Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies

Silva Emmanuel João Nogueira Leal,Pinto Karem Paula,Ajuz Natasha C.,Sassone Luciana Moura 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.3

Objectives This study aimed to analyze the main features of the 25 most-cited articles in minimally invasive access cavities. Materials and Methods An electronic search was conducted on the Clarivate Analytics' Web of Science ‘All Databases’ to identify the most-cited articles related to this topic. Citation counts were cross-matched with data from Elsevier's Scopus and Google Scholar. Information about authors, contributing institutions and countries, year and journal of publication, study design and topic, access cavity, and keywords were analyzed. Results The top 25 most-cited articles received a total of 572 (Web of Science), 1,160 (Google Scholar) and 631 (Scopus) citations. It was observed a positive significant association between the number of citations and age of publication (r = 0.6907, p < 0.0001); however, there was no significant association regarding citation density and age of publication (r = −0.2631, p = 0.2038). The Journal of Endodontics made the highest contribution (n = 15, 60%). The United States had the largest number of publications (n = 7) followed by Brazil (n = 4), with the most contributions from the University of Tennessee and Grande Rio University (n = 3), respectively. The highest number of most-cited articles were ex vivo studies (n = 16), and ‘fracture resistance’ was the major topic studied (n = 10). Conclusions This study revealed a growing interest for researchers in the field of minimally invasive access cavities. Future trends are focused on the expansion of collaborative networks and the conduction of laboratory studies on under-investigated parameters. Objectives This study aimed to analyze the main features of the 25 most-cited articles in minimally invasive access cavities. Materials and Methods An electronic search was conducted on the Clarivate Analytics' Web of Science ‘All Databases’ to identify the most-cited articles related to this topic. Citation counts were cross-matched with data from Elsevier's Scopus and Google Scholar. Information about authors, contributing institutions and countries, year and journal of publication, study design and topic, access cavity, and keywords were analyzed. Results The top 25 most-cited articles received a total of 572 (Web of Science), 1,160 (Google Scholar) and 631 (Scopus) citations. It was observed a positive significant association between the number of citations and age of publication (r = 0.6907, p < 0.0001); however, there was no significant association regarding citation density and age of publication (r = −0.2631, p = 0.2038). The Journal of Endodontics made the highest contribution (n = 15, 60%). The United States had the largest number of publications (n = 7) followed by Brazil (n = 4), with the most contributions from the University of Tennessee and Grande Rio University (n = 3), respectively. The highest number of most-cited articles were ex vivo studies (n = 16), and ‘fracture resistance’ was the major topic studied (n = 10). Conclusions This study revealed a growing interest for researchers in the field of minimally invasive access cavities. Future trends are focused on the expansion of collaborative networks and the conduction of laboratory studies on under-investigated parameters.

Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques

Emmanuel João Nogueira Leal Silva,Felipe Gonçalves Belladonna,Marianna Fernandes Carapiá,,Brenda Leite Muniz,Mariana Santoro Rocha,Edson Jorge Lima Moreira 대한치과보존학회 2018 Restorative Dentistry & Endodontics Vol.43 No.1

Objectives This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated. Materials and Methods Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded. Results Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups. Conclusions Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study

da Silva Emmanuel João Nogueira Leal,de Moura Sara Gomes,de Lima Carolina Oliveira,Barbosa Ana Flávia Almeida,Misael Waleska Florentino,Lacerda Mariane Floriano Lopes Santos,Sassone Luciana Moura 대한치과보존학회 2021 Restorative Dentistry & Endodontics Vol.46 No.2

Objectives: The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods: Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results: No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions: All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.

Does minimally invasive canal preparation provide higher fracture resistance of endodontically treated teeth? A systematic review of in vitro studies

Usta Sıla Nur,Silva Emmanuel João Nogueira Leal,Falakaloğlu Seda,Gündoğar Mustafa 대한치과보존학회 2023 Restorative Dentistry & Endodontics Vol.48 No.4

This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the “PubMed, Web of Science, and Scopus” databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.

Influence of access cavity design on calcium hydroxide removal using different cleaning protocols: a confocal laser scanning microscopy study

Falakaloğlu Seda,Yeniçeri Özata Merve,Güneş Betül,Silva Emmanuel João Nogueira Leal,Gündoğar Mustafa,Güçyetmez Topal Burcu 대한치과보존학회 2023 Restorative Dentistry & Endodontics Vol.48 No.3

Objectives The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex. Objectives The purpose of this study was to evaluate the influence of endodontic access cavities design on the removal of calcium hydroxide medication of the apical third of mandibular incisor root canal walls and dentinal tubules with different cleaning protocols: EDDY sonic activation, Er,Cr:YSGG laser-activated irrigation, or conventional irrigation with IrriFlex. Materials and Methods Seventy-eight extracted human mandibular incisors were assigned to 6 experimental groups (n = 13) according to the endodontic access cavity and cleaning protocol for calcium hydroxide removal: traditional access cavity (TradAC)/EDDY; ultraconservative access cavity performed in the incisal edge (UltraAC.Inc)/EDDY; TradAC/Er,Cr:YSGG; UltraAC.Inc/Er,Cr:YSGG; TradAC/IrriFlex; or UltraAC.Inc/IrriFlex. Confocal laser scanning microscopy images were used to measure the non-penetration percentage, maximum residual calcium hydroxide penetration depth, and penetration area at 2 and 4 mm from the apex. Data were statistically analyzed using Shapiro-Wilk and WRS2 package for 2-way comparison of non-normally distributed parameters (depth of penetration, area of penetration, and percentage of non-penetration) according to cavity and cleaning protocol with the significance level set at 5%. Results The effect of cavity and cleaning protocol interactions on penetration depth, penetration area and non-penetration percentage was not found statistically significant at 2 and 4 mm levels (p > 0.05). Conclusions The present study demonstrated that TradAC or UltraAC.Inc preparations with different cleaning protocols in extracted mandibular incisors did not influence the remaining calcium hydroxide at 2 and 4 mm from the apex.

Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis

Weissheimer Theodoro,Pinto Karem Paula,da Silva Emmanuel João Nogueira Leal,Hashizume Lina Naomi,da Rosa Ricardo Abreu,Só Marcus Vinicius Reis 대한치과보존학회 2023 Restorative Dentistry & Endodontics Vol.48 No.4

This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, −271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, −36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

Evaldo Rodrigues,Antônio Henrique Braitt,Bruno Ferraz Galvão,Emmanuel João Nogueira Leal da Silva 대한치과보존학회 2017 Restorative Dentistry & Endodontics Vol.42 No.1

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

Push-out bond strength of a self-adhesive resin cement used as endodontic sealer

Eduardo Diogo Gurgel-Filho,Felipe Coelho Lima,Vicente de Paula Aragão Saboia,Tauby de Souza Coutinho-Filho,Aline de Almeida Neves,Emmanuel João Nogueira Leal da Silva 대한치과보존학회 2014 Restorative Dentistry & Endodontics Vol.39 No.4

Objectives: The aim of the present study was to investigate the bond strength of RelyX Unicem (3M) to root canal dentin when used as an endodontic sealer. Materials and Methods: Samples of 24 single-rooted teeth were prepared with Gates Glidden drills and K3 files. After that, the roots were randomly assigned to three experimental groups (n = 8) according to the filling material, (1) AH Plus (Dentsply De Trey GmbH)/ Gutta-Percha cone; (2) Epiphany SE (Pentron)/Resilon cone; (3) RelyX Unicem/Gutta- Percha cone. All roots were filled using a single cone technique associated to vertical condensation. After the filling procedures, each tooth was prepared for a push-out bond strenght test by cutting 1 mm-thick root slices. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey test for multiple comparisons were used to compare the results among the experimental groups. Results: Epiphany SE/Resilon showed significantly lower pushout bond strength than both AH Plus/Gutta-Percha and RelyX Unicem/Gutta-Percha (p < 0.05). There was no significant difference in bond strength between AH Plus/Gutta- Percha and RelyX Unicem/Gutta-Percha (p > 0.05). Conclusions: Under the present in vitro conditions, bond strength to root dentin promoted by RelyX Unicem was similar to AH Plus. Epiphany SE/Resilon resulted in lower bond strength values when compared to both materials.

Intraoperative discomfort associated with the use of a rotary or reciprocating system: a prospective randomized clinical trial

Aline Cristine Gomes,Adriana Jesus Soares,Erick M Souza,Alexandre Augusto Zaia,Emmanuel João Nogueira Leal Silva 대한치과보존학회 2017 Restorative Dentistry & Endodontics Vol.42 No.2

Objectives: The aim of this randomized, controlled, prospective clinical study was to evaluate patients’ intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used. Materials and Methods: Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from ‘least possible discomfort’ (1) to ‘greatest possible discomfort’ (10). The Wilcoxon signed-rank test was used to determine significant differences at p < 0.05. Results: Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660). Conclusions: Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients’ intraoperative discomfort.