Special Issue "Innovative Techniques in Endodontics"

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry".

Deadline for manuscript submissions: 15 October 2021.

Special Issue Editor

Prof. Dr. Luca Testarelli
Website
Guest Editor
Department or Oral and Maxillo-Facial Sciences, Sapienza University, 00161 Rome, Italy
Interests: endodontics; restorative dentistry; oral surgery; dental implantology; prosthetics; digital dentistry; 3D radiology; TC cone beam; digital navigation in dentistry

Special Issue Information

Dear Colleagues,

It is a pleasure for me to introduce this Special Issue in the field of endodontics. Researchers are invited to submit their works.

Endodontics can be considered one of the most challenging disciplines in the field of dentistry: Experiencing difficulties during root canal treatment is common, and the breakage of an instrument, the missing of a canal, and the presence of any sort of obstacle interfering with the progression to the apex could lead to failure of the treatment.

Today, many innovations have been made in endodontics, from the intrinsic quality of the modern endodontic instruments which are more resistant to fracture, more flexible and efficient, to the production of even more safe torque-controlled motors with revolutionary kinematics that can avoid cyclical and torsional failure of the instruments.

This Special Issue is focused on innovating strategies for the diagnosis and clinical approach to the endodontic patient, including three-dimensional assessment of the pathologic conditions and the anatomical aspects of the endodontic space, and the development of new types of instrument and usage, with particular reference to thermal treatment and geometrical designs.

The definition of innovative strategies to approach the root canal system also includes computer-aided endodontics, with the development of specific software that could help clinicians to reach their goals and avoid iatrogenic damage to the important structures of the tooth.

Original articles, case reports, and reviews in the field of endodontics, which aim to enrich scientific knowledge and help not only clinicians, but also researchers involved in the development of new alloys, instruments, motors, and medicaments, are warmly welcome.

Prof. Dr. Luca Testarelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Endodontics;
  • Regenerative endodontics;
  • Restorative dentistry;
  • Endodontic radiology;
  • Endodontic instrumentarium;
  • Endodontic anatomy;
  • Software-guided endodontics;
  • Cone beam computed tomography;
  • Nuclear magnetic resonance;
  • Endodontic irrigants;
  • Endodontic medicaments;
  • Root canal treatment;
  • Cyclic fatigue investigation;
  • Torque investigation;
  • Endodontic motors;
  • Apex locators;
  • Fractured instrument removal;
  • Endodontic retreatment

Published Papers (8 papers)

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Research

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Open AccessArticle
A New Device to Test the Bending Resistance of Mechanical Endodontic Instruments
Appl. Sci. 2020, 10(20), 7215; https://doi.org/10.3390/app10207215 - 16 Oct 2020
Cited by 1
Abstract
The aims of the present study were to propose a new machine for testing the bending behavior of an instrument at multiple specific points along the cutting surface and to compare the influence of proprietary heat treatment on the bending ability of EdgeTaper [...] Read more.
The aims of the present study were to propose a new machine for testing the bending behavior of an instrument at multiple specific points along the cutting surface and to compare the influence of proprietary heat treatment on the bending ability of EdgeTaper (ET), Protaper Universal (PTU), EdgeTaper Platinum (ETP), and Protaper Gold (PTG). A total of 320 instruments were examined in the present study: 80 ET, 80 PTU, 80 ETP, and 80 PTG. The bending ability of all instruments was tested at a 45° angle and on three different portions of the instrument at 3, 6, and 9 mm from the tip using a customized device. Statistical analysis showed significant differences among each single instrument of the series and between ET and PTU as well as ETP and PTG. The bending behavior of a nickel–titanium rotary instrument is its ability to bend without any plastic deformation. This feature, according to the results of the present study, is variable along the cutting surface; therefore, it should be evaluated. Due to the present testing device, it would be possible to obtain reliable and trustworthy information about an instrument’s bending ability. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Open AccessArticle
Assessment of Real-Time Operative Torque during Nickel–Titanium Instrumentation with Different Lubricants
Appl. Sci. 2020, 10(18), 6201; https://doi.org/10.3390/app10186201 - 07 Sep 2020
Cited by 5
Abstract
The aim of the present study is twofold: to assess ex vivo the role of different lubricants on real-time torque generated during intracanal instrumentation and to check whether two different kinds of torque parameters, operative torque (OT) and average peak torque (APT), could [...] Read more.
The aim of the present study is twofold: to assess ex vivo the role of different lubricants on real-time torque generated during intracanal instrumentation and to check whether two different kinds of torque parameters, operative torque (OT) and average peak torque (APT), could produce similar results. Forty extracted single-rooted teeth were selected for the present study and divided into four equal groups (n = 10): Group A, NaCl 0.2%; Group B, NaOCl 5%; Group C, ethylenediaminetetraacetate (EDTA), and Group D, EDTA and hydrogen peroxide. Afterwards, Edge Taper F2 (Edge Endo, Albuquerque, New Mexico) were rotated clockwise at 300 rpm with 3 Ncm maximum torque by an endodontic torque recording motor. In each sample, mean OT and mean APT were recorded and statistically analyzed with one-way ANOVA and a post hoc Bonferroni between groups (p < 0.05). EDTA (12.11 ± 4.45 Ncm) showed statistically significant (p < 0.05) lower values compared with the other tested irrigant for both parameters. Overall, the two different parameters were both able to differentiate between the influence of lubricants on torsional loads. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Open AccessArticle
Influence of Different Heat Treatments on Torsional and Cyclic Fatigue Resistance of Nickel–Titanium Rotary Files: A Comparative Study
Appl. Sci. 2020, 10(16), 5604; https://doi.org/10.3390/app10165604 - 13 Aug 2020
Cited by 2
Abstract
Protaper Universal (PTU), Protaper Gold (PTG) (Maillefer, Ballaigues, CH), EdgeTaper (ET), and EdgeTaper Platinum (ETP) (Albuquerque, NM, USA) were tested for both torsional and flexural resistance. The aim of the present study was to evaluate the influence of proprietary heat treatment on the [...] Read more.
Protaper Universal (PTU), Protaper Gold (PTG) (Maillefer, Ballaigues, CH), EdgeTaper (ET), and EdgeTaper Platinum (ETP) (Albuquerque, NM, USA) were tested for both torsional and flexural resistance. The aim of the present study was to evaluate the influence of proprietary heat treatment on the metallurgical properties of the aforementioned instruments. Four groups of 30 different instruments (size 20.07) were tested, then divided into two subgroups of 15 instruments—one for the cyclic fatigue test in a curved canal (90°—2 mm radius) at 300 rpm and 2.5 Ncm. The time to fracture (TtF) and fragment length (FL) were recorded. The other subgroup was subjected to the torsional test (300 rpm, 5.5 Ncm). The torque to fracture and TtF were recorded. All the instruments underwent a SEM analysis. The heat-treated instruments showed a significantly higher fatigue resistance than the non-heat-treated instruments (p < 0.05). No significant differences were found in the torsional resistance between the ET and PTU, and the ETP and PTG. However, when comparing all the groups, the heat-treated instruments showed less torsional resistance. The improvement from heat treatment was mainly found in the cyclic fatigue resistance. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Open AccessArticle
Evaluation of Cross-Sectional Root Canal Shape and Presentation of New Classification of Its Changes Using Cone-Beam Computed Tomography Scanning
Appl. Sci. 2020, 10(13), 4495; https://doi.org/10.3390/app10134495 - 29 Jun 2020
Cited by 1
Abstract
The root canal system is considering the most important factor in endodontic treatment, due to the complexity of its anatomy and morphology. The aim of this study was to evaluate the cross-sectional root canal shape in three thirds (coronal, middle, apical) in different [...] Read more.
The root canal system is considering the most important factor in endodontic treatment, due to the complexity of its anatomy and morphology. The aim of this study was to evaluate the cross-sectional root canal shape in three thirds (coronal, middle, apical) in different age groups using cone-beam computed tomography scanning (CBCT) and to present a new classification for root canal shape changes. This cross-sectional study included 300 CBCT scans for patient aged 20–70, and these scans were evaluated to study the morphology of the cross-sectional root canal shape in coronal, middle, and apical thirds among three age groups, namely the young (20–44), middle (45–59), and elderly (60–70). The root canal shape was classified as round, oval, long oval, and ribbon (with or without isthmus). The cross-sectional root canal shape was identified in two groups: canals with an unchanging (constant) shape and canals with changing shape. In turn, in canals with changing shape, the change could be identified in the region of the middle or apical thirds of the canal. The results showed that root canal shape changes in two cases: (1) the presence of one or more canals in the root (with or without isthmus between them), and (2) with age, as it was observed that the cross-sectional shape of the root canal becomes round in the apical third with age. A new classification of the changes of root canal shape in three thirds (coronal, middle, apical) was presented in this study. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Open AccessArticle
Digital Design of Minimally Invasive Endodontic Access Cavity
Appl. Sci. 2020, 10(10), 3513; https://doi.org/10.3390/app10103513 - 19 May 2020
Cited by 2
Abstract
New minimally invasive endodontic cavities have been described and proposed to preserve dentin (and enamel) through strategic access, including point endodontic access cavity (PEAC). There is no consensus to what extent PEAC contributes to tooth’s resistance to fracture, because there is no agreement [...] Read more.
New minimally invasive endodontic cavities have been described and proposed to preserve dentin (and enamel) through strategic access, including point endodontic access cavity (PEAC). There is no consensus to what extent PEAC contributes to tooth’s resistance to fracture, because there is no agreement on how PEAC should be performed. The purpose of the present study is to describe and classify four different types of PEACs and to examine if a dynamic navigation system /DNS) could allow planning and precisely executing these cavities in vitro. Forty TrueTooth TM Replica # 3-001 models, were randomly divided into four identical groups of ten and scanned using a cone bean computed tomography (OP-Maxio 300, Instrumentarium-Kavo, Finland). Then, four different access cavities were planned and performed by using DNS (Navident dynamic navigation system, ClaroNav, Toronto, ON, Canada). For each tooth, a different PEAC was designed to obtain endodontic access to the main mesio-buccal canal (MB1), resulting in a different location of the entry point on the occlusal surface of the tooth. Precision was evaluated by comparing deviation in the inclinations between the planned and real cavity. Data were recorded and statistically analyzed. DNS allowed preparation of minimally invasive “straight line” cavities, with some differences in the accuracy. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Open AccessArticle
Torque Range, a New Parameter to Evaluate New and Used Instrument Safety
Appl. Sci. 2020, 10(10), 3418; https://doi.org/10.3390/app10103418 - 15 May 2020
Cited by 3
Abstract
The aim of the present study is to evaluate operative torque, torque at failure and the difference between these two values—the “torque range”—of two different NiTi files. We also sought to evaluate and compare these parameters for new and used files. Forty S-One [...] Read more.
The aim of the present study is to evaluate operative torque, torque at failure and the difference between these two values—the “torque range”—of two different NiTi files. We also sought to evaluate and compare these parameters for new and used files. Forty S-One 20.06 and forty M-Two 20.06 were tested, divided in four equal groups (n = 10) for each brand. Ten instruments from each brand performed three root canal treatments each on standardized extracted single-rooted teeth. Afterwards, each group was subjected to the following two tests: operative torque and torsional resistance. Mean values for all the tested groups were calculated. The results for new instruments showed that S-One developed significantly higher operative torque, but higher torsional resistance. The results for used instruments showed that the S-One 20.06 developed less operative torque and higher mean torsional resistance value compared to the M-Two. Moreover, the percentage reduction of both values was significantly higher for M-Two. The results of the present study showed a safer torsional behavior of the S-One. These results could be related to the heat treatment and the manufacturing process. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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Review

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Open AccessReview
A Review of Guidelines for Antibiotic Prophylaxis before Invasive Dental Treatments
Appl. Sci. 2021, 11(1), 311; https://doi.org/10.3390/app11010311 - 30 Dec 2020
Abstract
Bacteraemia associated with invasive dental treatments can propagate infective endocarditis in high-risk cardiac patients. Over the past decade, antibiotic prophylaxis before dental treatment has been questioned. This review aims to compare the variations between the UK, European and American antibiotic prophylaxis guidelines before [...] Read more.
Bacteraemia associated with invasive dental treatments can propagate infective endocarditis in high-risk cardiac patients. Over the past decade, antibiotic prophylaxis before dental treatment has been questioned. This review aims to compare the variations between the UK, European and American antibiotic prophylaxis guidelines before dental treatments. Antibiotic prophylaxis guidelines by the National Institute for Health and Care Excellence (NICE)—Clinical Guideline 64, Scottish Dental Clinical Effectiveness Programme (SDCEP), American Heart Association (AHA), European Society of Cardiology (ESC), European Society of Endodontology (ESE) and Belgian Health Care Knowledge Centre (KCE) position statements were compared regarding the indications, high-risk patients and prophylaxis regimens before dental treatments. In the United Kingdom, the NICE—Clinical Guideline 64 and SDCEP—Implementation Advice do not advise the prescription of prophylactic antibiotics for the majority of high-risk cardiac patients undergoing routine dental treatments. On the contrary, the AHA, ESC and KEC recommend the prescription of antibiotics prior to invasive dental procedures in high-risk cardiac individuals. The ESE also indicates prophylaxis before endodontic procedures for patients with other conditions, including impaired immunologic function, prosthetic joint replacement, high-dose jaw irradiation and intravenous bisphosphonates. Among these guidelines, there are variations in antibiotic prophylaxis regimens. There are variations regarding the indications and antibiotic prophylaxis regimens before invasive dental treatments among these available guidelines. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)

Other

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Open AccessCase Report
Print and Try Technique: 3D-Printing of Teeth with Complex Anatomy a Novel Endodontic Approach
Appl. Sci. 2021, 11(4), 1511; https://doi.org/10.3390/app11041511 - 08 Feb 2021
Abstract
The purpose of this report is to evaluate the applicability of a novel Print and Try technique in the presence of aberrant endodontic anatomies and to achieve a predictable treatment with improved outcome. According to guidelines, cone beam computed tomography (CBCT) is recommended [...] Read more.
The purpose of this report is to evaluate the applicability of a novel Print and Try technique in the presence of aberrant endodontic anatomies and to achieve a predictable treatment with improved outcome. According to guidelines, cone beam computed tomography (CBCT) is recommended in the presence of complex anatomies. The volumes were utilized to produce a stereo lithographic (STL) file, from which a 3D-plastic tooth model including a hollow root canal system was obtained. The 3D-patient-specific model facilitates the treatment planning and the trial of therapeutic approaches. Using a transparent material, all the treatment steps could be directly visualized. Subsequently, endodontic therapy could be performed in vivo with reduced operating time and with a better overview. Clinicians benefit from the Print and Try technique when facing a complicated root canal system with reduced stress and higher chances of success. In aberrant endodontic anatomies, the use of a transparent 3D plastic model, derived from the CBCT dicom, provides an exact preview of clinical challenges that will be met intra-operatively. A patient centered tailored approach to shaping, cleaning, and filling strategies can be applied. Full article
(This article belongs to the Special Issue Innovative Techniques in Endodontics)
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