scholarly journals Root canal curvature as a prognostic factor influencing the diagnostic accuracy of radiographic working length determination and postoperative canal axis modification: an in vitro comparative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bestoon Mohammed Faraj

Abstract Background Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique. Methods Radiographic image analysis was performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10°–25°) and severe canal curvature (26°–70°). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real canal length was determined by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland). Results There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P > 0.05). Conclusions A standardized digital periapical radiographic method performed similarly to the CBCT technique near to its true working length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.

2021 ◽  
Author(s):  
Bestoon Faraj

Abstract Background: Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique. Methods: Radiographic image analysis were performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10-25o) and severe canal curvature (26-70o). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real working length was established by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland). Results: There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P >0.05). Conclusion:  A standardized digital periapical radiographic method performed similarly to the CBCT technique closest to its real canal length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.


2020 ◽  
Author(s):  
Bestoon Mohammed Faraj

Abstract Background: An accurate estimation of the working canal length is essential for successful root canal treatment. This study aimed to investigate the diagnostic accuracy of root canal length estimation on cone-beam computed tomography (CBCT) scans and digital paralleling radiographs (PAs), using the real canal length as a gold standard, and to evaluate the influence of canal curvature on this estimation. Methods: Sixty extracted human premolar teeth selected for this study. Root canal length measurement performed on CBCT scans (NewTom, Giano, Verona, Italy) and digital paralleling radiography (EzRay Air W; Vatech, Korea). The real working length established by subtracting 0.5 mm from the actual canal length. Results: No significant difference was found between CBCT and digital paralleling radiography. There was a tendency for underestimation of the root canal length measured on the CBCT images in 52 (86.7%) of the examined teeth and overestimated it in 5 teeth (8.3%). All the digital radiographs slightly overestimated the real canal length. The analysis revealed a strong correlation between the estimation from moderate to severe curvature for digital radiography, and CBCT images. Conclusion: Preoperative working length estimation can be made closest to its real clinical canal length on the standardized paralleling technique, using a long (16-inch) target–receptor distance.


2020 ◽  
Vol 8 (02) ◽  
pp. 44-48
Author(s):  
Niharika Patalbansi ◽  
Yogesh Kumar ◽  
Neetu Jindal ◽  
Renu Aggarwal ◽  
Shefali Goyal

Abstract Introduction The establishment of accurate working length is one of the most critical steps in endodontic therapy from the biomechanical and obturation points of view. Traditionally, the use of radiography and tactile sense methods were used for working length estimation, but recently, the use of electronic apex locator (EAL) has come into existence. The aim was to evaluate the effect of conventional and herbal irrigants on working length determination by Root ZX. Materials and Methods A total of 110 extracted single rooted teeth were taken. Standard access cavities were prepared and samples were randomly divided into 11 groups (n = 10) according to the type of irrigating solutions used. The actual root canal length was measured, and the readings in dry conditions and wet conditions were recorded. The point where Root ZX showed beep was recorded and difference was recorded as well. The recorded data was calculated and statistically analyzed using unpaired t-test. Result In dry conditions, only saline, H2O2, Aloe vera, and green tea gave exact working length using apex locator values. Whereas in wet conditions, only Aloe vera and green tea gave exact working length. Conclusion Although the irrigants and dry conditions influenced the results, Root ZX can be considered to be accurate, and the difference was within the clinically acceptable range and not statistically significant.


2005 ◽  
Vol 6 (3) ◽  
pp. 53-61 ◽  
Author(s):  
Hanan Balto ◽  
Saad Al-Nazhan ◽  
Khulood Al-Mansour ◽  
Moneera Al-Otaibi ◽  
Yunus Siddiqu

Abstract The aim of this study was to evaluate the integrity of the coronal seal of Temp-Bond and compare it to Cavit and IRM after post space preparation using S. faecalis as a microbial tracer. In addition, the affect of two methods of gutta percha removal on the apical seal of root canal fillings was also evaluated. Forty extracted human single rooted teeth were prepared chemomechanically and obturated with gutta percha and AH26 sealer cement using the lateral cold condensation technique to a standardized working length of 15 mm. About 10 mm of the coronal gutta-percha was removed with either Peeso-reamer or a hot plugger. The roots were divided into three experimental groups of 10 roots and a control group. Each experimental group was subdivided equally into two groups of 15 each according to the method of post space preparation. Cavit, IRM, and Temp-Bond were used to seal the access opening. Each root was fixed in a cuvette containing Tryptic Soya Broth which, covered 2 mm of the root apex. Bacterial suspension was introduced through pipette. Fresh bacterial suspension was added every week, and the system was monitored daily for the growth of microorganisms for a period of one month. The results showed there was no significant difference in terms of coronal leakage between the three coronal materials used (P=0.478), but the methods of gutta-percha removal did have an impact on the apical leakage (P=0.047). The mean value showed the Peeso-reamer provided less leakage compared to using a hot plugger during the 30-day experimental time period. It was concluded the temporary type of coronal seal of endodontically treated teeth will not prevent coronal leakage if left for a long period of time. In addition, permanent cementation of the post with the coronal restoration should be carried out as soon as possible to prevent recontamination of the root canal. Citation Balto H, Al-Nazhan S, Al-Mansour K, Al-Otaibi M, Siddiqu Y. Microbial Leakage of Cavit, IRM, and Temp Bond in Post-prepared Root Canals Using Two Methods of Gutta-percha Removal: An In Vitro Study. J Contemp Dent Pract 2005 August;(6)3:053-061.


2007 ◽  
Vol 18 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Orlando Limongi ◽  
Diana Santana de Albuquerque ◽  
Flares Baratto Filho ◽  
José Roberto Vanni ◽  
Elias P. Motcy de Oliveira ◽  
...  

This in vitro study compared, using computed tomography (CT), the amount of dentin removed from root canal walls by manual and mechanical rotary instrumentation techniques. Forty mandibular incisors with dental crown and a single canal were selected. The teeth were randomly assigned to two groups, according to the technique used for root canal preparation: Group I - manual instrumentation with stainless steel files; Group II - mechanical instrumentation with RaCe rotary nickel-titanium instruments. In each tooth, root dentin thickness of the buccal, lingual, mesial and distal surfaces in the apical, middle and cervical thirds of the canal was measured (in mm) using a multislice CT scanner (Siemens Emotion, Duo). Data were stored in the SPSS v. 11.5 and SigmaPlot 2001 v. 7.101 softwares. After crown opening, working length was determined, root canals were instrumented and new CT scans were taken for assessment of root dentin thickness. Pre- and post-instrumentation data were compared and analyzed statistically by ANOVA and Tukey's post-hoc test for significant differences (p=0.05). Based on the findings of this study, it may be concluded that regarding dentin removal from root canal walls during instrumentation, neither of the techniques can be considered more effective than the other.


2019 ◽  
Vol 10 (5) ◽  
pp. S23-S29 ◽  
Author(s):  
Mohammad Asnaashari ◽  
Mohammad Jafar Eghbal ◽  
Amirali Sahba Yaghmayi ◽  
Mehdi Shokri ◽  
Saranaz Azari-Marhabi

Introduction: A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect the root canal is Enterococcus faecalis. This study seeks to examine the effectiveness of 3 methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP), and calcium hydroxide. Methods: Sixty-two single-rooted extracted anterior teeth were collected. After cleaning and disinfecting the teeth, their crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 ProTaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121°C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing E. faecalis for 21 days. Then the samples were divided into 5 groups: 2 positive control groups, 1 group treated with the antibiotic paste with the concentration of 1 mg/mL, 1 group treated with calcium hydroxide, and 1 group treated with photodynamic therapy. Then, to collect the biofilm, the ProTaper file F4 was used. After that, the microbial suspension was provided and counting the colonies was carried out to compare the groups. Results: The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole, ciprofloxacin in the concentration of 1 mg/mL and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%. Conclusion: Using photodynamic therapy causes a reduction in the biofilm and inhibits the growth of the E. faecalis bacterium. In addition, in this study, MTAP with a concentration of 1 mg/mL was used, which expunged the bacteria completely. Meanwhile, calcium hydroxide had the weakest effect of all on the E. faecalis bacterium.


2020 ◽  
Vol 14 (04) ◽  
pp. 626-633 ◽  
Author(s):  
Asmaa Alakshar ◽  
Abdul Rahman Mohammed Saleh ◽  
Mehmet Omer Gorduysus

Abstract Objective This study aimed to assess and compare XP-Endo Finisher (XP) cleaning efficiency with respect to the amount of remaining debris and smear layer versus Max-I-Probe needle (CI), EndoActivator device (EA), and combination of XP-Endo Finisher file with EndoActivator device (XP+EA) in oval root canals. Materials and Methods This in vitro study was performed on 36 extracted single root/canal mandibular premolars. Radiographic images were taken in buccolingual and mesiodistal projections to evaluate the shape of the root canal and determine whether it met exclusion criteria. All teeth were decoronated and prepared using Reciproc (R40). The samples were divided randomly into four groups: CI, EA, XP, and XP + EA. The root canals were irrigated with 5 mL of 17% EDTA and 2.5% NaOCl, respectively. Apart from the CI group, both solutions were activated by using the tested techniques for 1 minute.The teeth were split longitudinally, and the best visible identified sections of the roots were used as the representing samples for scanning electron microscope (SEM) evaluation. Each half was divided into the following three parts: 1 mm from the anatomic apex and a standardized photomicrograph with 500x and 1500x magnifications for debris and smear layer were obtained. A five-grade scoring system was utilized to quantify the results at the coronal, middle, and apical regions. Statistical analysis was performed by using the Kruskal–Wallis and Mann–Whitney U tests. Results Group differences in debris and smear layer scores were found statistically significant for all locations as well as for overall assessment, except for the coronal third. Intragroup comparison of debris and smear layer in CI, EA, and XP had the minimum score at the middle third, with no significant difference compared with the coronal and apical thirds. XP + EA had less debris and smear layer score at the coronal third, significantly different from apical third.CI and EA had less debris and smear layer compared with XP and XP + EA at all locations with a significant difference at the middle and apical third (p < 0.05). Conclusion EA and CI showed less debris and smear layer than XP and XP + EA in the middle and apical third. The use of the XP in conjunction with the present irrigation protocol failed to have debris-free dentin surface in the apical portion of most of the root canals.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bestoon Mohammed Faraj

An accurate estimation of the working canal length is essential for successful root canal treatment. This study is aimed at investigating the diagnostic accuracy of root canal length estimation on cone-beam computed tomography (CBCT) scans and digital paralleling radiographs (PAs), using the real canal length as a gold standard, and at evaluating the influence of canal curvature on this estimation. Sixty extracted human premolar teeth were selected for this study. Root canal length measurement was performed on CBCT scans (NewTom, Giano, Verona, Italy) and digital paralleling radiography (EzRay Air W; Vatech, Korea). The real working length was established by subtracting 0.5 mm from the actual canal length. No significant difference was found between CBCT and digital paralleling radiography. There was a tendency for underestimation of the root canal length measured on the CBCT images in 52 (86.7%) of the examined teeth and overestimation in 5 teeth (8.3%). All the digital radiographs slightly overestimated the real canal length. The analysis revealed a strong correlation between the estimation from moderate to severe curvature for digital radiography and CBCT images. Preoperative working length estimation can be made closest to its real clinical canal length on the standardized paralleling technique, using a long (16-inch) target-receptor distance.


2007 ◽  
Vol 21 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Isa Geralda Teixeira Constante ◽  
Harry Davidowicz ◽  
Fernando Branco Barletta ◽  
Abilio Albuquerque Maranhão de Moura

The purpose of this study was to compare, in vitro, by means of computerized analysis of digital radiographic images, the anatomic alterations produced in the mandibular molar tooth dentinal walls of mesiobucal canals with severe curvature by three different endodontic techniques: Progressive Preparation, Staged and Serial Preparation. A selection was made of 45 extracted, human, mandibular molars, with root curvatures greater than 25°. They were divided into three groups for every technique studied, which were then sub-divided into three sub-groups in accordance with the position of the curvature along the root: cervical, median or apical. After access surgery and tooth length determination, the canals were filled with 100% Barium Sulphate radiological contrast and the teeth were then radiographed with a direct digital radiography system, using a special apparatus capable of keeping the samples in the same spatial position during the different radiographic takes. After the above-mentioned endodontic techniques had been performed, the teeth were again filled with Barium sulphate and were also radiographed under the same previously mentioned conditions. The pre- and post-operative digital images were then analyzed in two computerized programs, AutoCAD 2004 and CorelDraw 10, to assess, respectively, the areas and the horizontal alterations which occurred in the internal and external walls of the root canals. The results indicated that although no significant differences among the techniques were shown in the statistical analysis, in a descriptive analysis the Progressive Preparation technique was shown to be more regular, uniform and effective.


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