scholarly journals Lasers in Endodontic: A review

2021 ◽  
Vol 12 (1) ◽  
pp. 150-153
Author(s):  
Akshay Jaiswal ◽  
Anuja Ikhar ◽  
Pradnya Nikhade ◽  
Manoj Chandak ◽  
Rushikesh Bhonde ◽  
...  

Since the development of ruby laser by Maiman in 1960 & application of laser for endodontics by Weichman in 1971, a variety of papers on potential applications for lasers in endodontics have been published. Lasers have been a significant advancement in the field of endodontics. Be it effective cleaning, root canal treatment, surgery etc. The lateral accessory canals and anatomical complexities have been a restraint in root canal procedure, for such cases lasers have been introduced to simplify the process & have good clinical results. As there has been a boon in the improvement of laser techniques, many latest lasers having a broad array of characteristics is accessible and can also be helpful in several areas related to dentistry. When compared with conventional techniques, laser treatments has been proven to be more advantageous. The purpose of this article is to summarize laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilization of root canals, root canal shaping & obturation & apicectomy. This article reviews the role of lasers in endodontics since the early 1970s & summarizes what future may hold for endodontics. With the potential availability of many new laser wavelengths and modes, much interest is developing in this promising field. 

2020 ◽  
Vol 75 (9) ◽  
pp. 493-504
Author(s):  
Christiaan Victor ◽  
Peet J Van der Vyver ◽  
Martin Vorster ◽  
Zunaid I Vally

It is well described that the presence of microbial flora in the pulp space of the tooth, and the inability of the immune system to remove these pathogens, are the major sources of peri-apical and radicular inflam-mation.1 Eradication of these pathogens from the pulp and root canal space by means of cleaning, shaping, disinfecting and complete obturation is necessary to safeguard the health of the periodontal tissues from endodontic infection and subsequent breakdown.2,3 The basic objectives of cleaning and shaping of root canals include: (1) removal of all infected soft and hard tissues; (2) creating space for delivery of disinfectants and medicaments to the apical part of the canal; (3) facilitating three dimensional obturation and (4) preservation of radicular structures.4 Even modern endodontic file systems leave untouched areas on the root canal walls after preparation and show compaction of hard tissue debris.5 This debris consists of pulp tissue remnants, bacteria and dentine chips of which most is found in the apical part of the prepared root canal system.6 Aiming for a centred preparation that corresponds to the original canal anatomy accompanied by the lowest amount of canal transportation, especially in middle and apical parts of curved canals, will result in the most favourable post instrumented canal shape. The four optimal canal shaping objectives are: (1) to have a tapered funnel from orifice to apex, (2) maintenance of original anatomical canal pathway, (3) apical foramen position should remain constant and (4) leaving the apical opening as small as possible.2,7


PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7419 ◽  
Author(s):  
Gül Çelik ◽  
Feyza Özdemir Kısacık ◽  
Emir Faruk Yılmaz ◽  
Arife Mersinlioğlu ◽  
İhsan Furkan Ertuğrul ◽  
...  

BackgroundDentistry has undergone an evolution in endodontics practice caused by the advancement of rotary techniques for root canal preparation and their subsequent incorporation into the teaching of dentistry undergraduates. This research aimed to evaluate the shaping ability of third-year dental students as their first experience in rotary instrumentation using ProTaper Universal (PTU) and ProTaper Next (PTN) (Dentsply Maillefer) rotary instruments in simulated curved canals.MethodsForty students instrumented 200 simulated canals with a 40° curvature in resin blocks according to the manufacturer’s instructions with PTU and 39 students and 195 canals with PTN files. The canals were prepared at a speed of 300 rpm using a 16:1 reduction hand-piece powered by an electric motor (Xsmart; Dentsply Maillefer). The final apical preparation was set to F2 for the PTU and X2 for the PTN group. The change in canal curvature was evaluated based on Schneider technique using the AutoCAD 2007 software on post-digital photographs. The incidence of instrument fracture and deformation, the incidence of ledge, the change in working length (WL), and the working time were noted. The data were analyzed with Student’st-test and Chi-Square test at a significance level of 0.05 using SPSS.ResultsPTN maintained the original canal curvature better, resulting in fewer fractures and ledges, and shaped the canals faster than the PTU (P < 0.05). The mean curves of the resin canals after the instrumentation for the PTU and PTN groups were 24.03° ± 3.14° and 25.64° ± 2.72°, respectively. Thirty-three (17.4%) PTU and 18 (9.3%) PTN files fractured (p < 0.05). Nine (4.5%) PTU and 2 (2.6%) PTN deformed (p > 0.05). The change in WL after instrumentation was 0.97 mm ± 0.95 mm in PTU and 0.96 mm ± 0.80 mm in PTN (p < 0.05). The mean times were 627 s ± 18 s for PTU and 379 s ± 18 s for PTN (p < 0.000).DiscussionPTN can be recommended in severely curved root canals in terms of maintenance of the original canal curvature, superior instrument fracture and fewer ledges. Even if training before preparation provides an acceptable level of canal shaping for preclinical students, the use of NiTi rotary instruments should be included in the undergraduate dental curriculum, contributing to an increase in the quality of root canal shaping and, consequently, to an improvement of the clinical experience of students.


2004 ◽  
Vol 51 (3) ◽  
pp. 130-135
Author(s):  
Vanja Opacic-Galic ◽  
Slavoljub Zivkovic

Pathological resorptions of a tooth root very often represent both a diagnostic and therapeutical problem. The goal of this study was, based on clinical research on a number of pathological resorptions of various types and localization in relation to time, to analyze and evaluate applied endodontic therapy. Clinical research covered 30 patients (40 root canals in total). 18 teeth (22 canal) with external and 12 (18 canal) with internal root resorptions received endodontic therapy. After standard endodontic procedure had been applied (cleaning and canal shaping) calcium hydroxide paste was used as a canal medicament for cases with internal resorptions and calcium hydroxide paste and points for cases with external resorptions. Canal opturations were done by modified technique of lateral condesation applying AH- Plus paste. The obtained results showed that in cases of internal resorption after 12 months, 11 cases were successful and only 1 failure occurred. In case of external resorption, after the same period of time, 15 cases were successful and failures occurred in 3 cases. The success of resorption treatment depends on many factors but, primarily, it depends on time and accuracy of diagnosis and properly applied treatment and root canal opturation.


2015 ◽  
Vol 16 (10) ◽  
pp. 834-839
Author(s):  
Alberto Dagna

ABSTRACT Aim This work describes clinical cases treated with a innovative single-use and single-file nickel-titanium (NiTi) system used in continuous rotation. Background Nickel-titanium files are commonly used for root canal treatment but they tend to break because of bending stresses and torsional stresses. Today new instruments used only for one treatment have been introduced. They help the clinician to make the root canal shaping easier and safer because they do not require sterilization and after use have to be discarded. A new sterile instrument is used for each treatment in order to reduce the possibility of fracture inside the canal. The new One Shape NiTi single-file instrument belongs to this group. Case description One Shape is used for complete shaping of root canal after an adequate preflaring. Its protocol is simple and some clinical cases are presented. It is helpful for easy cases and reliable for difficult canals. Conclusion After 2 years of clinical practice, One Shape seems to be helpful for the treatment of most of the root canals, with low risk of separation. After each treatment, the instrument is discarded and not sterilized in autoclave or re-used. Clinical significance This single-use file simplifies the endodontic therapy, because only one instrument is required for canal shaping of many cases. The respect of clinical protocol guarantees predictable good results. How to cite this article Dagna A. Nickel-Titanium Single-file System in Endodontics. J Contemp Dent Pract 2015;16(10): 834-839.


2020 ◽  
Author(s):  
Mika Tanaka-Sato ◽  
Noriko Mutoh ◽  
Kaori Shimojima ◽  
Nobuyuki Tani-Ishii

Abstract Background The purpose of this study was to evaluate the shaping advantage of M-wire NiTi ProTaper NEXT (PTN) compared with a conventional NiTi ProTaper Universal (PTU) file in heavy curvature canal. The shaping ability was measured by the amount of canal cutting and transportation between the PTN and conventional PTU. Methods Root canal shaping by the PTN and conventional PTU was classified into two experimental groups according to the final tip size, ISO #25 or ISO #40. Eighty-four J-shaped root canals (10°, 20°, 30° apical curvature) in resin block were used. Results After adjusting for the level and canal wall side, the mean transportation did not significantly decrease between the PTN and PTU with ISO #25. Significantly less deviation occurred with the PTN and PTU between 10° and 30° using ISO #40. Conclusions The M-Wire NiTi PTN improves file flexibility and enables accurate canal shaping for heavy curvature canals.


Author(s):  
Garance Voegeli ◽  
Enrico Di Bella ◽  
Mustapha Mekki ◽  
Pierre Machtou ◽  
Serge Bouillaguet

Abstract Objectives This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals. Materials and Methods Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX). Statistical Analysis Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (p < 0.05). Results In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (p < 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin. Conclusions Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.


2017 ◽  
Vol 18 (3) ◽  
pp. 198-204
Author(s):  
Carlos Estrela ◽  
Felipe C Sampaio ◽  
Ana PP Brito ◽  
Heloisa HP Veloso ◽  
Ana HG de Alencar ◽  
...  

ABSTRACT Aim This study analyzed the effect of the dimensions of the flute and shank in the first 4 mm of instrument tips on the deformation and dimensional changes of reciprocating instruments after root canal shaping (RCS). Materials and methods The reciprocating instruments used were Reciproc® R25, R40, and R50; WaveOne® Small, Primary, and Large; and Unicone® #20, #25, and #40. Scanning electron microscopy images of the first 4 mm of the tip were acquired at 30× magnification before and after simulated curved root canals were shaped. Each instrument was used only once. The images were transferred to the AxioVision® software to measure the flute area (µm2, shank area (µm2), flute length (µm), and crosssectional diameter (µm). Student's t test for paired samples was used to compare differences before and after RCS, and analysis of variance followed by the Tukey test, to compare differences between instruments of similar sizes. The instruments were classified according to deformations after RCS. Results Reciproc® instruments had larger flutes and smaller shanks. The Reciproc® R40 had significant differences in crosssectional diameter at 0.5 mm from the tip. Reciproc® had no plastic deformations. Unicone® #20 instruments had significant differences in cross-sectional diameter at 1.5 and 3.0 mm from the tip, and #25 instruments had differences at 1.5 and 3.0 mm and in length of the second and third flutes. One #20 and three #40 instruments had plastic deformations. The differences in length of the first and fourth flutes of WaveOne® Primary and in cross-sectional diameter at 2.0 mm from the tip of WaveOne® Large were significant. Two of three WaveOne® Large instruments had plastic deformations. Conclusion Reciproc® instruments had greater flute areas and lengths and smaller shanks than Unicone® and WaveOne® instruments of similar sizes. Reciproc® instruments had a greater flute-to-shank ratio. WaveOne® instruments had the lowest flute-to-shank ratio. Unicone® instruments had the most plastic deformations. Instruments with larger flutes and smaller shanks had fewer plastic deformations after curved RCS. Clinical significance The knowledge of mechanical behavior before choosing the endodontic instrument may avoid fracture, regardless of the clinical condition, and it is essential to the success of root canal treatment. How to cite this article Sampaio FC, Brito APP, Veloso HHP, Alencar AHG, Decurcio DA, Figueiredo JAP, Estrela C. Flute and Shank Dimensions of Reciprocating Instruments before and after Simulated Root Canal shaping. J Contemp Dent Pract 2017;18(3):198-204.


2021 ◽  
Vol 11 (16) ◽  
pp. 7224
Author(s):  
Andreea-Simona Boscornea-Pușcu ◽  
Laura Orel ◽  
Oana-Alexandra Velea-Barta ◽  
Razvan Mihai Horhat ◽  
Meda-Lavinia Negruțiu ◽  
...  

In modern endodontics, nickel-titanium (NiTi) rotary instruments are used on a large scale for root canal shaping. Nevertheless, the separation of an instrument is a serious concern during shaping. The aim of this study is to determine and compare the torsional fracture characteristics of three types of NiTi endodontic instruments, each with different cross-section designs and movements performed during root canal shaping: Endostar E3 (Endostar, Poldent Co. Ltd., Warsaw, Poland); Reciproc R25 (VDW, Munich, Germany); and Protaper Next X2 (Dentsply Maillefer, Ballaigues, Switzerland). Fifteen instruments are used in this study, divided in three groups (n = 5): Group Endostar, Group Reciproc and Group Protaper. For testing, each instrument is used to shape five simulated root canals, following which its torsional stress to failure is measured. The fracture lengths of all three groups are roughly between 2 and 3 mm from the tip. Higher values of the moment of torsion in fracture, and smaller values of the maximum twisting angle are observed for Group Endostar, as well as closer to circular cross-sections. However, the values of the shear tension are similar for all three groups, because the disadvantage given by the fracture section shape for Groups Reciproc and Protaper is compensated either by size or by intrinsic properties of the instrument material. For the shear tension the Endostar values are insignificantly increased (Kruskal–Wallis test, p = 0.207), and in the case of the maximum twist angle the Protaper values are insignificantly increased (Kruskal–Wallis test, p = 0.287). Because of the instruments shape and conicity, the analysis had to be carried out separately with regard to the length of the fractured tip. Rules-of-thumb are extracted from the study for current practice: if a blockage of the first 2 to 3 mm part of the tip can be anticipated (by the excessive curving of the instrument), the handpiece must be adjusted to torque values that do not exceed 1.5 to 2.5 N · cm for Endostar and 1 to 2 N · cm for Reciproc and Protaper instruments.


2019 ◽  
Vol 14 (1) ◽  
pp. 92
Author(s):  
Dr. Maha Abdul- Kareem Mahmood ◽  
Dr. Huda Elias Ali ◽  
Dr. Haraa Khairi Abdul-Kadher

Microbes are considered as the primary etiologic agents in endodontic diseases.Disinfection of the root canal is obtained by the combined effect of biomechanicalpreparation, irrigation and intra canal medicament. The aim of the present study wasto assess the antimicrobial activity of intracanal medicaments (formocresol andEndosepton) against two micro organisms (Streptococcus mutans and staphylococcusaureus) isolated from 15 necrotic pulps of primary molars indicated for pulpectomyprocedure. The samples were cultured, and purified using microbiological evaluation.Broth dilution test was performed in our study by preparing test tubes containing10 ml of BHI broth (pH. 7) which then inoculated with strains of the tested bacteriaand incubated at 37 C° for 24 h. After over night incubaction, ten fold dilution weremade in test tubes containing 9 ml of normal saline by adding 1 ml of the inoculum tothe first tube . Then from dilution 10-1 , 0.1 ml of cell suspension was added to 9.9 mlof formocresol and endosepton, then 0.1 ml was taken and spread on duplicates ofBHI agar plates at different intervals and incubated aerobically for 24 h. at 37 C°.Colonies on the plates were counted after incubation and CFU/mL (colony formingunit) was calculated. Our results indicating that there were no significant differencesbetween the intracanal medicaments, but there were high significant differencesbetween the intervals time of the study. We concluded that both materials had greatantibacterial effect against the pathogens commonly isolated from necrotic pulpaltissue of primary teeth.


2020 ◽  
Vol 1 (12) ◽  
pp. 40-42
Author(s):  
F. Yu. Daurova ◽  
D. I. Tomaeva ◽  
S. V. Podkopaeva ◽  
Yu. A. Taptun

Relevance: the reason for the development of complications in endodontic treatment is poor-quality instrumental treatment root canals.Aims: a study of the animicrobial action and clinical efficacy of high-frequency monopolar diathermocoagulation in the treatment of chronic forms of pulpitis.Materials and methods: 102 patients with various chronic forms of pulpitis were divided into three groups of 34 patients each. In the first two groups, high-frequency monopolar diathermocoagulation was used in endodontic treatment in different modes. In the third group, endodontic treatment was carried out without the use of diathermocoagulation (comparison group). The root canal microflora in chronic pulpitis in vivo was studied twice-before and after diathermocoagulation.Results: it was established that high-frequency monopolar diathermocoagulation in the effect mode is 3, power is 4 (4.1 W) and effect is 4, power is 4 (5.4 W) with an exposure time of 3 seconds, it has a pronounced antibacterial effect on all presented pathogenic microflora obtained from the root canals of the teeth.


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