Dentinal Crack Formation and Quality of Obturation Using Two Single File Systems and Two Obturation Techniques: A micro-CT Study.

Authors

  • Shaban Shaban Omar Department of Conservative Dentistry, College of Dentistry, University of Duhok, Iraq.
  • Bahar Jafaar Selivany Department of Conservative Dentistry, College of Dentistry, University of Duhok, Iraq.

DOI:

https://doi.org/10.15218/edj.2024.8

Keywords:

Dentinal crack, Voids, Micro CT, Guttacore, Singlecone, TruNatomy, Genius

Abstract

Background and objectives: Root canal preparation following obturation with rotary instruments and different obturation techniques may lead to formation of microcracks in the root canal wall, void and gaps between the canal wall and obturation material.

Aim: This study aimed to evaluate dentinal microcracks and voids formation after using two different files TruNatomy (TRN) and Genius (GN) and two obturation techniques Single Cone (SC) and GuttaCore (GC) using Microcomputed tomography scan (micro-CT).

Methods: 40 extracted mandibular premolars were decoronated, leaving 13mm roots. The roots were randomly divided into two main groups TRN and GN ((n=20)) according to instrumentation, afterwards each group subdivided into two subgroups ((n=10)) according to obturation techniques. The root canals instrumented with TRN and GN file and obturated with Single Cone (SC) and GuttaCore (GC) obturation techniques. AH Plus sealer was used in all groups. The specimens were scanned with Micro-CT before and after root canal preparation and after obturation. subsequently, all pre-and postoperative cross-sectional images of the roots were screened to identify the presence of dentinal defects. Furthermore, the percentage of voids volume calculated. Data were analyzed statistically to determine difference between groups, the level of statistical significance was at p < 0.05.

Results: GN revealed the least number of microcracks. There were no significant differences between groups in the incidence of dentinal microcracks. The highest percentage of filling material was observed in GC groups. There were significant differences between the obturation groups in the number of voids present after obturation (P < 0.001).

Conclusion: The instrumentation of root canals induces dentinal microcracks. Obturation have no effect on the formation of cracks. None of the root canal filling procedures yield fillings that are void-free.

References

Aydın Z, Keskin, N. B., & Özyürek, T. (2019). Effect of Reciproc blue, XP‐endo shaper, and WaveOne gold instruments on dentinal microcrack formation: A micro‐computed tomographic evaluation. Microscopy Research and Technique, 82(6), 856-860.

Aksoy, Ç., Keriş, E. Y., Yaman, S. D., Ocak, M., Geneci, F., & Çelik, H. H. (2019). Evaluation of XP-endo Shaper, Reciproc Blue, and ProTaper Universal NiTi Systems on dentinal microcrack formation using micro–computed tomography. Journal of endodontics, 45(3), 338-342.

Singla, R., Jhamb, S., Kaur, A., & Vashisht, R. (2017). Incidence of dentinal defects during root canal preparation with hand files using different irrigants: An in vitro study. Journal of Conservative Dentistry: JCD, 20(6), 459.

Elnaghy, A. M., Elsaka, S. E., & Mandorah, A. O. (2020). In vitro comparison of cyclic fatigue resistance of TruNatomy in single and double curvature canals compared with different nickel-titanium rotary instruments. BMC Oral Health, 20(1), 1-8.

Drukteinis, S., Peciuliene, V., Dummer, P. M. H., & Hupp, J. (2019). Shaping ability of BioRace, ProTaper NEXT and Genius nickel‐titanium instruments in curved canals of mandibular molars: a MicroCT study. International Endodontic Journal, 52(1), 86-93.

Somani, R., Jaidka, S., Singh, D. J., & Kaur, N. (2019). Hermetic Seal in Obturation: An Achievable Goal with Recently Introduced Cpoint. International Journal of Clinical Pediatric Dentistry, 12(5), 410.

Kim, J. H., Cho, S. Y., Choi, Y., Kim, D. H., Shin, S. J., & Jung, I. Y. (2022). Clinical efficacy of sealer-based obturation using calcium silicate sealers: a randomized clinical trial. Journal of Endodontics, 48(2), 144-151.

Eskandarloo, A., Karkehabadi, H., Hashemi, S. Z. H., Ahmadi, M., & Hendi, S. S. (2017). Radiographic quality of root canal obturation performed by fifth year students of hamadan dental school. Iranian endodontic journal, 12(2), 236.

Bhandi, S., Mashyakhy, M., Abumelha, A. S., Alkahtany, M. F., Jamal, M., Chohan, H., ... & Patil, S. (2021). Complete Obturation—Cold Lateral Condensation vs. Thermoplastic Techniques: A Systematic Review of Micro-CT Studies. Materials, 14(14), 4013.

Girelli CF, Lacerda MF, Lemos CA, Amaral MR, Lima CO, Silveira FF, Nunes E. (2022). The thermoplastic techniques or single-cone technique on the quality of root canal filling with tricalcium silicate-based sealer: An integrative review. J Clin Exp Dent. Jul 1;14(7):e566-e572.

Heran, J., Khalid, S., Albaaj, F., Tomson, P. L., & Camilleri, J. (2019). The single cone obturation technique with a modified warm filler. Journal of dentistry, 89, 103181.

Jorgensen, B., Williamson, A., Chu, R., & Qian, F. (2017). The efficacy of the WaveOne reciprocating file system versus the ProTaper retreatment system in endodontic retreatment of two different obturating techniques. Journal of endodontics, 43(6), 1011-1013.

Harandi, A., Mirzaeerad, S., Mehrabani, M., Mahmoudi, E., & Bijani, A. (2017). Incidence of dentinal crack after root canal preparation by ProTaper universal, Neolix and SafeSider systems. Iranian endodontic journal, 12(4), 432.

Ashraf, F., Shankarappa, P., Misra, A., Sawhney, A., Sridevi, N., & Singh, A. (2016). A stereomicroscopic evaluation of dentinal cracks at different instrumentation lengths by using different rotary files (ProTaper Universal, ProTaper Next, and HyFlex CM): An Ex Vivo Study. Scientifica, 2016.

Martins, J. N. R., Marques, D., Silva, E. J. N. L., Caramês, J., Mata, A., & Versiani, M. A. (2019). Prevalence of C‐shaped canal morphology using cone beam computed tomography–a systematic review with meta‐analysis. International Endodontic Journal, 52(11), 1556-1572.

Kırıcı, D., Demirbuga, S., & Karataş, E. (2019). Micro–computed Tomographic Assessment of the Residual Filling Volume, Apical Transportation, and Crack Formation after Retreatment with Reciproc and Reciproc Blue Systems in Curved Root Canals. Journal of Endodontics.

Aydinbelge, H. A., Azmaz, N. T., & Yilmaz, M. O. (2019). Dentinal crack formation after different obturation techniques. Saudi Journal of Oral Sciences, 6(1), 3.

Alakabani, T. F., Faus-Llácer, V., Faus-Matoses, I., Ruiz-Sánchez, C., Zubizarreta-Macho, Á., Sauro, S., & Faus-Matoses, V. (2020). The efficacy of rotary, reciprocating, and combined non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems: a micro-computed tomography analysis. Journal of Clinical Medicine, 9(6), 1989.

Iglecias, E. F., Freire, L. G., de Miranda Candeiro, G. T., dos Santos, M., Antoniazzi, J. H., & Gavini, G. (2017). Presence of Voids after Continuous Wave of Condensation and Single-cone Obturation in Mandibular Molars: A Micro-computed Tomography Analysis. Journal of Endodontics, 43(4), 638–642.

De-Deus, G., Belladonna, F. G., Marins, J. R., Silva, E. J. N. L., Neves, A. D. A., Souza, E. M., ... & Versiani, M. A. (2016). On the causality between dentinal defects and root canal preparation: a micro-CT assessment. Brazilian Dental Journal, 27, 664-669.

De-Deus, G., Silva, E. J. N. L., Vieira, V. T. L., Belladonna, F. G., Elias, C. N., Plotino, G., & Grande, N. M. (2017). Blue thermomechanical treatment optimizes fatigue resistance and flexibility of the Reciproc files. Journal of endodontics, 43(3), 462-466.

Barreto, M. S., do Amaral Moraes, R., da Rosa, R. A., Moreira, C. H. C., Só, M. V. R., & Bier, C. A. S. (2012). Vertical root fractures and dentin defects: effects of root canal preparation, filling, and mechanical cycling. Journal of endodontics, 38(8), 1135-1139.

Yan, W., Montoya, C., Øilo, M., Ossa, A., Paranjpe, A., Zhang, H., & Arola, D. (2017). Reduction in fracture resistance of the root with aging. Journal of Endodontics, 43(9), 1494-1498.

Abou El Nasr, H. M., & Abd El Kader, K. G. (2014). Dentinal damage and fracture resistance of oval roots prepared with single-file systems using different kinematics. Journal of endodontics, 40(6), 849-851.

Alkahtany, S. M., & Al-Madi, E. M. (2020). Dentinal microcrack formation after root canal instrumentation by XP-endo shaper and protaper universal: A microcomputed tomography evaluation. International Journal of Dentistry, 2020.

Tawil, P. Z., Saraiya, V. M., Galicia, J. C., & Duggan, D. J. (2015). Periapical microsurgery: the effect of root dentinal defects on short-and long-term outcome. Journal of endodontics, 41(1), 22-27.

Kumari, M. R., & Krishnaswamy, M. M. (2016). Comparative analysis of crack propagation in roots with hand and rotary instrumentation of the root canal-an ex-vivo study. Journal of clinical and diagnostic research: JCDR, 10(7), ZC16.

Rahimi, S., Janani, M., Lotfi, M., Shahi, S., Aghbali, A., Pakdel, M. V., ... & Ghasemi, N. (2014). A review of antibacterial agents in endodontic treatment. Iranian endodontic journal, 9(3), 161.

Miguéns-Vila, R., Martín-Biedma, B., De-Deus, G., Belladonna, F. G., Peña-López, A., & Castelo-Baz, P. (2021). Micro–computed Tomographic Evaluation of Dentinal Microcracks after Preparation of Curved Root Canals with ProTaper Gold, WaveOne Gold, and ProTaper Next Instruments. Journal of Endodontics, 47(2), 309-314.

Govindaraju, L., Jeevanandan, G., & Subramanian, E. M. G. (2017). Knowledge and practice of rotary instrumentation in primary teeth among indian dentists: A questionnaire survey. Journal of International Oral Health, 9(2), 45.

Oliveira Vieira ML, Dantas, H. V., de Sousa, F. B., Salazar-Silva, J. R., Silva, E. J. N. L., Batista, A. U. D., & Lima, T. F. R. (2020). Morphologic changes of apical foramen and microcrack formation after foraminal enlargement: a scanning electron microscopic and micro–computed tomographic analysis. Journal of Endodontics, 46(11), 1726-1732.

Shantiaee, Y., Zandi, B., Shojaeian, S., Mortezapour, N., & Soltaninejad, F. (2021). Micro-computed tomography assessment of dentinal microcracks after the preparation of curved root canals with rotary and reciprocal systems. Dental and Medical Problems, 58(4), 515-523.

Kansal, R., Rajput, A., Talwar, S., Roongta, R., & Verma, M. (2014). Assessment of dentinal damage during canal preparation using reciprocating and rotary files. Journal of endodontics, 40(9), 1443-1446.

De-Deus, G., Silva, E. J. N. L., Marins, J., Souza, E., de Almeida Neves, A., Belladonna, F. G., ... & Versiani, M. A. (2014). Lack of causal relationship between dentinal microcracks and root canal preparation with reciprocation systems. Journal of Endodontics, 40(9), 1447-1450.

Khoshbin, E., Donyavi, Z., Atibeh, E. A., Roshanaei, G., & Amani, F. (2018). The effect of canal preparation with four different rotary systems on formation of dentinal cracks: An in vitro evaluation. Iranian Endodontic Journal, 13(2), 163.

Koroth, S., Ponnappa, K. C., Simon, E. P., Bharath, S., Vivek, V. J., & Raveendran, C. (2021). Evaluation of root dentinal damage associated with protaper gold, waveone gold, and protaper next during cleaning and shaping procedures: An In vitro analysis. Journal of Pharmacy & Bioallied Sciences, 13(Suppl 2), S1098.

Mohamed, R., Majid, S., & Faiza, A. (2021). Root Microcracks Formation during Root Canal Instrumentation Using Reciprocating and Rotary Files. The Journal of Contemporary Dental Practice, 22(3), 259-263.

Anous, W. H., Al-Ashry, S., Ali, M. M., & Kataia, M. M. (2020). Effect of different kinematic cutting motion in multiple versus single-file concept on dentinal crack formation: An in vitro study. Journal of International Oral Health, 12(7), 30.

Shantiaee, Y., Dianat, O., Mosayebi, G., Namdari, M., & Tordik, P. (2019). Effect of root canal preparation techniques on crack formation in root dentin. Journal of endodontics, 45(4), 447-452.

Cassimiro, M., Romeiro, K., Gominho, L., de Almeida, A., Silva, L., & Albuquerque, D. (2018). Effects of reciproc, protaper next and waveone gold on root canal walls: a stereomicroscope Analysis. Iranian endodontic journal, 13(2), 228.

Pedullà, E., Genovesi, F., Rapisarda, S., La Rosa, G. R., Grande, N. M., Plotino, G., & Adorno, C. G. (2017). Effects of 6 single-file systems on dentinal crack formation. Journal of endodontics, 43(3), 456-461.

Shemesh, H., Bier, C. A. S., Wu, M. K., Tanomaru‐Filho, M., & Wesselink, P. R. (2009). The effects of canal preparation and filling on the incidence of dentinal defects. International endodontic journal, 42(3), 208-213.

Shemesh, H., Wesselink, P. R., & Wu, M. K. (2010). Incidence of dentinal defects after root canal filling procedures. International endodontic journal, 43(11), 995-1000.

Karataş, E., Gündüz, H. A., Kırıcı, D. Ö., Arslan, H., Topçu, M. Ç., & Yeter, K. Y. (2015). Dentinal crack formation during root canal preparations by the twisted file adaptive, ProTaper Next, ProTaper Universal, and WaveOne instruments. Journal of endodontics, 41(2), 261-264.

Daokar, S., Ali, S. N., & Baig, A. R. (2016). Stereomicroscopic evaluation of radicular dentinal defects after using EDTA gel with different rotary systems: An in vitro Study. Saudi J Oral Dent Res, 1, 113-8.

Saha, S. G., Vijaywargiya, N., Saxena, D., Saha, M. K., Bharadwaj, A., & Dubey, S. (2017). Evaluation of the incidence of microcracks caused by Mtwo and ProTaper Next rotary file systems versus the self-adjusting file: A scanning electron microscopic study. Journal of conservative dentistry: JCD, 20(5), 355.

Li, M. L., Liao, W. L., & Cai, H. X. (2018). A micro-computed tomographic evaluation of dentinal microcrack alterations during root canal preparation using single file Ni Ti systems. Experimental and Therapeutic Medicine, 15(1), 494-499.

Pandey, S. H., Patni, P. M., Jain, P., Raghuwanshi, S., Sanwatsarkar, G., & Chaturvedi, A. (2021). Light emitting diode assessment of dentinal microcracks after root canal preparation with 4 different heat-treated file systems. Minerva Dental and Oral Science.

Deopujari, J., Singh, H., Pathak, I., Shyamal, R., Antony, S. M., & Singh, S. (2022). Evaluation of Microcracks formed During Root Canal Preparation by Different File Systems Using Micro-Computed Tomography: An In Vitro Study. The Journal of Contemporary Dental Practice, 23(1), 74-78.

Pawar, A. M., Thakur, B., Kfir, A., & Kim, H. C. (2019). Dentinal defects induced by 6 different endodontic files when used for oval root canals: an in vitro comparative study. Restorative Dentistry & Endodontics, 44(3).

Fráter, M., Jakab, A., Braunitzer, G., Tóth, Z., & Nagy, K. (2020). The potential effect of instrumentation with different nickel titanium rotary systems on dentinal crack formation—An in vitro study. Plos one, 15(9), e0238790.

Arumugam, S., Yew, H. Z., Baharin, S. A., Qamaruz Zaman, J., Muchtar, A., & Kanagasingam, S. (2021). Micro‐computed tomography evaluation of dentinal microcracks following canal preparation with thermomechanically heat‐treated engine‐driven files. Australian Endodontic Journal, 47(3), 520-530.

De-Deus, G., Belladonna, F. G., Souza, E. M., Silva, E. J. N. L., de Almeida Neves, A., Alves, H., ... & Versiani, M. A. (2015). Micro–computed tomographic assessment on the effect of ProTaper Next and Twisted File Adaptive systems on dentinal cracks. Journal of endodontics, 41(7), 1116-1119.

Bayram, H. M., Bayram, E., Ocak, M., Uygun, A. D., & Celik, H. H. (2017). Effect of ProTaper Gold, Self-Adjusting File, and XP-endo Shaper instruments on dentinal microcrack formation: a micro–computed tomographic study. Journal of endodontics, 43(7), 1166-1169.

Versluis, A., Messer, H. H., & Pintado, M. R. (2006). Changes in compaction stress distributions in roots resulting from canal preparation. International Endodontic Journal, 39(12), 931-939.

Bürklein, S., Tsotsis, P., & Schäfer, E. (2013). Incidence of dentinal defects after root canal preparation: reciprocating versus rotary instrumentation. Journal of endodontics, 39(4), 501-504.

Liu, R., Hou, B. X., Wesselink, P. R., Wu, M. K., & Shemesh, H. (2013). The incidence of root microcracks caused by 3 different single-file systems versus the ProTaper system. Journal of endodontics, 39(8), 1054-1056.

Karataş, E., Gündüz, H. A., Kırıcı, D. Ö., & Arslan, H. (2016). Incidence of dentinal cracks after root canal preparation with ProTaper Gold, Profile Vortex, F360, Reciproc and ProTaper Universal instruments. International endodontic journal, 49(9), 905-910.

Ustun, Y., Aslan, T., Sagsen, B., & Kesim, B. (2015). The effects of different nickel-titanium instruments on dentinal microcrack formations during root canal preparation. European journal of dentistry, 9(01), 041-046.

Ashwinkumar, V., Krithikadatta, J., Surendran, S., & Velmurugan, N. (2014). Effect of reciprocating file motion on microcrack formation in root canals: an SEM study. International endodontic journal, 47(7), 622-627.

Chellapilla, P. K., Boddeda, M. R., Jyothi, M., Uppalapati, L. V., Konagala, R. K., & Dasari, L. (2021). Influence of obturating techniques on root dentin crack propagation: A micro-computed tomography assessment. Journal of Conservative Dentistry: JCD, 24(1), 72.

Jain, A., Nikhil, V., & Bansal, P. (2018). Effect of root canal preparation, obturation, and retreatment on the induction of dentinal microcracks: A microcomputed tomography study. Journal of conservative dentistry : JCD, 21(5), 521–525.

Kumaran, P., Sivapriya, E., Indhramohan, J., Gopikrishna, V., Savadamoorthi, K. S., & Pradeepkumar, A. R. (2013). Dentinal defects before and after rotary root canal instrumentation with three different obturation techniques and two obturating materials. Journal of Conservative Dentistry, 16(6), 522.

Alim, B. A., & Berker, Y. G. (2020). Evaluation of different root canal filling techniques in severely curved canals by micro-computed tomography. The Saudi Dental Journal, 32(4), 200-205.

Castagnola, R., Marigo, L., Pecci, R., Bedini, R., Cordaro, M., Liborio Coppola, E., & Lajolo, C. (2018). Micro-CT evaluation of two different root canal filling techniques. Eur Rev Med Pharmacol Sci, 22(15), 4778.

De-Deus, G., Reis, C., Beznos, D., de Abranches, A. M. G., Coutinho-Filho, T., & Paciornik, S. (2008). Limited ability of three commonly used thermoplasticized gutta-percha techniques in filling oval-shaped canals. Journal of Endodontics, 34(11), 1401-1405.

Yadav, S., Nawal, R. R., Chaudhry, S., & Talwar, S. (2020). Assessment of quality of root canal filling with C Point, Guttacore and Lateral Compaction Technique: a confocal laser scanning microscopy study. European Endodontic Journal, 5(3), 236.

Schäfer, E., Schrenker, C., Zupanc, J., & Bürklein, S. (2016). Percentage of gutta-percha filled areas in canals obturated with cross-linked gutta-percha core-carrier systems, single-cone and lateral compaction technique. Journal of Endodontics, 42(2), 294-298.

Gavini, G. (2017). Presence of Voids after Continuous Wave of Condensation and Single-cone Obturation in Mandibular Molars: A Micro-computed Tomography Analysis. Journal of Endodontics, 43(4), 638–642.

Zare, S., Shen, I., Zhu, Q., Ahn, C., Primus, C., & Komabayashi, T. (2021). Micro-computed tomographic evaluation of single-cone obturation with three sealers. Restorative Dentistry & Endodontics, 46(2).

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Published

2024-06-06

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Omar SS, Selivany BJ. Dentinal Crack Formation and Quality of Obturation Using Two Single File Systems and Two Obturation Techniques: A micro-CT Study. EDJ [Internet]. 2024 Jun. 6 [cited 2024 Jun. 30];7(1):60-74. Available from: https://edj.hmu.edu.krd/index.php/journal/article/view/272

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