“Comparative Evaluation of The Shaping Ability and Post-operative Pain after Preparation using Different Single File Systems”

Abstract

The efficient shaping of the root canals and maintaining their curvatures is an essential goal for every root canal treatment. However, an accurate prediction of the performance of endodontic files in the curved canals is not always achievable. The introduction of the new single file techniques is promising in providing efficient, safe and quick preparation with less time consuming and more comfortable to the patient, where minimizing the number of files used inside the root canals aims to reduce the procedural errors associated with these large sequences of files. However, how these new files behave inside the root canals usually requires thorough investigations. The aim of this study was to compare and evaluate the efficacy of different single file techniques in terms of shaping ability of the canal according to canal centering, canal transportation, change in canal volume, change in canal angle and radius of curvature, apical extrusion of debris after preparation with the four single-file systems, also the preparation time was recorded. The incidence and the intensity of post-operative in patients treated with these files was examined as well. The study was divided into two parts; the first part was carried on natural mandibular molar teeth (in vitro), while the second part was carried on endodontic patients with symptomatic irreversible pulpitis. In the first part; 80 canals of the mesial root of mandibular molars were included in the study. After cleaning the teeth from any deposits, access cavity preparations were prepared. The teeth were scanned using Micro-CT before canal preparation. The canals were then dived into four groups according to the single-file system used; WaveOne Gold files, RECIPROC Blue files, HyFlex EDM files and One Shape files. Each file prepared four canals then the file was discarded. Saline was used as irrigating solution. The teeth were placed in special glass vials for the collection of the extruded debris apically that were weighted before and after preparation to record the quantity of extruded debris. The time taken by each file type to reach the full working length was recorded. The teeth were the scanned again with Micro-CT for the post-instrumentation records. The data from the pre- and post-instrumentation scans were recorded, tabulated, compared and statistically analyzed using one‑way analysis of variance (ANOVA) with the level of significance set at  = 0.05.