Micro-computed Tomography versus the Cross-sectioning Method to Evaluate Dentin Defects Induced by Different Mechanized Instrumentation Techniques

Abstract

Introduction: The objective of this study was to compare the methods of micro-computed tomography (micro-CT) and cross-sectioning followed by stereomicroscopy in assessing dentinal defects after instrumentation with different mechanized systems.

Methods: Forty mesial roots of mandibular molars were scanned and divided into 4 groups (n = 10): Group R, Reciproc; Group PTN, ProTaper Next; Group WOG, WaveOne Gold; Group PDL, ProDesign Logic. After instrumentation, the roots were once again submitted to a micro-CT scan, and then sectioned at 3, 6, and 9 mm from the apex, and assessed for the presence of complete and incomplete dentinal defects under a stereomicroscope. The nonparametric Kruskal-Wallis, Friedman, and Wilcoxon tests were used in the statistical analysis. The study used a significance level of 5%.

Results: The total number of defects observed by cross-sectioning followed by stereomicroscopy was significantly higher than that observed by micro-CT, in all of the experimental groups (P ≤ .05). All of the defects identified in the postoperative period were already present in the corresponding preoperative period. There was no significant difference among the instrumentation systems as to the median numbers of defects, for either cross-sectioning followed by stereomicroscopy or micro-CT, at all the root levels (P > .05). In the micro-CT analysis, no significant difference was found between the median numbers of pre- and postinstrumentation defects, regardless of the instrumentation system (P > .05).

Conclusion: None of the evaluated instrumentation systems led to the formation of new dentin defects. All of the defects identified in the stereomicroscopic analysis were already present before instrumentation, or were absent at both time points in the micro-CT analysis, indicating that the formation of new defects resulted from the sectioning procedure performed before stereomicroscopy and not from instrumentation.

Keywords: Dental instruments; X-ray computed tomography; endodontics; evaluation methods.