Comparison of Canal Transportation, Separation Rate, and Preparation Time between One Shape and Neoniti (Neolix): An In Vitro CBCT Study

Purpose. This in vitro study compared root canal preparation in curved mesiobuccal canals of molar teeth using either the One Shape™ or the Neoniti (Neolix) rotary NiTi single-file systems, assessing canal transportation, instrument separation and time required for preparation. Methods. Extracted maxillary and mandibular human molar teeth with mesiobuccal canals having apical angles of curvature between 25 and 35o were selected and embedded in acrylic resin blocks, and an initial CBCT was taken. The teeth were divided into two equal groups (n = 20), and the canals were cleaned and shaped using either Neoniti™ or One Shape™ engine-driven NiTi rotary files. Each individual instrument was used to prepare 5 canals. The time required for the preparation of each canal was recorded. Postpreparation CBCT scans were taken and used to determine the extent of canal transportation at levels of 2, 4, 6, and 8 mm from the apex. The Kolmogorov–Smirnov test for normality was applied, and then, datasets were compared using independent t-tests, with a threshold of P < 0.05 . Results. Neoniti rotary files caused significantly less canal transportation of the curved canals ( P = 0.0001 ). On the other hand, the time required for canal preparation was significantly shorter for One Shape ( P = 0.0001 ). No instrument separation was recorded in both groups. Conclusion. Based on these results, the Neoniti™ rotary file system is preferred because it maintains the original shape of curved root canals better than One Shape™; even though this benefit comes at the cost of an increase in preparation time in clinical practice, the better technical performance may be more important than a difference in procedural time.

INTENTIONAL REPLANTATION- A VIABLE SOLUTION FOR INSTRUMENT SEPARATION: A CASE REPORT

The fracture of an endodontic instrument is an obstacle in the completion of successful endodontic therapy. Non-surgical re-treatment and surgical endodontics are not always viable solutions. The various methods of re-treatment for a separated instrument include le bypass, le retrieval or the surgical method of Apicoectomy. However, the mode of treatment also depends on the position of the separated instrument in the tooth, the anatomy of the tooth and also the root. In certain cases, le bypass or retrieval is not advocated. In such cases, other options for re-treatment are needed to be considered. Intentional replantation is a treatment option considered by many as a procedure of last resort when non-surgical and surgical endodontics is contraindicated. This procedure is often indicated where the separated instrument is at or beyond the apex. The case report discussed in this paper presentation demonstrates the procedure of intentional replantation as a viable solution where other retreatment procedures are not possible.

Gentlefile Versus Protaper in the Shaping Ability in Simulated J-shaped Root Canals

Background: The aim of this study was to compare the shaping ability of Gentlefile (GF), a unique stainless-steel (SS) rotary system, and ProTaper (PT), a popular mechanical nickel-titanium (NiTi) system, in J-shaped simulated canals. Methods: Thirty-three resin blocks with a J-shaped canal were selected and randomly divided into 3 groups according to tip diameters: GF red (#23); PT F2(#25); GF blue (#26). They were prepared in one training model which imitated human dentition. Specimens were photographed by a dental operating microscope before and after preparation. The images were processed and measured using professional software. Centering ability and canal transportation were calculated, canal aberration and instrument separation were also recorded. Results: The GF system was significantly less transported than PT F2 in the apical and middle section. What’s more, better centering ability of GF was shown in all sections, including the coronal level. However, there was no difference between GF red and GF blue based on above criteria. Two cases of instrument separation of GF were noted.Conclusion: Under the conditions of this study, the two GF files showed better shaping ability, but were more easily separated than PT F2. As a novel SS rotary system, Gentlefile is more flexible to prepare narrow and curved root canals by scraping dentin with high-speed rotation, which might help remove smear layer much thoroughly and cause less dentin microcracks.

Complications in Endodontics

Difficulties encountered during endodontic treatment can be a cause of frustration for both clinician and patient. Complications such as iatrogenic perforation, ledge formation, canal blockage, instrument separation and untreated anatomy may impact the outcome of endodontic treatment. Clinicians should understand how each of these complications can occur, be prevented and predictably rectified. It is also important for clinicians to understand the impact of a specific complication on treatment prognosis and to appreciate how this may differ in each case. There may be scenarios where a complication does not significantly affect the prognosis, whereas in other situations, the same complication will be detrimental to the outcome of treatment. An appreciation of the clinical factors which determine prognosis is important, so that the correct intervention is chosen, and the patient is correctly informed of the likely sequelae.

Modern considerations when approaching fractured endodontic instruments - Part 2: A review of the literature and clinical techniques

Once root canal treatment is considered, the treating clinicians must be aware of the real possibility that complications and unforeseen accidents can occur during any stage of the treatment. Complications and accidents may include instrument separation, root perforation on different levels and ledge formation.

Ethical Aspects concerning Instrument Separation and Perforations during Endodontic Treatment: A Cross-Sectional Study

Aim. During endodontic treatment, dentists may face various unwanted procedural accidents, at any stage of the treatment that might compromise endodontic treatment outcome and bring obstacles to dentists as well. This study aimed to address and analyze several ethical concerns relating to the behavioural conduct of dentists towards endodontic instrument separation as well as perforation of the crown and/or root during root canal treatment in Riyadh, Saudi Arabia. Method. Hundred and eleven questionnaires were distributed among dentists working in Riyadh in university clinics and government and private sectors. Data were collected, reviewed, and statistically analyzed by Fisher’s exact and chi-square tests at a 5% significance level, using SPSS software. Results. 54.5% of the respondents have encountered instrument separation. 53.2% stated that they would inform the patient about the instrument separation. 43.6% of the respondents had experienced perforation during root canal treatment, and 54.9% reported that they would inform the patient of the accident. Conclusion. Within the limitation of this survey, we concluded that most of the dental professionals did not hesitate to adhere to the correct ethical conduct, and they would inform the patient if an incident occurred.