An evaluation of root canal preparation with the automated Excalibur endodontic handpiece

The aim of this study was to evaluate several parameters for automated root canal preparation with the Excalibur handpiece compared with hand instrumentation. The parameters investigated were straightening of curved canals, cleaning ability, working safety (loss of working length, instrument separation, perforation), cross sectional diameter before and after enlargement, and working time. Sixty curved root canals were prepared using the Excalibur handpiece and 30 curved canals with conventional hand instruments to ISO-size 35. The Excalibur left significantly less debris and smear layer on the root canal walls, but hand preparation resulted in fewer unprepared regions. Root canal curvature was well maintained by either technique; the degree of straightening depended on original root canal curvature rather than on the preparation technique. The Excalibur removed significantly more dentin. In the coronal part of the root canal, hand instruments produced significantly more round and oval cross sections; in the middle and apical part no differences could be detected. Working time was shorter for hand preparation, but the difference was not significant. Manual instrumentation proved to be safe; no instrument fracture, perforation or loss of working length could be observed, whereas automated preparation resulted in one perforation and two cases of loss of working length.