Influence of Prior Cervical Enlargement on Apical Cleaning Using Single File

Abstract

The goal of this study was to compare the apical cleaning capabilities of single files from 3 different rotary systems in the presence or absence of prior cervical preparation based on a histological analysis. A total of 84 human single-rooted mandibular permanent incisors were divided into 6 groups (14 canals each). Cleaning and shaping was performed under the following protocols: Group I, F2 ProTaper at working length; Group II, SX ProTaper and F2 ProTaper; Group III, size 25, .06 taper Mtwo at working length; Group IV, SX ProTaper and size 25, .06 taper Mtwo; Group V, size 25, .06 taper BR3 BioRace at working length; and Group VI, SX ProTaper and size 25, .06 taper BR3 BioRace. After cleaning and shaping, the root canals were evaluated by histological analysis. The percentage of remaining debris was evaluated using a cross-hatched grid superimposed over each image. Data were assessed using the Shapiro-Wilk and ANOVA tests. Statistically significant differences were observed between groups (p=0.0001) with respect to amount of remaining debris; use of SX in conjunction with F2 ProTaper yielded a significantly lower mean percentage of debris. It was concluded that cleaning ability improves when root canal preparation with F2 ProTaper is complemented by prior cervical enlargement.

A micro-CT evaluation of the performance of rotary and reciprocating single-file systems in shaping ability of curved root canals

“…The literature shows that the presence of interference in the cervical region results in accidents and major changes in apical third, 32 and that performing a cervical pre-flaring prior to the use of single file systems is critical to the maintenance of root canal, avoiding canal transportation in the middle and apical thirds. 25,33 During the biomechanical preparation of curved canals, the maintenance of the root canal shape and direction is directly related to the success of endodontic treatment. 25,34,35…”

Alterações sinusiais e sua relação com as infecções de origem endodôntica: revisão de literatura

“…Uma vez instalada a necrose pulpar, pode ocorrer uma evolução do processo patológico através do forame apical e causar periodontite apical aguda ou crônica e até mesmo os abcessos periapicais agudos e crônicos (Kwiatkowska et al, 2021;Boeddinghaus e Whyte, 2020). Nos quadros agudos a sintomatologia é dolorosa, no teste de percussão vertical e horizontal a sensibilidade é aumentada, apresenta-se dor pulsátil, permanente e localizada, já nos quadros crônicos não há sintomatologia dolorosa (Leonardi et al, 2011;Yilmaz et al, 2016).…”

“…Em radiografias periapicais podemos notar uma região radiolúcida e circunscrita no ápice dentário podendo ser sutil ou evidente (Leonardi et al, 2011;Craig et al, 2021;Craig et al, 2020). As lesões periapicais também podem surgir após tratamentos endodônticos ineficazes, em casos de sinusites odontogênicas, o edema formado devido as periodontites e abcessos podem estar ausentes, pois a infecção pode se expandir para seio maxilar e não para a cavidade oral (CRAIG et al, 2021;GÂTA et al,2021).…”

“…As iatrogenias foram mostradas como a principal causa das sinusites odontogênicas, em segundo foram os casos de patologias periodontais e periapicais e os dentes mais acometidos foram os primeiros molares superiores e em seguida os segundos molares superiores (NETO et. al., 2019;Leonardi et al, 2011;Craig et al, 2021;Craig et al, 2020;Kwiatkowska et. al., 2021;Boeddinghaus e Whyte, 2020).…”

Root canal length changes during mechanical preparation due to different cervical enlargement patterns

“…3 The cervical flaring has been pointed as an important chemical-mechanical preparation step of the root canal once it reduces cervical interferences, such as dentin projection. 4 Flaring the cervical third of the root also improves its medium and apical third cleaning 5,6 and reduces the amount of debris that could be extruded from the apical foramina 7,8 and also a flare-up incidence. 4,9 Cervical preflaring may also reduce the instrument fracture incidence 10,11 and allow a more precise electronic odontometry performance, [12][13][14] given that the endodontic file could be better adjusted to the apical third of the root.…”