An in vitro study comparing root-end cavities prepared by diamond-coated and stainless steel ultrasonic retrotips.
OBJECTIVE
This study compared the appearance of root-end cavity preparations and the time required to prepare them using prototype ultrasonic diamond-coated (DC) and stainless-steel (SS) retrotips.


METHODS
In 12 maxillary and 12 mandibular molar teeth 48 root-end cavities were prepared ultrasonically in the palatal, mesio-buccal, distal and mesial root-ends using DC and SS retrotips, alternately. Replicas of the resected root tips and the root-end cavities were examined under a scanning electron microscope (SEM), recording (i) incidence and extent of dentine cracks (ii) minimum remaining thickness of the dentine walls and (iii) surface quality of the resected root-ends. The time taken to complete the preparation was also recorded. Means of these parameters were compared for both types of retrotips using nonparametric tests.


RESULTS
No resected root-ends had cracks before preparation. However, after preparation one root-end cavity shaped by an SS retrotip had a microcrack visible at 23x magnification. Four and seven other root-ends had crazed surfaces in the DC and SS groups, respectively (P > 0.05). Remaining minimum dentine thickness was 0.56 +/- 0.28 mm and 0.71 +/- 0.24 for the DC and SS groups, respectively, and this difference was significant (P < 0.05). A root-end cavity in one specimen in the DC group was perforated. Preparation times ranged from 25 s to 361 s and were significantly lower for DC tips (P < 0.01) than the SS tips. The time required to prepare root-end cavities also differed between roots; root-end preparation in mandibular molars was more time consuming.


CONCLUSIONS
A better quality surface was produced by the prototype diamond-coated retrotips, in less time than the SS retrotips, which in turn caused fewer cracks than previously reported. DC retrotips removed more dentine than SS retrotips and should therefore be used with care to avoid overpreparation or perforation.
Peters
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CI
Endodontic Division, Department of Preventive Dentistry, Cariology and Periodontology, University of Zurich, Plattenstr. 11, CH-8028 Zurich, Switzerland. c.peters@zzmk.unizh.ch
Peters
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OA
Barbakow
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F
D001047:Apicoectomy / Q000295:instrumentation* / Q000379:methods; D003804:Dentin / Q000648:ultrastructure; D018130:Diamond; D004867:Equipment Design; D006801:Humans; D015994:Incidence; D008855:Microscopy, Electron, Scanning; D008963:Molar; D016628:Replica Techniques; D018915:Root Canal Preparation / Q000295:instrumentation* / Q000379:methods; D013193:Stainless Steel; D018709:Statistics, Nonparametric; D013499:Surface Properties; D013997:Time Factors; D019227:Tooth Apex / Q000648:ultrastructure*; D014092:Tooth Root / Q000648:ultrastructure*; D014464:Ultrasonic Therapy / Q000295:instrumentation* / Q000379:methods
D013193:Stainless Steel; D018130:Diamond