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OBJECTIVES: The aim of this cross-sectional retrospective study was to evaluate radiographically the technical quality of root canal treatment performed by undergraduate students using reciprocating NiTi instrumentation and single-cone obturation. METHODS: Endodontic treatment on 1102 teeth performed by undergraduate students from the School of Dentistry of the University of Santa Cecilia (Brazil) was evaluated. All root canal preparations were performed using Reciproc files and were irrigated with 1% NaOCl. The root canal was filled with gutta-percha, along with AH Plus sealer, using the single-cone obturation technique. The technical quality of the root canal treatment was evaluated based on immediate postoperative radiographs. Distance between the end of the filling and the radiographic apex, the filling density, and the taper of the root filling was assessed. Inter-examiner agreement statistic (Kappa) and Chi-square statistic test were used for statistical evaluation of the results. Differences were considered statistically significant when p < 0.05. RESULTS: Anterior teeth, maxillary premolars, and molars presented better results than mandibular premolars and molars (p < 0.05). Mandibular premolars presented a high incidence of a short length of obturation (33.34%) and mandibular molars presented a high incidence of overfilling (6.55%). The majority of the treatment analyzed (62.46%) fulfilled all the criteria showing acceptable working length, taper, and density of obturation. Instrument fractures occurred in eighteen root canals (0.81%). CONCLUSIONS: The use of NiTi reciprocating instruments with the single-cone obturation technique provided an acceptable quality of endodontic treatment in the majority of the cases performed by undergraduate students.

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INTRODUCTION: The aim of this study was to evaluate pain perception, pain medication intake, and sealer extrusion after single-visit root canal treatment of asymptomatic teeth with or without foraminal enlargement. The correlation between sealer extrusion and pain was also investigated. METHODS: One hundred forty necrotic, single-rooted teeth were divided into 2 groups (n = 70): foraminal patency (FP), in which treatment was performed up to 1 mm short of the apex, and foraminal enlargement (FE), in which treatment was performed up to the apex. The canals were instrumented using WaveOne Gold files (Dentsply Maillefer, Ballaigues, Switzerland), irrigated with 2.5% sodium hypochlorite, and filled using the single-cone technique and AH Plus sealer (Dentsply Maillefer). A visual analog scale was used to record pain 24, 48, and 72 hours and 1 week postoperatively. The presence or absence of sealer extrusion was recorded. RESULTS: Pain levels were significantly higher for FE than FP at 24 hours (P < .05), namely 0.3 ± 0.9 versus 0.1 ± 0.1; no difference was found at 48 hours, namely 0.1 ± 0.5 versus 0.0 ± 0.0 (P > .05). No pain was reported 72 hours or 1 week postoperatively in either group. Although all patients requiring pain medication at 24 hours were from the FE group, the difference between FE and FP was not statistically significant with respect to this variable (P > .05). Nevertheless, the intake amount was significantly higher in FE than in FP at this time point (P < .05). Sealer extrusion occurred more frequently in FE than FP, namely 57.14 % versus 14.29% (P < .05). There was no association between pain and sealer extrusion (P > .05) or between pain and sex, age, or tooth type (P > .05). CONCLUSION: FE was related to higher pain levels 24 hours postoperatively and to higher rates of filling material extrusion; however, there was no association between filling material extrusion and postoperative pain.

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AIM: This prospective clinical study evaluated the incidence of instrument fracture observed after single-file root canal treatment of molars using WaveOne Gold instruments. METHODOLOGY: Three standardized, experienced and calibrated specialists treated 750 maxillary and mandibular molars with curvatures less than 45° (2691 root canals) over a 12-month period. All the treatments were performed in a single session. A total of 1104 WaveOne Gold instruments were used, including 38 small, 750 primary, 228 medium and 88 large instruments. Intracanal procedures were performed according to the manufacturer's recommendations, and each instrument was used in a single clinical case. The instruments were examined after their removal from the canal, under an operating microscope at 8× magnification. RESULTS: No fractures were observed in any of the 1104 instruments used. CONCLUSIONS: No fractures of WaveOne Gold reciprocating instruments occurred during root canal preparations performed in maxillary and mandibular molars with curvatures less than 45° when used strictly according to the manufacturer's recommendations and applied in a single clinical case.

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Objetivos: Este estudo teve por objetivo avaliar e comparar a resistência em fadiga cíclica de três tipos de sistemas reciprocantes de lima única: WaveOne Gold Primary (25/0.07), WA1 file (25/0.07) e X1 Blue (25/0.06), fabricados com ligas de níquel-titânio com diferentes tratamentos térmicos de superfície, e comparar os programas Reciproc ALL e WaveOne All, quanto a vida em fadiga dos três sistemas testados. Métodos: Uma amostra, de sessenta instrumentos de 25 mm de comprimento, com diâmetro em D0 de 0,25mm e conicidade aproximada em 0,07mm/mm, foi dividida em dois grupos. Cada grupo continha trinta instrumentos, sendo dez de cada sistema mecanizado. Um grupo foi testado no programa Reciproc All e o outro no WaveOne All do motor Silver Reciproc (VDW). A resistência a fadiga cíclica foi testada medindo-se o tempo e o número de ciclos que o instrumento realizou, em um canal artificial de aço inoxidável extremamente curvo (ângulo de 86° e 6 mm de raio), até atingir a fratura. As superfícies fraturadas dos fragmentos de três instrumentos, um de cada sistema, escolhidos aleatoriamente em cada grupo, foram examinadas com um microscópio eletrônico de varredura. Os resultados foram estatisticamente analisados utilizando-se a análise de variância (ANOVA) e os testes F e de Tukey com níveis de significância de 5%. Resultados: O instrumento 1 File apresentou maior tempo de vida em fadiga, tanto no programa Reciproc All quanto no programa WaveOne All, do que os outros dois sistemas testados (p < 0.05). WaveOne Gold Primary apresentou uma vida em fadiga cíclica maior do que a X1 Blue file nos dois programas testados (p < 0.05). O programa Reciproc All apresentou melhores resultados com relação ao tempo de vida em fadiga dos três sistemas reciprocantes testados quando comparado ao programa WaveOne All (p < 0.05). Conclusão: O instrumento WA1 apresentou uma maior resistência a fadiga cíclica em canais severamente curvos, quando utilizado tanto no programa Reciproc All quanto no WaveOne All, do que os sistemas WaveOne Gold Primary e X1 Blue File. O programa Reciproc All apresentou melhores resultados para tempo de vida em flexão rotativa para os três sistemas reciprocantes testados, quando comparado ao programa WaveOne All (AU).

Objectives: This study aimed to evaluate and compare the resistance in cyclic fatigue of three types of single file reciprocating systems: WaveOne Gold Primary (25 / 0.07), WA1 file (25 / 0.07) and X1 Blue (25 / 0.06), made of nickel-titanium alloys with different surface thermal treatments, and compare Reciproc All and WaveOne All programs, regarding the fatigue life of the three systems tested. Methods: A sample of sixty instruments measuring 25 mm long, with a D0 diameter of 0.25 mm and an approximate conicity of 0,07 mm/mm, was divided into two groups. Each group contained thirty instruments, being ten of each mechanized system. One group was tested in the Reciproc All program and the other one in the WaveOne All of the Silver Reciproc motor (VDW). The resistance to Cyclic fatigue was tested by measuring the time and number of cycles which the instrument performed in an extremely curved stainless steel artificial channel (angle 86° and 6 mm radius) until fracture was reached. The fractured surfaces of the fragments of three instruments, one of each system, randomly chosen in each group, were examined with a scanning electron microscope. The results were statistically analyzed using analysis of variance (ANOVA) and the F and Turkey tests with significance levels of 5%. Results: The 1 File instrument had a longer fatigue life, both in the Reciproc All program and in the WaveOne All program, than the other two systems tested (p < 0.05). WaveOne Gold Primary presented a cyclic fatigue life longer than the X1 Blue file in the two tested programs (p < 0.05). Conclusion: The WA1 instrument presented higher resistance to cyclic fatigue in severely curved channels when used in both Reciproc All and WaveOne All programs than WaveOne Gold Primary and X1 Blue File systems. The Reciproc All program presented better results for life cycle in rotating flexion for the three reciprocating systems tested when compared to the WaveOne All program (AU).

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Abstract The aim of this study was to assess the amount of apically extruded debris during filling removal with WaveOne Gold (WOG), ProTaper Universal Retreatment (PTR), D-RaCe Retreatment (DRR) or hand files (HF), to compare the working time during filling removal, and to describe failures of NiTi instruments. Forty mesiobuccal roots of maxillary first molars were prepared with WOG Primary, obturated and divided into 4 groups (n=10), according to the instruments used: WOG, PTR, DRR or HF. Distilled water was used as irrigant and the extruded debris were collected in Eppendorf tubes and dried. The amount of extruded debris was determined by subtracting the final from the initial weight. The time of filling removal for each canal was recorded and the instruments used were analyzed pre and post-operatively by SEM. Kruskal-Wallis and Dunn's test analyzed extruded debris data and ANOVA, followed by Tukey's test, compared the working time data (a=0.05). Instrument deformation and fracture were described. WOG produced significantly less debris compared with HF and DRR (p<0.05), and similar to PTR (p>0.05). HF, PTR and DRR showed no significant difference (p>0.05). Working time in HF group was significantly higher than others (p<0.05). SEM analyses showed, from the 18 instruments evaluated, 3 fractures and 10 deformations. All instruments tested caused debris extrusion. WOG was associated with less extrusion than DRR and HF. Filling removal with HF was slower than with the other instruments. All NiTi systems presented fracture and deformation.

Resumo O objetivo deste estudo foi avaliar a extrusão apical de debris durante a desobturação com WaveOne Gold (WOG), ProTaper Universal Retratamento (PTR), D-RaCe (DRR) ou limas manuais (HF), comparar o tempo de trabalho durante a desobturação, e descrever as falhas dos instrumentos de NiTi. Quarenta canais de raízes mésio-vestibulares de primeiros molars superiores foram preparados com WOG Primary, obturados e divididos em 4 grupos (n = 10), de acordo com os instrumentos a serem utilizados: WOG, PTR, DRR ou HF. Água destilada foi utilizada como irrigante, e os debris extruídos foram coletados em tubos Eppendorf e secos. A quantidade de debris extruídos foi determinada subtraindo-se o peso inicial do peso final. O tempo de cada desobturação foi anotado e os instrumentos utilizados foram analisados no pré e pós-operatório em MEV. Os testes Kruskal-Wallis e Dunn foram utilizados para analisar os dados da extrusão de debris, e os testes ANOVA e Tukey para comparar os dados do tempo de trabalho (a=0.05). As deformações e fraturas dos instrumentos foram descritas. O grupo WOG produziu significativamente menos debris quando comparado aos grupos HF e DRR (p<0.05), e foi similar ao grupo PTR (p>0.05). Os grupos HF, PTR e DRR não apresentaram diferença estatisticamente significante (p>0.05). O tempo de trabalho no grupo HF foi significativamente maior do que nos outros grupos (p<0.05). A análise em MEV mostrou que, dos 18 instrumentos avaliados, 3 fraturaram e em 10 foi observado deformação. Todos os sistemas testados causaram extrusão apical de debris. WOG foi associado com menor extrusão do que DRR e HF. A desobturação com HF foi mais lenta do que com os demais instrumentos. Todos os sistemas de NITI apresentaram fratura e deformação.

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INTRODUCTION: Reciprocating instruments were developed to improve and simplify the preparation of the root canal system by allowing greater centralization of the canal and requiring a shorter learning curve. Despite the risk of instrument separation, using a reciprocating instrument in more than 1 case is a relatively common clinical practice. The aim of this study was to evaluate the fracture resistance of Reciproc (R25; VDW, Munich, Germany) and WaveOne (Primary; Dentsply Maillefer, Ballaigues, Switzerland) instruments according to the number of uses during the preparation of root canals in up to 3 posterior teeth. METHODS: A prospective clinical study was conducted by 3 experienced specialists who performed treatment of 358 posterior teeth (1130 canals) over a period of 12 months using 120 reciprocating instruments, 60 of which were Reciproc R25 and 60 were WaveOne Primary. The motion used during instrumentation followed the recommendations of the respective manufacturers. After each use, the instruments were observed under a dental operating microscope at 8× magnification. In the case of fracture or deformation, the instrument was discarded. RESULTS: None of the instruments showed any signs of deformation, but 3 instruments fractured (0.26% of the number of canals and 0.84% of the number of teeth). All fractures occurred in mandibular molars (1 WaveOne Primary file during the third use and 2 Reciproc R25 files, 1 during the first use and the other during the third use). CONCLUSIONS: There was a low incidence of fracture when reciprocating files were used in up to 3 cases of endodontic treatment in posterior teeth.

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OBJECTIVE: The present study aimed to evaluate the bending resistance and cyclic fatigue fracture resistance of a new single-file reciprocating instrument called WaveOne Gold. Reciproc and WaveOne instruments were used as references for comparison. METHODS: Sixty 25-mm NiTi instruments (Reciproc R25, WaveOne Primary and WaveOne Gold Primary) were tested. Flexibility was determined by applying 45° bending tests using a universal testing machine (n=10). A custom-made device was used during cyclic fatigue test (n=10), comprising a stainless steel artificial canal measuring 1.4 mm in diameter, 19 mm in total length with an 86° angle and 6 mm radius of curvature. Possible deformations at the helical shaft and mode of fracture were evaluated using scanning electron microscopy analysis. Statistical analysis was performed using one-way analysis of variance. Post hoc pair-wise comparisons were performed using Tukey's test for multiple comparisons (P<0.05). RESULTS: WaveOne presented significantly higher bending resistance than the other tested systems (P<0.05), whereas Reciproc presented the lowest bending resistance (P<0.05). Reciproc revealed a significantly longer cyclic fatigue fracture resistance than the other systems (P<0.05). CONCLUSION: Although WaveOne Gold presented higher flexibility than WaveOne, no differences in the resistance to fatigue were observed between both systems. The Reciproc files were more flexible and resistant to fatigue for the angle of curvature of 86° and 6 mm radius than WaveOne and WaveOne Gold files.

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Variations in the root canal's anatomy play an important role on endodontic therapy success, primarily in teeth with pulp necrosis. Traditionally, the preparation of root canals was performed with the use of stainless steel hand files; but over the years, new flexible instruments were introduced to prevent or minimize iatrogenic errors in shaping the root canal system. In most of recent publications, alternating rotation movements have been proposed as an alternative to continuous rotation in order to reduce the risk of fracture of the instrument and the root canal deformation. The aim of this article was to report a clinical case describing the simple way to perform the endodontic treatment of a maxillary premolar with three root canals, with the WaveOne reciprocating system.

Las variaciones anatómicas de los canales radiculares juegan un papel importante en el éxito del tratamiento endodóntico, sobre todo en dientes con necrosis pulpar. Tradicionalmente, la preparación de los canales radiculares se realizó con el uso de limas de acero inoxidable, pero en los últimos años, nuevos instrumentos flexibles se introdujeron para evitar o reducir al mínimo errores o iatrogénias en la conformación del sistema canalicular. Se ha propuesto el movimiento reciprocante como alternativa al movimiento de rotación continua, con el fin de reducir el riesgo de fractura del instrumento y la deformación del canal radicular. El objetivo de este artículo fue presentar un caso clínico que describe una forma sencilla de realizar el tratamiento endodóntico de un premolar maxilar con tres canales radiculares utilizando el sistema reciprocante WaveOne.

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Objetivo: Comparou o tempo de preparo, ocorrência de fratura e manutenção do trajeto do canal em canais artificiais do instrumento Reciproc R25 em movimento reciprocante e rotação contínua anti-horária. Material e Métodos: Foram utilizados dois grupos contendo 10 canais artificiais em blocos de acrílico cada, sendo um o grupo controle, instrumentado com movimento reciprocante, e o grupo teste utilizando rotação contínua anti-horária a 300rpm para a instrumentação. Resultados: os resultados mostraram que houve diferença estatística significante em relação ao tempo de preparo entre os grupos, uma vez que a rotação contínua anti-horária proporcionou um menor tempo de preparo; ambos mantiveram o trajeto original do canal sem qualquer desvios no terço apical e ocorreu uma fratura no grupo da rotação contínua. Conclusão: o sistema Reciproc manteve a trajetória original do canal, não influenciou na incidência de fratura dos instrumentos e demandou menor tempo de preparo utilizando rotação contínua. Portanto, o sistema Reciproc pode ser utilizado com rotação contínua anti-horária desde que velocidade, torque e pressão apical sejam respeitados e se empregue os instrumento uma única vez.

Objective: This study aimed to compare the preparation time, occurrence of fracture and maintenance of the canal path in artificial canals using Reciproc R25 instrument moving reciprocating and continuous counterclockwise rotation. Methods: Two groups of 10 Simulated rootcanals, each one in an artificial acrylic block, was instrumented with reciprocating motion (control group) and using counterclockwise continuous rotation to 300rpm (test group). Results: The results showed statistically significant difference in relation to the preparation time between the groups, since the counterclockwise continuous rotation allowed shorter preparation time, both kinematics kept the original route of the canal without any deviations in the apical third. A fracture occurred in the group of continuous rotation. Conclusion: The Reciproc system kept the original trajectory of the canals and did not influence the incidence of instruments fracture. A less preparation time was required when the continuous rotation was used. Therefore, the Reciproc system can be used with counterclockwise continuous rotation since that speed, torque and apical pressure are respected. The instrument also should be employed just one time.

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A instrumentação dos canais radiculares através do uso de lima única em movimento recíproco vem se popularizando devido à redução do tempo de trabalho e menor tendência de fraturas dos instrumentos. Antes de escolher o sistema que vai utilizar, o cirurgião- -dentista deve conhecer as capacidades e limitações de cada sistema baseado em evidências científicas. Esse artigo realizou uma revisão de literatura sobre o movimento recíproco para instrumentação do sistema de canais radiculares apontando as vantagens e desvantagens da utilização dessa cinemática de instrumentação.

The canal’s instrumentation by using single file in reciprocation movement is gaining popularity due to the reduction of working time and less prone to fractures of the instruments. Before choosing which system will use, the dentist must know the capabilities and limitations of each system based on scientific evidence. This article reviews the literature on the reciprocation movement pointing out the advantages and disadvantages of this different kinematic instrumentation.

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A instrumentação dos canais radiculares através do uso de lima única em movimento recíproco vem se popularizando devido à redução do tempo de trabalho e menor tendência de fraturas dos instrumentos. Antes de escolher o sistema que vai utilizar, o cirurgião- -dentista deve conhecer as capacidades e limitações de cada sistema baseado em evidências científicas. Esse artigo realizou uma revisão de literatura sobre o movimento recíproco para instrumentação do sistema de canais radiculares apontando as vantagens e desvantagens da utilização dessa cinemática de instrumentação.

The canal’s instrumentation by using single file in reciprocation movement is gaining popularity due to the reduction of working time and less prone to fractures of the instruments. Before choosing which system will use, the dentist must know the capabilities and limitations of each system based on scientific evidence. This article reviews the literature on the reciprocation movement pointing out the advantages and disadvantages of this different kinematic instrumentation.

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