Success of Ultrasonic Technique in Removing Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals and Its Effect on the Required Force for Root Fracture

Shahabinejad, Hasan; Ghassemi, Amirreza; Pishbin, Lida; Shahravan, Arash

doi:10.1016/j.joen.2013.02.008

Cited by 54 publications

(68 citation statements)

References 33 publications

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“…Furthermore, Ni-Ti fragments are up to seven times less likely to be removed from inside root canals, even by experienced endodontists [10]. This explains the current interest in the subject by several researchers [11–17]. …”

Section: Introductionmentioning

confidence: 99%

Structural Characterisation and Mechanical FE Analysis of Conventional and M-Wire Ni-Ti Alloys Used in Endodontic Rotary Instruments

Montalvão

Alçada

Fernandes

et al. 2014

The Scientific World Journal

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The purpose of this study is to understand how the M-Wire alloy conditions the mechanical flexibility of endodontic rotary files at body temperature.Two different rotary instruments, a Profile GT 20/.06 and a Profile GT Series X 20/.06, were selected due to their geometrical similarity and their different constituent alloy. GT series X files are made from M-Wire, a Ni-Ti alloy allegedly having higher flexibility at body temperature. Both files were analysed by X-Ray Diffraction and Differential Scanning Calorimetry to investigate phase transformations and the effects of working temperature on these different alloys. Mechanical behaviour was assessed by means of static bending and torsional Finite Element simulations, taking into account the nonlinear superelastic behaviour of Ni-Ti materials. It was found that GT files present austenitic phase at body temperature, whereas GT series X present R-phase at temperatures under 40°C with a potential for larger flexibility. For the same load conditions, simulations showed that the slight geometrical differences between the two files do not introduce great disagreement in the instruments' mechanical response. It was confirmed that M-Wire increases the instrument's flexibility, mainly due to the presence of R-phase at body temperature.

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Section: Introductionmentioning

confidence: 99%

Structural Characterisation and Mechanical FE Analysis of Conventional and M-Wire Ni-Ti Alloys Used in Endodontic Rotary Instruments

Montalvão

Alçada

Fernandes

et al. 2014

The Scientific World Journal

View full text Add to dashboard Cite

show abstract

“…Different ranges among clinical studies may be attributed to the fact that they were conducted under different and non-comparable conditions with respect to sample choice, technique used, as well as the capability of the clinician. The rate of successful fragment removal (44%-95%) is higher than that of successful instrument bypass (9%-47.7%) 28,61 ; something that could be ascribed to the challenging nature of bypass procedure 28 .…”

Section: Ultrasonics-dental Operating Microscopementioning

confidence: 94%

“…According to both in vitro and ex vivo studies, the success rate for treatment of a separated instrument ranges between 70% and 91.8% [56][57][58][59][60][61][62] Clinical studies (of in vivo treatment) indicate an even higher range, since they start at 53% and reach 95% 1,3,18,20,[27][28][29]57 . Both bypass and removal of the fragment are included in the above success rates.…”

Section: Ultrasonics-dental Operating Microscopementioning

confidence: 99%

Separated instrument in endodontics: Frequency, treatment and prognosis

Vouzara¹,

Chares²,

Lyroudia³

2018

Balkan J Dent Med

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SummaryInstrument separation during endodontic therapy is a frequent accident with rotary instruments being more likely to separate than manual ones. The treatment of cases with a separated instrument can be either conservative or surgical. A conservative approach involves the following treatment choices: a) bypass of the fragment, b) removal of the fragment, c) instrumentation and obturation coronally to the fragment. Concerning the removal of a separated instrument, a variety of techniques and systems have been developed. Ultrasonics, in combination with the operative microscope constitute the most effective and reliable tools for removing a separated endodontic instrument from a root canal. The likelihood of successful removal depends on: the level of separation (coronal, middle or apical third); location in relation to the root canal curvature; the type of separated instrument; its length; the degree of canal curvature and the tooth type. Several complications may occur during the management of a separated instrument: separation of the ultrasonic tip or file used for bypassing or removing the instrument; further separation of the fragment; perforation; ledge; extrusion of the file into periapical tissues; tooth weakening due to dentin removal, as well as excessive temperature rise in periodontal tissues. Prognosis for a tooth retaining a separated instrument depends on the presence of a periapical lesion, the microbial load of the root canal during the time of separation and the quality of the obturation.

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“…8,9 Nonsurgical remedies for file fracture consist of three strategies: removal of fractured instrument from canal space, to bypass the fractured file and instrument in the apical third and if above two are not possible then prepare and obturate the accessible part of the canal. 2 Presence of separated instrument in the canal hinders accessibility to the apical terminus thus compromising cleaning and shaping procedure.…”

Section: Jcdmentioning

confidence: 99%

Retrieval of Separated Instrument using Ultrasonics in a Permanent Mandibular Second Molar: A Case Report

Shenoy¹,

Sokhi²

2014

Journal of Contemporary Dentistry

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Clinicians are frequently challenged by endodontically treated teeth that have obstructions, such as hard impenetrable pastes, separated instruments, silver points or posts in their root canals. Intracanal separation of endodontic instruments may hinder cleaning and shaping procedures within the root canal system, with a potential impact on the outcome of treatment. Broken instruments usually prevent access to the apex and the prognosis of teeth with broken instruments in the canals may be lower than for normal ones. The prognosis of these cases mainly depends on the preoperative condition of the periapical tissues. For these reasons, an attempt to remove broken instruments should be undertaken in every case.Ultrasonics have often been advocated for the removal of broken instruments because the ultrasonic tips or endosonic files may be used deep in the root canal system. Furthermore, the use of an ultrasonic endodontic device is not restricted by the position of the fragment in the root canal or the tooth involved. This case report elaborates on retrieval of broken instrument lodged in the coronal third of the root canal using ultrasonics and dental operating microscope.

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Success of Ultrasonic Technique in Removing Fractured Rotary Nickel-Titanium Endodontic Instruments from Root Canals and Its Effect on the Required Force for Root Fracture

Cited by 54 publications

References 33 publications

Structural Characterisation and Mechanical FE Analysis of Conventional and M-Wire Ni-Ti Alloys Used in Endodontic Rotary Instruments

Structural Characterisation and Mechanical FE Analysis of Conventional and M-Wire Ni-Ti Alloys Used in Endodontic Rotary Instruments

Separated instrument in endodontics: Frequency, treatment and prognosis

Retrieval of Separated Instrument using Ultrasonics in a Permanent Mandibular Second Molar: A Case Report

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