CONFOCAL MICROSCOPIC EVALUATION OF DENTINAL CRACKS USING DIFFERENT ROTARY FILE SYSTEMS: PROTAPER NEXT, HYFLEX CM AND HYFLEX EDM.

Dr. Kirti Rathee, Dr. Ankita Sundan, Dr. Anjum Zia, Dr. Deepanshi, Dr. Vandana Gulia

Abstract


Aim: The aim of the present study was to investigate the incidence of cracks in root dentin after root canal preparation with ProTaper Next, HyFlex CM and Hyflex EDM rotary file systems. Methods: 60 single rooted mandibular premolars were selected. All the specimens were divided into four groups of 15 teeth each. Group I- unprepared root canal serve as control. Group II- were prepared with ProTaper Next to size 25/0.06, Group III- were prepared with Hyflex CM to size 25/0.04 and Group IV- were prepared with Hyflex EDM to size 25/-. After root canal preparation, all the roots were horizontally sectioned at 2mm and 4mm from the apex, and the sections were then observed under Confocal Laser Scanning Microscope with 4X magnification. The absence/presence of cracks was recorded, and the data were analyzed with a chi-square test. The significance level was set at P = .05. Results: No cracks were observed in the control group. Vertical root fractures were not observed in any of the groups. The Hyflex EDM file system caused fewer cracks (10%) than the ProTaper Next (20%) and Hyflex CM (16.7) file systems. However, there were no significant differences in crack formation among different file systems (P > .05). Conclusions: Within the limitations of this in vitro study, all of the instrumentation systems used in this study created cracks in the root dentin. The Hyflex EDM  file system tended to cause fewer dentinal cracks compared with the ProTaper Next and Hyflex CM file systems.


Keywords


ProTaper Next, Hyflex CM, Hyflex EDM, Confocal laser electron microscope, Dentinal cracks.

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References


Peters OA. Current challenges and concepts in the preparation of root canal systems: A review. J Endod.2004;30:559–67.

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: An in vitro study. J Endod.2009;35(2):236-8.

Hargreaves KM, Cohen S. Pathways of the Pulp, 10th ed. Mosby, Elsevier; 2011. Chapter 23, Instruments of Cleaning and Shaping; p.813-48.

Pasqualini D, Scotti N, Tamagnone L, Ellena F, Berutti E. Hand-operated and rotary ProTaper instruments: a comparison of working time and number of rotations in simulated root canals: An in vitro study. J Endod.2008;34(3):314-7.

Yoldas O, Yilmaz S, Atakan G, Kuden C, Kasan Z. Dentinal microcrack formation during root canal preparations by different NiTi rotary instruments and the self­adjusting file: An in vitro study. J Endod.2012;38(2):232–5.

Ruddle CJ. Endodontic disinfection: Tsunami irrigation: An in vitro study. Saudi Endod J.2015;5(1):1-12.

Casido R, Stephen J. Hyflex CM rotary files: An excellent innovation for endodontic treatment. Endod Pract.2012;6(4):10-7.

Daneshmand S, Monfared V, Neyestanak A. Effect of tool rotational and aluminium oxide powder in electrodischarge machining characteristics of NiTi-60 shape memory alloy. Silicon.2017;9(2):273-83.

Savio FL, Pedullà E, Rapisarda E, La Rosa G. Influence of heat-treatment on torsional resistance to fracture of nickel-titanium endodontic instruments: An in vitro study. Int Endod J.2016;31(2):1311-8.

Adorno CG, Yoshioka T, Suda H. Crack initiation on the apical root surface caused by three different Nickel-titanium rotary files at different working lengths: An in vitro study. J Endod.2011;37(4):522-5.

Barreto MS, Moraes Rdo A, Rosa RA, Moreira CH, Reis MV, Bier CA. Vertical root fractures and dentin defects: effects of root canal preparation, filling and mechanical cycling: An in vitro study. J Endod.2012;38(8):1135-8.

Mavani P, Pujar M, Uppin V, Vagarali H, Patil C, Yalagi V. Comparative evaluation of root microcracks by different rotary and reciprocating endodontic file system: An in vitro study. IOSR.2015;15(9):18-22.

Gergi RM, Osta NE, Naaman AS. Dentinal crack formation during root canal preparation by the twisted file adaptive, Reciproc and WaveOne instruments: An in vitro study. Eur J Dent.2015;9(4):508-12.

Ashraf F, Shankarappa P, Misra A, Sawhney A, Sridevi N, Singh A. A stereomicroscopic evaluation of dentinal cracks at different instrumentation length by using different rotary files Protaper Universe, Protaper Next and Hyflex CM: An ex vivo study. Int Endod J.2016;45(4):1-7.

Priya NT, Chandrasekhar VE, Anita S, Tummala MU, Raj TB, Badami V et al. Dentinal microcracks after root canal preparation” a comparative evaluation with hand, rotary and reciprocating instrumentation: An in vitro study. J Clin Diagn Res.2014;8(12):70-2.

Milani AS, Froughreyhani M, Rahimi S, Jafarabadi MA, Paksefat S. The Effect of Root Canal Preparation on the Development of Dentin Cracks: An in vitro study. Iran Endod J.2012;7(4):177-182.

Capar ID, Arslan H, Akcay M, Uysal B. Effects of ProTaper Universal, ProTaper Next, and HyFlex instruments on crack formation in dentin: An in vitro study. J Endod.2014;40(9):1482-4.

Shemesh H, Bier CA, Wu MK, Tanomaru‐Filho M, Wesselink PR. The effects of canal preparation and filling on the incidence of dentinal defects: An in vitro study. Int Endod J.2009;42(3):208-13.

Jain A, Bhadoria K, Chaudhary B, Patidar N. Comparison of dentinal defects induced by hand files, multiple and single rotary files: A stereomicroscopic study. World J Dent.2017;8(1):45-8.

Venino PM, Citterio CL, Pellegatta A, Ciccarelli M, Maddalone M. A micro-computed tomography evaluation of the shaping ability of two NiTi instruments, Hyflex EDM and Protaper Next: An in vitro study. J Endod.2017;43(4):628-32.

Hulsmann M, Peters OA, Dummer PM. Mechanical preparation of root canals: shaping goals, techniques and means. Endodontic topics.2005;1(10):30-76.

Mcspadden JT. Mastering Endodontic Instrumentation. 2nd ed.2007. Chapter 2, Mastering Instrument Design; p.54-90.

Goldberg IS, Maree M, Liberman R, Heling L. Effect of sodium hypochlorite on dentin microhardness. J Endod.2004;30(12):880-2.

Burklein S, Tsotsis P, Schafer E. Incidence of dentinal defects after root canal preparation: reciprocating versus rotary instrumentation: An in vitro study. J Endod.2013;39(4):501-4.

Nasr H.M, Kader K.G. Dentinal damage and fracture resistance of oval roots prepared with single file system using different kinematics: An in vitro study. J Endod.2013;40(6):849-51.

Shori DD, Shenoi PR, Baig AR, Kubde R, Makade C, Pandey S. Stereomicroscopic evaluation of dentinal defects induced by new rotary system:“ProTaper NEXT”: An in vitro study. J Conserv Dent.2015;18(3):210-13.

Singh H, Kapoor P. Hyflex CM and Hyflex EDM files: Revolutionizing the art and science of endodontics. J Dent Health Oral Disord Ther.2016;5(7):1-4.

Sankhe DD. Evaluation of effect of Hyflex EDM on root dentin during root canal preparation: A stereomicroscopic study. Int J Med Dent Sci.2017;6(2):1525-8.

Pedulla E, Genovesi F, Rapisarda S, Larosa GR, Grande NM, Plotino G, Adorno CG. Effect of 6 single file systems on dentinal crack formation: An in vitro study. J Endod.2016;43(3):456-61.

Kesim B, Sagsen B, Aslan T. Evaluation of dentinal defects during root canal preparation using thermomechanically processed nickel-titanium files: An in vitro study. Eur J Dent.2017;11(2):157-61.


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