Assessing Accumulated Hard-tissue Debris Using Micro–computed Tomography and Free Software for Image Processing and Analysis

• Published in: Journal of endodontics Vol. 40; no. 2; pp. 271 - 276
• Main Authors: De-Deus, Gustavo, DDS, MSc, PhD, Marins, Juliana, DDS, MSc, PhD, de Almeida Neves, Aline, DDS, MSc, PhD, Reis, Claudia, DDS, MSc, PhD, Fidel, Sandra, PhD, Versiani, Marco A., DDS, MSc, PhD, Alves, Haimon, MSc, Lopes, Ricardo Tadeu, MSc, DSc, Paciornik, Sidnei, MSc, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2014
• Subjects: Anatomy, Cross-Sectional; Biomechanical preparation; debris; Dental Alloys; Dental Pulp Cavity - diagnostic imaging; Dentistry; Edetic Acid - therapeutic use; Endocrinology & Metabolism; Equipment Design; free software; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; irrigation; micro-computed tomography; Molar - diagnostic imaging; Nickel - chemistry; Root Canal Irrigants - therapeutic use; Root Canal Preparation - instrumentation; Root Canal Preparation - methods; root canal system; Smear Layer - diagnostic imaging; Sodium Hypochlorite - therapeutic use; Software; Titanium - chemistry; Water; X-Ray Microtomography - methods; Biomechanical preparation; debris; micro-computed tomography; irrigation; root canal system; free software
• ISSN: 0099-2399; 1878-3554
• DOI: 10.1016/j.joen.2013.07.025

Abstract Introduction The accumulation of debris occurs after root canal preparation procedures specifically in fins, isthmus, irregularities, and ramifications. The aim of this study was to present a step-by-step description of a new method used to longitudinally identify, measure, and 3-dimensionally map the accumulation of hard-tissue debris inside the root canal after biomechanical preparation using free software for image processing and analysis. Methods Three mandibular molars presenting the mesial root with a large isthmus width and a type II Vertucci's canal configuration were selected and scanned. The specimens were assigned to 1 of 3 experimental approaches: (1) 5.25% sodium hypochlorite + 17% EDTA, (2) bidistilled water, and (3) no irrigation. After root canal preparation, high-resolution scans of the teeth were accomplished, and free software packages were used to register and quantify the amount of accumulated hard-tissue debris in either canal space or isthmus areas. Results Canal preparation without irrigation resulted in 34.6% of its volume filled with hard-tissue debris, whereas the use of bidistilled water or NaOCl followed by EDTA showed a reduction in the percentage volume of debris to 16% and 11.3%, respectively. The closer the distance to the isthmus area was the larger the amount of accumulated debris regardless of the irrigating protocol used. Conclusions Through the present method, it was possible to calculate the volume of hard-tissue debris in the isthmuses and in the root canal space. Free-software packages used for image reconstruction, registering, and analysis have shown to be promising for end-user application.