Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars

2021 ◽  
pp. 20200503
Author(s):  
Clarissa Teles Rodrigues ◽  
Reinhilde Jacobs ◽  
Karla Faria Vasconcelos ◽  
Paul Lambrechts ◽  
Izabel Regina Fisher Rubira-Bullen ◽  
...  
Keyword(s):  
Cone Beam Ct ◽  
Wilcoxon Test ◽  
Reference Image ◽  
Filling Material ◽  
Beam Hardening ◽  
Root Canal Filling ◽  
Voxel Size ◽  
Root Canals ◽  
Significant Difference ◽  
Diagnostic Values

Objectives: To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. Methods: 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. Results: For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. Conclusions: Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.

scholarly journals Apical Transportation and Centering Ability After Root Canal Filling Removal Using Reciprocating and Continuous Rotary Systems: A CBCT Study

2019 ◽  
Vol 13 (04) ◽  
pp. 613-618 ◽  
Author(s):  
Etienny da Silva Arruda ◽  
Emílio Carlos Sponchiado-Júnior ◽  
Mariana Travi Pandolfo ◽  
Márcio Acris de Carvalho Fredson ◽  
Lucas da Fonseca Roberi Garcia ◽  
...  
Keyword(s):  
Root Canal ◽  
Material Removal ◽  
Filling Material ◽  
Root Canal Filling ◽  
Universal System ◽  
Root Canals ◽  
Computed Tomographic ◽  
Apical Transportation ◽  
Significant Difference ◽  
Before And After

Abstract Objective To evaluate the apical transportation and centering ability promoted by reciprocating and continuous rotary systems after root canal filling removal. Materials and Methods After obturation, 40 mesial root canals of mandibular molars were distributed into four groups (n = 20) for filling material removal: PTU group–F2 instrument (25.08) of ProTaper Universal system; R25 group–R25 instrument (25.08) of Reciproc system; X2 group–X2 instrument (25.06) of ProTaper Next system and X3 group–X2 instrument (25.06) of ProTaper Next system, followed by X3 instrument (30.07). Cone-beam computed tomographic analysis was performed before and after filling material removal for acquisition of apical images. Apical transportation (AT) and its direction, and centering ability (CA), were assessed using the equations AT = (X1–X2)–(Y1–Y2) and CA = (X1–X2/Y1–Y2 or Y1–Y2/X1–X2), respectively. Data were submitted to the nonparametric Kruskal–Wallis and Dunn multiple comparison tests (p < 0.05) for statistical analysis. Results There was no statistically significant difference among groups for AT (p > 0.05), with a tendency toward transportation in the distal direction. Also, there was no statistically significant difference among groups regarding CA (p > 0.05). Conclusions The different systems, including ProTaper Next, caused AT within the acceptable clinical limit after filling removal. In addition, none of the tested systems presented adequate CA.

scholarly journals A Digital Microscopic Inspection of Dentinal Defects after Using Endodontic Retreatment Files

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ammar AbuMostafa ◽  
Hala Almoqayyad ◽  
Al-Omari Mohammad
Keyword(s):  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Control Group ◽  
Filling Material ◽  
Root Canals ◽  
Root Canal Retreatment ◽  
Significant Difference ◽  
Digital Microscope ◽  
Microscopic Inspection

Aim. The study aimed at evaluating the incidence of dentinal defects after root canal retreatment with ProTaper Universal retreatment (PTUR) and XP-endo Shaper and Finisher R (XP). Materials and Methods. Sixty extracted single-rooted human premolars were selected and divided into 4 groups of 15 teeth each. In the negative control group, the teeth were left unprepared. In the positive control group, the teeth were prepared with ProTaper Next and obturated with no further retreatment. In the PTUR and XP groups, the teeth were prepared and obturated followed by removal of the filling material at body temperature using PTUR and XP instruments, respectively. The roots were then sectioned at 3, 6, and 9 mm from the apex and observed under a digital microscope to detect defects. Results. PTUR group showed significantly higher ( p value <0.05) incidence of defects than the other groups. Comparison of no defects versus defects between groups in different areas of root canals demonstrated significant difference among the groups in the apical and cervical regions. Conclusion. Within the limitations of the present study, PTUR files created significantly more dentinal defects than XP files, with most of those defects at the cervical and apical areas of the root canals.

scholarly journals Efficacy Of Two NI-TI Retreatment Systems and Hand Files in Removing Gutta-Percha and Sealer From Root Canals Filled With Three Different Types of Sealers

2015 ◽  
Vol 03 (02) ◽  
pp. 071-079
Author(s):  
Rajender Singh ◽  
Ashu Gupta ◽  
Vishal Sharma
Keyword(s):  
Operating Time ◽  
Filling Material ◽  
Test Results ◽  
Root Canals ◽  
Gutta Percha ◽  
Honestly Significant Difference ◽  
Working Length ◽  
Significant Difference ◽  
Hand Instrumentation ◽  
Difference Test

Abstract Objectives: This study was undertaken to evaluate the efficiency of two rotary nickel titanium instruments and hand instrumentation in removing gutta-percha and sealer from root canals. Study design: – 63 extracted human single rooted premolars were instrumented with K-files and filled using lateral compaction of gutta-percha (GP) and three different sealers. The teeth were randomly divided into three experimental groups of 21 specimens each. Removal of gutta-percha was performed with R-Endo retreatment files, Mtwo retreatment files and Hedstrom files. Time to reach working length and to eliminate filling material was also recorded. The specimens were sectioned for evaluation of the area of the remaining gutta-percha/sealer under stereomicroscope at 6X magnification. Photographs were taken for further analysis using computer image analysis program. The results were statistically analyzed using Analysis of variance (ANOVA) and Tukey’s honestly significant difference test. Results: The R-Endo retreatment system resulted in a smaller percentage of canal area covered by residual GP/sealer than in other groups, a significant difference was found between R-Endo and Mtwo group and between Hedstrom groups (P < 0.001). The Mean operating time was minimum with R-Endo group while it was found to be maximum with hand files. Conclusion: It was concluded that all test techniques left gutta-percha/sealer remnants within the root canal. The R-Endo retreatment files and Mtwo retreatment files system proved to be an efficient method for removing gutta-percha and sealer from single rooted premolars.

scholarly journals Effectiveness of ProTaper Retreatment System associated with Organic Solvents in the Removal of Root Canal Filling Material

2013 ◽  
Vol 4 (3) ◽  
pp. 175-179
Author(s):  
Renato de Toledo Leonardo ◽  
Gisselle Moraima Chávez-Andrade ◽  
Milton Carlos Kuga ◽  
Flávia Angélica Guiotti ◽  
Gisele Faria ◽  
...  
Keyword(s):  
Organic Solvents ◽  
Root Canal ◽  
Filling Material ◽  
Root Canal Filling ◽  
Universal System ◽  
Orange Oil ◽  
Root Canals ◽  
Covered Area ◽  
Rotary Instruments ◽  
Root Canal Dentin

ABSTRACT Aim To evaluate the effectiveness of ProTaper universal retreatment system in the removal of root canal filling material with thermomechanical compaction, in comparison to manualmechanical technique, associated with orange oil or eucalyptol. Materials and methods Forty extracted lower incisors were filled with thermomechanical compaction technique. After 3 years, the root canal filling was removed by: G1 - manualmechanical technique with orange oil; G2 - manual-mechanical technique with eucalyptol; G3 - ProTaper universal retreatment system with orange oil and G4 - ProTaper universal retreatment system with eucalyptol. In sequence, all root canals were instrumented to F5 instrument. The teeth were longitudinally grooved, images of buccal half were obtained in stereomicroscope and covered area by root canal filling material was measured using image tool software, in cervical, middle and apical radicular thirds. The results were subjected ANOVA and Tukey test (p = 0.05). Results In all thirds, the manual-mechanical technique showed lower presence of root canal filling material on root canal dentin in comparison to ProTaper retreatment universal system, regardless of organic solvent used (p < 0.05). There is no difference between organic solvents in removal root canal filling material (p > 0.05). Conclusion The ProTaper universal retreatment system showed lower effectiveness in removal root canal filling material than manual-mechanical technique, regardless of organic solvents (orange oil or eucalyptol oil) used. Clinical significance Recently rotary instruments have been proposed to removal of root canal filling material. However, there are no studies evaluating its effectiveness in removal root canal filling material in association with orange oil or eucalyptol oil. How to cite this article Guiotti FA, Kuga MC, de Toledo Leonardo R, Chávez-Andrade GM, Magro MG, Cavenago BC, Faria G. Effectiveness of ProTaper Retreatment System associated with Organic Solvents in the Removal of Root Canal Filling Material. World J Dent 2013;4(3):175-179.

scholarly journals Radiographic and scanning electron microscopic assessment of root canal filling remnants after endodontic re-instrumentation

2017 ◽  
Vol 20 (1) ◽  
pp. 80 ◽  
Author(s):  
Luciane Geanini Pena Santos ◽  
Wilson Tadeu Felippe ◽  
Beatriz Dulcineia Mendes Souza ◽  
Andrea Cristina Konrath ◽  
Mabel Mariela Rodríguez Cordeiro ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Root Canal ◽  
Filling Material ◽  
Root Canal Filling ◽  
Root Canals ◽  
Filling Materials ◽  
Ah Plus ◽  
Endodontic Retreatment ◽  
Scanning Electron

<p><strong>Objective: </strong>Failures in endodontic treatment may occur by several reasons. Endodontic retreatment is an interesting alternative to manage this clinical problem. However, it is not possible to completely remove the root canal filling by any current retreatment technique. The aim of this study was to evaluate the presence of residual root canal filling materials after endodontic re-instrumentation. <strong>Material and Methods:</strong> Sixty extracted anterior human teeth were prepared by step-back technique with Flexofiles, K-files and Gates-Glidden (GG) burs. Between the use of each file or bur, root canals were irrigated with sodium hypochlorite (NaOCl). Smear layer was removed by irrigation with ethylenediaminetetraacetic acid and NaOCl. After drying with paper points the root canals were randomly divided into 5 groups (n = 12), according to filling material: Resilon cones/Real Seal sealer or gutta-percha cones and Endofill, Sealapex, AH Plus or MTA Fillapex sealers. After one week, root canal fillings were removed using Eucaliptol and K-files. Root canals were re-instrumented with K-files and GG burs sized larger than the first ones. The removal of root canal filling material was analyzed by radiography and scanning electron microscopy (SEM). Statistical analysis was performed using Binary Logistic Regression test (P &lt; 0.05). <strong>Results: </strong>Radiographic and SEM analysis showed that material from the<strong> </strong>MTA Fillapex group was better removed than that from Endofill, Sealapex, AH Plus and Real Seal groups. <strong>Conclusion: </strong>After re-instrumentation<strong>, </strong>MTA Fillapex group showed less remnants into the root canals than Endofill, Sealapex, AH Plus and Real Seal groups. Residual material was most often found in the apical third.</p><p><strong>Keywords </strong></p><p>Dental radiography; Endodontic retreatment; Root canal filling materials; Scanning electron microscopy.</p>

scholarly journals Impacts of contracted endodontic cavities compared to traditional endodontic cavities in premolars

2020 ◽  
Author(s):  
Xia Juan ◽  
Wang weidong ◽  
Li Zhengmao ◽  
Lin Bingpeng ◽  
Zhang Qian ◽  
...  
Keyword(s):  
Root Canal ◽  
Fracture Resistance ◽  
Testing Machine ◽  
Filling Material ◽  
Root Canal Filling ◽  
Surface Areas ◽  
Significant Difference ◽  
3D Printed ◽  
Post Hoc

Abstract Background: This study aims to compare the percentage of dentin removed, instrumentation efficacy, root canal filling and load at fracture between contracted endodontic cavities, and traditional endodontic cavities on root canal therapy in premolars. Methods: Forty extracted intact human first premolars were imaged with micro-CT and randomly assigned to the contracted endodontic cavity (CEC) or traditional endodontic cavity (TEC) groups. CEC was prepared with the aid of a 3D-printed template, canals were prepared with a 0.04 taper M-Two rotary instrument, and cavities were restored with resin. Specimens were loaded to fracture in an Instron Universal Testing Machine after a fatigue phase. The data were analyzed by the independent samples T test and Mann-Whitney U test, appropriate post hoc tests. Results: In the premolars tested in vitro, the percentage of dentin removed in the premolars with two dental roots in the CEC group (3.85% ± 0.42%) was significantly smaller (P < 0.05) than in the TEC group (4.94% ± 0.5%). The untouched canal wall (UCW) after instrumentation for TECs (16.43% ± 6.56%) was significantly lower (P< .05) than the UCW (24.42% ± 9.19%) for CECs in single-rooted premolars. No significant differences were observed in the increased canal volume and surface areas in premolars between the TEC and CEC groups (P > 0.05). CECs conserved coronal dentin in premolars with two dental roots but no impact on the instrument efficacy. There were no differences between the CEC groups and the TEC groups in the percentage of filling material and voids (P > 0.05). In addition, the mean load at failure of premolars did not significantly differ between the CEC and TEC groups and there was no significant difference in the type of fracture (P > 0.05). Conclusion: The results of this study suggest that CEC could not improve the fracture resistance of the endodontically treated premolars. The instrumentation efficacy and the percentage of filling material did not significantly differ between CECs and TECs in premolars. Keywords: 3D-printed template, contracted endodontic cavities, instrumentation efficacy, root canal filling, fracture resistance

scholarly journals Influence of gutta-percha points on the filling of simulated lateral canals

2005 ◽  
Vol 13 (2) ◽  
pp. 176-179 ◽  
Author(s):  
Juliana Machado Barroso ◽  
Laise Daniela Carrasco ◽  
Alexandre Capelli ◽  
Danilo Mathias Zanello Guerisoli ◽  
Paulo César Saquy ◽  
...  
Keyword(s):  
Preparation Technique ◽  
Linear Measurements ◽  
Root Canal Filling ◽  
Root Canals ◽  
Gutta Percha ◽  
Significant Difference ◽  
Classic Technique ◽  
Ah Plus ◽  
Group 2

The aim of this study was to investigate, in vitro, the percentage of filling of simulated lateral canals in teeth obturated with TP medium and standardized gutta-percha points. Twenty human mandibular canines were prepared with LA Axxess (SybronEndo) and K³ Endo rotary system (SybronEndo) up to a #50 file, according to the Free Tip Preparation Technique. During instrumentation, the root canals were alternately irrigated with 1% sodium hypochlorite and 17% EDTA. Six artificial lateral canals were prepared at the apical third of each tooth. Then, the teeth were assigned to two groups (n=10): Group 1 - filled with TP medium master gutta-percha points (Dentsply, Mailleffer); Group 2 - filled with standardized master gutta-percha points (Dentsply, Mailleffer). Root canal filling was complemented with AH Plus sealer (Dentsply, Mailleffer) and accessory gutta-percha points (Dentsply, Mailleffer), according to the classic technique. The teeth were radiographed and the images obtained were digitized. Linear measurements of the percentage of filling of the artificial lateral canals in each group were accomplished on the Image Tool 2.02 software. Statistical analysis of the data using Mann-Whitney U non-parametric test evidenced significant difference (p<0.01) between the experimental groups. The group obturated with TP medium points yielded higher percentage of filling of the lateral canals. It may be concluded that the use of master gutta-percha points with larger taper resulted in better filling of the simulated lateral canals, as compared to the use of standardized master gutta-percha points.

scholarly journals Impacts of contracted endodontic cavities compared to traditional endodontic cavities in premolars

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Xia ◽  
Weidong Wang ◽  
Zhengmao Li ◽  
Bingpeng Lin ◽  
Qian Zhang ◽  
...  
Keyword(s):  
Root Canal ◽  
Testing Machine ◽  
Filling Material ◽  
Root Canal Filling ◽  
Surface Areas ◽  
Significant Difference ◽  
3D Printed ◽  
Post Hoc ◽  
Rotary Instrument

Abstract Background This study aims to compare the percentage of dentin removed, instrumentation efficacy, root canal filling and load at fracture between contracted endodontic cavities, and traditional endodontic cavities on root canal therapy in premolars. Methods Forty extracted intact human first premolars were imaged with micro-CT and randomly assigned to the contracted endodontic cavity (CEC) or traditional endodontic cavity (TEC) groups. CEC was prepared with the aid of a 3D-printed template, canals were prepared with a 0.04 taper M-Two rotary instrument, and cavities were restored with resin. Specimens were loaded to fracture in an Instron Universal Testing Machine after a fatigue phase. The data were analyzed by the independent samples T test and Mann-Whitney U test, appropriate post hoc tests. Results In the premolars tested in vitro, the percentage of dentin removed in the premolars with two dental roots in the CEC group (3.85% ± 0.42%) was significantly smaller (P < 0.05) than in the TEC group (4.94% ± 0.5%). The untouched canal wall (UCW) after instrumentation for TECs (16.43% ± 6.56%) was significantly lower (P < .05) than the UCW (24.42% ± 9.19%) for CECs in single-rooted premolars. No significant differences were observed in the increased canal volume and surface areas in premolars between the TEC and CEC groups (P > 0.05). CECs conserved coronal dentin in premolars with two dental roots but no impact on the instrument efficacy. There were no differences between the CEC groups and the TEC groups in the percentage of filling material and voids (P > 0.05). In addition, the mean load at failure of premolars did not significantly differ between the CEC and TEC groups and there was no significant difference in the type of fracture (P > 0.05). Conclusion The results of this study suggest that CEC could not improve the fracture resistance of the endodontically treated premolars. The instrumentation efficacy and the percentage of filling material did not significantly differ between CECs and TECs in premolars.

scholarly journals Effectiveness of Three Rotary Niti Instruments and Hand Instrumentation in Removing Gutta Percha from Root Canals: an in vitro Study

2015 ◽  
Vol 03 (03) ◽  
pp. 152-158
Author(s):  
Varun Jindal ◽  
Ajay Chhabra ◽  
◽  
Keyword(s):  
In Vitro Study ◽  
Radiographic Analysis ◽  
Filling Material ◽  
Universal System ◽  
Root Canals ◽  
Gutta Percha ◽  
Significant Difference ◽  
Niti Instruments ◽  
Hand Instrumentation

Abstract Objectives: The study aimed to assess variation in the remaining filling material by radiographic analysis and the time taken for retreatment system, with H-files; the ProTaper Universal Retreatment System; Mtwo retreatment system and the SybronEndo K3. Methods: 120 human mandibular premolars with single straight root canals were prepared with rotary twisted files (up to size 40/0.04) using the crown down technique and filled by cold lateral condensation and the radiographs were taken. After one week, teeth were divided into four groups (n = 30). Gutta-percha was removed using H-files, the ProTaper Universal Retreatment System, Mtwo system and the K3 System. After retreatment radiographs were taken for each sample and the remaining material was calculated for each canal third. Results: Rotary NiTi instruments were significantly faster than the hand instrumentation technique in performing the retreatment. In radiographic analysis there was significant difference in between the groups for coronal third in ProTaper group and for apical third in H-file group. Conclusions: In the radiographic analysis the ProTaper Universal System left less filling material in the coronal third and the H-files left less filling material in apical third as compared to other groups. Rotary instruments worked faster than H files.

scholarly journals Performance of RaCe Instrumentation System in Curved Root Canals: A Comprehensive Analysis by Three Study Methods

2013 ◽  
Vol 24 (3) ◽  
pp. 230-234 ◽  
Author(s):  
Denise Piotto Leonardi ◽  
Gilson Blitzkow Sydney ◽  
Mario Tanomaru Filho ◽  
Flares Baratto-Filho ◽  
Samantha Schaffer Pugsley Baratto ◽  
...  
Keyword(s):  
Root Canal ◽  
Histological Analysis ◽  
Wilcoxon Test ◽  
Study Methods ◽  
Root Canals ◽  
Working Length ◽  
Apical Transportation ◽  
Significant Difference ◽  
Canal Enlargement ◽  
Curved Root Canals

In this study, curved maxillary molar root canals were instrumented with RaCe rotary system to evaluate: 1. the occurrence of canal transportation using a radiographic platform; 2. the action of the instruments on the dentin walls, centering ability and canal enlargement by analysis of digital images; and the percentage of regular dentin surfaces and debris within the canal by histological analysis. Ten mesiobuccal roots of extracted human maxillary molars were embedded in acrylic resin and sectioned at the middle and apical thirds. Root canal shaping was performed using the RaCe rotary system at 250 rpm and 1 Ncm torque. Each instrument set was used five times according to a crown-down technique in the following sequence: 40/0.10, 35/0.08, 25/0.06, 25/0.04, 25/0.02 (working length - WL), 30/0.02 (WL) and 35/0.02 (WL). Each instrument was inserted until resistance was felt and then pulled back, followed by brushing movements towards all canal walls. Each specimen was assessed by three study methods: radiographic platform, digitized image assessment and histological analysis. The radiographic platform showed lack of apical transportation. No statistically significant difference (Wilcoxon test, p>0.05) was found between the middle and apical thirds regarding instrument action on dentin walls, centering ability, area of root canal enlargement, percentage of regular dentin surfaces and debris within the root canal. It may be concluded that RaCe system is a suitable method for the preparation of curved root canals, regarding the maintenance of root canal original path, action on dentin walls, canal enlargement and removal of debris from the root canal lumen.

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