Dentinal Microcracks Induced by Endodontic Procedures: Suggested Design for Experimental Studies Using Micro–Computed Tomography and Strain Gauges

Tonelli, Stéphanie Quadros; Antunes, Marcelo Avelar; Toubes, Kênia Maria Soares de; Miranda, Antônio Carlos de; Pereira, António; Nunes, Eduardo; Silveira, Frank Ferreira

doi:10.1016/j.joen.2021.04.016

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…In fact, the reciprocating kinematics has been considered a strategy to reduce the occurrence of instrument fracture, as alternating clockwise and counter‐clockwise rotation decreases tensional stress on the instrument, thus preventing cyclic fatigue or torsional failure (Martins, Silva, Marques, Belladonna, Simões‐Carvalho, Vieira et al, 2021). Studies have also shown no association between the increase of the root surface strain detected by strain gauges and the occurrence of dentinal microcracks observed through micro‐CT imaging during root canal shaping using various rotary and reciprocating systems (Jamleh et al, 2021; Tonelli et al, 2021). This phenomenon can be attributed to the elastic nature of dentine, which enables it to evenly distribute the stress placed on it during instrumentation and absorb any additional force resulting from the use of reciprocating instruments (Mayhew et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Quasi‐3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems

Moriya,

de Carvalho,

Kishen

et al. 2023

Int Endodontic J

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AimThe aim of this study is to compare the stress produced on the internal walls of simulated canals by nine rotary and four reciprocating systems.MethodologySixty‐five isotropic transparent blocks containing a 60° curved and tapered simulated canal were selected and distributed into 13 groups (n = 5) according to the preparation system: BioRace, HyFlex EDM, iRaCe, Mtwo, One RECI, ProTaper Next, RaCe EVO, Reciproc, Reciproc Blue, R‐Motion, VDW.ROTATE, XP‐Endo Rise Shaper, and XP‐Endo Shaper. Each resin block was mounted in a vice and a digital camera recorded the entire sequence of each preparation system through a circular polariscope set for dark field analysis. The video frames when each instrument reached the end of the coronal, middle, and apical thirds of the canal were extracted from the recordings and analysed by two independent observers regarding the stress generated on the canal walls using a semi‐quantitative evaluation on a 0–5 scale. Intra‐ and inter‐observer agreement were subjected to the Cohen's Kappa coefficient test, whilst the experimental results were compared using Kruskal‑Wallis test post hoc pairwise comparisons with Bonferroni correction (α = 5%).ResultsThe inter‐ and intra‐observer agreement were 0.98 and 1, respectively. Most instruments demonstrated acceptable performance (scores ≤ 2) in all thirds. Other instruments, such as the HyFlex EDM 25.12 (coronal and middle thirds), Reciproc Blue R25 and Reciproc R25 (coronal and apical thirds), R‐Motion 30.04 (apical third), and VDW.ROTATE 20.05 (apical third) showed scores higher than 3. Statistical analysis revealed a significant difference amongst the tested systems at the coronal, middle, and apical thirds (p < .05).ConclusionNone of the canal instrumentation protocols were stress‐free, showing varying levels of stress concentrations. Various factors seemed to influence the magnitude of stress and its distribution pattern on the canal walls. Overall, instruments characterized by a larger taper, lower speed, reciprocating motion, and made of heat‐treated NiTi alloy exhibited higher patterns of stress distribution.

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Section: Discussionmentioning

confidence: 99%

Quasi‐3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems

Moriya,

de Carvalho,

Kishen

et al. 2023

Int Endodontic J

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“…Since most of the studies were conducted with extracted human teeth, and the extraction procedure may lead to some dentinal cracks, it should be underscored that this procedure requires the appropriate selection of teeth. [ 65 ] Furthermore, there may be previous microcracks in the dentin of human teeth, caused by functional and parafunctional habits. Therefore, in vitro design is the first option for carrying out this evaluation.…”

Section: Discussionmentioning

confidence: 99%

Dentinal microcracks induced by endodontic procedures: A scientometric and bibliometric analysis

et al. 2022

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Background: Due to the large number of publications relating the occurrence of dental microcracks to endodontic procedures, this bibliometric study evaluated the scientific pattern and trends in literature and provided an overview of scientific production in this context. Aim: To analyze, quantify, and characterize the scientific production and trends of published articles evaluating dentinal microcracks formation after endodontic treatment procedures between 2010 and 2020 using bibliometric indicators. Materials and Methods: Published articles were found by the search in the Medline (PubMed) and Scopus database using the combination of the following keywords: Dentinal crack OR Dentinal Microcrack OR Crack formation OR Dentin Defect AND Endodontic treatment OR Root canal preparation OR Canal Preparation OR Root canal treatment OR endodontic procedures. The search was also conducted in the Journal of Endodontics and International Endodontic Journal. After inclusion and exclusion criteria application, data from all studies included were collected. Results: Among the 556 results after the search, 45 studies were included and analyzed in this bibliometry. No trend was observed in terms of the increasing number of articles over time. Most of them used an in vitro design, compared the effect of different endodontic techniques/systems for root canal instrumentation on dentinal microcracks formation, and were conducted in Turkey, Brazil, and India. Journal of Endodontics and International Endodontic Journal were the main journals with a higher number of articles published. Interestingly, studies conducted with some funding did not lead to higher citation numbers. Moreover, a relevant proportion of studies did not consider the inclusion of control groups, baseline evaluation, or statistical analysis. Micro-CT was the main technique used to evaluate microcrack presence. Conclusion: Microcrack formation after the use of different endodontic techniques/systems has been constantly evaluated in the literature. There is a pattern of methodologies used, which may explain the concentration of these studies in specific journals and countries.

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“…NiTi rotary retreatment systems were associated with an increase in dentinal crack formation [36][37][38]. other studies reported that NiTi retreatment systems did not create dentinal cracks [7,39]. These contradictions may be explained by discrepancies in experimental methods such as scanning and reconstruction parameters, the interval at which the cross-sectional images are examined, defect interpretation criteria, and the conditions in which the samples are stored [30].…”

Section: Discussionmentioning

confidence: 99%

“…This is in accordance with many studies using micro-CT that found that NiTi rotary retreatment systems were associated with an increase in dentinal crack formation [ 36 – 38 ]. However, other studies reported that NiTi retreatment systems did not create dentinal cracks [ 7 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Dentinal Microcracks following Diode Laser- and Ultrasonic-Activated Removal of Bioceramic Material during Root Canal Retreatment

et al. 2022

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This study is aimed at evaluating the use of microcomputed tomography (micro-CT) analysis and the dentinal microcrack formation following retreatment of bioceramic sealer employing adjunct laser-activated irrigation and ultrasonic-activated irrigation. Thirty sound human single-canal teeth ( n = 30 ) obturated using the single-cone technique with bioceramic sealer were retreated using nickel-titanium (NiTi) rotary files. The sample was randomly divided into three equal groups: group 1, the control group, was not subjected to further treatment; group 2 underwent ultrasonic activation of irrigants; group 3 underwent active irrigation with a diode laser (980 nm wavelength). Using micro-CT, the teeth were scanned before and after retreatment protocols. Two calibrated experienced observers viewed the cross-sectional images and calculated the number of dentinal defects. The presence of any crack or craze line on the external root surface or internal canal wall was counted. Data were analyzed using Friedman’s two-way analysis of variance and Fisher’s exact test. Statistical significance was set at p < 0.05 . A significant increase occurred in the number of cracks post retreatment protocols, specifically in the coronal and middle canal thirds, compared to pre- and postinstrumentation ( p = 0.0001 ). However, ultrasonic- or laser-activated irrigation did not result in a significant increase in the number of cracks ( p = 0.345 ). NiTi rotary root canal retreatment was associated with a significant increase in dentinal microcracks. However, employing ultrasonic- or laser-activated irrigation as adjunct retreatment techniques did not reveal a significant increase in dentinal microcracks within the roots.

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Dentinal Microcracks Induced by Endodontic Procedures: Suggested Design for Experimental Studies Using Micro–Computed Tomography and Strain Gauges

Cited by 3 publications

References 31 publications

Quasi‐3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems

Quasi‐3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems

Dentinal microcracks induced by endodontic procedures: A scientometric and bibliometric analysis

Evaluation of Dentinal Microcracks following Diode Laser- and Ultrasonic-Activated Removal of Bioceramic Material during Root Canal Retreatment

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