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

A SEM/EDS evaluation of debris removal of used rotary Ni-Ti endodontic files by four different cleaning solutions

Purpose

The aim of this study was to compare the efficacies levels of four cleaning solutions for removing debris from rotary Nickel-Titanium (Ni-Ti) endodontic instruments.

Materials and methods

Twelve instruments that fractured during ex vivo instrumentation were used. Fractured surfaces were investigated by SEM before and after 3, 6 and 9 min of ultrasonic cleaning in 17 % EDTA.3NaOH (Group A), 2.5 % NaOCl (Group B), Dentasept 3H Rapide (Group C) and ZymeX™ (Group D) solutions. EDS analyses of selected files from all four groups of untreated and ultrasonically cleaned samples were performed to assess the elemental composition of the alloy surfaces.

Results

SEM analysis revealed that after 9 min of ultrasonic agitation, all four investigated solutions had cleaned fractured surfaces. However, some low-atomic-number regions exhibited random distributions on the fractured surfaces. EDS analyses indicated that only C was retained on surface after 9 min of ultrasonic cleaning. This finding was common in all tested groups.

Conclusions

All four investigated solutions substantially removed debris from the surfaces of the Ni-Ti files and were considered appropriate for clinical practice.

An in vitro comparison of alterations in surface topographies of three different rotary files after root canal preparation with different irrigating solutions: Atomic force microscopic study

Objectives

The objective of the study was to evaluate and compare the surface topographies of WaveOne Gold (WOG), FlexiCON X1, and EdgeOne Fire (EOF) reciprocating files before and after root canal instrumentation using different irrigating solutions.

Materials and Methods

Forty-eight extracted mandibular molars were selected and randomly assigned into three groups (n = 16) based on the file system used and each group was divided into two subgroups based on the irrigants used during root canal treatment. (Group-1: WOG; Group-2: FlexiCON X1; Group-3: EOF; Subgroup-A: 3% sodium hypochlorite [NaOCl] +17% ethylenediaminetetraacetic acid [EDTA]; Subgroup-B: Citra wash as irrigating solutions). The surface topography of the files was analyzed using atomic force microscope before and after instrumentation. Average roughness and root mean square roughness were calculated. Independent and paired t-tests and one-way analysis of variance with Tukey's post hoc were used for statistical analysis.

Results

Atomic force microscopy results showed an increase in surface roughness after instrumentation, EOF showing the highest roughness. Citra wash showed more roughness compared to NaOCl and EDTA together. However, the surface roughness between the experimental groups WOG and EOF are statistically insignificant and this insignificance was also seen among subgroups (P>0.05).

Conclusion

Instrumentation with various irrigating solutions affected the surface topography of EOF, WOG, and FlexiCON X1 reciprocating files.

Metallurgical Tests in Endodontics: A Narrative Review

Since there are no reviews of the literature on this theme, the aim of this narrative review is to summarize the metallurgical tests used in endodontics, pointing out their functional use and their pros and cons and giving readers a user-friendly guide to serve as an orientation aid in the plethora of metallurgical tests. With this purpose, a literature search for articles published between January 2001 and December 2021 was conducted, using the electronic database PubMed to collect all published articles regarding the metallurgical tests used in endodontics for the evaluation of NiTi rotary instruments. The search was conducted using the following keywords: “metallurgy”, “differential scanning calorimetry” (DSC), “X-ray diffraction” (XRD), “atomic force microscopy” (AFM), “energy-dispersive X-ray spectroscopy” (EDS), “focused ion beam analysis” (FIB) and “Auger electron spectroscopy” (AES) combined with the term “endodontics” or “NiTi rotary instruments”. Considering the inclusion and exclusion criteria, of the 248 articles found, only 81 were included in the narrative review. According to the results, more than 50% of the selected articles were published in one of the two most relevant journals in endodontics: International Endodontic Journal (22.2%) and Journal of Endodontics (29.6%). The most popular metallurgical test was DSC, with 43 related articles, followed by EDS (33 articles), AFM (22 articles) and XRD (21 articles). Few studies were conducted using other tests such as FIB (2 articles), micro-Raman spectroscopy (4 articles), metallographic analysis (7 articles) and Auger electron spectroscopy (2 articles).

Surface Alterations Induced on Endodontic Instruments by Sterilization Processes, Analyzed with Atomic Force Microscopy: A Systematic Review

Endodontic canal disinfection procedures that use sodium hypochlorite, and subsequently, heat sterilization procedures can alter the surface of endodontic instruments, described as corrosion and micropitting. These phenomena can be visualized on the surface of the instruments by SEM and atomic force microscopy analyses. The endodontic instruments used in probing, pre-enlargement, and shaping phases are made of steel alloy or nickel-titanium alloy (NiTi) and are subject to torsional, flexor, and cyclic fatigue; indeed, reuse of these instruments must be done with the knowledge that these instruments are subject to fracture following stress caused during their use. Fracture of the instrument within the canal is an eventuality that can lead to failure of the treatment, and therefore it is important to try to reduce situations that can contribute to the fracture. This review was performed based on the PRISMA protocol. Studies were identified through bibliographic research using electronic databases. A total of 1036 records were identified on the PubMed and Scopus databases. After screening the articles, restricted by year of publication (1979 to 2019), there were 946 records. With the application of the eligibility criteria (all the articles pertaining to the issue of sterilization in endodontics), there were 228 articles. There were 104 articles after eliminating overlaps. There were 50 articles that discussed the influence of sterilization procedures on the surface characteristics of endodontic instruments, and 26 articles that measured parameters on surface alteration. Applying the inclusion and exclusion criteria resulted in a total of eleven articles for quantitative analysis. Four articles were in reference to the primary outcome, eight articles to secondary outcome, and five articles to tertiary outcome. The meta-analysis showed a statistically significant surface alteration effect after five autoclaves and after immersion in the canal irrigants after 10 min.