Immediate and Delayed Post Space Preparations in Endodontically Treated Teeth: A Scoping Review.

BACKGROUND: The aim of the present review was to identify the effect of the post-space preparation (PSP) timing (immediate or delayed) on endodontically treated teeth. METHODS: All studies in any language that compared the effect of immediate versus delayed PSP on the outcomes of an endodontically treated tooth were searched in PubMed, Scopus, Web of Science, Cochrane, ProQuest, WorldCat, and Google Scholar databases by two independent researchers until February 12, 2022. Studies assessing merely the immediate or delayed PSP were excluded. A descriptive analysis was performed to evaluate the study design and the characteristics of the included studies. RESULTS: The initial search yielded 2612 records, of which 68 were included. Except for one randomized controlled trial, all were in vitro. The evaluated variables were apical/coronal microleakage (n = 48/n = 1), post-bond strength (n = 8), bacterial infiltration (n = 7), presence of voids (n = 3), apical extrusion and residual of filling material (n = 1), and post-operative pain (n = 1). The number of publications had steady growth per year and fast growth per decade. "Post-space preparation" was the most popular keywords. CONCLUSIONS: The present review highlights the need for further investigations due to the various design of studies, controversial results, and an inadequate number of randomized controlled trials. TRIAL REGISTRATION: Retrospectively registered. Open Science ( https://doi.org/10.17605/OSF.IO/2YTM6 ).

Effect of maleic acid on the bond strength of fibre posts to root dentine.

The aim of this study was to evaluate the effect of maleic acid (MA) on both the bond strength of fibre post to root dentine and smear layer removal after post space preparation. Sixty, single-canal premolars were endodontically treated and randomly assigned to four groups: group 1 [0.9% saline solution (control]); group 2 [2.5% sodium hypochlorite (NaOCl)]; group 3 [17% ethylenediaminetetraacetic acid (EDTA) followed by 2.5% NaOCl]; and group 4 (7% MA followed by 2.5% NaOCl). Self-adhesive resin cement was used to test the adhesion of a glass-fibre post to the root dentine through a micropush-out test. Scanning electron microscopy was performed to examine and score the treated specimens for smear layer removal, and stereomicroscopy was applied to investigate the failure modes of fibre posts. Maleic acid exhibited the highest mean bond-strength values in the apical regions among all the groups. Most failure modes (31.9%) were adhesive-type failures between the dentine and luting materials. Maleic acid performed statistically significantly better than the other groups regarding smear layer removal, especially in the apical region. Maleic acid is an effective irrigant that can remove the smear layer, open dentinal tubules, and act as a high-efficiency final irrigant in activation protocols.

Micro-computed tomography analysis of post space preparation in root canals filled with carrier-based thermoplasticized gutta-percha.

AIM: To determine whether post space preparation deviated from the root canal preparation in canals filled with Thermafil, GuttaCore or warm vertically compacted gutta-percha. METHODOLOGY: Forty-two extracted human permanent maxillary lateral incisors were decoronated, and their root canals instrumented using a standardized protocol. Samples were divided into three groups and filled with Thermafil (Dentsply Tulsa Dental Specialties, Johnson City, TN, USA), GuttaCore (Dentsply Tulsa Dental Specialties) or warm vertically compacted gutta-percha, before post space preparation was performed with a GT Post drill (Dentsply Tulsa Dental Specialties). Teeth were scanned using micro-computed tomography after root filling and again after post space preparation. Scans were examined for number of samples with post space deviation, linear deviation of post space preparation and minimum root thickness before and after post space preparation. Parametric data were analysed with one-way analysis of variance (anova) or one-tailed paired Student's t-tests, whilst nonparametric data were analysed with Fisher's exact test. RESULTS: Deviation occurred in eight of forty-two teeth (19%), seven of fourteen from the Thermafil group (50%), one of fourteen from the GuttaCore group (7%), and none from the gutta-percha group. Deviation occurred significantly more often in the Thermafil group than in each of the other two groups (P < 0.05). Linear deviation of post space preparation was greater in the Thermafil group than in both of the other groups and was significantly greater than that of the gutta-percha group (P < 0.05). Minimum root thickness before post space preparation was significantly greater than it was after post space preparation for all groups (P < 0.01). CONCLUSIONS: The differences between the Thermafil, GuttaCore and gutta-percha groups in the number of samples with post space deviation and in linear deviation of post space preparation were associated with the presence or absence of a carrier as well as the different carrier materials.

Selecting drill size for post space preparation based on final endodontic radiographs: An in vitro study.

BACKGROUND: For placement of intraradicular posts the intracanal filling material has to be removed. If drills are employed for this purpose, extra widening of the canal, incomplete cracks or root perforation are probable when inappropriate size of drill is used. OBJECTIVE: This in vitro study assessed the efficacy of radiographs taken after completion of root canal therapy in selecting the appropriate-sized Peeso reamer for post space preparation. METHODS: Canals of 53 extracted maxillary and mandibular teeth of different types were cleaned and shaped. Then with acrylic resin 3-dimensional model of the intracanal space of each tooth was fabricated. Next, all canals were filled with gutta-percha and teeth were radiographed buccolingually. Based on these radiographs two observers selected a Peeso reamer that best matched each canal's diameter. The diameter of the selected Peeso reamer was compared to the diameter of the corresponding resin model of each canal by two independent observers and the difference was measured. The data were analyzed by paired sample t-test using SPSS version 22. RESULTS: The diameter of the selected Peeso reamers ranged from 0.21 mm smaller to 0.12 mm larger than the diameter of intracanal spaces. The difference between reamer and resin model was less than 0.1 mm in 75% of the cases. CONCLUSION: The result of this study suggests that post-operation endodontic radiographs are reliable means for selecting a size of Peeso reamer that does not encroach on dentinal wall during removal of intracanal filling material and post space preparation.

A Comparative Evaluation of Real-Time Guided Dynamic Navigation and Conventional Techniques for Post Space Preparation During Post Endodontic Management: An In Vitro Study.

INTRODUCTION:  The three-dimensional (3D) dynamic navigation system (DNS; Navident, ClaroNav Technology, Toronto, ON) is a revolutionary technique in endodontics that offers superior precision and efficiency compared to existing techniques for post space preparation. AIM: The aim is to evaluate and contrast the efficacy and efficiency of the DNS with conventional post space preparation techniques. This assessment considers several parameters, notably canal deviation (global coronal and apical deviation and angular deflection), duration of the procedure, and total volumetric loss of instrumented root canal and volumetric loss of instrumented root canal above 4 mm from the apex. MATERIALS AND METHODS: Freshly extracted maxillary central incisors were chosen for this study. A total sample size of 60 (n) was included. The extracted teeth samples were divided into two groups: 3D DNS (group I; n = 30) and conventional techniques (group II; n = 30). The samples were taken, and 50% of the crown structure was reduced for post space preparation to ensure standardization between the two groups. The samples were root canal-treated and mounted in a 3D-printed maxillary cast. Preoperative micro-computed tomography (micro-CT) and cone-beam computed tomography (CBCT) were taken for both groups. For group I, post space preparation was conducted with the DNS, which provided comprehensive guidance. The procedure was stopped when post space preparation was 4 mm short of the apex, as indicated in the system display. For group II, post space preparation was done without the guidance of DNS. Time taken for the procedure was assessed using a timer; canal deviation was evaluated using CBCT analysis, and volumetric loss was estimated using micro-CT analysis. RESULTS: The dynamic navigation group achieves significantly more precise outcomes in post space preparation than the conventional technique. The DNS group has significantly lesser global coronal and apical deviation and angular deflection compared to the conventional group (p < 0.05). The DNS group has reduced the volumetric loss of instrumented root canals compared to the conventional group (p < 0.05). Furthermore, the DNS group requires significantly less time than the conventional method, with a mean difference of about 10.567 minutes (p < 0.05). CONCLUSION: Implementing dynamic navigation improves precision in post space preparation, with a notable reduction in canal deviation and volumetric loss and a decrease in procedure time compared to the conventional method.

Effect of intra-radicular cleaning protocols after post-space preparation on marginal adaptation of a luting agent to root dentin.

PURPOSE: To evaluate the effect of intra-radicular cleaning protocols after post-space preparation (PSP) on marginal adaptation of a luting agent to root dentin. METHODS: Eighty bovine incisors were sectioned transversely to obtain 18-mm-long root sections. The roots were prepared with ProTaper instruments and filled using Tagger's hybrid technique. PSP was performed at a length of 14 mm using #3-5 Largo drills. The roots were distributed into eight groups according to the chelating solution used (17% EDTA or 0.2% Chitosan) and the chelating activation/delivery method employed (conventional needle irrigation [CNI], EndoActivator [EA], XP-Endo Finisher [XPF] or passive ultrasonic irrigation [PUI]). The fiber posts were cemented using self-adhesive resin cement, and the roots were sectioned to obtain three discs from each root third. The dentin discs were observed under an optical microscope at ×40 magnification to assess marginal adaptation. The different protocols were compared considering the frequency of the marginal adaptation scores using the Kruskal-Wallis test, followed by the Dwass-Steel-Critchlow-Fligner test (α = 5%). RESULTS: The use of 17% EDTA resulted in better marginal adaptation (P < 0.001). PUI yielded results that were similar to those for EA (P = 0.949) and superior to those for XPF (P = 0.020). The combination of 17% EDTA + PUI provided a greater number of interfaces without marginal gaps (P < 0.001). CONCLUSION: The cleaning protocol influenced the marginal adaptation of resin cement to root dentin.

Age and experience with dental operating microscope: Do these factors influence on the post space preparation and adhesion of glass fiber posts?

This study evaluated the influence of operator's age and experience with dental operating microscope (DOM) on the cleaning of post space walls and on bond strength of glass fiber posts associated with self-adhesive resin cement. Sixty bovine roots were selected. Root canal preparation was performed and roots were filled using gutta-percha/AH Plus. For post space preparation, specimens were divided into four groups (n = 15), according to operator's age and the use of DOM: (1) ≥40 years; (2) ≥40 years with magnification; (3) <40 years; (4) <40 years with magnification. Next, a high-speed bur of the post system and torque-controlled round burs were used for cleaning of post space. Five roots in each group were evaluated for the degree of cleanliness under a stereo microscope using a scoring system. In the remaining 10 specimens from each group, glass fiber posts were cemented with RelyX U200. Two slices (1 ± 0.1 mm) prepared on each root third of all specimens were evaluated by push-out analysis. The scoring system was analyzed using Kruskal-Wallis and push-out data using ANOVA. Significance level was set at 5%. No significant difference was observed in cleaning scores among groups (p > .05). There was no significant difference when comparing the groups and the root thirds (p > .05). The adhesive failure between dentin, cement, and post predominated in all groups. Operator's age and experience with DOM did not influence the cleanliness of root canal walls or the bond strength of glass fiber posts associated with self-adhesive resin cement for post space preparation. RESEARCH HIGHLIGHTS: Although magnification is considered part of Endodontics, little is known about the variables associated. Operator's age and experience with microscope on cleaning of canals and on push-out of posts with self-adhesive resin cement were evaluated.

Sealing Ability of Various Types of Root Canal Sealers at Different Levels of Remaining Gutta Percha After Post Space Preparation at Two Time Intervals.

OBJECTIVE: This study evaluated the apical sealing ability of various types of sealers (Sure-Seal Root, AH Plus, and GuttaFlow2) at different levels of remaining gutta percha after post space preparation at two time intervals (1 day and 1 week after obturation). MATERIALS AND METHODS: One hundred and two single canal mandibular premolars were decoronated at the cement-enamel junction and biomechanically prepared. Twelve samples served as negative and positive controls (n = 6). The remaining 90 samples were distributed into three groups (n = 30 each), based on the used sealer for obturation with gutta percha (Sure-Seal Root, AH Plus, GuttaFlow2). Each experimental group was divided into two subgroups (n = 15 each), subgroup I: post space prepared 1 day after obturation and subgroup II: post space prepared 1 week after obturation. For each subgroup, the post space was prepared to a length that remained 3, 4, or 5 mm of gutta percha apically for each of five samples. Then, the dye penetration technique was used to measure the apical microleakage. Data were analyzed using "ANOVA test" and "post hoc Duncan's test." RESULTS: Sure-Seal Root sealer demonstrated the best apical seal compared with other tested sealers. Post space preparation 1 day after obturation exhibited less microleakage than the group with 1 week after obturation. Additionally, 5 mm of remaining gutta percha showed superior sealing value than 3 and 4 mm. CONCLUSION: Bioceramic (Sure-Seal) sealer is the material of choice to be used when post space preparation is required. Post space preparation was preferred to be done 1 day after obturation than 1 week after obturation. Superlative apical seal was obtained with a maximum length of remaining gutta percha.

Effect of post space preparation drills on the incidence of root dentin defects.

OBJECTIVES: This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. MATERIALS AND METHODS: Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance. RESULTS: Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). CONCLUSIONS: PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

Effect of obturation technique with immediate and delayed post space preparation on apical voids and bond strength of apical gutta-percha.

OBJECTIVE: The purpose of this study was to evaluate the effect of immediate and delayed post space preparation on the sealing ability of two root canal obturation techniques by using micro-computed tomography imaging and a push-out test. METHODS: The root canals of 40 human maxillary premolar teeth were instrumented and divided into four groups: (A) single cone (SC) followed by immediate post space preparation, (B) continuous wave of condensation (CWC) followed by immediate post space preparation, (C) SC followed by delayed post space preparation, and (D) CWC followed by delayed post space preparation. Micro-CT scans were performed for volumetric analysis of voids and filling materials in the apical 4-mm portion. A push-out test was performed, and failure modes (adhesive, cohesive, or mixed) were assessed. Data were analyzed using the Kruskal-Wallis test and one-way analysis of variance. RESULTS: No significant differences were observed among the four groups in terms of the percentage volume of voids of the apical 4 mm or the bond strength of apical gutta-percha. CONCLUSIONS: The percentage volume of voids and bond strength of apical gutta-percha were similar and were not significantly influenced by the timing of post space preparation or the obturation technique.

Effects of Endodontic Sealers and Irrigation Systems on Smear Layer Removal after Post Space Preparation.

INTRODUCTION: The aim of this study was to investigate the effects of endodontic sealer types and ultrasound on smear layer removal after post space preparation. METHODS: Thirty-six bovine incisors were chemomechanically instrumented and randomly divided into 3 groups (n = 12) according to the endodontic sealer (AH Plus [Dentsply DeTrey, Konstanz, Germany], Apexit Plus [Ivoclar Vivadent AG, Schaan, Fürstentum Liechtenstein], or iRoot SP [Innovative Bioceramix, Vancouver, BC, Canada]) used during root canal obturation, and the groups were further subdivided randomly into 3 subgroups (n = 4) based on the post dowel irrigation systems (ultrasound, regular rinse, or control) used. The samples were examined under a scanning electron microscope and were scored for debris and tubule openings using a 3-scale grading system. The Friedman test, Wilcoxon signed rank test, Kruskal-Wallis analysis, and Mann-Whitney U test were used to statistically analyze the results (α = 0.05). RESULTS: Samples in the AH Plus group were more easily debrided than those in the iRoot SP group (P < .05). The best tubule opening condition was presented in samples in the AH Plus group, whereas those in the iRoot SP group presented the worst (P < .05). The regular rinse and ultrasonic groups were similarly good at smear layer removal and tubule opening (P > .05) compared with the control group (P < .05). The samples using AH Plus in combination with ultrasound or syringe rinsing showed the best cleaning result among all of the subgroups (P < .05). CONCLUSIONS: AH Plus presented the easiest removal from the post space, whereas iRoot SP presented the most difficult removal. Ultrasound improved the cleaning efficacy of post dowels as did the regular rinse.

Effect of Post Space Preparation on Apical Obturation Quality of Teeth Obturated with Different Techniques: A Micro-computed Tomographic Study.

INTRODUCTION: The purpose of this study was to evaluate the obturation quality of root canals filled with different techniques and to determine whether post space preparation had an effect on the quality of apical obturation using micro-computed tomographic (micro-CT) imaging. METHODS: The root canals of 30 human mandibular premolar teeth were instrumented, and the specimens were divided into 3 groups according to the obturation technique used: cold lateral compaction (CLC), warm vertical compaction (WVC), or single-cone (SC) techniques. The specimens were stored at 37°C and 100% humidity for 1 week. Then, the coronal root filling material was removed in order to create a post space. Micro-CT scans were performed before and after post space preparation for the volumetric analysis of voids and filling materials. Data were analyzed using repeated-measures analysis of variance and Bonferroni tests. RESULTS: The CLC and SC groups showed a significantly greater percentage volume of voids than the WVC group (P < .05), whereas no significant difference was found between the CLC and SC groups before and after post space preparation (P > .05). The post space preparation caused a significant increase in the percentage volume of voids in the CLC and SC groups (P < .05). No significant difference was detected in the percentage volume of voids in the WVC group after post space preparation (P > .05). CONCLUSIONS: No root fillings were void free. The WVC group presented the best obturation quality. The post space preparation negatively influenced the apical integrity of the filling materials in the CLC and SC groups, whereas it had no significant effect in the WVC group.

Residual Endodontic Filling Material after Post Space Preparation: A Confocal Microscopic Study.

This laboratory study assessed removability of endodontic alkaline cements and resin sealers using coronal cross-sectional slices of roots with single canals. Materials were labelled with 0.1% (w/w) sodium fluorescein prior to mixing so that confocal microscopy could be used to quantify material remaining on the walls of post spaces, to assess cleanliness. Roots of extracted teeth were prepared using rotary NiTi instruments then obturated using lateral condensation with gutta percha and epoxy resin sealers (AH-Plus™ or Zirmix™), or were filled by injecting mineral trioxide aggregate (MTA) cement (GC Nex™ MTA or MTAmix™) or a hard-setting calcium hydroxide cement (Supercal™). Brown (#3) ParaPost™ drills were used at 600 rpm with a torque setting of 3 N cm-1 for 2 min to remove 5 mm of the root filling. Roots were embedded and coronal slices examined by confocal microscopy, with the perimeter of the drill channel divided into clean, unclean and non-accessible regions. The choice of material affects cleanliness, with MTA being the most difficult and calcium hydroxide cement the easiest to remove. With epoxy resin-based sealers, almost half of the accessible canal walls remained coated with remnants of sealer after post space preparation.

Failure of Cone-Beam Computed Tomography in Detection of Fiber Post Perforation.

Detection of iatrogenic root perforation during post-space preparation especially in labiolingual plane can be challenging due to the two-dimensional nature of conventional radiography; this can be even more challenging if the cemented post is radiolucent. Cone-beam computed tomography (CBCT) scans were shown to be a valuable diagnostic aid in diagnosis of such cases. However, in this case, the application of CBCT did not help in diagnosis of a labial fiber post perforation in a maxillary central incisor which was finally detected through exploratory surgery.

Effect of timing of post space preparation on the apical seal when using different sealers and obturation techniques.

BACKGROUND/PURPOSE: To prepare the post apace, some of the root-canal filling material has to be removed, which can affect the apical seal. The aim of this study was to compare the effect of immediate post space preparation to that of delayed post space preparation on apical sealing using three different endodontic sealers and obturation techniques. MATERIALS AND METHODS: In total, 90 decrowned single-rooted human teeth were studied. After root canals were prepared with 0.06 tapered nickel-titanium rotary files to size 30, the roots were categorized randomly into three experimental groups according to the obturation material: (1) AH plus/gutta-percha; (2) Sealite Ultra/gutta-percha; and (3) Epiphany/Resilon. Furthermore in all groups, specimens were categorized randomly into three subgroups according to the obturation technique (n = 10): (1) single cone; (2) cold lateral compaction; and (3) System B + Obtura. After root-canal filling, post space preparation was immediately performed in Group 1, after 24 hours in Group 2, and after 7 days in Group 3. Apical leakage was measured using the fluid-filtration method. Statistical analysis was performed using the Kruskal-Wallis test and Wilcoxon signed ranks test at P < 0.001. RESULTS: Regardless of the obturation technique and sealers used, significantly better (P < 0.001) sealing was achieved at the apical ends using delayed post space preparation than with immediate post preparation. The obturation techniques tested did not significantly affect leakage values. The following statistical ranking of fluid filtration values was obtained for the obturation materials: Epiphany/Resilon > Sealite Ultra/gutta-percha > AH plus/gutta-percha (P < 0.001). CONCLUSION: To reduce apical leakage, clinicians should use AH plus together with any of the obturation techniques after 7 days of obturation.

In vitro evaluation of temperature rise during different post space preparations.

OBJECTIVE: The aim of this study was to evaluate temperature alterations on the outer root surface during post space preparation with six different post drills by using an infrared thermometer. MATERIALS AND METHODS: Sixty extracted single-rooted human mandibular incisor teeth were used. After root canal obturation, the specimens were divided into six groups (n = 10). During post space preparation, the temperature rises were measured in the middle third of the roots using a noncontact infrared thermometer with a sensitivity of 0.1°C. The temperature data were transferred from the thermometer to the computer and were observed graphically. RESULTS: The maximum temperature rise was observed in Snowpost 2 (29.95 ± 10.2°C) (P < 0.001), but there were no significant differences among Snowpost 2 (29.95 ± 10.2°C), Snowpost 1 (24.6 ± 8.0°C), and Relyx 2 (17.68 ± 9.1°C) (P > 0.05). CONCLUSIONS: Although water coolant used, the critical temperature rise was observed on the outer root surface in all post drill systems.

Effect of post space preparation on the sealing ability of mineral trioxide aggregate and Gutta-percha: A bacterial leakage study.

AIM: The purpose of this study was to evaluate the effect of post space preparation on the sealing ability of teeth obturated with mineral trioxide aggregate (MTA) and Gutta-percha. MATERIALS AND METHODS: Fifty intact human mandibular premolars, after decoronation and biomechanical preparation, were randomly divided into three experimental groups. In Group A (n = 10), the canals were obturated with Gutta-percha using cold lateral compaction technique, followed by immediate post space preparation. In Group B (n = 10), the canals were obturated with 8 mm of MTA and in Group C (n = 10), sectional obturation with 4 mm of MTA was done, followed by delayed post space preparation. All specimens were subjected to bacterial leakage analysis, and the occurrence of turbidity was checked. RESULTS: All specimens in the lateral compaction group leaked. The mean number of days at which leakage was observed in Groups A, B and C were 18.5 days, 93.6 days and 95.5 days. CONCLUSIONS: MTA can be considered as an alternative to Gutta-percha as an apical third restorative material for teeth indicated for post and core, as it demonstrates better-sealing ability compared with Gutta-percha. Further, the removal of set MTA for post space preparation does not disrupt the integrity of the remaining apical MTA.

Apical displacement and residual root canal filling with single-cone after post space preparation: a micro-ct analysis

Abstract The purpose of this study was to evaluate the presence of residues after post space preparation (PSP) and establish whether the apical displacement of the gutta-percha was affected by the moments and methods of PSP in teeth filled by the single-cone technique. The root canals of 20 bovine incisor teeth were instrumented with Reciproc and filled with single-cone and AH Plus. The specimens were divided into 4 groups according to the moment and method of PSP (n=5): immediate with drill, immediate with thermoplasticizer, delayed with drill and delayed with thermoplasticizer. Micro-CT scans were performed before and after the PSP for residues of the root canal filling (1) and analysis of apical displacement (2). Data were analyzed by using 2-way repeated measurement ANOVA (1) and 2-way ANOVA (2) followed by the Tukey's test (a=0.05). Significance effect on the residues percentage remaining for methods (p=0.044), for moments (p=0.006), for thirds repetition (p<0.001), and for interaction between methods and thirds (p<0.001), and moments and thirds (p=0.044). Significance effect on the apical displacement of root canal filing was detected for methods (p=0.008), however no difference was found between moments (p=0.617). In general, PSP using drill resulted in more homogeneous root canal preparation, mainly when made immediately. For all other combinations between methods and moments for PSP, the middle and apical thirds presented significant higher residues remaining. Thermo method performed in both moments and the drill method performed immediately had displacement in the apical direction, representing extrusion of the root filling material.

Resumo O objetivo deste estudo foi avaliar a presença de resíduos após o alívio do canal (AC) e verificar se o deslocamento apical da guta-percha foi afetado pelos momentos e métodos de AC em dentes obturados pela técnica do cone único. Os canais radiculares de 20 dentes incisivos bovinos foram instrumentados com Reciproc e obturados com cone único e AH Plus. As amostras foram divididas em 4 grupos de acordo com o momento e método de AC (n=5): broca imediato, termocompactador imediato, broca tardio e termocompactador tardio. Escaneamentos em micro-CT foram realizados antes e após o AC para análise dos resíduos da obturação (1) e do deslocamento apical (2). Os dados foram analisados empregando ANOVA em 2 fatores com medida repetida (1), ANOVA em dois fatores (2), seguidas do teste de Tukey (α=0,05). A porcentagem de resíduos remanescentes foi influenciada pelos métodos (p=0,044), momentos (p=0,006), pelo fator de repetição terços do canal (p<0,001), e pelas interações entre métodos e terços (p<0,001), e momentos e terços (p=0,044). Já para o deslocamento apical da obturação do canal radicular foi detectada influência significativa para os métodos (p=0,008), no entanto, nenhuma diferença foi encontrada entre os momentos (p=0,617). Em geral, AC usando brocas resultou em preparo mais homogêneo dos canais radiculares, principalmente quando realizado imediatamente após a obturação. Para todas as outras combinações entre métodos e momentos de AC, o terço médio e apical apresentaram significativamente maiores resíduos remanescentes. O método termo realizado nos dois momentos e o método broca de preparo realizado imediatamente resultaram em deslocamento na direção apical, representando a extrusão do material de obturação no canal radicular.

Effect of the size of the apical enlargement with rotary instruments, single-cone filling, post space preparation with drills, fiber post removal, and root canal filling removal on apical crack initiation and propagation.

INTRODUCTION: The purpose of this study was to investigate the incidence of apical crack initiation and propagation in root dentin after several endodontic procedures. METHODS: Sixty intact mandibular premolars were sectioned perpendicular to the long axis at 1 mm from the apex, and the apical surface was polished. Thirty teeth were left unprepared and served as a control, and the remaining 30 teeth were instrumented with ProTaper Universal instruments (Dentsply Maillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with the single-cone technique. Gutta-percha was removed with drills of the Rebilda post system (VOCO, Cuxhaven, Germany). Glass fiber-reinforced composite fiber posts were cemented using a dual-cure resin cement. The fiber posts were removed with a drill of the post system. Retreatment was completed after the removal of the gutta-percha. Crack initiation and propagation in the apical surfaces of the samples were examined with a stereomicroscope after each procedure. The absence/presence of cracks was recorded. Logistic regression was performed to analyze statistically the incidence of crack initiation and propagation with each procedure. RESULTS: The initiation of the first crack and crack propagation was associated with F2 and F4 instruments, respectively. The logistic regression analysis revealed that instrumentation and F2 instrument significantly affected apical crack initiation (P < .001). Post space preparation had a significant effect on crack propagation (P = .0004). The other procedures had no significant effects on crack initiation and propagation (P > .05). CONCLUSIONS: Rotary nickel-titanium instrumentation had a significant effect on apical crack initiation, and post space preparation with drills had a significant impact on crack propagation.

Preparación Ultrasónica del Espacio Protésico y su Influencia en la Resistencia Adhesiva de Postes de Fibroresina en Conductos Ovalados / Ultrasonic Preparation of the Prosthetic Space and its Influence on the Bond Strength of Fiber Post in Oval-Shaped Canals

RESUMEN: Paredes sin instrumentar y con material obturador endodóntico residual pueden elevar la posibilidad de la falla adhesiva de postes de fibroresina. Las fresas de desobturación y conformación del espacio protésico poseen una sección circular, lo que dificulta una adecuada preparación y limpieza de las paredes de los conductos ovales. El objetivo del presente estudio fue evaluar la capacidad de limpieza ultrasónica del espacio protésico y cómo ésta influyó en la resistencia a la tracción de postes de fibroresina en conductos ovales. Se utilizaron 30 premolares con conducto ovalado divididos aleatoriamente en 3 grupos de estudio (n=10), siendo: grupo A: preparación rotatoria con complemento ultrasónico, grupo B: preparación rotatoria y grupo C: grupo control. Postes de fibra de vidrio fueron cementados y luego de 7 días se realizaron cortes de un milímetro de grosor del tercio cervical y medio de cada muestra y se evaluó microscópicamente el área de gutapercha remanente y área efectiva de adhesión. Estos fueron sometidos a una prueba de push out evaluando la resistencia adhesiva de los postes. Finalmente fueron observados microscópicamente para analizar tipo de falla. Los resultados se analizaron mediante el test de ANOVA, Bonferroni, Kruskal-Wallis y Mann Whitney (p < 0.05), registrando diferencias estadísticamente significativas en la resistencia a tracción, área de gutapercha remanente y área disponible para la adhesión; además de una relación directa entre gutapercha remanente y menor resistencia a la tracción. Conclusiones: La preparación ultrasónica del espacio protésico aumenta la resistencia a la tracción de postes de fibroresinas cementados en conductos ovalados.

ABSTRACT: Untouched canal walls with residual filling materials can increase the probability of adhesive failure of fiber posts. The drills used for desobturation and conformation of the prosthetic space, has a circular cross section, which does not allow a proper preparation and cleaning of oval-shaped canal walls. The objective of the study was to evaluate the ultrasonic cleaning of the prosthetic space and how this influences the adhesive strength of fiber posts in oval-shaped canals. Thirty (30) oval-shaped canal premolars were randomly divided into 3 groups (n = 10): Group A: rotary desobturation with ultrasonic complement, group B: rotary desobturation without ultrasonic complement and group C: control group. Fiberglass posts were cemented; after 7 days, one-millimeter slices were performed, one of the cervical and another from the middle third of the root. The slices were analyzed under an optical microscope to evaluate remaining gutta percha and effective adhesion area. Samples were subjected to a push-out test to evaluate bond strength of the fiber resin posts. Finally, samples were evaluated microscopically to analyze the type of failure. The results were analyzed using ANOVA, Bonferroni, KruskalWallis and Mann Whitney test (p < 0.05), recording statistically significant differences in bond strength, remaining gutta-percha area and clean walls for adhesion; In addition, to a direct relationship between remaining gutta percha and lower adhesive strength, the ultrasonic preparation of the prosthetic space increases bond strength of fiber posts in oval canals.