Effect of Root Canal Preparation Techniques on Crack Formation in Root Dentin

J Endod. 2019 Apr;45(4):447-452. doi: 10.1016/j.joen.2018.12.018. Epub 2019 Mar 1.

Abstract

Introduction: The aim of this study was to assess the frequency of root crack formation caused by the use of manual instrumentation, 2 rotary systems, and 1 reciprocating system using light-emitting diode transillumination.

Methods: One hundred fifty mandibular premolars were randomly divided into 5 groups (n = 30): control 1, no intervention; control 2, instrumented with hand files; group 3, instrumented with ProTaper Universal rotary files (Dentsply Maillefer, Ballaigues, Switzerland); group 4, instrumented with OneShape rotary files (Micro-Mega, Besancon, France); and group 5: instrumented with the WaveOne reciprocal system (Dentsply Maillefer, Ballaigues, Switzerland). After root canal preparations, the roots were sectioned at 3, 6, and 9 mm from the apex with water irrigation. The slices were inspected under a stereomicroscope with light-emitting diode transillumination from the buccal, lingual, mesial, and distal directions at ×40 magnification to determine the presence/absence of cracks (dentinal defects). The chi-square test was used to analyze the data.

Results: There was a significant difference among the groups in crack frequency (P < .05). The 2 single systems had significantly higher cracks than the other 3 groups. At 3 mm from the apex, there were significantly more cracks in groups 4 and 5 than in groups 1, 2, and 3 (P < .05). At 6 mm from the apex, no significant difference was noted (P > .05). At 9 mm from the apex, the frequency of cracks in group 3 was significantly higher (P < .05).

Conclusions: According to the results, using rotary instrumentation can result in some dentinal defects, and single-file systems, regardless of motion type, can cause significantly higher crack formation in the apical third of root canals.

Keywords: Cracks; light-emitting diode; reciprocating motion; root canal preparation; rotary systems; single-file systems.

MeSH terms

  • Bicuspid
  • Cracked Tooth Syndrome / etiology*
  • Dental Instruments / adverse effects*
  • Dentin / injuries*
  • Humans
  • Mandible
  • Root Canal Preparation / adverse effects*
  • Root Canal Preparation / instrumentation*
  • Tooth Fractures / etiology*
  • Tooth Root / injuries*