Microtomographic Evaluation of Canal Centralization and Dentine Removal after Canal Preparation with Two Rotary Systems: HyFlex EDM and ProTaper Next

Objective This study compared the ProTaper Next (PTN; Dentsply Sirona, Tulsa, Oklahoma, United States) and HyFlex EDM (HEDM; Coltene/Whaledent AG, Alstätten, Switzerland) systems using micro–computed tomography (CT). Materials and Methods Twenty-one mesial roots classified as Vertucci's type IV from extracted mandibular first molars with curvatures between 20 and 40 degrees were selected. The teeth were scanned using a micro-CT before and after root canal preparation by both systems, applied to the same root, in alternating canals. The following parameters were analyzed: canal centering, apical transportation, root canal diameter/root diameter. Results No statistically significant differences between both systems were observed for any of the assessed morphological parameters (p > 0.05). All canals presented diameter enlargement of more than 40% in relation to root diameter in the cervical and middle segments. No statistically significant difference was noted between the HEDM and PTN groups. The wear percentage for the HEDM group in the cervical and middle thirds were 49.66 ± 8.65 and 46.48 ± 14.29, respectively, and 51.02 ± 11.81 and 45.48 ± 10.79 for the PTN group, respectively. Conclusion Both systems displayed similar mandibular molar mesial canals preparation, with no differences noted for any of the assessed parameters. Both groups showed increased canal diameter in the cervical and middle thirds by more than 40%.

Finding Appropriate Nickel-Titanium Instruments for Lingual Canals in Mandibular First Premolars with Two Canals: A Micro-CT Study

Background: To find appropriate Nickel-Titanium instruments for lingual canals in mandibular first premolars with two canals.Methods: A total of 42 extracted mandibular first premolars with two canals were selected after micro-CT scanning. The teeth were matched and divided into three groups, and three types of Nickel-Titanium instruments (M3, HyFlex CM and XP-endo Shaper) were used to prepare the lingual canals of the sample teeth. After instrumentation, micro-CT scanning was used again to reconstruct the three-dimensional (3D) teeth model, and then it was geometrically aligned with the original model before instrumentation. Two-dimensional (2D) and three-dimensional parameters of teeth models were measured to evaluate the ability of cleaning and maintaining the original canal shape by the three different instruments. Results: Compared with HyFlex CM and XP-endo Shaper, the apical transportation of M3 was significantly greater within the apical 3 mm (P < 0.05), while there was no significant difference between HyFlex CM and XP-endo Shaper (P > 0.05). There was no significant difference in centering ability among three types of instruments (P > 0.05). In general, HCM group and XPS group performed better than M3 group in the 2D and 3D analysis (P < 0.05). Conclusions: Preparation of the lingual canal in mandibular first premolar was more challenging than that of the main buccal canal. All the three nickel-titanium instruments are safe for canal preparation, and generally, the HyFlex CM and XP-endo Shaper performed better than the M3.

Comparison of Shaping Ability between Continuous Rotary and Manual Instrumentations in Pediatric Endodontics

Objective: The aim of this in vitro study was to evaluate the efficacy of rotary EndoArt Ni-Ti Gold Pedo Kit and K-files in shaping ability, canal transportation, centering ability and instrumentation time in primary molars. Methods: For the study total of 30 extracted primary molars root with minimum 7mm root length were selected. Shaping of root canals in primary molars were done using the two systems, and CBCT and specialized software were used for scanning and analysis of pre-operative and post-operative to evaluate the groups for their shaping properties, apical transportation and preparation time in primary root canals. Results: No differences were found in canal transportation measures and instrumentation time between the two groups (p>0.05). The EndoArt group removed more dentin compared to K-file in all sides of the root curvature. The statistical differences were significant for coronal and middle third of the root (p<0.05). Conclusions: Under the conditions of this study, rotary EndoArt Ni-Ti Gold Pedo Kit provided more conical canals than K-files in primary teeth.

Cone-beam computed tomographic analysis of apical transportation and centering ratio of ProTaper and XP-endo Shaper NiTi rotary systems in curved canals: an in vitro study

Background Cleaning and shaping of the root canal system is an important step of endodontic treatment. Canal transportation is a common procedural error in preparation of curved canals. This study aimed to compare the canal transportation and centering ratio of two rotary files in curved canals using cone-beam computed tomography (CBCT). Methods Forty-four extracted human mandibular first molars with mature apices and 10° to 30° apical curvature were selected. The samples were randomly divided into two groups (n = 22) with similar curvature. The canals were prepared with ProTaper and XP-endo Shaper file systems according to the manufacturers’ instructions. The CBCT images were obtained using Cranex 3D CBCT scanner before and after root canal preparation, and canal transportation and centering ratio of the files at 3, 4 and 5 mm levels from the apex were calculated. Data were compared between the two groups using independent t-test at 0.05 level of significance. Results The ProTaper Universal caused greater canal transportation and had lower centering ratio than XP-endo Shaper in both mesiodistal and buccolingual directions at all levels from the apex. The difference between the two groups regarding canal transportation was significant at all levels from the apex in buccolingual direction (P < 0.05) except for 3 mm from the apex (P > 0.05). The difference between the two groups regarding centering ratio was not significant (P > 0.05) in mesiodistal direction at all levels except for 4 mm from the apex (P < 0.05). Conclusion The ProTaper Universal causes greater canal transportation in both buccolingual and mesiodistal directions than XP-endo Shaper.

Cone-beam Computed Tomographic Analysis of Canal Transportation and Centering Ability of Three Different Nickel-Titanium Rotary File Systems

AIM: The aim of the present study was to compare the canal transportation and centering ability of three rotary nickel-titanium file systems, HyFlex controlled memory, Revo-S, and Mtwo in moderately curved root canals using computed tomography (CT). MATERIALS AND METHODS: Thirty freshly extracted single-rooted teeth having curved root canals with at least 10°–20° of curvature were selected. The teeth were divided into three experimental groups of ten each. After preparation with HyFlex CM (Coltene-Whaledent, Allstetten, Switzerland), Revo-S (Micro-Mega, Besançon, France), and Mtwo (VDW, Munich, Germany) all teeth were scanned using CT to determine the root canal shape. Pre- and post-instrumentation images were obtained at three levels, 3 mm apical, 9 mm middle, and 15 mm coronal above the apical foramen were compared using CT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and post-hoc Tukey’s honestly significant difference test. RESULTS: Least apical transportation and higher centering ability were seen in HyFlex CM file system in all the three sections followed by Revo-S, Mtwo file system showed maximum transportation. CONCLUSIONS: According to the present in-vitro study, we can conclude that HyFlex CM rotary file systems showed least canal transportation and highest centering ability as compared to Revo-S and Mtwo file system but there was no statistically significant difference among these file systems (p > 0.05) at coronal, middle, and apical level of root canal.

Evaluation of apical transportation and apical root sealing in root canals prepared with mtwo rotary system with and without apical enlargement – an in vitro study

The aim of this study was to evaluate apical transportation and apical root canal sealing after root canal filling in human teeth prepared with MTwo® Rotary System with and without apical foramen enlargement. Twenty mandibular premolars were divided into two groups (n=10). Group 1 had root canals prepared 1mm beyond the apical foramen. Group 2 had root canals prepared 1mm below the root canal length. After chemo-mechanical preparation, samples were submitted to scanning electronic microscopy. Apical foramen images had 75x magnification at standardized positions, allowing measurements from the apical foramen area before and after root canal preparation, and after root canal filling. Apical foramen shape and apical transportation, as well as its level of circumferential filling after root canal preparation were accessed using the Image Subtraction System. Scanning electronic microscopy analysis demonstrated that samples of Group 1 showed larger foraminal diameter than samples of Group 2 (p<0.05). Apical foramen transportation was statistically different between Groups 1 and 2 (p=0.0108). Furthermore, the apical foramen sealing also differed statistically between groups 1 and 2 (p=0.0007) and 100% of samples of Group 1 showed apical root canal sealing. Apical root canal sealing was more effective when the root canal was prepared with apical foramen enlargement, even when the apical transportation was detected.

Effects of a Novel NiTi Thermomechanical Treatment on the Geometric Features of the Prepared Root Canal System

Objectives: This study aimed to compare the ex vivo performance of two rotary nickel–titanium (NiTi) systems with similar designs but manufactured from martensitic and austenitic alloys, the One Curve (OC) and One Shape (OS) rotary endodontic files, respectively. Methods: Forty separate mesial canals of 20 extracted mandibular molars were scanned using micro-computed tomography (CT), which were divided into 2 groups and instrumented with OC and OS, respectively. Post-instrumentation micro-CT scans were evaluated using validated computer algorithms to compare changes in canal thickness, surface area, structure model index (SMI) scores, volume of removed dentin, percentage of untreated canal surface, percentage of curvature straightening, and the amount of canal transportation. Results: Both files led to significant changes in the basic root canal geometry, with no preparation errors and no statistically significant differences. However, OC treatment resulted in significantly less curvature straightening (17.30%; 10.77%) (independent samples t test, p < 0.05) and less apical transportation (55.11 µm; 33.15 µm) (Mann–Whitney U, test p < 0.05) compared to OS treatment. Transportation values in the middle and coronal thirds were statistically similar (independent sample t-test, p > 0.05). OC treatment produced significantly less straightening and less apical transportation than OS.