Procedural errors during root canal preparation using rotary NiTi instruments detected by periapical radiography and cone beam computed tomography

Alencar, Ana Helena Gonçalves de; Dummer, P. M. H.; Oliveira, Henrique César Marçal; Pécora, Jesus Djalma; Estrela, Carlos

doi:10.1590/s0103-64402010000600011

Cited by 35 publications

(42 citation statements)

References 20 publications

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“…The risk of instrument fracture represents a dilemma in rotary root canal preparation. Instruments tend to deform before fracture occurs, which could be avoided by constantly monitoring the spirals (22). More researches are required to determine how many times the NiTi file could be used safely in root-curved canals.…”

Section: Discussionmentioning

confidence: 99%

Cyclic Fatigue Resistance of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals

2013

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The aim of this study was to assess cyclic fatigue resistance in rotary nickel-titanium instruments after simulated clinical use in curved root canals (40-degree, 5-mm radius curve). Thirty-six RaCe rotary NiTi files, size #5, taper 0.04, were divided into 3 groups: Groups A, B and C with one, three and five cycles of use, respectively. Time to failure was recorded with a stopwatch in seconds and subsequently converted to number of cycles to fracture. The data were analyzed statistically by ANOVA and Tukey's test (α=0.05). Five sets of clinically used files (group C) reached significantly lower cycle-numbers before fracture (mean=197.5 cycles) when compared with one set of clinically used files (mean=309.2) and three sets (mean=287.5). Results showed that the number of simulated clinical uses of RaCe instruments for shaping curved canals affects adversely the fatigue resistance of these instruments after five uses.

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Section: Discussionmentioning

confidence: 99%

Cyclic Fatigue Resistance of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals

2013

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“…This contribution may be applied to planning, diagnosis, therapeutic process and prognosis of several diseases. The continuous advance of technology enabled the development of cone beam computed tomography (CBCT) (78,79), which has widen numerous perspectives for application in different research areas and clinical dentistry (80)(81)(82)(83)(84)(85)(86)(87)(88)(89). Imaging resources have been routinely used before, during and after dental treatment.…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

“…Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth (86,87). Errors characterize disability, non-observance of therapeutic protocol and low level of knowledge Successful root canal treatment involving the endodontic principles.…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

“…Wu et al (85) in function of the limitations of previous systematic reviews evaluating the RCT outcomes, considered the need of re-evaluating the outcome in longitudinal studies using CBCT with rigorous evaluation criteria. One concern discussed at meetings in endodontics and in several recent studies (80)(81)(82)(83)(84)(85)(86) relates to overestimated numbers of success in RCT.…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Knowing the outcome of root canal treatment (RCT) is determinant to substantiate the clinical decision making process, especially when RCT is weighed against the extraction of natural teeth or replacement by prosthetic elements. The ideal scenario in all clinical situations should combine healing/prevention of disease (apical periodontitis) and the functional retention of the tooth. Understanding the risk factors associated with endodontic failure is a key factor to increase the chances of success. The logical action is to reverse the existing disease, which requires intervention to neutralize the bacterial invasion and disrupt the bacterial biofilm within the complex anatomy. Success is more predictable when the immune host defenses are favorable. However, success has different meanings to the dentist, to the patient and to the tooth itself. The life of an endodontically treated tooth depends on the accuracy of the diagnosis and planning, excellence of disinfection, instrumentation and filling procedures (antimicrobial strategies, root canal shaping and coronal and apical seal) and finally the rehabilitation management. The interpretation of constant or intermittent pain and/or discomfort associated with apical periodontitis (AP) in endodontically treated tooth may be suggestive of endodontic failure. The success features of RCT, namely absence of pain, regression of AP, tight seal of canal and coronal spaces, and recovery of tooth function, must be reevaluated over time. In case of doubt between success and failure, cone beam computed tomography (CBCT) could be indicated for detection and precise localization of AP. The possibility of map reading on CBCT images characterizes the real multidimensional structure, providing accurate information on the presence, absence or regression of AP. The survival of an endodontically treated tooth implies understanding the biological and mechanical outcomes as multifactorial events over the individual's life span. The objective of this review of literature is to discuss relevant factors associated with patient's health, tooth and dentist that could account for a successful RCT.

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“…Despite the advantages, when excessive, the enlargement may cause accidents that may affect success, such as perforation or weakening of the furcal wall, especially in lower molars mesial roots 11,19 . Several methods may be used to evaluate the cervical preparation, such as resin blocks 20,21 , scanning electron microscopy 18 , X-rays 4 and computed tomography 22,23 . Thus, this work aimed to determine, through CBCT, the variation of the cervical dentin thickness after preparation with different systems.…”

Section: Discussionmentioning

confidence: 99%

The dentin thickness remaining in the risk zone of mandibular molars after cervical preflaring with four methods

Pinto

Marceliano-Alves

Lins

et al. 2016

Rev. odontol. UNESP

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ResumoIntrodução: O preparo cervical é uma etapa importante da instrumentação do sistema de canais, mas pode levar ao alargamento excessivo ou rasgo da raiz. Objetivo: Avaliar, em tomografia computadorizada cone beam, da espessura remanescente de dentina cervical da raiz mesial de molares inferiores, após o preparo com diferentes técnicas: Gates-Glidden (ordem crescente); Gates-Glidden (ordem decrescente); LA Axxess e Easy Pro-Design. Material e método: Foram selecionadas 40 raízes mesiais de molares inferiores, que foram escaneadas em tomógrafo cone beam antes e após o preparo. Das imagens tomográficas foram obtidos cinco cortes com intervalo de 1 mm a partir da furca e, então, mensurada a variação da espessura entre o canal radicular até a porção externa da raiz em software de análise. Resultado: Avaliação dos diferentes níveis demonstraram ausência de significância dentro do mesmo grupo para o grupo das Gates-Glidden. Por outro lado, foi notada diferença para LA Axxess (p=0,002) e para Easy Pro-Design (p=0,005). Na avaliação entre os grupos, foi observada diferença em todos os níveis, sobretudo, para Gates-Glidden na ordem crescente (ANOVA e Tukey). Conclusão: Considerando as limitações desse estudo, concluiu-se que o protocolo que apresentou maior desgaste da área de perigo cervical foi o da Gates-Glidden em ordem crescente, sendo que os demais grupos foram equivalentes (p>0,05).Descritores: Instrumentos odontológicos; preparo de canal radicular; tomografia computadorizada de feixe cônico. AbstractIntroduction: Cervical preflaring is an important step of the canal system instrumentation, but can lead to excessive enlargement or root perforation. Objective: Evaluate the remaining dentin thickness in the mandibular molars of mesial roots using cone beam computed tomography: Gates-Glidden (crown-down); Gates-Glidden (step-back); LA Axxess and Easy Pro-Design. Material and method: Were selected 40 lower molars mesial roots, which were scanned in a cone beam CT scanner before and after preparation. Were obtained five sections of the CT images with an interval of 1 mm from the furcation, and measured the thickness variation between the root canal to the root external portion in analysis software. Result: The evaluation of the different levels showed no significance within the same group for the Gates-Glidden group. On the other hand, were observed difference for LA Axxess (p=0.002) and Easy Pro-Design (p=0.005). In the intergroup analysis, were observed difference in all levels, especially for Gates-Glidden in the ascendant order (ANOVA and Tukey). Conclusion: Within the limitations of these study, is possible to conclude that the protocol with greater wear in the cervical risk area was the Gates-Glidden in step-back sequence, as the other groups were equivalent (p>0.05).

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Procedural errors during root canal preparation using rotary NiTi instruments detected by periapical radiography and cone beam computed tomography

Cited by 35 publications

References 20 publications

Cyclic Fatigue Resistance of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals

Cyclic Fatigue Resistance of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals

Characterization of Successful Root Canal Treatment

The dentin thickness remaining in the risk zone of mandibular molars after cervical preflaring with four methods

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