Quantitative evaluation of apically extruded debris using

TRUShape, TruNatomy, and WaveOne Gold in curved canals

Critical Review Assignment

Fajar Satrio 22/496202/PKG/01610

Pradika Danu Martha 22/500947/PKG/01625
 Authorship : Clearly listed

Conflict of Interest : No conflict of interest

Ethically approved

No Plagiarism : There are many trials about apically extruded debris, but none of them
comparing TruShape, Trunatomy and Waveone Gold.

Pre-Critical Review
BDJ Guidelines
Authorship : Clearly listed
Conflict of Interest : No conflict of interest
Ethically approved
No Plagiarism : There are many trials about apically extruded debris, but none of them
comparing TruShape, Trunatomy and Waveone Gold.
 Authorship : Clearly listed

Conflict of Interest : No conflict of interest

Ethically approved

No Plagiarism : There are many trials about apically extruded debris, but none of them
comparing TruShape, Trunatomy and Waveone Gold.
 Title

Abstract

Introduction

Material and Methods

Result

Discussion

Conclusions

References

Author Contributions

Conflict of interests

Ethical Approval

STRUCTURE of JOURNAL
Based on BDJ Guidelines
Title : Clear enough to illustrate comparison 3 file systems in resulting apical extruded
debris an outcome.

Abstract : Clearly describes the objective, material & method (including statistical
analysis), the results and brief conclusions. No Keywords search is on the journal. It
contained 127 words.
 Introduction : Well described of Background (Connections of
Apical extruded debris and File system TRUShape, TruNatomy,
and WaveOne Gold), Method is well introduced (tested in curve
canal) and the Null hypothesis is written.

(Connections of Apical extruded debris and File

systen TRUShape, TruNatomy, and WaveOne
Gold)

Method is well introduced (tested in curve canal)

Null hypothesis
 Sample Size Calculation :
51 teeth samples (mesial roots) of mandibular teeth

Inclusion Criteria :
Mesial roots that have 25-45 degree curvature
Curvature radius less than 6 mm
Mesial Root with type IV Vertucci

Exclusion Criteria :
External defects, Calcification, type II Vertucci

Homogenity by matching samples with curvature and radius

with alike criteria ; also same Working length

SAMPLE SIZE and SAMPLE SELECTION

 Sample Size Calculation :
51 teeth samples (mesial roots) of mandibular teeth
Inclusion Criteria :
Mesial roots that have 25-45 degree curvature
Curvature radius less than 6 mm
Mesial Root with type IV Vertucci
Exclusion Criteria :
External defects, Calcification, type II Vertucci
Homogenity by matching samples with curvature and radius
with alike criteria ; also same Working length
SAMPLE SIZE and SAMPLE SELECTION
Major Concerns
• Sample Criteria : All of them are caries free,
or slight caries acceptable?
• Age ranges of patient whose teeth were
extracted?
• No detail of sample matching amongst
groups of intervention
• Different root canal configurations may lead
differrent canal transportation volume
• In Silico or Simulation with the same
characters of canal advised for future trial
 Each tube measured without stopper 3 times
Mean Mesurement as (W1)

Vial were coded and randomly allocated

According to file system used

All Samples were instrumented

All tubes stored at 70C for 5 days

To eliminate water

Each tube measured 3 times

Mean Mesurement as (W2)

Modified Myers and Montgomery Experimental Model (1991)

Apically extruded debris = (W2-W1)

Trial Design
 51 teeth samples
Working Length K-File No.10
1 mm short (17 mm)

Group I Group II Group III

TRUShape (TRS) TruNatomy (TRN) WaveOne Gold(WOG)
17 samples 17 samples 17 samples

Canal irrigated by 3 ml distilled water (40C)

2 mm short of WL with 30 G needle

Patency Check with #10 K-File, reach WL

All root canals were instrumented by one operator

Extruded debris measure by another examiner

Blinded to tested group

Trial Design
 51 teeth samples
Working Length K-File No.10
1 mm short (17 mm)

Group I Group II Group III

TRUShape (TRS) TruNatomy (TRN) WaveOne Gold(WOG)
17 samples 17 samples 17 samples
Major Concerns
• S???????????

Canal irrigated by 3 ml distilled water (40C)

2 mm short of WL with 30 G needle

Patency Check with #10 K-File, reach WL

All root canals were instrumented by one operator

Extruded debris measure by another examiner

Blinded to tested group

Trial Design
Statistical Analysis
RESULTS
Samples Mandibular Mesial Roots with Curvature to simulate clinical situations.

Myers and Motngomery Method was chosen because of precise measurements Major Concerns
• The study is well described from the
Suggestion for simulation periapical tissue back pressure for future trial selection samples, trial method and
controlling confouding factor
NaOCl was not used, because of resulting to sodium crystallization. To avoid • This study can be baseline to further study
confounding factor that simulates clinical treatement (Irigaton
Warmed distilled water (40C) to simulate in vivo conditions NaOCl and Agitation)

WOG produced less debris, automated force balance, cross-sectional rectangular

cross-section, but many conflicting studies about the result

Limitation different system, different number of files, taper, rotational speed and
kinematic,but this study could be baseline for future trial

DISCUSSION
Waveone Gold outperformed TRUShape dan TruNatomy because producing less apical debris in severely curved
canals.

Future in vivo study for comparing incidence dan intensity of postoperative pain after mechanical preparation for
further correlation

CONCLUSION
REFERENCES