Dentinal Defects in Endodontically Treated Teeth using NiTi Rotary vs Reciprocating Endodontic Instruments- A Systematic Review
ZE01-ZE04
Correspondence
Dr. Gaurav Lal Aidasani,
Postgraduate Student, Department of Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital,
Sant Tukaram Nagar, Pimpri, Pune-411018, Maharashtra, India.
E-mail: gauravaidasani20@gmail.com
Introduction: Nickel titanium (NiTi) instruments offer many advantages over conventional files. It is mandatory for the clinician to know the pros and cons of each endodontic file systems available today. With more root structure removed while increasing the diameter of the root canal, fracture resistance of the tooth is reduced thus, propagating dentinal craze lines.
Aim: To critically review published in vitro reports comparing effects of rotary and reciprocating file systems on dentin defects of the root canal and to identify, synthesize and present an analysis of the available data.
Materials and Methods: MEDLINE, The Cochrane Library, Science Direct, Wiley Online Library and Google Scholar were searched for studies from 1st January 2005 to 31st December 2016. Two reviewers independently screened the articles for eligibility criteria. In vitro studies comparing the formation of dentinal microcracks and defects caused by different rotary and reciprocating file systems were included. The main outcomes of interest was dentinal defects in endodontically treated tooth using greater tapered instruments. Only relevant studies that met the reviewer’s objectives were considered.
Results: A total of eight articles out of 300 titles met the eligibility criteria which included 100 mandibular incisors, 60 mandibular first molars, 150 mandibular premolars, 100 mesiobuccal canals of mandibular molars, 180 mandibular premolars, 120 mandibular premolars, Seven distobuccal roots of maxillary molars, Seven mesial roots of the mandibular molars, 100 mandibular incisors, 100 extracted mandibular premolars. Almost all studies reported dentinal cracks with engine driven endodontic systems. One study showed a reciprocating system to produce more complete cracks than a rotary system. One study reported no cracks with self-adjusting file system.
Conclusion: Mechanical instrumentation invariably produces micro cracks in the radicular dentin. While full sequence rotary instruments induce more complete dentinal craze lines, single reciprocating file systems produce more incomplete dentinal cracks.