Micro-CT assessment of two different endodontic preparation systems

Abstract

The aim of this study was to compare two endodontic preparation systems using micro-CT analysis. Twenty-four one-rooted mandibular premolars were selected and randomly assigned to two groups. The samples (n = 12) of Group 1 were prepared using the ProTaper Universal rotary system, while Group 2 (n = 12) was prepared using the EndoEZE AET system complemented by manual apical preparation with K-type hand files up to #30. A 2.5% sodium hypochlorite solution was used in both groups for irrigating. Both groups were scanned by highresolution microcomputed tomography before and after preparation (SkyScan 1172, SkyScan, Kontich, Belgium). The root canal volume and surface area was measured before and after preparation, and the differences were calculated and analyzed for statistically significant differences using ANOVA complemented by the Tukey test (p < 0.05). The results showed no statistically significant differences between the mean volumes of dentin removal by the two systems. However, the EndoEZE AET system presented a significantly greater mean surface area compared to the ProTaper system (p < 0.05). The EndoEZE AET system enabled preparation of a greater root canal surface area when compared to the ProTaper Universal system. There seemed to be no difference in dentin volume loss between the two systems used.

CT study of the performance of reciprocating and oscillatory motions in flattened root canal areas

“…6,7,17,18,19 This is due to inappropriate endodontic preparation that does not reach such areas. For analysis of this issue, mandibular incisors were selected for this study.…”

“…14,23,24 This final configuration does not respect the common original root canal anatomy of mandibular incisors, mainly in the middle thirds, which is the area of greatest flattening. 7,10 This final shape could lead to untouched areas with remaining debris, smear layer, and bacteria. Clinically, this fact could decide the outcome of the endodontic treatment, decreasing the success rate.…”

“…Usually, instruments do not touch these areas, leaving microorganisms and debris, contributing to the failure of endodontic treatment. 6,7 Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.…”

“…8,9 In spite of offering many advantages, these instruments have limitations owing to their rotation kinematics, causing excessive preparation in some areas and leaving others untouched. 7,10 Thus, stainless steel systems have been developed, such as the Tilos system, which comprises six instruments that perform symmetric oscillatory movements with 30 degrees of amplitude.…”

“…7 The remaining instruments are the so-called transitional files and are comprised of three NiTi instruments to create a tapered shape to up to prepare the apical third. The system is complemented with five manual K-type Apical Finishing NiTi files designed for the final enlargement of the apical portion of the root.…”