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Apical Dentin Microcrack Formation After Ultrasonic Instrumentation in Flattened Root Canals: A Comparative Analysis
Mariana Pereira Pereira de Souza da Silva1, Adriana da Costa Ribeiro2, Jeynifer Rafaella Bezerra de Oliveira1
1Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Journal of Endodontics
|December 11, 2025
Summary
Ultrasonic instrumentation did not significantly increase apical microcracks compared to non-ultrasonic methods. Optical coherence tomography (OCT) proved reliable for detecting these microcracks in extracted teeth.
Area of Science:
- Endodontics
- Dental Materials Science
Background:
- Ultrasonic inserts are common for flat root canal instrumentation.
- The potential for instrument contact to cause dentinal microcracks is understudied.
Purpose of the Study:
- To evaluate apical microcrack formation from ultrasonic instrumentation.
- To compare ultrasonic instrumentation with a non-ultrasonic brushing protocol.
- To assess micro-computed tomography (microCT) and optical coherence tomography (OCT) for microcrack detection.
Main Methods:
- Twenty maxillary second premolars were divided into ultrasonic and brushing groups.
- Initial preparation used Reciproc Blue files.
- Post-preparation, microCT and OCT imaging were performed.
Main Results:
- The ultrasonic group showed new apical microcracks, unlike the brushing group.
- No significant difference was found between imaging techniques.
- High intra- and inter-examiner agreement was achieved.
Conclusions:
- Ultrasonic insert use did not significantly increase apical microcrack incidence.
- OCT is a reliable method for detecting apical microcracks in extracted teeth.
