Rasterelektronenmikroskopische Untersuchung zur Aufbereitungsqualität von Wurzelkanälen nach Instrumentierung mit reziproken und vollrotierenden Wurzelkanalinstrumenten

Endodontic treatment focuses on the preservation of the infected tooth. Ensuring this permanently, the tooth has to be cleaned by chemical and mechanical means. The mechanical treatment can be done by hand or mechanical driven endodontic instruments. To compare the four mechanical driven endodontic preparation systems ProTaper, WaveOne, Reciproc and SafeSider, referring to the cleaning quality with special regards on the different types of motion pattern (rotating, reciprocating, and oscillating) and the assembling of the various systems (single-file or multiple-file system) as well as on the time needed to prepare the root canal, was the aim of this study. Revising it, 60 teeth with curved root canals were cleaned by the 4 different types of instruments. Chemo-mechanical preparation was performed using flushes of distilled water, EDTA, and NaOCl. The teeth were x-rayed before and after the preparation to be able to show and compare variations of the root canal anatomy. Then the teeth were split alongside the longitudinal axis of the curvature and observed with scanning electron microscope referring to the smear layer, the debris and the condition of the root canal wall by different scoring systems. The analysis of the different parameters showed significant disparities of the 4 systems, comparing the time needed to prepare the root canal, the difference of the angle of curvature before and after treatment, the smear layer and the debris (p<0,05). WaveOne, a single-file reciprocating system, showed brilliant performance and worked out as well as the ProTaper rotating instruments, even better in some aspects. The Reciproc instruments appeared to be slightly inferior to ProTaper and WaveOne. The SafeSider instruments showed the least sufficient cleaning. Therefore, the WaveOne preparation system can be regarded as an acceptable option in preparing the curved root canal in reciprocating motion.