Öz
Objective: This study aimed to compare the removability of fractured nickel-titanium rotary instruments with different working principles in the middle and coronal thirds of the canal using ultrasonic tips and the BTR pen.
Method: Thirty-two mandibular molars were selected from recently extracted teeth that met the inclusion criteria. Teeth had to have a closed apex, no root caries, anomalies, fractures, cracks, or signs of internal or external resorption. The mesiobuccal roots were intentionally fractured, and the root inclination was confirmed to be ≤20° using Schneider's method. Teeth with a higher inclination angle were excluded. Access cavities were opened traditionally to allow direct canal access, and apical patency was verified with #10 K files. Canal lengths were measured, and teeth were embedded in acrylic blocks for easier handling. The teeth were divided into four study groups (n=8) based on the working principle of the instrument and the location of the fractured instrument (coronal or middle third). NiTi instruments with the same taper (0.6) and heat treatment (blue) were selected. A 4 mm mark was made on each file, and files were thinned to half their thickness at the designated breaking point using a diamond bur. A stage platform was created with Gates Glidden burs to improve the visibility of the broken instruments. After creating the platform, dentin around the broken files was removed by 2 mm with ultrasonic tips, and the broken pieces were extracted using a BTR Pen with a 0.3 mm thin wire loop.
Results: When analyzed by working principle, the removal time for fractured instruments in the middle third was significantly higher (p=0.0001). Within the coronal third, the removal time for reciprocal files was significantly longer (p=0.021). Similarly, in the middle third, the removal time for reciprocal files was statistically longer (p=0.004).
Conclusion: The BTR Pen was effective for both rotary file systems. The location of the fractured instrument influenced the removal time, with faster results in the coronal third due to better access and visibility. Additionally, the type of fractured NiTi rotary instrument also impacted the time required for successful removal, with rotary instruments in the middle third taking significantly longer.
Anahtar Kelimeler
Broken file Broken file removal NiTi rotary instruments ultrasonic BTR Pen
Proje Numarası
A-2123
Kaynakça
- Dulundu M, Helvacioglu-Yigit D. The Efficiency of the BTR-Pen System in Removing Different Types of Broken Instruments from Root Canals and Its Effect on the Fracture Resistance of Roots. Materials. 2022 Sep 1;15(17).
- Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod. 1979 Mar 1;5(3):83–90.
- Iqbal MK, Kohli MR, Kim JS. A Retrospective Clinical Study of Incidence of Root Canal Instrument Separation in an Endodontics Graduate Program: A PennEndo Database Study. J Endod. 2006 Nov;32(11):1048–52.
- Tzanetakis GN, Kontakiotis EG, Maurikou D V., Marzelou MP. Prevalence and Management of Instrument Fracture in the Postgraduate Endodontic Program at the Dental School of Athens: A Five-year Retrospective Clinical Study. J Endod. 2008 Jun;34(6):675–8.
- Grossman LI, Shepard LI, Pearson LA. Roentgenologic and clinical evaluation of endodontically treated teeth. Oral Surgery, Oral Medicine, Oral Pathology. 1964;17(3):368–74.
- Crump MC, Natkin E. Relationship of broken root canal instruments to endodontic case prognosis: a clinical investigation. J Am Dent Assoc. 1970;80(6):1341–7.
- Hülsmann M, Schinkel I. Influence of several factors on the success or failure of removal of fractured instruments from the root canal. Dental Traumatology. 1999;15(6):252–8.
- Ingle JI. A standardized endodontic technique utilizing newly designed instruments and filling materials. Oral Surgery, Oral Medicine, Oral Pathology. 1961;14(1):83–91.
- Madarati AA, Hunter MJ, Dummer PMH. Management of intracanal separated instruments. J Endod. 2013 May;39(5):569–81.
- Lertchirakarn V, Palamara JEA, Messer HH. Patterns of Vertical Root Fracture: Factors Affecting Stress Distribution in the Root Canal. J Endod. 2003 Aug;29(8):523-8.
- Souter NJ, Messer HH. Complications Associated with Fractured File Removal Using an Ultrasonic Technique. J Endod. 2005 Jun;31(6):450–2.
- Hülsmann M. Methods for removing metal obstructions from the root canal. Endod Dent Traumatol. 1993 Dec;9(6):223-37.
- Gencoglu N, Helvacioglu D. Comparison of the Different Techniques to Remove Fractured Endodontic Instruments from Root Canal Systems. Eur J Dent. 2009 Apr;3(2):90-5.
- Ungerechts C, Bårdsen A, Fristad I. Instrument fracture in root canals - where, why, when and what? A study from a student clinic. Int Endod J. 2014 Feb;47(2):183–90.
- Walia H, Brantley WA, Gerstein H. An initial investigation of the bending and torsional properties of nitinol root canal files. J Endod. 1988 Jan 1;14(7):346–51.
- Pettiette MT, Olutayo Delano E, Trope M. Evaluation of Success Rate of Endodontic Treatment Performed by Students with Stainless-Steel K–Files and Nickel–Titanium Hand Files. J Endod. 2001 Feb;27(2):124–7.
- Hieawy A, Haapasalo M, Zhou H, Wang ZJ, Shen Y. Phase Transformation Behavior and Resistance to Bending and Cyclic Fatigue of ProTaper Gold and ProTaper Universal Instruments. J Endod. 2015 Jul;41(7):1134-8.
- Pruett JP, Clement DJ, Carnes DL. Cyclic Fatigue Testing of Nickel-Titanium Endodontic Instruments. J Endod. 1997 Feb;23(2):77-85.
- Zanza A, Seracchiani M, Reda R, Di Nardo D, Gambarini G, Testarelli L. Role of the crystallographic phase of NiTi rotary instruments in determining their torsional resistance during different bending conditions. Materials (Basel). 2021 Oct 23;14(21):6324
- Seracchiani M, Donfrancesco O, Relucenti M, Reda R, Zanza A, Gambarini G, et al. In vitro evaluation of a recently developed rotary file: Af rotary. Braz Dent Sci. 2021 Oct;24(4):1-6.
- Parashos P, Messer HH. Rotary NiTi Instrument Fracture and its Consequences. J Endod. 2006 Nov;32(11):1031–43.
- Santos Coelho M, Card SJ, Abe D. Light-emitting Diode Assessment of Dentinal Defects after Root Canal Preparation with Profile, TRUShape, and WaveOne Gold Systems. J Endod. 2016 Sep;42(9):1393-6.
- Sanches Cunha R, Junaid A, Ensinas P, Nudera W, Da CE, Bueno S. Assessment of the Separation Incidence of Reciprocating WaveOne Files: A Prospective Clinical Study. J Endod. 2014 Jul;40(7):922-4.
- Wolcott S, Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S, et al. Separation Incidence of Protaper Rotary Instruments: A Large Cohort Clinical Evaluation. J Endod. 2006 Dec 1;32(12):1139–41.
- Cheung GSP, Darvell BW. Low-cycle fatigue of NiTi rotary instruments of various cross-sectional shapes. Int Endod J. 2007 Aug;40(8):626–32.
- De-Deus G, Moreira EJL, Lopes HP, Elias CN. Extended cyclic fatigue life of F2 ProTaper instruments used in reciprocating movement. Int Endod J. 2010 Dec;43(12):1063–8.
- Lopes HP, Elias CN, Vieira MVB, Siqueira JF, Mangelli M, Lopes WSP, et al. Fatigue life of reciproc and mtwo instruments subjected to static and dynamic tests. J Endod. 2013 May;39(5):693–6.
- Shahabinejad H, Ghassemi A, Pishbin L, Shahravan A. Success of ultrasonic technique in removing fractured rotary nickel-titanium endodontic instruments from root canals and its effect on the required force for root fracture. J Endod. 2013 Jun;39(6):824–8.
- Ruddle CJ. Nonsurgical Retreatment. J Endod. 2004 Dec;30(12):827-45.
- Spili P, Parashos P, Messer HH. The Impact of Instrument Fracture on Outcome of Endodontic Treatment. J Endod. 2005 Dec;31(12):845-50.
- Terauchi Y, O’Leary L, Kikuchi I, Asanagi M, Yoshioka T, Kobayashi C, et al. Evaluation of the Efficiency of a New File Removal System in Comparison With Two Conventional Systems. J Endod. 2007 May;33(5):585–8.
- Shen Y, Peng B, Cheung GSP. Factors associated with the removal of fractured NiTi instruments from root canal systems. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2004;98(5):605–10.
- Fu M, Zhang Z, Hou B. Removal of broken files from root canals by using ultrasonic techniques combined with dental microscope: A retrospective analysis of treatment outcome. J Endod. 2011 May;37(5):619–22.
- Ormiga F, Da Cunha Ponciano Gomes JA, De Araújo MCP, Barbosa AOG. An initial investigation of the electrochemical dissolution of fragments of nickel-titanium endodontic files. J Endod. 2011 Apr;37(4):526–30.
Öz
Etik Beyan
Bu çalışmanın, özgün bir çalışma olduğunu; çalışmanın hazırlık, veri toplama, analiz ve bilgilerin sunumu olmak üzere tüm aşamalarından bilimsel etik ilke ve kurallarına uygun davrandığımı; bu çalışma kapsamında elde edilmeyen tüm veri ve bilgiler için kaynak gösterdiğimi ve bu kaynaklara kaynakçada yer verdiğimi; kullanılan verilerde herhangi bir değişiklik yapmadığımı, çalışmanın Committee on Publication Ethics (COPE)' in tüm şartlarını ve koşullarını kabul ederek etik görev ve sorumluluklara riayet ettiğimi beyan ederim. Herhangi bir zamanda, çalışmayla ilgili yaptığım bu beyana aykırı bir durumun saptanması durumunda, ortaya çıkacak tüm ahlaki ve hukuki sonuçlara razı olduğumu bildiririm.
Destekleyen Kurum
Ordu Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi
Proje Numarası
A-2123
Teşekkür
Ordu Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi'ne projeye olan desteklerinden ötürü teşekkürlerimizi sunarız.
Kaynakça
- Dulundu M, Helvacioglu-Yigit D. The Efficiency of the BTR-Pen System in Removing Different Types of Broken Instruments from Root Canals and Its Effect on the Fracture Resistance of Roots. Materials. 2022 Sep 1;15(17).
- Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod. 1979 Mar 1;5(3):83–90.
- Iqbal MK, Kohli MR, Kim JS. A Retrospective Clinical Study of Incidence of Root Canal Instrument Separation in an Endodontics Graduate Program: A PennEndo Database Study. J Endod. 2006 Nov;32(11):1048–52.
- Tzanetakis GN, Kontakiotis EG, Maurikou D V., Marzelou MP. Prevalence and Management of Instrument Fracture in the Postgraduate Endodontic Program at the Dental School of Athens: A Five-year Retrospective Clinical Study. J Endod. 2008 Jun;34(6):675–8.
- Grossman LI, Shepard LI, Pearson LA. Roentgenologic and clinical evaluation of endodontically treated teeth. Oral Surgery, Oral Medicine, Oral Pathology. 1964;17(3):368–74.
- Crump MC, Natkin E. Relationship of broken root canal instruments to endodontic case prognosis: a clinical investigation. J Am Dent Assoc. 1970;80(6):1341–7.
- Hülsmann M, Schinkel I. Influence of several factors on the success or failure of removal of fractured instruments from the root canal. Dental Traumatology. 1999;15(6):252–8.
- Ingle JI. A standardized endodontic technique utilizing newly designed instruments and filling materials. Oral Surgery, Oral Medicine, Oral Pathology. 1961;14(1):83–91.
- Madarati AA, Hunter MJ, Dummer PMH. Management of intracanal separated instruments. J Endod. 2013 May;39(5):569–81.
- Lertchirakarn V, Palamara JEA, Messer HH. Patterns of Vertical Root Fracture: Factors Affecting Stress Distribution in the Root Canal. J Endod. 2003 Aug;29(8):523-8.
- Souter NJ, Messer HH. Complications Associated with Fractured File Removal Using an Ultrasonic Technique. J Endod. 2005 Jun;31(6):450–2.
- Hülsmann M. Methods for removing metal obstructions from the root canal. Endod Dent Traumatol. 1993 Dec;9(6):223-37.
- Gencoglu N, Helvacioglu D. Comparison of the Different Techniques to Remove Fractured Endodontic Instruments from Root Canal Systems. Eur J Dent. 2009 Apr;3(2):90-5.
- Ungerechts C, Bårdsen A, Fristad I. Instrument fracture in root canals - where, why, when and what? A study from a student clinic. Int Endod J. 2014 Feb;47(2):183–90.
- Walia H, Brantley WA, Gerstein H. An initial investigation of the bending and torsional properties of nitinol root canal files. J Endod. 1988 Jan 1;14(7):346–51.
- Pettiette MT, Olutayo Delano E, Trope M. Evaluation of Success Rate of Endodontic Treatment Performed by Students with Stainless-Steel K–Files and Nickel–Titanium Hand Files. J Endod. 2001 Feb;27(2):124–7.
- Hieawy A, Haapasalo M, Zhou H, Wang ZJ, Shen Y. Phase Transformation Behavior and Resistance to Bending and Cyclic Fatigue of ProTaper Gold and ProTaper Universal Instruments. J Endod. 2015 Jul;41(7):1134-8.
- Pruett JP, Clement DJ, Carnes DL. Cyclic Fatigue Testing of Nickel-Titanium Endodontic Instruments. J Endod. 1997 Feb;23(2):77-85.
- Zanza A, Seracchiani M, Reda R, Di Nardo D, Gambarini G, Testarelli L. Role of the crystallographic phase of NiTi rotary instruments in determining their torsional resistance during different bending conditions. Materials (Basel). 2021 Oct 23;14(21):6324
- Seracchiani M, Donfrancesco O, Relucenti M, Reda R, Zanza A, Gambarini G, et al. In vitro evaluation of a recently developed rotary file: Af rotary. Braz Dent Sci. 2021 Oct;24(4):1-6.
- Parashos P, Messer HH. Rotary NiTi Instrument Fracture and its Consequences. J Endod. 2006 Nov;32(11):1031–43.
- Santos Coelho M, Card SJ, Abe D. Light-emitting Diode Assessment of Dentinal Defects after Root Canal Preparation with Profile, TRUShape, and WaveOne Gold Systems. J Endod. 2016 Sep;42(9):1393-6.
- Sanches Cunha R, Junaid A, Ensinas P, Nudera W, Da CE, Bueno S. Assessment of the Separation Incidence of Reciprocating WaveOne Files: A Prospective Clinical Study. J Endod. 2014 Jul;40(7):922-4.
- Wolcott S, Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S, et al. Separation Incidence of Protaper Rotary Instruments: A Large Cohort Clinical Evaluation. J Endod. 2006 Dec 1;32(12):1139–41.
- Cheung GSP, Darvell BW. Low-cycle fatigue of NiTi rotary instruments of various cross-sectional shapes. Int Endod J. 2007 Aug;40(8):626–32.
- De-Deus G, Moreira EJL, Lopes HP, Elias CN. Extended cyclic fatigue life of F2 ProTaper instruments used in reciprocating movement. Int Endod J. 2010 Dec;43(12):1063–8.
- Lopes HP, Elias CN, Vieira MVB, Siqueira JF, Mangelli M, Lopes WSP, et al. Fatigue life of reciproc and mtwo instruments subjected to static and dynamic tests. J Endod. 2013 May;39(5):693–6.
- Shahabinejad H, Ghassemi A, Pishbin L, Shahravan A. Success of ultrasonic technique in removing fractured rotary nickel-titanium endodontic instruments from root canals and its effect on the required force for root fracture. J Endod. 2013 Jun;39(6):824–8.
- Ruddle CJ. Nonsurgical Retreatment. J Endod. 2004 Dec;30(12):827-45.
- Spili P, Parashos P, Messer HH. The Impact of Instrument Fracture on Outcome of Endodontic Treatment. J Endod. 2005 Dec;31(12):845-50.
- Terauchi Y, O’Leary L, Kikuchi I, Asanagi M, Yoshioka T, Kobayashi C, et al. Evaluation of the Efficiency of a New File Removal System in Comparison With Two Conventional Systems. J Endod. 2007 May;33(5):585–8.
- Shen Y, Peng B, Cheung GSP. Factors associated with the removal of fractured NiTi instruments from root canal systems. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 2004;98(5):605–10.
- Fu M, Zhang Z, Hou B. Removal of broken files from root canals by using ultrasonic techniques combined with dental microscope: A retrospective analysis of treatment outcome. J Endod. 2011 May;37(5):619–22.
- Ormiga F, Da Cunha Ponciano Gomes JA, De Araújo MCP, Barbosa AOG. An initial investigation of the electrochemical dissolution of fragments of nickel-titanium endodontic files. J Endod. 2011 Apr;37(4):526–30.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Endodonti |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | A-2123 |
| Yayımlanma Tarihi | 31 Mayıs 2025 |
| Gönderilme Tarihi | 1 Ağustos 2024 |
| Kabul Tarihi | 20 Şubat 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 11 Sayı: 2 |
e-ISSN 2149-7796