Santos-Junior Airton Oliveira, Fontenele Rocharles Cavalcante, Tavares Karina Ines Medina Carita, Torres Fernanda Ferrari Esteves, Pinto Jáder Camilo, Rosim Pedro Luis Busto, Gonçalves Andréa, Duarte Marco Antonio Hungaro, Guerreiro-Tanomaru Juliane Maria, Tanomaru-Filho Mário
Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, São Paulo, Brazil.
OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.
Clin Oral Investig. 2025 Mar 19;29(4):194. doi: 10.1007/s00784-025-06273-w.
To evaluate the performance in endodontic retreatment and pericervical dentin preservation using ProDesign Logic (PDL), Reciproc Blue (RB), and WaveOne Gold (WOG) NiTi systems in first (MB1) and second (MB2) mesiobuccal root canals of maxillary molars, using cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT).
MB1 and MB2 canals were prepared, filled, and randomized into four groups (n = 8). MB1 were retreated using PDL up to file 40/0.05 or RB R40 (40/0.06), while MB2 were retreated using PDL up to file 35/0.05 or WOG (35/0.06). Micro-CT scans were performed before and after retreatment to assess the remaining filling material, canal transportation, and canal centralization. Dentin removal and remaining dentin were measured at four levels below the furcation through CBCT scans analyzed with the e-Vol DX software, with micro-CT serving as the reference standard.
RB was more effective than PDL in removing MB1 filling material, while PDL outperformed WOG in the apical third of MB2 (p < 0.05). Overall, CBCT measurements for dentin removal were consistent with micro-CT in MB1 but occasionally underestimated in MB2 (p < 0.05). A significant reduction in MB2 danger zone dentin thickness below 0.5 mm was observed after retreatment (p < 0.05).
RB was more effective in retreating MB1, while PDL was more efficient in the apical third of MB2. A substantial decrease in dentin thickness in the MB2 danger zone was noted after retreatment, regardless of the NiTi system or imaging modality used. Overall, CBCT scans provided consistent assessments of dentin.
Selecting appropriate NiTi systems minimizes dentin removal in MB1 and MB2 danger zones, reducing the risk of perforation in the furcation area. CBCT reliably assesses dentin thickness, aiding clinical decisions and improving endodontic retreatment outcomes.
使用锥形束计算机断层扫描（CBCT）和显微计算机断层扫描（micro-CT），评估ProDesign Logic（PDL）、Reciproc Blue（RB）和WaveOne Gold（WOG）镍钛系统在上颌磨牙近中颊根第一根管（MB1）和第二根管（MB2）进行根管再治疗及保存颈周牙本质的性能。
对MB1和MB2根管进行预备、充填，并随机分为四组（n = 8）。MB1使用PDL预备至40/0.05锉或RB R40（40/0.06）进行再治疗，而MB2使用PDL预备至35/0.05锉或WOG（35/0.06）进行再治疗。再治疗前后进行micro-CT扫描，以评估剩余充填材料、根管偏移和根管中心化情况。通过使用e-Vol DX软件分析CBCT扫描，在根分叉下方四个水平测量牙本质去除量和剩余牙本质量，以micro-CT作为参考标准。
在去除MB1充填材料方面，RB比PDL更有效，而在MB2根尖三分之一处，PDL的表现优于WOG（p < 0.05）。总体而言，MB1中CBCT测量的牙本质去除量与micro-CT结果一致，但在MB2中偶尔会低估（p < 0.05）。再治疗后，观察到MB2危险区牙本质厚度显著降低至0.5毫米以下（p < 0.05）。
RB在MB1再治疗中更有效，而PDL在MB2根尖三分之一处更高效。无论使用何种镍钛系统或成像方式，再治疗后MB2危险区牙本质厚度均显著降低。总体而言，CBCT扫描对牙本质的评估结果一致。
选择合适的镍钛系统可最大程度减少MB1和MB2危险区的牙本质去除，降低根分叉区穿孔风险。CBCT可可靠地评估牙本质厚度，有助于临床决策并改善根管再治疗效果。
