Cyclic fatigue testing of nickel-titanium endodontic instruments

Fatigue resistance of ProTaper gold exposed to high-concentration sodium hypochlorite in double curvature artificial canal

This study aimed to evaluate and compare the fatigue resistance of ProTaper Gold (PTG) and ProTaper Universal (PTU) in artificial single and double curvature canals in 5% sodium hypochlorite (NaOCl) at body temperature (37 °C). PTG and PTU files (size F1) were subjected to fatigue tests in two different artificial ceramic canals. The single curvature model had a 60° curvature angle with a 5 mm radius. The double curvature model had a 60° curvature angle with a 5 mm radius and a second 30° curvature with a 2 mm radius. A file segment was introduced into the artificial canal and immersed in water or 5% NaOCl at 37 °C. The total number of cycles to fracture (NCF) was recorded. Data were analyzed using t-test and linear regression analysis. The NCF of all files was significantly influenced by the type of NiTi metal alloy (P < .01), canal curvatures (P < .01), and the environmental conditions (P < .05). PTG had higher fatigue resistance than PTU files in both single and double curvature canals (P < .05). The NCF of PTU files in 5% NaOCl was shorter than that in water (P < .05). The mean length of broken PTG was significantly shorter than those of PTU files in both single and double curvature canals (P < .01). The fatigue performance of PTG is better than that of PTU in both single and double curvature. Environmental conditions may affect the fatigue behavior of PTU files with single curvature.

Increase in [corrected] the glyde path diameter improves the centering ability of F6 Skytaper

Objective:

The aim of this study was to assess the impact of glide path preparation, performed with PathGlider 0.15 (Komet Brasseler GmbH & Co., Lemgo, Germany) and PathGlider 0.20 (Komet Brasseler GmbH & Co., Lemgo, Germany), on the centering ability of 25-size F6 Skytaper in J-shape simulated root canals, compared with no glide path executed.

Materials and Methods:

Sixty J-shaped ISO 15 0.02 taper endo training blocks (Dentsply Maillefer) were assigned to three groups (n = 20 for each group). Photographic images were taken on endoblocks before and after shaping procedures. After superimposition, the software AutoCAD 2013 (Autodesk Inc., San Rafael, USA) was used for record the centering and shaping ability at 9 different levels from the apex.

Results:

Shaping procedures including the using of PathGlider 0.20 resulted in a lower amount of resin removed and in a clear improvement of centering ability of the Skytaper 0.25 at almost all reference point levels.

Conclusions:

Within the limitations of this study, it could be concluded that the glide path procedure, performed with the PathGlider 0.20 before the shaping with 25-size F6 Skytaper, might determine a lower amount of resin removed and a better centering ability compared with the groups without glide path procedure and those treated with PathGlider 0.15.

Effect of autoclave sterilization on cyclic fatigue and torsional fracture resistance of NiTi rotary instruments

The purpose of this study is to assess the effect of autoclave sterilization on the cyclic fatigue and torsional fracture resistance of ProTaper Universal (PTU), K3XF, HyFlex EDM (EDM), and TF adaptive (TFA). Sixty instruments from each file type were divided into two categories for cyclic fatigue group (CGr) and torsional fracture group (TGr). CGr and TGr were divided into three subgroups, respectively, consisting of ten instruments from each file type. Cyclic fatigue fracture test was performed using artificial canal made of stainless steel, and the mean number of cycles to failure (NCF) were determined. CGr1, the files were tested to establish baseline for NCF; CGr2, the files were tested cyclic fatigue after 10 cycles of autoclave; CGr3, instruments were autoclaved after being cycled to 25, 50, and 75% of corresponding NCF determined in CGr1, followed by cyclic fatigue test. The torsional fracture test was performed without autoclave (TGr1), after 3-cycle autoclave (TGr2), and 7-cycle autoclave (TGr3), respectively, which evaluated maximum torque and angular deflection. NCF, maximum torque and angular deflection were compared using one-way ANOVA with Bonferroni test. Two-way ANOVA was performed to determine the interaction between 'autoclave treatment' and 'type of NiTi file'. EDM showed highest NCF within the same autoclave treatment. TFA presented the lowest maximum torque and the highest angular deflection, and PTU presented the lowest angular deflection. Within the same NiTi file systems, most of NCF, maximum torque and angular deflection of tested files were not significantly influenced by autoclave condition.

Microcomputed tomographic investigation of the trepan bur/microtube technique for the removal of fractured instruments from root canals without a dental operating microscope

OBJECTIVES

The aim of this study was to evaluate the removal of fractured instruments in mandibular incisor canals by using the trepan bur/microtube technique without a dental operating microscope (DOM).

MATERIALS AND METHODS

Thirty-four mandibular incisors were selected, and 5-mm apical segments of #25/.06 taper K3 NiTi instruments were fractured in the apical portion of each canal. Coronal enlargement was performed, and a staging platform was prepared at the coronal aspect of the fractured instrument. Then, a trepan bur was used to expose 1-1.5 mm of the fragmented instrument, and a microtube device was used to withdraw the fragment. Microcomputed tomographic (micro-CT) imaging was used to evaluate the geometric changes in the root canal and dentin. The time required for fractured instrument removal in each sample was recorded, and the results were statistically analyzed with a paired t test.

RESULTS

The trepan bur/microtube technique exhibited a success rate of 76.47%, and the average fractured instrument removal time was 8.55 ± 5.81 min. The changes in canal volume and dentin volume from the coronal end of the fractured instrument to 1.5 mm apical to the end were significantly greater than those from the cementoenamel junction (CEJ) to the coronal end of the fractured instrument during fractured instrument removal (P < 0.0001).

CONCLUSIONS

The study showed that the trepan bur/microtube technique had a significant impact on geometric changes in the root canal and dentin from the coronal end of the fractured instrument to 1.5 mm apical to the end.

CLINICAL RELEVANCE

These findings suggest that the trepan bur/microtube technique may be an optional method for fractured instrument removal from relatively straight canals.

A critical appraisal of studies on cyclic fatigue resistance of engine-driven endodontic instruments

The endodontic literature contains a plethora of studies on static and dynamic cyclic fatigue resistance tests performed on a large array of rotary or reciprocating nickel-titanium endodontic instruments. It was the aim of this review to summarize the currently available evidence to point out the different outcomes from static versus dynamic tests and to assess whether cyclic fatigue tests provide useful data and information for clinical practice. An electronic literature research in the database PubMed was performed using appropriate search terms, and the titles and abstract were screened for relevance. Language was restricted to English. The review reveals marked differences between the results obtained in static and dynamic tests, and also, the results for the same instruments assessed either under static or dynamic experimental conditions are widely inconsistent. Between the lowest and the highest value for one and the same pathfinding instrument was a factor of about 123 when cyclic fatigue was assessed either under static or dynamic experimental conditions. Moreover, standard deviations of up to 30% have been reported. Environmental temperature has a 500% impact on the lifetime of instruments. In conclusion, fatigue resistance tests conducted under room temperature should be regarded as having little meaning and the scientific and clinical benefits of fatigue resistance tests are very limited. These data should be provided by the manufacturer of the instruments.

Cyclic fatigue resistance of rotary NiTi instruments produced with four different manufacturing methods

The aim of this study was to compare the cyclic fatigue resistance of rotary NiTi files, produced with four different manufacturing methods on specially designed dynamic models that simulated clinical conditions. In this study, 120 files, consisting of 30 files for Typhoon, ProTaper Next, RaCe, and Twisted Files nickel titanium rotary systems were used. The 30 files of each group were divided into three subgroups to be used in artificial canals with a 60° angle of curvature and radii of curvature of 2, 5, and 8 mm (n = 10). All files were rotated in the artificial canals until fracture occurred and the number of cycles to fracture was calculated. The data were analyzed using one- and two-way analyses of variance and Tamhane multiple comparison tests. In all three groups, Typhoon instruments had the highest number of cycles to failure than the RaCe, ProTaper Next, and Twisted Files instruments, and the difference statistically significant (p < .05). There were no significant differences between the RaCe, ProTaper Next, and Twisted Files groups (p > .05). The CM wire Typhoon system was significantly more resistant to cyclic fatigue compared to the other file systems in all three artificial canals. When the fracture resistance of an instrument in three different artificial canals was compared, the mean NCFs decreased as the radius of the curvature of the canal decreased from 8 to 2 mm. Manufacturing method is one of the most important factors on cyclic fatigue resistance, also the radius of curvature effects the cyclic fatigue.

Comparison of the cyclic fatigue resistance of ProGlider, PathGlider and One G path-finding instruments

Background. The aim of the present study was to compare the cyclic fatigue resistance of novel nickel titanium rotary pathfinding instruments.

Methods. Twenty instruments were selected for each file system. A simulated stainless steel root canal, with a 90° angle of curvature and a curvature radius of 3 mm, was used for cyclic fatigue test of the ProGlider (#16, progressive taper: 0.02‒ 0.085), PathGlider (#15, taper: .03), and One G (#14, taper: .03) instruments. Statistical analyses were performed with oneway ANOVA (P=0.05). Post hoc Tukey tests were used to determine any statistically significant differences between the groups.

Results. The ProGlider instruments exhibited significantly more cyclic fatigue resistance than both PathGlider and One G instruments (P<0.001). One G instruments had significantly more resistance to fracture than PathGlider instruments (P<0.05).

Conclusion. ProGlider instruments had better cyclic fatigue resistance than PathGlider and One G instruments.

Torsional resistance of three ProTaper rotary systems

BACKGROUND

The aim of this study is to compare the torsional resistance of the available ProTaper rotary systems, namely, ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG).

METHODS

A total of 195 files from the three systems distributed into 13 groups (PTU-S1, PTU-S2, PTU-F1, PTU-F2, PTU-F3, PTG-S1, PTG-S2, PTG-F1, PTG-F2, PTG-F3, PTN-X1, PTN-X2 and PTN-X3) were subjected to torsional fatigue until failure. The torsional test was performed according to ISO 3630-1, where each file was placed in a straight position to eliminate the influence of cyclic fatigue. The Kruskal-Wallis test was conducted to compare the mean maximum torques and angular deflections at fracture for the groups, and the Mann-Whitney test was performed for pairwise comparisons. The significance level was set at 0.05 and the fractured surfaces were examined under a scanning electron microscope.

RESULT

Among the tested files, PTG-S1 had the lowest torsional fatigue resistance, whereas PTU-F2 and PTU-F3 had the highest torsional resistance. The scanning electron microscope showed typical features of torsional failure.

CONCLUSION

The new ProTaper systems (PTG and PTN) did not show improved torsional resistance in comparison with PTU.

Structural Characteristics and Torsional Resistance Evaluation of WaveOne and WaveOne Gold Instruments after Simulated Clinical Use

INTRODUCTION

The aim of this study was to compare 2 reciprocating nickel-titanium systems with different manufacturing characteristics and to evaluate the influence of simulated clinical use on their torsional resistance.

METHODS

New 25/.08 WaveOne Primary (WO; Dentsply Sirona, York, PA) and 25/.07 WaveOne Gold Primary (Dentsply Sirona) files were used in this study. The diameter and cross-sectional area at 3 mm from the tip were measured using image analyses. The alloy microstructure was evaluated by X-ray diffraction and the phase transformation temperatures by differential scanning calorimetry analyses. Forty files were divided into 4 groups: control group 1 and control group 2, which were submitted to torsion tests until rupture, and experimental group 1 and experimental group 2, in which instruments were used to shape 2 mesial canals of an extracted mandibular molar and then submitted to torsion tests until rupture.

RESULTS

WO had higher values of diameter and area at 3 mm from the tip. X-ray diffraction analysis presented R-phase and austenite for both systems. Austenite finish temperatures, determined by differential scanning calorimetry, were above room temperature. WO showed higher values of torque until rupture, and WaveOne Gold showed higher values of angular deflexion (P > .05). No differences were found between the same type of instrument in the control and experimental groups.

CONCLUSIONS

The higher torsional resistance of WO can be attributed to geometric characteristics. The use in 1 tooth with curved canals is safe and does not affect the torsional resistance of the instruments analyzed.

Effect of glide path preparation with PathFile and ProGlider on the cyclic fatigue resistance of WaveOne nickel-titanium files

Objectives

The aim of this study was to investigate the effect of glide path preparation with PathFile and ProGlider nickel-titanium (NiTi) files on the cyclic fatigue resistance of WaveOne NiTi files.

Materials and Methods

Forty-four WaveOne Primary files were used and divided into four groups (n = 11). In the first group (0 WaveOne), the WaveOne Primary files served as a control group and were not used on acrylic blocks. In the 1 WaveOne Group, acrylic blocks were prepared using only WaveOne Primary files, and in the PF+WaveOne group and PG+WaveOne groups, acrylic blocks were first prepared with PathFile or ProGlider NiTi files, respectively, followed by the use of WaveOne Primary files. All the WaveOne Primary files were then subjected to cyclic fatigue testing. The number of cycles to failure was calculated and the data were statistically analyzed using one-way analysis of variance (ANOVA) and the Tukey honest significant difference multiple-comparison test at a 5% significance level.

Results

The highest number of cycles to failure was found in the control group, and the lowest numbers were found in the 1 WaveOne group and the PF+WaveOne group. Significant differences were found among the 1 WaveOne, PF+WaveOne, and control groups (p < 0.05). No statistically significant differences were found between the PG+WaveOne group and the other three groups (p > 0.05).

Conclusion

Glide path preparation with NiTi rotary files did not affect the cyclic fatigue resistance of WaveOne Primary files used on acrylic blocks.

Anatomic Analysis of Palatal Roots of Maxillary Molars Using Micro-computed Tomography

INTRODUCTION

The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning.

METHODS

Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test.

RESULTS

The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation.

CONCLUSIONS

The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.

Cyclic fatigue resistance of novel Genius and Edgefile nickel-titanium reciprocating instruments

This study aimed to assess the cyclic fatigue resistance of Genius and EdgeFile X1 reciprocating instruments compared with WaveOne Gold Primary. Twenty Genius (Ultradent) 25.04, 20 Genius 30.04, 20 EdgeFile X1 (EdgeEndo) and 20 WaveOne Gold Primary (Dentsply Maillefer) instruments were included in this study and tested in a static cyclic fatigue testing device, which has an artificial stainless steel canal with a 60° angle of curvature and a 5-mm radius of curvature. All instruments were operated in reciprocation mode until fracture occurred. The number of cycles to failure (NCF) was calculated and time to fracture (TF) was recorded in seconds using a digital chronometer. The mean and standard deviations of NCF and TF were calculated for each reciprocating system and the data were subjected to Kruskal-Wallis one-way analysis of variance and to Dunn's test (p < .05) using SigmaPlot software (Systat software, CA, USA). The fractured surfaces of five instruments from each brand were randomly examined and microphotographed by a low-vacuum environmental scanning electron microscopy - SEM (Tabletop Microscope TM3030, Hitachi, Japan) to confirm the cyclic fatigue fracture. EdgeFile exhibited the highest cyclic fatigue resistance, followed by both Genius files (p < .05). Within the limitations of this in vitro study, EdgeFile X1 instruments had significantly higher cyclic fatigue resistance than did Genius and WaveOne Gold Primary instruments. The cyclic fatigue resistance of both Genius files was higher than that of WaveOne Gold Primary.

Evaluation of deformation and fracture rates for nickel-titanium rotary instruments according to the frequency of clinical use

Purpose

To evaluate the deformation and fracture rates for ProTaper Universal (PTU) nickel-titanium rotary instruments according to the frequency of clinical use.

Materials and Methods

A total of 619 PTU instruments (S1, S2, F1, F2, and F3) that have been used in the clinic by a single endodontist were collected over a period of 4 years. These instruments were grouped on the basis of one to three (Group A), four to six (Group B) and seven to nine (Group C) clinical uses (one canal = one use). All instruments were evaluated by a blinded investigator under a stereomicroscope at 15×-45× magnification for the presence of deformation and fracture.

Results

The overall rates of deformation and fracture were 10% and 1.2%, respectively. The deformation and fracture rates for the S2, F1, and F2 instruments showed no significant differences among groups. However, fracture rate for S1 instruments in Group A was significantly higher than for those in Group B (p=0.025) and Group C (p=0.004). In Group C, the S1 instruments showed a significantly higher deformation rate compared with the S2 (p=0.04), F1 (p=0.008) and F2 (p=0.049) instruments; there were no other significant differences within groups.

Conclusion

Under the conditions of the current study, frequency of use seemed to influence the deformation rates of PTU rotary instruments. Except S1, these instruments could be used without any fracture or deformation in up to 9 clinical cases by an experienced endodontist.

Mechanical Properties of Various Glide Path Preparation Nickel-titanium Rotary Instruments

INTRODUCTION

The aim of this study was to compare the cyclic fatigue, torsional resistance, and bending stiffness of single-file glide path preparation nickel-titanium instruments.

METHODS

ProGlider (#16/progressive taper; Dentsply Sirona, Ballaigues, Switzerland), One G (#14/.03; Micro-Mega, Besancon, France), and EdgeGlidePath (#16/progressive taper; Edge Endo, Albuquerque, NM) were tested. For the bending stiffness test, the instrument was bent to a 45° angle along the main axis while 3 mm of the tip was secured. Cyclic fatigue resistance was measured during pecking movement, whereas the file was rotated within a reproducible simulated canal with a 3-mm radius and a 90° angle of curvature. The ultimate torsional strength and toughness were evaluated using a custom device. While tightly holding the end of the file at 3 mm, a rotational load of 2 rpm speed was applied until fracture. The results were analyzed using 1-way analysis of variance and Tukey post hoc comparison. A microscopic inspection was performed on the surface of a separate instrument using a scanning electron microscope.

RESULTS

EdgeGlidePath showed superior cyclic fatigue resistance compared with the other systems. One G showed higher maximum torsional strength than the others. One G showed the largest distortion angle and the highest toughness followed by EdgeGlidePath and ProGlider (P < .05). One G also showed larger bending stiffness than the others, whereas EdgeGlidePath showed a larger residual angle than the others (P < .05).

CONCLUSIONS

Conventional wire showed higher toughness and torsional resistance than M-Wire and heat-treated nickel-titanium instruments. However, heat-treated wire showed higher cyclic resistance than conventional wire and M-Wire.

A comparative evaluation of cyclic fatigue resistance for different endodontic NiTi rotary files: An in-vitro study

Aim

This in-vitro study evaluated and compared the flexural fatigue resistance for Hero Shapers, Hyflex CM, One Shape, Profile Vortex and Protaper Next rotary NiTi files.

Method and materials

Total 25 rotary NiTi files allocated to each experimental group were tested in a simulated constructed apparatus with an angle of curvature 60° & radius of curvature 5 mm. Each experimental file was coated with EDTA gel and was placed in endodomotor handpiece with rubber stopper at support steel cylinder and its end between two shaping steel cylinders on the simulated apparatus. File was then rotated at 400 rpm, 2.5 N/cm torque and simultaneously digital stop watch was started. Time taken (in seconds) until the file got fractured was recorded.

Results

Time taken to fracture ranged from 7 to 58 s in different groups. Analysis of variance show a statistically significant intergroup difference (p < 0.001). Tukey HSD test showed the significant differences. The Weibull modulus values ranged from 7.31 to 24.19.

Conclusion

Cyclic flexural fatigue resistance was observed highest for Grp IV (Hyflex CM) and lowest for Grp I (Hero Shapers).

Clinical significance

Hyflex CM rotary NiTi files can be used in curved root canals as they had superior resistance and long survival time which will be helpful in eliminating one of the reasons for file fracture (due to cyclic flexural fatigue) during the root canal treatment clinically where root canal possesses a sharp bend or curve.

Cyclic fatigue resistance of 2Shape, Twisted File and EndoSequence Xpress nickel-titanium rotary files at intracanal temperature

Background. The aim of this study was to compare the cyclic fatigue resistance of 2Shape, Twisted File (TF) and EndoSequence Xpress (ESX) nickel-titanium rotary files at intracanal temperature (35°C).

Methods. Twenty 2Shape TS1 (25/.04), 20 TF (25/.04) and 20 ESX (25/.04) files were tested for cyclic fatigue at intracanal temperature (35°C). All the instruments were rotated in artificial canals which were made of stainless steel with an inner diameter of 1.5 mm, 60° angle of curvature and a radius curvature of 5 mm until fracture occurred; the time to fracture was recorded in seconds using a digital chronometer and the number of cycles to fracture (NCF) for each file was calculated. Kruskal-Wallis test with Bonferroni correction was performed to statistically analyze data using SPSS 21.0. Statistical significance was set at P<0.05.

Results. NCF values revealed that the 2Shape had significantly the highest cyclic fatigue resistance, followed by TF and ESX at intracanal temperature (P<0.05). The difference was significant between the TF and ESX groups (P<0.05). There was no significant difference among the 2Shape, TF and ESX files with respect to the lengths of the fractured file fragments (P>0.05).

Conclusion. Within the limitations of present study, it was concluded that the cyclic fatigue resistance of 2Shape files at the intracanal temperature is higher than that of TF and ESX files.

Cyclic fatigue resistance of three rotary file systems in a dynamic model after immersion in sodium hypochlorite

To evaluate the effect of immersion in 3% sodium hypochlorite solution in the resistance to cyclic fatigue of three nickel-titanium (NiTi) rotary file systems, ProTaper Next (PTN), Hyflex CM (CM), and Hyflex EDM (EDM), in a mechanical model featuring axial movement. Ninety instruments of three different NiTi rotary file systems, PTN (size 25, 0.06 taper), CM (25, 0.06), and EDM (25/~, variable taper), were randomly divided according to a 3 × 3 factorial design and tested under dynamic immersion in a 3% NaOCl solution (1 or 5 min) or without immersion, making a total of 9 groups (n = 10). Files were tested in an artificial root canal with 45° angle and 5 mm radius apical curvature being submitted to back-and-forth movements until fracture. Statistical analysis was performed using two-way factorial ANOVA with Bonferroni post-hoc tests, at a significance level of 5%. Instruments were evaluated for reliability using a Weilbull approach. Regardless of the immersion treatment, PTN had on average 1200 ± 178 cycles to fracture, CM had 1949 ± 362, and EDM had 5573 ± 853, which was a significantly different (P < 0.01). The NaOCl immersion promoted a significant reduction in the mean number of cycles to fracture (P = 0.01), and was reflected in a significant reduction of the characteristic life of the instruments of the CM end EDM groups. Within this study conditions, EDM instruments performed better to cyclic fatigue followed by CM and then PTN. Immersion in NaOCl decreased the resistance to cyclic fatigue of all tested instruments, but affected more those manufactured from CM wire.

Effect of Sodium Hypochlorite and EDTA on Surface Roughness of HyFlex CM and HyFlex EDM Files

The aim of the present study was to compare the effect of exposure to sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) on the surface topography and roughness of HyFlex controlled memory (CM) and HyFlex electrical discharge machining (EDM) using atomic force microscopy (AFM). Twenty HyFlex EDM (25/.08) and 20 HyFlex CM (25/.06) files were divided into five groups (n = 4). One group served as a negative control group. The files in the other groups were exposed to 5.25% NaOCl and 17% EDTA solutions at 37°C for 5 and 10 min, respectively, and examined using AFM after each exposure. The data were analyzed using one-way ANOVA test. The lowest values were observed in the control group of HyFlex EDM files (p < .05). The highest values were observed in the HyFlex EDM and HyFlex CM files immersed in EDTA for 10 min (p < .05). In conclusion, the tested irrigants had a significant negative effect on the surface porosity of NiTi files. The immersion of NiTi files in irrigants during cleaning and sterilization procedures results in corrosion and surface deformation of the files, and this can lead to unexpected file fracture during clinical use. Thus, the investigation of effect of ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on surface topography of HyFlex files is important.

An in vitro cyclic fatigue resistance comparison of conventional and new generation nickel-titanium rotary files

Background

New designs and processing of Niquel-Titanium (NiTi) have been introduced to increase resistance to cyclic fatigue. The purpose of this study was to compare the cyclic fatigue resistance of 3 NiTi rotary instruments, ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), Profile Vortex Blue (PVB; Dentsply Tulsa Dental, Tulsa, OK, USA) and ProTaper Universal (PTU; Dentsply Maillefer, Ballaigues, Switzerland).

Material and Methods

A cyclic fatigue test was conducted operating instruments from ProTaper Next X2, Profile Vortex Blue 25.06 and ProTaper F2. A total of 234 instruments were rotated in 2 simulated stainless steel curved canals with different angles of curvature (45º and 60°) and 5-mm radius of curvature. The number of cycles to fracture (NCF) was calculated. Data were compared using 2-way analysis of variance and post-hoc Bonferroni test in software (SPSS 15.0, Chicago, IL). Statistical significance was set at P<0.05.

Results

Profile Vortex Blue showed higher resistance to cyclic fatigue in both curved canals than ProTaper Next and ProTaper Universal (P<0.001). ProTaper Universal obtained the lowest resistance to cyclic fatigue in both canals (P<0.001).

Conclusions

Profile Vortex Blue was the most resistant to cyclic fatigue failure, followed by ProTaper Next and ProTaper Universal. Anatomical complexity (angle of curvature) and manufacturing process of NiTi are important factors for resistance to cyclic fatigue.

Key words:Cyclic fatigue, M-Wire, Protaper Next, ProTaper Universal, Profile Vortex Blue.

Cyclic fatigue of Reciproc Blue and Reciproc instruments exposed to intracanal temperature in simulated severe apical curvature

OBJECTIVE

The aim of this study was to evaluate the cyclic fatigue resistance of Reciproc and Reciproc Blue by testing in a severe apical curvature at intracanal temperature.

MATERIALS AND METHODS

Eighteen Reciproc R25 (25.08) and Reciproc Blue (25.08) instruments were tested in a cyclic fatigue device at body temperature (37 °C) using a stainless steel block with an artificial canal with a curvature angle of 90° and radius of curvature of 2 mm. The number of cycles to fracture (NCF) was calculated. The instruments were examined by differential scanning calorimetry (DSC). The data were analyzed using both Student's t tests and Weibull analysis.

RESULTS

The NCF values of Reciproc R25 were significantly lower than Reciproc Blue R25 (P < 0.05). There was no significant difference between the instruments regarding the length of fractured fragments (P > 0.05).

CONCLUSIONS

Reciproc Blue R25 instruments displayed significantly higher NCF than Reciproc R25.

CLINICAL RELEVANCE

This study reported that novel reciprocating blue wire instruments exhibited higher cyclic fatigue resistance than its precedence M-wire instrument when tested in severely curvatured canals.

Methods for measurement of root canal curvature: a systematic and critical review

The assessment of root canal curvature is essential for clinical and research purposes. This systematic review presents an overview of the published techniques for the measurement of root canal curvature features using imaging and to provide a critique of their clinical application. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify measurement methods for root canal curvatures. The search strategy retrieved 10594 records in total, and 31 records fulfilled the inclusion criteria. From 2D image acquisitions, eleven studies measured exclusively the angle of curvature, an additional thirteen measured other curvature features (level, height, radius, length and shape). Seven reports described methods from 3D imaging (CBCT, μCT). Root canal curvatures should be measured, for clinical proposes, to facilitate endodontic treatment planning, and in research, to reduce the risk of selection bias. This review has revealed that there are many methods described in the literature; however, no consensus exists on which method should be used. Some of the methodologies have potential clinical translation, whereas others are suitable for research purpose only, as they require a specific software or radiographic exposure in the mesiodistal direction.

Curvature height and distance of MB canal of mandibular molar with Schneider angle and its comparison with canal access angle

Aim

To measure the proposed curvature height and distance of MB canal of mandibular molar with Schneider angle and its comparison with canal access angle both before and after instrumentation, and to compare among each other with multiple linear regression analysis.

Methodology

One hundred human mandibular first and second molars were used for the study. After endodontic access, a size 10 k-file was placed in the mesiobuccal canal extending to the apical foramen and radiographs were taken by using Radiovisiography. Both Schneider and canal access angle with its respective linear counterpart (Curvature height and curvature distance) was measured and calculated by using PLANMECA romexis (Helsinki Finland) software connected to the Intraoral x-ray unit both before and after biomechanical preparation with mesiobuccal canal till size F2. Statistical analysis was done by using multiple linear regression analysis.

Results

A significant difference was observed between before and after enlargement with respect to Schneider angle and Canal access angle with a t-value being (t = 11.0629, p < 0.05) (t = 10.5773, p < 0.05) for before and after enlargement of canals respectively. Percent of change is observed more with curvature height (29.62%) as compared with the curvature distance (8.87%).

Conclusions

Schneider angle with its proposed curvature height and distance reduced after instrumentation. Whereas canal access angle decreased and its curvature height and distance have increased after instrumentation.

Nickel-Titanium Rotary Instruments: Development of the Single-File Systems

Over the past two decades, the nickel-titanium (NiTi) rotary instruments have highly improved the quality of the cleaning and shaping of the root canals. The superelasticity and shape memory of these instruments reduce the possibility of the canal transportation along with saving the time for both the patients and the clinicians. Several commercial types of these instruments, produced by different manufacturers, have currently become available by modifying the characteristics of the wonder NiTi alloy and also the cross-sectional shapes, cutting edges, tapering and numbers and distances of the flutes of the instruments. Up to this date, five generations for NiTi rotary instruments have been described according to the time of introduction, properties, and method of application. The aim of this article is to review the evolution of these five generations of NiTi rotary instruments since their inception.

Cyclic flexural fatigue resistance of NiTi Controlled Memory and Blue Technology instruments after torsional preloading

Objective

The aim of this study was to evaluate the influence of torsional preloading on the cyclic flexural fatigue resistance of thermally treated NiTi instruments.

Material and Methods

Ten new instruments New Hyflex CM (HF 30.06; Coltene/Whaladent Inc.), Typhoon CM (TYP 30.06; Clinician's Choice Dental Products) and Vortex Blue (VB 30.06; Dentsply Tulsa Dental) were chosen, based on geometry and specific characteristics of the manufacturing process. The new instruments of each system were tested in a bench device to determine their fatigue resistance through mean value of number of cycles to failure (Nf) (Control Group – CG). Another group of 10 new HF, TYP and VB instruments were submitted to 20 cycles of torsional straining between 0° and 180° (Experimental Group – EG) and then submitted to fatigue until rupture under the same conditions of the CG. Tested instruments were examined by scanning electron microscopy (SEM). Data were analyzed using one-way analysis of variance and post hoc Tukey’s test (α=.05).

Results

Higher fatigue resistance was accomplished by HF instruments, followed by VB and TYP (p<0.05). During the torsional preloading, the lowest mean torque value was observed for TYP instruments (p<0.05). The torsional preload caused a significant reduction in the Nf values (p<0.05) of about 20%, 39% and 45% for instruments HF, VB and TYP, respectively. Longitudinal cracks, generated during the torsional preloading, were present in VB files, but were not observed in the CM instruments (HF and TYP).

Conclusions

In conclusion, the flexural fatigue resistance of thermally treated instruments is diminished after cyclic torsional loading.

Shaping ability of four root canal instrumentation systems in simulated 3D-printed root canal models

Introduction

The aim of this study was to compare the shaping ability of four root canal preparation systems in newly developed 3D-printed root canal models.

Materials and methods

For this study, 1080 3D-printed acrylic resin blocks with nine different root canal configurations were produced. They were prepared with Reciproc R25 (#25), F6 SkyTaper (#25 and #30) F360 (#25 and #35) and One Shape (#25) (N = 30 per system). Pre- and post-instrumentation images were superimposed for evaluation of the centering ratio of the different systems. Ledges, instrument fractures and preparation times were also recorded. Analysis of variance (ANOVA) and post-hoc Tukey tests were conducted, comparing the mean canal centering ratios and the mean preparation times.

Results

There were significant differences between all systems regarding the centering ratios in the different root canal configurations (ANOVA p < 0.001). The root canal configuration had considerable effect on the centering ratio of the instruments. The best overall mean centering ratios were achieved with F6 SkyTaper #25 instruments especially in canal configurations with big curvature angles and radii, while F360 #35 was least centered especially in canals with small curvature angles and radii. Most ledges occurred with OneShape, while it was the significantly (p < 0.001) fastest preparation system (86.7 s (SD 13.53)) and Reciproc the significantly (p < 0.001) slowest (103.0 s (SD 20.67)).

Conclusion

3D-printed root canals are suitable to produce challenging canal configurations and to investigate the limitations of root canal instruments. We found that all instruments caused canal transportations. However, F6 SkyTaper #25 files had better overall centering ratios than the other instruments. In canal configurations with small curvature radii, the centering ratio of some instruments is low and the probability for ledges is increased.

Fracture incidence of instruments from a single-file reciprocating system by students in an endodontic graduate programme: a cross-sectional retrospective study

AIM

To assess the fracture incidence of instruments from single-file reciprocating systems when used by students in an endodontic graduate programme.

METHODOLOGY

Dental records and periapical radiographs of patients treated by students on an endodontic graduate programme using reciprocating systems were assessed. Data on tooth type, number of treated root canals, number of fractured instruments, fragment size, angle, radius, arc length and position of root canal curvature where fractures occurred were tabulated for analysis. The risk of fracture was calculated for each group of teeth, root canal and root thirds, whilst the incidence of fractures reported for the reciprocating systems was compared using the chi-squared test at 5% significance level.

RESULTS

Overall, 2056 root canals (826 teeth) from 810 patients were included. The incidence of fractured files from single-file reciprocating systems in relation to a number of instrumented canals was 0.92%. Fracture rates of 0.84% and 0.93% were found in 830 and 1226 root canals instrumented with WaveOne and Reciproc systems, respectively. No significant differences were observed between the systems. The highest fracture rate was 52.6% in the mesiobuccal root of mandibular molars. The central angle, radius and arc length of the curvature of root canals where the instruments fractured ranged from 58° to 84°, from 1.7 to 7.2 mm and from 2.4 to 7.6 mm, respectively.

CONCLUSION

The use of WaveOne and Reciproc single-file reciprocating systems in an endodontic graduate programme was associated with a low incidence of instrument fractures.

Incidence of ProTaper Universal System Instrument Fractures - A Retrospective Clinical Study

Objective:

The aim of this retrospective clinical study was to evaluate the incidence of ProTaper Universal System instrument fractures, associated with observation of the arch, group of teeth, and root thirds in which these fractures occurred.

Methods:

From analysis of charts, clinical record cards and radiographs of endodontic treatments performed by postgraduate students using the ProTaper Universal System at a reference center, a total of 1031 teeth and 2355 canals were analyzed. The general incidence of instrument fractures and their frequency, considering the group of teeth, arch and root thirds, were cataloged and the data obtained were statistically analyzed (Exact Fischer test, with level of significance of 1%).

Results:

The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. Instrument fractures occurred more frequently in the mandibular first (8.8%) and second (9.6%) molars, however, without statistically significant difference between them (P=0.81). In the first and second maxillary molars, the incidence of fracture was 4.7% and 5.1%, respectively, also without significant difference (P=0.81). Considering the dental arches (maxillary and mandibular), the fractures occurred with significantly higher frequency in the mandibular arch (66.7%), in comparison with the maxillary arch (33.3%) (P<0.01). A significantly higher percentage of fractures occurred in the apical third (84.4%) compared with the middle third (15.6%) (P<0.01).

Conclusion:

The general percentage of fractures, considering the number of teeth and number of root canals evaluated was 4.4% and 1.9%, respectively. However, the arch (mandibular) and root third (apical) had a significant effect on the incidence of instrument fractures.

Cyclic Fatigue Life of Two Single File Engine-Driven Systems in Simulated Curved Canals

Introduction:

This study aimed to evaluate the cyclic fatigue resistance of two single file engine-driven instruments, Reciproc and NeoNiTi, in simulated root canals.

Methods and Materials:

Two groups of 15 NiTi endodontic instruments with an identical tip size of 0.25 mm were tested: Reciproc R25 (group A) and NeoNiTi A1 (group B). Cyclic fatigue testing was performed in a stainless steel artificial canal. The simulated canals had a 60^° angle and 5-mm radius curvature. The Reciproc instruments were operated using the preset program on torque control electric motor specific for the Reciproc instruments, while the NeoNiTi instruments were operated using the manufacturer recommendation. All instruments were rotated until fracture occurred, and the number of cycles to fracture (NCF) and the length of the fractured tip were recorded and registered. Means and standard deviations of NCF and fragment length were calculated for each system and data were subjected to Student’s t test (P<0.05).

Results:

A statistically significant difference (P<0.05) was noted between Reciproc and NeoNiTi instruments. NeoNiTi A1 instruments were associated with a significantly higher mean NCF as compared to Reciproc R25 instruments (833±176 vs. 318±87 NCF). There was no significant difference (P>0.05) in the mean length of the fractured fragments between the instruments.

Conclusion:

NeoNiTi instruments were associated with a significantly higher cyclic fatigue resistance than Reciproc instruments.

Cyclic fatigue resistance, torsional resistance, and metallurgical characteristics of M3 Rotary and M3 Pro Gold NiTi files

Objectives

To evaluate the mechanical properties and metallurgical characteristics of the M3 Rotary and M3 Pro Gold files (United Dental).

Materials and Methods

One hundred and sixty new M3 Rotary and M3 Pro Gold files (sizes 20/0.04 and 25/0.04) were used. Torque and angle of rotation at failure (n = 20) were measured according to ISO 3630-1. Cyclic fatigue resistance was tested by measuring the number of cycles to failure in an artificial stainless steel canal (60° angle of curvature and a 5-mm radius). The metallurgical characteristics were investigated by differential scanning calorimetry. Data were analyzed using analysis of variance and the Student-Newman-Keuls test.

Results

Comparing the same size of the 2 different instruments, cyclic fatigue resistance was significantly higher in the M3 Pro Gold files than in the M3 Rotary files (p < 0.001). No significant difference was observed between the files in the maximum torque load, while a significantly higher angular rotation to fracture was observed for M3 Pro Gold (p < 0.05). In the DSC analysis, the M3 Pro Gold files showed one prominent peak on the heating curve and 2 prominent peaks on the cooling curve. In contrast, the M3 Rotary files showed 1 small peak on the heating curve and 1 small peak on the cooling curve.

Conclusions

The M3 Pro Gold files showed greater flexibility and angular rotation than the M3 Rotary files, without decrement of their torque resistance. The superior flexibility of M3 Pro Gold files can be attributed to their martensite phase.