Microcracks after apicoectomy with three surgical instruments: A comparative scanning electron microscopy study

Area of Science:

• Endodontics
• Microsurgery
• Dental Materials Science

Background:

• Dentinal microcracks can occur during apicoectomy.
• The choice of instrument for root-end resection and preparation influences crack formation.
• Understanding instrument-related cracks is crucial for safe apicoectomy procedures.

Purpose of the Study:

• To evaluate and compare dentinal microcracks on root-end surfaces.
• To assess cracks resulting from using a tungsten carbide bur (TCB), diamond-coated ultrasonic tip (DUT), and surgical saw (SS).
• To utilize scanning electron microscopy (SEM) for detailed crack analysis.

Main Methods:

• Sixty endodontically treated human canine teeth were used.
• Teeth were randomly assigned to three groups based on the resection instrument (TCB, DUT, SS).
• Root-end resections were performed, and surfaces were examined via SEM to classify microcracks.

Main Results:

• Instrument type significantly affected dentinal microcrack formation.
• The surgical saw (SS) group exhibited the highest incidence of complete cracks.
• The diamond-coated ultrasonic tip (DUT) group showed the lowest incidence of complete cracks.

Conclusions:

• The diamond-coated ultrasonic tip (DUT) may be preferable for minimizing dentinal microcracks during apicoectomy.
• Selecting appropriate instruments and employing standardized techniques can reduce iatrogenic damage.
• This research aids in optimizing microsurgical choices for root-end preparation.