scholarly journals An Update on Root Canal Preparation Techniques and How to Avoid Procedural Errors in Endodontics

2021 ◽  
Vol 15 (1) ◽  
pp. 318-324
Author(s):  
Mohamed El-Kishawi ◽  
Khaled Khalaf

Background: Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors. Methods: A comprehensive search was carried out using multiple databases, PubMed, Medline, Google scholar, and Scopus, to identify relevant studies addressing the objective of this study and to summarize the current evidence to readers. Keywords, i.e., endodontics, root canal preparation, hand instrumentation, techniques and procedural errors, as well as, MeSH terms, i.e. “endodontics”, “instrumentation”, “root canal preparation” were used to conduct our comprehensive search. Results: The hybrid technique is a commonly-used approach that combines the benefits of both the crown-down and step-back techniques and was reported to be one of the best techniques to produce an optimal root canal preparation outcome. Hand-instrument manipulation using the balanced forced technique is also favoured as it rapidly and safely permits removal of canal contents allowing irrigants and medications to reach deep inside canal spaces. Conclusion: The use of hand files is still recommended for initial canal negotiation and preparation and is essential for the correction of procedural errors. This study provided an update on several hand instrumentation techniques commonly used in endodontics. The correct and safe application of these techniques can prevent iatrogenic procedural errors from occurring which optimizes the quality of treatment outcome.

Author(s):  
Abdulkader Abdulelah Abulhamayel ◽  
Hamdi Abdullah Altukhays ◽  
Hatim Abdullah Alamri ◽  
Abdulrahman Ahmad Salem ◽  
Jummar Ammar Farrash ◽  
...  

Evidence indicates that root canal preparation is a critical step upon which the prognosis of the endodontic treatment depends. Vertical root fractures can furtherly develop as propagations from the previously formed dentin cracks. Therefore, root canal preparation should be carefully approached with the minimal crack formation and careful dentin removal. Different modalities have been proposed in the literature and rotary systems are most commonly used nowadays. Although the reported efficacy of these modalities is high, evidence shows that they are usually associated with a considerable risk of crack formation. In the present literature review, we have discussed the effects of rotary instrumentation and root canal preparation on dentinal crack formation based on evidence from the different studies in the literature. Our evidence showed that all of the investigated approaches to prepare root canals adequately can result in crack formation. The different rotary instrumentations also showed variable frequencies of developing dentinal cracks, and evidence from some comparative investigations shows that ProTaper modalities are associated with the least frequencies of the events. However, to make a solid conclusion for clinical practice, further research is still needed to validate our current evidence.


2018 ◽  
Vol 6 (3) ◽  
pp. 46 ◽  
Author(s):  
Andreas Bartols ◽  
David Christofzik ◽  
Matthias Krummel ◽  
Christian Friedrichs ◽  
Tim Pousset ◽  
...  

This study investigated which preparation strategy for root canals leads to the best technical preparation quality, and moreover, which is perceived to be performed best by novice students. Sixty-four students were recruited to prepare one simulated root canal with each of the following: FlexMaster files (F), Mtwo files (M), and Reciproc files (R). After preparation, the students assessed the different instrument systems through a questionnaire. The technical quality of the root canal preparations was evaluated by the centering ratio of the preparation. A total of 186 prepared root canals were submitted for evaluation. With R, significantly better centered preparations were achieved when compared to M and F (p < 0.001). The students evaluated R faster than M and F, and evaluated F significantly (p < 0.05) slower than R and M. M was rated as the easiest system to learn and to handle, as well as the best at reaching the working length; therefore, it was evaluated as the overall favorite of the students. A difference was found between the students’ perceptions and their achieved technical quality of root canal preparations.


2008 ◽  
Vol 55 (4) ◽  
pp. 221-228
Author(s):  
Violeta Pavlovic ◽  
Slavoljub Zivkovic

Aim: To evaluate the effect of irrigation techniques, i.e. different types of irrigation needles, on the quality of cleaning of root canal walls using scanning electron microscopy (SEM). Material and Method: The study was conducted on 16 extracted, single-rooted, human teeth. The samples were allocated to two experimental groups depending on the type of the irrigation needle. Conventional needles were used for the irrigation of Group I and laterally perforated ones for Group II. All root canals were instrumented using K files and the Step-back technique. During instrumentation, all samples were irrigated with 2.5 % sodium hypochlorite solution followed by final irrigation with 17 % EDTA for 1 min. After that, all samples were irrigated with 10 ml of distilled water. The roots were, then, sectioned longitudinally and middle one third of each root canal was analyzed using SEM. Quantitative analysis was based on criteria by H?lsmann et al. Results: The obtained results showed that the more efficient removal of debris and the smear layer was accomplished in the group of samples irrigated using laterally perforated needles than conventional needles. The difference between the investigated irrigation techniques were statistically significant (p<0.01). Conclusion: The use of laterally perforated needles for irrigation allows more efficient cleaning of root canal walls, i.e. the removal of debris and the smear layer.


2020 ◽  
Vol 73 (6) ◽  
pp. 1145-1148
Author(s):  
Maryna A. Goray ◽  
Nataliia G. Gadzhula ◽  
Olena V. Muntian ◽  
Olena L. Cherepakha ◽  
Larysa F. Kurdysh

The aim: To compare the quality of root canal system preparation with the use of manual K-files, machine Protaper Universal and Silk files by in vitro studies. Materials and methods: Root canals preparation in 45 extracted premolars was performed in three groups with 15 teeth in each with K-files, Protaper Universal and Silk files. Transverse sections of the dental root were prepared. Histologically were assessed: amount of sawdust and predentin remaining, the purity degree of root canal walls. Results: When calculating the sawdust amount at the distance of 3 mm from an apex, a high degree of contamination was observed in the manual K-file group: 53.3% versus 33.3% in the Protaper Universal group and against 20.0% in the Silk file group. The amount of predentin after root canal treatment with manual files reached 25-30%. At the distance of 5 mm from the apex the root canals with high and medium purity degree were detected in 86.7% with Silk files and 80.0% with Protaper Universal files used. All predentin was removed when working with Protaper Universal and Silk files. Conclusions: In the histological sections of the root canals treated with K-files, the larger amount of dentine particles and predentin has been revealed than when using machine tools. The largest amount of predentin and dentine were removed with Protaper Universal files. Silk endodontic system is better for treatment of the root canals dentine surface in the apical area compared to Protaper Universal and K-files.


Author(s):  
Vinod Singh Thakur ◽  
Pavan Kumar Kankar ◽  
Anand Parey ◽  
Arpit Jain ◽  
Prashant Kumar Jain

The shaping and cleaning of the root canal are very important in root canal treatment. The excessive force and vibration during biomechanical preparation of the root canal may result in failure of the endodontic file. In this study, force and vibration analysis was carried out during root canal preparation. The samples of human extracted (premolar) teeth were provided by the College of Dental Science and Hospital. Endodontic instruments for reciprocating motion, such as the WaveOne Gold file system, had been used for root canal preparation. Force and vibration signals were recorded by dynamometer and accelerometer, respectively. The acquired signals were denoised using the db4 (SWT denoising 1-D) wavelet. Four levels of decomposition were carried out for each signal. The signal denoising technique was used to remove unwanted noise from the acquired signal. FESEM analysis was used to visualize the levels of severity of endodontic files during the cleaning and shaping of the root canal. In most of the cases, the failure occurred due to the improper use of the root canal instrumentation. The optimum amount of force was used to avoid the file failure and provided the proper instrumentation. The curve fitting regression model was used to find the interdependency between force and vibration.


2020 ◽  
Vol 9 (3) ◽  
pp. 854 ◽  
Author(s):  
Alexandre P. L. Carvalho ◽  
Laura C. L. Nardello ◽  
Fernanda S. Fernandes ◽  
Fernanda P. Bruno ◽  
Luiza R. Paz ◽  
...  

New tools for activating endodontic irrigants have evolved, yet their impact on root canal disinfection, in comparison to the passive placing of an inter-visit medication, have not yet been fully elucidated. The use of DNA- and rRNA-based methods may cast some new light on this issue, as they allow a comparison to be made between microbial presence and activity. Therefore, the aim of this single-arm intervention trial is to evaluate the antibacterial effect of endodontic procedures using both molecular methods. Root canal samples were obtained from 20 patients with asymptomatic apical periodontitis after each treatment step: access cavity, chemo-mechanical preparation, adjunctive procedures (XP-endo Finisher file and passive ultrasonic irrigation), calcium hydroxide medication, and 2nd-visit root canal preparation. DNA and cDNA from the samples were subjected to quantitative polymerase chain reaction with universal primers for the bacterial 16S rRNA gene. Chemo-mechanical preparation promoted a drastic reduction in bacterial levels and activity, whereas the adjunctive procedures did not make a significant contribution to further disinfection. At the 2nd visit, bacteria were active after the use of calcium hydroxide medication; however, they were significantly reduced after a 2nd-visit preparation. Consequently, the lowest bacterial levels were found at the end of the treatment. This clinical trial, which used an rRNA and rDNA combined approach, confirmed previous studies showing that root canal preparation represents the main strategy for root canal disinfection.


2020 ◽  
Vol 53 (12) ◽  
pp. 1680-1688
Author(s):  
C. O. Lima ◽  
A. F. A. Barbosa ◽  
C. M. Ferreira ◽  
C. M. Augusto ◽  
L. M. Sassone ◽  
...  

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