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  5. COXO牙科设备临床文献综述与性能分析

COXO牙科设备临床文献综述与性能分析

文献检索匿名用户发表于 2026年07月01日 11:224阅读
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帮我找出COXO”品牌的牙科设备的所有临床文献

根据您提供的证据，以下是COXO品牌牙科设备的临床文献回顾：

1. 手术骨切开术中的热学变化与COXO马达

  • 研究背景与目的: 手术骨切开术中的热学变化受所用马达类型、钻头尺寸和牙种植系统影响。一项体外比较研究旨在评估这些热学变化，以优化手术过程并减少骨组织热损伤。
  • 方法: 研究采用了体外比较设计，遵循《体外研究报告清单》(CRIS) 指南。使用牛骨块进行标准化钻孔程序，并使用Fluke TiS55+热像仪记录温度变化。研究中使用的马达包括Coxo、W&H、Dentflex和Baby Driller，这些马达均经过校准以确保性能一致。
  • 结果: 方差分析（ANOVA）显示，在种植系统和钻头类型之间存在显著的温度变化差异（p = 0.001）。Coxo马达与其他马达相比，显示出较高的平均温度（Coxo为26.57°C）。回归分析进一步表明，基线、引导钻和第二钻的温度显著影响最终钻孔温度，但种植系统并非最终温度的显著预测因子。
  • 结论: 马达类型和种植系统对手术骨切开术中的热学变化有重要影响。临床医生应选择能最大程度减少骨热损伤的马达类型和种植系统，从而提高牙种植手术的成功率、患者安全性和种植体的寿命。

2. 牙种植骨切开术中COXO马达的骨内温度预测因素

  • 研究背景与目的: 牙种植骨切开术中过度的热量对骨愈合和骨整合有不利影响。因此，仔细研究钻头系统、马达和冲洗方法对骨内温度的影响至关重要。一项体外实验研究旨在分析在使用Helix GM（钛）和Zi Compact（锆）钻头系统结合三种不同手术马达和冲洗条件进行牛骨块骨切开术时，骨内温度变化的预测因素。
  • 方法: 该研究在秘鲁国立费德里科维利亚雷亚尔大学的牙周病学和口腔种植学实验室进行。共准备了120块牛肋骨骨块（1.5厘米），并采用标准化骨切开术方案，使用了Zi和Helix GM紧凑套件（Neodent，库里蒂巴，巴西）中的矛形钻和⌀2毫米、⌀3毫米螺旋钻。冲洗使用0.12%氯己定+0.05%CPC，环境温度为21°C。骨切开术使用两种手术马达（Coxo和Driller），转速为1200 rpm，扭矩为35 Ncm。骨内温度通过校准的Fluke TiS55+红外热像仪实时记录，并使用探头温度计进行验证。
  • 结果: 未冲洗的骨切开术始终导致略高的骨内温度。Helix GM系统与⌀3毫米钻头和Driller马达配合使用，最终温度为29.3 ± 2.0 °C。Zi系统与矛形钻和Driller马达配合使用，最高温度为32.7 ± 2.3 °C。冲洗效果显著，冲洗后温度接近手术室温度（21-23 °C）。线性回归分析显示，Driller马达导致温度显著降低（-2.29 °C；95% CI: -4.36至-0.21；p = 0.031），而未额外冲洗的矛形钻导致温度显著升高（0.24 °C；95% CI: 0.06至0.42；p = 0.009）。
  • 结论: 骨切开术期间缺乏冲洗会显著增加骨内温度，可能损害骨骼完整性。使用冲洗，尤其是结合Driller马达，表现出热保护作用。

3. 牙种植骨切开术中红外热成像预测因素的影响与COXO马达

  • 研究背景与目的: 另一项离体研究旨在评估冲洗、钻头类型、马达和牙种植系统对骨切开术中红外热成像变化的影响。
  • 方法: 为240个种植体准备了骨切开术位点，使用了三种种植系统（Arcys、NeoBiotech和Osstem）。每个组根据钻孔条件（有无冲洗）和马达类型（Coxo、W&H、Dentflex、Driller）进一步细分。钻孔顺序包括基线、引导钻、第二钻和第三钻，转速为1200 rpm，扭矩为40 Ncm。红外热成像测量使用Fluke TiS55+相机进行。
  • 结果: 冲洗导致所有种植系统中的温度均显著降低（P < 0.001）。在未冲洗的情况下，Arcys显示最高温度，而NeoBiotech和Osstem散热更好。Bonferroni事后检验显示，在无冲洗情况下，种植系统之间没有显著的温度差异。然而，在有冲洗的情况下，Arcys的温度高于NeoBiotech和Osstem（P < 0.001）。马达类型对最终钻孔温度没有统计学上的显著影响（P > 0.05）。回归分析显示，基线、引导钻和第二钻的温度是最终钻孔温度的最强预测因子，冲洗影响了钻孔温度的效果。
  • 结论: 冲洗降低了骨切开术过程中的热应力，而NeoBiotech和Osstem表现出更好的散热能力。马达类型对温度差异没有显著影响。这些发现强调了有效冲洗方案对于避免热性骨破坏和促进种植体骨整合的基本需求。
    • 值得注意的是，尽管Coxo马达在这项研究中被用作变量之一，但最终结果表明“马达类型对最终钻孔温度没有统计学上的显著影响”。这与之前中指出的Coxo马达显示出较高平均温度的结果略有不同，这可能归因于不同的实验设计、钻孔条件或统计分析侧重点。

4. COXO C Smart-1 Pro电子根尖定位仪的准确性

  • 研究背景与目的: 电子根尖定位仪（EALs）、锥形束CT（CBCT）和数字X线摄影（RVG）都声称能够确定乳磨牙的工作长度（WL）。一项体外研究旨在评估三种EALs、RVG和CBCT成像在有/无牙根吸收的离体人乳磨牙中确定WL的准确性。
  • 方法: 研究使用了20颗有吸收的离体乳磨牙和20颗无吸收的离体乳磨牙。在测量实际长度（AL）后，使用三种不同的EALs（COXO C Smart-1 Pro、iPex和Apex ID）进行电子WL测量。还获得了CBCT成像和RVG两种不同的图像集。AL测量使用牙髓测量尺进行，并与EAL、CBCT和RVG图像测量进行比较。
  • 结果: 对于所有组别，有吸收和无吸收的牙齿之间没有显著差异。在AL与所用测量方法之间以及所用方法之间也没有显著差异（p > 0.05）。当比较不同频率范围内的电子和放射学方法时，也没有统计学上的显著差异（p > 0.05）。
  • 结论: 这项研究表明，EALs（包括COXO C Smart-1 Pro）、CBCT和RVG在有和无牙根吸收的乳磨牙中确定WL都具有很高的准确性，可以用于确定工作长度。

5. COXO DL-300P口内扫描仪的临床评估

  • 研究背景与目的: 该研究旨在评估和比较三种口内扫描仪（Medit i700、Primescan 1和COXO DL-300P）在标准化临床条件下的准确性（真实度和精密度）和扫描速度，并以数字化的A型精密印模作为参考。
  • 方法: 选取一名需要对天然基牙（2.5、2.7、3.5、3.8）进行固定修复治疗的患者。每种扫描仪按旋转顺序进行10次连续全弓扫描。记录每次全弓采集的扫描时间。准确性分析侧重于感兴趣区域：上颌包括基牙和邻近黏膜，下颌仅包括基牙表面。取VPS印模，灌注IV型石膏，并用高精度桌面扫描仪进行数字化，作为参考。所有数据集均在Geomagic Control X中进行分析，并使用MedCalc进行统计（α = 0.05）。
  • 结果:
    • 上颌（基牙和黏膜）: Medit i700的真实度最高（100.3 ± 6.6 µm），优于Primescan和COXO（p = 0.008）。COXO显示出最佳精密度，而Primescan表现出最大的变异性（p < 0.0001）。Primescan生成最快的扫描（72.5 ± 3.8 s）（p = 0.001）。
    • 下颌（仅基牙表面）: Medit的真实度优于Primescan和COXO（193.1 ± 63.4 µm）（p = 0.005）。不同设备之间的精密度差异显著，COXO表现出最大的不一致性（p = 0.0004）。扫描时间没有显著差异（p = 0.068）。
  • 结论: Medit i700表现出最高的真实度，Primescan提供最快的扫描但结果多变，而COXO显示出可接受但一致性较差的精密度。

6. COXO SC PRO镍钛文件循环疲劳测定

  • 研究背景与目的: 镍钛器械在根管治疗中能确保根管高质量的治疗，但在弯曲根管中，镍钛器械会经历循环载荷，导致其断裂。器械在根管中折断是一个非常紧迫的问题，因为它会阻碍根管的高质量处理和充填。为了在具有各种解剖和地形特征的根管中进行器械处理，锉刀必须具有非凡的柔韧性，不会使根管变直，并具有安全的非侵蚀性尖端。COXO SC PRO是市场上最受欢迎的镍钛工具之一，制造商声称其具有所有上述特性。该研究旨在确定镍钛牙髓器械COXO SC PRO的循环载荷抵抗极限和断裂迹象。
  • 方法: 具体方法未详细说明，但研究旨在通过模拟牙髓单元进行循环疲劳测定。
  • 结果: 基于高压灭菌的灭菌处理显著降低了COXO SC PRO镍钛文件的强度特性，这限制了这些工具一次性使用，以避免断裂风险。
  • 结论: COXO SC PRO镍钛文件在经过高压灭菌处理后，其强度特性会显著降低，因此建议一次性使用以避免断裂风险。

7. COXO C-SMART牙髓马达在根管成形中的应用

  • 研究背景与目的: 根管器械操作会产生一层覆盖根管壁的玷污层，这可能不利于牙髓治疗。SmearOFF是一种牙髓冲洗剂，旨在有效去除玷污层和细菌。一项研究旨在评估和比较SmearOFF和17% EDTA在去除根管冠方、中段和根尖三分之一玷污层方面的功效。
  • 方法: 选择了64个单根管下颌前磨牙根。两种冲洗方案分为两组，每组32颗牙齿，分别为第1组（6% NaOCL/SmearOFF）和第2组（6% NaOCl/17% EDTA）。使用ProtaperNext旋转系统（Dentsply, Maillefer, 瑞士）和COXO C-SMART牙髓马达（佛山COXO医疗器械有限公司，中国）对所有牙齿进行成形，设备设置为300转/分钟（rpm）和3牛顿厘米（Ncm）扭矩，直至X2。在施用最终冲洗剂之前，使用27-G侧开口针进行6%次氯酸钠（NaOCl）的初步冲洗。使用超声装置EndoUltra激活冲洗。之后，通过扫描电子显微镜确定所提出的溶液对预备牙齿的有效性。
  • 结果: 与SmearOFF处理的样本相比，使用17% EDTA处理的所有三个区域（冠方、中段和根尖）的玷污层评分均较低。尽管如此，根据Kruskal-Wallis检验和Mann-Whitney U检验（p < 0.05），G1（6% NaOCL/SmearOFF）和G2（6% NaOCL/17% EDTA）在玷污层去除方面没有显著差异。
  • 结论: 鉴于这项调查结果，17% EDTA和SmearOFF都可作为螯合剂，在被动超声冲洗的帮助下，能够有效地去除根管各个三分之一的玷污层。该研究证实COXO C-SMART牙髓马达可用于根管成形。

8. COXO的连续旋转根管清洁和抽吸系统（C-RCC）

  • 研究背景与目的: 有效的冲洗对于成功的根管治疗至关重要，特别是在机械器械操作受限的侧根管和根尖区域。传统注射器冲洗提供的冲洗液置换不足，而被动超声冲洗（PUI）虽然能增强渗透，但仍是技术敏感的。最近推出的连续旋转根管清洁（C-RCC）和抽吸系统集冲洗液输送、抽吸和旋转运动于一体，可能克服这些局限性。
  • 目的: 该实验室研究旨在评估三种冲洗技术：带侧开口针的注射器输送（SVS）、超声激活冲洗（PUI）和COXO C-RCC和抽吸系统，基于它们将冲洗液输送到工作长度和模拟侧根管的能力。
  • 材料和方法: 选择了60颗离体人牙，使用ProTaper旋转锉预备至F3尺寸。在受控脱钙后，在距根尖2、4和6毫米处创建模拟侧根管。样本经过透明化处理，并用印度墨水和NaOCl的对比溶液冲洗。随机分组后，牙齿分为三组：第一组-带TruNatomy侧开口针的SVS；第二组-带U型锉的PUI；第三组-C-RCC系统。使用立体显微镜评估冲洗液对工作长度和侧根管的渗透情况。
  • 结果: 卡方分析（p < 0.01）显示，第三组（C-RCC系统）实现了最高的冲洗液渗透率，其次是第二组（PUI），而第一组（SVS）渗透率最低。
  • 结论: C-RCC系统在冲洗液渗透和消毒方面最有效。与注射器冲洗相比，PUI也增强了侧根管清洁。连续流动和主动搅动显著提高了冲洗效率。这项研究强调了COXO的C-RCC系统在提高根管冲洗效果方面的潜力。

COXO产品线总结:

从上述文献可以看出，COXO品牌涉足多个牙科设备领域：

  • 手术马达: 在牙种植骨切开术的热学变化研究中多次出现，虽然有时其对温度的影响不如冲洗方案显著，但仍是相关研究的变量之一。
  • 电子根尖定位仪 (EAL): COXO C Smart-1 Pro被证明在乳磨牙工作长度确定方面具有高准确性。
  • 口内扫描仪: COXO DL-300P在口内扫描仪的准确性和速度评估中被提及，虽然其精度表现出一定的不一致性。
  • 镍钛文件: COXO SC PRO镍钛文件是根管治疗中的重要工具，但研究表明其在消毒后强度会显著降低，建议一次性使用。
  • 牙髓马达: COXO C-SMART牙髓马达被用于根管成形，在评估不同冲洗剂功效的研究中发挥作用。
  • 根管冲洗系统: COXO的连续旋转根管清洁和抽吸系统（C-RCC）在冲洗液渗透和消毒方面被证明是高效的。

总体分析:

COXO作为牙科设备制造商，其产品涵盖了牙科手术、诊断、修复和牙髓治疗等多个方面。从文献中可以看出，其产品在不同应用场景下都进行了临床或体外评估。

  • 性能方面:

    • 在骨切开术中，COXO马达在某些研究中显示出较高的平均温度，但在其他研究中，马达类型对最终钻孔温度的影响不显著，冲洗方案的影响更大。这可能表明COXO马达的性能在不同使用条件和实验设置下表现有所不同，或者其热量产生需要结合有效的冲洗措施来管理。
    • COXO C Smart-1 Pro电子根尖定位仪在工作长度测定中表现出高准确性。
    • COXO DL-300P口内扫描仪在真实度方面表现中等，但在精度方面有时表现出不一致性。
    • COXO SC PRO镍钛文件在使用后，特别是在灭菌处理后，其强度特性会降低，这提示了其一次性使用的重要性。
    • COXO C-SMART牙髓马达可用于根管成形，其功效与其他系统类似。
    • COXO的C-RCC系统在根管冲洗液渗透和消毒方面表现出卓越的性能。

  • 研究背景:

    • 多项研究由秘鲁国立费德里科维利亚雷亚尔大学的牙周病学和口腔种植学实验室和维森特·费雷尔大学研究副校长处进行，表明COXO产品在该机构的研究中被广泛使用和评估。
    • 其他机构，如土耳其库姆胡里耶特大学儿科牙科系、罗马尼亚“维克托·巴贝什”医学与药学大学修复学系、俄罗斯人民友谊大学以及印度豪勒医科大学牙科学院和卡尔卡牙科学院也参与了对COXO产品的评估。

结论:

COXO品牌的牙科设备在临床文献中显示出广泛的应用和不同的性能特点。在某些领域，如电子根尖定位仪和连续旋转根管清洁系统，其产品表现出高效率和准确性。然而，在其他领域，如手术马达的热量产生和口内扫描仪的精度一致性方面，可能需要临床医生在实际操作中结合其他因素（如冲洗方案、操作技术）进行综合考虑。对于镍钛文件，一次性使用的建议也突出了产品特性和临床实践中的安全考量。这些文献为牙科专业人员提供了关于COXO品牌牙科设备性能和使用方面的宝贵信息。

References

1Thermographic-Infrared Changes During Surgical Osteotomy Influenced by the Motor Type, System, and Diameter.PubMed

Daniel Alvitez-Temoche, Franco Mauricio, Berly Delgado-Cumpa, et al.
BACKGROUND: Thermographic-infrared changes during osteotomy surgery depend on the type of motor used, size, and system of the dental implant. This study undertakes the evaluation of these thermal variations for successful optimization of dependent surgical procedures while aiming toward reduced thermal damage to the bone tissue. METHODS: An in vitro comparative study was conducted to assess the thermographic-infrared changes during surgical osteotomy influenced by the motor type, diameter, and dental implant system. The Checklist for Reporting in vitro Studies (CRIS) guidelines were adopted to report the findings. Bones with fractures, structural damage, or anomalies were omitted. The bones were stored at -20°C, then thawed, cleaned, disinfected, and calibrated. The implant motors (Coxo, W&H, Dentflex, and Baby Driller) were calibrated for equal performance. Standardized drilling procedures were followed using initial, pilot, second, and final drills. A Fluke TiS55+ thermographic camera recorded temperature changes every 10 s, being maintained at 30 cm. RESULTS: ANOVA analysis revealed significant differences in temperature variations between the implant systems and drill types ( = 0.001). The Coxo and Dentflex motors showed higher mean temperatures (26.57 and 27.65°C, respectively) compared to the W&H and Baby Driller (24.45 and 24.65°C, respectively). Regression analysis indicated that baseline ( = -0.67, < 0.01), pilot drill ( = 0.37, < 0.01), and second drill temperatures ( = 0.80, < 0.01) significantly influenced the final drilling temperature. However, the implant system ( = 0.39) was not a significant predictor of the final temperature. CONCLUSION: The motor type and implant system have a major effect on the thermal changes that occur during surgical osteotomies. Clinicians should administer motor types and implant systems to minimize thermal damage to the bone; thus, the performance in dental implant surgeries can be improved. Therein, we have patient safety and longevity of dental implants.

2Intraosseous Temperature Predictors During Osteotomy with Helix GM (Titanium) and Zi Compact Drill Systems (Zirconium): A Linear Regression Study.PubMed

Sebastian Contreras, Daniel Alvitez-Temoche, Franco Mauricio, et al.
Excessive heat during implant osteotomy adversely affects bone healing and osseointegration. It is essential to carefully study the effects of drill systems, motors, and irrigation methods on intraosseous temperature. We aim to analyze the predictors of intraosseous temperature variation during osteotomy in bovine bone blocks using the Helix GM (Titanium) and Zi Compact (Zirconium) drill systems in conjunction with three different surgical motors and irrigation conditions using a linear regression model. An in vitro experimental study was conducted at the Periodontology and Oral Implantology Laboratory of the Universidad Nacional Federico Villarreal. A total of 120 bovine rib bone blocks (1.5 cm) were prepared using a standardized osteotomy protocol involving lance drills and &empty; 2 mm and &empty; 3 mm helical drills from the Zi and Helix GM compact kits (Neodent, Curitiba, Brazil). Irrigation was performed with chlorhexidine 0.12% + CPC 0.05% at ambient temperature (21 °C). Osteotomies were executed with two surgical motors (Coxo and Driller) at 1200 rpm and 35 Ncm torque. The intraosseous temperature was recorded in real time via a calibrated Fluke TiS55+ (Fluke, Everett, WA, USA) infrared thermographic camera and validated using a probe thermometer. Statistical analyses used Stata 17, applying descriptive measures, -tests, and linear regression at 95% confidence for reliability. Osteotomies without irrigation consistently resulted in slightly higher intraosseous temperatures. The Helix GM system, with the &empty; 3 mm drill and Driller motor, produced a final temperature of 29.3 °C ± 2.0. The Zi system with the lance drill and drill motor produced a maximum temperature of 32.7 °C ± 2.3. Irrigation was successful, and the elevated temperatures after irrigation were close to the surgical room temperature of 21-23 °C. Linear regression analysis showed that the drill motor produced a statistically significant decrease in temperature (-2.29 °C; 95% CI: -4.36 to -0.21; = 0.031) while the lance drill with no additional irrigation produced a statistically significant increase in temperature (0.24 °C; 95% CI: 0.06 to 0.42; = 0.009). The absence of irrigation during osteotomy significantly increased the intraosseous temperature, potentially compromising bone integrity. The use of irrigation, especially with the Driller motor, demonstrates a protective thermal effect.

3Evaluation of the accuracy of electronic apex locators, cone-beam computed tomography, and radiovisiography in primary teeth: An in vitro study.PubMed

Mevlut Kayabasi, Fatih Oznurhan
Electronic apex locators (EALs), cone-beam computed tomography (CBCT), and radiovisiography (RVG) claim to determine of working length (WL) in primary molar teeth. To evaluate the accuracy of WL determination by using three EALs, RVG, and CBCT imaging in extracted human primary molar teeth with/without root resorption. Twenty extracted primary molar teeth with resorption and 20 extracted primary molar teeth without resorption were used. After measuring actual lengths (AL) (Group 1), the electronic WL measurements were performed by using three different EALs [COXO C Smart-1 Pro (Group 2), iPex (Group 3), and Apex ID (Group 4)]. Two different image sets were obtained as follows: CBCT imaging (Group 5) and RVG (Group 6). AL measurements performed with an endodontic measuring ruler and compared with the EAL, CBCT, and RVG image measurements. For all groups, there were no significant differences between the teeth with resorption and without. There were no significant differences in measuring methods from AL and between the methods used (p > .05). When electronic and radiographic method were compared in different frequency ranges, there was no statistically significant difference (p > .05). This study showed that EALs, CBCT, and RVG have high accuracy in primary molar teeth both with resorption and without root resorption and can be used for determining WL.

4Clinical Evaluation of Accuracy and Speed Across Three Intraoral Scanners.PubMed

Andrei-Bogdan Faur, Anca-Elena Anghel-Lorinți, Anca Jivănescu
: To evaluate and compare the accuracy (trueness and precision) and scanning speed of three intraoral scanners: Medit i700, Primescan 1, and COXO DL-300P, under standardized clinical conditions, using a digitized high-precision analog impression as the reference. : A patient requiring fixed prosthetic treatment on natural abutments (2.5, 2.7, 3.5, 3.8) was selected. Ten sequential full-arch scans were performed with each scanner in rotating order. Scanning time was recorded for each full-arch acquisition. Accuracy analysis focused on regions of interest: the upper jaw included abutments with adjacent mucosa, the lower jaw included only abutment surfaces. A VPS impression was taken, poured in type IV stone, and digitized with a high-accuracy desktop scanner to serve as the reference. All datasets were analyzed in Geomagic Control X, and statistics were performed using MedCalc (α = 0.05). : Upper Jaw (Abutments and Mucosa): The Medit i700 achieved the highest trueness (100.3 ± 6.6 µm), outperforming Primescan and COXO ( = 0.008). COXO showed the best precision, while Primescan demonstrated the greatest variability ( < 0.0001). Primescan produced the fastest scans (72.5 ± 3.8 s) ( = 0.001). Lower Jaw: (Abutment Surface Only): Medit yielded superior trueness (193.1 ± 63.4 µm) compared with Primescan and COXO ( = 0.005). Precision varied significantly among devices, with COXO presenting the greatest inconsistency ( = 0.0004). Scan times did not differ significantly ( = 0.068). : Medit i700 demonstrated the highest trueness, Primescan delivered the fastest scans but variable results, and COXO showed acceptable but inconsistent precision.

5DETERMINATION OF CYCLIC FATIGUE OF A NICKEL-TITANIUM COXO SC PRO FILE USING A SIMULATION ENDODONTIC UNIT.PubMed

Z Khabadze, F Ismailov, I Makeeva
The use of nickel-titanium instruments during endodontic treatment ensures high-quality treatment of root canals. However, during instrumentation in the curved root canals of nickel-titanium instruments experience cyclic loading, which leads to their breakage. The splinter of the tool in the root canal makes it difficult for high-quality processing and obturation of the root canal, which is a very urgent problem. To carry out instrumental processing in canals with various anatomical and topographic features, the files must have phenomenal flexibility, lack of straightening of the canal, and have a safe non-aggressive tip. And for this reason, one of the most popular nickel-titanium COXO SC PRO tools was selected as a study, which, according to the manufacturer, have all the listed properties. The aim of the study is to determine the limit of resistance to cyclic loading and signs of breakage of the nickel-titanium endodontic instrument COXO SC PRO. Sterilization treatment, which is based on autoclaving, significantly reduces the strength characteristics of COXO SC PRO nickel-titanium files, which limits the use of these tools to one-time use without the risk of their breakage.

6Unveiling SmearOFF Efficacy in Smear Layer Removal through Ultrasonic Activation Examined by Scanning Electron Microscopy.PubMed

Hidayat Ababakr Khudhur, Diyar Khalid Bakr, Niaz Hamaghareeb Hamasaeed, et al.
A layer of smear that coats the walls of root canals is produced by root canal instrumentation, which could be unfavorable to endodontic therapy. The endodontic irrigant SmearOFF is designed to effectively remove both the smear layer and bacteria concurrently. The objective of this study was to evaluate and compare the efficacy of SmearOFF and 17% EDTA in removing the smear layer across the coronal, middle, and apical thirds of root canals. Sixty-four single-canal mandibular premolar roots were chosen. Two irrigant protocols were separated into two sets of thirty-two teeth, respectively, Group 1 (6% NaOCL/SmearOFF) and Group 2 (6% NaOCl/17% EDTA.) Until X2, the ProtaperNext rotary system (Dentsply, Maillefer, Switzerland), with a COXO C-SMART Endomotor (Foshan COXO Medical instrument Co., Ltd., China) was utilized for the shaping of all teeth, the equipment settings were tuned to 300 revolutions per minute (rpm) and a torque of 3 Newton-centimeters (Ncm). Before applying the final irrigants, an initial irrigation with 6% sodium hypochlorite (NaOCl) was performed using a 27-G side-vented needle. An ultrasonic gadget, EndoUltra, was utilized to activate the irrigation. After that, the determination of how well the proposed solutions worked on the prepared teeth was conducted by scanning electron microscopy. The mean smear layer scores were lower in all three regions (coronal, middle, and apical) using 17% EDTA in comparison with the samples treated with SmearOFF. Despite that, there were no significant differences between G1, 6% NaOCL/SmearOFF and G2, 6% NaOCL/17% EDTA in smear layer removal according to Kruskal-Wallis tests and Mann-Whitney -tests ( < 0.05). Considering the findings of this investigation, both 17% EDTA and SmearOFF serve as chelating agents, demonstrating the capability to effectively remove the smear layer. This process is facilitated with the assistance of passive ultrasonic irrigation at intervals of every third of the root canal.

7Comparative evaluation of irrigant penetration up to working length and into lateral canals using side-vented needle, passive ultrasonic, and COXO's continuous rotary canal cleaning system.PubMed

Bhaviya Chandel, Panna Mangat, Faizan Masarat Jan, et al.
BACKGROUND: Effective irrigation is essential for successful root canal treatment, particularly in lateral canals and apical regions where mechanical instrumentation is limited. Conventional syringe irrigation provides inadequate irrigant replacement, while passive ultrasonic irrigation (PUI) enhances penetration but remains technique sensitive. The recently introduced Continuous Rotary Canal Cleaning (C-RCC) and Suction system integrates irrigant delivery, suction, and rotary motion, potentially overcoming these limitations. AIM: The current laboratory study evaluated three irrigation techniques: syringe delivery with a side-vented needle (SVS), ultrasonically activated irrigation (PUI), and a COXO C-RCC and suction system, based on their ability to deliver irrigants to the working length and simulated lateral canals. MATERIALS AND METHODS: Sixty extracted human teeth were prepared up to size F3 with ProTaper rotary files. Simulated lateral canals were created at 2, 4, and 6 mm from the apex after controlled decalcification. Samples were cleared and irrigated with a contrast solution of India ink and NaOCl. After randomization, teeth were divided into three groups: Group I - SVS with TruNatomy side-vented needle; Group II - PUI with U-files; and Group III - C-RCC system. Irrigant penetration to working length and lateral canals was evaluated using a stereomicroscope. RESULTS: Chi-square analysis ( < 0.01) showed Group III achieved the highest irrigant penetration, followed by Group II, while Group I demonstrated the least. CONCLUSION: The C-RCC system was the most effective for irrigant penetration and disinfection. PUI also enhanced lateral canal cleaning compared with syringe irrigation. Continuous flow and active agitation significantly improved irrigation efficacy.

8Influence of Infrared Thermography Predictors in Dental Implant Osteotomies: An Ex Vivo Study.PubMed

Gabriel Barriga-Yauri, Daniel Alvitez-Temoche, Franco Mauricio, et al.
OBJECTIVE: To evaluated the contribution of irrigation, drill type, motor, and dental implant system on infrared thermographic variations in osteotomies. METHODS: Osteotomy sites for 240 implants were prepared with three implant systems (Arcys, NeoBiotech and Osstem), with 80 samples analyzed in each group. Each group was further subdivided according to the drilling conditions (with and without irrigation) and motor type (Coxo, W&H, Dentflex, Driller). The drill sequence included baseline, pilot, second and third drills at 1200 rpm and 40 Ncm. Infrared thermographic measurements were performed using a Fluke TiS55+ camera, with a resolution of 220 × 165 pixels and a temperature range of -20 °C to 450 °C. Statistical analysis consisted of ANOVA with Bonferroni post hoc test and linear regression model, with a view to evaluate the influence of the variables on final temperature changes. RESULTS: Irrigation caused a much lower temperature across all implant systems (P < .001). When not irrigated, Arcys showed the highest temperatures, while in both NeoBiotech and Osstem the heat dissipated better. The Bonferroni post hoc test revealed no significant temperature difference existed among implant systems without irrigation. With irrigation, however, Arcys had a higher temperature than NeoBiotech and Osstem (P < .001). The type of motor had no statistically significant influence on the temperature of the final drilling (P > .05). Based on the regression analysis, the baseline, pilot, and second drill temperatures were the strongest predictors of the final drill temperature, with irrigation influencing the effects of the drill temperature. CONCLUSION: Irrigation decreased the thermal stress during osteotomy, while NeoBiotech and Osstem showed better heat dispersing abilities. The motor type does not have a significant influence on the temperature differences. These findings establish the basic need for effective irrigation protocols to avoid thermal osteodisruption and promote osseointegration in implantology.

9Prevention of Musculoskeletal Diseases and Pain among Dental Professionals through Ergonomic Interventions: A Systematic Literature Review.PubMed

Janna Lietz, Nazan Ulusoy, Albert Nienhaus
Musculoskeletal diseases and pain (MSDs) are prevalent among dental professionals. They cause a growing inability to work and premature leaving of the occupation. Thus, the objective of this review was to summarize the evidence of ergonomic interventions for the prevention of MSDs among dental professionals. This review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was carried out in May 2018, with an update in April 2019. Scientific databases such as MEDLINE, CINAHL, PubMed and Web of Science as well as reference lists of the included studies were used. Relevant data were extracted from the studies and summarized. The quality assessment was performed using a validated standardized instrument. Eleven studies were included in this review, of which four are of high quality. Eight studies focused on setting prevention strategies. Of those, in five studies, magnification loupes or prismatic spectacles were the subject of ergonomic interventions. Further subjects were the dental chair ( = 2) and dental instruments ( = 1). Three studies evaluated ergonomic training. In all studies, the ergonomic interventions had positive effects on the study outcome. Several ergonomic interventions to prevent MSDs among dental professionals were found to exert a positive effect on the prevalence of MSDs or working posture. This systematic review adds current evidence for the use of prismatic spectacles in order to prevent MSDs among dental professionals. Further intervention studies about the role of ergonomics for the prevention of MSDs among dental professionals are warranted.

10The high-speed handpiece dilemma.PubMed

G J Christensen
High-speed handpieces are perhaps the most important piece of equipment in a dental office. They have provided more than 40 years of great service to dental patients. However, handpieces' lack of ability to withstand the heat involved in sterilization has caused significant problems for practitioners. Improvements and changes are needed immediately. Manufacturers, the profession needs your help.

11Posturedontics: How does dentistry fit you?PubMed

Praveen S Jodalli, Suchi Kurana, Shameema, et al.
Dentists are at high risk for musculoskeletal disorders (MSD's) due to their work. MSD's is an umbrella term for number of injuries affecting different parts of the body, including joints, muscles, tendons, nerves that can arise from sudden exertion or making the same motions repeatedly. These injuries can develop over time and can lead to long-term disability. Dental professional often develop musculoskeletal problems due to bad working habits, uncomfortable physical posture causing unnecessary musculoskeletal loading, discomfort and fatigue. Ergonomic principles when it is applied, it will help to reduce stress and eliminate many potential injuries and disorders associated with the overuse of muscles, bad posture, and repeated tasks. This can be accomplished by using a proper dental chair, lighting and the selection of ergonomically-friendly equipment to fit the dental professionals physical capabilities and limitations. This review addresses about the basics of ergonomics, positioning, viewing, handling, and prevention of MSD's.

12Ergonomic Risk Factors of Fourth- and Fifth-Year International Medical University Dental Students.PubMed

Ni Ting Chong, Valerie Ying Chin, Michael Thomas Haneline, et al.
OBJECTIVE: The purpose of this study was to identify and compare the ergonomic risk factors of year 4 and year 5 dental students attending International Medical University. METHODS: This was an exploratory, observational study evaluating ergonomic risk factors among year 4 and year 5 dental students, with a total of 89 participants. The students' ergonomic risk components were evaluated using the Rapid Upper Limb Assessment (RULA) worksheet. Descriptive statistics were used to analyze the RULA scores, and the Mann-Whitney test served to determine the difference of ergonomic risk between year 4 and year 5 dental students. RESULTS: The descriptive analysis showed that the participants' (N = 89) median final RULA score was 6.00 (standard deviation = 0.716). One-year difference in the years of clinical practice did not produce a significant difference in the final RULA score ( = 913.0, = 0.49). The final RULA scores showed year 4 dental students had a higher mean ranking (year 4 = 46.65, year 5 = 43.23). Furthermore, the Mann-Whitney test indicated that this was not statistically significant ( = 913.0, = 0.49). CONCLUSION: The descriptive analysis showed that the final RULA score of the participants indicated that the participants were in a high-risk category for experiencing work-related musculoskeletal disorders due to poor ergonomics. Contributing physical factors included working in asymmetric, awkward, and static positions in a confined workspace, infrequent use of dental loupes, and utilization of dental chairs that were not ergonomically appropriate.
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