Comparative evaluation of remaining dentin thickness, canal centering ability and apical deformity between ProFit S3 and Protaper gold - A nano CT study.

Purpose: For the root canal treatment to be successful, the root canal system must be cleaned and shaped, and must be gradually widened from the apical to the coronal region in order to preserve dentin thickness. ProFit S3 (Profit Dental, India) patented rotary file with variable taper design preserves dentin. The study employs ultra-high-resolution nano-computed tomography to assess the volumetric changes of two new rotary files in permanent mandibular premolars. Materials and methods: Based on inclusion and exclusion criteria, this in-vitro investigation used extracted premolars. Before the pre-operative scan, samples were made and the working length was determined using a high-precision nano-CT (SkyScan 2214, Bruker, Kontich, Belgium). A single skilled pediatric dentist used ProFit S3 (Profit Dental, India) and Protaper Gold (PTG; Dentsply, Tulsa Dental Specialties, Tulsa, OK, USA) to prepare the canals. Post-op scans were similar to pre-ops. For 3D root canal visualization and analysis, NRecon software was used to rebuild images. Results: Profit S3 has a mean value of 0.65500 and Protaper gold 1.38800, indicating a significant range. Protaper gold followed Profit S3 in canal volume differential. The two rotating file systems differed significantly (p 0.05). ProFit S3 maintained mesiodistal and buccolingual dentin thickness at 4 mm, 8 mm, and 12 mm, followed by Protaper Gold. Conclusions: ProFit S3 exhibited the lowest mean canal volume difference compared to Protaper gold. Unlike Protaper Gold, ProFit S3 offers a variable taper design that preserves root canal anatomy, peri cervical dentin, and dentin thickness.

Comparative Evaluation of Solite RS3 and HyFlex Remover Retreatment Files in Conserving Remaining Dentin Thickness During Endodontic Retreatment Using Cone Beam Computed Tomography: An In Vitro Analysis.

Introduction Non-surgical retreatment is seen as a conservative choice for dealing with recurrent infections, instead of opting for periapical surgery. The retreatment processes should be promptly and efficiently carried out, utilizing a suitable armamentarium. The objective of this experiment is to evaluate the quantity of root dentin that remains following the removal of gutta-percha (GP) from the root canal employing two distinct retreatment files. Materials and methods Sixty single-rooted teeth were selected for the examination. The process of shaping and cleaning was performed using the step-back approach, with a master apical file size of 40. The smear layer was effectively eliminated by rinsing with a solution of 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Paper points were employed to desiccate the canals. The obturation process involved the utilization of the lateral compaction technique with the AH Plus sealer (Dentsply Sirona, NC, USA). The teeth were classified into two groups: Group I (n=30) underwent retreatment using HyFlex Remover (Coletene India, Pvt., Ltd.), whereas Group II (n=30) received therapy with Solite RS3 retreatment files (Solite Dental in Chennai, India). The remaining dentin thickness (RDT) was assessed by cone beam computed tomography at levels 3, 6, and 9 mm from the cemento enamel junction after the removal of GP. The acquired data underwent examination using an independent t-test to determine statistical significance. Results The findings demonstrate that the utilization of Solite RS3 files led to a higher level of dentin thickness remaining at 3 mm, 6 mm, and 9 mm on the mesial side in comparison to HyFlex Remover retreatment files. The observed difference was found to be statistically significant at a significance level of p<0.05 on the mesial side. Nevertheless, there was no notable disparity seen between the two file types at these three levels on the distal side (p>0.05). Conclusion Based on the obtained results of the study, it can be concluded that Solite RS3 files show promise in preserving the RDT. However, further studies encompassing diverse parameters are needed to establish a conclusive and definitive conclusion.

Analyzing the Impact of Different Bonding Protocol Strategies to Improve the Fracture Resistance of Uncomplicated Crown Fractures on Tooth Fracture Reattachment in Permanent Anterior Teeth: An In-vitro Study.

Objective This study aims to analyze three different bonding protocol strategies in determining the fracture resistance on the reattachment of fragments in permanent anterior teeth. Methodology This study evaluated the ability of three bonding methods (Group A, total-etch technique; Group B, selective-etch technique; and Group C, self-etch technique) to enhance the fracture resistance of reattached tooth fragments. Sixty permanent maxillary central incisors were chosen, segmented at 3 mm from the incisal edge, and randomly distributed among the three groups. Tooth fragments were stored for 24 hours in GC Tooth Mousse (GC Corporation, Tokyo, Japan), and then reattachment was done using respective bonding techniques. Fracture resistance was gauged using a universal testing machine. Results The mean fracture resistance values were as follows: total-etch (419.5995 N), selective-etch (359.1448 N), and self-etch (192.0887 N). One-way analysis of variance (ANOVA) and post hoc Tukey tests revealed a statistically significant difference between the groups. It was inferred that the total-etch technique exhibited the highest fracture resistance, while the self-etch technique resulted in the lowest fracture resistance (P < 0.05). Conclusions The choice of bonding technique for reattaching tooth fragments should be made based on clinical context and patient needs. Total-etch provided the highest fracture resistance, but selective etch can be preferred for anterior teeth with lower occlusal loads to prevent sensitivity. The self-etch technique may not provide sufficient strength and should be used cautiously. More clinical studies are required to validate these findings and guide clinical decision-making in traumatic dental injury management.

Comparative analysis of novel heat-treated retreatment file system on the removal of obturating material using nano-computed tomography.

Introduction: The aim of nonsurgical retreatment is to remove the previous filling material followed by chemo-mechanical preparation of the canal to achieve proper disinfection of the root canal system. This is then followed by re-obturation. This study evaluates the time taken to retrieve the gutta-percha and the quantity of remaining filling material after retreatment with two different file systems. The quantity of remaining filling material was assessed using nano-computed tomography (CT) due to its increased accuracy. Materials and Methods: Forty extracted single-rooted teeth were split into two groups at random and decoronated and obturated at a standard root length of 16 mm. Solite RS3 (SRS-3) Retreatment and ProTaper Universal Retreatment (PTUR) systems were used to retrieve the gutta-percha after a preoperative nano-CT scan. Postoperative nano-CT scan was taken and both the scans were superimposed to quantify the remaining filling material. The time taken to remove gutta-percha was measured using a stopwatch. The statistical analysis comparing the two groups was conducted using the independent t-test. Results: The quantitative analysis of remaining filling material using nano-CT showed no statistical difference between both the file systems used (P > 0.05). However, SRS-3 took significantly less time in the removal of gutta-percha (P < 0.05). Conclusion: Hence, we can conclude that there is no significant difference in the amount of remaining filling material between both the file systems. However, time taken to remove the gutta-percha was lesser in SRS-3 compared to PTUR file system.

Comparative Analysis of the Surface Roughness of Class V Composite Restorations Using a Conventional Polishing System and Pre-contoured Cervical Matrices: An In Vitro Study.

BACKGROUND: Rough surfaces of restorations have an impact on the accumulation of plaque, unaesthetic contour, and marginal adaptation, thereby affecting their functional, aesthetic, and clinical performance and the long-term stability of the restoration. Several polishing systems are currently in use for composite restorations, but information on their impact on surface roughness is limited. The present study aimed to determine the surface roughness of class V composite restorations polished using pre-contoured cervical matrices and to compare it with a conventional disc polishing system. MATERIALS AND METHODS: Twenty maxillary anterior teeth were collected and used in the study. Class V cavity preparation was done, and the cavities were restored with two types of composites (microhybrid and nanohybrid) from commercially available brands (Ivoclar and Dentsply) and finished and polished using two polishing systems (super-snap and pre-contoured cervical matrices). The evaluation of surface roughness was done using an atomic force microscope (AFM). RESULTS: The surface roughness parameters (Ra-arithmetic mean/average line roughness and Sa-average surface roughness) of the class V cavities restored using pre-contoured cervical matrices were significantly lower for both the tested resin composites. CONCLUSION: The surface roughness of Class V cavities restored using pre-contoured cervical matrix systems was significantly less for both microhybrid and nanohybrid composites.

Endodontic management of aberrant canal morphology in mandibular premolar: A case series.

A thorough assessment of complex canals in any tooth is a crucial prerequisite for the success of the treatment. The radicular space is often complex, and the canals might also additionally separate at all levels of the root canals, which poses a great challenge to the treating clinician. The mandibular premolars often have variations and complexity in the canal system. The abnormal morphology of these mandibular premolars makes it inaccessible to find and negotiate the additional canals; failure to identify other canals often leads to unsuccessful root canal treatment. This case series reports five successful nonsurgical root canal treatments in mandibular premolars.

Endodontic Management of Middle Mesial Canal in Mandibular Molars: A Report of Three Cases.

Knowledge of both normal and aberrant root canal anatomy is the key to any successful root canal treatment. A mandibular molar demonstrates considerable variations with respect to additional canals or roots. The clinician must aim to identify all possible canals with the help of any magnification aids. This report discusses the variations of the middle mesial canal in mandibular molars.

Effect of adhesive strategy of universal adhesives in noncarious cervical lesions - an updated systematic review and meta-analysis.

OBJECTIVE: To determine the effect of adhesive strategy (total etch or self-etch) of universal adhesives in non-carious cervical lesions. DATA SOURCE: A search was made in PubMed, Scopus, Cochrane, Web Of Science, Open Gray, Clinical Registries. DATA SELECTION: Randomized Controlled Clinical Trials, studies on non-carious cervical lesions restored using Universal Adhesives, and studies in which universal adhesives have been used in total etch and self -etch strategies were included in this systematic review. DATA EXTRACTION: A total of 17 articles were included in the systematic review and 13 in the meta-analysis. Meta-analysis was conducted to assess the clinical performance of NCCLs in terms of retention, marginal adaptation, marginal discoloration, secondary caries and post-operative sensitivity at 18, 24, 36 month follow-up using USPHS as well as FDI criteria, separately. DATA SYNTHESIS: Overall there was no significant difference between total etch and self etch adhesive strategies for any of the five outcome measures using either the FDI or the USPHS criteria. p > 0.05, 95% CI, I2 value of 0%. A strongly suspected publication bias in the retention domain was seen at 18 month follow up under FDI criteria. CONCLUSION: Most universal adhesives show acceptable clinical performance. There is no significant effect of the adhesive strategy of universal adhesives on their clinical performance according to the results of our meta-analysis.

Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study.

OBJECTIVE: The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques. METHODOLOGY: Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A-conventional needle (CN), Group B-side-vented needle (SVN), Group C-manual dynamic agitation (MDA), and Group D-EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups. RESULTS: Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05). CONCLUSION: It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.

Comparison of postoperative pain reduction following laser, ultrasonic activation and conventional needle irrigation after root canal treatment - A randomized clinical trial.

Background: To compare the incidence of postoperative pain and analgesic intake on the administration of passive ultrasonic irrigation (PUI) using IrriSafeTM, laser-activated irrigation (LAI) using Er:Cr: YSGG in comparison to conventional needle irrigation (CNI) in participants diagnosed with symptomatic irreversible pulpitis (SIP). Material and Methods: In this randomised double-blinded parallel trial, 75 participants requiring root canal treatment in mandibular first molars diagnosed with SIP were enrolled. A 10 cm visual analogue scale (VAS) was used for pain assessment and patients presented with a preoperative pain score of 5 cm and above were only selected. After biomechanical preparation, the final irrigation protocols varied based on the irrigation protocol employed. In CNI, intracanal irrigation was conducted without agitation using a 31G side vented needle. In PUI, irrigant activation was conducted using IrriSafeTM and in LAI, irrigant activation was conducted using a pulsed Er:Cr: YSGG (2940 nm) laser with radial firing tip (RFT - 2). The pain scores and analgesic intake were assessed postoperatively after obturation at 6, 24 and 48 h. Results: A significant reduction in postoperative pain levels and analgesic intake was seen among all groups at assessed time intervals (p<0.05). Overall, mean postoperative pain scores and analgesic intake were CNI>LAI>PUI (p<0.05) respectively. Conclusions: Participants diagnosed with SIP receiving PUI and LAI showed low and comparable levels of postoperative pain scores. Based on the analgesic intake, PUI showed the least analgesic intake when compared to LAI and CNI respectively. Key words:Endodontics, Root canal irrigants, Postoperative Pain, Passive ultrasonic activation, Laser ultrasonic activation.

Comparative evaluation of various analgesics in reducing pain in irreversible pulpitis.

It is of interest to evaluate a single dose of three different analgesics compared to placebo in patients with symptomatic irreversible pulpitis. 120 patients were enrolled with severe pain in this prospective clinical trial. Patients were randomly divided into four groups after shaping and cleaning of root canals. This includes placebo, piroxicam 20mg, acetaminophen 325mg with aceclofenac sodium 100mg and acetaminophen 650mg. Participants were given a questionnaire to note the pain scores at various time intervals (6 hrs, 12 hrs, and 24 hrs) along with the respective tablets in a concealed manner. Data thus collected was analyzed for statistical significance. The severity of pain decreased in all the three interventional groups compared to the control group (p <0.01) at 6 hours. Zerodol-P and dolonex showed better pain reduction in comparison to the placebo and dolo 650 group (p <0.05) at 12 and 24 hours. Data shows that both zerodol-P and dolonex groups had similar effects at all time intervals. Thus, a single dose of analgesic such as Zerodol-P and Dolonex following shaping and cleaning of root canals relieved pain at all time intervals of the treatment. However, Dolo 650 performed better during the initial 6hrs after completion of the shaping and cleaning of root canals compared to the placebo.

Comparison of antibacterial effectiveness of three rotary file system with different geometry in infected root canals before and after instrumentation-a double-blinded randomized controlled clinical trial.

INTRODUCTION: To compare the antibacterial effectiveness of three rotary file systems i.e., ProTaper Next, ProTaper Gold and XP-endo Shaper in root canals of teeth with asymptomatic apical periodontitis by using the real-time polymerase chain reaction. MATERIALS AND METHODS: Root canals from single or multi-rooted teeth (straight canals) with necrotic pulps and asymptomatic apical periodontitis were instrumented using either ProTaper Next (n = 20), ProTaper Gold (n = 20) and XP-endo Shaper (n = 20) under irrigation with 3% sodium hypochlorite. Samples obtained before and after instrumentation were subjected to DNA extraction, amplification and quantitation of total amount of bacteria by using the real-time polymerase chain reaction. RESULTS: Samples were taken before preparation (S1) were positive for presence of bacteria, with mean numbers of 9.94 × 107, 20.4 × 107 and 9.20 × 107 bacterial cells for the ProTaper Next, ProTaper Gold and XP-endo Shaper groups, respectively. After preparation (S2) with ProTaper Next, ProTaper Gold, and XP-endo Shaper, root canals still had bacteria with mean counts of 11.8 × 105, 87.2 × 105 and 4.52 × 105 bacterial cells, respectively. Both XP-endo Shaper (99.50%) and ProTaper Next (98.81%) were effective in reducing total bacterial count, and there was no statistically significant difference between them (P > 0.05). XP-endo Shaper succeeded in reducing total bacterial count than ProTaper Gold (95.72%) and there exists statistically significant difference between them (P < 0.05). CONCLUSIONS: XP-endo Shaper was highly effective in reducing total bacterial count from root canals of teeth with asymptomatic apical periodontitis than ProTaper Gold. ProTaper Next also showed improved microbial reduction percentage as compared with ProTaper Gold.

Comparative evaluation of canal transportation, centering ability, and dentin removal between ProTaper Gold, One Curve, and Profit S3: An in vitro study.

AIM: The aim of the study was to compare the canal transportation, centering ability, and dentin removal of Profit S3 (PS3), One Curve (OC), and ProTaper Gold (PTG) systems using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all the teeth in arch form was taken using CBCT. To increase standardization, crowns were removed and only teeth measuring 16 mm were included in the study. The samples were randomly divided into three groups, with ten samples in each group; Group I was instrumented with PS3, Group II was instrumented with OC, and Group III - PTG. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and dentin removal at 3, 6, and 9 mm, from the apex. STATISTICAL ANALYSIS: One-way-ANOVA and the independent t-test were done for the pairwise comparison. The significance level was set at P = 0.05; statistical analysis was performed with SPSS statistics version 20.0 (SPSS Inc., Chicago, IL, USA). RESULTS: The mean canal centering ratio and canal apical transportation for PS3, OC and PTG show no statistical difference (P > 0.05). The mean value of dentin removal showed a statistically significant difference between the three groups (P < 0.05). PS3 and OC rotary file showed less removal of dentin compared to PTG (P < 0.00). CONCLUSION: It was evident that PS3, OC, and PTG had no statistically significant difference when analyzed based on canal transportation and canal centering ratio. However, there was a significant difference among the three groups comparing the removal of dentin. PS3 and OC rotary file showed less removal of dentin compared to PTG.

Cone-beam Computed Tomography Evaluation of Root Canal Preparation using Various Rotary Instruments: An in vitro Study.

AIM: To evaluate the remaining dentin thickness of teeth after cleaning and shaping the root canal using three rotary instrumentation technique using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This in vitro study is being done with 30 premolar samples with 20' curvature. The study is divided into three groups a CBCT was taken to measure the shortest distance from the root canal outline to the closest adjacent root surface was measured at each level from the cementoenamel junction (CEJ) (1,3, 5 and 7 mm) before and after root canal instrumentation. The purpose of this study was to compare the effects of different instruments used to prepare curved root canals on the remaining cervical dentin thickness and total amount of dentin removed from root canals during instrumentation by using multi-slice CBCT. The remaining dentin thickness is very much necessary for the success rate of root canal treatment. However, this study helps to prove that a conservative preparation with a sound remaining dentin thickness is much more advisable. RESULT: It was observed that there was a significant difference at 1 and 3 mm (p < 0.05) and at 5 and 7 mm there was no significant difference ( p > 0.05). Mtwo has removed less amount dentin when compared to ProTaper Universal and ProTaper Next system at 1 and 3 mm. CONCLUSION: Under the conditions of the study, we concluded that ProTaper Universal and ProTaper Next should be used judiciously, as it causes higher thinning of root dentin of the root when compared with Mtwo.