulp exposure using an erbium: yttrium-aluminum-garnet (Er:YAG) laser. BACKGROUND DATA The Er:YAG laser has been proven to be effective in ablating dental hard tissue and offers advantages, as there is none of the vibration and noise you get with conventional methods, but it has limitations in relation to the tactile feedback that would aid in identification of entry into the pulp chamber. Based on depth-resolved optical reflectivity, OCT technology has been developed to provide high-resolution, cross-sectional images of the internal structure of biological tissues. MATERIALS AND METHODS The pulp chambers of 20 human mandibular incisors were examined, and the average thickness of hard tissue covering the pulp chamber was assessed using micro-computed tomography (micro-CT) images. An Er:YAG laser was used to gradually penetrate the hard tissue over the pulp chamber under microscopic guidance. The preparation was constantly imaged using a swept-source OCT at 10 sec intervals until a pulp chamber exposure was identified using the technology. The pulp exposure was re-examined under the microscope and compared with micro-CT images for verification. RESULTS The pulp exposures of 20 incisors were all verified microscopically and with micro-CT images. The thickness of hard tissue penetrated by the laser ranged from 0.44 to 1.69 mm. CONCLUSIONS Swept-source OCT is a useful tool for identifying pulp exposure during access opening with the Er: YAG laser.

Pulpal reaction in dogs following cavity preparation by Er:YAG laser

A histopathological study was performed on the tooth pulp of mongrel dogs after cavity preparation using the conventional high speed method (control group) and the newly developed Er:YAG laser system (laser group, output energy: 100 mJ, 150 mJ, and 200 mJ/pulse). All samples were divided into two groups (deep cavity and shallow cavity) according to the remaining dentin thickness (RDT) and histopathologically evaluated. After 1, 2, 4, 7 and 28 days postoperatively, there was no histopathological difference between the control group and the laser group. Er:YAG laser irradiation with three different output energies made little difference in the degree of pulpal damage. In the deep cavities, damage of the pulp was more remarkable than the shallow cavities in all groups. The efficacy of cutting rate in the laser group was not very different from the control group.