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Micro-computed tomography evaluation of dentinal cracks after root canal preparation with different endodontic rotary
Mohammed Mana Alzamanan1, Abdullah Abdulrahman Albassam2, Emad Mahmoud Khattab2
1Department of Endodontics, Najran Specialized Dental Center, Ministry of Health, Saudi Arabia.
Background:
The occurrence of dentinal cracks is rather frequent during root canal preparation and increases with some endodontic file systems. There have been few ex vivo studies on the incidence of the formation of microcracks after root canal preparation, using the micro-computed tomography (micro-CT) analysis.
Objectives:
The aim of the present study was to compare the incidence of dentinal cracks after using the XP-endo® Shaper, TRUShape®, ProTaper Next™ (PTN), and ProTaper Universal™ (PTU) instruments in the preparation of mandibular premolar teeth with oval canals, using the micro-CT evaluation method.
Material And Methods:
Thirty-six extracted human mandibular premolars with single oval root canals were distributed randomly to 4 experimental groups (n = 9) for root canal preparation: group 1 - XP-endo Shaper; group 2 - TRUShape; group 3 - PTN; and group 4 - PTU. The teeth were scanned using micro-CT with high resolution, before and after mechanical root preparation. Then, the cross-sectional images of preand post-scanning were visualized simultaneously to detect new dentinal cracks. The number of dentinal cracks was determined as percentage for each group, and the results were statistically analyzed using the Wilcoxon signed rank test and the Kruskal-Wallis test.
Results:
A total of 49,628 cross-sectional images were obtained from preand post-scanning with micro-CT. Dentinal cracks were observed in 11,223 (22.6%) of the images. No new dentinal cracks were formed after using XP-endo Shaper, TRUShape or PTN. New dentinal cracks were found in the PTU group, and the difference between the percentages of the preand post-preparation dentinal cracks was statistically significant (37.6% vs. 62.4%) (p = 0.008).
Conclusions:
The use of the heat-treated nickel-titanium (NiTi) files (XP-endo Shaper, TRUShape, PTN) did not lead to the formation of new dentinal cracks. New dentinal cracks were formed while using the traditional NiTi file (PTU) only. Future studies are required to investigate the association between the formation of dentinal cracks and new endodontic file systems.
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