In vitro apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc and Reciproc Blue instruments and a novel stainless steel rotary system (Gentlefile) versus manual instrumentation.

Background: This study compared apical extrusion of debris and instrumentation time following root canal instrumentation with Reciproc, Reciproc Blue, and Gentlefile (GF) rotary instruments versus the manual step-back technique. Methods: This in vitro study was conducted on 80 extracted mandibular premolars with mature apices and a root curvature of<10°. The teeth were randomly assigned to 4 groups (n=20), standardized regarding working length, and placed in pre-weighed vials. The root canals were instrumented with Reciproc, Reciproc Blue, and GF systems and the manual step-back technique in the four groups. The vials containing the collected debris were then dried and weighed. The instrumentation time was also recorded for each group. Data were analyzed with one-way ANOVA and post hoc Games-Howell test (α=0.05). Results: Minimum apical debris extrusion was noted in Reciproc, followed by Reciproc Blue, GF, and manual technique (P<0.05). Pairwise comparisons showed significantly lower apical extrusion of debris in the Reciproc compared with GF (P=0.015) and manual instrumentation (P=0.011) groups. The Reciproc system also had the shortest instrumentation time, followed by Reciproc Blue, GF, and manual instrumentation (P<0.05). Pairwise comparisons showed significant differences between all the systems (P<0.05) except between Reciproc and Reciproc Blue (P>0.05) in this respect. Conclusion: Although all systems caused apical extrusion of debris, manual instrumentation caused maximum extrusion of debris. In contrast, the Reciproc system was superior to others regarding minimal apical extrusion of debris and the shortest instrumentation time.

Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time.

The new Gentlefile (GF) system, made of stainless steel and developed by MedicNRG in Kibbutz Afikim, Israel, claims to have advantages over traditional nickel-titanium files. However, research has shown that nickel-titanium files are mechanically superior due to their increased flexibility, cutting efficiency, and ability to maintain canal anatomy with less risk of procedural errors. This study compared the amount of debris extrusion and the time required for root canal instrumentation using GF versus the nickel-titanium ProTaper Universal (PTU) system and a manual step-back (MSB) stainless steel technique. This in vitro experimental study utilized 66 extracted human single-canal mandibular premolars with mature apices and root curvature of less than 10 degrees. The teeth were randomly divided into three groups (n = 22) and standardized for working length before being placed in preweighed vials. Group 1 was instrumented with PTU, Group 2 with GF, and Group 3 with the MSB technique. Extruded debris was collected in the vials, dried in an incubator, and weighed using the same scale. The change in weight indicates the debris amount. Instrumentation time was recorded using a stopwatch. The normal distribution of data was assessed using the Kolmogorov-Smirnov test. The groups were then compared regarding the amount of extruded debris and instrumentation time using the Kruskal-Wallis test and one-way ANOVA, followed by the Games-Howell test, respectively (alpha = 0.05). No significant difference in apical debris extrusion was found among the three groups (P > 0.05). However, a significant difference in instrumentation time was detected between the groups (P < 0.05). MSB instrumentation took significantly longer than both the PTU (P = 0.001) and GF (P = 0.001) systems. The GF system did not demonstrate reduced apical debris extrusion or faster instrumentation time compared to PTU. MSB had the longest instrumentation time compared to the other techniques.

Comparison of Microscopic Endodontic Techniques: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the success rates of resin-based endodontic surgery (RES) and endodontic microsurgery (EMS), and compare their results. Material and Methods: A total of 19 and 34 full-text papers were reviewed, and finally, 2 and 6 studies were selected for RES and EMS, respectively. The stages of the study selection process were illustrated in Figure 1. The demographic characteristics were also described using the IBM SPSS Software, and the meta-analysis was fulfilled via Stata V.14. Results: A total number of 811 teeth were analyzed in this systematic review and meta-analysis, with a mean follow-up of 38.63 months. Besides, the results of the meta-analysis indicated that both methods not only differed in terms of implementation but also produced varying outcomes. Accordingly, EMS demonstrated a higher success rate likelihood with a significant difference from that of RES. Conclusion: An excellent proof was made available through this meta-analysis regarding the resin-based endodontic surgery success rate likelihood (79.9%) and an update for the endodontic microsurgery success rate possibility (100%).

Evaluation of the apical microleakage of MTA Fillapex, AH26, and Endofill sealers / Avaliação da microinfiltração apical de cimentos MTA Fillapex, AH26 e Endofill

Objective: Proper apical seal plays an important role in the success of root canal treatment. The most common cause of failure of root canal therapy is known as the lack of adequate apical seal. The aim of this in vitro study was to compare the apical microleakage of MTA Fillapex, AH26, and Endofill sealers using dye penetration method. Material and Methods: In this in vitro study, 72 single-rooted extracted human teeth were selected. The teeth were randomly divided into three experimental groups of 20 and two positive and negative control groups of 6. The canals were prepared by step-back technique and then filled with gutta-percha and one of the sealers mentioned. In the positive control group, the canals were filled with gutta-percha without sealer, and in the negative control group, the canals were prepared but not filled. The teeth were immersed in 2% methylene blue dye for 72 hours. The teeth were then cut longitudinally and the level of dye penetration was measured under a stereomicroscope. Data were analyzed by SPSS ver. 19 software, ANOVA and Bonferroni post-hoc tests. Results: The mean level of dye penetration in the Endofill test group was significantly higher than that in the AH26 and MTA Fillapex test groups. While, the observed difference between AH26 and MTA Fillapex groups was not statistically significant (p<0.05). Conclusion: The results of this study showed that AH26 and MTA Fillapex sealers did not show any significant difference in apical seal properties. However, their sealing strength was significantly greater than Endofill sealer. (AU)

Objetivo: O selamento apical adequado desempenha um papel importante no sucesso do tratamento do canal radicular. A causa mais comum de falha da terapia endodôntica é conhecida como falta de selamento apical adequado. O objetivo deste estudo in vitro foi comparar a microinfiltração apical dos cimentos MTA Fillapex, AH26 e Endofill usando o método de penetração de corantes. Materiais e métodos: Neste estudo in vitro, 72 dentes humanos unirradiculares extraídos foram selecionados. Os dentes foram divididos aleatoriamente em três grupos experimentais de 20 e dois grupos controle, positivo e negative, de 6. Os canais foram preparados pela técnica escalonada e preenchidos com guta-percha e um dos cimentos mencionados. No grupo controle positivo, os canais foram preenchidos com guta-percha sem cimento, e no grupo controle negativo, os canais foram preparados, mas não preenchidos. Os dentes foram imersos em corante azul de metileno a 2% por 72 horas. Os dentes foram então cortados longitudinalmente e o nível de penetração do corante foi medido sob um estereomicroscópio. Os dados foram analisados pelo software SPSS ver. 19 e pelos testes ANOVA e post-hoc de Bonferroni. Resultados: O nível médio de penetração do corante no grupo de teste Endofill foi significativamente maior do que nos grupos de teste AH26 e MTA Fillapex. Enquanto, a diferença observada entre os grupos AH26 e MTA Fillapex não foi estatisticamente significante (p <0,05). Conclusão: Os resultados deste estudo mostraram que os cimentos AH26 e MTA Fillapex não apresentaram diferença significativa nas propriedades do selamento apical. No entanto, suas forças de vedação foram significativamente maiores que a do cimento Endofill. (AU)