Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals

Fornari, Volmir João; Silva-Sousa, Yara Teresinha Corrêa; Vanni, José Roberto; Pécora, Jesus Djalma; Versiani, Marco Aurélio; Sousa‐Neto, Manoel Damião

doi:10.1111/j.1365-2591.2010.01724.x

Cited by 116 publications

(109 citation statements)

References 43 publications

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“…According to Berber et al, 26 the microorganisms inside the root canal are able to penetrate the dentinal tubules at around 200 micrometers. Regarding the impact of instrumentation cleaning, Fornari et al 27 observed that the larger the final diameter, the greater the percentage of touched walls, which leads to increased cleaning of the root canal. Aside from this, the enlargement of the apical segment favors the effectiveness of substances used during both the root canal irrigation as medications in certain periapical pathological conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Aside from this, the enlargement of the apical segment favors the effectiveness of substances used during both the root canal irrigation as medications in certain periapical pathological conditions. 26,27 In light of the recent efforts to simplify the biomechanical preparation techniques, the effect of rotary instruments at the apical segment should be considered for the proper cleaning, shaping, and disinfection of root canals. Thus, in systems like the Twisted File and ProTaper, which favor the preparation of cervical and middle segments through the use of instruments with greater taper, additional smaller taper files could be considered to complement this technique and enlarge the apical region.…”

Section: Discussionmentioning

confidence: 99%

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Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

et al. 2015

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The endodontic preparation of curved and narrow root canals is challenging, with a tendency for the prepared canal to deviate away from its natural axis. The aim of this study was to evaluate, by cone-beam computed tomography, the transportation and centering ability of curved mesiobuccal canals in maxillary molars after biomechanical preparation with different nickel-titanium (NiTi) rotary systems. Forty teeth with angles of curvature ranging from 20° to 40° and radii between 5.0 mm and 10.0 mm were selected and assigned into four groups (n = 10), according to the biomechanical preparative system used: Hero 642 (HR), Liberator (LB), ProTaper (PT), and Twisted File (TF). The specimens were inserted into an acrylic device and scanned with computed tomography prior to, and following, instrumentation at 3, 6 and 9 mm from the root apex. The canal degree of transportation and centering ability were calculated and analyzed using one-way ANOVA and Tukey's tests (α = 0.05). The results demonstrated no significant difference (p > 0.05) in shaping ability among the rotary systems. The mean canal transportation was: -0.049 ± 0.083 mm (HR); -0.004 ± 0.044 mm (LB); -0.003 ± 0.064 mm (PT); -0.021 ± 0.064 mm (TF). The mean canal centering ability was: -0.093 ± 0.147 mm (HR); -0.001 ± 0.100 mm (LB); -0.002 ± 0.134 mm (PT); -0.033 ± 0.133 mm (TF). Also, there was no significant difference among the root segments (p > 0.05). It was concluded that the Hero 642, Liberator, ProTaper, and Twisted File rotary systems could be safely used in curved canal instrumentation, resulting in satisfactory preservation of the original canal shape.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

et al. 2015

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“…In this study, apical cleaning was assessed by the morphometric analysis of root cross-sections to determine the percent canal areas occupied by debris, as reported elsewhere (7,13,14). The morphometric analysis was performed with Image Tool software, an image-analysis software that provides good acuity and accurate measurements of delineated areas (7,14).…”

Section: Discussionmentioning

confidence: 99%

“…The morphometric analysis was performed with Image Tool software, an image-analysis software that provides good acuity and accurate measurements of delineated areas (7,14).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Fornari et al (7) have shown that greater instrument diameters allow better fitting to the canal walls and produces more efficient cleaning. However, excised material composed of dentin chips, vita/necrotic pulp tissue fragments, microorganisms and irrigation solution might be forced beyond the apex in direction of the periapical region causing inflammatory reactions and post-instrumentation pain (8).…”

Section: Introductionmentioning

confidence: 99%

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Influence of apical enlargement in cleaning and extrusion in canals with mild and moderate curvatures

et al. 2011

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Optical microscopy and morphometric analysis were used in this study to evaluate, in vitro, the cleaning of the apical region in root canals with mild or moderate curvatures subjected to biomechanical preparation with a rotary system, as well as to assess the amount of extruded material to the periapical area. Lateral incisors (n = 32), 16 with curvature angles smaller or equal to 10° (GI) and 16 between 11° and 25° angles (GII) were submitted to Hero 642 rotary instrumentation with different surgical diameters: (A) 30.02 and (B) 45.02. Irrigation was performed at each change of instrument with 5 mL of ultrapure Milli-Q water and the extruded material through the apical foramen was collected. Root cross-sections were subjected to histological analysis by optical microscopy (×40) and the images were evaluated morphometrically using the Image Tool software. Quantification of the extruded material was performed by weighing after liquid evaporation. ANOVA showed no statistically significant differences (p>0.05) among the groups with respect to the procedures used to clean the apical region. Considering the amount of extruded material, the Tukey's HSD showed that canals with mild curvature prepared with the 45.02 surgical diameter showed significantly higher values (p<0.05) that those of the other groups, which were similar between themselves (p>0.05). In conclusion, the effect of cleaning the apical region did not differ in the groups, considering root curvature and the surgical diameter of instruments used for apical preparation. The amount of extruded material was greater in canals with mild curvature that were prepared with the 45.02 surgical instrument diameter.

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Impact of Root Canal Disinfection on Treatment Outcome

Johnson

Flake

2014

Disinfection of Root Canal Systems

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Histological evaluation of the effectiveness of increased apical enlargement for cleaning the apical third of curved canals

Abstract: No apical enlargement size allowed the root canal walls to be prepared completely. Apical third cleanliness could be predicted by instrument diameter.

Cited by 116 publications

References 43 publications

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

Computed tomography evaluation of rotary systems on the root canal transportation and centering ability

Influence of apical enlargement in cleaning and extrusion in canals with mild and moderate curvatures

Impact of Root Canal Disinfection on Treatment Outcome

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