Comparison of Two Reciprocating and Anatomical Single File Techniques in Cleaning Oval Anatomies

Introduction: The present study aimed to compare the capability of two single-file shaping systems in disinfecting and cleaning long oval root canals. Materials and Methods: Fifty single-rooted teeth were prepared, contaminated with Enterococcus faecalis and divided into two groups. Two samplings were obtained; S1 before chemo-mechanical preparation and S2 after the preparation. Depending on the group, chemo-mechanical preparation was performed with XP-endo Shaper (XPS) and Wave One Gold (WOG). Five teeth from each group were observed under scanning electron microscopy (1000×) to evaluate the cleanliness of root canals at 3, 6 and 9 mm from the apex. All probability (P-values) were two-tailed, statistical significance was set at 0.05 and analyses were conducted using SPSS statistical software. Results: A significant reduction in the colony forming units was observed from S1 to S2 in both tested groups. In S2, XPS group obtained significantly lower colony forming units (P<0.001). In the cleanliness study, XPS group resulted in significantly cleaner canals compared to WOG. Conclusions: Based on this in vitro study XPS system was more effective in disinfecting and cleaning long oval canals

Self-adjusting file (SAF) compared to newly designed rotary and reciprocating files: composition and microstructure, microbial biofilm removal capability and shaping effectiveness.

Σκοπός αυτής της μελέτης είναι η σύγκριση του Self adjusting file (SAF) με το Wave One (WO), το BT-Race (BTR) και τις ρίνες χειρός (MAN) στη βασική τους σύνθεση μέσω της φασματοσκοπίας SEM-EDX, την ικανότητα απολύμανσης ex vivo μακρύς οβάλ σωλήνες μετά από μόλυνση με E.Faecalis μέσω καλλιεργειών και την καθαριότητα του χώρου του ριζικού σωλήνα για τα συντρίμμια και το στρώμα επιχρίσματος μέσω SEM και οπτικής μικροσκοπίας μετά από χημεικομηχανική επεξεργασίας. Τα αρχεία αναλύθηκαν μέσω φασματοσκοπίας SEM-EDX για τη βασική σύνθεση. Όλα τα εργαλεία που αναλύθηκαν περιείχαν Ni και Ti. Το WO περιείχε 52,14% κατά βάρος. του Ni και 46,79% κατά βάρος. του Ti, το SAF 51,99% κατά βάρος. του Ni και 47,12% κατά βάρος. Ti και BTR 51,49% κ.β. του Νι και 47,31% κατά βάρος. του Ti. Δεν παρατηρήθηκαν διαφορές μεταξύ των ομάδων. Για το μικροβιολογικό πείραμα συλλέχθηκαν 100 μακρά οβάλ δόντια και μετά την αρχική προετοιμασία και μόλυνση με E.Faecalis διαιρέθηκαν τυχαία σε τέσσερις ομάδες (n = 25). Πριν από τη χημεικομηχανική προετοιμασία πραγματοποιήθηκε η πρώτη μικροβιολογική δειγματοληψία (S1). Στη συνέχεια πραγματοποιήθηκε η διαμόρφωση σύμφωνα με το πρωτόκολλο κάθε εργαλείου και η δεύτερη δειγματοληψία εκτελείται στη συνέχεια (S2). Από τα αποτελέσματα στο S1 μεταξύ των ομάδων δεν παρατηρήθηκε καμία διαφορά. η μείωση από το S1 σε S2 και στις τέσσερις ομάδες ήταν σημαντική, ενώ στη σύγκριση στο S2 μεταξύ των ομάδων ο ΜΑΝ μείωσε σημαντικά λιγότερο τον αριθμό των CFU σε σύγκριση με τις άλλες ομάδες ρινών (p <0,001) και το SAF μείωσε σημαντικά λιγότερο τους αριθμούς των βακτηρίων σε σύγκριση με BTR (Ρ <0,01). Για το πείραμα καθαριότητας επιλέχθηκαν πέντε δόντια από κάθε ομάδα και διαχωρίστηκαν στον επιμήκη άξονά τους και παρατηρήθηκαν κάτω από το οπτικό μικροσκόπιο (200x) για τα συντρίμμια και κάτω από το SEM (200x και 1000x) για τα συντρίμμια και το επίχρισμα. Δύο ανεξάρτητοι εξεταστές αξιολόγησαν τα ευρήματα που αποδίδουν βαθμολογίες από 1-4. Από τις μέσες βαθμολογίες προέκυψε ότι το MAN και το SAF ήταν σημαντικά λιγότερο αποτελεσματικά από τα BTR και WO στον καθαρισμό του ριζικού σωλήνα στη μελέτη των συντριμμιών και του επιχρίσματος. Η θέση καθαρισμού ήταν η μηλική με σημαντική διαφορά με την ακροριζική. Μεταξύ των δύο τεχνικών παρατήρησης στη μελέτη των συντριμμιών δεν βρέθηκε καμία σημασία. Συμπερασματικά και τα τρία εργαλεία Ni-Ti έχουν καλύτερη απόδοση σε σύγκριση με τα χειροκίνητα. Το Self adjusting file δεν απέδωσε όσο κάλα το παλινδρομικό και το περιστρεφόμενο σύστημα διαμορφωσης. Κανένα από τα εργαλεία που δοκιμάστηκαν δεν πέτυχε τέλεια βαθμολογία στον καθαρισμό του ριζικού σωλήνα και στην απολύμανση των μακρών οβάλ σωλήνων.The aim of this study is to compare the Self adjusting file (SAF) to Wave One (WO) , BT-Race (BTR) and manual instrumentation (MAN) in their basic composition through SEM-EDX spetroscopy, the ability in disinfecting ex vivo long oval canals after E.Faecalis contamination though cultures and the cleanliness of the root canal space for debris and smear layer through SEM and Optical microscopy after chemomechanical preparation. Files were analysed through SEM-EDX spectroscopy for the basic composition. All files analysed contained Ni and Ti. The WO contained 52,14%wt. of Ni and 46,79%wt. of Ti, the SAF 51,99%wt. of Ni and 47,12 %wt. Ti and the BTR 51,49%wt. of Ni and 47,31%wt. of Ti. No differences were observed between the groups. For the microbiological experiment 100 long oval teeth were collected and after initial preparation and contamination with E.Faecalis were divided into four groups randomly (n=25). Before chemomechanical preparation the first microbiological sampling was performed (S1). Afterwards instrumentation was performed according to the protocol of each instrument and the second sampling performed afterwards (S2). From the results in S1 between the groups no difference was observed. the reduction from S1to S2 in all four groups was significant while in the comparison in S2 between the groups MAN reduced significantly less the CFU counts in comparison to the other tree groups (p<0,001) ant the SAF reduced significantly less the bacterial counts compared to BTR (P<0,01). For the cleaningness experiment five teeth from each group were selected and separated in their longitudinal axis and observed under the optical microscope (200x) for debris and under the SEM (200x and 1000x) for debris and smear layer. Two independent examiners evaluated the findings attributing scores from 1-4. From the average scores resulted that MAN and SAF were significantly less effective to BTR and WO in cleaning the root canal in the debris and smear layer study. The cleaner location was the coronal with significant difference to the apical. Between the two observation techniques in the debris study no significance was found. Concluding all three Ni-Ti instruments performed better compared to manual instrumentation. The self adjusting file did non perform as well as the reciprocating and the rotating system. None of the instruments tested achieved perfect score in cleaning the root canal and disinfecting long oval canals

Self-adjusting file (SAF) σε σύγκριση με περιστρεφόμενα και παλινδρομικά εργαλεία διαμόρφωσης: βασική σύνεση, ικανότητα απόμακρης βιωμενίων σε μακρύς οβάλ σωλήνες, και αξιολόγηση καθαρότητας ριζικού σωλήνα

The aim of this study is to compare the Self adjusting file (SAF) to Wave One (WO) , BT-Race (BTR) and manual instrumentation (MAN) in their basic composition through SEM-EDX spetroscopy, the ability in disinfecting ex vivo long oval canals after E.Faecalis contamination though cultures and the cleanliness of the root canal space for debris and smear layer through SEM and Optical microscopy after chemomechanical preparation.Files were analysed through SEM-EDX spectroscopy for the basic composition. All files analysed contained Ni and Ti. The WO contained 52,14%wt. of Ni and 46,79%wt. of Ti, the SAF 51,99%wt. of Ni and 47,12 %wt. Ti and the BTR 51,49%wt. of Ni and 47,31%wt. of Ti. No differences were observed between the groups. For the microbiological experiment 100 long oval teeth were collected and after initial preparation and contamination with E.Faecalis were divided into four groups randomly (n=25). Before chemomechanical preparation the first microbiological sampling was performed (S1). Afterwards instrumentation was performed according to the protocol of each instrument and the second sampling performed afterwards (S2). From the results in S1 between the groups no difference was observed. the reduction from S1to S2 in all four groups was significant while in the comparison in S2 between the groups MAN reduced significantly less the CFU counts in comparison to the other tree groups (p<0,001) ant the SAF reduced significantly less the bacterial counts compared to BTR (P<0,01).For the cleaningness experiment five teeth from each group were selected and separated in their longitudinal axis and observed under the optical microscope (200x) for debris and under the SEM (200x and 1000x) for debris and smear layer. Two independent examiners evaluated the findings attributing scores from 1-4. From the average scores resulted that MAN and SAF were significantly less effective to BTR and WO in cleaning the root canal in the debris and smear layer study. The cleaner location was the coronal with significant difference to the apical. Between the two observation techniques in the debris study no significance was found.Concluding all three Ni-Ti instruments performed better compared to manual instrumentation. The self adjusting file did non perform as well as the reciprocating and the rotating system. None of the instruments tested achieved perfect score in cleaning the root canal and disinfecting long oval canals.Σκοπός αυτής της μελέτης είναι η σύγκριση του Self adjusting file (SAF) με το Wave One (WO), το BT-Race (BTR) και τις ρίνες χειρός (MAN) στη βασική τους σύνθεση μέσω της φασματοσκοπίας SEM-EDX, την ικανότητα απολύμανσης ex vivo μακρύς οβάλ σωλήνες μετά από μόλυνση με E.Faecalis μέσω καλλιεργειών και την καθαριότητα του χώρου του ριζικού σωλήνα για τα συντρίμμια και το στρώμα επιχρίσματος μέσω SEM και οπτικής μικροσκοπίας μετά από χημεικομηχανική επεξεργασίας.Τα αρχεία αναλύθηκαν μέσω φασματοσκοπίας SEM-EDX για τη βασική σύνθεση. Όλα τα εργαλεία που αναλύθηκαν περιείχαν Ni και Ti. Το WO περιείχε 52,14% κατά βάρος. του Ni και 46,79% κατά βάρος. του Ti, το SAF 51,99% κατά βάρος. του Ni και 47,12% κατά βάρος. Ti και BTR 51,49% κ.β. του Νι και 47,31% κατά βάρος. του Ti. Δεν παρατηρήθηκαν διαφορές μεταξύ των ομάδων.Για το μικροβιολογικό πείραμα συλλέχθηκαν 100 μακρά οβάλ δόντια και μετά την αρχική προετοιμασία και μόλυνση με E.Faecalis διαιρέθηκαν τυχαία σε τέσσερις ομάδες (n = 25). Πριν από τη χημεικομηχανική προετοιμασία πραγματοποιήθηκε η πρώτη μικροβιολογική δειγματοληψία (S1). Στη συνέχεια πραγματοποιήθηκε η διαμόρφωση σύμφωνα με το πρωτόκολλο κάθε εργαλείου και η δεύτερη δειγματοληψία εκτελείται στη συνέχεια (S2). Από τα αποτελέσματα στο S1 μεταξύ των ομάδων δεν παρατηρήθηκε καμία διαφορά. η μείωση από το S1 σε S2 και στις τέσσερις ομάδες ήταν σημαντική, ενώ στη σύγκριση στο S2 μεταξύ των ομάδων ο ΜΑΝ μείωσε σημαντικά λιγότερο τον αριθμό των CFU σε σύγκριση με τις άλλες ομάδες ρινών (p <0,001) και το SAF μείωσε σημαντικά λιγότερο τους αριθμούς των βακτηρίων σε σύγκριση με BTR (Ρ <0,01).Για το πείραμα καθαριότητας επιλέχθηκαν πέντε δόντια από κάθε ομάδα και διαχωρίστηκαν στον επιμήκη άξονά τους και παρατηρήθηκαν κάτω από το οπτικό μικροσκόπιο (200x) για τα συντρίμμια και κάτω από το SEM (200x και 1000x) για τα συντρίμμια και το επίχρισμα. Δύο ανεξάρτητοι εξεταστές αξιολόγησαν τα ευρήματα που αποδίδουν βαθμολογίες από 1-4. Από τις μέσες βαθμολογίες προέκυψε ότι το MAN και το SAF ήταν σημαντικά λιγότερο αποτελεσματικά από τα BTR και WO στον καθαρισμό του ριζικού σωλήνα στη μελέτη των συντριμμιών και του επιχρίσματος. Η θέση καθαρισμού ήταν η μηλική με σημαντική διαφορά με την ακροριζική. Μεταξύ των δύο τεχνικών παρατήρησης στη μελέτη των συντριμμιών δεν βρέθηκε καμία σημασία.Συμπερασματικά και τα τρία εργαλεία Ni-Ti έχουν καλύτερη απόδοση σε σύγκριση με τα χειροκίνητα.Το Self adjusting file δεν απέδωσε όσο κάλα το παλινδρομικό και το περιστρεφόμενο σύστημα διαμόρφωσης. Κανένα από τα εργαλεία που δοκιμάστηκαν δεν πέτυχε τέλεια βαθμολογία στον καθαρισμό του ριζικού σωλήνα και στην απολύμανση των μακρών οβάλ σωλήνων

Fluoroscopic-guided insertion of self-expanding metal stents for malignant gastroduodenal outlet obstruction:immediate results and clinical outcomes

Background Application of self-expanding metal stents (SEMS) to treat patients suffering from malignant gastroduodenal outlet obstruction (GDOO) is today considered a well-recognized palliative treatment. Use of SEMS has emerged as an attractive alternative to surgical treatment of such patients. Purpose To report the immediate and the mid-term clinical outcomes from a series of consecutive patients treated with exclusively fluoroscopic-guided insertion of SEMS. Material and Methods This was a retrospective study including patients suffering from GDOO that were either ineligible for or unwilling to undergo surgery. Patients with potentially curable disease, uncorrectable coagulopathy, gastrointestinal perforation, sepsis, presence of distal small bowel obstruction, and bowel ischemia were excluded. Technical success, clinical success, and major complications were calculated. In addition, stent migration, stent re-obstruction, restenosis, and overall re-interventions due to recurrent symptoms were considered. Kaplan-Meier survival analysis was used for patient survival estimation while both bivariable and multivariable analysis were performed to identify any independent predictors of outcomes. Results Fifty-one patients, (mean age, 63.73 ± 15.62 years) met the study’s criteria and were included in the final analysis. Technical and clinical success were 90.19% ( n = 46/51) and 91.30% ( n = 42/46), respectively. Major complications rate was 3.92%. Stent migration was noted in four cases. Restenosis and re-obstruction rates were 19.57% and 10.87%, respectively. No cases of peri-procedural mortality were noted, while Kaplan-Meier estimates for 1- and 2-year survival were 16.8% and 7.2%, respectively. Clinically successful cases and patients with primary GI tumor were related with more favorable survival compared to unsuccessful and patients suffering from GDOO due to extrinsic compression by neoplastic or lymph node disease. Conclusion Exclusively fluoroscopically inserted SEMS for GDOO is safe and highly effective method for palliative treatment. </jats:sec

Adhesive Restoration of Endodontically Treated Premolars: Influence of Posts on Cuspal Deflection

PURPOSE: To determine, by means of a non-destructive experimental procedure, the effectiveness of adhesive restorations in reducing the cuspal deflection of endodontically treated premolars, with or without root canal fiber posts. MATERIALS AND METHODS: The cuspal deflection of ten sound, intact maxillary premolars was evaluated. A loading device induced deformation by axial force (ranging from 98 to 294 N) applied on the occlusal surface of teeth while laser sensors registered the amount of deflection. Once tested, teeth were endodontically treated and the marginal ridges were removed. The teeth were randomly divided into two groups and restored with: group 1) dual curing adhesive, flowable composite, and microhybrid composite; group 2) the same materials associated with root canal glass fiber post and composite cement. The cuspal deflection test was repeated with the same protocol after restorative procedures, allowing a direct comparison of the same samples. Statistical analysis was performed using ANOVA at a significance level of 0.05. RESULTS: Different average cuspal deflection was detected in the two groups: composite resin with post insertion resulted in lower deformation compared with composite alone. Mean deflection ranged from 3.43 to 12.17 μm in intact teeth, from 14.42 to 26.93 μm in group 1, and from 15.35 to 20.39 μm in group 2. ANOVA found significant differences (p = 0.02). CONCLUSION: Bonded composite restorations with fiber posts may be more effective than composite alone in reducing the cuspal deflection in endodontically treated premolars in which the marginal ridges have been lost

Effect of restorative, endodontic, and fatigue treatments on the cuspal deflection of maxillary premolars subjected to different cyclic occlusal forces: an in vitro study

This study aimed to determine the effect of adhesive direct composite restorations, endodontic treatments, and fatigue treatments on the cuspal deflection of maxillary premolars subjected to different cyclic occlusal forces. Thirty intact maxillary second premolars were selected. Ten teeth were left untreated (group IN), 10 teeth were subjected to endodontic and restorative treatment (group FL), and the remaining 10 teeth were subjected to endodontic, restorative, and fatigue treatments (group FT). All teeth were subjected to 5 occlusal compressive loading forces (98, 147, 196, 245, and 294 N) with a universal testing device. A total of 15 experimental groups were obtained with 3 tooth conditions (IN, FL, FT) and 5 different occlusal loading values. Deflection amounts (μm) were measured with laser sensors and recorded, and obtained data were statistically analyzed with one-way analysis of variance at a significance level of .05. Mean cuspal deflection values (μm) and SDs of experimental groups ranged as follows: IN-98 (24.4 ± 19.8), IN-147 (34.8 ± 28.9), IN-196 (43.8 ± 34.7), IN-245 (54.5 ± 46.4), IN-294 (60.3 ± 50.6), FL-98 (56 ± 49.1), FL-147 (62.6 ± 49.6), FL-196 (72.4 ± 52.1), FL-245 (81.3 ± 56), FL-294 (92.2 ± 60.9), FT-98 (77.2 ± 80.9), FT-147 (83.4 ± 81.3), FT-196 (92.6 ± 83.7), FT-245 (102.7 ± 85.4), and FT-294 (124.2 ± 89.5). Mean values of three main experimental groups were as follows: IN (43.5 μm), FL (72.9 μm) and FT (96.0 μm). Significant differences were found between the three main groups and relevant subgroups (P < .001). Highest cuspal deflection values (CDV) were obtained in FT groups. Lowest CDV were obtained in IN groups. FL groups showed higher deflection values than IN groups. CDV increased progressively as the teeth were restored and subjected to fatigue treatment

Tracheobronchial Stenting for Malignant Airway Disease:Long-Term Outcomes From a Single-Center Study

The aim of this retrospective study is to investigate the immediate and long-term outcomes following the insertion of covered and uncovered self-expandable metallic stent (SEMS) for the management of malignant tracheobronchial disease. A total of 49 patients (27 male, mean age 60.9 ± 15 years) underwent 77 SEMS insertions (57 uncovered). The procedure was performed in theater using combined bronchoscopic and fluoroscopic guidance. The study’s primary end points included technical success (97.9%), clinical success (91.8%), and symptom recurrence (14.2%). The mean follow-up time was 5.5 ± 5.9 months. We concluded that tracheobronchial SEMSs provide safe and effective minimally invasive long-term management of patients with symptomatic malignant airway disease. </jats:p