A Comparative Evaluation of Effectiveness of Three Techniques of Retrieval of Separated Endodontic Instruments from Curved Root Canals (An In Vitro Study)

doi:10.21203/rs.3.pex-2200/v1

Method Article

A Comparative Evaluation of Effectiveness of Three Techniques of Retrieval of Separated Endodontic Instruments from Curved Root Canals (An In Vitro Study)

https://doi.org/10.21203/rs.3.pex-2200/v1

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Introduction:Root canal preparation is an important step of root canal treatment, it includes proper cleaning and shaping of the canals. Root canal mechanical preparation can be carried out using manual or rotary instruments.Nickel-titanium instruments provide more centered preparation inside canals so, less procedural errors. Despite these advantages, separation of rotary NiTi instruments during use has become a real concern among dental practitioners especially endodontists. There have been many methods for retrieval of separated instruments such as ulrasonics, loop pen system and xp-shaper file. To our knowledge there are no studies on the effect of using different retrieval methods on root fracture resistance, retrieval time and success.

Methodology: 27 extracted human mandibular molars with 15-30 degree angle of curvature (moderate curve) with rotary Ni-Ti broken file size 25 taper 6 in middle third of canal and dividing teeth into three groups.

· Access cavities will be prepared under the dental operating microscope, using high speed diamond round bur and Endo-Z bur (Dentsply, Maillefer, Ballaigues, Switzerland).

· Patency will be established in the canals using a size 10 K-file (Mani Inc., Kiyohara, Tochigi, Japan).

· Glide path will be formed using #15 K-file (Mani Inc., Kiyohara, Tochigi, Japan).

· Engine-driven Plex-V rotary NiTi files (Orodeka LTD, Jining City – Shandong Province, China) will be used to prepare the canals.

Placement of samples in the resin molds
The teeth will be mounted in acrylic resin molds with standardized vertical and horizontal positions. They will be positioned upright so that their occlusal surfaces will be horizontal and their buccal sides will be parallel to the front side of the block.

In each root, the apical 4mm of size 25, taper 0.6 (Mpro) file will be fractured in the middle third of the root canal.

Fracturing the instruments

- Instruments will be notched to half the depth of the instrument thickness at 4 mm from the tip by using a low-speed 0.3-mm-thick diamond disk. The notched instruments will then be introduced into the randomly selected canals at 250 rpm so that they will fracture at the apical part of the root canal when they engaged the canal wall.

Staging platform

- With the help of the dental operating microscope, the removal process will be initiated with creating of a staging platform using a modified Gates-Glidden drill (Mani Inc., Kiyohara, Tochigi, Japan) then ultrasonic tips will be used to trephine dentin around coronal tip of separated instrument.

The   roots will be divided randomly into three groups according to the type of   retrieval system to be used:
Group 1: Ultrasonic tip Ed4 (Guilin Woodpecker Medical Instrument Co., Ltd,   China)
Group 2: XP-endo shaper (FKG,   Switzerland)
Group 3: LeoPen (LeoDent, Egypt)

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A Comparative Evaluation of Effectiveness of Three Techniques of Retrieval of Separated Endodontic Instruments from Curved Root Canals (An In Vitro Study)

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