Comparative Evaluation of Ultrasonic Tips and the Masserann Kit for Retrieval of Separated Endodontic Instruments – an in vivo study
Keywords:
Ultrasonic tips, Ultrasonic tips, Masserann kit, Masserann kit, fractured instruments, fractured instruments, dentin preservation, dentin preservation, minimally invasive endodontics, minimally invasive endodontics, postoperative pain, postoperative painAbstract
Aim:This in vivo study introduces a novel dual-parameter evaluation—dentin preservation and postoperative patient comfort—while comparing ultrasonic tips and the Masserann kit for retrieval of separated endodontic instruments.
Materials and Methods:Forty patients (20–60 years) with fractured instruments were randomly divided into two groups: Group 1 underwent retrieval using ultrasonic tips, and Group 2 with the Masserann kit. Residual dentin thickness and postoperative discomfort (Visual Analog Scale, VAS) were recorded. Data were analyzed using the Shapiro–Wilk test, followed by the Mann–Whitney U test. A p-value < 0.05 was considered significant.
Results:Ultrasonic tips preserved significantly greater dentin thickness (1.45 ± 0.10 mm) than the Masserann kit (1.03 ± 0.19 mm, p < 0.001). VAS pain scores were lower in the ultrasonic group (1.20 ± 1.20) compared to the Masserann group (2.50 ± 1.61, p = 0.006).
Conclusion:This study is one of the first controlled in vivo clinical trials to simultaneously quantify dentin preservation and postoperative comfort in fractured instrument retrieval. Ultrasonic tips proved superior to the Masserann kit, offering a minimally invasive, tooth-conserving, and patient-friendly approach.
Clinical Significance:By integrating structural preservation with patient-centered outcomes, this work provides an innovative clinical decision framework—positioning ultrasonic tips as the preferred technique for modern, minimally invasive endodontic practice
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Sattapan B, Nervo GJ, Palamara JE, Messer HH. Defects in rotary nickel-titanium files after clinical use. J Endod. 2000;26(3):161-5.
Nevares G, Cunha RS, Zuolo ML, Bueno CE. Success rates for removing or bypassing fractured instruments: a prospective clinical study. J Endod. 2012;38(4):442-4.
Saunders JL, Eleazer PD, Zhang P, Michalek S. Effect of a separated instrument on bacterial penetration of obturated root canals. J Endod. 2004;30(3):177-9.
Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod. 1997;23(2):77-85.
Sattapan B, Nervo GJ, Palamara JE, Messer HH. Defects in rotary nickel-titanium files after clinical use. J Endod. 2000;26(3):161-5.
McGuigan MB, Louca C, Duncan HF. Clinical decision-making after endodontic instrument fracture. Br Dent J. 2013;214(8):395-400.
Ward JR, Parashos P, Messer HH. Evaluation of an ultrasonic technique to remove fractured rotary nickel-titanium endodontic instruments from root canals: an experimental study. J Endod. 2003;29(11):756-63.
Cujé J, Bargholz C, Hülsmann M. The outcome of retained instrument removal in a specialist practice. Int Endod J. 2010;43(7):545-54.
Nevares G, Cunha RS, Zuolo ML, Bueno CE. Success rates for removing or bypassing fractured instruments: a prospective clinical study. J Endod. 2012;38(4):442-4.
Machtou P, et al. Removal of fractured instruments. Int Endod J. 1989;22(6):261-7.
Reit C, et al. Management of fractured endodontic instruments. Int Endod J. 1987;20(2):61-9.
Rocke D, Guldener P. Factors affecting instrument removal. Quintessence Int. 1995;26(9):611-7.
Suter B, et al. Predictability of fractured instrument removal. J Endod. 2005;31(7):542-4.
Lim SS, Stock CJ. Dentin preservation during instrumentation. Int Endod J. 1987;20(1):33-9.
Nagai O, et al. Ultrasonic removal techniques. J Endod. 1986;12(7):341-4.
Ward JR, Parashos P. Ultrasonic use in endodontics. Aust Dent J. 2009;54(3):200-7.
Hülsmann M, Schinkel I. Efficacy of various retrieval methods. Int Endod J. 1999;32(3):199-208.
Shen Y, et al. Canal curvature and retrieval success. Int Endod J. 2004;37(7):614-20.
Eid D, Seyam A. Effect of curvature on retrieval. Egypt Dent J. 2016;62(2):1749-56.
Yang Q, et al. Endodontic retreatment and postoperative pain. Int J Oral Sci. 2010;2(4):195-201.
Tzanetakis GN, et al. Clinical management of separated instruments. Int Endod J. 2008;41(10):841-8.
Cujé J, et al. Ultrasonics for fractured file retrieval. J Endod. 2010;36(3):469-72.
Meng L, et al. Dentin loss after file retrieval. Aust Endod J. 2018;44(2):110-6.
Lin LM, et al. Endodontic instrument removal success. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(3):304-10.
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