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BACKGROUND: The dentinal debris produced during root canal preparation can be extruded through the apical foramen, which may cause undesired consequences, such as the postoperative inflammation of periapical tissues. OBJECTIVES: The aim of the present in vitro study was to evaluate the effect of glide path preparation on apical debris extrusion for the Reciproc®, WaveOne Gold® and One Curve file systems. MATERIAL AND METHODS: A total of 72 mandibular incisors were divided into 6 groups according to the nickel-titanium (NiTi) system used and glide path preparation: group Rp - Reciproc; group Rp-O - Reciproc after glide path preparation; group WG - WaveOne Gold; group WG-O - WaveOne Gold after glide path preparation; group OC - One Curve; and group OC-O - One Curve after glide path preparation. The preand post-instrumentation weight of Eppendorf tubes was measured. The pre-weight was subtracted from the post-weight to calculate the amount of apically extruded debris. The data was analyzed using the one-way analysis of variance (ANOVA) with the statistical program PASW Statistics for Windows, v.18.0. RESULTS: No statistically significant differences were found between the single-NiTi file systems with different kinematics in terms of apical debris extrusion, with or without glide path preparation (p > 0.05). CONCLUSIONS: The amount of apically extruded debris was not affected by the kinematics of different single-NiTi file systems. Moreover, creating a glide path had no effect on the apically extruded debris in straight root canals.

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BACKGROUND: Occlusal contacts can be stained and thereby visualised employing occlusal indicators. Qualitative and quantitative indicators are differentiated. The hybrid system OccluSense supposedly combines analogue contact marking and digital registration of contacts. The reliability and validity of its contact marking have not yet been validated. OBJECTIVES: The aim of this controlled randomised in-vitro study was to examine the reliability and validity of analogue contact staining with OccluSense compared to Arti-Fol and the reference standard Gnatho-Film. MATERIALS AND METHODS: An experimental apparatus was designed to simulate static occlusion. The occlusal contacts were stained 50 times with Gnatho-Film to determine the average number and location of contacts registered. For comparison, the contacts were pre-stained with Gnatho-Film and then registered with Arti-Fol or OccluSense 50 times each. Every staining was statistically evaluated and compared to Gnatho-Film alone, regarding the number and location of contacts. Based on the observed characteristic staining behaviour of OccluSense, a modified evaluation strategy was developed for its colour markings (OccluSense (mod.)). RESULTS: Both evaluations of OccluSense determine that the same number of contacts was registered in over 94% of all cases. Neither OccluSense nor Arti-Fol stain the exact same number of contacts as Gnatho-Film, but the modified evaluation OccluSense (mod.) did improve the results for validity. CONCLUSION: When employing the modified evaluation strategy, OccluSense staining achieves similar reliability and validity as the reference standard. Pre-colouring of occlusal contacts with Gnatho-Film and the modified evaluation strategy, might become standard for analysing occlusal contacts stained by OccluSense in the future.

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INTRODUCTION: Curved mesial roots can be challenging for different stages of endodontic treatment. Preparation aims to enlarge, clean, and shape the root canal system, and hundreds of systems are available to carry it out. Aiming to maintain pericervical dentin, minimally invasive preparation was proposed, and with it, instruments with lower tapers emerged. This study aimed to evaluate the increase in canal volume, the centering ability of the instruments, and root canal transportation of two different rotary systems with lower tapers. METHODS: Eighteen curved mesial roots of extracted mandibular molars were scanned by micro-CT at 3 moments: initial and after the 2 stages of endodontic preparation. The canals were prepared using TruNatomy (TN) and ProDesign Logic 2 (PDL2) instruments up to sizes 25.04 and 26.04, respectively, and after 36.03 and 35.05, respectively. The data were analyzed using parametric and nonparametric tests with a significance level of 5%. RESULTS: TN and PDL2 systems showed no difference regarding the increase in the volume of the canals with the first instruments, but after preparation with a diameter size of 35 or 36, there was a difference (P < .01) between the systems in the cervical and middle thirds. CONCLUSION: Both systems shaped the mesial canals of mandibular molars while keeping low transportation and good centering ability in enlargements up to diameter size 35 or 36 with tapers of 3 or 5%.

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BACKGROUND: Dynamic navigation for implant placement is becoming popular under the concept of top-down treatment. The purpose of this study is to verify the accuracy of a dynamic navigation system for implant placement. METHODS: Implant placement was performed on 38 patients using 50 implant fixtures. Patients in group C were treated using a conventional method, in which thermoplastic clips were fixed to the teeth, and patients in group M were treated using thermoplastic clips fixed to a mouthpiece attached to the teeth. The groups were compared to verify whether an accuracy difference existed. A treatment planning support program for dental implants was used to superimpose the postoperative computed tomography data on the preoperative implant design data to measure the entry point, apex point, and angular deviation. RESULTS: The accuracy of group C was 1.36 ± 0.51 mm for entry point, 1.30 ± 0.59 mm for apex point, and 3.20 ± 0.74° for angular deviation. The accuracy of group M was 1.06 ± 0.31 mm for the entry point, 1.02 ± 0.30 mm for the apex point, and 2.91 ± 0.97° for angular deviation. Significant differences were observed in the entry and apex points between the two groups. CONCLUSIONS: The results indicate that group M exhibited better accuracy than group C, indicating that the stability of the thermoplastic clip is important for ensuring the accuracy of the dynamic navigation system. No previous studies have verified the accuracy of this system using the mouthpiece method, and additional data is required to confirm its accuracy for dental implant placement. The mouthpiece method improves the accuracy of implant placement and provides a safer implant treatment than the conventional method. TRIAL REGISTRATION: University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), Registration Number: UMIN000051949, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view_his.cgi on August 21, 2023.

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Objective: To evaluate the influence of different instrument identifiers on the microbial growth of critical devices after cleaning and steriliza-tion steps. Method: Fifteen No. 3 scalpel handles were used as test specimens, divided into 3 groups (n=5), with each group consisting of an instrument without an identifier and four other instruments with the following identifiers: laser engraving, silicone ring, vinyl identifier with permanent adhesive and personalized adhesive label. After being submerged in the surgical aspirate, the instruments were processed in accordance with the good practice requirements of Resolution No. 15/2012 from the National Health Surveillance Agency (Anvisa). Microbial growth was evaluated at different times qual-itatively, by the presence or absence of growth, and quantitatively for positive cases, by counting viable colony-forming units (log CFU/scalpel handle). Results: At some point, there was microbial growth on the instruments regardless of the type of identifier. However, there was no continuous and pro-gressive contamination after repeating the cleaning and sterilization steps. Conclusion: The type of dental instrument identifier does not interfere with microbial growth as long as cleaning and sterilization standards are respected. (AU)

Objetivo: Evaluar la influencia de los diferentes identificadores de instrumental en el crecimiento microbiano de dispositivos críticos después de las etapas de limpieza y esterilización. Método: Se utilizaron 15 mangos #3 para cuchillas de bisturí como cuerpo de prueba, divididos en 3 grupos (n=5), cada grupo compuesto por un instrumental sin identificador y otros cuatro instrumentales con los siguientes identificadores: grabado a láser, ani-llo de silicona, identificador vinílico con adhesivo permanente y etiqueta adhesiva personalizada. Después de ser sumergidos en el aspirado quirúrgico, los instrumentales fueron procesados de acuerdo con los requisitos de buenas prácticas de la Resolución nº 15/2012 de la Agencia Nacional de Vigilancia Sanitaria (Anvisa). El crecimiento microbiano se evaluó en diferentes momentos de forma cualitativa, por la presencia o ausencia de crecimiento, y de forma cuantitativa para los casos positivos, mediante el recuento de unidades formadoras de colonias viables (log UFC/mango de bisturí). Resultados: En algún momento, hubo crecimiento microbiano en los instrumentales independientemente del tipo de identificador. Sin embargo, no hubo contaminación con-tinua y progresiva después de la repetición de las etapas de limpieza y esterilización. Conclusión: El tipo de identificador de instrumental odontológico no interfiere en el crecimiento microbiano siempre que se respeten las normas de limpieza y esterilización. (AU)

Objetivo: Avaliar a influência dos diferentes identificadores de instrumental no crescimento microbiano de dispositivos críticos após etapas de limpeza e esterilização. Método: Foram utilizados 15 cabos no 3 para lâminas de bisturi como corpo de prova, divididos em 3 grupos (n=5), sendo cada grupo composto de um instrumental sem identificador e outros quatro instrumentais com os seguintes identificadores: gravação a laser, anel de silicone, identificador vinílico com adesivo permanente e etiqueta adesiva personalizada. Após serem submersos no aspirado cirúrgico, os instrumentais foram processados de acordo com os requisitos de boas práticas da Resolução n. 15/2012 da Agência Nacional de Vigilância Sanitária (Anvisa). O crescimento microbiano foi avaliado em diferentes momentos de forma qualitativa, pela presença ou ausência de crescimento, e de forma quantitativa para os casos positivos, por meio de contagem de unidades formadoras de colônia viáveis (log UFC/cabo de bisturi). Resultados: Em algum momento, houve cres-cimento microbiano nos instrumentais independentemente do tipo de identificador. No entanto, não houve contaminação contínua e progressiva após repetição das etapas de limpeza e esterilização. Conclusão: O tipo de identificador de instrumental odontológico não interfere no crescimento micro-biano desde que sejam respeitadas as normas de limpeza e esterilização. (AU)

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Abstract The aim of this study was to evaluate the root canal shaping effect of ProTaper Gold (PTG) versus ProTaper Next (PTN) instrumentation systems, and of a manual #15 K-type file (K15) versus the ProGlider (PG) mechanized instrument for glide path creation, in severely curved mesial canals. Twenty-four mandibular molars with two separate mesial canals were anatomically matched using computed tomographic scanning, and then divided into two groups (n=12) according to the glide path instrument used, either K15 or PG. In all teeth, the PTG system was used to prepare the mesiobuccal canal, and the PTN, the mesiolingual canal. The teeth were scanned by computed microtomography, before and after root canal preparation, and the values of the initial volume, final volume, volumetric variation, untouched walls, and canal transportation variables were determined. The data were analyzed using the two-way ANOVA test, and the Tukey test for multiple comparisons. There was no significant difference among the study groups regarding volumetric variation or root canal transportation, either in the cervical, middle or apical thirds, or in the entire root canal (p>0.05). In the apical third, the percentage of untouched walls was significantly higher in groups using K15 than in those using PG (p<0.05), namely 33.144% and 23.285%, respectively, irrespective of the instrumentation system. In the other regions, there was no difference between K15 and PG regarding this variable. It was concluded that PG was associated with a lower rate of untouched walls in the apical region than K15.

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Abstract Cleaning and shaping the root canal system are essential steps for performing successful endodontic therapy, and are challenging procedures in the apical region. This study aimed to conduct an ex vivo assessment of the debridement ability of the WaveOne Gold (Medium 35/.06) and TruNatomy (Medium 36/.03) systems in the apical third of round root canals of mandibular premolars. Forty-eight teeth, extracted for orthodontic or periodontal reasons, were divided into three groups (n=16), as follows: Group C, control (without instrumentation or irrigation); Group WOG, instrumentation with WaveOne Gold; Group TN, instrumentation with TruNatomy. A total of 40 mL of 2.5% sodium hypochlorite and 5 mL of 17% ethylenediamine tetraacetic acid were used per root canal in all the groups. Ten 0.5-μm serial cross-sections per specimen were obtained every 0.2 mm from a 2-mm segment of the apical region, extending from 1 to 3 mm short of the root apex. The sections were stained with hematoxylin-eosin and analyzed under a digital microscope (100x). The percentages of unprepared walls and remaining debris were quantified using ImageJ software. Generalized linear models were used to analyze the results (α=5%). Groups WOG and TN had significantly lower percentages of unprepared walls and remaining debris than Group C (p<0.05). There was no significant difference between groups WOG and TN for either of the variables studied (p>0.05). Instrumentation with the WaveOne Gold Medium and TruNatomy Medium instruments was associated with equivalent percentages of unprepared walls and remaining debris in the apical third of round canals of mandibular premolars.

Resumo A limpeza e modelagem do sistema de canais radiculares são etapas fundamentais para o sucesso da terapia endodôntica e são procedimentos desafiadores na região apical. O objetivo deste trabalho foi realizar uma avaliação ex vivo da capacidade de debridamento dos sistemas WaveOne Gold (Medium 35/.06) e TruNatomy (Medium 36/.03) no terço apical de canais radiculares circulares de pré-molares inferiores. Quarenta e oito dentes que haviam sido extraídos por razões ortodônticas ou periodontais foram divididos em três grupos (n=16),da seguinte forma: Grupo C, Controle (sem instrumentação nem irrigação); Grupo WOG, instrumentação com WaveOne Gold; Grupo TN, instrumentação com TruNatomy. Um total de 40 mL de hipoclorito de sódio a 2,5% e 5 mL de ácido etilenodiamino tetraacético a 17% foi utilizado por canal radicular em todos os grupos. Dez secções transversais em série de 0,5 μm por espécime foram obtidas a cada 0,2 mm de um segmento de 2 mm da região apical, estendendo-se desde 1 até 3 mm aquém do ápice radicular. As seções foram coradas com hematoxilina-eosina e analisadas sob um microscópio digital (100x). As porcentagens de paredes não tocadas e detritos remanescentes foram quantificadas utilizando-se o software ImageJ. Modelos lineares generalizados foram utilizados para analisar os resultados (α=5%). Os grupos WOG e TN apresentaram porcentagens significativamente menores de paredes intocadas e detritos remanescentes do que o grupo C (p<0,05). Não houve diferença significativa entre os grupos WOG e TN quanto a nenhuma das variáveis estudadas (p>0,05). A instrumentação com os instrumentos WaveOne Gold Medium e TruNatomy Medium foi associada a porcentagens equivalentes de paredes intocadas e detritos remanescentes no terço apical de canais circulares de pré-molares inferiores.

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Objective: This study evaluated different methods of calcium hydroxide (CH) removal from root canals with simulated internal resorptions using microcomputed tomography (micro-CT). Material and Methods: Sixty acrylic resin blocks with simulated root canals and internal resorptions were prepared using a Reciproc R25 file and then filled with CH. The blocks were divided into five test groups (n=12) according to the method used for CH removal: hand files (HF), Easy Clean (EC), passive ultrasonic irrigation (PUI), XP-Endo Finisher (XP), XP-Endo Finisher + PUI (XP+PUI). The blocks were scanned using a SkyScan 1172 scanner before and after CH removal to measure the volume and percentage of CH removal. The OriginPro 2017 software was used for statistical analyses. The level of significance was set at p<0.05 for all tests. Results: No method under study removed all CH. All methods had similar results in the cervical third (P>0.05). The percentage of CH removal was significantly greater in the area of internal resorption and along the total length of the canal in the XP+PUI group (P<0.05). The best results of CH removal were found in the apical third of roots in the XP+PUI and PUI groups (P>0.05). Conclusion: No method removed all CH from the root canals, but the combined XP+PUI method removed more CH than the other methods, especially from the area of the internal resorption(AU)

Objetivo: Este estudo avaliou diferentes métodos de remoção de hidróxido de cálcio (CH) de canais radiculares com reabsorções internas simuladas por meio de microtomografia computadorizada (micro-CT). Material e Métodos: Sessenta blocos de resina acrílica com canais radiculares simulados e reabsorções internas foram preparados com lima Reciproc R25 e posteriormente preenchidos com CH. Os blocos foram divididos em cinco grupos de teste (n=12) de acordo com o método utilizado para remoção de CH: limas manuais (HF), Easy Clean (EC), irrigação ultrassônica passiva (PUI), XP-Endo Finisher (XP), XP -Endo Finalizador + PUI (XP + PUI). Os blocos foram escaneados usando um scanner SkyScan 1172 antes e depois da remoção do CH para medir o volume e a porcentagem de remoção do CH. O software OriginPro 2017 foi utilizado para análises estatísticas. O nível de significância foi estabelecido em p<0,05 para todos os testes. Resultados: Nenhum método em estudo removeu todos o CH. Todos os métodos tiveram resultados semelhantes no terço cervical (P>0,05). A porcentagem de remoção de CH foi significativamente maior na área de reabsorção interna e ao longo do comprimento total do canal no grupo XP+PUI (P<0,05). Os melhores resultados de remoção de CH foram encontrados no terço apical das raízes nos grupos XP+PUI e PUI (P>0,05). Conclusão: Nenhum método removeu todo o CH dos canais radiculares, mas o método combinado XP+PUI removeu significativamente mais CH do que os outros métodos, especialmente da área de reabsorção interna (AU)

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The introduction of nickel-titanium (NiTi) mechanical instruments dramatically changed clinical endodontics over the last few decades. Before NiTi, it was necessary to use more instruments to create an ideal root canal shape, and many approaches, sequences and techniques were developed over the years. Recently, NiTi endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments to improve their root canal preparation outcomes and reduce associated canal preparation risks during root canal treatment. Heat treatment is one of the most fundamental approaches to improving the fatigue resistance and flexibility of NiTi endodontic instruments. In addition, new kinematics have been developed to offer greater safety and efficiency. This narrative review describes the general properties and manufacturing of NiTi instruments, and the mechanical system evolution of NiTi instruments.

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PURPOSE: To investigate whether depth-gauge burs in veneer preparations influence preparation depth in a randomized, controlled, single-blinded trial and whether inexperienced operators can perform adequate veneer preparations. METHODS: Participants were 20 undergraduate dental students with no prior veneer preparation experience. The instruments used were the "Laminate Veneer System" (LVS), "Keramik-Veneers. de" (KVD), and a "Freehand" group (FH) for reference. All participants prepared three educational acrylic resin maxillae and three mandibular central incisors mounted in typodonts in patient simulators. The objectives were to achieve a preparation depth of 0.6 mm (tooth 11) and 0.4 mm (tooth 31). The sequences of the instruments used and prepared teeth were randomized. The measurements were performed using a laser triangulation coordinate-measuring machine. The data were stratified according to tooth location. RESULTS: The preparation depths of both depth-gauge-instrument-groups LVS and KVD achieved the objectives significantly better than did the instruments from the "Freehand" group (P < 0.001). The differences between the depth gauge groups were insignificant, although the maximum preparation depths were smaller in the KVD group. Regarding the prepared teeth, the preparation depths in the mandibular incisors were lower, and the differences were smaller. CONCLUSIONS: The use of special depth-gauge burs for initial veneer preparation leads to significantly lower preparation depths than "Freehand" preparations. The tapered instruments resulted in a lower incidence of extreme preparation depths. The inexperienced operators performed veneer preparation remarkably well.

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Objectives: The current study aimed to assess the cyclic fatigue resistance of two nickel-titanium (NiTi) rotary files after immersion in 5% sodium hypochlorite (NaOCl) and Deconex. Materials and Methods: In this in vitro study, 90 new M3 Pro Gold size 25.06 and size F2 SP1 files were tested. Forty-five files of the same brand were randomly distributed into three groups (n=15) and submitted to the following immersion protocol for 5 minutes at room temperature: no immersion (control group), immersion in 5% NaOCl, and immersion in Deconex. The cyclic fatigue resistance of the files was then measured in a custom-made tester. Two-way ANOVA was applied to compare the cyclic fatigue resistance of SP1 and M3 NiTi rotary files based on the type of disinfectant solution. Post-hoc LSD test was used for pairwise comparisons and P<0.05 was considered significant. Results: Two-way ANOVA indicated a significant difference in the mean cyclic fatigue resistance of M3 and SP1 NiTi rotary files. The M3 files immersed in NaOCL displayed the lowest and the SP1 files immersed in Deconex showed the maximum cyclic fatigue resistance. The effect of type of disinfectant solution (P<0.001) and type of NiTi file (P<0.001) on cyclic fatigue resistance was statistically significant. Conclusion: The cyclic fatigue resistance of NiTi rotary instruments can be affected by immersion in disinfectants, and the specific type of file and disinfectant used will ultimately determine the extent of this impact.

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Introduction: the in vitro study compared the dynamic cyclic fatigue resistance of 3 reciprocating NiTi files with heat treatment. Methods: we distributed 30 new endodontic files in three groups. The endodontic files selected for this experiment were: AF Blue R3 25/06 (AFB) (Fanta Dental, Shanghai, China), X1 Blue File 25/06 (X1B) (MK Life, Porto Alegre, RS, Brazil), and Reciproc Blue 08/25 (RB) (VDW, Munich, Germany. We measured the time to file fractureand the length of the fractured fragment. ANOVA analysis was used, followed by the Tukey test for multiple comparisons, with a significance level of 5% (P < 0,05). Results: the mean time in seconds until the file fractured was 170.7 ±15,1 for AFB files, 110,4 ±26,8 for X1B, and 163,3 ±22,9 for RB files. This difference was statistically significant when comparing X1B to AFB (p: 0,000) and X1B to RB (p: 0,000). However, there are no statistically significant differences between RB and AFB (p:0,739). Conclussions: this study found that RB and AFB files exhibit similar resistance to cyclic fatigue.

Introducción: el estudio in vitro comparó la resistencia a la fatiga cíclica dinámica de 3 limas NiTi recíprocas con tratamiento térmico. Métodos: distribuimos 30 limas endodónticas nuevas en tres grupos. Las limas endodónticas seleccionadas para este experimento fueron: AF Blue R3 25/06 (AFB) (Fanta Dental, Shanghai, China), X1 Blue File 25/06 (X1B) (MK Life, Porto Alegre, RS, Brasil), y Reciproc Blue 08/25 (RB) (VDW, Munich, Alemania. Se midió el tiempo transcurrido hasta la fractura de la lima y la longitud del fragmento fracturado. Se utilizó el análisis ANOVA, seguido de la prueba de Tukey para comparaciones múltiples, con un nivel de significación del 5% (P < 0.05). Resultados: el tiempo medio en segundos hasta la fractura de la lima fue de 170.7 ±15.1 para las limas AFB, 110.4 ±26.8 para las X1B y 163.3 ±22.9 para las RB. Esta diferencia fue estadísticamente significativa al comparar X1B con AFB (p: 0.000) y X1B con RB (p: 0.000). Sin embargo, no hay diferencias estadísticamente significativas entre RB y AFB (p:0.739). Conclusiones: en este estudio se ha comprobado que las limas RB y AFB presentan una resistencia similar a la fatiga cíclica.

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The nickel-titanium (NiTi) instruments' geometry plays an important role in their performance and behavior. The present assessment intends to validate and test the applicability of a 3D surface scanning method using a high-resolution laboratory-based optical scanner to create reliable virtual models of NiTi instruments. Sixteen instruments were scanned using a 12-megapixel optical 3D scanner, and methodological validation was performed by comparing quantitative and qualitative measurements of specific dimensions and identifying some geometric features of the 3D models with images obtained through scanning electron microscopy. Additionally, the reproducibility of the method was assessed by calculating 2D and 3D parameters of three different instruments twice. The quality of the 3D models created by two different optical scanners and a micro-CT device was compared. The 3D surface scanning method using the high-resolution laboratory-based optical scanner allowed for the creation of reliable and precise virtual models of different NiTi instruments with discrepancies varying from 0.0002 to 0.0182 mm. The reproducibility of measurements performed with this method was high, and the acquired virtual models were adequate for use in in silico experiments, as well as for commercial or educational purposes. The quality of the 3D model obtained using the high-resolution optical scanner was superior to that acquired by micro-CT technology. The ability to superimpose virtual models of scanned instruments and apply them in Finite Element Analysis and educational purposes was also demonstrated.

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INTRODUCTION: This randomized clinical trial aimed to compare postoperative pain after the use of 2different irrigation activation techniques: passive ultrasonic irrigation and the EasyClean device. METHODS: Sixty-six single-rooted teeth diagnosed with asymptomatic pulp necrosis and apical periodontitis were randomly assigned to 2experimental groups (n = 33), which differed in the irrigation activation technique. Postoperative pain levels were assessed after 24, 48, and 72 hours using a verbal rating scale; the ibuprofen intake amount was recorded at the same time intervals. Data were analyzed using Student's t-test, Mann-Whitney U and Fisher's exact tests, with a significance level of 5%. RESULTS: Postoperative pain levels and analgesic intake frequency were not significantly different across the 2irrigation activation techniques (P > .05). The frequencies obtained in relation to the prevalence of postoperative pain were 3.1-25.8% for all participants of the 2studied groups. CONCLUSION: The irrigation activation techniques of passive ultrasonic irrigation and the EasyClean device were found to be equivalent in terms of postoperative pain and analgesic intake.

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BACKGROUND: Rotary cutting instruments (RCIs) are sterilized routinely. The authors aimed to analyze the structural integrity, presence of dirt, and microbial contamination of RCIs used in clinical practice after processing. METHODS: Eighty-four RCIs (42 carbide burs, 42 diamond burs) were divided into baseline, control, and test groups. The RCIs were evaluated by means of scanning electron microscopy and microbiological analysis. Evaluation criteria included presence of structural damage, dirt, biofilm, and isolated cells and their phenotypic profile. RESULTS: The carbide burs from all groups and diamond burs from the test groups had structural damage. Dirt was observed in the baseline and test groups. Three bacterial species were isolated from 4 RCIs (9.52%). An isolated cell was observed from 1 carbide bur. Biofilm was observed on 3 RCIs (7.14%). CONCLUSIONS: RCIs should not be subjected to multiple uses; after the first clinical use they accumulate structural damage and dirt that hampers the cleaning step, causing failure in the sterilization process. PRACTICAL IMPLICATIONS: The presence of microorganisms and structural damage on the RCIs confirmed that they are not amenable to processing, a fact that characterizes them as a single-use health care product.

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Objectives: This study aimed to compare the torsional and cyclic fatigue resistance of ProGlider (PG), WaveOne Gold Glider (WGG), and TruNatomy Glider (TNG). Materials and Methods: A total of 15 instruments of each glide path system (n = 15) were used for each test. A custom-made device simulating an angle of 90° and a radius of 5 millimeters was used to assess cyclic fatigue resistance, with calculation of number of cycles to failure. Torsional fatigue resistance was assessed by maximum torque and angle of rotation. Fractured instruments were examined by scanning electron microscopy (SEM). Data were analyzed with Shapiro-Wilk and Kruskal-Wallis tests, and the significance level was set at 5%. Results: The WGG group showed greater cyclic fatigue resistance than the PG and TNG groups (p < 0.05). In the torsional fatigue test, the TNG group showed a higher angle of rotation, followed by the PG and WGG groups (p < 0.05). The TNG group was superior to the PG group in torsional resistance (p < 0.05). SEM analysis revealed ductile morphology, typical of the 2 fracture modes: cyclic fatigue and torsional fatigue. Conclusions: Reciprocating WGG instruments showed greater cyclic fatigue resistance, while TNG instruments were better in torsional fatigue resistance. The significance of these findings lies in the identification of the instruments' clinical applicability to guide the choice of the most appropriate instrument and enable the clinician to provide a more predictable glide path preparation.

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Due to permanent contact with bodily secretions such as blood and saliva, the dental workplace poses a high risk of infection for patients as well as for personnel. High-speed dental instruments are still considered one of the major hygienic risks, as the high-speed rotation of the attachments leads to the retraction of infectious material from patients' oral cavities. The aim of this study was to investigate the extent to which dental handpieces are contaminated after use. Spray-water samples were taken from different handpieces used in seven dental offices and protein concentrations were measured photometrically. In the first part of the study, samples were collected from each handpiece before and after the treatment of the patients. Additionally, the changes in protein concentration after consecutive treatments in which the same high-speed dental instrument was used were investigated. The results demonstrated measurable protein concentrations in 91.2% of a total of 398 samples, and 96.4% of the spray-water samples taken after treatment showed a discrepancy from the initial measured protein concentration. In 68.4% an increase in protein concentration was observed, whereas in 27.9% a decrease was measured. In conclusion, the internal contamination of high-speed dental instruments frequently occurs in daily usage and consequently may lead to the transmission of infectious agents by flushing the contaminated water out of the spray water tubes. Moreover, it must be pointed out that internal cleansing of handpieces is insufficient and that a final mechanical disinfection is indispensable.

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Introducción: el material para empaquetar el instrumental odontológico, como pueden ser bolsas de tela, papel o plástico, es usado por profesionales de la salud; sin embargo, es necesario esclarecer la efectividad de cada uno y determinar el tiempo que permanece estéril luego del procedimiento. Objetivo: identificar la eficacia de tela, plástico y papel como materiales para esterilizar instrumental a corto y largo plazo. Material y métodos: se realizaron cultivos sólidos y líquidos de instrumental esterilizado en tres materiales y con diferentes tiempos de postesterilización. Se incubaron a 36 oC por 72 horas en condiciones aerobias y anaerobias. Los resultados se analizaron usando una prueba de Kruskal-Wallis, seguida de una prueba de Dunn. Resultados: los resultados mostraron que inmediatamente después del proceso de esterilización, los tres materiales son efectivos (Kruskal-Wallis test, p = 0.2752), 24 horas (p = 0.2492), siete (p = 0.0509) y 14 días (p = 0.0006). Veinticuatro horas posterior a la esterilización la tela no es efectiva, el plástico disminuye su efectividad y el papel sigue siendo efectivo. Conclusión: en nuestros resultados, el papel es la mejor opción para esterilizar instrumental (AU)

Introduction: material such as cloth, paper or plastic bags to wrap dental instruments is used by health professionals, however, it is necessary to clarify the effectiveness of each one and determine if it remains sterile after the procedure. Objective: to determine the effectiveness of cloth, plastic and paper as materials to sterilize dental instruments in the short and long term. Material and methods: we carry out solid and liquid cultures of sterilized instruments in three materials, at different post-sterilization times, incubated at 36 oC for 72 hours under aerobic and anaerobic conditions, and the results were analyzed using a Kruskal-Wallis test, followed by from a Dunn's test. Results: our results showed that immediately after the sterilization process the three materials are effective (Kruskal-Wallis; p = 0.2752), 24 hours (p = 0.2492), 7 (p = 0.0509) and 14 (p = 0.0006) days. Twenty-four hours after the cloth is not effective, plastic decreases its effectiveness and paper remain effective. Conclusion: in our results, paper is the best option to sterilize dental instruments (AU)

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This study compared the accumulated hard-tissue debris (AHTD) after preparation with WaveOne Gold (WOG) to XP-endo Shaper (XPS), without and with a supplementary step using XP-endo Finisher (XPF) using clinically applicable irrigation. Twenty-four mesial roots with two canals and single foramen were micro-CT-scanned and matched. Scans were also taken after preparation with WOG or XPS, and after XPF. Irrigation with 2.5% NaOCl (total: 17 ml per canal) and 17% EDTA (2.5 ml per canal) was performed using a 30ga Max-I-Probe needle placed up to the working length. Morphological parameters were calculated and compared within and among groups. XPF significantly reduced unprepared area within XPS and WOG groups, and AHTD within WOG (p < 0.05). There were no significant differences between WOG and XPS after preparation and after XPF (p > 0.05). In conclusion, WOG and XPS produced a similar volume of AHTD, but the supplementary step with XPF decreased the AHTD in the WOG group.

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Objective: The aim of this study was to evaluate the effect of different glide path files on the amount of apically extruded debris. Material and Methods: Sixty single-canaled mandibular premolars were accessed and randomly divided into three groups (n= 20) according to the file used for glid path creation; group A using Traverse file, group B using WaveOne Gold Glider, group C using stainless steel K file. All teeth were then instrumented using the Reciproc system. The debris extruded apically during instrumentation were collected into pre-weighed Eppendorf tubes which were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post instrumentation weights of the Eppendorf tubes. The data were analyzed using one-way ANOVA test, and post hoc analysis. Results: WaveOne Gold Glider produced the least amount of apical extruded debris (0.41±0.25) followed by the Traverse group (0.59±0.20) then the K-file group (0.64±0.16) with a statistically significant difference (p=0.003). Conclusion: Apical extrusion of debris is inevitable during root canal cleaning and shaping. Creation of glide path using engine-driven files produces less amount of apically extruded debris compared to hand-driven K-files. (AU)

Objetivos: O objetivo deste estudo foi avaliar o efeito de diferentes limas glide path na quantidade de detritos extruídos apicalmente. Metodologia: Sessenta pré-molares inferiores com canal único foram acessados e divididos aleatoriamente em três grupos (n= 20) de acordo com a lima utilizada para criação do glid path; grupo A usando lima Traverse, grupo B usando WaveOne Gold Glider, grupo C usando lima K de aço inoxidável. Todos os dentes foram então instrumentados usando o sistema reciprocante. Os detritos extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pré-pesados que foram então armazenados em uma incubadora a 70°C por 5 dias. O peso dos detritos secos extruídos foi estabelecido subtraindo-se os pesos dos tubos Eppendorf antes e após instrumentação. Os dados foram analisados por meio do teste one-way ANOVA e análise post-hoc. Resultados: WaveOne Gold Glider produziu a menor quantidade de detritos apicais extruídos (0,41±0,25) seguido pelo grupo Traverse (0,59±0,20) e depois pelo grupo K-file (0,64±0,16) com uma diferença estatisticamente significativa (p=0,003). Conclusão: A extrusão apical de detritos é inevitável durante a limpeza e modelagem do canal radicular. A criação do glide path usando limas acionadas por motores produz menos quantidade de detritos extruídos apicalmente em comparação com as limas K manuais. (AU)

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