Comparative Evaluation of Stress Distribution Against the Root Canal Wall at Three Different Levels by Using TruNatomy, XP-endo Shaper, F360, and 2Shape Files-A Finite Element Analysis.

OBJECTIVE: The aim of this in vitro study was to assess the stress distribution of novel endodontic rotary files of different cross sections and metallurgy against the root canal wall at three different levels by using finite element analysis. METHODS: A total of 60 novel NiTi rotary files were included in this study after being scanned for any surface deformities using a scanning electron microscope. The scanned files were assigned into 4 groups of 15 samples each based on their metallurgy and design: Group A-TruNatomy, Group B-XP-endo Shaper, Group C-F360, and Group D-2shape files. ANSYS® 15 Workbench finite element software (Canonsburg, Pennsylvania, United States) was used to numerically analyse the stress created by computer-aided models of these instruments on the dentinal wall of a simulated root canal to test the mechanical behaviour of these files. All data were analysed using one-way ANOVA with post hoc Tukey analysis, the Shapiro Wilk test, and Levene's test. The significance level was set at 5%. RESULTS: XP-endo Shaper files employed minimal stress on the surface of dentine during instrumentation, and F360 files exerted maximum stress on the dentinal wall. However, no statistically significant difference was found among the groups in relation to the amount of stress produced at the distinct levels of the root canal wall (p>0.05). CONCLUSION: There was no discernible difference in stress generation among the four groups in the current investigation. Therefore, it can be inferred that the upgrade in design and metallurgy of rotary files has the potential to downgrade the stress during the shaping of the canal and the menace of instrument breakage during their clinical usage.

Comparative evaluation of stress distribution against the root canal wall at three different levels using novel NiTi rotary files - A finite element analysis.

Background: Recent innovations in the physical and mechanical features of endodontic file systems have diminished the prospect of stress generation and fracture risk in novel endodontic files. Aim: The purpose of this research was to comparatively evaluate the stress distribution of recently introduced endodontic rotary files with distinct features and metallurgy at three different levels of the root canal wall by finite element analysis. Materials and Methods: Forty endodontic files were used in this experiment after being inspected through a scanning electron microscope for any surface deformities. Based on their metallurgy and design, the scanned files were divided into four groups, each with 10 samples: Group A-2Shape files, Group B-F360, Group C-One Curve, and Group D-TruNatomy. To assess the mechanical behavior of these files, the stress produced by computer-aided models of these instruments on the dentinal wall of a simulated root canal was numerically analyzed using ANSYS® 15 Workbench finite element software. Results: A one-way ANOVA was used to assess all the raw data with post hoc Tukey analysis, the Shapiro-Wilk test, and Levene's test. F360 files exerted the maximum stress on the dentinal wall, while TruNatomy files exerted the least stress at all the distinct levels of dentinal walls. Conclusions: There was no statistically significant variation in the stress generated between the four groups. Therefore, it can be concluded that improvements in rotary file design and metallurgy have the potential to reduce the stress during canal shaping and the risk of instrument breakage during clinical use.

Guidodontics: A global positioning system (GPS) to surgical Endodontics - A case series.

Endodontic treatment is associated with the risk of instrument separation due to multiple factors that create complications not only in further completion of the procedure but also on the final outcome and long-term prognosis of the treatment at times. Separated instrument retrieval is definitely challenging and technique sensitive, requiring a lot of clinical expertise for a successful therapy. All these hurdles make such cases a nightmare to the clinician. This case report presents two clinical cases in which cone-beam computed tomography (CBCT)-guided surgery was used for retrieval of separated instruments extending beyond the confines of root canals in a mandibular molar and maxillary premolar. This novel approach utilizes a customized 3D printed surgical guide fabricated with the help of CBCT, which is stabilized intraorally, helping in predefining the osteotomy site, angulation and depth required for retrieval of separated instruments without performing apicoectomy or root end filling. CBCT also plays an important role in these cases as the actual size, location, and depth of the separated instrument can be appreciated preoperatively. In the present cases, 3D surgical guides helped clinicians to selectively retrieve the separated instruments more conservatively and predictably. Furthermore, complete healing was seen within 3 months in both cases.

Trios Lidisi Veneer, Transforming Smiles Using an Intraoral Scanner - A Case Report.

INTRODUCTION: The need to perform restorations with a natural appearance is one of the most challenging aspects of dentistry, and reproducing the colour of natural teeth in restorations is a clinical challenge due to the complex optical characteristics of dentition. Various procedures have been advocated in the literature to correct dental anomalies, particularly in the aesthetic region, such as tooth discoloration due to fluorosis or dentition spacing due to changes in tooth shape, such as peg laterals. CLINICAL APPLICATIONS: Veneer are one of the most commonly used treatment modalities in such cases. As the use of ceramics necessitates the use of more opaque restorative materials or different thickness, obtaining adequate results in terms of the final colour of the restoration becomes increasingly difficult. The purpose of this study is to present a clinical case of smile rehabilitation in the anterior region with facets made of lithium disilicate, with the goal of achieving colour uniformity and demonstrating the benefits and achieving smile aesthetics. TAKEAWAY LESSONS: Technological advancement such as intraoral scanner for impression making have significant improved the success of prosthesis. This case report presents conservative and aesthetic procedure in the management of closing the space in maxillary anterior region using lithium disilicate laminate veneers with trios software.

Attitude among dental practioners towards use of rotary instruments and hand instruments for root canal treatment: a comparative study

Aim: The purpose of present study is to assess the attitude of general dental practioners towards use rotary instruments and hand instruments for root canal treatment. Material and Methods: It was a cross-sectional questionnaire study conducted in the private clinics in Lucknow city, Uttar Pradesh. A total of 400 clinics were visited and face to face interview schedule was conducted. Questionnaire consists of demographic details of dental professionals. Information regarding the years of experience, OPD details and number of root canal treatment done per week by dental professionals was obtained. Use of rotary and hand instruments by dental professionals was inquired. Years of experience with Rotary instruments, procedural problems with rotary instruments faced by dental professionals and reasons for not using the rotary instruments if any was also recorded. Results: 102 (33%) of the total study samples were using rotary instruments for root canal treatment and 100 (32%) using both rotary and hand instruments for root canal treatment. Dentists who are using rotary instruments are facing the procedural problem of file breakage {70 (36%)}. And those dental professionals using hand instruments are facing the problem of ledge formation {82(40%)}. Conclusions: The main procedural failure of the rotary instruments in root canal treatment, faced by dental professionals was file breakage and with hand instrument is ledge formation. Lack of expertise is the main reason which restricts dental professionals from using rotary instruments.

To comparatively evaluate the antimicrobial efficacy of chlorhexidine, nisin and linezolid as an intracanal medicament on Enterococcus faecalis: An in vitro study.

AIM: The present study evaluated the antimicrobial efficacy of Chlorhexidine, Nisin and Linezolid and a control group (Normal saline ) against Enterococcus faecalis (EF). METHODS: Human single rooted premolars with type I canal anatomy were instrumented with ProTaper using NaOCl as an irrigant. Supension of EF was inoculated into each root specimen and incubated. The medicaments were syringed into each root and incubated. After 24 hours, 8 samples per group (among the 4 groups) were retrieved. A hole was drilled on each root, and the dentinal shavings obtained were allowed to fall in brain-heart infusion (BHI) broth. Dilutions from the broth were plated and spread over blood agar. Colony-forming units (CFU) of EF was counted. The procedure was repeated after 72 hrs and 1 week. RESULTS: In group Nisin, the mean CFU was 10.6250 at 24 hrs, 6.6250 at 72 hrs and 6.2500 after 1 week respectively (statistically significant). In group Chlorhexidine, mean CFU was found to be the lowest of 10.5000 at 24 hrs, with further gradual increase to 13.7500 at 72 hrs and further increase to 15.8750 by 1 week. Similarly, in group linezolid , the mean CFU was found to decrease from 49.0000 at 24 hrs to 29.8750 at 72 hrs and then increase to 34.8750 in 1 week.