Root canal preparation using micro-computed tomography analysis: a literature review.

This literature review has critically analyzed the published research related to the biomechanical preparation of root canals with three-dimensional analysis using micro-computed tomography (micro-CT). In December 2017, six databases (PubMed, Cochrane, Web of Science, Embase, Scopus, and Science Direct) were accessed using keywords to find articles including the use of the micro-CT analysis in biomechanical root canal preparation. There were 60 full articles that were selected, which were screened and read by two authors. The research that was reviewed and analyzed included root canal anatomy and sample selection, changes in canal shape and untouched canal areas, canal transportation and centering ability, and kinematics (motion). Of the studies selected, 49.18% discussed anatomical characteristics, with 54.1% of these studies describing mesial roots of mandibular molars with moderate curvature. Only 35% used a stratified distribution based on root canal system morphology and quantitative data obtained by micro-CT. The analysis of canal transportation and centering ability showed that transport values in the apical third exceeded the critical limit of 0.3 mm in mesial roots of mandibular molars with moderate curvature, especially in the groups in which a reciprocating system was used. In relation to kinematics, 91.70% of the reviewed studies evaluated continuous rotating instruments, followed by reciprocating rotation (38.33%), vibratory (15%), and the adaptive kinematics, which was in only 8.33%. The reciprocating kinematics was associated with higher canal decentralization and transportation indexes, as well as a greater capacity for dentin removal and debris accumulation. This literature review showed that the anatomy, the type of design and kinematics of instruments, and the experimental design are factors that directly influence the quality of biomechanical preparation of root canals analyzed in a qualitative and quantitative manner by micro-CT.

Root canal preparation using micro-computed tomography analysis: a literature review

Abstract: This literature review has critically analyzed the published research related to the biomechanical preparation of root canals with three-dimensional analysis using micro-computed tomography (micro-CT). In December 2017, six databases (PubMed, Cochrane, Web of Science, Embase, Scopus, and Science Direct) were accessed using keywords to find articles including the use of the micro-CT analysis in biomechanical root canal preparation. There were 60 full articles that were selected, which were screened and read by two authors. The research that was reviewed and analyzed included root canal anatomy and sample selection, changes in canal shape and untouched canal areas, canal transportation and centering ability, and kinematics (motion). Of the studies selected, 49.18% discussed anatomical characteristics, with 54.1% of these studies describing mesial roots of mandibular molars with moderate curvature. Only 35% used a stratified distribution based on root canal system morphology and quantitative data obtained by micro-CT. The analysis of canal transportation and centering ability showed that transport values in the apical third exceeded the critical limit of 0.3 mm in mesial roots of mandibular molars with moderate curvature, especially in the groups in which a reciprocating system was used. In relation to kinematics, 91.70% of the reviewed studies evaluated continuous rotating instruments, followed by reciprocating rotation (38.33%), vibratory (15%), and the adaptive kinematics, which was in only 8.33%. The reciprocating kinematics was associated with higher canal decentralization and transportation indexes, as well as a greater capacity for dentin removal and debris accumulation. This literature review showed that the anatomy, the type of design and kinematics of instruments, and the experimental design are factors that directly influence the quality of biomechanical preparation of root canals analyzed in a qualitative and quantitative manner by micro-CT.

Rehabilitation of weakened premolars with a new polyfiber post and adhesive materials.

BACKGROUND: Polyfiber posts used inside the root canal can help to restore the fracture resistance of weakened premolars. AIM: To assess the fracture resistance of endodontically treated premolars restored with different techniques, including the new polyfiber post (Spirapost). MATERIALS AND METHODS: One hundred superior premolars were distributed into 10 groups (n = 10): Sound teeth (G1-positive control) and experimental (G2 to G10), which received MODP cavities and canal treatment. Groups were restored as follows: G2 - unrestored (negative control); G3 - microhybrid resin (MR); G4 - flowable resin (FR) + (MR); G5 - glass fiber post (Reforpost) + MR; G6 - Reforpost + FR + MR; G7 - polyethylene fiber (Ribbond) + MR; G8 - Ribbond + FR + MR; G9 - polyfiber post (Spirapost) + MR and G10 - Spirapost + FR + MR. After 24 h, the specimens were loaded until fracture. Data were analyzed by ANOVA and Tukey's test (P < 0.05). RESULTS: Premolars restored with Spirapost (G9 and G10) provided the highest fracture strength (P < 0.05), similar to sound teeth (G1), regardless of the composite resin. Intermediate values were achieved by G3, G4, G5, G6, G7, and G8, which were similar (P > 0.05) and different from the others (P < 0.05). Inferior values were found in G2 (P < 0.05). CONCLUSION: Fracture resistance of premolars with MODP cavities and endodontic access was recovered with the direct rehabilitation with Spirapost, regardless of the type of composite resin.

Effect of light sources on the bond strength of resin material to thin-walled roots.

The aim of this study was to evaluate the bond strength to the dentin of an adhesive material used for root reinforcement light activated with different sources. Roots were divided into 4 groups (n=15) according to the light source used to activate the resin reinforcement: GI, non-weakened roots (control); GII, halogen light (H) 600 mW/cm²; GIII, LED 800 mW/cm² and GIV, LED 1500 mW/cm². The reinforcement was done with adhesive, composite resin and fiberglass posts. After 24 h, the specimens were sectioned and the first slice of each post region was used in the push out test in a universal testing machine with a crosshead speed of 0.5 mm/min. Failure modes of the debonded specimens were examined. Data (MPa) were analyzed by ANOVA and Holm-Sidak test (α=0.05). The second slice from each region was analyzed by scanning electron microscopy (SEM). LED-1500 (4.69 ± 1.74) provided bond strength similar to the control group (5.05 ± 2.63) and statistically different from H-600 (1.96 ± 0.94) and LED-800 (2.75 ± 1.90), which were similar to each other (p<0.05). Cervical (4.16 ± 2.32) and middle (4.43 ± 2.32) regions showed higher bond strength than the apical (2.25 ± 1.50) (p<0.05). There was a prevalence of adhesive failures in H-600 and LED-800 and cohesive failures in LED-1500. SEM showed the formation of long, numerous and fine tags. It was concluded that LED-1500 provided higher bond strength of resin reinforcement to the dentin.

Effect of Light Sources on the Bond Strength of Resin Material to Thin-walled Roots

The aim of this study was to evaluate the bond strength to the dentin of an adhesive material used for root reinforcement light activated with different sources. Roots were divided into 4 groups (n=15) according to the light source used to activate the resin reinforcement: GI, non-weakened roots (control); GII, halogen light (H) 600 mW/cm2; GIII, LED 800 mW/cm2 and GIV, LED 1500 mW/cm2. The reinforcement was done with adhesive, composite resin and fiberglass posts. After 24 h, the specimens were sectioned and the first slice of each post region was used in the push out test in a universal testing machine with a crosshead speed of 0.5 mm/min. Failure modes of the debonded specimens were examined. Data (MPa) were analyzed by ANOVA and Holm-Sidak test (=0.05). The second slice from each region was analyzed by scanning electron microscopy (SEM). LED-1500 (4.69 ± 1.74) provided bond strength similar to the control group (5.05 ± 2.63) and statistically different from H-600 (1.96 ± 0.94) and LED-800 (2.75 ± 1.90), which were similar to each other (p<0.05). Cervical (4.16 ± 2.32) and middle (4.43 ± 2.32) regions showed higher bond strength than the apical (2.25 ± 1.50) (p<0.05). There was a prevalence of adhesive failures in H-600 and LED-800 and cohesive failures in LED-1500. SEM showed the formation of long, numerous and fine tags. It was concluded that LED-1500 provided higher bond strength of resin reinforcement to the dentin.

O objetivo deste estudo foi avaliar a resistência de união à dentina de uma resina utilizada para reforço de raiz, ativada com diferentes fontes de luz. De acordo com a fonte de luz utilizada as raízes foram divididas em 4 grupos (n = 15): GI, raízes não fragilizadas (controle); GII, luz halógena (H) 600 mW/cm2; GIII, LED 800 mW/cm2 e GIV, LED 1500 mW/cm2. O reforço foi feito com adesivo, resina composta e pino de fibra de vidro. Após 24 h, os espécimes foram seccionados e o primeiro slice de cada região utilizado para o teste de união push out, na máquina de ensaios universais com 0,5 mm/min, e o tipo da falha avaliada. Os dados obtidos (MPa) foram analisados utilizando os testes de ANOVA e Holm-Sidak (=0.05). O segundo slice de cada região foi analisado por microscopia eletrônica de varredura (MEV). O LED-1500 (4.69 ± 1.74) proporcionou resistência a união similar ao controle (5.05 ± 2.63) e estatisticamente diferente do H-600 (1.96 ± 0.94) e LED-800 (2.75 ± 1.90), que são similares entre si (p<0.05). As regiões cervical (4.16 ± 2.32) e média (4.43 ± 2.32) apresentaram alta resistência à união quando comparadas à região apical (2.25 ± 1.50) (p<0.05). Houve uma predominância de falhas adesivas com as fontes de luzes H-600 e LED-800 e coesivas com o LED-1500. A análise em MEV demonstrou a formação de longos tags resinosos. Desta forma, pode-se concluir que o LED-1500 proporcionou maior resistência à resina utilizada para o reforço da dentina radicular.