Elsevier

Journal of Endodontics

Volume 36, Issue 10, October 2010, Pages 1693-1697
Journal of Endodontics

Basic Research
Scanning Electron Microscopic Analysis of the Integrity of the Root-end Surface after Root-end Management Using a Piezoelectric Device: A Cadaveric Study

https://doi.org/10.1016/j.joen.2010.06.028Get rights and content

Abstract

Introduction

The introduction of piezoelectric instruments in endodontic surgery allowed clinicians to manage the bone tissue with precision reducing the risk of damaging soft tissues. Although such instruments can also be used to prepare root-end cavity, few information is available on the effect of piezosurgery on dentine. This cadaveric study investigated the integrity of root apices after root-end cavity preparation by piezoelectric instruments at different device settings.

Methods

Fifty maxillary anterior teeth underwent endodontic treatment and apical resection in situ. Ten teeth were used as control. Retrograde cavities were prepared in 40 teeth (10 per group). In three groups, the piezoelectric device was set at constant vibration mode (CV), and three power levels were used. In another experimental group (n = 10), vibration + pulsation mode (VP) was selected, and low power was used. Each root was duplicated and analyzed by scanning electron microscopy for the presence of cracks and marginal chipping.

Results

The number of cracks was significantly higher in the VP group, whereas no significant difference was found among CV groups. No difference between groups was found for crack type. The VP group showed a significantly poorer quality of cavity margin respect to the CV groups.

Conclusion

Constant vibration mode is recommended for retrograde preparation with piezosurgery.

Section snippets

Material and Methods

Sixty monoradicular teeth deriving from 20 fresh human cadavers were eligible. The subjects had donated their body for research purpose. The age range was 47 to 87 (mean, 56) years with equal sex distribution. The study obtained ethical approval from the Department of Anatomy, Faculty of Medicine René Descartes, University of Paris 5, Paris, France.

Teeth were excluded in the presence of restoration, root filling, tooth cracking, or root fracture assessed by transillumination and radiographs.

Results

Table 1 summarizes the results of the scanning electron microscopic evaluation.

Discussion

Endodontic surgery outcomes improved in the recent years because of the adoption of microsurgical instruments, which permit a better management of the root end 28, 29. It is unknown if root-end alterations induced by retro tips affect the clinical outcome, yet, any approach for minimizing adverse effects like cracks should be considered. The introduction of piezoelectric devices using various tip vibration patterns prompted the present investigation.

Acknowledgments

The authors wish to thank Professor JF Gaudy and his staff from the Department of Cranial Cervicofacial Anatomy, University of Paris 5, Paris, France, for guidance and cadavers preparation; and Mr Dario Picenoni and Gabriele Candiani, Department of Chemistry, Materials and Chemical Engineering “Giulio Natta,” Politecnico di Milano, Italy, for assistance in the scanning electron microscopic analysis.

References (35)

Cited by (19)

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