Comparative study on the shaping ability and cleaning efficiency of rotary Mtwo instruments. Part 1. Shaping ability in simulated curved canals

Shaping ability of nickel-titanium rotary instruments in curved root canals

INTRODUCTION

Disinfection and subsequent obturation of the root canal space require adequate mechanical enlargement of the canals. The purpose of this in vitro study was to compare the shaping ability of Mtwo, RaCe and Medin rotary instruments during the preparation of curved root canals.

MATERIALS AND METHODS

Sixty mesiobuccal root canals of mandibular molars with severe curvatures between 25-35(°) and radius of 4-9 mm were randomly divided into three groups of 20 canals each. Using pre- and post-instrumentation radiographs, straightening of the canal and the apical transportation were determined with AutoCAD software. The data were analyzed using Chi square, analysis of variance, and post-hoc tests and the significance level was set at P<0.05.

RESULTS

Mtwo instruments maintained the canal curvature significantly better than Race and Medin instruments (P<0.05). There was significant difference between the rotary instruments for iatrogenic transportation of the major foramen (P>0.05).

CONCLUSIONS

Under the conditions of this in vitro study, Mtwo instruments seemed superior to the two other rotary instruments.

A comparative evaluation on the cleaning and shaping ability of three nickel titanium rotary instruments using computerized tomography - An ex vivo study

Introduction:

Successful root canal treatment depends primarily on the removal of micro-organisms through chemo-mechanical instrumentation of the root canal system. This encompasses shaping by mechanical removal of the dentine and cleaning by chemical disinfection of microorganisms and dissolution of organic tissues from the root canal. While root canal shaping can be predictably and efficiently attained with advanced instrumentation technology, effective cleaning of the entire root canal system remains a challenge. Rotary nickel titanium instruments are known for their efficient preparation of root canal. This is mainly because of the super elasticity of the nickel titanium alloy which gives an increased flexibility and allows the instrument to efficiently follow the original path of root canal. The purpose of this study is to compare the cleaning efficiency and shaping ability of M two, K3, Race ni-ti rotary instruments during the preparation of curved canals in extracted molars.

Materials and Methods:

Thirty teeth with 18 mm as their working length were selected and divided into three groups of 10 teeth each Angle of curvature, Radius of curvature, was determined using computerized tomography. A Pre and Post-operative measurement of canal width and volume was recorded and compared using CT. The teeth was then sectioned into two halves and subjected to scanning electron microscope. Images were taken at the level of apical third, middle third and coronal third for debris and smear layer. Scoring was done separately for both debris and smear layer.

Results:

Results were tabulated and statistically analyzed to evaluate the shaping ability and cleaning efficiency. Instruments were examined for any deformation or fracture during canal preparation.

Conclusion:

M two showed greater enlargements in all the three levels, when compared its width and volume, with other two instruments. K3 was better than Race when compared among them. In the scanning electron microscope study for debris and smear layer M Two performed better followed by K3 and Race.

Comparison of the cleaning capacity of Mtwo and Pro Taper rotary systems and manual instruments in primary teeth

Background:

Root canal cleaning is an important step in endodontic therapy. In order to develop better techniques, a new generation of endodontic instruments has been designed. The aim of this study was to compare the effectiveness of manual K-files (Mani Co, Tokyo, Japan) and two rotary systems–Mtwo (Dentsply-Maillefer, Ballaigues, Switzerland) and ProTaper (VDW, Munich, Germany)–for root canal preparation in primary molars.

Materials and Methods:

India ink was injected to 160 mesiobuccal and distal root canals of mandibular primary molars. The teeth were randomly divided into three experimental groups and one control group. In each experimental group, either manual instruments (K-files) or rotary instruments (Mtwo or ProTaper) were used to prepare root canals. After cleaning the canals and clearing the teeth, ink removal was evaluated with a stereomicroscope. Statistical analysis was done with Kruskal–Wallis and Friedman tests.

Results:

There were no significant differences in cleaning efficiency between manual and rotary instruments. Only ProTaper files performed significantly better in the coronal and middle thirds than in the apical third of the root canal.

Conclusion:

Manual K-files and the Mtwo and ProTaper rotary systems showed equally acceptable cleaning ability in primary molar root canals.

Electrochemical corrosion assessment of RaCe and Mtwo rotary nickle-titanium instruments after clinical use and sterilization

Aim: The aim of the present study was to electrochemically evaluate corrosion resistance of RaCe and Mtwo files after repeated sterilization and preparation procedures. Study Design: A total of 450 rotary files were used. In the working groups, 72 files from each file type were distributed into 4 groups. RaCe and Mtwo files were used to prepare one root canal of the mesial root of extracted human mandibular first molars. The procedure was repeated to prepare 2 to 8 canals. The following irrigation solutions were used: group 1, RaCe files with 2.5% NaOCl; group 2, RaCe files with normal saline; group 3, Mtwo files with 2.5% NaOCl; and group 4, Mtwo files with normal saline in the manner described. In autoclave groups, 72 files from each file type were evenly distributed into 2 groups. Files were used for a cycle of sterilization without the use of files for root canal preparation. Nine new unused files from each file type were used as controls. Then the instruments were sent for corrosion assessment. Mann-Whitney U and Wilcoxon tests were used for independent and dependent groups, respectively. Results: Statistical analysis indicated that there were significant differences in corrosion resistance of files associated with working and autoclave groups between RaCe and Mtwo file types (p<0.001). Conclusions: Corrosion resistance of #25, #30, and #35 Mtwo files is significantly higher than that in RaCe files with similar sizes.

Key words:Corrosion, NiTi instruments, autoclave, RaCe, Mtwo.

'Simultaneous technique' and a hybrid Microseal/PacMac obturation

In these endodontic case reports we present a root canal preparation protocol using the Mtwo Ni-Ti rotary files according to the 'simultaneous technique' which is a'crown-down' approach, where every instrument in the sequence is used to the full working length. A hybrid Microseal/PacMac obturation (consisting of three stages: master cone compaction, backfill with pre-plasticized guttapercha and vertical compaction) is proposed in order to: maintain the obturation length control associated with the Microseal system; use preheated gutta-percha to backfill the canal rapidly with the PacMac condensor; and to reduce potential voids in the obturation material with the final vertical compaction.

CLINICAL RELEVANCE

The'simultaneous technique'followed by apical preparation using Mtwo apical files allows obturation using the proposed hybrid Microseal/Pacmac method, aiming to overcome some of the shortcomings of the Microseal and Pacmac obturation methods, such as length control difficulty and sealer pooling.

Effects of two nickel-titanium instrument systems, Mtwo versus ProTaper universal, on root canal geometry assessed by micro-computed tomography

INTRODUCTION

The aim of this study was to compare the effects of Mtwo and ProTaper Universal (PTU) on root canal geometry three-dimensionally by using micro-computed tomography.

METHODS

A total of 20 canals were prepared with Mtwo or PTU system. Micro-computed tomography scanner was used to scan the specimens before and after instrumentation. Three-dimensional images were reconstructed. The parameters evaluated included canal surface area, volume, structure model index, thickness, straightening, canal transportation, and uninstrumented surface area.

RESULTS

Preparation significantly changed canal surface area, volume, structure model index, thickness, and canal curvature. There were no significant differences between instrument types concerning these parameters and uninstrumented surface area. The canals prepared with PTU showed larger values of transportation compared with those in Mtwo group at the apical third.

CONCLUSIONS

Both of the instrumentation systems produced canal preparations with adequate geometry. PTU produced larger transportation at apical third.

Evaluation of surface preparation and maintenance of canal curvature following instrumentation with hand 'K' file and three different Ni-Ti rotary systems: A radiographic and SEM study

Aim:

To determine the shaping ability and cleaning efficiency of hand K-flexofiles, ProTaper, LightSpeed and Mtwo instruments during the preparation of curved root canals in extracted human teeth.

Materials and Methods:

A total of 120 root canals of mandibular and maxillary molars with curvature more than 20° were divided into four groups of 30 each. In group A, canals were prepared using hand K-flexofiles following the crown down technique. In group B LightSpeed, in group C ProTaper, and in group D Mtwo rotary instruments were used to prepare the root canals. Using pre- and post-instrumentation radiographs, straightening of the canal curvature was determined with Corel Draw 9.0 software tools. The amount of debris and smear layer were quantified at three different areas (coronal, middle, and apical thirds) of root canal using SEM. The collected data were analyzed statistically using Student's paired ‘t’ test.

Results:

The mean change in curvature for hand K-files was 7.71°, for ProTaper files 6.03°, for Mtwo 5.43°, and for LightSpeed instruments were found to be 4.57°. The percentage change in the curvature for all the four groups was statistically highly significant (P< 0.01). LightSpeed instruments maintained the original canal curvature significantly (P< 0.01) better than the other instruments. For leftover debris, the minimum percentage was found to be associated with ProTaper (65.48%) followed by Mtwo (66.22%), LightSpeed (71.67%) and the maximum with hand K-files (74.16%). However, the difference in mean leftover debris between ProTaper and Mtwo was not significant.

Conclusion:

ProTaper and Mtwo resulted in good cleaning, and LightSpeed maintained the original canal curvature better than the ProTaper, Mtwo, or Hand K-files.

Assessment of canal walls after biomechanical preparation of root canals instrumented with Protaper Universal rotary system

Objective:

The aim of this study was to examine the instrumented walls of root canals prepared with the ProTaper Universal™ rotary system.

Material and Methods:

Twenty mesiobuccal canals of human first mandibular molars were divided into 2 groups of 10 specimens each and embedded in a muffle system. The root canals were transversely sectioned 3 mm short of the apex before preparation and remounted in their molds. All root canals were prepared with ProTaper Universal™ rotary system or with Nitiflex™ files. The pre and postoperative images of the apical thirds viewed with a stereoscopic magnifier (×45) were captured digitally for further analysis. Data were analyzed statistically by Fisher's exact test and Chi-square test at 5% significance level.

Results:

The differences observed between the instrumented and the noninstrumented walls were not statistically significant (p<0.05).

Conclusions:

The Nitiflex™ files and the ProTaper Universal™ rotary system failed to instrument all the root canal walls.

Shaping ability of four nickel-titanium rotary instruments in simulated S-shaped canals

INTRODUCTION

The purpose of this study was to compare the shaping ability of ProTaper, Mtwo, BioRaCe, and BioRaCe + S-Apex instruments in simulated canals with an S-shaped curvature.

METHODS

Canal transportation and aberrations were assessed by comparing the preinstrumentation and postinstrumentation images under a stereomicroscope. Analysis of variance and post hoc Student-Newman-Keuls test were used for statistical analysis.

RESULTS

ProTaper instruments caused more pronounced canal transportation in the apical curvature (P < .01) than all other instruments. The use of ProTaper, Mtwo, and BioRaCe instruments resulted in more canal aberrations compared with BioRaCe + S-Apex (P < .05).

CONCLUSIONS

NiTi systems including less tapered and more flexible instruments like S-Apex seem to be favorable when preparing S-shaped canals.

Comparison of shaping ability of RaCe and Hero Shaper instruments in simulated curved canals

OBJECTIVE

This study compared the shaping ability of Hero Shaper and RaCe instruments in simulated curved canals.

STUDY DESIGN

Forty simulated canals in resin blocks were divided into 2 experimental groups, each comprising 20 resin blocks, and prepared with Hero Shaper and RaCe using the crown-down technique. Preoperative and postoperative photographs, recorded using a digital camera, were superimposed and aberrations were recorded. Material removal was measured at 10 points beginning 1 mm from the end point of the canal. Mean total widths, outer and inner width measurements, were determined on each central canal path and differences were statistically analyzed using Student t test.

RESULTS

The Hero Shaper and RaCe instruments removed almost the same amount of material from the inner side of the simulated canals. On the outer canal wall, the RaCe instruments removed significantly more material from the first 3 mm (P < .05). However, Hero Shaper removed more material from the middle and coronal aspects of the canal and the differences were statistically significant (P < .01).

CONCLUSION

RaCe instruments removed more resin from the outside of the curvature at the apical thirds, while Hero Shaper removed more material from the middle and coronal thirds on the outer canal wall. Hero Shaper instruments showed better centering ability and fewer aberrations. No instrument fractures but some deformations were observed for both systems.

Shaping ability of progressive versus constant taper instruments in curved root canals of extracted teeth

AIM

To compare the shaping ability of progressive versus constant taper shaft instruments in curved root canals of extracted human teeth.

METHODOLOGY

A total of 40 root canals of mandibular molars with curvatures ranging between 20 degrees and 40 degrees were divided into two groups of 20 canals each and embedded in a muffle system. The root canals sectioned horizontally at three levels before preparation and then remounted into the mould. All root canals were prepared with ProTaper (progressive taper) or Hero Shaper (constant taper) instruments. Pre- and post-instrumentation radiographs and cross-sectional images were obtained. The parameters evaluated were: working safety (instrument failure, apical blockage and loss of working length) and shaping ability (straightening, cross-sectional area, transportation and centring ability). The data were analysed statistically using Student's t-test.

RESULTS

No instrument fractured during preparation. One Hero Shaper instrument permanently deformed. Both instrument systems maintained working length well. The canals prepared with Hero Shaper instruments were straightened to a lesser degree (P < 0.05). ProTaper instruments removed more dentine in the coronal and the middle sections of the canals. Canals prepared with Hero Shaper instruments had less transportation (P < 0.01) and better centring ability (P < 0.05) in the apical section.

CONCLUSIONS

Both instrument systems were safe to use and maintained working length well. The canals prepared with Hero Shaper had less transportation and were better centred in the apical region, possibly because their smaller taper reduced instrument stiffness.

Root canal preparation with the NiTi systems K3, Mtwo and ProTaper

The aim of this paper was to examine the result of rotary root canal preparation with the nickel-titanium (NiTi) systems K3, ProTaper and Mtwo. One hundred and fifty curved artificial root canals and 60 mesial canals of human mandibular molars were selected. In the group of curved artificial canals, all canals were prepared to size 35/0.04 taper with the three systems. In the group of human mandibular molars, the teeth with mature root canals were radiographed with silver points inserted in bucco-lingual and in mesio-distal positions. In the artificial root group, one K3 instrument separated. Mtwo (20%) showed significantly (P = 0.003) less zips than K3 (46.9%) or ProTaper (50%). There were no significant differences in ledge and elbow formation. K3 and Mtwo had the lowest percentage of canal transportation. There was no significant difference regarding the preparation length or the condition of the apical foramina following the preparation. Canals prepared with K3 (26.5%) were significantly (P < 0.001) less tapered than ProTaper (62%) and Mtwo (82%). In the human mandibular molar group, one Mtwo and one ProTaper instrument separated. No significant differences were found in the preparation length, transportation or taper. The three systems tested, K3, Mtwo and ProTaper, achieved good preparation results.

Influence of a brushing working motion on the fatigue life of NiTi rotary instruments

AIM

To evaluate the cyclic fatigue resistance of Mtwo NiTi rotary instruments when used with a brushing or no-brushing action in oval root canals.

METHODOLOGY

Cyclic fatigue testing of instruments was performed in tapered artificial canals with a 5 mm radius of curvature and an angle of curvature of 60 degrees. Twenty Mtwo instruments for each size were selected and divided into two groups: group A = 10 instruments used with a no-brushing motion (control group); group B = 10 instruments used with a brushing-milling action. Each Mtwo instrument was used for cleaning and shaping 10 oval root canals. In all 80 instruments were rotated until fracture occurred and the number of cycles to failure (NCF) recorded. Data were analysed by one-way ANOVA, Tukey HSD test and independent sample t-test to determine any statistical difference; the significance was determined at the 95% confidence level.

RESULTS

No statistically significant reduction of NCF between instruments used with a no-brushing motion (group A) and instruments used with a brushing motion (group B) were apparent except for size 25, 0.06 taper. Mtwo size 10, 0.04 taper, size 15, 0.05 taper, size 20, 0.06 taper, size 25, 0.06 taper instruments had a decrease in life span of 1%, 0.5%, 8% and 19%, respectively.

CONCLUSIONS

Fatigue life of instruments of larger size could be reduced by using them with a lateral brushing or pressing movement. However, each file was successfully operated without intracanal failure, demonstrating that Mtwo rotary instruments can be used safely in a brushing action in simulated clinical conditions up to 10 times in oval canals.

The influence of various automated devices on the shaping ability of Mtwo rotary nickel-titanium instruments

AIM

To compare the shaping ability of Mtwo rotary nickel-titanium instruments in simulated curved canals and in curved canals of extracted teeth when set into permanent rotation with two different torque-limited automated devices.

METHODOLOGY

Root canal instrumentation was performed with two different torque-limited automated devices (Mtwo direct handpiece and Endo IT motor) using Mtwo rotary nickel-titanium instruments up to size 35. Simulated canals: 28 degrees and 35 degrees curved canals in resin blocks (n = 20 canals in each group) were prepared. Pre- and post-instrumentation images were recorded and assessment of canal shape was completed with a computer image analysis program. Extracted teeth: a total of 40 curved root canals were divided into two groups, which were balanced with respect to the angle and the radius of canal curvature. Straightening of the canal curvatures was determined with a computer image analysis program. Incidence of canal aberrations, preparation time, changes of working length and instrument failures were recorded both in simulated and real canals and were analysed using the t-test and a chi-square test.

RESULTS

In simulated canals, instrumentation with Endo IT was significantly faster than with Mtwo direct (P < 0.05). No significant differences between the two devices were noted when all other parameters were assessed (P > 0.05). Only one instrument separated (Mtwo direct) during the enlargement of 28 degrees curved simulated canals. All systems maintained working distance well.

CONCLUSIONS

Both systems respected original root canal curvature well and were safe, indicating that the Mtwo direct handpiece is suitable for preparing curved root canals with the Mtwo instruments.

Comparative study on the shaping ability and cleaning efficiency of rotary Mtwo instruments. Part 2. Cleaning effectiveness and shaping ability in severely curved root canals of extracted teeth

AIM

To compare the cleaning effectiveness and shaping ability of Mtwo, K3, and RaCe nickel-titanium rotary instruments during the preparation of curved root canals in extracted human teeth.

METHODOLOGY

A total of 60 root canals of mandibular and maxillary molars with curvatures ranging between 25 degrees and 35 degrees were divided into three groups of 20 canals. Based on radiographs taken prior to instrumentation with the initial instrument inserted into the canal, the groups were balanced with respect to the angle and the radius of canal curvature. Canals were prepared using a low-torque control motor. Using pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. The amount of debris and smear layer was quantified on the basis of a numerical evaluation scale. The data established for scoring the debris and the smear layer was separately recorded and analysed statistically using the Kruskal-Wallis test.

RESULTS

During preparation no instrument separated. Completely clean root canals were never observed. For debris removal Mtwo instruments achieved significantly better results (P < 0.001) than K3 and RaCe instruments. The results for remaining smear layer were similar and not significantly different (P > 0.05). Mtwo instruments maintained the original canal curvature significantly better (P < 0.05) than the other instruments. Instrumentation with Mtwo files was significantly faster than with K3 or RaCe instruments (P < 0.05).

CONCLUSIONS

Under the conditions of this study, Mtwo instruments resulted in good cleaning and maintained the original curvature significantly better than K3 or RaCe files.