Document Type

Article

Publication Date

2024

Abstract

Objective: to evaluate different approaches (ultrasonic troughing, and trephine bur

with extractors) to manage separated endodontic instruments.

Methods and Materials: A block of wax containing mandibular molars were

scanned to get preoperative CBCT to select a total number of 32 mandibular molars

that were later divided into two groups (n=16) according to file retrieval procedure:

Group (A) (control group): the broken segment was retrieved by ET-25 ultrasonic

tips, Group (B): the broken segment was retrieved by micro-extractor (Zumax

retrieval kit). Traditional endodontic access cavity was created, orifice opener was

used to make coronal third enlargement up to 4mm of the cervical root, glide path

is ensured up to file #20/.02, shaping of the canal was made up to file #20.04 and

cleaning of the canal was achieved using sodium hypochlorite 5.25% for one minute

between each file. A 2nd CBCT was made before file breakage and the sample was

mounted at the same place in the wax block. 5mm apical to the canal orifice, the

apical 4-mm of a size 25/.04 NiTi instrument with was intentionally fractured in the

mesiobuccal canal. A 3rd CBCT was made to confirm the location of the broken

instrument in the canal while the sample remained in the same position in the wax

block. Staging platform was created using dental microscope, Gates Glidden burs

size (1,2,3) and modified Gates Glidden (no.3). The broken segments were

subjected to the retrieval procedures assigned for each group and the specimens

were scanned to get postoperative CBCT. The 2nd CBCT and the postoperative

CBCT were constructed on a (software) to measure canal volume changes,

efficiency and practicality of each method.

Results: regarding canal volume change, results showed no statistically significant

difference between file retrieval techniques whether ultrasonic or zumax. The

highest mean value was recorded by Group A ultrasonic group 37.5610 ± 11.64880

in Comparison to Group B Zumax which recorded a mean value of 36.5370 ±

12.79829 at the p-value level set at 0.05*. Regarding efficiency, this study showed

that instrument retrieval attempts using ultrasonic technique is more efficient than

zumax instrument retrieval kit. Regarding practicality, results showed a statistically

significant difference between ultrasonic and zumax measurements with p-value set

at 0.000000003. The mean of the Ultrasonic group was 30.2000 ± 0.9613 while the

zumax group recorded a higher. Mean of 40.6000 ± 0.5251

Conclusion: micro trepan technique made more changes in canal volume than

ultrasonic technique.

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