An in vitro comparison of different techniques for glide path preparation

Abstract

INTRODUCTION : The study compared modification of canal curvature and the incidence of canal aberrations after glide path preparation using four different instrumentation techniques. METHODS : One hundred and twenty S-shaped Endo- Training-Blocks were selected, the canals coloured with ink and digital images acquired. Glide paths were prepared by a single operator with stainless steel K-files by hand (Group 1), stainless steel K-files in a reciprocating hand piece (Group 2), PathFile (Group 3) and X-Plorer files (Group 4). Pre-instrumentation and post-instrumentation images were superimposed to evaluate the parameters investigated. The images were also examined by three blinded operators for the presence of aberrations. Differences in canal curvature modification were analysed with respect to logarithmic transformed change from baseline using ANCOVA (p<0.001) with logarithmic transformed pre-instrumentation values as covariate. The incidence of canal aberrations was analyzed using Fisher’s exact test (p<0.05). RESULTS : There was no difference between PathFiles and X-Plorer files (p<0.001) and both systems demonstrated significantly less modification of curvature compared with hand files and hand files in a reciprocating hand-piece (p<0.001). The Groups differed significantly regarding the number of aberrations (p=0.005). Hand files and hand files in the reciprocating hand piece did not differ statistically (p=0.254; 20% and 6.67%). However, hand files in reciprocating hand piece also did not differ significantly from PathFiles and X-Plorer files (p=0.326). There were no aberrations detected in the rotary NiTi Groups. CONCLUSION : The stainless steel K-files in the reciprocating hand-piece performed better than their use by hand only. Overall, PathFiles and X-Plorer files equally demonstrated the least modification to original canal geometry. Further research utilising the different techniques in extracted teeth is warranted.