Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: an in vivo study

Med Oral Patol Oral Cir Bucal. 2014 Mar 1;19 (2):e202-5. Evaluation of Dentaport ZX and Raypex 6: An in vivo study e202 Journal section: Clinical and Experimental Dentistry Publication Types: Research Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: An in vivo study Saddy Moscoso 1 , Kenneth Pineda 1 , Juan Basilio 1 , Carlos Alvarado 2 , Miguel Roig 2 , Fernando Duran- Sindreu 3 1 MD, Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain 2 MD, DDS, PhD, Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain 3 Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain Correspondence: Dentistry Faculty Universitat Internacional de Catalunya C/Josep Trueta s/n. 08195 Sant Cugat del Vallès, Spain [email protected] Received: 10/02/2013 Accepted: 04/05/2013 Abstract Introduction: Raypex 6 is an electronic apex locator (EAL) that has not yet been tested in vivo. The purpose of this in vivo study was to compare the accuracy of two EALs: the Dentaport ZX and the Raypex 6. Material and Methods: The study involved 36 straight single-rooted teeth. A 10-K file was advanced until the EAL detected the major foramen. The file was fixed in a replaceable pattern of light-cured composite. The apical part of each canal was trimmed to expose the file tip. The distances from the file tips to the major foramen were measured. Results: Wilcoxon's signed Rank test found no significant differences between the Dentaport ZX and Raypex 6 in terms of their abilities to detect the major foramen (P = .52) The Dentaport ZX was accurate 82.35% of the time to ± 0.5 mm and 97.05% of the time to ± 1 mm, whereas the Raypex 6 was accurate 88.22% of the time to ± 0.5 mm and 100% of the time to ± 1 mm. Conclusions: No statistically significant differences were observed between the performance of the Dentaport ZX and Raypex 6 EALs under the in vivo clinical conditions used in this study

Danger zone analysis using cone beam computed tomography after apical enlargement with K3 and K3XF in a manikin model

Background: The objective of the study was to evaluate and compare how apical enlargement with K3 and K3XF nickel-titanium (NiTi) rotary instruments reduces the root thickness in the danger zone and affects canal transportation and centering ability in mandibular molar mesial canals in a manikin extracted tooth model. Material and Methods: Seventy-two mesial root canals of first mandibular molars were instrumented. Initial and post-instrumentation Cone Beam Computed Tomography scans were performed after root canal preparation up to size 25, 30, 35 and 40 files. Canal transportation, canal centering and remaining root dentin thickness toward the danger zone were calculated in sections 1, 2 and 3 mm under the furcation level. Data were analyzed using nonparametric Kruskal-Wallis analysis of variance at a significance level of P < 0.05. Results: K3 instruments removed more dentin toward the danger zone compared with K3XF instruments (P< .05) and significant differences in dentin thickness were found when canal enlargement was performed to a #35-40 with both systems (P< 0.05). No significant differences in canal transportation and centering ability were found between systems, except when canal enlargement was performed to a #40 (P = 0,0136). No differences were observed when comparing the number of uses in both systems (P> 0.05). Conclusions: Under the conditions of this study K3 removed a significant amount of dentin at the furcation level compared with the R-Phase K3XF rotary system in curved root canals. Enlargement to a 35-40/04 file removed significantly more dentin with both systems

Failure of ProTaper rotary Ni-Ti instruments used by undergraduate students

Objective: To evaluate the effect of number of uses, angle and radius of curvature and type of instrument on the fracture of ProTaper rotary instruments when used by undergraduate students. Study design: Three hundred and seventy-six molars, with a total of 1114 root canals, extracted were instrumented by undergraduate students using ProTaper instruments according to the manufacturer´s recommendations. When fracture occurred, data were collected concerning the number of uses, type of instrument, level of fracture, angle and radius of curvature. ANOVA test were used to determine the influence of type of instrument in the incidence of instrument fracture. Logistic regression model was used to determine the influence of number of uses, angle and radius of curvature in the incidence of instrument fracture. Significance was set at p< 0.05. Results: A total of 37 Ni-Ti rotary instruments fractured during the treatment. Fracture occurred in 9.84% (37/376) of the teeth treated and 3.32% of the canals prepared with Ni-Ti rotary instruments (37/1114). A decrease in the radius of curvature of the canal significantly increased the likelihood of fracture (p=0.0001). Instrument fracture significantly increased as the number of uses increased (p=0.0037). No significant differences were found between the 6 types of ProTaper instruments (p=0.8). A reduction in the angle of curvature did not produce a significant decrease in the incidence of instrument separation (p=0.08). Conclusions: The results of this study imply that instrument fracture is linked to radius of curvature and number of uses

Dental anxiety, cardiovascular changes and patient preconceptions toward implants and root canal treatments : an observational study

There is little information about dental anxiety and the patient?s vital signs during dental procedures. This study evaluates and compare patient anxiety levels and cardiovascular changes before and during root canal treatment (RCT) and single-tooth impl

Comparison of postoperative pain after root canal treatment using reciprocating instruments based on operator?s experience : a prospective clinical study

The aim of the present study was to compare clinically the incidence of postoperative pain after endodontic treatment using the Reciproc System, taking into account the operator?s experience. One hundred patients scheduled for routine endodontic treatment were enrolled in this study. Endodontic treatment was carried out in a single visit by undergraduate and postgraduate students. The chemomechanical preparation of root canals was performed with Reciproc instruments. Pretreatment and postoperative pain was recorded using a visual analogue scale (VAS). Postoperative pain and the need for analgesic consumption were assessed at 4, 8, 16, 24, 48 and 72 hours post-treatment. The data were analyzed using the Mann?Whitney U and Chi-Square test, and the significance was set at P<0.05. The mean value of pain after root canal treatment was 1.13±1.94 and 1.91±2.07 on a VAS between 0 and 10 in treatments performed by undergraduate and postgraduate students, respectively. There was a significant difference in the incidence of postoperative pain between the two groups (P<0.05). The prevalence of postoperative pain was high in the treatments performed by postgraduate students in comparison with undergraduate students. This suggests that operator experience has an influence on the prevalence of postoperative pain after root canal treatment

Nanoparticles in Endodontics Disinfection: State of the Art

Endodontic-related diseases constitute the fourth most expensive pathologies in industrialized countries. Specifically, endodontics is the part of dentistry focused on treating disorders of the dental pulp and its consequences. In order to treat these problems, especially endodontic infections, dental barriers and complex root canal anatomy should be overcome. This constitutes an unmet medical need since the rate of successful disinfection with the currently marketed drugs is around 85%. Therefore, nanoparticles constitute a suitable alternative in order to deliver active compounds effectively to the target site, increasing their therapeutic efficacy. Therefore, in the present review, an overview of dental anatomy and the barriers that should be overcome for effective disinfection will be summarized. In addition, the versatility of nanoparticles for drug delivery and their specific uses in dentistry are comprehensively discussed. Finally, the latest findings, potential applications and state of the art nanoparticles with special emphasis on biodegradable nanoparticles used for endodontic disinfection are also reviewed. Keywords: PLGA; dentistry; endodontics; metal nanoparticles; nanoparticles

Novel strategies enhancing endodontic disinfection: antibacterial biodegradable calcium hydroxide nanoparticles in an ex vivo model.

Due to the high failure rates associated to endodontic disinfection, this study aimed to investigate the antibacterial properties of poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with Ca(OH)2 for endodontic disinfection procedures. Ca(OH)2 NPs production and physicochemical characterization were carried out as well as multiple antibacterial tests using three bacterial strains and an ex vivo model of endodontic infection with extracted human teeth. Agar diffusion test and broth dilution determined the inhibition growth zones (n=5) and the minimal inhibitory concentration (MIC, n=5), respectively. Cell viability was assessed using Live/Dead staining with confocal microscopy (n=5). Data was analysed using ANOVA followed by post-hoc analysis. After 24 hours of incubation, Ca(OH)₂ NPs demonstrated a MIC of 10 µg/mL for Porphyromonas gingivalis (p<0.001) and Enterococcus faecalis and 5 µg/mL for Fusobacterium nucleatum (p<0.001). Although the agar diffusion test did not exhibit any inhibition for Ca(OH)2 nor for Ca(OH)₂ NPs area probably due to the buffering effect of the agar medium. However, the antibacterial capacity was confirmed in an ex vivo model, where instrumentalized teeth were infected with Enterococcus Faecalis and treated after 28 days of culture. A significant reduction in bacterial metabolic activity was confirmed for Ca(OH)2 NPs (40% reduction with a single dose) and confirmed by Live/Dead staining. In conclusion, Ca(OH)₂-loaded PLGA NPs present promising antibacterial efficacy for endodontic disinfection procedures

Failure of ProTaper rotary Ni-Ti instruments used by undergraduate students

Objective: To evaluate the effect of number of uses, angle and radius of curvature and type of instrument on the fracture of ProTaper rotary instruments when used by undergraduate students. Study design: Three hundred and seventy-six molars, with a total of 1114 root canals, extracted were instrumented by undergraduate students using ProTaper instruments according to the manufacturer´s recommendations. When fracture occurred, data were collected concerning the number of uses, type of instrument, level of fracture, angle and radius of curvature. ANOVA test were used to determine the influence of type of instrument in the incidence of instrument fracture. Logistic regression model was used to determine the influence of number of uses, angle and radius of curvature in the incidence of instrument fracture. Significance was set at p< 0.05. Results: A total of 37 Ni-Ti rotary instruments fractured during the treatment. Fracture occurred in 9.84% (37/376) of the teeth treated and 3.32% of the canals prepared with Ni-Ti rotary instruments (37/1114). A decrease in the radius of curvature of the canal significantly increased the likelihood of fracture (p=0.0001). Instrument fracture significantly increased as the number of uses increased (p=0.0037). No significant differences were found between the 6 types of ProTaper instruments (p=0.8). A reduction in the angle of curvature did not produce a significant decrease in the incidence of instrument separation (p=0.08). Conclusions: The results of this study imply that instrument fracture is linked to radius of curvature and number of use

Endodontic applications of cone beam computed tomography: case series and literature review

Cone beam computed tomography (CBCT) is a relatively new method that produces three-dimensional (3D) information of the maxillofacial skeleton, including the teeth and their surrounding tissue, with a lower effective radiation dose than traditional CT scans. Specific endodontic applications for CBCT are being identified as the use of this technology becomes more common. CBCT has great potential to become a valuable tool for diagnosing and managing endodontic problems, as well as for assessing root fractures, apical periodontitis, resorptions, perforations, root canal anatomy and the nature of the alveolar bone topography around teeth. This article aims to review cone beam technology and its advantages over CT scans and conventional radiography, to illustrate current and future clinical applications in endodontic practice, and to highlight areas of further research of CBCT in endodontics. Specific case examples illustrate how treatment planning has changed with the images obtained with CBCT technology compared with only periapical radiography

In vivo and in vitro spectrophotometric evaluation of upper central incisors before and after extraction

This in vivo and in vitro study investigated the influence of pulpal vitality on the optical properties of teeth over a 1-month period. We monitored two specific areas (2-mm-thick pure enamel and 3-mm-thick enamel-dentine complex) in 10 teeth against two backgrounds (white and black) using a calibrated reflectance spectrophotometer at the following time points: before extraction (T0); immediately after extraction (T1); at 1-day post-extraction (T2); at 1-week post-extraction (T3); and 1-month post-extraction (T4). We recorded tooth colour based on the Commission Internationale d'Eclairage L*a*b* model and translucency and analysed these characteristics over time using analysis of variance. The 2-mm-thick pure enamel area showed significant changes (p &gt; 0.05) in L*, a* and b* values between before and 1 month after extraction (T0-T4). Translucency was detectable between (T0-T3) and (T0-T4). The 3-mm-thick enamel-dentine complex also exhibited significant differences (p &gt; 0.05) in L*, a* and b* values within (T0-T4). Translucency value changes significantly (p &gt; 0.05) within the first day (T0-T2) and (T0-T3). CIEDE 2000 DE values revealed no statistically significant differences (p &lt; 0.05) in colour between the T0 L*a*b* measures and all the subsequent measures at times T1, T2, T3 and T4. Within the limitations of this study, we conclude that the optical characteristics (i.e. colour and translucency) of teeth change after extraction. The results help understanding the precise moment when the colour of extracted tooth changes to identify optimum time to use a tooth for scientific investigation and determine whether it is necessary to extract pulp tissue beforehand.</p