Effect of Instrumentation Length and Instrumentation Systems: Hand Versus Rotary Files on Apical Crack Formation – An In vitro Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Introduction: Stresses generated during root canal instrumentation have been reported to cause apical cracks. The smaller, less pronounced defects like cracks can later propagate into vertical root fracture, when the tooth is subjected to repeated stresses from endodontic or restorative procedures. Aim: This study evaluated occurrence of apical cracks with stainless steel hand files, rotary NiTi RaCe and K3 files at two different instrumentation lengths. Materials and Methods: In the present in vitro study, 60 mandibular premolars were mounted in resin blocks with simulated periodontal ligament. Apical 3 mm of the root surfaces were exposed and stained using India ink. Preoperative images of root apices were obtained at 100x using stereomicroscope. The teeth were divided into six groups of 10 each. First two groups were instrumented with stainless steel files, next two groups with rotary NiTi RaCe files and the last two groups with rotary NiTi K3 files. The instrumentation was carried out till the apical foramen (Working Length-WL) and 1 mm short of the apical foramen (WL-1) with each file system. After root canal instrumentation, postoperative images of root apices were obtained. Preoperative and postoperative images were compared and the occurrence of cracks was recorded. Descriptive statistical analysis and Chi-square tests were used to analyze the results. Results: Apical root cracks were seen in 30%, 35% and 20% of teeth instrumented with K-files, RaCe files and K3 files respectively. There was no statistical significance among three instrumentation systems in the formation of apical cracks (p=0.563). Apical cracks were seen in 40% and 20% of teeth instrumented with K-files; 60% and 10% of teeth with RaCe files and 40% and 0% of teeth with K3 files at WL and WL-1 respectively. For groups instrumented with hand files there was no statistical significance in number of cracks at WL and WL-1 (p=0.628). But for teeth instrumented with RaCe files and K3 files significantly more number of cracks were seen at WL than WL-1 (p=0.057 for RaCe files and p=0.087 for K3 files). Conclusion: There was no statistical significance between stainless steel hand files and rotary files in terms of crack formation. Instrumentation length had a significant effect on the formation of cracks when rotary files were used. Using rotary instruments 1 mm short of apical foramen caused lesser crack formation. But, there was no statistically significant difference in number of cracks formed with hand files at two instrumentation levels.
Authors and Affiliations
Madhuri R Devale, MC Mahesh, Shreetha Bhandary
Keywords
Related Articles
- EP ID EP328826
- DOI 10.7860/JCDR/2017/22059.9159
- Views 167
- Downloads 0
Ultrasound Guided Superficial Cervical Plexus and Superior Trunk Interscalene Block as Sole Anaesthetic Technique for Acromioclavicular Joint Fixation Surgery
ABSTRACT Treating pain that patient experiences from repair of distal clavicle fracture can be a challenge for the anaesthesiolgists. The primary technique employed in the management of distal clavicular surgeries is by...
Impact of Hyperthyroidism on Biochemical Markers of Bone Metabolism
ABSTRACT Introduction: Hyperthyroidism is a common endocrine disorder associated with multi-systemic effects, a rarely reported of which is bone loss in newly diagnosed hyperthyroid cases. Elevated thyroid hormones direc...
Evaluation of Oral Health Status among 5-15-Year-old School Children in Shimoga City, Karnataka, India: A Cross-sectional Study
Introduction: Oral health is an integral part of general health. Dental problems can be avoided if identified at an early stage. There is no data on oral health status of school going children in Karnataka state’s Shimog...
Relation of Lymphocyte Subsets and Cytokines in Different Grades of Alcoholic Cirrhosis
ABSTRACT Introduction: The pathogenesis of Alcoholic Liver Disease (ALD) shows immune dysregulation with decreasing lymphocyte subsets and increasing CD4/CD8 ratio. T lymphocyte activation leads to secretion of cytokines...
Is There Over Use of Computed Tomography Scan in Paediatric Head Injury Patients?
ABSTRACT Introduction: Paediatric Computed Tomography (CT) utilisation has increased now-a-days; but its use comes with risks. The ionising radiation doses delivered by CT are much higher and are linked with cancer risks...