The power of ultrasonic vibrations has been harnessed in the field of dentistry—evolving in its use and purpose—for just over 60 years. The first section of this review describes the evolution and various applications of ultrasound in dentistry, and examines in detail the ultrasonic tools that have been developed for endodontic purposes. The second section of this review describes the use of ultrasonics during specific endodontic procedures, from access to obturation, incorporating as much as possible the most recent and relevant research available to date.

Ultrasonics in endodontics

Cone-beam Computed Tomography Volumetric Analysis and Comparison of Dentin Structure Loss after Retrieval of Separated Instrument by Using Ultrasonic EMS and ProUltra Tips

Effects of Ultrasonic Removal of Fractured Files from the Middle Third of Root Canals on the Resistance to Vertical Root Fracture.

Objective The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments. Materials and methods A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK. Results The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05). Conclusion Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

https://rde.ac/pdf/10.5395/rde.2020.45.e14

Comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit for the removal of separated endodontic instruments.

This paper describes two cases of instrument fragment removal from the apical thirds of root canals using a customized extractor and a modified needle technique, respectively In case 1, a customized extractor was manufactured to remove a bur fragment located in the apical root canal of a maxillary central incisor The use of this extractor enabled successful and conservative removal of the instrument fragment In case 2, a modified injection needle was used as a trepan to gain access around an instrument fragment located in the curved apical portion of the mesiobuccal canal of a mandibular molar A segment of steel wire was inserted into the needle lumen to engage the metallic fragment, enabling its removal with counter-clockwise rotation and a simultaneous pull-out motion Alternative and creative methods are useful for the management of intracanal metallic fragments during root canal treatment

/pdf/alternative-techniques-to-remove-fractured-instrument-1vbpuyurbc.pdf

Alternative Techniques to Remove Fractured Instrument Fragments from the Apical Third of Root Canals: Report of Two Cases

Gerek M, Baser ED, Kayahan MB, Sunay H, Kaptan RF, Bayirli G. Comparison of the force required to fracture roots vertically after ultrasonic and Masserann removal of broken instruments. International Endodontic Journal, 45, 429–434, 2012.

Abstract
Aim  To evaluate the force required to fracture roots vertically after the removal of broken instruments using ultrasonic tips and a Masserann kit.

Methodology  Thirty-nine extracted human anterior teeth with single and straight roots were used. The crown of each tooth was removed until the full length of the tooth was 13 mm. All canals were instrumented with the step-back technique to a size 25 K-file. The teeth were randomly divided into three groups: two experimental groups and a control group. The size 30 K-files used for the test were notched to a depth of half of the instrument with a No. 2 round bur at a point 3 mm from the tip to facilitate breakage of the file at this point. The fractured instruments were removed from the canals using ultrasonic tips or a Masserann kit. The samples were subjected to a continual vertical loading, using a universal testing machine. For each root, the force at the time of fracture was recorded in Newtons. The results were analysed statistically using one-way anova and Tukey HSD test.

Results  The force required to fracture the roots vertically was significantly higher in the control group than the experimental groups (P < 0.01). The roots from which the broken instruments had been removed using ultrasonic tips required more force to fracture than roots in the Masserann group; however, the difference was not statistically significant.

Conclusion  Removal of a fractured instrument from the middle third of the root decreased the force required to fracture the root vertically, regardless of the technique used for instrument removal. There was not difference between the ultrasonic technique and the Masserann technique.

Comparison of the force required to fracture roots vertically after ultrasonic and Masserann removal of broken instruments.

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Comparison of the force required to fracture roots vertically after ultrasonic and Masserann removal of broken instruments.