To determine the optimal CBCT settings for an automatic edge-detection-based endodontic segmentation procedure by assessing the accuracy of the root canal measurements. 12 intact teeth with closed apexes were cut perpendicular to the root axis, at pre-determined levels to the reference plane (the first section made before acquisition). Acquisitions of each specimen were performed with Kodak 9000(®) 3D (76 µm, 14 bits; Kodak Carestream Health, Trophy, France) by using different combinations of milliamperes and kilovolts. Three-dimensional images were displayed and root canals were segmented with the MeVisLab software (edge-detection-based method; MeVis Research, Bremen, Germany). Histological root canal sections were then digitized with a 0.5- to 1.0-µm resolution and compared with equivalent two-dimensional cone-beam reconstructions for each pair of settings using the Pearson correlation coefficient, regression analysis and Bland-Altman method for the canal area and Feret's diameter. After a ranking process, a Wilcoxon paired test was carried out to compare the pair of settings. The best pair of acquisition settings was 3.2 mA/60 kV. Significant differences were found between 3.2 mA/60 kV and other settings (p < 0.05) for the root canal area and for Feret's diameter. The quantitative analyses of the root canal system with the edge-detection-based method could depend on acquisition parameters. Improvements in segmentation still need to be carried out to ensure the quality of the reconstructions when we have to deal with closer outlines and because of the low spatial resolution.

We assessed the efficiency of two shaping file systems and two passive ultrasonic irrigation (PUI) devices for removing filling material during retreatment. The mesial canals from 44 extracted mandibular molars were prepared and obturated. The teeth were randomly divided into two groups, and then one group was retreated with Reciproc R25 (VDW, Munich, Germany) (n = 44) and the other group was retreated with 2Shape (TS, Micro Mega, Besançon, France) (n = 44). A micro-computed tomography (CT) scan was taken before and after the retreatment to assess the volume of the filling material remnants. The teeth were then randomly divided into four groups to test two different PUI devices: Irrisafe (Satelec Acteon Group, Merignac, France) and Endo Ultra (Vista Dental Products, Racine, WI, USA). The teeth in Group A were retreated with 2Shape to test the Endo Ultra (n = 22) device, the teeth in Group B were retreated with 2Shape in order to test the Irrisafe (n = 22) device, the teeth in Group C were retreated with Reciproc to test the Endo Ultra (n = 22) device, and Group D was retreated with Reciproc to test the Irrisafe (n = 22) device. A third micro-CT scan was taken after the retreatment to test the PUIs. The percentage of Gutta-Percha (GP) and sealer removed was 94.75% for TS2 (p < 0.001) and 89.3% for R25 (p < 0.001). The PUI significantly enhanced the removal of the filling material by 0.76% for Group A (p < 0.001), 1.47% for Group B (p < 0.001), 2.61% for Group C (p < 0.001), and by 1.66% for Group D (p < 0.001). 2Shape was more effective at removing the GP and sealer during retreatment (p = 0.018). The supplementary approach with PUI significantly improved filling material removal, with no statistical difference between the four groups (p = 0.106).

This ex vivo study aimed to measure the performance of an electronic apex locator (EAL) in the presence of sodium hypochlorite irrigants with different concentrations. Two EALs (Root ZX Mini and Locapex 6) were used to locate the apical foramen in 10 extracted single-rooted teeth in the presence of 0.5%, 2.5% and 5% sodium hypochlorite. Visual working lengths were also determined using #10 K-file under a microscope before the electronic measurements were made. The performance of both EALs was compared for the electronic working lengths determined under the different concentrations of sodium hypochlorite. A multiple-way ANOVA and PLSD Fisher’s test with an α risk fixed at 5% were conducted. There were no statistical differences in the working lengths determined by both EALs between the three groups with different concentrations of sodium hypochlorite and their visual control measurements. When a ± 0.5 mm margin was applied, the Root ZX Mini and the Locapex 6 presented 88% and 83% accuracy, respectively. Sodium hypochlorite concentration in irrigants does not affect the accuracy and reliability of either the Root ZX Mini or the Locapex 6. Electronic apex locators are reliable with any concentration of sodium hypochlorite irrigants.