Hand and nickel-titanium root canal instrumentation performed by dental students: a micro-computed tomographic study

Area of Science:

• Endodontics
• Dental Materials Science
• Biomaterials Engineering

Background:

• Root canal instrumentation aims to clean and shape the canal space.
• Traditional hand instrumentation techniques can be time-consuming and prone to procedural errors.
• Nickel-titanium (NiTi) rotary systems offer potential advantages in efficiency and safety.

Purpose of the Study:

• To compare the efficacy of modified double-flared technique, System GT, and ProTaper NiTi rotary files in root canal preparation.
• To evaluate the preservation of root structure and procedural errors during instrumentation by dental students.
• To assess the time efficiency of different instrumentation techniques.

Main Methods:

• Micro-computed tomography (MCT) was used to scan 36 root canals pre- and post-instrumentation.
• Three groups were formed: modified double-flared technique (K-flexofiles, Gates-Glidden), System GT rotary files, and ProTaper rotary files.
• Canal cross-sectional area, volume, perimeter, and root structure thinning were quantitatively analyzed.

Main Results:

• System GT and ProTaper resulted in significantly less canal enlargement and root structure thinning compared to the modified double-flared technique.
• Rotary techniques were approximately three times faster than the hand instrumentation method.
• ProTaper and System GT showed significantly fewer procedural errors.

Conclusions:

• NiTi rotary files (System GT and ProTaper) are superior to the modified double-flared technique for root canal preparation by dental students.
• Rotary instrumentation enhances preservation of tooth structure and reduces procedural errors.
• NiTi rotary systems offer a more efficient and safer approach for endodontic treatment.