Jain Ashish K, Jain Rishabhkumar, Rao Rahul, Rao Prajakta, Yadav Pooja, Thorat Vinayak
Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India.
Department of Periodontology, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India.
J Conserv Dent Endod. 2024 Jun;27(6):634-638. doi: 10.4103/JCDE.JCDE_130_24. Epub 2024 Jun 6.
An unfavorable event that can hinder endodontic treatment and affect the outcome of root canal treatment is the separation of endodontic instruments. Endodontic instrument separation can occur due to clinical or metallurgical factors. Friction between the ultrasonic tip and the remaining dentin generates heat, which is subsequently transferred to the external root surface. Elevated temperatures exceeding 10°C above body temperature for more than a minute may result in injury to periodontal or bone tissue.
The aim of this study was to evaluate and compare temperature rise on the external root surface of teeth during retrieval of broken NiTi instrument using two different ultrasonic tips and two power settings.
In each group, a sample size of 8 was sufficient to attain a statistical power exceeding 90%, enabling the detection of a minimum mean difference of 0.9204 (delta) through a one-way ANOVA test at a 95% confidence level (alpha 0.05). After access opening and working length determination, samples were randomly distributed into two groups - Group 1 (A and B) - ProUltra tip at high and low power settings and Group 2 (A and B) - Cric Dental IR3 at high and low power settings. The temperature rise was measured using K-type thermocouple thermometer. The comparisons were analyzed using the Kruskal-Wallis test with pairwise comparisons using the Dunn's test.
Group 1A and Group 1B resulted in lower heat generation compared to Group 2A and 2B and its difference was statistically significant ( < 0.05). Minimum temperature rise is seen in the ProUltra group at lower power settings (Group 1A) at the apical level and maximum temperature rise is seen in the Cric Dental IR3 group at higher power settings (Group 2B) at the middle third level.
It was found that there is a significant temperature rise seen when ultrasonic tips are used for the retrieval of separated files, especially at higher power settings. The ProUltra tip demonstrated the lowest temperature rise at lower power settings, particularly at the apical level, whereas the IR3 Cric Dental tip exhibited the highest temperature rise, notably at higher power settings and the middle third level.
牙髓治疗器械分离是一种可能阻碍牙髓治疗并影响根管治疗效果的不良事件。牙髓治疗器械分离可能由临床或冶金因素引起。超声探头与剩余牙本质之间的摩擦会产生热量,随后热量会传递到牙根外表面。温度超过体温10°C以上并持续超过一分钟可能会导致牙周或骨组织损伤。
本研究的目的是评估和比较使用两种不同的超声探头和两种功率设置取出折断的镍钛器械时牙齿外表面的温度升高情况。
每组样本量为8足以获得超过90%的统计功效,通过95%置信水平(α = 0.05)的单向方差分析测试能够检测到最小平均差异为0.9204(δ)。在开髓和确定工作长度后,样本被随机分为两组——第1组(A和B)——高功率和低功率设置下的ProUltra探头组以及第2组(A和B)——高功率和低功率设置下的Cric Dental IR3探头组。使用K型热电偶温度计测量温度升高。使用Kruskal-Wallis检验进行比较分析,并使用Dunn检验进行成对比较。
与第2组A和2B相比,第1组A和第1组B产生的热量更低,且差异具有统计学意义(<0.05)。在根尖水平,低功率设置下的ProUltra组(第1组A)温度升高最小,在中三分之一水平,高功率设置下的Cric Dental IR3组(第2组B)温度升高最大。
研究发现,使用超声探头取出分离的锉时会出现显著的温度升高,尤其是在高功率设置下。ProUltra探头在低功率设置下,特别是在根尖水平,温度升高最低,而Cric Dental IR3探头在高功率设置下和中三分之一水平,温度升高最高。