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Biomedical subjects

O A Peters

Publications and source records attributed to O A Peters.

At least 19 recordsLinked to original sources

Effect of liquid and paste-type lubricants on torque values during simulated rotary root canal instrumentation.

AIM: To evaluate the effects of lubrication on torque generated during rotary preparation of simulated root canals in dentine using ProFile and ProTaper Nickel-Titanium instruments. METHODOLOGY: Thirty-two 3 mm thick dentine discs were used for this study. Four pilot holes were drilled perpendicularly through each disc. These simulated root canals were filled with water, aqueous 15% ethylenediamine tetraacetic acid (EDTA) or a paste-type lubricant (Glyde). Empty canals served as controls. Peak torque values and apically directed forces of rotary instruments were measured using a specially designed testing platform. Full torsional loads over time were calculated by integration of continuous torque records. Data were compared using analyses of variance with the alpha-type error set at 0.05. RESULTS: Maximum torque values using ProFile instruments were significantly (P < 0.005) reduced by the EDTA solution, whilst no reduction was observed using Glyde. With ProTaper instruments, no lubricant effects on maximum torque values were observed (P = 0.372). Full torsional loads over time were significantly reduced for both ProFile and ProTaper preparation (P < 0.005) by the use of lubrication. The two fluids performed significantly better than paste-based Glyde. All lubricants reduced force when applied to ProTaper by mean reductions ranging from 12 to 54%, whilst Glyde lead to increased force when applied to ProFile. CONCLUSIONS: Under the conditions of this laboratory study, lubrication appeared to be advantageous. Aqueous solutions generally performed better than the paste-type product under investigation, which showed untoward effects when used in conjunction with a rotary instrument with a U-shaped cross-section (ProFile).

Analysis of Variance↗

Root canal preparation with Endo-Eze AET: changes in root canal shape assessed by micro-computed tomography.

AIM: To evaluate the relative performance of Endo-Eze Anatomic Endodontic Technology (AET) stainless steel instruments when shaping maxillary molar root canals in vitro. Methodology Extracted human maxillary molars were scanned, before and after root canal shaping with Endo-Eze AET, employing micro-computed tomography (muCT) at an isotropic resolution of 34 microm. Three-dimensional root canal models were reconstructed and evaluated for volume, surface area, 'thickness' (diameter), canal transportation and prepared surface. Preparation errors such as apical zips, perforations and fractured instruments were visually determined from those models. Means were contrasted using anova and Scheffé post-hoc tests. RESULTS: Volume and surface area increased significantly and similarly in mesiobuccal (mb), distobuccal (db) and palatal (p) canals and gross preparation errors (n = 17) were found. Mean root canal diameters, 5 mm coronal to the apex, increased from 0.31 to 0.52, 0.35 to 0.50 and 0.50 to 0.70 mm for mb, db and p canals, respectively. Mean canal transportation ranged from 0.15 to 0.29, 0.15 to 0.27 and 0.21 to 0.33 mm for apical, middle and coronal root canal levels, respectively, with highest values found for mb canals (P < 0.003). Root canals were significantly straightened during preparation (P < 0.002). CONCLUSIONS: In summary, Endo-Eze AET instruments shaped root canals in maxillary molars with substantial canal transportation, particularly in mesiobuccal root canals. Preparation with this instrument removed high volumes of dentine, even though apical preparation was size 30. Based on the current results, Endo-Eze AET cannot be recommended for the preparation of teeth with curved root canals.

Analysis of Variance↗

Calcium hydroxide dressings using different preparation and application modes: density and dissolution by simulated tissue pressure.

AIM: To study the effect of different apical shapes in prepared simulated root canals on the application of a commercially prepared calcium hydroxide paste by a syringe or lentulo spiral. METHODOLOGY: Three different types of root canal preparation were performed in 90 simulated canals: group A to an apical size 20 and a 0.10 taper using hand and rotary instruments, group B to an apical size 30 and a 0.08 taper using GT rotary instruments and group C to an apical size 40 and a 0.04 taper using ProFile 0.04 instruments. The insertion of calcium hydroxide [Ca(OH)2] paste was accomplished using either a lentulo spiral or a syringe. After 1 week of simulated fluid pressure applied to the apical end of the canal using physiological saline solution, the solution was evaluated for released Ca(OH)2. The specimens were weighed initially, after preparation, after insertion of Ca(OH)2 paste, after temporization with Cavit and after 1 week of simulated fluid pressure. Digital radiographs of the filled canals were taken and canal areas in mm2, gray values of the Ca(OH)2 dressings, total area of voids in mm2, as well as location of voids in the apical, middle or coronal thirds of the root canals were measured. Analyses of variance, with Scheffe's post-hoc tests, as well as chi-square tests were performed. RESULTS: Canals in group C had significantly fewer (P < 0.01) radiographic voids than canals in groups A and B. Using a lentulo spiral resulted in significantly (P < 0.05) fewer voids compared with the injection technique. More voids were detected coronally compared with middle and apical root canal thirds (P < 0.05). CONCLUSIONS: Canal shape and method of application had an impact on the amount and radiodensity of calcium hydroxide dressings in simulated root canals. Canals prepared to an apical size 40 and a taper of 0.04 had the least number of voids; Ca(OH)2 was placed with significantly fewer voids using a lentulo spiral compared with the injection technique.

Calcium Hydroxide↗

An analysis of endodontic treatment with three nickel-titanium rotary root canal preparation techniques.

AIM: To investigate clinical results of root canal treatment performed with the aid of nickel-titanium (NiTi) rotary instruments. SUMMARY: A total of 179 patients underwent root canal treatment with either (A) Lightspeed, or (B) ProFile .04 or (C) ProFile .04 and .06 or GT rotary instruments to create tapered preparations. In groups A and B, laterally condensed gutta-percha and AH Plus were used. Canals in group C were obturated with System B, Obtura II and Roth's 801 sealer. Initial and recall radiographs were assessed using the periapical index (PAI). Outcomes were analysed using chi-square tests, event-time analyses and logistic regression models. Two hundred and thirty-three teeth were radiographically assessed after a mean interval of 25.4 +/- 11.8 months. Favourable outcome of treatment, defined as PAI < 3 at recall was 86.7%. Logistic regression analysis and univariate analyses indicated that teeth with preoperative PAI scores >2 and retreated teeth had a significantly lower chance of healing compared with periapically healthy teeth and primary treatments, respectively. Preparation technique, length of fill and the type of sealer did not significantly affect healing rates. KEY LEARNING POINTS: Root canal treatment with NiTi root canal instrumentation systems renders favourable outcomes in more than 86% of the cases. Outcome is significantly affected by preoperative diagnoses but not by the specific choice of instrumentation system.

Adolescent↗

ProTaper rotary root canal preparation: effects of canal anatomy on final shape analysed by micro CT.

AIM: To evaluate the relative performance of ProTaper nickel-titanium (Ni-Ti) instruments shaping root canals of varying preoperative canal geometry. METHODOLOGY: Extracted human maxillary molars were scanned, before and after shaping with ProTaper, employing micro computed tomography (muCT) at a resolution of 36 mum. Canals were three-dimensionally reconstructed and evaluated for volume, surface area, 'thickness' (diameter), canal transportation and prepared surface. Based on median canal volume, canals were divided into 'wide' and 'constricted' groups. Comparisons were made between mesiobuccal (mb), distobuccal (db) and palatal (p), as well as 'wide' and 'constricted' canals, using repeated-measures anova and Scheffé posthoc tests. RESULTS: Volume and surface area increased significantly and similarly in mb, db and p canals, and gross preparation errors were found infrequently. Root canal diameters, 5-mm coronal to the apex, increased from 0.38 to 0.65 mm, 0.42 to 0.66 mm and 0.57 to 0.79 mm for mb, db and p canals, respectively. Apical canal transportation ranged from 0.02 to 0.40 mm and was independent of canal type; 'wide' canals had a significantly higher (P < 0.05) proportion of unprepared surfaces than 'constricted' canals. CONCLUSIONS: Canals in maxillary molars were prepared in vitro using ProTaper instruments without major procedural errors. These instruments may be more effective in shaping narrow canals than wider, immature ones.

Analysis of Variance↗

ProTaper rotary root canal preparation: assessment of torque and force in relation to canal anatomy.

AIM: To investigate physical parameters for ProTaper nickel-titanium (NiTi) rotary instruments whilst preparing curved canals in maxillary molars in vitro. METHODOLOGY: A novel torque-testing platform was used to prepare root canals in 15 extracted human maxillary molars with ProTaper rotary instruments. Peak torque and force was registered along with numbers of rotations required to shape the canals. Canals were divided into 'wide' and 'constricted' groups depending on canal volumes assessed by micro computed tomography. Mean scores for each instrument type were calculated and statistically compared using anova and Scheffé posthoc tests. RESULTS: Mean torque varied between 0.8 +/- 0.5 and 2.2 +/- 1.4 N cm whilst mean force ranged from 4.6 +/- 2.6 to 6.2 +/- 2.7 N. Mean numbers of rotations totalled up to 21. All three variables registered were significantly correlated to preoperative canal volumes (P < 0.001) and differed significantly between 'wide' and 'constricted' canals (P < 0.001). CONCLUSIONS: Whilst high forces were used in some cases, no ProTaper instrument fractured when a patent glide path was present. There were significant positive correlations between canal geometry and physical parameters during shaping.

Analysis of Variance↗

Teaching an engine-driven preparation technique to undergraduates: initial observations.

AIM: This paper describes the initial experiences following the introduction of a rotary engine-driven preparation technique into the undergraduate endodontic programme at the Zurich University Dental Centre. METHODS: Forty third-year students practised the ProFile.04 (PF.04) technique between January and July 2001 in a preclinical course. Between November 2001 and February 2002, 20 of these students (Group A) root-treated 51 teeth in their clinical course using either PF.04, the balanced force technique (BFT) or a combination of both. The second group of 20 students (Group B) similarly treated another 36 randomly selected teeth between April and July 2002. Types of teeth treated by the students and the canal preparation techniques were recorded. The students also completed a short questionnaire, evaluating their opinions of the new course. RESULTS: Of the 87 teeth endodontically treated during the clinical course, 34, 14 and 39 were shaped using PF.04 alone, a combination of PF.04 and BFT and BFT alone, respectively. No rotary instruments were fractured during the 1-year clinical course, although some instruments were fractured during the preclinical laboratory course. Overall, the students rated the rotary technique as positive. CONCLUSION: A rotary technique was successfully introduced into an undergraduate endodontic programme (this will be continued in the foreseeable future). However, the continuity between the preclinical and the clinical courses was poor as a result of the constraints of the general teaching programme.

Clinical Competence↗

Root-canal preparation with FlexMaster: canal shapes analysed by micro-computed tomography.

AIM: To evaluate the relative performance of FlexMaster nickel-titanium instruments shaping maxillary molar root canals in vitro. METHODOLOGY: Extracted human maxillary molars were scanned, before and after root-canal shaping, with FlexMaster, employing micro-computed tomography (microCT) at a resolution of 36 microm. Canals were three-dimensionally reconstructed and evaluated for volume, surface area, 'thickness' (diameter), canal transportation and prepared surface. Based on median canal volume, the canals were divided into 'wide' and 'constricted' groups. Comparisons were made between mesiobuccal (mb), distobuccal (db) and palatal (p), as well as 'wide' and 'constricted' canals, using anova and Scheffé post-hoc tests. RESULTS: Volume and surface area increased significantly and similarly in mb, db and p canals, and no gross preparation errors were found. Mean root-canal diameters, 5 mm coronal to the apex, increased from 0.45 to 0.65 mm, from 0.41 to 0.56 mm and from 0.79 to 0.85 mm for mb, db and p canals, respectively. Apical canal transportation ranged from 0.01 to 0.29 mm and was independent of canal type; 'wide' canals had a significantly higher (P < 0.05) proportion of unprepared surfaces than 'constricted' canals had. CONCLUSIONS: FlexMaster instruments shaped curved and narrow root canals in maxillary molars to sizes 40 and 45 without significant shaping errors. Canal anatomy had an insignificant impact on preparation, indicating that FlexMaster instruments were able to shape 'constricted' canals as well as 'wide' ones.

Analysis of Variance↗

Root canal preparation with FlexMaster: asessment of torque and force in relation to canal anatomy.

AIM: To investigate physical parameters of FlexMaster nickel-titanium instruments while preparing curved canals in maxillary molars in vitro. METHODOLOGY: A torque-testing platform was used to prepare root canals in 11 extracted human maxillary molars with FlexMaster rotary instruments. Peak torque and force was registered along with numbers of rotations required to shape the canals. Canals were divided into 'wide' and 'constricted' groups depending on canal volumes assessed by microcomputed tomography. Resistance to cyclic fatigue was also tested. Mean scores for each instrument type were calculated and statistically compared using anova and Scheffé post hoc tests. RESULTS: Mean torque varied between 0.1 +/- 0.1 and 0.8 +/- 0.5 N cm while mean force ranged from 4.2 +/- 2.0 to 7.3 +/- 3.5 N. Mean numbers of rotations totalled up to 18. All three variables registered showed weak correlations to preoperative canal volumes (P < 0.01) and differed significantly between 'wide' and 'constricted' canals (P < 0.001). Numbers of rotations to fracture in a cyclic fatigue test were between 348 and 1362. CONCLUSION: FlexMaster instruments generated low torque scores and were highly resistant to cyclic fatigue, whilst three instruments fractured in extremely narrow canals. Consequently, more research is required to limit fracture incidence and to optimize instrumentation guidelines.

Analysis of Variance↗

Dynamic torque and apical forces of ProFile.04 rotary instruments during preparation of curved canals.

AIM: To analyse torque and force generated whilst shaping curved canals using rotary instruments. METHODOLOGY: A specially designed computer-controlled testing platform was used to record events during the shaping of straight and curved canals in plastic blocks and in extracted human teeth using ProFile.04 instruments. Size 40 apical stops were prepared using crown-down, apical preparation and step-back procedures. Maximum torque, apically directed force and the numbers of revolutions were recorded at a resolution of 100 samples s-1. Load causing separation as required by the ISO 3630-1 test and cyclic fatigue was also recorded. Mean maximum scores were calculated and statistically tested using one- and two-way analyses of variance. RESULTS: Highest and lowest torque scores were recorded, respectively, in straight canals in plastic blocks at 25 Nmm and in natural canals at 14 Nmm. Significant differences were recorded for canal type and preparation phase (P < 0.0001). Loads causing separation varied from 3.7 to 32.3 Nmm. Apically directed forces ranged from 1 to 7.5 N. Again, there were significant differences depending on canal type and preparation phase (P < 0.0001). The number of revolutions during preparation ranged from 18 to 41. Size 15, 30 and 45 ProFile.04 instruments separated after 581, 430 and 402 revolutions, respectively, in a standard cyclic fatigue test. CONCLUSIONS: The new torque-testing platform details physical parameters during preparation of curved canals. To improve predictability, instrumentation sequences must be tested for excessively high torsional moments or forces. This study indicated that up to 10 curved canals could be safely prepared with a sequence of ProFile. 04 rotary instruments without separation due to cyclic fatigue. Efforts should continue to correlate root canal anatomy with torque and force generated during rotary root canal preparation.

Analysis of Variance↗

Occlusal loading of EBA and MTA root-end fillings in a computer-controlled masticator: a scanning electron microscopic study.

AIM: The aim of this investigation was to assess the marginal adaptation of Super-EBA (EBA) and Pro Root MTA (MTA) root-end fillings and the occurrence of microcracks in resected root-ends of extracted teeth before and after occlusal loading for a five-year equivalent period in a computer-controlled masticator. METHODOLOGY: Twenty-four molar teeth were root-filled using lateral condensation and their root-ends resected. Root-end cavities were prepared and either EBA or MTA root-end fillings were placed. All surgical procedures were completed in vitro under an operating microscope. Replicas taken of the root-end fillings and resected root-ends were examined using an SEM before and after they were subjected to in vitro chewing cycles in a computer-controlled chewing simulator for the equivalent of 5 years. Marginal adaptation and integrity of the two root-end filling materials were evaluated and the presence of microcracks recorded. RESULTS: Before loading, a continuous margin was observed with 99.4 +/- 2.4% of EBA and 99.2 +/- 1.6% of MTA root-end fillings. After loading, the percentage of continuous margin decreased to 93.1 +/- 6.6% and 98.9 +/- 3.2% for EBA and MTA, respectively. After occlusal loading, 39.5% of the EBA root-end fillings were overfilled, whilst 52.6% of the MTA root-end fillings were underfilled. In total, 12.5% of the resected root-end surfaces showed microcracking before loading and 25% after occlusal loading. CONCLUSIONS: Both EBA and MTA displayed excellent marginal adaptation before masticatory loading. After loading, the amount of continuous margin for both root-end filling materials decreased slightly but was still high.

Aluminum Compounds↗

Effects of rotary instruments and ultrasonic irrigation on debris and smear layer scores: a scanning electron microscopic study.

AIM: This study evaluated debris and smear layer scores after two types of instruments manufactured from different alloys were used to ultrasonically activate irrigants during canal preparation. The influence of two rotary preparation techniques on cleanliness of the shaped canals was also studied. METHODOLOGY: Apical stops were prepared to size 45 in 42 single-canalled extracted premolars and canines, which were divided into six equal groups. Groups 1, 2 and 3 were prepared by ProFile.04 (PF) while groups 4, 5 and 6 were prepared by Lightspeed (LS). All groups were irrigated using 5.25% NaOCl and 17% EDTA. Irrigants in groups 2 and 5 were ultrasonically activated using a size 15 steel K-file and by a blunt flexible nickel-titanium wire in groups 3 and 6. Groups 1 and 4 served as negative controls. Roots were split and canal walls examined at 15x, 200x and 400x magnification in an SEM. Smear layer and debris scores were recorded at 3, 6 and 9 mm levels using a 5-step scoring scale and a 200- micro m grid. Means were tested for significance using nonparametric Mann-Whitney U and Kruskal-Wallis tests. RESULTS: Debris and smear layer scores for the six groups varied from 1.98 +/- 1.04 to 3.47 +/- 0.97 and from 1.37 +/- 0.4 to 2.36 +/- 0.99, respectively. Although all groups had significantly higher smear layer and debris scores at the 3 mm levels compared to the 9 mm levels (P < 0.05), no significant differences were recorded due to the ultrasonic energy transmitted by the two alloys. CONCLUSION: Ultrasonically activated irrigants did not reduce debris or smear layer scores. This finding was not influenced by the material nor by the design of the instrument used to transmit ultrasonic activation.

Dental Instruments↗

An in vitro study comparing root-end cavities prepared by diamond-coated and stainless steel ultrasonic retrotips.

AIM: This study compared the appearance of root-end cavity preparations and the time required to prepare them using prototype ultrasonic diamond-coated (DC) and stainless-steel (SS) retrotips. METHODOLOGY: In 12 maxillary and 12 mandibular molar teeth 48 root-end cavities were prepared ultrasonically in the palatal, mesio-buccal, distal and mesial root-ends using DC and SS retrotips, alternately. Replicas of the resected root tips and the root-end cavities were examined under a scanning electron microscope (SEM), recording (i) incidence and extent of dentine cracks (ii) minimum remaining thickness of the dentine walls and (iii) surface quality of the resected root-ends. The time taken to complete the preparation was also recorded. Means of these parameters were compared for both types of retrotips using nonparametric tests. RESULTS: No resected root-ends had cracks before preparation. However, after preparation one root-end cavity shaped by an SS retrotip had a microcrack visible at 23x magnification. Four and seven other root-ends had crazed surfaces in the DC and SS groups, respectively (P > 0.05). Remaining minimum dentine thickness was 0.56 +/- 0.28 mm and 0.71 +/- 0.24 for the DC and SS groups, respectively, and this difference was significant (P < 0.05). A root-end cavity in one specimen in the DC group was perforated. Preparation times ranged from 25 s to 361 s and were significantly lower for DC tips (P < 0.01) than the SS tips. The time required to prepare root-end cavities also differed between roots; root-end preparation in mandibular molars was more time consuming. CONCLUSIONS: A better quality surface was produced by the prototype diamond-coated retrotips, in less time than the SS retrotips, which in turn caused fewer cracks than previously reported. DC retrotips removed more dentine than SS retrotips and should therefore be used with care to avoid overpreparation or perforation.

Apicoectomy↗

Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography.

AIM: The aim of this study was to compare the effects of four preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. In addition, micro CT data was used to describe morphometric parameters related to the four preparation techniques. METHODOLOGY: A micro computed tomography scanner was used to analyse root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using Ni-Ti - K-Files, Lightspeed instruments, ProFile.04 and GT rotary instruments. Differences in dentine volume removed, canal straightening, the proportion of unchanged area and canal transportation were calculated using specially developed software. RESULTS: Instrumentation of canals increased volume and surface area. Prepared canals were significantly more rounded, had greater diameters and were straighter than unprepared canals. However, all instrumentation techniques left 35% or more of the canals' surface area unchanged. Whilst there were significant differences between the three canal types investigated, very few differences were found with respect to instrument types. CONCLUSIONS: Within the limitations of the micro CT system, there were few differences between the four canal instrumentation techniques used. By contrast, a strong impact of variations of canal anatomy was demonstrated. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

Analysis of Variance↗

Marginal adaptation of inlay-retained adhesive fixed partial dentures after mechanical and thermal stress: an in vitro study.

STATEMENT OF PROBLEM: There are no studies that analyze the long-term durability of minimally invasive fixed partial dentures (FPDs) by comparing different methods of adhesive bonding. PURPOSE: This in vitro study examined the influence of cavity design and operative technique on the marginal adaptation of resin-bonded composite FPDs. MATERIAL AND METHODS: Slot-inlay tooth preparations with cavity margins located in enamel were prepared in 18 maxillary canines and 18 maxillary first molars designated as abutments. The specimens were divided equally into 3 experimental groups. In all groups, butt joint tooth preparations were created in canines and molars. In group 2, canines were prepared additionally with a 1.5-mm wide palatal bevel in enamel. After pretests with modification spaces of 11 and 17 mm (length), 2 missing premolars were replaced by the ceromer Targis and reinforced with the glass-fiber material Vectris. The prostheses were inserted with Tetric Ceram with use of an ultrasonic-supported, high-viscosity technique. Restorations were selectively bonded to cavity finish lines in groups 1 and 2 ("selective bonding"). In group 3, restorations were bonded totally to the whole cavity surface ("total bonding"). The restorations were stressed in a computer-controlled masticator. Marginal quality was examined with an SEM at x 200. RESULTS: The percent area of optimal margins after thermomechanical loading between composite and enamel in each group was as follows: group 1, 86.2% +/- 12.3% for canines and 95.5% +/- 3.5% for molars; group 2, 95.3% +/- 2.1% for canines and 96.2% +/- 2.7% for molars; and group 3, 95% +/- 0.9% for canines and 86.4% +/- 3.2% for molars. The marginal quality for molars inserted with total bonding was significantly lower (P< or =.05). CONCLUSION: Within the limitations of this study, the selective bonding technique for slot inlay-retained fixed partial dentures resulted in a negligible loss of marginal quality after extensive mechanical and thermal stress. The selective bonding technique is recommended for box-shaped cavity preparations.

Acid Etching, Dental↗

Changes in root canal geometry after preparation assessed by high-resolution computed tomography.

Root canal morphology changes during canal preparation, and these changes may vary depending on the technique used. Such changes have been studied in vitro by measuring cross-sections of canals before and after preparation. This current study used nondestructive high-resolution scanning tomography to assess changes in the canals' paths after preparation. A microcomputed tomography scanner (cubic resolution 34 microm) was used to analyze 18 canals in 6 extracted maxillary molars. Canals were scanned before and after preparation using either K-Files, Lightspeed, or ProFile .04 rotary instruments. A special mounting device enabled precise repositioning and scanning of the specimens after preparation. Differences in surface area (deltaA in mm2) and volume (deltaV in mm3) of each canal before and after preparation were calculated using custom-made software. deltaV ranged from 0.64 to 2.86, with a mean of 1.61 +/- 0.7, whereas deltaA varied from 0.72 to 9.66, with a mean of 4.16 +/- 2.63. Mean deltaV and deltaA for the K-File, ProFile, and Lightspeed groups were 1.28 +/- 0.57 and 2.58 +/- 1.83; 1.79 +/- 0.66 and 4.86 +/- 2.53; and 1.81 +/- 0.57 and 5.31 +/- 2.98, respectively. Canal anatomy and the effects of preparation were further analyzed using the Structure Model Index and the Transportation of Centers of Mass. Under the conditions of this study variations in canal geometry before preparation had more influence on the changes during preparation than the techniques themselves. Consequently studies comparing the effects of root canal instruments on canal anatomy should also consider details of the preoperative canal geometry.

Computer Simulation↗

[Engine-driven preparation of curved root canals: a platform to assess physical parameters].

The number of engine-driven rotary instruments available on the market is steadily increasing. These instruments enable clinicians to prepare better shaped root canals, however, rotary instruments have a higher risk for fracture than hand instruments. Unfortunately, the stresses placed on engine-driven rotary instruments in curved canals are insufficiently studied. The aim of this study was to develop a device which could measure more accurately the physical parameters influencing rotary instruments in curved canals. For this purpose, a specially designed machine was constructed to measure the torque which develops between the rotary instrument and the motor. Apical forces and penetration depths could also be directly measured in real time. A variety of other measurements was also possible because of other special set-ups integrated into the device. In the current study torque was assessed for GT-Files, size 35 with a .12 and sizes 20 with a .12 to .06 taper. In additions to preparations in simulated canals in plastic blocks, the "ISO 3630-1 specification for fracture moment" and "number of cycles till fatigue fracture" was measured. The findings indicated that when instruments were used for preparations, torques up to 40 Nmm were present. This exceeded the static fracture load, which was less than than 13 Nmm for the size 20 with .12 taper. In contrast, the number of rotations were more than 10 times lower when shaping canals in plastic blocks with a 5 mm radius of curvature than the number of rotations to fracture in the "cyclic fatigue test". This suggests that a GT-instrument could be used in ten canals. The apical force was always greater than 1 N and occasionally, 8 N or more was recorded. Further studies on natural teeth with varying canal geometries are required using the specially developed torsional machine to reduce the incidence of instrument fracture. In this way an efficient clinical potential can be confirmed for engine-driven rotary instruments in canal preparation.

Humans↗

Effects of irrigation on debris and smear layer on canal walls prepared by two rotary techniques: a scanning electron microscopic study.

Debris and smear layer were evaluated in canals prepared with either Lightspeed (LS) or ProFile (PF) rotary instruments. Irrigants used were tap water (group A) or alternating 5.25% NaOCl and 17% EDTA (group B). Apical stops were prepared to size 52.5 in the LS and to size 6 (approximately ISO size 36) in the PF techniques. The roots were split longitudinally and examined at apical, middle and coronal levels for debris and the smear layer using a 5-step scale. Using only water, mean debris scores were similar for LS and PF. In contrast, with EDTA/NaOCl, LS- and PF-prepared canals had similar debris scores at the apical and coronal levels, but there was a significant difference at the middle level. Mean smear layer scores were similar in LS- and PF-shaped canals when water was the sole irrigant. In contrast, with NaOCl and EDTA, mean smear layer scores were significantly different at the apical and middle levels, but not at the coronal level. Neither technique was superior in removing debris, but larger canal preparations obtained in this study with LS instruments enabled a more effective removal of the smear layer in the EDTA-NaOCl group.

Dental High-Speed Equipment↗