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VOLUME 23 , ISSUE 1 ( January, 2022 ) > List of Articles

ORIGINAL RESEARCH

Comparative Evaluation of Potential Dentinal Microcracks Related to Instrumentation alongside Bypassed Broken Instruments: An In Vitro Study

Mohammad Yaman Seirawan, Mohammad Kinan Seirawan, Mazen Doumani

Keywords : Bypassed broken instruments, Dentinal microcracks, Microscopic magnification

Citation Information : Seirawan MY, Seirawan MK, Doumani M. Comparative Evaluation of Potential Dentinal Microcracks Related to Instrumentation alongside Bypassed Broken Instruments: An In Vitro Study. J Contemp Dent Pract 2022; 23 (1):14-21.

DOI: 10.5005/jp-journals-10024-3282

License: CC BY-NC 4.0

Published Online: 21-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim and objective: To investigate the occurrence of microcracks in the canals containing broken instruments in the middle and apical thirds after instrumentation with various systems. Materials and methods: One-hundred and fifty mature mandibular premolars with single straight canal were collected and stored in distilled water. Samples were checked out from any preexisting deformation or cracks, and then standardized in length. Thirty teeth were never instrumented (NI) as a control group, 60 teeth have received a broken instrument in the middle third, and 60 ones at the apical third. Teeth were placed in resin blocks with simulation of periodontal ligaments. After bypassing the instruments, samples were divided into four groups n = 30; first group was prepared manually MN until 25/0.02, while the other three groups were prepared until 25/0.04 using three different rotary systems; Race RC—2Shape TS—Hyflex CM HCM. Roots were cut transversely at levels of broken instruments and examined under 40× microscopic magnification. Results: All the rotary groups produced microcracks. No significant difference of the partial cracks was observed among all groups at the middle and apical levels p >0.05. TS produced more complete cracks compared to each of NI, MN, RC at middle level and NI, MN at apical level; p <0.05. No significant differences of microcracks incidence were observed between two middle and apical levels among the five groups. Conclusion: Dentinal microcracks could be obviously resulted after rotary instrumentation alongside broken instruments, while manual shaping was less likely to cause microcracks. Clinical significance: Manual files were less likely to induce microcracks alongside broken instruments in comparison with rotary files which could be considered much safer.


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  1. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod 2004;30(8):559–567. DOI: 10.1097/01.don.0000129039.59003.9d.
  2. Yoldas O, Yilmaz S, Atakan G, et al. Dentinal microcrack formation during root canal preparations by different NiTi rotary instruments and the self-adjusting file. J Endod 2012;38(2):232–235. DOI: 10.1016/j.joen.2011.10.011.
  3. Shantiaee Y, Dianat O, Mosayebi G, et al. Effect of root canal preparation techniques on crack formation in root dentin. J Endod 2019;45(4):447–452. DOI: 10.1016/j.joen.2018.12.018.
  4. Schäfer E, Lau R. Comparison of cutting efficiency and instrumentation of curved canals with nickel-titanium and stainless-steel instruments. J Endod 1999;25(6):427–430. DOI: 10.1016/S0099-2399(99)80272-6.
  5. Garg S, Mahajan P, Thaman D, et al. Comparison of dentinal damage induced by different nickel-titanium rotary instruments during canal preparation: an in vitro study. J Conserv Dent 2015;18(4):302–305. DOI: 10.4103/0972-0707.159730.
  6. Gambill JM, Alder M, del Rio CE. Comparison of nickel-titanium and stainless steel hand-file instrumentation using computed tomography. J Endod 1996;22(7):369–375. DOI: 10.1016/S0099-2399(96)80221-4.
  7. Bier CA, Shemesh H, Tanomaru-Filho M, et al. The ability of different nickel-titanium rotary instruments to induce dentinal damage during canal preparation. J Endod 2009;35(2):236–238. DOI: 10.1016/j.joen.2008.10.021.
  8. Kim HC, Lee MH, Yum J, et al. Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture. J Endod 2010;36(7):1195–1199. DOI: 10.1016/j.joen.2010.02.010.
  9. Abou El Nasr HM, Abd El Kader KG. Dentinal damage and fracture resistance of oval roots prepared with single-file systems using different kinematics. J Endod 2014;40(6):849–851. DOI: 10.1016/j.joen.2013.09.020.
  10. Baumann MA. Reamer with alternating cutting edges-concept and clinical application. Endod Topics 2005;10(1):176–178. DOI: 10.1111/j.1601-1546.2005.00116.x.
  11. 2Shape Brochure. Available from: https://micro-mega.com/wp-content/uploads/2018/03/60301807-C_Brochure-2Shape_EN_WEB.pdf [Accessed in December 2020].
  12. Hyflex-CM-EDM Brochure. Available from: https://global.coltene.com/pim/DOC/BRO/docbro6846-03-18-en-hyflex-cm-edm-a4senaindv1.pdf [Accessed in December 2020].
  13. Adl A, Shahravan A, Farshad M, et al. Success rate and time for bypassing the fractured segments of four NiTi rotary instruments. Iran Endod J 2017;12(3):349–353. DOI: 10.22037/iej.v12i3.16866.
  14. Madarati AA, Hunter MJ, Dummer PM. Management of intracanal separated instruments. J Endod 2013;39(5):569–581. DOI: 10.1016/j.joen.2012.12.033.
  15. Capar ID, Arslan H, Akcay M, et al. Effects of ProTaper Universal, ProTaper Next, and HyFlex instruments on crack formation in dentin. J Endod 2014;40(9):1482–1484. DOI: 10.1016/j.joen.2014.02.026.
  16. Wilcox LR, Roskelley C, Sutton T. The relationship of root canal enlargement to finger-spreader induced vertical root fracture. J Endod 1997;23(8):533–534. DOI: 10.1016/S0099-2399(97)80316-0.
  17. Shemesh H, Bier CA, Wu MK, et al. The effects of canal preparation and filling on the incidence of dentinal defects. Int Endod J 2009;42(3):208–213. DOI: 10.1111/j.1365-2591.2008.01502.x.
  18. Shori DD, Shenoi PR, Baig AR, et al. Stereomicroscopic evaluation of dentinal defects induced by new rotary system: “ProTaper NEXT”. J Conserv Dent 2015;18(3):210–213. DOI: 10.4103/0972-0707.154045.
  19. Onnink PA, Davis RD, Wayman BE. An in vitro comparison of incomplete root fractures associated with three obturation techniques. J Endod 1994;20(1):32–37. DOI: 10.1016/s0099-2399(06)80024-5.
  20. Rahimi S, Janani M, Lotfi M, et al. A review of antibacterial agents in endodontic treatment. Iran Endod J 2014;9(3):161–168. PMID: 25031587.
  21. Versiani MA, Souza E, De-Deus G. Critical appraisal of studies on dentinal radicular microcracks in endodontics: methodological issues, contemporary concepts, and future perspectives. Endod Topics 2015;33:87–156. DOI: 10.1111/etp.12091.
  22. Çapar İD, Gök T, Uysal B, et al. Comparison of microcomputed tomography, cone beam tomography, stereomicroscopy, and scanning electron microscopy techniques for detection of microcracks on root dentin and effect of different apical sizes on microcrack formation. Microsc Res Tech 2019;82(10):1748–1755. DOI: 10.1002/jemt.23341.
  23. De-Deus G, Silva EJ, Marins J, et al. Lack of causal relationship between dentinal microcracks and root canal preparation with reciprocation systems. J Endod 2014;40(9):1447–1450. DOI: 10.1016/j.joen.2014.02.019.
  24. De-Deus G, Belladonna FG, Souza EM, et al. Micro-computed tomographic assessment on the effect of ProTaper next and twisted file adaptive systems on dentinal cracks. J Endod 2015;41(7):1116–1119. DOI: 10.1016/j.joen.2015.02.012.
  25. Stringheta CP, Pelegrine RA, Kato AS, et al. Micro-computed tomography versus the cross-sectioning method to evaluate dentin defects induced by different mechanized instrumentation techniques. J Endod 2017;43(12):2102–2107. DOI: 10.1016/j.joen.2017.07.015.
  26. Ceyhanli KT, Erdilek N, Tatar I, et al. Comparison of ProTaper, RaCe and Safesider instruments in the induction of dentinal microcracks: a micro-CT study. Int Endod J 2016;49(7):684–689. DOI: 10.1111/iej.12497.
  27. Bayram HM, Bayram E, Ocak M, et al. Effect of ProTaper Gold, Self-Adjusting File, and XP-endo shaper instruments on dentinal microcrack formation: a micro-computed tomographic study. J Endod 2017;43(7):1166–1169. DOI: 10.1016/j.joen.2017.02.005.
  28. PradeepKumar AR, Shemesh H, Chang JW, et al. Preexisting dentinal microcracks in nonendodontically treated teeth: an ex vivo micro-computed tomographic analysis. J Endod 2017;43(6):896–900. DOI: 10.1016/j.joen.2017.01.026.
  29. Zuolo ML, De-Deus G, Belladonna FG, et al. Micro-computed tomography assessment of dentinal micro-cracks after root canal preparation with TRUShape and self-adjusting file systems. J Endod 2017;43(4):619–622. DOI: 10.1016/j.joen.2016.11.013.
  30. Liu R, Hou BX, Wesselink PR, et al. The incidence of root microcracks caused by 3 different single-file systems versus the ProTaper system. J Endod 2013;39(8):1054–1056. DOI: 10.1016/j.joen.2013.04.013.
  31. Üstün Y, Topçuoğlu HS, Düzgün S, et al. The effect of reciprocation versus rotational movement on the incidence of root defects during retreatment procedures. Int Endod J 2015;48(10):952–958. DOI: 10.1111/iej.12387.
  32. Karataş E, Gündüz HA, Kırıcı DÖ, et al. Incidence of dentinal cracks after root canal preparation with ProTaper Gold, Profile Vortex, F360, Reciproc and ProTaper Universal instruments. Int Endod J 2016;49(9):905–910. DOI: 10.1111/iej.12541.
  33. De Vasconcelos RA, Murphy S, Carvalho CA, et al. Evidence for reduced fatigue resistance of contemporary rotary instruments exposed to body temperature. J Endod 2016;42(5):782–787. DOI: 10.1016/j.joen.2016.01.025.
  34. Nishad SV, Shivamurthy GB. Comparative analysis of apical root crack propagation after root canal preparation at different instrumentation lengths using ProTaper Universal, ProTaper Next and ProTaper Gold Rotary Files: an in vitro study. Contemp Clin Dent 2018;9(1):S34–S38. DOI: 10.4103/ccd.ccd_830_17.
  35. Uslu G, Özyürek T, Gündoğar M, et al. Cyclic fatigue resistance of 2Shape, Twisted File and EndoSequence Xpress nickel-titanium rotary files at intracanal temperature. J Dent Res Dent Clin Dent Prospects 2018;12(4):283–287. DOI: 10.15171/joddd.2018.044.
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