A new endodontic technology: pilot study

Aim: the success of endodontic treatment depends on cleaning and shaping of canals. In primary teeth is more important the cleaning of debris than the shaping, but we need the knowledge of the anatomy. We studied the endodontic anatomy of primary teeth by micro-ct and we used in the second mandibular primary molar of a child 7 years old a new endodontic system, SAF system. Materials and methods. we studied the anatomy of root canals by micro-ct and we selected, as strumentation the SAF system, which is a cleaning-shaping-irrigation system. The file is used with a particular handpiece head, which turns the rotation into in and out vibration and is used with irrigation provided by a pump. The SAF file is the first endodontic file that doesn’t have a central metallic core. The walls of the cylinder are made of a ni-ti lattice and the tip is asymmetrical. The metallic surface is rough and, when it is compressed into a root canal, it adapts itself to the cross section of the canal with light pression. It operates at 5000 rpm and is linked to a peristaltic pump and its flow rate can be adjusted from 1 ml/min to 10 ml/min. At the beginning the file uses rotation and when it is adapted to the shape of canal it changes its movement in vibration. Before the use of SAF file we prepared the tooth opening the pulpal chamber and identifying the working length, so made the glide path with a 20 k-file. Results. Primary teeth are characterized by narrow and ribbon canals. Maxillary molars have 3 canals, one in each root and the distal is more narrow than the others and it, in its first third, is always joined to the palatal by an isthmus. Mandibular molars have generally 3 canals, two mesials and one distal; but the distal canal is narrow and in 50% of cases it has 2 entrances joined by a long isthmus. SAF strumentation can adapt the file to the root canal. It doesn’t impose its shape, but adapts itself to the walls of canals removing a thin and uniform layer of dentine. So the canal will maintain the same shape, but with larger dimension. In particular when there is an isthmus which is the link between two canals, it will be the area where dentine chips will be packed. So using SAF file, which adapts itself to the canal, also this area can be shaped and our idea is confirmed by literature. In fact, unaffected walls by the procedures is greatly reduced. In SAF system is 24% compared to 45% for Profile, 48% for ProTaper or 53% for GT. Conclusions. The SAF system is a new technology, which can change the concept of shaping. With this file is cleaned a portion of dentin which was ignorated by other files with rotary or reciproc movement. Another advantage of this new file is the property of maintain the same shape, but with larger dimension. In particular, the file is minimally invasive and preserve dentine in the thinnest layer where there is the permanent germ. This is a preliminary study, which will be study in deep using micro-ct and 3D image to compare the endodontic system before and after the treatment.