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PURPOSE: The aim of this study was to investigate the accessory root canal morphology of maxillary first molars in a Black South African subpopulation. METHODS: Micro-computed tomography was used to investigate 101 maxillary first molars (from 50 male and 51 female teeth, right 53 teeth, left 48 teeth). The prevalence of chamber canals, and the number, type and location (root third) of accessory canals were recorded. The relationships between arch side, sex and age were examined using chi-squared tests of association. Intra- and inter-observer reliability were assessed using Cohen's kappa test. RESULTS: Intra- and inter-rater agreement was 96.9% and 98.1%, respectively. Variations in accessory root canal anatomy according to side, sex and age were evident. Chamber canals were identified in 10.9% of teeth. Accessory canals were found mainly in the apical third of most teeth in the sample, and distributed predominantly in the mesio-buccal root. Apical deltas were most prevalent in the mesio-buccal root, and their frequency decreased in the palatal and then finally the disto-buccal root. CONCLUSION: Accessory root canals were common in this population, and showed a diverse range of anatomy. The present findings will be of assistance to clinicians during endodontic treatment and will also be valuable for educational purposes.

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PURPOSE: This study was conducted to investigate the root canal anatomy of maxillary first molars in Black South Africans. METHODS: Micro-computed tomography was used to investigate 101 maxillary first molars (53 teeth from the right, 48 from the left; 50 male and 51 female teeth). The number of root canals in each tooth was determined, and the relationship between side, sex and age was analyzed using chi-squared test. To determine intra- and inter-observer reliability, Cohen's kappa coefficients were calculated. RESULTS: Intra- and inter-rater agreements of 96.92% and 98.08% were achieved, respectively. Most teeth contained either three or four canals, but a second, third and fourth mesio-buccal canal was found in 60.39%, 5.94% and 0.99% of teeth, respectively. The disto-buccal and palatal roots contained predominantly single canals, but additional canals were noted in 2.97% and 1.98% of teeth. Four canals were common in females and teeth on the right side often contained a second mesio-buccal canal. However, the prevalence of a third mesio-buccal canal was higher in males than in females. CONCLUSION: The teeth studied showed diversity and variations between sexes and arch sides. These findings will aid clinicians in endodontic treatment and will be applicable for educational purposes.

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AIM: To compare preparation times using manual, rotary, and reciprocating files during pulpectomy treatment of primary molars. SETTINGS AND DESIGN: This study was an in vitro, randomised, cross-sectional study. METHODS: The study was performed on 60 extracted human primary mandibular second molars. Only mesiobuccal canals were prepared using one of three preparation techniques; each preparation technique group comprised 20 canals. Canal preparations were performed by a single, skilled operator using stainless-steel (ss) K-files (ISO size 20-35), a ProTaper Gold SX file, and a WaveOne Gold Medium file following glide path preparation. Preparation times were recorded in second (s) with a digital stopwatch. STATISTICAL ANALYSIS: Preparation times were compared using analysis of variance and the Kruskal-Wallis analysis of variance, where appropriate. The level of significance was set at P ≤ 0.05. RESULTS: The mean preparation time using the ss K-files was significantly longer (186.4 s) than when using the ProTaper Gold SX (29.6 s) or WaveOne Gold Medium files (30.5 s) (P < 0.001). Similar preparation times were recorded when using the ProTaper Gold SX and WaveOne Gold Medium files (P = 0.939). CONCLUSION: Preparation times with the ProTaper Gold SX and WaveOne Gold Medium files were significantly faster than when using the ss K-files to prepare primary tooth root canals for pulpectomy. Similar preparation times were noted when using the rotary and reciprocation instrumentation groups (P > 0.05).

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This case report focuses on the diagnosis and treatment of a maxillary lateral incisor affected by a talon cusp, a rare developmental dental anomaly. The case presented with irreversible pulpitis and an immature apex. The article discusses the prevalence, etiology, classification, and treatment options for talon cusps, highlighting their clinical significance and potential complications. Clinical and radiographic findings obtained from a periapical radiograph and a cone-beam computed tomography (CBCT) scan are outlined. The treatment approach involved the removal of the talon cusp, endodontic therapy including apexification with mineral trioxide aggregate, and aesthetic restoration of the tooth. The report underscores the value of precise diagnosis, careful treatment planning, and the utility of CBCT scans in effectively managing talon cusps.

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Key Clinical Message: Dens evaginatus is an uncommon dental anomaly presenting on mandibular premolar teeth. Affected teeth are difficult to diagnose and manage, and often demonstrate immature apices requiring complex endodontic treatment approaches. Abstract: Dens evaginatus (DE) is an uncommon anomaly affecting mandibular premolars, frequently requiring endodontic intervention. This report documents the treatment of an immature mandibular premolar presenting with DE. Early diagnosis and preventive strategies remain the preferred management for these anomalies, however endodontic approaches may be successfully applied to retain these teeth.

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INTRODUCTION: This study evaluated the effect of traditional and conservative endodontic access cavity designs in combination with WaveOne Gold and TruNatomy instrumentation systems on the fracture resistance of mandibular first molars by means of nonlinear finite element analysis (FEA). METHODS: Micro-CT images of 4 human mandibular first molars were used to generate representative FEA models. The mandibular first molars samples were scanned before and after endodontic access cavity preparation and instrumentation of all 3 canals. Five nonlinear static loads were applied vertically and horizontally to specific contact points on the occlusal surface of the teeth. Maximum von Mises stress before failure and distribution of von Mises strains were recorded and compared between groups. RESULTS: Molars with conservative endodontic access cavities required similar levels of loads to reach failure compared with their control samples, whereas molars with traditional endodontic access cavities required significantly reduced loads in order to fail. According to the numerical investigation, the type of instrumentation system was found to have an insignificant effect on the fracture resistance of the teeth under study. Von Mises stress was concentrated around the cervical region and in the larger distal roots for all numerical models. CONCLUSIONS: The fracture resistance of mandibular first molars is influenced significantly by a reduction in dental hard tissue, which was found to control the level of the ultimate failure load for each tooth.

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INTRODUCTION: The purpose of this study was to evaluate and compare 2 different access cavity designs in combination with 2 popular single-file preparation systems to see which combination preserves dentin, more specifically pericervical dentin, best. The minimum remaining dentin thickness and dentin volumes were evaluated pre- and postinstrumentation. METHODS: Sixty extracted human mandibular molars were selected and randomly divided into 2 different access cavity design preparation groups: traditional access cavities (n = 30) and conservative access cavities (n = 30). Within each cavity preparation design group, the 30 teeth were divided into 2 instrumentation groups (WaveOne Gold Primary; Dentsply Sirona, Ballaigues, Switzerland [n = 15] and TruNatomy Prime, Dentsply Sirona [n = 15]). Samples were scanned using micro-computed tomographic imaging before and after access cavity preparation as well as after final endodontic instrumentation. The pericervical remaining dentin thickness and dentin volume changes were evaluated and compared. RESULTS: Conservative access cavity designs resulted in more favorable remaining dentin thickness. The least amount of mean dentin volume loss was also recorded in the conservative access cavity preparation groups regardless of the preparation instrumentation. CONCLUSIONS: In terms of the remaining pericervical dentin thickness and dentin volume reductions, the authors conclude that conservative access cavity designs preserve dentin best.

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INTRODUCTION: The aim was to compare the glide path and final preparation times of WaveOne Gold and TruNatomy in conjunction with two different endodontic access cavity designs in extracted human molar teeth. METHODS: 60 extracted human mandibular molars with mesiobuccal canals were selected and randomly divided into two different access cavity design preparation groups (n = 30). Traditional access cavities (TAC) and conservative access cavities (CAC). Within each cavity design group, the 30 teeth were divided in to two instrumentation groups (WaveOne Gold Primary (n = 15) and TruNatomy Prime (n = 15)). Group 1: TAC, #10 stainless steel manual K-file followed by WaveOne Gold Glider and WaveOne Gold Primary. Group 2: CAC, #10 stainless steel manual K-file followed by WaveOne Gold Glider and WaveOne Gold Primary. Group 3: TAC, #10 stainless steel manual K-file followed by TruNatomy Orifice Modifier and Glider and TruNatomy Prime. Group 4: CAC, #10 stainless steel manual K-file followed by TruNatomy Glider and TruNatomy Prime. Glide path and final preparation times were recorded. RESULTS: Shaping time with TruNatomy Glider in combination with TruNatomy Prime instruments were faster compared to the WaveOne Gold Glider/ WaveOne Gold Primary instruments regardless of the type of access cavity preparation. TAC design yielded faster preparation time (38.2 ± 4.57 seconds) compared to the CAC (55.6 ± 6.91 seconds) in the WaveOne Gold Glider/ WaveOne Gold Primary instrumentation group. No difference was found between the different access cavity design groups in combination with TruNatomy Glider/TruNatomy Prime preparation. CONCLUSION: Preparation time with TruNatomy Glider and Prime instruments was significantly faster than WaveOne Gold Glider/WaveOne Gold Primary, regardless of the access cavity design. TAC design in combination with WaveOne Gold Glider/ WaveOne Gold Primary instrumentation resulted in faster preparation time compared to WaveOne Gold Glider/WaveOne Gold in combination with the CAC design.

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The aim was to evaluate apical debris extrusion produced by a single-file system used in counter-clockwise reciprocation and compare it to rotary single-file systems used in clockwise rotation and clockwise reciprocation. A total of 100 first mandibular molars were divided into five groups (n = 20): (i) WaveOne Gold Glider and Primary instrument in counter-clockwise reciprocation; (ii) One G and One Curve file in clockwise rotation; (iii) One G and One Curve file in clockwise reciprocation; (iv) TruNatomy Glider and Prime instrument in clockwise rotation; and (v) TruNatomy Glider and Prime instrument in clockwise reciprocation. Apical debris extruded was measured after glide path preparation and canal preparation. WaveOne Gold displayed significantly higher amounts of apical debris extrusion in all the groups (P < 0.05). The lowest mean values were recorded by clockwise reciprocation groups: TruNatomy Glider, One Curve and TruNatomy Glider and Prime combined value, for glide path, canal preparation and combined mean values, respectively.

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INTRODUCTION: The aim of this study was to evaluate the root canal shaping effect of instruments manufactured from nickel titanium, M-Wire, and Gold wire with different glide path preparation techniques. METHODS: One hundred thirty-five mesiobuccal canals of extracted human maxillary molars were randomly divided into 3 equal groups (N = 45) for glide path preparation with K-files (KF) (Dentsply Sirona, Ballaigues, Switzerland), One G (OG) files (Micro-Mega, Besançon, France), and ProGlider (PG) files (Dentsply Sirona). Specimens of each glide path group were further divided equally into 3 groups for instrumentation with ProTaper Next (PTN, Dentsply Sirona), One Shape (OS, Micro-Mega), and WaveOne Gold (WOG, Dentsply Sirona) systems (n = 15). Micro-computed tomographic imaging was used to scan teeth before instrumentation and after shaping to compare centering ratio and canal transportation values at the apical, midroot, and coronal levels and the overall changes in canal volume. Data sets were statistically analyzed (analysis of variance and Kruskal-Wallis H tests). RESULTS: The centering ratios for all groups were statistically similar at all levels. Apical canal transportation was significantly high for K/OS and K/PTN (P = .003). Midroot canal transportation was significantly high for K/PTN, K/OS, and OG/OS (P = .0003). Coronal canal transportation was significantly high for K/PTN and K/OS (P = .011). The highest change in canal volume was observed with all PTN groups and the lowest with PG/WOG (P = .06). CONCLUSIONS: WOG manufactured from Gold wire combined with PG showed better root canal shaping ability and removed less dentin from the canal walls. The nickel-titanium (OS) and M-Wire (PTN) instruments used in combination with KF significantly transported more canals. PTN removed the most dentin from the canal walls regardless of the GPP technique.

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INTRODUCTION: The aim of this study was to compare centering ability and transportation values of the Primary WaveOne Gold (PWOG; Dentsply Sirona, Ballaigues, Switzerland) instrument with or without different glide path techniques. Centering ability and transportation were also compared between the 3 different glide path preparation groups. METHODS: The mesiobuccal canals of 60 extracted human mandibular molars (curvature angles between 25° and 35° and radii ≤10 mm) were selected and randomly divided into 4 groups with 15 canals each. Canals were negotiated to patency with a #8 K-file. Canal preparations were performed by a single operator using precurved #10, 15, and 20 stainless steel manual K-files (group KF); a #10 stainless steel manual K-file followed by PathFiles #1-3 (Dentsply Sirona) (group PF); a #10 stainless steel manual K-file followed by the WaveOne Gold Glider (Dentsply Sirona) (group WOGG); and no further glide path preparation (group NG). Micro-computed tomographic imaging was used to scan teeth before and after glide path preparation. The final canal preparation was performed with PWOG; after which, all 60 specimens were scanned again using micro-computed tomographic imaging. Canal transportation and centering ratio values were determined over levels 3 mm, 5 mm, and 7 mm from the root apex after glide path preparation and again after final preparation with PWOG. One-way analysis of variance was used to statistically compare groups. The significance level was set at P < .05. RESULTS: No statistically significant difference in the mean centering ratios was found after glide path preparation when the KF, PF, and WOGG groups were compared (P > .05). The mean combined transportation values after glide path preparation were statistically significantly higher in the KF group compared with the PF and WOGG groups (P > .05). There was no statistically significant difference in the mean combined centering ratios or transportation values of the NG and 3 glide path groups in combination with PWOG over the 3 levels (P > .05). CONCLUSION: KF group showed the highest mean transportation values during glide path preparation. However, the PWOG instrument's performance regarding centering ability and transportation was not influenced by the different glide path/no glide path preparation groups.

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INTRODUCTION: The aim of this study was to compare the glide path preparation times of stainless steel hand files, PathFiles (Dentsply Sirona, Ballaigues, Switzerland), and the WaveOne Gold Glider (Dentsply Sirona). The preparation times for final root canal shaping with the Primary WaveOne Gold instrument in extracted human molar teeth with and without prior glide path preparation were also recorded and compared. METHODS: Mesiobuccal canals of 60 extracted human mandibular molars (curvature angles between 25° and 35° and radii <10 mm) were selected and randomly divided into 4 groups with 15 canals each. Canals were negotiated to patency with a #8 K-file. Canal preparations were performed by a single operator using precurved #10-15-20 stainless steel manual K-files (the K-file group), a #10 stainless steel manual K-file followed by PathFiles #1-3 (the PathFile group), a #10 stainless steel manual K-file followed by WaveOne Gold Glider (the WaveOne Gold Glider group), or no further glide path preparation. Final canal preparation of all 60 canals was performed with the Primary WaveOne Gold instrument. Glide path and final preparation times were recorded. RESULTS: Glide path enlargement was statistically significantly fastest in the WaveOne Gold Glider group (19.7 ± 5.6 seconds) followed by the PathFile group (41.0 ± 6.8 seconds) and then the K-file group (81.2 ± 26.3 seconds) using analysis of variance (ANOVA) and Kruskal-Wallis tests (P < .0001). No statistically significant difference in the mean final preparation times was found among the WaveOne Gold Glider (23.1 ± 6.0 seconds), PathFile (24.4 ± 4.9 seconds), and K-file groups (27.2 ± 9.5 seconds). All 3 groups were statistically significantly faster than the no glide path preparation group (35.4 ± 10.2 seconds) using ANOVA (P = .0004) and Kruskal-Wallis tests (P = .0010). CONCLUSIONS: Preparation time with the Primary WaveOne Gold file was statistically significantly reduced when the file was used in combination with any of the glide path preparation techniques. The WaveOne Gold Glider performed statistically significantly faster in glide path preparation time than the other glide path preparation techniques.

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INTRODUCTION: The preparation of a glide path before the introduction of rotary nickel-titanium instruments is a standard adjunct to ensure increased safety during root canal preparation. The aim of this study was to compare the mean preparation time of manual instrumentation with K-files, G-Files, and the ProGlider instrument to prepare a glide path in curved root canals. METHODS: The mesial canals of 90 mandibular molars (with curvature angles between 25° and 35°) were selected. The specimens were randomly divided into 3 groups with 30 canals each, and canal preparations were performed by an endodontist who used #10-15-20 stainless steel manual K-files (group KF), #10 stainless steel manual K-file followed by #12-17 G-File instruments (group GF), and #10 stainless steel manual K-file followed by #16 ProGlider instrument (group PG). The total time it took to prepare the glide paths was recorded with an electronic stopwatch. New instruments were used for each canal. RESULTS: Glide path enlargement with the PG group (27.9 ± 8.6 seconds) and GF group (41.9 ± 20.1 seconds) was shown to be statistically significantly faster than stainless steel KF group (74.9 ± 24.1 seconds) by using analysis of variance (P < .05). There was no statistically significant difference observed between the mean preparation times of the PG and GF groups (P < .05). CONCLUSIONS: Glide path preparation times with the rotary instrument groups were significantly faster than with stainless steel manual K-files.

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INTRODUCTION: The purpose of this study was to compare centering ability and apical canal transportation of K-files (KF), ProGlider (PG), and G-Files (GF) after glide path enlargement in curved canals by using micro-computed tomography. METHODS: Thirty canals each were randomly assigned to KF, GF, and PG. Teeth were scanned before and after glide path enlargement to compare centering ability at 3 levels: 1 mm (D1) and 7 mm (D7) from the apical foramen and at the point of maximum root curvature (Dmc). Transportation was assessed in 8 directions at D1. RESULTS: KF were significantly less centered than both nickel-titanium (NiTi) groups at D1. At Dmc, PG exhibited a significantly more centered enlargement than both GF and KF, which were significantly similar. At D7, PG was significantly more centered than KF, but there were no significant differences between GF and KF or between PG and GF (P < .016). KF exhibited significantly more canal transportation at D1 than the NiTi groups (P < .05). CONCLUSIONS: NiTi files cause less transportation than KF. At D1, KF was less centered than both NiTi files. PG remained more centered at Dmc and D7.

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