|Year : 2020 | Volume
| Issue : 2 | Page : 100-103
Evaluation of various kinematics in WaveOne Gold reciprocating file system: An in vitro study
Sheerin A Sarthaj1, Priya Johnson2, Anoop Samuel3, Eazhil4, Vijay Kannan5
1 Private Practitioner, Chennai, Tamil Nadu, India
2 Senior Lecturer, Rajas Dental College, Tirunelveli, Tamil Nadu, India
3 Reader, Noorul Islam College of Dental Sciences, Thiruvanantha Puram, Kerala, India
4 Professor, Chettinad Dental College, Chennai, Tamil Nadu, India
5 Reader, Asan Memorial Dental College & Hospital, Chennai, Tamil Nadu, India
|Date of Submission||15-Mar-2019|
|Date of Decision||01-Apr-2019|
|Date of Acceptance||13-Jun-2019|
|Date of Web Publication||18-Jun-2020|
Sheerin A Sarthaj
Private Practitioner, Root canal and Implant clinic, Sudarson Hospitals, Tirunelveli, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Aim: To evaluate the various kinematic effects of WaveOne Gold reciprocating file system such as 150°° counterclockwise (CCW)–30°° clockwise (CW), 270°° CCW–30°° CW, 360°° CCW–30°° CW, and continuous rotation and the influence of reciprocating and continuous rotary motions of the same file system on the apical extrusion of debris.
Materials and Methods: Sixty mandibular premolars were selected. Instrumentation of the canals was done using WaveOne Gold single-file reciprocating systems and grouped into four groups as follows: Group I – 150°° CCW–30°° CW; Group II – 270°° CCW–30°° CW; Group III – 360°° CCW–30°° CW; and Group IV – continuous rotation. The debris extruded through the apical foramen was collected, dried, and weighed, and the raw data thus obtained were subjected to statistical analysis using one-way analysis of variance and least significant difference post hoc tests (P = 0.05).
Results: The mean value for the difference of debris extrusion for the four groups was as follows: Group I: 0.0023 ± 0.002 g, Group II: 0.0071 ± 0.0049 g, Group III: 0.0029 ± 0.002 g, and Group IV: 0.0019 ± 0.002 g. The mean value depicted that the manufacturer recommended reciprocation kinematics (Group I) and the continuous rotation (Group IV) extruded less debris than compared to the other two. The intergroup comparison showed that there were significant differences between Group II and III but no significant differences between Group I and IV.
Conclusions: Debris extrusion is inevitable. However, the manufacturer prescribed kinematics 150°° CCW–30°° CW and 270°° CCW–30°° CW extruded less debris than compared with the other two groups.
Keywords: Apical extrusion, kinematics, reciprocating instruments, rotary, WaveOne gold
|How to cite this article:|
Sarthaj SA, Johnson P, Samuel A, Eazhil, Kannan V. Evaluation of various kinematics in WaveOne Gold reciprocating file system: An in vitro study. Endodontology 2020;32:100-3
| Introduction|| |
The prime objective of endodontic treatment is to provide straight-line access, clean and shape the root canal system, provide three-dimensional obturation, and facilitate a hermetic seal. The hermetic seal could be effectively achieved if we follow the mechanical and biological objectives. Whatever the file system we use whether it is hand files, rotary or the reciprocating, and whatever the procedural techniques we employ these protocols should be strictly adhered to.
The concept of reciprocation is not new to endodontics. Reciprocation is nothing but to cause to move alternately backward and forward. The advantages of reciprocating files using bidirectional movements, clockwise (CW) and counterclockwise (CCW) at unequal angles, would enable a single reciprocating file to shape any canal.
After the launch of WaveOne (Dentsply Maillefer) in 2011 using the M wire technology, it took almost 4 long years from the same company to launch one more reciprocating single-file system in the fields of endodontics WaveOne Gold (Dentsply Maillefer) using the Gold wire technology. Cleaning and shaping and apical extrusion are inseparable.,, Even though the manufacturer promises four times safer and three times faster canal preparation efficacy with WaveOne Gold reciprocating file systems, the concept of apical extrusion of debris whether it is less or more compared with rotary single-file systems remains a confliction.
The reciprocating file systems because of its reciprocating motion results with marked resistance to cyclic fatigue, which is one of the leading causes of file separation. Apical extrusion of the debris has a direct correlation to apical periodontitis and the release of neuropeptides.,,
The distinct gold appearance of the WaveOne Gold files is the result of a unique heat treatment process applied after manufacture. The raw metal is nickel-titanium which is repeatedly heated and cooled, giving it not only its gold color but also considerably improving its strength and flexibility.
There is a lot of published data that deal with the apical extrusion of the debris comparing the rotary and reciprocating instruments, among the different rotary file systems and among the different reciprocating file systems. However, to evaluate if the manufacturer recommended reciprocating motion is optimum in the canal preparation ability if it is optimum to extrude less debris apically, we need to conduct original researches. Thus, the aim of this study was to evaluate the various kinematic effects of WaveOne Gold Reciproc instruments such as 150° CCW–30° CW, 270° CCW–30° CW, 360° CCW–30° CW, and continuous rotation using endomotor. The null hypothesis as such would be that there will not be any difference in the weight of apically extruded debris.
| Materials and Methods|| |
The accepted or established code of procedure of this study was approved by the Institutional Review Board and Ethics Committee of Rajas Dental College, Kavalkinaru. Sixty mandibular premolars with similar lengths were selected from a pool of extracted teeth from the Department of Oral and Maxillofacial Surgery, Rajas Dental College, Kavalkinaru. The extracted teeth were scaled using an ultrasonic scaler (Sirosonic, Dentsply Sirona, Pennsylvania, USA). The ultrasonically treated teeth were stored in distilled water (Sankalp Scientific and Associates, Nagpur, India) in a refrigerator until use. The teeth were radiographed at two different angulations to rule out additional canals, canal curvature, and root angulations. Teeth with more than 10° curvature were excluded from the study, and also, those teeth with other canals and those with calcifications and resorption were also excluded from the study. A marking was made at a length of 14 mm from the apex, and the teeth were decoronated to obtain a standardized length of 14 mm. The patency of the canal was checked by inserting a 10 k (Dentsply Maillefer, Ballaigues, Switzerland). The working length was calculated to be 13 mm, which was later confirmed by radiographs.
Grouping of samples was done in such a way that a total of 60 mandibular premolars which satisfied all the necessary criteria were divided into 15 teeth in each group. The rotation speed for all the groups was kept at 300 rpm.
- Group 1: 150° CCW–30° CW
- Group 2: 270° CCW–30° CW
- Group 3: 360° CCW–30° CW
- Group 4: Continuous rotation.
For all groups, instrumentation was performed using an electric motor (Satelec Endo Dual, Acteon, Mérignac, France).
Empty vials were preweighed in an electronic weight balance thrice, and the mean was calculated and recorded. The samples were mounted on the rubber stoppers of the vials by piercing a hole in the rubber stopper using a sharp instrument. The space that was left between the tooth and the rubber stopper is glued with cyanoacrylate. A 27-gauge needle was inserted into the stopper to equalize the air pressure inside and outside the vials.
To prepare the canals first, a WaveOne Gold primary (025.07) was used for initiation. This helps set up a glide path. Further instrumentation of the canal was done using the same file in a brushing motion to reduce resistance and more effectively instrument the canals. The files were used with a gentle inward “stroking” motion of short 2–3 mm amplitude, to passively advance the file along with a smooth, reproducible glide path.
The irrigation protocol that was used is as follows. A total of 2 ml of irrigant was used for each sample. After every three pecking motions, the file was taken out, the flutes were cleaned of debris using dampened cotton, and the canal space was irrigated. The irrigation needle was placed 1 mm short of the apex, and irrigation was done passively. The rubber stopper is opened, and the external surface of the root below the level of the stopper was washed with 1 ml of the irrigant to make sure we do not leave any debris adhering to the root surface.
The vials with the distilled water irrigant and the extruded debris were placed in a hot air oven (Contemp Laboratory Hot Air Oven CEI-248 by Contemp, India) at 90°C for 2 h only to confirm that all the irrigant solution is evaporated. Even after the evaporation of the distilled water, some amount of moisture may still be remaining in the vials. To desiccate the debris, the vials were again placed in a desiccator (ESAW Vacuum Desiccator, Ambala, Haryana, India) for 2 h to desiccate the debris free of moisture. The vials were now postweighed in the same electronic balance as before; the average of three consecutive measurements was recorded. The outstanding amount of the initial and the final weights were calculated. The raw data that were obtained were recorded in an Excel Sheet, and it was subjected to statistical analysis using SPSS 21 software (SPSS Inc., Chicago, IL, USA). The tests that were used include one-way analysis of variance and the least significant difference post hoc tests (P = 0.05).
| Results|| |
The mean value for the difference of debris extrusion for the four groups was as follows: Group I: 0.0023 ± 0.002 g, Group II: 0.0071 ± 0.0049 g, Group III: 0.0029 ± 0.002 g, and Group IV: 0.0019 ± 0.002 g. The mean value depicted that the manufacturer recommended reciprocation kinematics (Group I) and the continuous rotation (Group IV) extruded less debris than compared with the other two. The intergroup comparison showed that there were significant differences between Group II and III but no significant differences between Group I and IV. The results are depicted in [Table 1].
|Table 1: The mean value for the difference of debris extrusion for the four groups|
Click here to view
| Discussion|| |
Various studies conducted by Gambarini et al., Lee et al., Pedulla et al., Pérez-Higueras et al., Rubini et al., and Kiefner et al. and the systematic review by Ahn et al. used the same file system with different kinematics to evaluate only the effect of kinematics. WaveOne Gold reciprocating file system is used in both the kinematics in this study to evaluate the effect of kinematics in the apical extrusion of debris. Using the same file system for both the reciprocating and the continuous rotary motions, the influence of kinematics on the apical extrusion of debris could be compared without the other variables. The results shown above portrayed that there were differences in the amount of apically extruded debris in all the four groups, of which two groups showed statistically significant results. Hence, the null hypothesis here was rejected.
The focus of this study was to keep the apical extrusion of debris to a minimum. Apical extrusion of debris is one of the major reasons for postoperative pain. When the virulence of the bacteria is overcome by the host defense mechanism, the tooth is symptomless. However, when the bacteria are virulent, it disrupts the host defense mechanism  causing pain, and the concept is explained very well in Kronfeld's mountain pass theory.
The postoperative pain or interappointment flare-ups result in walk-in of patients without any appointment. To relieve the pain and to make the patient comfortable, sometimes, antibiotics and analgesics need to be prescribed.
The WaveOne Gold Reciprocating single-file system has a cross-section which takes up the shape of a parallelogram, and the cutting edge is angulated by 85° with an off-centered cross-section where only one cutting edge is in contact with the canal wall. The other design features of this file system include a 24° helical angle which remains constant throughout the length of the canal combined with a reverse cutting helix which reduces the taper lock effect. A literature search proved that NiTi rotary endodontic files in continuous rotation extruded less debris than compared to the NiTi reciprocating fie systems. The authors have validated the results with the concept that the files in continuous rotary motion act in a screwing effect, which pulls out the debris from the root canals in a coronal direction.
In the present study, the angle of progression for the three groups in reciprocating motion was 120°, 240°, and 330°, respectively. The Group 1: 150° CCW–30° CW with the owest angle of progression of 30° yielded the lowest amount of apical extrusion of debris than compred to the other groups. Since this study is the first of its kind, more researches regarding the physical and mechanical properties of the file system are necessary to validate the results.
| Conclusions|| |
From this study, it could be concluded that movement kinematics had an effect on the amount of apically extruded debris. The manufacturer recommended 150° CCW–30° CW reciprocating kinematics showed the lowest amount of apical extrusion of debris followed by the WaveOne Gold reciprocating file in continuous rotation. The reciprocation kinematics in 360° CCW–30° CW with the largest angle of progression of 330° resulted in the highest amount of apical extrusion of debris.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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