Evaluation of Dentinal Microcracks following Diode Laser- and Ultrasonic-Activated Removal of Bioceramic Material during Root Canal Retreatment

Barakat, Reem M.; Almohareb, Rahaf A.; Alsayyar, Aljuharh; Almalki, Fayruz; Alharbi, Hissah

doi:https://doi.org/10.1155/2022/6319743

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Abstract Introduction Materials and Methods Results Discussion Conclusion Data Availability Conflicts of Interest Acknowledgments Supplementary Materials References Copyright Related Articles

Research Article | Open Access

Volume 2022 | Article ID 6319743 | https://doi.org/10.1155/2022/6319743

Evaluation of Dentinal Microcracks following Diode Laser- and Ultrasonic-Activated Removal of Bioceramic Material during Root Canal Retreatment

Reem M. Barakat,¹Rahaf A. Almohareb,¹Aljuharh Alsayyar,²Fayruz Almalki,²and Hissah Alharbi²

Academic Editor: Marilena Vivona

Received01 Jun 2022

Revised20 Oct 2022

Accepted15 Nov 2022

Published21 Nov 2022

Abstract

This study is aimed at evaluating the use of microcomputed tomography (micro-CT) analysis and the dentinal microcrack formation following retreatment of bioceramic sealer employing adjunct laser-activated irrigation and ultrasonic-activated irrigation. Thirty sound human single-canal teeth () obturated using the single-cone technique with bioceramic sealer were retreated using nickel-titanium (NiTi) rotary files. The sample was randomly divided into three equal groups: group 1, the control group, was not subjected to further treatment; group 2 underwent ultrasonic activation of irrigants; group 3 underwent active irrigation with a diode laser (980 nm wavelength). Using micro-CT, the teeth were scanned before and after retreatment protocols. Two calibrated experienced observers viewed the cross-sectional images and calculated the number of dentinal defects. The presence of any crack or craze line on the external root surface or internal canal wall was counted. Data were analyzed using Friedman’s two-way analysis of variance and Fisher’s exact test. Statistical significance was set at . A significant increase occurred in the number of cracks post retreatment protocols, specifically in the coronal and middle canal thirds, compared to pre- and postinstrumentation (). However, ultrasonic- or laser-activated irrigation did not result in a significant increase in the number of cracks (). NiTi rotary root canal retreatment was associated with a significant increase in dentinal microcracks. However, employing ultrasonic- or laser-activated irrigation as adjunct retreatment techniques did not reveal a significant increase in dentinal microcracks within the roots.

1. Introduction

The primary objective of nonsurgical root canal retreatment is to optimize the removal of all filling materials, bacteria, and debris by thorough cleaning and reshaping [1]. This method, which involves extra mechanical manipulation and root canal preparation, will degrade the root canal dentine’s structure and make it more vulnerable to fracture development [2]. As a result of the increased instrument–canal wall contact, a buildup of stress in the dentin leads to the formation of microcracks, which may ultimately lead to fractures and tooth loss [3, 4]. Although weaker dentin caused by retreatment is not always the primary cause of problems, several extrinsic variables, including stress, temperature change, and instrument friction with the root canal wall, all contribute to canal wall deterioration. Additionally, the effect of some sealers, such as bioceramic (BC), may result in the formation of dentine crack defects [2].

BC root canal fillings are a feasible alternative to the current gold standard. Researchers have studied BC sealers in depth, and they have shown bioactive, nontoxic, and biocompatible properties [5], in addition to higher binding strength in comparison to other sealers [6]. However, in the event of retreatment, BC has shown more complexity than conventional sealers [7]. Additionally, the effect of removing BC from the root canal system during retreatment is a cause for concern [8].

In clinical practice, no scientifically proven methods exist for removing BC sealer [6]. Conventional retreatment methods that employ mechanical removal techniques using nickel-titanium (NiTi) rotary instruments have been unable to eliminate the BC sealer from the surface [6].

Recently, adjunct methods have been suggested to enhance the efficacy of removal of BC sealer, such as the use of XP-endo finisher instruments, ultrasonic-activated irrigation, and photoacoustic streaming [9–12]. Although limited to the straight area of the canal, ultrasonic tips are an excellent adjunct technique in endodontic retreatment, particularly in cases with BC sealer [13]. Ultrasonic-activated irrigation has been found to significantly increase the efficacy of sealant removal [10, 11]. In general, ultrasonic energy has been effectively employed to clean root canals from filling materials with and without BC sealer [14, 15]. However, treatment preparation with ultrasonic tips has caused a higher occurrence of microcracks [16].

In recent years, dental lasers have been advocated for a variety of uses in endodontics. Near-infrared (diode) and erbium (Er:YAg) laser with a wavelength of 2940 nm have been approved to remove the smear layer and clean and disinfect the root canal [17]. New systems applying erbium (Er:YAg) laser have been recently introduced, such as photoinduced photoacoustic streaming (PIPS) and shockwave-enhanced emission photoacoustic streaming (SWEEPS). These techniques rely on the absorption of pulses of laser energy by canal irrigants to create a series of shockwaves and turbulent photoacoustic currents, enhancing the cleaning and disinfection of the root canal [18]. Recent studies have shown that SWEEPS can enhance the antimicrobial effect of low-concentration sodium hypochlorite (NaOCl) [19]. Adjunct laser-activated irrigation has also greatly improved the removal of root-filling materials such as gutta percha and BC sealer during retreatment [10, 15, 20].

Diode laser is arguably less efficient than Er:YAg lasers due to the latter’s superior absorption in water and thus canal irrigants [21]. However, diode lasers are more economical and readily available [22]. Additionally, a previous study reported that diode laser can enhance the removal of BC sealer material during root canal retreatment [15].

That said, using diode laser in root canal irrigation has been reported to decrease tooth fracture resistance [23]. Other studies have shown that microcrack creation is influenced by laser radiation in a dry canal [17, 24]. The present study is aimed at evaluating the use of microcomputed tomography (micro-CT) analysis and dentinal microcrack formation following retreatment of the BC sealer employing two adjunct techniques: ultrasonic- and laser-activated irrigation.

2. Materials and Methods

The randomized controlled cross-sectional in vitro study was exempt, according to Princess Nourah Bint Abdulrahman University Institutional Review Board in Riyadh, Saudi Arabia (IRB Number: 21-0435).

2.1. Sample Selection

For this study, thirty sound human single-canal teeth, which had been extracted for periodontal or orthodontic reasons, were selected according to predefined criteria. Teeth with calcification, open apices, abnormally short roots, visible root fractures or cracks (under magnification), root resorption or erosion, or more than one canal in the root were excluded. The teeth were preserved in saline at room temperature after calculus, and soft tissue debris were removed. GPower 3.1 software (Heinrich-Heine-University, Düsseldorf, Germany) was used to calculate the sample size. It considered an effect size of 0.35, with an estimated power of 0.90 and type I error α of 0.05.

2.2. Preparation of Teeth

All crowns were cut 2 mm above the cemento-enamel junction using a straight-fissure diamond bur to guarantee uniformity and a root length of 15–18 mm. Access to the cavity was performed using access burs. The working length was calculated by inserting a size 10 K file into the canal until it reached the apical foramen; then, 1 mm was reduced. Only teeth where the initial apical file was a size 10 or 15 K files were included. To form a closed system, the canal apex was closed with a soft piece of wax, and the tooth was lodged in silicon. All canals were prepared using ProTaper Universal files (Dentsply Maillefer, Ballaigues, Switzerland) to size F3, regularly irrigating with 2.5% NaOCl (1 mL) between each file, with a final irrigation of 17% EDTA (3 mL) and normal saline (5 mL). Before obturation, the canals were dried with paper points. The TotalFill BC sealer (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) and a single standardized gutta percha cone size F3 (Dentsply Maillefer, Ballaigues, Switzerland) were used to fill all root canals using the single-cone method. To allow for the complete setting of the BC sealer, all teeth were placed in a humidor for three weeks at 37°C and 100% relative humidity.

2.3. Retreatment

Mechanical retreatment was carried out using D-Race NiTi rotary instruments (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) with 20 mL of saline. The root canal filling material was removed, and patency was obtained with a size 15 K file, followed by taking a size F3 ProTaper Universal instrument to the working length. The sample () was then randomly divided into three equal groups: group 1 was the control group, and group 2 underwent passive ultrasonic irrigation using a size 15 ultrasonic K file (Satelec Ultrasonic Unit) with 2.5% NaOCl followed by saline. In group 3, a laser diode (Master lase/expert lase, Kavo, Biberach/Riβ, Germany) with a wavelength of 980 nm, a frequency of 100 Hz (37°C), and a power of 2.5 W were used.

The protocol conducted in groups 2 and 3 was previously described for effective retreatment of BC sealer filling material [15].

Passive ultrasonic irrigation was conducted by inserting the ultrasonic file into the canal 1 mm short of the full working length. It was activated for a total of 1 min in three 20 sec cycles, with 3 mL of 2.5% NaOCl. This was repeated five times, followed by final activation for 1 min using 5 mL of saline.

For teeth in group 3, the laser diode 300 μm fiber tip was introduced into the canal and activated at a distance of 1 mm from the working length for 10 secs. During every activation, the tip was gently withdrawn and then reinserted along the entire length of the root canal in a helical movement. This was repeated for a total of 1 min for every specimen with 3 mL of 2.5% NaOCl then with 5 mL of saline.

All irrigants were delivered into the canal using monovac Luer lock 30-gauge side-vented irrigation needle tips and inserted 1 mm short of the full working length.

2.4. Evaluation of Dentinal Defects

Using micro-CT, teeth were scanned four times: before and after root canal preparation, then after the mechanical retreatment using NiTi rotary instruments, and finally, after the use of ultrasonic and laser energy. To guarantee that teeth were scanned in the same location each time, silicone molds were made for each root. The teeth were stored in a humidor before and after each scan.

Two calibrated trained observers who were experienced endodontists viewed the cross-sectional images on Data Viewer (Skyscan, Kontich, Belgium) and calculated the number of dentinal defects according to the method described by Almeida et al. [7]. The presence of any type of defect, whether a crack or craze line on the external root surface or internal canal wall, was counted. The images from the postirrigation scans were viewed first, and the slice number associated with the defect was recorded. The same slice was then evaluated in the post retreatment and post- and preinstrumentation scans to see whether the defect was also present. Interobserver agreement calculated using the intraclass correlation coefficient was found to be 0.948, indicating excellent interobserver agreement. Cases of disagreement were analyzed by both examiners until an agreement was reached. The process was repeated after four weeks.

2.5. Statistical Analysis

SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY, USA: IBM Corp.) was used to analyze the data. After the normality of the data was explored using the Shapiro–Wilk test, Friedman’s two-way analysis of variance by ranks was used to compare the number of cracks pre- and posttreatment. Fisher’s exact test was used to compare the percentage of cracks. The statistical significance level was set at .

3. Results

In total, 32,300 slices were inspected, and 11,845 slices contained cracks. Table 1 shows the percentage of cracks pre- and posttreatment. A significant increase occurred in the number of cracks postmechanical retreatment and activated irrigation compared to both pre- and postinstrumentation (). However, activated irrigation protocols did not result in a significant increase in the number of cracks compared to the mechanical retreatment (; Figure 1).

The coronal and middle canal thirds showed a significant increase in the number of cracks postmechanical retreatment and activated irrigation compared to pre- and postinstrumentation (). However, cracks in the apical third showed no significant change (; Figure 2).

A comparison between ultrasonic and laser irrigation revealed no significant difference between the percentage of cracks after laser and ultrasonic irrigation ().

4. Discussion

Nonsurgical retreatment of root canals filled using BC sealer has been deemed problematic [6, 7]. Photoacoustic techniques such as PIPS and SWEEPS can improve root canal filling removal during root canal retreatment [20]. Recently, laser- and ultrasonic-activated irrigation have been proposed as adjunct procedures to enhance the complete removal of the BC sealer material [10, 15, 25, 26]. This study evaluated the toll that these treatments may have on the dentinal root in terms of dentinal defects that jeopardize the tooth’s longevity.

The results showed no crack propagation following instrumentation using NiTi rotary files, which is in accordance with many studies that have used micro-CT to evaluate crack formation [27–30]. The association between canal instrumentation and dentinal crack formation has mainly been reported by studies using root-sectioning methods that result in specimen destruction. Not only could such methods create dentinal cracks [31, 32], but it is not possible to determine how many preexisting dentinal defects were in the specimen.

On the other hand, micro-CT, the method used in this study, is a nondestructive technique that allows a three-dimensional representation of the tooth. This facilitates comparing pre- and postoperative images with preoperative specimens serving as an authentic control [30].

Some studies have used micro-CT and found that certain instrumentation systems caused more dentinal cracks to form [33, 34]. They linked their findings to differences in instrument design, taper, number, and type of movements [4, 34–36].

One reason for the different results is that some studies did not report coregistration, which allows images taken from the same specimen at different times to be overlaid in the same place so that they can be compared accurately [33, 34].

The highest percentage of dentinal cracks in this study was found after using the NiTi rotary retreatment files. This is in accordance with many studies using micro-CT that found that NiTi rotary retreatment systems were associated with an increase in dentinal crack formation [36–38]. However, other studies reported that NiTi retreatment systems did not create dentinal cracks [7, 39].

These contradictions may be explained by discrepancies in experimental methods such as scanning and reconstruction parameters, the interval at which the cross-sectional images are examined, defect interpretation criteria, and the conditions in which the samples are stored [30]. The age of the tooth itself must also be considered. Teeth from older patients have demonstrated a greater number of dentinal cracks [40].

In this study, adjunct-activated irrigation procedures, whether ultrasonic or diode laser activation, were not associated with an increase in dentinal crack formation. Previous studies [17, 41] have shown that disinfection during root canal instrumentation using constant diode laser 980 nm irradiation (employed in this study) caused significant crack formation in the apical and middle third of the canals. These studies did not carry out their investigations using micro-CT.

However, the dentinal crack formation was associated with the use of ultrasonic tips to remove fractured instruments from the middle third of the canal [42] and create root-end preparation during periapical surgery. Researchers have reported crack formation in high-frequency settings when using ultrasonic tips for root-end preparation [43]. Such procedures involve using tips instead of the files used to activate irrigation in this study. The tip application is concentrated at a certain point that is in direct contact with the dentine, which does not happen during ultrasonic irrigant activation.

Dentinal cracks have also been linked to filling techniques that put stress on the dentinal walls [44]. However, the teeth in this study were not evaluated after root canal filling because it used the single-cone technique, which does not create such stresses and so may not initiate or propagate dentinal cracks [45].

Previous studies [36, 46] have reported an increase in crack formation focused in the apical or middle thirds [47]. In the current study, this increase was observed in the middle and coronal thirds, and not the apical third. One explanation could be related to the differences in the NiTi files used in those studies, regarding their design, mode of movement, and rotation speed [47]. Another possible explanation is the different types of teeth used in the studies. While mesial roots of molars and mandibular incisors were used in those studies [36, 46], premolars were chosen for the present study. Their canals tend to be more oval, concentrating instrumentation stresses in the middle and coronal canal thirds [47].

An important limitation of this study is that it was conducted in vitro on extracted teeth with the absence of a periodontal ligament, which would have acted as an energy absorber. Therefore, the study may have overestimated crack formation.

5. Conclusion

Applying laser- or ultrasonic-activated irrigation as adjunct retreatment techniques did not reveal a significant increase in dentinal microcracks in the roots. However, using NiTi rotary retreatment instruments was associated with a significant increase in dentinal microcracks. These cracks were more frequently observed in the coronal and middle canal thirds.

Data Availability

The datasets generated and/or analyzed during the current study are available as a supplementary file.

Conflicts of Interest

The authors declare no conflict of interest.

Acknowledgments

Princess Nourah Bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R162), Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

Supplementary Materials

See Figure S1 in the Supplementary Material for whole dataset. (Supplementary Materials)

References

E. Pedullà, R. S. Abiad, G. Conte et al., “Retreatability of two hydraulic calcium silicate-based root canal sealers using rotary instrumentation with supplementary irrigant agitation protocols: a laboratory-based micro-computed tomographic analysis,” International Endodontic Journal, vol. 52, no. 9, pp. 1377–1387, 2019.
View at: Publisher Site | Google Scholar
H. Shemesh, A. C. Roeleveld, P. R. Wesselink, and M.-K. Wu, “Damage to root dentin during retreatment procedures,” Journal of Endodontia, vol. 37, no. 1, pp. 63–66, 2011.
View at: Publisher Site | Google Scholar
N. Sachdeva, V. Nikhil, and P. Jha, “Effect of ultrasonic root-end cavity preparation on dentinal microcrack formation: a micro-computed tomography study,” Journal of Conservative Dentistry, vol. 22, no. 4, pp. 362–366, 2019.
View at: Publisher Site | Google Scholar
M. L. Li, W. L. Liao, and H. X. Cai, “A micro-computed tomographic evaluation of dentinal microcrack alterations during root canal preparation using single-file Ni-Ti systems,” Experimental and Therapeutic Medicine, vol. 15, no. 1, pp. 494–499, 2018.
View at: Publisher Site | Google Scholar
E. J. N. L. Silva, T. P. Rosa, D. R. Herrera, R. C. Jacinto, B. P. F. A. Gomes, and A. A. Zaia, “Evaluation of cytotoxicity and physicochemical properties of calcium silicate- based endodontic sealer MTA Fillapex,” Journal of Endodontia, vol. 39, no. 2, pp. 274–277, 2013.
View at: Publisher Site | Google Scholar
K. I. Zhekov and V. P. Stefanova, “Retreatability of bioceramic endodontic sealers: a review,” Folia Medica, vol. 62, no. 2, pp. 258–264, 2020.
View at: Publisher Site | Google Scholar
A. Almeida, K. Romeiro, M. Cassimiro et al., “Micro-CT analysis of dentinal microcracks on root canals filled with a bioceramic sealer and retreated with reciprocating instruments,” Scientific Reports, vol. 10, no. 1, article 15264, 2020.
View at: Publisher Site | Google Scholar
F. Kakoura and O. Pantelidou, “Retreatment efficacy of endodontic bioceramic sealers: a review of the literature,” Odovtos - International Journal of Dental Sciences, vol. 20, no. 2, pp. 39–50, 2018.
View at: Publisher Site | Google Scholar
B. M. Eid, H. B. Abdel Maksoud, and T. M. Elsewify, “Efficacy of XP-endo Finisher-R in enhancing removal of bioceramic sealer from oval root canal: a micro CT study,” Giornale Italiano di Endodonzia, vol. 35, no. 1, pp. 201–208, 2021.
View at: Publisher Site | Google Scholar
R. Yang, Y. Han, Z. Liu, Z. Xu, H. Liu, and X. Wei, “Comparison of the efficacy of laser-activated and ultrasonic-activated techniques for the removal of tricalcium silicate-based sealers and gutta-percha in root canal retreatment: a microtomography and scanning electron microscopy study,” BMC Oral Health, vol. 21, no. 1, pp. 275–279, 2021.
View at: Publisher Site | Google Scholar
C. Sinsareekul and S. Hiran-us, “Comparison of the efficacy of three different supplementary cleaning protocols in root-filled teeth with a bioceramic sealer after retreatment—a micro-computed tomographic study,” Clinical Oral Investigations, vol. 26, no. 4, pp. 3515–3521, 2022.
View at: Publisher Site | Google Scholar
B. M. Crozeta, F. C. Lopes, R. Menezes Silva, Y. T. C. Silva-Sousa, L. F. Moretti, and M. D. Sousa-Neto, “Retreatability of BC sealer and AH plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment,” Clinical Oral Investigations, vol. 25, no. 3, pp. 891–899, 2021.
View at: Publisher Site | Google Scholar
M. Marinova-Takorova, E. Radeva, I. Kisjova, and E. Naseva, “Effectiveness of different retreatment techniques in the removal of gutta-percha cones and bioceramic-based root canal sealer in the different parts of the root canal,” Journal of Medical and Dental Practice, vol. 5, no. 1, pp. 713–723, 2018.
View at: Publisher Site | Google Scholar
P. Agrawal, P. K. Ramanna, S. Arora, S. Sivarajan, A. Jayan, and K. M. Sangeetha, “Evaluation of efficacy of different instrumentation for removal of gutta-percha and sealers in endodontic retreatment: an in vitro study,” The Journal of Contemporary Dental Practice, vol. 20, no. 11, pp. 1269–1273, 2019.
View at: Publisher Site | Google Scholar
R. A. Almohareb, R. M. Barakat, N. Aljarallah, H. Mudhish, A. Almutairi, and F. N. Algahtani, “Efficiency of diode laser and ultrasonic-activated irrigation in retreatment of gutta percha and bioceramic sealer: an in vitro study,” Australian Endodontic Journal, 2022.
View at: Publisher Site | Google Scholar
P. J. Palma, J. A. Marques, M. Casau et al., “Evaluation of root-end preparation with two different endodontic microsurgery ultrasonic tips,” Biomedicine, vol. 8, no. 10, p. 383, 2020.
View at: Publisher Site | Google Scholar
M. Godiny, A. Khavid, and M. Jalilvand, “Evaluation of the effect of various powers of the diode laser in microcrack formation in the wall of the dental root canal by scanning electron microscope (SEM),” The Open Dentistry Journal, vol. 14, no. 1, pp. 529–538, 2020.
View at: Publisher Site | Google Scholar
E. Kosarieh, B. Bolhari, S. Sanjari Pirayvatlou et al., “Effect of Er:YAG laser irradiation using SWEEPS and PIPS technique on dye penetration depth after root canal preparation,” Photodiagnosis and Photodynamic Therapy, vol. 33, article 102136, 2021.
View at: Publisher Site | Google Scholar
L. Lei, F. Wang, Y. Wang, Y. Li, and X. Huang, “Laser activated irrigation with SWEEPS modality reduces concentration of sodium hypochlorite in root canal irrigation,” Photodiagnosis and Photodynamic Therapy, vol. 39, article 102873, 2022.
View at: Publisher Site | Google Scholar
G. K. Petričević, M. Katić, I. Anić, I. Salarić, D. Vražić, and I. Bago, “Efficacy of different Er:YAG laser-activated photoacoustic streaming modes compared to passive ultrasonic irrigation in the retreatment of curved root canals,” Clinical Oral Investigations, vol. 26, no. 11, pp. 6773–6781, 2022.
View at: Publisher Site | Google Scholar
M. H. Aras, M. Göregen, M. Güngörmüş, and H. M. Akgül, “Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia,” Photomedicine and Laser Surgery, vol. 28, no. 2, pp. 173–177, 2010.
View at: Publisher Site | Google Scholar
S. Selvaganesh, P. L. Gajendran, T. Nesappan, and A. R. Prabhu, “Comparison of clinical efficacy of diode laser and erbium, chromium: yttrium, scandium, gallium, and garnet for implant stage 2 recovery procedure - a randomized control clinical study,” Journal of Indian Society of Periodontology, vol. 25, no. 4, pp. 335–340, 2021.
View at: Publisher Site | Google Scholar
E. Karataş, H. Arslan, H. S. Topçuoğlu, C. B. Yılmaz, K. Y. Yeter, and L. B. Ayrancı, “The effect of diode laser with different parameters on root fracture during irrigation procedure,” Artificial Organs, vol. 40, no. 6, pp. 604–609, 2016.
View at: Publisher Site | Google Scholar
R. Yamazaki, C. Goya, D. G. Yu, Y. Kimura, and K. Matsumoto, “Effects of erbium, chromium:YSGG laser irradiation on root canal walls: a scanning electron microscopic and thermographic study,” Journal of Endodontia, vol. 27, no. 1, pp. 9–12, 2001.
View at: Publisher Site | Google Scholar
M. Suk, I. Bago, M. Katić, D. Šnjarić, M. Š. Munitić, and I. Anić, “The efficacy of photon-initiated photoacoustic streaming in the removal of calcium silicate-based filling remnants from the root canal after rotary retreatment,” Lasers in Medical Science, vol. 32, no. 9, pp. 2055–2062, 2017.
View at: Publisher Site | Google Scholar
B. M. Crozeta, L. Chaves de Souza, Y. T. Correa Silva-Sousa, M. D. Sousa-Neto, D. E. Jaramillo, and R. M. Silva, “Evaluation of passive ultrasonic irrigation and gentlewave system as adjuvants in endodontic retreatment,” Journal of Endodontia, vol. 46, no. 9, pp. 1279–1285, 2020.
View at: Publisher Site | Google Scholar
G. De-Deus, J. C. de Azevedo Carvalhal, F. G. Belladonna et al., “Dentinal microcrack development after canal preparation: a longitudinal _in situ_ micro -computed tomography study using a cadaver model,” Journal of Endodontia, vol. 43, no. 9, pp. 1553–1558, 2017.
View at: Publisher Site | Google Scholar
G. De-Deus, F. G. Belladonna, E. M. Souza et al., “Micro-computed tomographic assessment on the effect of protaper next and twisted file adaptive systems on dentinal cracks,” Journal of Endodontia, vol. 41, no. 7, pp. 1116–1119, 2015.
View at: Publisher Site | Google Scholar
H. M. Bayram, E. Bayram, M. Ocak, M. B. Uzuner, F. Geneci, and H. H. Celik, “Micro-computed tomographic evaluation of dentinal microcrack formation after using new heat-treated nickel-titanium systems,” Journal of Endodontia, vol. 43, no. 10, pp. 1736–1739, 2017.
View at: Publisher Site | Google Scholar
J. C. L. G. D. Martins, B. P. Oliveira, D. A. Duarte, A. C. D. Antonino, C. M. Aguiar, and A. C. Câmara, “Micro-computed tomographic assessment of dentinal microcrack formation in straight and curved root canals in extracted teeth prepared with hand, rotary and reciprocating instruments,” International Endodontic Journal, vol. 54, no. 8, pp. 1362–1368, 2021.
View at: Publisher Site | Google Scholar
O. Yoldas, S. Yilmaz, G. Atakan, C. Kuden, and Z. Kasan, “Dentinal microcrack formation during root canal preparations by different NiTi rotary instruments and the self-adjusting file,” Journal of Endodontia, vol. 38, no. 2, pp. 232–235, 2012.
View at: Publisher Site | Google Scholar
V. Ashwinkumar, J. Krithikadatta, S. Surendran, and N. Velmurugan, “Effect of reciprocating file motion on microcrack formation in root canals: an SEM study,” International Endodontic Journal, vol. 47, no. 7, pp. 622–627, 2014.
View at: Publisher Site | Google Scholar
I. Pop, A. Manoharan, F. Zanini, G. Tromba, S. Patel, and F. Foschi, “Synchrotron light-based μCT to analyse the presence of dentinal microcracks post-rotary and reciprocating NiTi instrumentation,” Clinical Oral Investigations, vol. 19, no. 1, pp. 11–16, 2015.
View at: Publisher Site | Google Scholar
K. T. Ceyhanli, N. Erdilek, İ. Tatar, and D. Celik, “Comparison of ProTaper, RaCe and Safesider instruments in the induction of dentinal microcracks: a micro-CT study,” International Endodontic Journal, vol. 49, no. 7, pp. 684–689, 2016.
View at: Publisher Site | Google Scholar
A. Jamleh, M. Nassar, A. Alfadley, S. Khan, K. Alfouzan, and C. Adorno, “Influence of additional apical enlargement on microcrack formation in root dentine: a micro-computed tomography investigation,” Clinical Oral Investigations, vol. 25, no. 6, pp. 4137–4143, 2021.
View at: Publisher Site | Google Scholar
M. M. Koçak, N. Y. Çirakoğlu, S. Koçak et al., “Effect of retreatment instruments on microcrack formation: a microcomputed tomography study,” The International Journal of Artificial Organs, vol. 40, no. 3, pp. 123–127, 2017.
View at: Publisher Site | Google Scholar
M. Çitak and T. Özyürek, “Effect of different nickel-titanium rotary files on dentinal crack formation during retreatment procedure,” Journal of Dental Research, Dental Clinics, Dental Prospects, vol. 11, no. 2, pp. 90–95, 2017.
View at: Publisher Site | Google Scholar
M. Jain, A. Singhal, A. Gurtu, and V. Vinayak, “Influence of ultrasonic irrigation and chloroform on cleanliness of dentinal tubules during endodontic retreatment-an invitro SEM study,” Journal Of Clinical And Diagnostic Research, vol. 9, no. 5, p. ZC11, 2015.
View at: Publisher Site | Google Scholar
S. Q. Tonelli, M. A. Antunes, K. M. S. de Toubes et al., “Dentinal microcracks induced by endodontic procedures: suggested design for experimental studies using micro-computed tomography and strain gauges,” Journal of Endodontia, vol. 47, no. 7, pp. 1157–1165, 2021.
View at: Publisher Site | Google Scholar
L. R. de Lima Aboud, B. C. dos Santos, R. T. Lopes, L. A. C. Viana, and M. F. Z. Scelza, “Effect of aging on dentinal crack formation after treatment and retreatment procedures: a micro-CT study,” Brazilian Dental Journal, vol. 29, no. 6, pp. 530–535, 2018.
View at: Publisher Site | Google Scholar
A. Braun, F. J. P. Hagelauer, J. Wenzler, M. Heimer, R. Frankenberger, and S. Stein, “Microcrack analysis of dental hard tissue after root canal irradiation with a 970-nm diode laser,” Photomedicine and Laser Surgery, vol. 36, no. 11, pp. 621–628, 2018.
View at: Publisher Site | Google Scholar
M. Fu, X. Huang, W. He, and B. Hou, “Effects of ultrasonic removal of fractured files from the middle third of root canals on dentinal cracks: a micro-computed tomography study,” International Endodontic Journal, vol. 51, no. 9, pp. 1037–1046, 2018.
View at: Publisher Site | Google Scholar
S. Taschieri, T. Testori, L. Francetti, and M. Del Fabbro, “Effects of ultrasonic root end preparation on resected root surfaces: SEM evaluation,” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. 98, no. 5, pp. 611–618, 2004.
View at: Publisher Site | Google Scholar
I. Tsenova-Ilieva, R. Vasileva, and E. Karova, “Damages to radicular dentin during root canal filling and retreatment procedures: analysis, evaluation methods and methodological issues,” International Journal of Science and Research (IJSR), vol. 7, pp. 524–533, 2018.
View at: Publisher Site | Google Scholar
I. D. Capar, G. Saygili, H. Ergun, T. Gok, H. Arslan, and H. Ertas, “Effects of root canal preparation, various filling techniques and retreatment after filling on vertical root fracture and crack formation,” Dental Traumatology, vol. 31, no. 4, pp. 302–307, 2015.
View at: Publisher Site | Google Scholar
A. Yilmaz, D. Helvacioglu-Yigit, C. Gur et al., “Evaluation of dentin defect formation during retreatment with hand and rotary instruments: a micro-CT study,” Scanning, vol. 2017, Article ID 4868603, 7 pages, 2017.
View at: Publisher Site | Google Scholar
J. Johnson, H. Abd-Elaal, T. Elsewify, W. El-Sayed, and B. Eid, “Evaluation of dentin microcracks after root canal instrumentation using three thermally treated rotary nickel titanium files,” Journal of International Dental and Medical Research, vol. 15, no. 2, pp. 511–515, 2022, https://web-s-ebscohost-com.ezproxy.uwc.ac.za/ehost/pdfviewer/pdfviewer?vid=1&sid=e527e35d-855a-42e7-8e9f-e65208c73bad%40redis.
View at: Google Scholar

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Copyright © 2022 Reem M. Barakat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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