Efficacy of LA Axxess burs, Gates Glidden drills and Protaper Sx in obtaining straight line access in mesiobuccal roots of mandibular first molars: A cone-beam computed tomography assessment

ABSTRACT

Objective: This study aims at cone-beam computed tomography (CBCT) evaluation of the ability of Gates Glidden (GG) drills, Protaper Sx, and LA Axxess burs to produce a straight line access (SLA) in mesiobuccal canals of mandibular first molars. Methodology: Forty-five freshly extracted mandibular teeth with a canal curvature of 10-20° were taken for the study and divided into three groups according to the instruments used for cervical preflaring: Group I (LA Axxess burs), Group II (GG drills), and Group III (Protaper Sx). Pre- and post-instrumentation CBCT images were evaluated for comparing the ability of GG drills, Protaper Sx and LA Axxess burs to produce an SLA in mesiobuccal canals of mandibular first molars. Results: There was no significant change (P = 0.06) in the angle in the preSLA images of LA Axxess Group I (12.37 ± 1.01), GG Group II (13.39 ± 1.74), and Protaper Sx Group III (13.90 ± 1.74). The mean decrease in the angle from preSLA to postSLA was significant for all the three groups (P = 0.0001). However, the mean change was highest in Group I (4.25 ± 1.14), followed by Group II (3.28 ± 1.22) and Group III (2.89 ± 1.53). Conclusion: LA Axxess burs were the most effective in reducing the coronal curvature and produced a straighter access to apical third compared to GG Drills and Protaper Sx.

Key words:

Cervical preflaring - coronal curvature - straight line access

• REFERENCES

• 1 Leeb J. Canal orifice enlargement as related to biomechanical preparation. J Endod 1983; 9: 463-70
• 2 Sureshchandra B, Gopikrishna V. Grossman’s Endodontic Practice. 12th ed.. New Delhi: Wolter’s-Kluwer (India) Pvt. Ltd.; 2010
• 3 Peters O, Koka R. Preparation of coronal and radicular space. In: Ingle JI, Bakland LK, Baumgartner JC. editors. Endodontics. 6th ed.. Hamilton: BC Decker Inc.; 2008: 877-81
• 4 Vertucci F, Haddix J. Tooth morphology and access cavity preparation. In: Hargreaves KM, Cohen S. editors. Pathways of the Pulp. 10th ed.. St. Louis: Mosby; 2011: 160-2
• 5 Weine FS, Kelly RF, Lio PJ. The effect of preparation procedures on original canal shape and on apical foramen shape. J Endod 1975; 1: 255-62
• 6 Morgan LF, Montgomery S. An evaluation of the crown-down pressureless technique. J Endod 1984; 10: 491-8
• 7 Isom TL, Marshall JG, Baumgartner JC. Evaluation of root thickness in curved canals after flaring. J Endod 1995; 21: 368-71
• 8 Busquim SS, dos Santos M. Cervical shaping in curved root canals: Comparison of the efficiency of two endodontic instruments. Braz Oral Res 2002; 16: 327-31
• 9 Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol 1971; 32: 271-5
• 10 Torabinejad M, Sigurdsson A. Evaluation of endodontic outcomes. In: Torabinejad M, Walton R. editors. Endodontics Principles and Practice. 4th ed.. St. Louis, Missouri: Elsevier; 2009: 383
• 11 Ehrhardt IC, Zuolo ML, Cunha RS, De Martin AS, Kherlakian D, Carvalho MC. et al. Assessment of the separation incidence of Mtwo files used with preflaring: Prospective clinical study. J Endod 2012; 38: 1078-81
• 12 Duarte MA, Bernardes RA, Ordinola-Zapata R, Vasconcelos BC, Bramante CM, Moraes IG. Effects of Gates-Glidden, LA Axxess and orifice shaper burs on the cervical dentin thickness and root canal area of mandibular molars. Braz Dent J 2011; 22: 28-31
• 13 Sharma SA, Tyagi SP, Sinha DJ, Singh UP, Chandra P, Kaur G. Influence of cervical preflaring using different rotary instruments on the accuracy of apical file size determination: A comparative in-vitro study. J Conserv Dent 2014; 17: 575-8
• 14 Mahran AH, AboEl-Fotouh MM. Comparison of effects of ProTaper, HeroShaper, and Gates Glidden burs on cervical dentin thickness and root canal volume by using multislice computed tomography. J Endod 2008; 34: 1219-22
• 15 Martin LR, Gilbert B, Dickerson 2^nd AW. Management of endodontic perforations. Oral Surg Oral Med Oral Pathol 1982; 54: 668-77
• 16 Al-Nuaimi N, Patel S, Foschi F, Mannocci F. The detection of simulated periapical lesions in human dry mandibles with cone beam computed tomography – A dose reduction study. Int Endod J. 2015 [Doi: 10.1111/iej.12565]. [Epub ahead of print]
• 17 Durack C, Patel S. Cone beam computed tomography in endodontics. Braz Dent J 2012; 23: 179-91
• 18 Farhad MollashahiN, Sohrabi M, Farhad MollashahiL, Mehdizadeh M. The efficacy of FlexMaster’s IntroFile, PreRaCe and gates Glidden drills in straight-line access: A CBCT assessment. Iran Endod J 2014; 9: 199-203