Soltaninejad Fatemeh, Shantiaee Yazdan, Zandi Babak, Moslemi Arsham, Mirebeigi-Jamasbi Seyed Sepehr
Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshju Blvd., Velenjak St., Chamran Highway, Tehran, 1983963113, Iran.
BMC Oral Health. 2025 Apr 11;25(1):529. doi: 10.1186/s12903-025-05929-z.
The goal of root canal preparation is to eliminate microorganisms and debris from the root canal system, while providing space for the placement of root filling materials. However, the process can lead to the formation of dentin microcracks, increasing the risk of vertical root fractures. This study used micro-CT to evaluate the formation of dentinal microcracks following instrumentation with One Curve, EdgeOne Fire, and VDW.ROTATE systems.
Thirty-three extracted maxillary molars with non-calcified Vertucci type 4 s mesiobuccal canals were included. After pre-instrumentation micro-CT scans, a single endodontist prepared the canals with three aforementioned rotary systems. Post-instrumentation scans were conducted and axial sections from both the pre- and post-preparation scans were analyzed by two blinded observers to identify newly formed microcracks. Cohen's Kappa coefficient assessed interobserver agreement and dentinal microcracks were evaluated using ANOVA, ANCOVA, Kruskal-Wallis, and McNemar's test (P < 0.05).
All three rotary systems led to significant increases in dentinal microcracks post-instrumentation. While the VDW.ROTATE group showed a slightly higher percentage of cracked Sect. (72%), statistical analysis showed no significant difference between the groups (P = 0.35).
Preparation of maxillary molar root canals using different rotary systems resulted in the formation of dentin microcracks, with no significant correlation to the specific system used.
根管预备的目的是清除根管系统中的微生物和碎屑,同时为根充材料的放置提供空间。然而,该过程可能导致牙本质微裂纹的形成,增加垂直根折的风险。本研究使用显微CT评估使用One Curve、EdgeOne Fire和VDW.ROTATE系统进行根管预备后牙本质微裂纹的形成情况。
纳入33颗拔除的上颌磨牙,其近中颊根管为未钙化的Vertucci 4型。在预备前进行显微CT扫描后,由一名牙髓病医生使用上述三种旋转系统对根管进行预备。预备后进行扫描,两名盲法观察者对预备前后扫描的轴向切片进行分析,以识别新形成的微裂纹。采用Cohen's Kappa系数评估观察者间的一致性,并使用方差分析、协方差分析、Kruskal-Wallis检验和McNemar检验评估牙本质微裂纹(P < 0.05)。
所有三种旋转系统在预备后均导致牙本质微裂纹显著增加。虽然VDW.ROTATE组的裂纹切片百分比略高(72%),但统计分析显示各组之间无显著差异(P = 0.35)。
使用不同旋转系统对上颌磨牙根管进行预备会导致牙本质微裂纹的形成,与所使用的特定系统无显著相关性。