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Influence of additional apical enlargement on microcrack formation in root dentine: a micro-computed tomography investigation

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Abstract

Objectives

To assess the effect of additional apical enlargement using nickel titanium (NiTi) instruments on the incidence of microcracks using micro-computed tomographic analysis.

Materials and methods

Fifty-one premolars with single canals were enlarged to ProTaper Gold (PTG) F2 (25/08) (Dentsply Sirona), ProFile Vortex Blue (VB) 25/06 (Dentsply Tulsa), or WaveOne Gold (WOG) primary (25/07) (Dentsply Sirona) NiTi rotary instruments (n = 17 each). Afterward, additional apical enlargement was performed in each group with its corresponding larger instrument (F3 (30/09), VB 30/06, or WOG Medium (35/06) instruments, respectively). All teeth were imaged with micro-computed tomography before canal enlargement and after initial and additional apical enlargements to detect new microcracks at the apical 5 mm. An Aligned Rank Transform ANOVA was conducted to examine the effects of file type and canal enlargement on the number of new microcracks resulting from enlargement. A Kruskal-Wallis test was run to compare the file types at each canal enlargement stage.

Results

A significant main effect (P = 0.026) of canal enlargement on the number of new microcracks was found; the number of apical microcracks found after additional enlargement was significantly greater than baseline (P = 0.021); no significant difference was found between baseline and initial enlargement (P = 0.506) and between initial enlargement and additional enlargement (P = 0.252). The Kruskal-Wallis tests found no difference between file types at baseline (P = 0.348), after initial enlargement (P = 0.369) or additional enlargement (P = 0.133).

Conclusions

Regardless of the instrumentation system used, additional apical enlargement led to the formation of high number of new microcracks.

Clinical significance

The results indicated that additional enlargement induced significant number of apical microcracks.

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Funding

This work was supported by a research grant (RC15/027/R) from King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.

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Authors and Affiliations

  1. Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia

    Ahmed Jamleh, Abdulmohsen Alfadley, Sulthan Khan & Khalid Alfouzan

  2. King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Saudi Arabia

    Ahmed Jamleh, Abdulmohsen Alfadley, Sulthan Khan & Khalid Alfouzan

  3. Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates

    Mohannad Nassar

  4. Endodontics and Research Methodology, School of Dentistry, National University of Asuncion, Asuncion, Paraguay

    Carlos Adorno

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  1. Ahmed Jamleh
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  2. Mohannad Nassar
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  3. Abdulmohsen Alfadley
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  4. Sulthan Khan
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  5. Khalid Alfouzan
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  6. Carlos Adorno
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Correspondence to Ahmed Jamleh.

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Jamleh, A., Nassar, M., Alfadley, A. et al. Influence of additional apical enlargement on microcrack formation in root dentine: a micro-computed tomography investigation. Clin Oral Invest 25, 4137–4143 (2021). https://doi.org/10.1007/s00784-020-03745-z

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  • DOI: https://doi.org/10.1007/s00784-020-03745-z

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