Lup Vlad Mircea, Malvicini Giulia, Gaeta Carlo, Grandini Simone, Ciavoi Gabriela
Doctoral School of Biomedical Sciences, University of Oradea, 410 087 Oradea, Romania.
Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy.
Dent J (Basel). 2024 Aug 14;12(8):257. doi: 10.3390/dj12080257.
The introduction of nickel-titanium rotary instruments revolutionized shaping procedures as they were able to produce a well-tapered preparation while reducing operator fatigue. The major drawback of rotary instruments was the high risk of fracture due to bending and torsional stress. Thus, the creation of a glide path has been advocated and recommended by most rotary instrument manufacturers. The aim of the present review is to summarize existing knowledge on glide path preparation and identify areas where further research is needed. The primary goal is to provide a comprehensive overview of the techniques and instruments used in glide path preparation, highlighting their advantages and limitations. The secondary goal is to explore the effect of glide path creation on the overall success of endodontic treatment, particularly in terms of reducing procedural errors and improving treatment outcomes. An online search on PubMed, ScienceDirect, UCLA, and Scopus databases was conducted, and 116 articles were identified. Eligible articles were divided into nine categories based on what they researched and compared. The categories included centering ability and/or root canal transportation, cyclic fatigue resistance, glide path and shaping time, tortional stress resistance, apical extrusion of debris and/or bacteria, defects in dentine walls, file separation, postoperative pain assessment, and scouting ability and performance. Establishing a glide path reduces root canal transportation, especially with rotary methods. Reciprocating and heat-treated files offer higher fatigue resistance and shorter preparation time. Instruments with shorter pitch lengths have greater torsional strength. Preparation and coronal preflaring reduce apical debris and bacteria. Glide paths do not affect dentine microcracks, file separation, or defects but reduce immediate postoperative pain and improve cutting ability. Randomized trials are needed to assess their impact on treatment outcomes.
镍钛旋转器械的引入彻底改变了根管预备程序,因为它们能够在减少术者疲劳的同时制备出良好的锥度。旋转器械的主要缺点是由于弯曲和扭转应力导致的骨折风险高。因此,大多数旋转器械制造商都提倡并推荐建立引导通路。本综述的目的是总结关于引导通路预备的现有知识,并确定需要进一步研究的领域。主要目标是全面概述引导通路预备中使用的技术和器械,突出其优点和局限性。次要目标是探讨引导通路的建立对根管治疗总体成功率的影响,特别是在减少操作失误和改善治疗效果方面。我们在PubMed、ScienceDirect、加州大学洛杉矶分校和Scopus数据库上进行了在线搜索,共识别出116篇文章。符合条件的文章根据其研究和比较内容分为九类。这些类别包括定心能力和/或根管偏移、循环疲劳抗力、引导通路与预备时间、抗扭转应力、碎屑和/或细菌的根尖挤出、牙本质壁缺陷、器械分离、术后疼痛评估以及探查能力和性能。建立引导通路可减少根管偏移,尤其是采用旋转方法时。往复式和热处理器械具有更高的疲劳抗力和更短的预备时间。螺距长度较短的器械具有更大的抗扭转强度。预备和冠部预扩可减少根尖碎屑和细菌。引导通路不会影响牙本质微裂纹、器械分离或牙本质壁缺陷,但可减轻术后即刻疼痛并提高切削能力。需要进行随机试验来评估它们对治疗效果的影响。