A case report of multiple bilateral dens invaginatus in maxillary anteriors.

The present report presents a case of dens invaginatus (DI) in a patient with 4 maxillary incisors. A 24-year-old female complained of swelling of the maxillary left anterior region and discoloration of the maxillary left anterior tooth. The maxillary left lateral incisor (tooth #22) showed pulp necrosis and a chronic apical abscess, and a periapical X-ray demonstrated DI on bilateral maxillary central and lateral incisors. All teeth responded to a vitality test, except tooth #22. The anatomic form of tooth #22 was similar to that of tooth #12, and both teeth had lingual pits. In addition, panoramic and periapical X-rays demonstrated root canal calcification, such as pulp stones, in the maxillary canines, first and second premolars, and the mandibular incisors, canines, and first premolars bilaterally. The patient underwent root canal treatment of tooth #22 and non-vital tooth bleaching. After a temporary filling material was removed, the invaginated mass was removed using ultrasonic tips under an operating microscope. The working length was established, and the root canal was enlarged up to #50 apical size and obturated with gutta-percha and AH 26 sealer using the continuous wave of condensation technique. Finally, non-vital bleaching was performed, and the access cavity was filled with composite resin.

Clinical efficiency and reusability of the reciprocating nickel-titanium instruments according to the root canal anatomy.

The application of the single-file technique using the reciprocating motion is gaining concern in root canal preparation. The purpose of this research is to compare the efficiency of the reciprocating motion-employing files (RECIPROC and WaveOne) by measuring the working time for complete canal shaping, and to evaluate their reusability under scanning examinations. One hundred curved root canals of the extracted molars were used. The working length was determined and the glide path was confirmed using a #15 K-file. Canals shaping was completed to the length either with RECIPROC R25 file (n = 50), or with WaveOne Primary file (n = 50). The time taken for the file to reach the working length was also measured. Each file was repeatedly used in a maximum of 10 canals for comparing the change of the efficiency (shaping time) according to the working length, canal curvature, and number of file re-use. The deformations or surface defects of the files after the in vitro use were observed using a scanning electron microscope (SEM). There was no difference under the SEM between the 2 file groups with no initiation of micro-cracks until they were re-used up to 5 canals. WaveOne Primary file showed significantly shorter working time than RECIPROC R25 (p < 0.05). There was a statistically significant correlation between the working time and three variables. As the working length and the curvature of the canal increased, the shaping time was increased in both file systems. Reusability of these reciprocating instruments might be maximum 5 canals with minimal surface deformations.

Effect of reciprocation usage of nickel-titanium rotary files on the cyclic fatigue resistance.

The use of reciprocating motion for a nickel-titanium file has been claimed to increase its resistance to fatigue in comparison to continuous rotation. The purpose of this study was to investigate the effect using a reciprocating motion instead of continuous rotation for nickel-titanium files on their cyclic fatigue resistance. Cyclic fatigue tests simulating clinical use with ProTaper F2 and ProFile #25/.06 instruments were carried out in an artificial stainless-steel root canal with a 1.5 mm inner diameter, 5 mm radius and 60° angle of curvature. The instruments were driven using either continuous rotation or reciprocation until fracture. For the reciprocation, the rotation angles were set to 140° clockwise and 45° counterclockwise. The number of cycles to fracture was determined by measuring the time to fracture. Statistical analysis was performed using two-way anova. There were no significant differences in the fracture cycles due to the use of reciprocation or continuous rotation for either instrument. The results found using reciprocation were comparable to those found using continuous rotation with regard to the cyclic fatigue resistance of nickel-titanium rotary files.

Micro-computed tomography and scanning electron microscopy comparisons of two nickel-titanium rotary root canal instruments used with reciprocating motion.

The single-file root canal instrumentation technique using reciprocating motion has been gaining concern. Therefore, the purpose of this study was to compare the shaping ability of single ProTaper F2 file and WaveOne Primary file when they were used in the curved root canal with reciprocation motion and to investigate the durability of the file after use with a scanning electron microscopy (SEM). Changes in structure model index (SMI), root canal volume, curvature, surface area, and degree of transportation were measured from the cross-sectional images of the prepared canals using the micro-CT system with an isotropic resolution of 16 µm. Results showed that there were no differences in the changes of root canal volume, surface area, and SMI between the two file groups after the preparation (p > 0.05). The ProTaper group showed a curvature straightening value of 25.45 ± 12.51%, while the WaveOne group showed 27.30 ± 10.91%, and there was no statistically significant difference (p > 0.05). The transportation values between the two groups showed no significant differences (p > 0.05). SEM revealed that 60% of ProTaper files showed initiation of microcracks on the surface while those were detected on the only one WaveOne file. The single-file technique using either WaveOne Primary or ProTaper F2 can be safely used under each reciprocating motion without creating an increased apical transportation in curved canals. However, the metallurgic property resists cyclic fatigue was more favorable with WaveOne under the scanning evaluation.

Shaping ability of reciprocating motion in curved root canals: a comparative study with micro-computed tomography.

INTRODUCTION: Recently, root canal shaping with reciprocating motion has been postulated to reduce the possibility of unexpected file fractures. However, there has been little information on the shaping capability of this reciprocating motion preparation technique. Therefore, the purpose of this study was to evaluate the shaping ability of reciprocating motion when compared with continuous rotation motion in curved root canals. METHODS: The mesiobuccal and distobuccal canals of 20 extracted maxillary molars with curvatures of 20-45 degrees were instrumented with a series of ProTaper rotary files. The canals in the continuous rotation motion (CM) group (n = 20) were prepared by using continuous rotation with pecking motion, whereas the canals in the reciprocating motion (RM) group (n = 20) were prepared with reciprocating motion (clockwise 140 degrees and counterclockwise 45 degrees). Basic geometric parameters such as curvature, root canal volume, surface area, and structure model index (SMI) before and after canal shaping were evaluated by using micro-computed tomography. The degrees and directions of transportation were also measured, and statistical analysis was carried out with one-way analysis of variance and Tukey post hoc tests. RESULTS: There were no significant differences between the 2 groups in canal curvature, volume, surface area, and SMI categories measured before preparation (P > .05). Changes in curvature, root canal volume, surface area, and SMI were not affected by the instrumentation technique used (P > .05). There were no significant differences in the degrees and directions of transportation between CM and RM groups (P > .05). CONCLUSIONS: The application of reciprocating motion during instrumentation did not result in increased apical transportation when compared with continuous rotation motion, even in the apical part of curved canals. Reciprocating motion might be an attractive alternative method to prevent procedural errors during root canal shaping.

Lifespan of one nickel-titanium rotary file with reciprocating motion in curved root canals.

INTRODUCTION: The purpose of this study was to examine the lifespan of one nickel-titanium (NiTi) rotary file when used in reciprocating motion and to compare the time required for its preparation of a curved root canal using both reciprocating and continuous motion. METHODS: One hundred twenty curved canals from 60 extracted maxillary and mandibular molars were selected for measuring the mean number of uses. Each canal was prepared with reciprocating motion until the ProTaper F2 single file (Dentsply Maillefer, Ballaigues, Switzerland) reached the working length. One file was used until it was fractured. Another 60 canals were divided into two groups. 30 canals in the continuous rotation motion (CM) group were prepared using continuous rotation following the sequence of ProTaper files, whereas the canals in the reciprocating motion (RM) group (n = 30) were prepared with reciprocating motion with the sole use of the ProTaper F2. The total root canal preparation time was measured until the F2 file finally reached the working length in both groups. RESULTS: A total of 11 files were used in the preparation of 120 curved root canals. The average lifespan of one F2 file was 10.60 ± 4.35 canals with the longest lifespan of 21 canals. The total time for canal preparation was 46.42 ± 18.12 seconds and 21.15 ± 6.70 seconds in the CM and RM groups, respectively. There was a statistically significant difference between the groups (p < 0.01). CONCLUSION: Within the limitation of this study, one F2 file can be safely used to the working length of curved canals at least six times under reciprocating motion. Reciprocating preparation with only one F2 file was much faster than root canal instrumentation with continuous rotation.