Hofpeter Kevin, Zehnder Matthias, Deari Shengjile
Clinic of Conservative and Preventive Dentistry, Division of Endodontology, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.
Front Dent Med. 2025 Jul 25;6:1617425. doi: 10.3389/fdmed.2025.1617425. eCollection 2025.
The impact of contemporary endodontic motors on shaping outcomes has not been weighed against that of the motor operators.
One motor (X-Smart Pro+) specifically developed for the reciprocating files that were used (Reciproc Blue R25) was compared to three cordless counterparts, two of which lacked a designated reciprocation mode. Standardized J-shaped canals in bovine incisor roots were instrumented by four different operators, who were residents with similar levels of education and clinical experience. One reciprocating file per simulated root canal was used. The root canal models were pre-warmed and kept in a vice at 37°C in a water bath. The operators were instructed to instrument two simulated canals per motor in a random sequence, applying three pecking motions and alternating with 3% NaOCl irrigation. Instrumentation time was measured. Pre- and postoperative images obtained using a digital microscope were superimposed to assess canal transportation. Parametric tests (two-way ANOVA) were applied to weigh the overall effects of the motor and operator on instrumentation time and canal transportation. The impact of the motor and operator on the number of unwound flutes was explored using likelihood ratio tests. The level of significance was set at 5% ( < 0.05).
Operators had a highly significant ( < 0.001) impact on instrumentation time and file unwinding, while motors did not ( > 0.05). File unwinding was negatively correlated with instrumentation time ( < 0.001). There was no effect of either the motor or the operator on canal transportation ( > 0.05).
Technological advancements in endodontic motors do not necessarily compensate for operator variability.
当代牙髓动力系统对根管预备效果的影响尚未与手动器械进行权衡比较。
将一款专门为所用的往复式锉(Reciproc Blue R25)研发的动力系统(X-Smart Pro+)与三款无线动力系统进行比较,其中两款没有指定的往复运动模式。由四名教育水平和临床经验相近的住院医师作为操作者,对牛切牙根中的标准化J形根管进行预备。每个模拟根管使用一根往复式锉。根管模型预先加热并固定在37°C的水浴虎钳中。要求操作者以随机顺序对每个动力系统的两根模拟根管进行预备,采用三次啄击动作并交替使用3%次氯酸钠冲洗。记录预备时间。使用数字显微镜获取的术前和术后图像进行叠加,以评估根管偏移情况。采用参数检验(双向方差分析)来权衡动力系统和操作者对预备时间和根管偏移的总体影响。使用似然比检验探讨动力系统和操作者对锉刃展开数量的影响。显著性水平设定为5%(<0.05)。
操作者对预备时间和锉刃展开有极显著影响(<0.001),而动力系统则无显著影响(>0.05)。锉刃展开与预备时间呈负相关(<0.001)。动力系统和操作者对根管偏移均无影响(>0.05)。
牙髓动力系统的技术进步不一定能弥补操作者的个体差异。