DETECTION OF CRACK FORMATION FOLLOWING CORONAL FLARING WITH THREE DIFFERENT INSTRUMENTS USING TWO EVALUATION METHODS (IN VITRO STUDY) | ||||
Alexandria Dental Journal | ||||
Article 2, Volume 42, Issue 2, December 2017, Page 135-140 PDF (854.78 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/adjalexu.2017.57916 | ||||
View on SCiNiTO | ||||
Authors | ||||
Sally M. Nazir* 1; Amr M. Abdallah2; Nayera A. Mokhless3 | ||||
1B.D. S 2009 | ||||
2Professor of Endodontics, Faculty of Dentistry, Alexandria University | ||||
3Assistant Professor of Endodontics, Faculty of Dentistry, Alexandria University | ||||
Abstract | ||||
INTRODUCTION: Coronal flaring is now considered as an essential preparatory step in root canal treatment sequence. OBJECTIVES: To detect crack formation after coronal flaring of root canals with Gates Glidden (GG) drills, ProTaper Universal (PT) SX, and Endoflare (Ef) flaring instruments using cone beam computed tomography (CBCT) and scanning electron microscope (SEM). MATERIALS AND METHODS: Thirty mesiobuccal canals of mandibular first molars were selected. Teeth specimens were classified into three equal groups according to the instrument used for coronal flaring. Group1: Gates Glidden drills, group 2: ProTaper Universal SX and group 3: Endoflare instruments. Preoperative and postoperative (CBCT) imaging was performed and defect formation was detected. All roots were sectioned horizontally at 2,4and 6 mm from the cementoenamel junction. The sections were inspected under SEM, and any defect formations were recorded and compared with CBCT images according to scoring system. Data were collected and then statistically analyzed at an alpha error of 0.05. P≤0.05 were considered significant. RESULTS: The Ef file produced significantly less dentinal defects compared with the GG and PT SX at the three studied sections. Significant differences were found between the 3 groups at 2 and 4 mm with values (P=0.026) & (P=0.050) respectively, while no significant difference was found at 6mm with value of (P=0.217) when using the 2 evaluation methods. There was a significant difference (P=0.049) between the two used evaluation methods. CONCLUSIONS: Although all used coronal flaring instruments caused dentinal defects, Endoflare file showed the least defects. CBCT was not able to detect the smallest defects such as craze lines while SEM showed more capabilities and was considered as a confirmatory method. | ||||
Keywords | ||||
Coronal flaring; cracks; Cone beam computed tomography; Scanning electron microscope | ||||
References | ||||
1. Peters OA, Peters CI, Schonenberger K, Barbakow F. Pro Taper rotary root canal preparation: effect of canal anatomy on final shape analyzed by micro CT. Int Endod J 2003; 36:86-92.
2. Schneider SW. Comparison of the canal preparation in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971; 32:271-5
3. Liu R, Kaiwar A, Shemesh H. Incidence of Apical Root Cracks and Apical Dentinal Detachments after Canal Preparation with Hand and Rotary Files at Different Instrumentation Lengths. J Endod. 2013; 39:129-32
4. Barreto MS, MoraesRdo A, Rosa RA, Moreira CH, So MV, Bier CA. Vertical root fractures and dentin defects: Effects of root canal preparation, filling and mechanical cycling. J Endod. 2012; 38:1135-9.
5. Tahmasebi P, Javadpour F, Sahimi M. Three-Dimensional Stochastic Characterization of Shale SEM Images. Transp Porous Med. 2015; 3:521-31.
6. Canillioglu E, Bahcesehir ES. Preparation Techniques of Luminal and Hard Tissues for Scanning Electron Microscopy. In: Méndez-Vilas A, ed. Microscopy: advances in scientific research and education. Spain: Formatex Research Center; 2014;741-6.
7. Bernardes RA, deMoraes IG, Duarte MAH, Azevedo BC, de Azevedo JR, Bramante CM. Use of cone-beam volumetric tomography in diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108:270-7.
8. Hassan B, Metska ME, Ozok AR, Van der Stelt P, Wesselink PR. Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. J Endod. 2009; 35:719-22
9. Hartmann MSM, Barletta FB, Fontanella VRC, Vanni JR. Canal transportation after root canal instrumentation: a comparative study with computed tomography. J Endod. 2007; 33:962-5.
10. Sanfelice CM, da Costa FB, Reis Só MV, Vier-Pelisser F, Souza Bier CA, Grecca FS. Effects of Four Instruments on Coronal Pre-enlargement by Using Cone Beam Computed Tomography. J Endod. 2010; 36:858-61.
11. Sousa K, Andrande-junior CV, Da silva JM, De-Deus G. Comparison of the effects of TripleGates and GatesGlidden burs on cervical dentin thickness and root canal area by using cone beam computed tomography J Appl Oral Sci. 2015;23:164-8
12. Farman AG. ALARA still applies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2005;4:395-7.
13. Ӧzer SY. Detection of Vertical Root Fractures by Using Cone Beam Computed Tomography with Variable Voxel Sizes in an in Vitro Model. J Endod. 2011; 37:75-9.
14. Tanimoto H, Arai Y. The effect of voxel size on image reconstruction in cone-beam computed tomography. Oral Radiol. 2009; 25:149-53.
15. Ashwinkumar V, Krithikadatta J, Surendran S, Velmurugan N. Effect of reciprocating file motion on microcrack formation in root canals: an SEM study. Int Endod J. 2014; 47:622-7.
16.Ҫiҫek E, KoҫAK MM, SağLam BC, KoҫAK S. Evaluation of Microcrack Formation in Root Canals After Instrumentation with different NiTi Rotary File Systems: A Scanning Electron Microscopy Study. Scanning. 2015; 37:49-53.
17. Ӧzer SY. Detection of Vertical Root Fractures of Different Thicknesses in Endodontically Enlarged Teeth by Cone Beam Computed Tomography versus Digital Radiography. J Endod. 2010; 36:1245-9.
18.Bier CA, Shemesh H, Tanomaru-Filho M, Wesselink PR, Wu MK. The ability of different nickel-titanium rotary instruments to induce dentinal damage during canal preparation. J Endod. 2009; 35:236-8.
19. Shemesh H, Bier CA, Wu MK, Tanomaru-Filho M, Wesselink PR. The effects of canal preparation and filling on the incidence of dentinal defects. Int Endod J. 2009; 42:208-13.
20. Neves FS, Souza TC, de-Azevedo-Vaz SL. Influence of cone-beam computed tomography milliamperage settings on image quality of the mandibular third molar region. Oral Radiol. 2014; 30:27-31.
21. Gunduz K, Avsever H, Orhan K. Comparison of intraoral radiography and cone beam computed tomography for the detection of vertical root fractures: an in vitro study. Oral Radiol 2013; 29:6-12.
22. Kajan ZD, Taromsari M. Value of cone beam CT in detection of dental root fractures. Dentomaxillofac Radiol. 2012; 41:3-10.
23. Heard F, Walton RE. Scanning electron microscope study comparing four root canal preparation techniques in small curved canals. Int Endod J. 1997; 30:323-31.
24. Onnink PA, Davis RD, Wayman BE. An in vitro Comparison of incomplete root fractures associated with three obturation techniques. J Endod. 1994;20;32-7.
25. Shemesh H, Van Soest G, Wu MK, Wesselink PR. Diagnosis of vertical root fracture with optical coherence tomography. J Endod. 2008; 34:739-42
26. Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Relationship between density variability and imaging volume size in cone-beam computerized tomographic scanning of the maxillofacial region: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107:420-5.
27. Arslan H, Karataş E, Capar ID, Ozsu D, Doğanay E. Effect of ProTaper Universal, Endoflare, Revo-S, HyFlex Coronal Flaring Instruments, and Gates Glidden Drills on Crack Formation. J Endod. 2014; 40:1681-3.
28.Blum JY, Machtou P, Ruddle C, Micallef JP. Analysis of mechanical preparations in extracted teeth using ProTaper rotary instruments: value of the safety quotient. J Endod. 2003; 29:567-75.
29. Kim HC, Lee MH, Yum J, Versluis A, Lee CJ, Kim BM. Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture. J Endod. 2010; 36:1195-9.
30. Porto Carvalho LA, Bonetti I, Gagliardi Borges MA. A comparison of molar root canal preparation using stainless steel and nickel–titanium instruments. J Endod.1999; 25:807-10.
31.Coutinho-Filho T, De-Deus G, Gurgel-Filho ED, RochaLima AC, Dias KR, Barbosa CA. Evaluation of the risk of a stripping perforation with Gates-Glidden drills: serial versus crown-down sequences. Braz Oral Res. 2008; 22:18- 24.
32. Wu MK, Van der Sluis LW, Wesselink PR. The risk of furcal perforation in mandibular molars using GatesGlidden drills with anticurvature pressure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99:378-82.
33. Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J Endod. 1997; 23:533-4.
34.Rundquist BD, Versluis A. How does canal taper affect root stresses. Int Endod J. 2006; 39:226-37.
35. Sousa BC, Costa-Filho JR, Almeida-Gomes F, ManígliaFerreira C, Gurgel-Filho ED, Albuquerque DS. Evaluation of the dentin remaining after flaring using gates glidden drills and protaper rotary files. RSBO. 2011; 8:194-9.
36. Sathorn C, Palamara JE, Messer HH. A comparison of the effects of two canal preparation techniques on root fracture susceptibility and fracture pattern. J Endod. 2005; 31:283-7.
37. Yoldas O, Yilmaz S, Atakan G, Kuden C, Kasan Z. Dentinal Microcrack Formation during Root Canal Preparations by Different NiTi Rotary Instruments and the Self-Adjusting File. J Endod. 2012; 38:232-5.
| ||||
Statistics Article View: 415 PDF Download: 599 |
||||