Comparative Quality Assessment of Root Canal Preparation With Different Systems of Endodontic Instruments

Abstract

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.

Diagnosis of Internal Root Resorption: Clinical Manifestations and Radiological Features

“…Root resorption of a permanent tooth is a pathological process characterized by the progressive loss of dentin, cementum and bone tissue surrounding the tooth [1,2]. Dentin is lined internally from the pulp surface with odontoblast layer and predentin, and externally from the periodontal ligament with a layer of cementoblasts and cementum [3,4]. Both layers form a barrier that prevents resorption and adhering of osteoclasts on the unmineralized dentin matrix [5].…”

“…Nonsurgical therapy of resorption is based on adherence to a standard endodontic protocol. In the first visit, after instrumental treatment of root canal with nickel-titanium systems [3], removal of resorption tissue with the help of ultrasonic instruments and thorough irrigation of the root canal with ultrasonic activation of sodium hypochlorite [14], a temporary filling of the root canal is carried out using an antibiotic-corticosteroid paste (e.g. Ledermix), if the resorption is active, followed by calcium hydroxide [15].…”