1
|
Subramanian SK, Joshi V, Kalra S, Adhikari S. Unveiling the fatigue life of NiTi endodontic files: An integrated computational-experimental study. J Mech Behav Biomed Mater 2024; 157:106657. [PMID: 39024733 DOI: 10.1016/j.jmbbm.2024.106657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/03/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
Nickel-titanium (NiTi) rotary files used in root canal treatments experience fatigue and shear damage due to the complex curved geometries and operating conditions encountered within the root canal. This can lead to premature file fracture, causing severe complications. A comprehensive understanding of how different factors contribute to file damage is crucial for improving their functional life. This study investigates the combined effects of root canal curvature radius, file canal curvature, and rotational speed on the fatigue life and failure modes of NiTi endodontic files through an integrated computational and experimental approach. Advanced finite element simulations precisely replicating the dynamic motion of files inside curved canal geometries were conducted. Critical stress/strain values were extracted and incorporated into empirical fatigue models to predict the functional life of endodontic files. Extensive experiments with files rotated inside artificial curved canals at various canal curvatures and speeds provided validation. Increasing the canal curvature beyond 60∘ and shorter curvature radii below 5 mm dramatically reduced the functional life of the endodontic file, especially at rotational speeds over 360 rpm. The Coffin-Manson fatigue model based on strain amplitude showed the closest agreement with experiments. Shear stresses dominated damage at low canal curvatures, while the combined shear-fatigue loading effects were prominent at higher canal curvatures. This conclusive study elucidates how operational parameters like canal curvature radii, canal curvature, and rotational speed synergistically influence the fatigue damage processes in NiTi files. The findings offer valuable guidelines to optimize these factors, significantly extending the functional life of endodontic files and reducing the risk of intra-operative failures. The validated computational approach provides a powerful tool for virtual testing and estimation of the functional life of the new file designs before manufacturing.
Collapse
Affiliation(s)
| | - Vivek Joshi
- Department of Mechanical Engineering, Indian Institute of Technology Jammu, India.
| | - Sahil Kalra
- Department of Mechanical Engineering, Indian Institute of Technology Jammu, India.
| | - Sondipon Adhikari
- James Watt School of Engineering, The University of Glasgow, Glasgow G12 8QQ, UK.
| |
Collapse
|
2
|
Samara M, Nassar M, Alqedairi A, Alfawaz H, Jamleh A. Effect of phytic acid on chemical, structural, and mechanical characteristics of nickel-titanium endodontic files. Sci Rep 2024; 14:20164. [PMID: 39215062 PMCID: PMC11364813 DOI: 10.1038/s41598-024-69828-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
This study investigated phytic acid (IP6) effect on chemical, structural, and mechanical characteristics of nickel-titanium (NiTi) files. The tested files were equally divided into groups according to the immersion protocol: sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), IP6, EDTA followed by NaOCl, and IP6 followed by NaOCl. These groups were then compared in terms of Ni, Ti, and chromium (Cr) ions release from the files. Microstructural changes using field emission scanning electron microscope (Fe-SEM) and energy dispersive X-ray spectroscopy (EDX) and surface roughness were analyzed. The mechanical characterization was conducted using cyclic fatigue resistance test. Fractured segments were scanned under SEM. Statistical analysis was performed using one-way ANOVA, Tukey test, Kruskal-Wallis test and Mann-Whitney U test. Results showed that NaOCl caused significant release of Cr, followed by IP6 and EDTA (P < 0.05). When files were pre-immersed in EDTA, NaOCl tended to induce less release of Ti and Cr. EDX evaluation revealed that the main surface elements were Ni, Ti, carbon, and oxygen. EDTA group contained the highest amount of carbon, while the control group showed the lowest. Surface roughness evaluation revealed no significant differences between groups despite the minor increases after immersion in certain groups. Black areas were observed in the NaOCl group which indicated corrosion. However, the cyclic fatigue test showed no significant differences between the groups.
Collapse
Affiliation(s)
- Mai Samara
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohannad Nassar
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Abdullah Alqedairi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hussam Alfawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Jamleh
- Department of Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
3
|
Aydın U, Özdemir M, Çulha E, Baştürk Özer MN, Turan B. Evaluation of Cyclic Fatigue Resistance of Novel Replica-Like Instruments in Static Test Model. Appl Bionics Biomech 2024; 2024:8842478. [PMID: 39206445 PMCID: PMC11357823 DOI: 10.1155/2024/8842478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction The aim of our study is to comparatively analyze the canal cyclic fatigue resistance of widely used rotary file systems, including EndoArt Touch Gold (ETG), Perfect MTF Plus Gold (PPG), Fanta V-Taper Gold (FVG), and ProTaper Next (PTN). Methods Stainless steel canals with a 60° angle and a 3-mm curvature radius were specially prepared. The canals were shaped with each rotary file system and tested for resistance using a cyclic fatigue testing apparatus. The number of fracture cycles (NFC; K file tip separation) was measured. Data were analysed by one-way ANOVA and post hoc LSD tests. Results PTN and PPG rotary file systems exhibited the highest NFC. The NFC value for PTN was 589 ± 63, and for PPG, it was 507 ± 51. Conclusion The results of this study demonstrate that rotary file systems such as PTN and PPG exhibit higher cyclic fatigue resistance. ETG and FVG rotary file systems also possess generally acceptable cyclic fatigue resistance levels.
Collapse
Affiliation(s)
- Uğur Aydın
- Department of EndodonticsGaziantep University, Gaziantep, Türkiye
| | - Melih Özdemir
- Department of EndodonticsGaziantep University, Gaziantep, Türkiye
| | - Emre Çulha
- Department of EndodonticsGaziantep University, Gaziantep, Türkiye
| | | | - Bilal Turan
- Department of EndodonticsGaziantep University, Gaziantep, Türkiye
| |
Collapse
|
4
|
Herrera Á, Azabal M, Jimenez-Octavio JR, del Real-Romero JC, López de Armentia S, Asensio-Gil JM, Arias A. Comparative Analysis of Surface Roughness and Plastic Deformation of Reciprocating Instruments after Clinical Use. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3978. [PMID: 39203156 PMCID: PMC11356323 DOI: 10.3390/ma17163978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/24/2024] [Accepted: 08/03/2024] [Indexed: 09/03/2024]
Abstract
This study assessed the surface topography and plastic deformation (PD) of new and used contemporary reciprocating instruments. Twenty-six WaveOne Gold (WOG) and EdgeOne Fire (EO) instruments were photographed under magnification. The instruments were randomly assigned to a control group of new instruments preserved for surface roughness analysis (n = 6 each), or to an experimental group to shape the root canal system of a single molar (n = 20 each), making a total of four groups (WOGnew, EOnew, WOGused, EOused). Used instruments were also photographed after instrumentation. The presence of fractures was registered. Preoperative and postoperative images were randomly ordered for evaluation. Two blinded calibrated examiners evaluated the presence of PD. Inter-observer agreement was calculated with the Kappa coefficient (K = 0.89). 3D profilometry was also used for the surface roughness analysis of six randomly selected instruments from the WOGused and EOused groups. Chi-square and two-way ANOVA tests were used to, respectively, compare PD and changes in surface roughness among the groups. No instruments fractured; however, a significantly greater percentage of EO instruments suffered plastic deformation than WOG instruments (p < 0.001), (OR = 11.09 (CI 95% 2.6-56.3)). The overall surface roughness was higher for most parameters in the EO instruments (p < 0.05). Single uses of EO instruments produced significantly higher chances of PD and increased surface roughness values compared to WOG.
Collapse
Affiliation(s)
- Ángel Herrera
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain;
| | - Magdalena Azabal
- Department of Dentistry, School of Medicine, San Pablo CEU University, 28003 Madrid, Spain;
| | - Jesús R. Jimenez-Octavio
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Juan C. del Real-Romero
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Sara López de Armentia
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Juan M. Asensio-Gil
- MOBIOS Lab, Institute for Research in Technology, ICAI-School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain; (J.R.J.-O.); (J.C.d.R.-R.); (S.L.d.A.); (J.M.A.-G.)
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain;
| |
Collapse
|
5
|
Kosti E, Al Jabbari YS, Sufyan A, Zinelis S. A SEM/EDS evaluation of debris removal of used rotary Ni-Ti endodontic files by four different cleaning solutions. Saudi Dent J 2024; 36:1086-1092. [PMID: 39176155 PMCID: PMC11337967 DOI: 10.1016/j.sdentj.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/28/2024] [Accepted: 06/02/2024] [Indexed: 08/24/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Eleni Kosti
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Greece
| | - Youssef S. Al Jabbari
- Dental Biomaterials Research and Development Chair, King Saud University, Riyadh, Saudi Arabia
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Aref Sufyan
- Dental Biomaterials Research and Development Chair, King Saud University, Riyadh, Saudi Arabia
| | - Spiros Zinelis
- Dental Biomaterials Research and Development Chair, King Saud University, Riyadh, Saudi Arabia
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Greece
| |
Collapse
|
6
|
Namour A, El Mobadder M, Matamba P, Misoaga L, Magnin D, Arany P, Nammour S. The Safety of Removing Fractured Nickel-Titanium Files in Root Canals Using a Nd: YAP Laser. Biomedicines 2024; 12:1031. [PMID: 38790993 PMCID: PMC11117853 DOI: 10.3390/biomedicines12051031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
The fracture of nickel-titanium (Ni-Ti) instruments during root canal instrumentation leads to compromised outcomes in endodontic treatments. Despite the significant impact of instrument facture during a root canal treatment, there is still no universally accepted method to address this complication. Several previous studies have shown the ability of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser to cut endodontic files. This study aims to determine safe irradiation conditions for a clinical procedure involving the use of a Neodymium: Yttrium-Aluminum-Perovskite (Nd: YAP) laser for removing fractured nickel-titanium files in root canals. A total of 54 extracted permanent human teeth (n = 54) were used. This study involved nine distinct groups, each employing different irradiation conditions. Groups 1 s, 3 s, 5 s, 10 s, and 15 s simply consist of irradiation for 1, 3, 5, 10, and 15 s, respectively. After identifying the longest and safest duration time, four additional groups were proposed (labeled A, B, C, and D). Group A was composed of three series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT). Group B consisted of three series of irradiations of 5 s each separated by a rest time of 60 s (L5s + 60 s RT). Group C consisted of two series of irradiations of 5 s each separated by a rest time of 30 s (L5s + 30 s RT), and group D consisted of two series of irradiations of 5 s each separated by a rest time of 5 s (L5s + 5 s RT). In all groups, during the rest time, continuous irrigation with 2.5 mL of sodium hypochlorite (3% NaOCl) was carried out. The variation in temperature during irradiation was registered with a thermocouple during irradiation with different protocols. The mean and standard deviation of the temperature increase was noted. The calculation of the temperature was made as the Δ of the highest recorded temperature at the root surface minus (-) that recorded at baseline (37°). Additionally, scanning electron microscopy (SEM) was used after irradiation in all groups in order to assess the morphological changes in the root dentinal walls. The Nd: YAP laser irradiation parameters were a power of 3W, an energy of 300 mJ per pulse, a fiber diameter of 200 µm, a pulsed mode of irradiation with a frequency of 10 Hz, a pulse duration of 150 µs, and an energy density of 955.41 J/cm2. Our results show that the safest protocol for bypassing and/or removing broken instruments involves three series of irradiation of 5 s each with a rest time of 30 s between each series. Furthermore, our results suggest that continuous irradiation for 10 s or more may be harmful for periodontal tissue.
Collapse
Affiliation(s)
- Amaury Namour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
| | - Patrick Matamba
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Lucia Misoaga
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| | - Delphine Magnin
- Bio- and Soft Matter Division, Institute of Condensed and Nanosciences, Université Catholique de Louvain (UCL), 1348 Louvain-la-Neuve, Belgium;
| | - Praveen Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA;
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (A.N.); (M.E.M.); (P.M.); (L.M.)
| |
Collapse
|
7
|
Kimura S, Ebihara A, Maki K, Kyaw MS, Kasuga Y, Omori S, Okiji T. Phase transformation behavior and mechanical properties of HyFlex EDM nickel-titanium endodontic rotary instrument: Evaluation at body temperature. J Dent Sci 2024; 19:929-936. [PMID: 38618130 PMCID: PMC11010611 DOI: 10.1016/j.jds.2023.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/31/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Temperature-dependent phase compositional changes influence the mechanical properties of heat-treated nickel-titanium (NiTi) rotary instruments. This study evaluated the phase composition, bending properties, and cyclic fatigue resistance of HyFlex EDM NiTi rotary instruments against differently heat-treated and non-heat-treated NiTi instruments at body temperature (BT). Materials and methods HyFlex EDM OneFile (EDM) instruments, heat-treated HyFlex CM (CM) and Twisted File (TF) instruments, and non-heat-treated K3 instruments (size #25/.08) were subjected to differential scanning calorimetry, and the martensitic, R-phase, and reverse transformation starting and finishing temperatures were determined. A cantilever bending test and a cyclic fatigue test were conducted at BT (37 °C ± 1.0 °C), and the bending load and number of cycles to failure (NCF) were recorded. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). Results TF and K3 had reverse transformation finishing temperatures lower than BT, while those for EDM and CM were higher than BT. The bending loads at a 0.5 mm deflection were in the order of EDM < TF < CM < K3 (P < 0.05), and those at a 2.0 mm deflection were EDM < CM and TF < K3 (P < 0.05). EDM had the highest NCF among the four instruments (P < 0.05). Conclusion The EDM instrument had a reverse transformation finishing temperature higher than BT indicating its martensite/R-phase composition at BT. The EDM instrument had superior flexibility and greater resistance to cyclic fatigue than the CM, TF, and K3 instruments at BT.
Collapse
Affiliation(s)
- Shunsuke Kimura
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Arata Ebihara
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Keiichiro Maki
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Moe Sandar Kyaw
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuka Kasuga
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Omori
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| |
Collapse
|
8
|
Hamid T, Malik A, Kumar A, Anjum S. Comparative evaluation of cyclic fatigue resistance of thermomechanically treated NiTi rotary instruments in simulated curved canals with two different radii of curvature: An in vitro Study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:393-399. [PMID: 38779209 PMCID: PMC11108414 DOI: 10.4103/jcde.jcde_32_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 05/25/2024]
Abstract
Background This study aimed to compare the effect of heat treatment on the cyclic fatigue resistance of three different nickel-titanium rotary file systems: TruNatomy, HyFlex CM, and NeoEndo flex in simulated curved canals at two different radii of curvatures. Materials and Methods A total of 60 NiTi rotary files of three types were used, and the samples were divided into three groups TruNatomy, HyFlex CM, and NeoEndo flex. All the instruments were subjected to cyclic fatigue testing using a stainless steel custom-made canal model with a 60° angle of curvature and two radii of curvature 5 mm and 3 mm; the number of cycles to fracture and length of the fractured segment was measured. The separated instruments were subjected to fractographic analysis under scanning electron microscope. Results The number of cycles to failure to fracture a file at a 3 mm radius of curvature is significantly less as compared to a 5 mm radius of curvature (HCM > TRN > NE). Conclusion Within the limitation of the present study, there was a positive correlation between the radius of curvature and fatigue life of NiTi files.
Collapse
Affiliation(s)
- Tahira Hamid
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Azhar Malik
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Ajay Kumar
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Shamim Anjum
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| |
Collapse
|
9
|
Diaconu CT, Diaconu AE, Tuculina MJ, Mihai LL, Gheorghiță M, Gheorghiță LM, Mărășescu P, Gliga A, Diaconu OA. Assessment of the Cyclic Fatigue Performance of the Novel Protaper Ultimate File System Used in Different Kinematics: An In Vitro Study. J Funct Biomater 2024; 15:85. [PMID: 38667542 PMCID: PMC11051539 DOI: 10.3390/jfb15040085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
This in vitro study aims to assess the cyclic fatigue resistance of the Protaper Ultimate (PTU) files compared to the Protaper Gold (PTG) and the M3 UDG (M3) files using various motion kinematics in simulated canals. As far as the authors are aware, no study has previously compared the three file systems before this current investigation. Therefore, closing this information gap is the goal of the current research. Methods: A total of (60 new endodontic files were randomly divided into 6 groups (10 files per group); groups 1, 3, and 5 used continuous rotation (CR), while groups 2, 4, and 6 used forward reciprocating motion (FRM). A manufactured stainless-steel artificial canal was used to perform the cyclic fatigue testing. The results were analyzed using Student's t-test and two-way ANOVA. All pairwise comparisons revealed statistically significant differences in the time to failure (TTF) for every study group (p < 0.001), with the exception of the PTG and M3 files, which performed similarly using both CR and FRM. Conclusions: The PTU files performed better than the PTG and M3 files in terms of the TTF and number of cycles to failure (NCF) using both CR and FRM.
Collapse
Affiliation(s)
- Cezar Tiberiu Diaconu
- Faculty of Dental Medicine, Department of Endodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.T.D.); (A.E.D.); (L.M.G.); (O.A.D.)
| | - Anca Elena Diaconu
- Faculty of Dental Medicine, Department of Endodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.T.D.); (A.E.D.); (L.M.G.); (O.A.D.)
| | - Mihaela Jana Tuculina
- Faculty of Dental Medicine, Department of Endodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.T.D.); (A.E.D.); (L.M.G.); (O.A.D.)
| | - Laurența Lelia Mihai
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 031593 Bucharest, Romania
| | - Mircea Gheorghiță
- Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Lelia Mihaela Gheorghiță
- Faculty of Dental Medicine, Department of Endodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.T.D.); (A.E.D.); (L.M.G.); (O.A.D.)
| | - Petre Mărășescu
- Faculty of Dental Medicine, Department of Dental Prothesis Technology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Alexandru Gliga
- Faculty of Dental Medicine, Department of Operative Dentistry, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Oana Andreea Diaconu
- Faculty of Dental Medicine, Department of Endodontics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.T.D.); (A.E.D.); (L.M.G.); (O.A.D.)
| |
Collapse
|
10
|
Almnea RA, Mohammad Al Ageel Albeaji S, Ali Alelyani A, AlHarith D, Saeed Alshahrani A, Al Malwi AA, Alobaid MA, Al Moaleem MM. Comparative Analysis of Three Nickel-Titanium Rotary Files in Severely Curved L-Shaped Root Canals: Preparation Time, Aberrations, and Fracture Rates. Clin Cosmet Investig Dent 2024; 16:1-9. [PMID: 38384359 PMCID: PMC10878313 DOI: 10.2147/ccide.s452742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
Background This simulated study of 30 severely curved L-shaped root canals aimed to compare preparation time, aberrations, width measurements, and fractured files of three nickel-titanium (Ni-Ti) files, namely, ProTaper, ProTaper Next (PTN), and WaveOne (WO). Methods Thirty simulated L-curved root canals of resin blocks were randomly divided into three groups. The canals were prepared to a tip size of 25 using ProTaper, PTN, and WO rotary file systems. Pre- and post-operative views for each sample were captured by a professional camera at a standardized distance and position. Blue India ink was injected into the pre-operative canals, and red India ink was injected into the post-operative canals to give a clear superimposition image. Five points were assessed through the halfway of the canal to the orifice (area between the beginning of curvature and apical end point). Preparation time, aberrations, width measurements, and fractured files were recorded and analyzed. Results Mean preparation time was longest in ProTaper (4.89±0.68 minutes). PTN and WO were the fastest in preparing the canals (about 3 minutes). A statistically significant difference was found between WO and ProTaper & PTN and ProTaper (p=0.000), while the difference was non-significant (p > 0.05) between WO and PTN. Nine aberrations consisting of three zips, one ledge and one outer widening were related to ProTaper, while WO recorded a ledge and fractured file, but for PTN system, it verified an outer widening and ledge. Only one WO file fractured, with no deformation observed in the other instruments. No significance was recorded among the width measurements in the different levels. Conclusion ProTaper next achieved faster cutting than the ProTaper and WO file systems. PTN maintained the best apical termination position and produced the least canal aberration, followed by WO and ProTaper.
Collapse
Affiliation(s)
- Raid Abdullah Almnea
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | | | - Ahmed Ali Alelyani
- Restorative Department, Endodontic Division, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Dalia AlHarith
- Department of Restorative Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdulmajeed Saeed Alshahrani
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Ahmed Abdullah Al Malwi
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A Alobaid
- Restorative Dental Science Department & Department of Dental Education, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia
| |
Collapse
|
11
|
Youssef E, Jungbluth H, Jepsen S, Gruener M, Bourauel C. Comparing Cyclic Fatigue Resistance and Free Recovery Transformation Temperature of NiTi Endodontic Single-File Systems Using a Novel Testing Setup. MATERIALS (BASEL, SWITZERLAND) 2024; 17:566. [PMID: 38591373 PMCID: PMC10856488 DOI: 10.3390/ma17030566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/05/2024] [Accepted: 01/22/2024] [Indexed: 04/10/2024]
Abstract
The aim of this study was to assess the effect of body temperature (37 °C) on the cyclic fatigue resistance of three endodontic single-file systems using a new testing setup. One Shape® new generation (OS), WaveOne™ (WO) and WaveOne® GOLD (WOG), which are made from different NiTi alloys and operated in different motions (rotation/reciprocation), were evaluated. The study design included four groups. Each group comprised 30 files, 10 files of each of the three file systems, tested at 20 ± 2 °C (group 1 and 3) and at 37 ± 1 °C (group 2 and 4). All files were tested in a custom-made metal block with artificial canals of 60° angle, and a 5 mm and 3 mm radius of curvature, respectively. A heating element was attached to replicate a temperature of 37 °C. Files were introduced 18 mm into the canals and operated until failure. Transformation temperatures of five samples of each of the tested file systems were determined via the bend and free recovery (BFR) method. With the exception of WOG in canals with a 3 mm radius of curvature (p = 0.075), all the tested file systems showed statistically significantly less time needed to fracture when operated at 37 ± 1 °C compared to at 20 ± 2 °C in canals with a 5 mm and 3 mm radius of curvature using Mann-Whitney U test (p < 0.05). All file systems showed transformation temperatures below the body temperature. We concluded that body temperature directly affects the cyclic fatigue resistance of all tested file systems. Bend and free recovery can be suitable for the determination of austenite finish temperatures (Af) of endodontic instruments as it allows testing a longer portion of the instrument.
Collapse
Affiliation(s)
- Emad Youssef
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany
- Department of Oral Technology, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany
| | - Holger Jungbluth
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany
| | - Manfred Gruener
- Department of Oral Technology, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany
| | - Christoph Bourauel
- Department of Oral Technology, Faculty of Medicine, University of Bonn, 53111 Bonn, Germany
| |
Collapse
|
12
|
Alamoudi RA, Alfarran A, Alnamnakani B, Howait M, Alghamdi NS, Ain TS. Assessment of Incidence, Management and Contributory Factors of Root Canal Instrument Separation in an Endodontics Post- Graduate Program: A Retrospective Clinical Study. Niger J Clin Pract 2024; 27:16-21. [PMID: 38317030 DOI: 10.4103/njcp.njcp_833_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 11/08/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The successful outcome of nonsurgical root canal treatment (NS-RCT) is largely dependent on the technical quality of the procedure. OBJECTIVE To investigate the incidence of separated instruments in endodontic postgraduate clinics between January 2018 and December 2021, and to determine the potential contributory factors that increase the risk of instrument separation. MATERIALS AND METHODS A retrospective observational study was conducted in the Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. Data was collected to determine the incidence of separated instruments and their associated variables. Seven variables were analyzed separately: nonsurgical initial or retreatment case, tooth type, tooth arch, tooth location, canal type, root curvature, level of fracture, and file type. RESULTS A total of 3150 cases were treated, of which 108 cases had separated instruments. The overall incidence of instrument separation was 3.4% while 53.7% of separated instruments occurred in the mandibular molars, followed by 42.6% in the maxillary molars. The highest frequency of instrument separation was recorded in the mesiobuccal canal (35.2%). The level of separation was found to be statistically significant in relation to the management (P < .001). CONCLUSION Nickel-titanium instruments tend to separate more inside the root canal system than stainless steel instruments. However, under the limitation of this study, the incidence of instrument separation is still quite low, even with postgraduate endodontic residents with limited experience.
Collapse
Affiliation(s)
- R A Alamoudi
- Department of Endodontic, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - A Alfarran
- Faculty of Dentistry, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - B Alnamnakani
- Faculty of Dentistry, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - M Howait
- Department of Endodontic, King Abdulaziz University, College of Dentistry, Jeddah, Saudi Arabia
| | - N S Alghamdi
- Department of Restorative Dental Sciences, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia, College of Dentistry King Khalid University, Abha, Saudi Arabia
| | - T S Ain
- Pediatric Dentistry and Orthodontic Sciences (Division of Preventive Dentistry), College of Dentistry King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
13
|
Chandak M, Agrawal P, Mankar N, Sarangi S, Bhopatkar J. Navigating Separated Instrument Retrieval: A Case Report. Cureus 2023; 15:e50559. [PMID: 38222183 PMCID: PMC10787944 DOI: 10.7759/cureus.50559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Instrument separation during endodontic therapy is a complication occurring in 2% to 6% of cases. Focusing on the Masserann technique, the study presents a success rate of 55% in retrieving separated instruments. The technique's effectiveness is demonstrated through a case involving retrieving an instrument from the mandibular first premolar. The technique utilizes various tools, including trephine burs and an extractor, providing a reliable means to dislodge tightly wedged fragments. Despite limitations in specific tooth types and the necessity for frequent radiographic monitoring, the Masserann kit proves effective and underscores the importance of attempting retrieval before considering surgical interventions. The presented case exemplifies the technique's clinical applicability and positive outcomes in intricate scenarios, emphasizing its significance in endodontic practice.
Collapse
Affiliation(s)
- Manoj Chandak
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Paridhi Agrawal
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikhil Mankar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swayangprabha Sarangi
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jay Bhopatkar
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
14
|
Alharbi MA, Alghamdi BA, Alswajy WA, Kattan SA, Austah O, Othman B, Baeshen HA. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023; 24:895-901. [PMID: 38238279 DOI: 10.5005/jp-journals-10024-3566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
AIM This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). BACKGROUND Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. CASE DESCRIPTION A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. CONCLUSION This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. CLINICAL SIGNIFICANCE Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.
Collapse
Affiliation(s)
- Mohammed A Alharbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, Phone: +966503653414, e-mail:
| | - Batool A Alghamdi
- Department of Endodontics, King Fahad Hospital, Ministry of Health, Almadinah, Saudi Arabia; Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Wafa A Alswajy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Sereen A Kattan
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Obadah Austah
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Bader Othman
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Hosam A Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| |
Collapse
|
15
|
Eskibağlar M, Özata MY, Ocak MS, Öztekin F. Investigation of fracture prevalence of instruments used in root canal treatments at a faculty of dentistry: a prospective study. Restor Dent Endod 2023; 48:e38. [PMID: 38053782 PMCID: PMC10695725 DOI: 10.5395/rde.2023.48.e38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives The aim of this study was to examine the use of hand or rotary files by pre-graduation (fourth- and fifth-year) and postgraduate students in endodontic treatments and to determine the incidence of file fracture and the management of cases with broken instruments. Materials and Methods A total of 2,168 teeth undergoing primary endodontic treatment were included in this study. It was determined that 79 of these teeth resulted in broken tools. In the case of broken tools, the education level of the treating clinician, the tooth that was being treated, the canal and fracture level, the curvature of the tooth and the management of the broken instrument were recorded. Periapical radiographs of the patients were used to calculate curvature following the Schneider method. Results There was no significant difference in the incidence of broken tools according to education level (p > 0.05). The incidence of file fracture in molar teeth (73.4%) was higher than in other teeth (p < 0.05). More files were broken in the mandibular molar MB canal (20.25%) and in the apical third of the canals (72.1%). The risk of instrument fracture was high in teeth with moderate (44.3%) and severe (38%) curvature canals. The management of apically broken (80%) files mostly involved lefting (p < 0.05). Conclusions There was no statistically significant difference between fourth-year students, fifth-year students and postgraduate students in terms of instrument fracture.
Collapse
Affiliation(s)
- Mehmet Eskibağlar
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Merve Yeniçeri Özata
- Department of Endodontics, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mevlüt Sinan Ocak
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Faruk Öztekin
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| |
Collapse
|
16
|
Lakshmaiah D, Raj Kumar J, Sakthi N, Karunakaran J, Vishwanath S. The Management of Fractured Dental Instruments: A Case Series. Cureus 2023; 15:e49132. [PMID: 38130569 PMCID: PMC10733118 DOI: 10.7759/cureus.49132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
The most common problem faced by dentists during root canal therapy is instrument separation. Instrument separation leads to the inefficient biomechanical preparation of the canals, which can affect the outcome of the root canal-treated tooth. Hence, bypassing the fractured instrument or removal can be accounted as a viable choice to maintain the structural integrity of the tooth. This article illustrates a case series wherein the fractured instrument was managed successfully with the use of conservative techniques.
Collapse
Affiliation(s)
- Deepika Lakshmaiah
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Jwaalaa Raj Kumar
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Nikesh Sakthi
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Janani Karunakaran
- Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Sankar Vishwanath
- Department of Conservative Dentistry and Endodontics, KSR Institute of Dental Science and Research, Tiruchengode, IND
| |
Collapse
|
17
|
Tyagi G, Kumar P, Kumari A, Shakarwal P, Singh A, Kusum P. Comparing the EdgeFile X3, GenEndo, HeroGold, and ProTaper Gold Rotary Instruments Regarding the Effect of Different Concentrations and Temperature of NaOCl on Cyclic Fatigue Resistance. J Contemp Dent Pract 2023; 24:715-721. [PMID: 38152947 DOI: 10.5005/jp-journals-10024-3515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM This research was carried out with the objective of comparison between GenEndo, Protaper Gold, Hero Gold and EdgeFile X3 regarding the effect of different concentrations of NaOCl. MATERIALS AND METHODS About 720 study specimens were included in the study. They were divided into four groups. Each group consisted of 180 files. Group A: GenEndo, Group B: Protaper Gold, Group C: Hero Gold, Group D: EdgeFile X3. Each group of instruments were further subdivided into nine subgroups (n = 20 for each subgroup). Testing of the cyclic fatigue was carried out in artificial canals which were prepared inside the blocks of stainless steel. The stainless steel blocks with artificial canals were established in a receiver that was packed with experimental solutions like distilled water, 5.25% NaOCl and 2.5% NaOCl. The adjustment of temperature was done at 25, 37, and 60°C. The rotation of the instrument was carried out inside the artificial canal as per the instructions of the manufacturer. The instrument was rotated until it got fractured. The time taken by the instrument to fracture was recorded in seconds. The number of cycles to fracture (NCF) was analyzed with the help of the equation (NCF = time to fracture × rpm/60). Surfaces at the site of fracture were examined with the help of a scanning electron microscope (EVOLS10, ZEISS) at magnification (300x and 2000x). RESULTS It was noticed that there was a statistically significant increase in cyclic fatigue when sodium chloride was used as an endodontic irrigant instead of distilled water. The increase in cyclic fatigue was also observed when 5.25% sodium chloride was used instead of 2.5% sodium hypochlorite. Cyclic fatigue increased on change in temperature from 25 to 37°C and from 37 to 60°C. The difference was statistically significant (p < 0.05). It was observed that resistance against cyclic fatigue on treatment with different irrigation solutions at different temperatures was in the order of GenEndo > Protaper Gold > Hero Gold > EdgeFile X3. CONCLUSION The resistance against cyclic fatigue in new NiTi rotary files can be affected significantly by different concentrations of sodium hypochlorite irrigant solution and the GenEndo rotary endodontic instrument has the maximum resistance against cyclic fatigue. CLINICAL SIGNIFICANCE Irrigation of the root canal with irrigants, such as sodium hypochlorite (NaOCl) has been recommended strongly. NaOCl is used in the range of 0.5 and 6.5% concentration owing to its antimicrobial activity and tissue dissolution activities, particularly at higher temperatures. It has been postulated that fatigue of rotary endodontic instruments can be influenced by adjoining medium and their concentration.
Collapse
Affiliation(s)
- Garima Tyagi
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, India
| | - Prakash Kumar
- Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, Phone: +91 6205229036, e-mail:
| | - Annu Kumari
- Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College and Hospital, Darbhanga, Bihar, India
| | - Parul Shakarwal
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aditya Singh
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Pallavi Kusum
- Department of Orthodontics and Dentofacial Orthopedics, Buddha Institute of Dental Sciences & and Hospital, Patna, Bihar, India
| |
Collapse
|
18
|
Coaguila-Llerena H, Lazo-Quezada G, Teves A, Zevallos-Chávez M, Faria G. Removal of separated instruments from unfavourable locations: Case reports using the HBW ultrasonic ring or a surgical approach. AUST ENDOD J 2023; 49:358-364. [PMID: 35932460 DOI: 10.1111/aej.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023]
Abstract
Two patients were admitted to the dental clinic to evaluate two right mandibular first molars (both FDI no. 46). In Case 1, there was an accidental instrument separation, which was thought to have been bypassed; however, the instrument was located beyond the apical foramen, in the alveolar bone. The 1-week follow-up revealed that the fragment was close to the inferior alveolar nerve, thus allowing surgical removal to be performed. In Case 2, two separated instruments located in the apical third of the mesiobuccal and mesiolingual canals were removed using the HBW ultrasonic ring coupled to ISO 10 and 15 hand instruments. The 3-month and 1-year follow-ups (Case 1), and the 2-year and 3-year follow-ups (Case 2) showed a favourable evolution in both cases. It can be concluded that both the surgical approach and the HBW ultrasonic ring are viable options for the removal of separated instruments in unfavourable locations.
Collapse
Affiliation(s)
- Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| | | | - Abel Teves
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo - USP, Bauru, Brazil
| | - Marco Zevallos-Chávez
- Department of Endodontics, Catholic University of Santa Maria - UCSM, Arequipa, Peru
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, Brazil
| |
Collapse
|
19
|
Malentacca A, Zaccheo F, Rupe C, Lajolo C. Endodontic Clinical Outcome after Separated Instrument Removal Using a Spinal Needle Technique: A Retrospective Study of Thirty Years of Clinical Experience. J Endod 2023; 49:980-989. [PMID: 37422250 DOI: 10.1016/j.joen.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 07/10/2023]
Abstract
INTRODUCTION Current methods for the removal of separated endodontic instruments (RSI) are not predictable. METHODS The primary outcome of this retrospective study was to assess the clinical and radiographic success (CRS) of teeth in case of RSI after a 5-year follow-up. Secondary outcomes were to evaluate (1) the effectiveness in RSI and (2) the risk of root fracture after RSI. The study protocol was registered at ClinicalTrials.gov (ID: NCT05128266). The patients were treated by the same endodontist between January 1991 and December 2019. The RSI was performed under the operative microscope as follows: first, the dentine surrounding the coronal part of the broken instrument was selectively removed by using a small ultrasonic tip to loosen the fragment; then, a modified spinal needle was used to catch and remove the instrument. The 1-, 3-, 5-, and >5-year CRS were recorded. Logistic regression analysis was performed to determine independent predictors of failure (ie, tooth number, type of root canal, shape of the root canal, type of broken instrument, apicocoronal level of the separated instrument, presence of periapical lesions, and root perforations). RESULTS A total of 158 teeth were included in this study. Finally, 131 instruments underwent RSI (82.9%). RSI was an independent predictor of CRS after 1-year of treatment (odds ratio: 58.3; 95% confidence interval: 27.42-95.73, P < .05). At the 5-year follow-up, only 10 of 131 teeth (7.6%) failed. All failures were caused by root fracture (10/10) (χ2 test, P < .05). Separated instruments located in the apical third of the root were more difficult to remove (13/49 cases, 26.5%; χ2 test, P < .05). CONCLUSIONS The proposed technique can achieve excellent effectiveness in RSI, can achieve a high CRS rate when a periapical lesion is present, is not associated to a significant increase in root fracture incidence, and should be performed with the help of an operative microscope.
Collapse
Affiliation(s)
| | | | - Cosimo Rupe
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli-IRCCS", Rome, Italy.
| | - Carlo Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli-IRCCS", Rome, Italy
| |
Collapse
|
20
|
Hamdy TM, Alkabani YM, Ismail AG, Galal MM. Impact of endodontic irrigants on surface roughness of various nickel-titanium rotary endodontic instruments. BMC Oral Health 2023; 23:517. [PMID: 37488612 PMCID: PMC10367373 DOI: 10.1186/s12903-023-03227-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The aim of the current study is to assess the surface roughness of several recent nickel-titanium (Ni-Ti) rotary endodontic instruments, namely: Protaper next (PTN); Hyflex CM (CM); Hyflex EDM (EDM); WaveOne gold (WOG); and trunatomy (TN), before and after application of 5.25% sodium hypochlorite (NaOCl) irrigant solution. METHODS In this in vitro study, five recently introduced rotary endodontic instruments of different metallurgical properties and designs were subjected to Atomic Force Microscopy (AFM) analysis, and then each file was rotated in 5.25% NaOCl for 15 min., with speed and torque according to manufacturer's instructions. The instruments were then subjected to AFM analysis again. The surface roughness average (Sa) parameter was calculated. Data were analyzed by Paired T test, One-way ANOVA and Tukey tests. RESULTS There was a statistically significant decrease in the surface roughness of all rotary endodontic instruments after immersion in irrigants (P ≤ 0.05). CONCLUSION The new TN and PTN instruments showed the least surface roughness. All tested Ni-Ti rotary endodontic instruments after irrigants exposure showed a varying increase in surface roughness.
Collapse
Affiliation(s)
- Tamer M Hamdy
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt.
| | - Yasmine Mohsen Alkabani
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Amira Galal Ismail
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| | - Manar M Galal
- Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Giza, Dokki, 12622, Egypt
| |
Collapse
|
21
|
Olczak K, Grabarczyk J, Szymański W. Removing Fractured Endodontic Files with a Tube Technique-The Strength of the Glued Joint: Tube-Endodontic File Setup. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114100. [PMID: 37297234 DOI: 10.3390/ma16114100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/20/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
One recommended technique for removing broken root canal instruments is to glue the fragment into a cannula adapted to it (i.e., the tube technique). The aim of the study was to determine the influence of the adhesive kind and length of the joint on the breaking force. During the investigation, 120 files (60 H-files and 60 K-files) and 120 injection needles were used. Fragments of broken files were glued into the cannula using one of three materials: cyanoacrylate adhesive, composite prosthetic cement, or glass ionomer cement. The lengths of the glued joints were 2 and 4 mm. After the polymerization of adhesives, a tensile test was carried out to find a breaking force. The results were statistically analyzed (p < 0.05). For 4 mm lengths of glued joints, the breaking force was higher than for 2 mm for both file types (K and H). In the case of K-type files, the breaking force was higher for cyanoacrylate and composite adhesives than glass ionomer cement. For H-type files, no significant difference in joint strength was found between binders at 4 mm, while at 2 mm, a much better connection was obtained for cyanoacrylate glue than prosthetic cements.
Collapse
Affiliation(s)
- Katarzyna Olczak
- Department of Endodontics, Medical University of Lodz, 92-213 Lodz, Poland
| | - Jacek Grabarczyk
- Institute of Materials Science and Engineering, Lodz University of Technology, 90-924 Lodz, Poland
| | - Witold Szymański
- Institute of Materials Science and Engineering, Lodz University of Technology, 90-924 Lodz, Poland
| |
Collapse
|
22
|
Dhakshinamurthi B, Ashok R, Rajendran MR, Kalaiselvam R, Ramesh SR, Kuzhanchinathan M, Balaji L. Cyclic Fatigue Resistance of Different Glide Path Files in Simulated Double Curved Canal in Continuous Rotary Motion: An In Vitro Study. J Contemp Dent Pract 2023; 24:337-341. [PMID: 38149812 DOI: 10.5005/jp-journals-10024-3510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
AIM This in vitro study aimed to compare and evaluate the resistance to cyclic fatigue of a newly developed glide path file in a simulated double curvature canal in a cyclic fatigue-testing machine. METHODS In this in vitro study, a static cyclic fatigue-testing machine with a simulated double curve was created and the samples were divided into the following three groups: Group I-HyFlex EDM; group II-TruNatomy file; and group III-Aurum G files and each instrument is continued to rotate in the canal and a number of cycles to failure (NCF) was calculated and Fractographic analysis was done using scanning electron microscope (SEM), and the results were statistically analyzed. RESULTS Statistical analysis was done using parametric methods one-way analysis of variance (ANOVA) shows statistical significance between groups and then Tukey's HSD post hoc tests were used for multiple pairwise comparisons. TruNatomy glide path files had the highest cyclic fatigue resistance when compared to HyFlex EDM and Aurum G files. CONCLUSION The selection of file systems in cleaning and shaping protocols is an enigma to endodontics. From the results of this study, it can be concluded that TruNatomy files had higher cyclic fatigue resistance than other glide path files are canals with double curvature, hence it is suitable for usage in root canals with extreme curvature. CLINICAL SIGNIFICANCE The selection of file systems in cleaning and shaping protocols is an enigma to endodontics. This in vitro study explored the selection protocols for the execution of root canal preparation. Heat treatment of nickel-titanium (NiTi) endodontic files had improved the cyclic fatigue resistance significantly enhancing the clinical life of file systems.
Collapse
Affiliation(s)
- Balaji Dhakshinamurthi
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rupa Ashok
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9940072721, e-mail:
| | - Mathan Rajan Rajendran
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Rajeswari Kalaiselvam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Seshan Rakkesh Ramesh
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Manigandan Kuzhanchinathan
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Lakshmi Balaji
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
23
|
El Abed R, Al Raeesi D, Alshehhi A, Alkhatib Z, Khamis AH, Jamal M, Kim HC. Effect from Autoclave Sterilization and Usage on the Fracture Resistance of Heat-Treated Nickel-Titanium Rotary Files. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2261. [PMID: 36984141 PMCID: PMC10056662 DOI: 10.3390/ma16062261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess the effect of mechanical loading and heating on the cyclic fatigue and torsional fracture resistances of heat-treated nickel-titanium files after usage and autoclaving. Sixty files (One Curve) were tested for cyclic fatigue and torsional fracture resistances using customized devices. The files were divided into three groups according to the test conditions (n = 10); new (group-N), used for simulated canal shaping (group-U), and sterilized after use (group-S). For cyclic fatigue resistances, the files were freely rotated in a curved metal canal under body temperature; the time elapsed to fracture was recorded and the numbers of cycles to fracture (NCF) were calculated. For the torsional resistances, the file tip was fixed and rotated until the file fractured. The maximum torsional load and distortion angle were recorded. The toughness was calculated. Fracture fragments were examined with a scanning electron microscope. Data were analyzed using a one-way analysis of variance and Tukey's post hoc test at the significance level of 95%. Group-U showed significantly higher NCF than group-S (p < 0.05). However, there was no significant differences between groups-N and -S in the NCF (p > 0.05). Group-N showed a significantly bigger distortional angle and higher torsional toughness than groups-U and -S, but the ultimate torsional strength did not have significant difference between the groups. Under the limitation of this study, autoclave sterilization after single-usage did not improve the fracture resistance of heat-treated One Curve nickel-titanium files.
Collapse
Affiliation(s)
- Rashid El Abed
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Dana Al Raeesi
- Endodontic Department, Emirates Health Services Establishment, Dubai, United Arab Emirates
| | - Aisha Alshehhi
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Zuhair Alkhatib
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
- Emirates Endodontic Society, Dubai, United Arab Emirates
| | - Amar H. Khamis
- Biostatistics Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Mohamed Jamal
- Endodontic Department, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan 50612, Republic of Korea
- Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea
| |
Collapse
|
24
|
Silva EJNL, Martins JNR, Ajuz NC, Dos Santos Antunes H, Vieira VTL, Braz-Fernandes FM, Belladonna FG, Versiani MA. Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation. Clin Oral Investig 2023; 27:2427-2436. [PMID: 36749411 DOI: 10.1007/s00784-023-04899-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to compare 3 reciprocating systems regarding design, metallurgy, mechanical properties, and shaping ability. MATERIALS AND METHODS New Reciproc Blue R25, WaveOne Gold Primary, and REX 25 instruments (n=41 per group) were analyzed regarding design, metallurgy, and mechanical performance, while shaping ability (untouched canal walls, volume of removed dentin, and hard tissue debris) was tested in 36 anatomically matched root canals of mandibular molars. Results were compared using one-way ANOVA post hoc Tukey and Kruskal-Wallis tests with a significant level set at 5%. RESULTS All instruments showed symmetrical cross sections with asymmetrical blades, no radial lands, no major defects, and an almost equiatomic nickel and titanium ratio. The highest R-phase start temperatures were observed with WaveOne Gold (46.1°C) and REX (44.8°C), while Reciproc Blue had the lowest R-phase start (34.5°C) and finish (20°C) temperatures. WaveOne Gold had the lowest time to fracture (169 s) and the highest maximum load (301.6 gf) (P <0.05). The maximum torque of Reciproc Blue (2.2 N.cm) and WaveOne Gold (2.1 N.cm) were similar (P >0.05), but lower than REX (2.6 N.cm) (P <0.05). No statistical differences were observed among instruments in the angle of rotation (P >0.05) and in the shaping ability in both mesial and distal canals (P >0.05). CONCLUSION Although the overall design, temperature transition phases and mechanical behavior parameters were different among tested instruments, they were similar in terms of shaping ability. CLINICAL RELEVANCE All tested heat-treated NiTi reciprocating systems showed similar shaping ability, without clinically significant errors.
Collapse
Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil. .,Departament of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil. .,Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Natasha C Ajuz
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | | | | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | | | | |
Collapse
|
25
|
Endodontic malpractice litigations in the United States from 2000 to 2021. J Dent Sci 2023; 18:374-381. [PMID: 36643243 PMCID: PMC9831803 DOI: 10.1016/j.jds.2022.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background/purpose Little is known regarding the outcomes and distinguishing characteristics of lawsuits related to endodontic procedures. This study used a verdict-based data from United States of America to analyze the factors associated with endodontic malpractice lawsuits and mitigate the risk of litigation. Materials and methods The LexisNexis legal database was used to search for endodontic malpractice cases from January 1, 2000 to December 31, 2021 using the terms "medical malpractice" and (I) "endodontist" (II) "endodontics" (III) "root canal" (IV) "dental pulp." Each case was reviewed for reported medical characteristics and litigation outcomes. Results A total of 650 cases were initially identified, and 97 cases were included in the final analysis. Eighty-four (86.6%) of the 97 defendants were general practitioners; 42 cases favored the plaintiff, 53 (54.6%) favored the defendant, 1 was partial win/loss, and 1 was settled. The annual case mean was 4.41 ± 2.17 (Mean ± SD). The major allegations favored for the patients involving paresthesia, root perforation, rubber dam not use, wrong tooth therapy, and infections. Plaintiffs who claimed with post-procedural reasons had a significantly higher winning rate than non-post-procedural reasons (P < 0.05). Conclusion In the present study, 54.6% of endodontic litigation favored the dentists in the US. The authors recommend that general practitioners refer complicated cases to endodontists and treat carefully to avoid paresthesia, canal perforation and infections. Clinicians should always diagnose and treat correctly, shared decision making with the patient, use rubber dam routinely, and timely management to prevent malpractice claims.
Collapse
|
26
|
Thu M, Ebihara A, Maki K, Nishijo M, Kimura S, Nakatsukasa T, Kyaw MS, Okiji T. Effect of different axial speed patterns on cyclic fatigue resistance of rotary nickel-titanium instruments. BMC Oral Health 2022; 22:617. [PMID: 36529721 PMCID: PMC9761994 DOI: 10.1186/s12903-022-02639-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To evaluate the effect of pecking motions with faster upward speed on the dynamic cyclic fatigue resistance of nickel-titanium rotary instruments with different metallurgy. METHODS Forty each of ProTaper Universal F3 (PTU) and ProTaper Gold F3 (PTG) instruments (size #30/.09) were equally divided into four groups. The test was performed using an 18-mm-long stainless steel artificial canal with a 5-mm radius of curvature, a 45° canal curvature and a 2-mm canal diameter. A downward speed of 100 mm/min was employed, while the upward speed was set at 100, 150, 200 or 300 mm/min. Time to failure (Tf), number of cycles to failure (Nf) and number of pecking motions to failure (Np) were recorded. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests for Tf, Nf, and Np (α = 0.05). RESULTS The 100/300 mm/min group showed significantly higher Np values than the 100/100 mm/min group (p < 0.05), whereas there were no significant differences in Tf and Nf among the tested speed groups (p < 0.05) in either PTU or PTG. PTG exhibited significantly higher Tf, Nf, and Np than PTU (p < 0.05). CONCLUSIONS Under the tested conditions, the fastest upward speed group showed significantly higher cyclic fatigue resistance, as demonstrated by larger Np, than the same speed group. PTG had significantly higher cyclic fatigue resistance than PTU in all groups.
Collapse
Affiliation(s)
- Myint Thu
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Arata Ebihara
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Keiichiro Maki
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Miki Nishijo
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Shunsuke Kimura
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Taro Nakatsukasa
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Moe Sandar Kyaw
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| | - Takashi Okiji
- grid.265073.50000 0001 1014 9130Division of Oral Health Sciences, Department of Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo, 113-8549 Japan
| |
Collapse
|
27
|
Liu J, Watanabe S, Mochizuki S, Kouno A, Okiji T. Comparison of vapor bubble kinetics and cleaning efficacy of different root canal irrigation techniques in the apical area beyond the fractured instrument. J Dent Sci 2022. [DOI: 10.1016/j.jds.2022.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
28
|
Campos GO, Fontana CE, Vieira VTL, Elias CN, de Martin AS, Bueno CEDS. Influence of Heat Treatment of Nickel-Titanium Instruments on Cyclic Fatigue Resistance in Simulated Curved Canals. Eur J Dent 2022. [PMID: 36195211 DOI: 10.1055/s-0042-1747952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the cyclic fatigue of heat-treated and non-treated instruments. MATERIALS AND METHODS Twenty instruments with and without heat treatment from Bassi Logic were evaluated (n = 10). All instruments were subjected to dynamic cyclic fatigue through continuous rotations inside a stainless-steel tube (1.4-mm diameter, 9-mm curvature with 6-mm radius, and 90° angle) using a custom-made device, which performed 1 axial oscillation every 2 seconds with an amplitude of 3 mm, powered by a torque-controlled motor (Silver Reciproc, VDW, Germany), with speed adjusting to 950 rpm and torque to 4 N, according to manufacturer's guidance. The groups were compared using the Mann-Whitney test. RESULT The fracture time of the heat-treated instruments (97.20 ± 39.94 second and non-treated instruments (14.30 ± 6.78 seconds had statistical differences [p < 0.05]). Heat-treated instruments were 6.8 times more resistant to fatigue than non-treated instruments (p < 0.05). CONCLUSION Heat treatment provides increased fatigue resistance of NiTi alloy with the same design.
Collapse
Affiliation(s)
- Gustavo Oliveira Campos
- Department of Endodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carlos Eduardo Fontana
- Department of Center for Healthy Sciences, Postgraduate Program in Health Sciences, Pontifícia Universidade Católica, Campinas, São Paulo, Brazil
| | | | - Carlos Nelson Elias
- Departament of Material Science, Instituto Militar de Engenharia, Rio de Janeiro, Brazil
| | | | | |
Collapse
|
29
|
Ex Vivo Comparison of File Fracture and File Deformation in Canals with Moderate Curvature: Neolix Rotary System versus Manual K-files. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.4.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
|
30
|
Dulundu M, Helvacioglu-Yigit D. The Efficiency of the BTR-Pen System in Removing Different Types of Broken Instruments from Root Canals and Its Effect on the Fracture Resistance of Roots. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5816. [PMID: 36079199 PMCID: PMC9457077 DOI: 10.3390/ma15175816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
The study aimed to evaluate the efficiency of the BTR-Pen system in removing different types of instrument fragments from root canals and to assess its effect on fracture resistance of the roots after the removal of the instruments. One hundred thirty human teeth were divided into 10 groups (2 control groups and 8 study groups) according to the localization and type of the fractured fragment as well as the retrieval techniques. Broken instruments were extracted either with BTR-Pen system loops or removed using solely ultrasonic tips. The success rate of instrument removal and consumed time were recorded. All the teeth were subjected to a load at a 1 mm/min rate in a universal testing machine for mechanical testing. The success of removing broken instruments using the BTR-Pen and ultrasonic was 86.7% and 83.3%, respectively (p > 0.05). When the time is compared, the BTR-Pen system (23.97 ± 8.35 min) showed similar results to that of the ultrasonic technique (24.1 ± 8.28 min) (p > 0.05). The BTR-Pen group required less force to fracture than the ultrasonic group (p = 0.024). In conclusion, the BTR-Pen and ultrasonic groups showed no significant difference in terms of the success rate and removal time. The roots that underwent instrument removal using the BTR-Pen system had less fracture resistance.
Collapse
Affiliation(s)
- Merve Dulundu
- Faculty of Dentistry, Kocaeli University, Kocaeli 41190, Turkey
| | | |
Collapse
|
31
|
Influence of 17% EDTA and Sapindus mukorossi on the Surface Property of Protaper Gold Rotary Endodontic Instruments. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The aim of the study was to evaluate the influence of 17% ethylenediaminetetraacetic acid (EDTA) and ethanolic extract of Sapindus mukorossi (S. mukorossi) in combination with canal shaping on surface properties of ProTaper Gold rotary endodontic file. Sixteen F1 ProTaper Gold rotary files underwent the standard protocol for root canal treatment using two irrigants (S. mukorossi and 17% EDTA) in single-rooted decoronated teeth. Eight unused files were used as a control. All files were examined under an atomic force microscope (AFM) to evaluate surface roughness (Ra) and root mean square (RMS). Data were analyzed using the t-test. RMS and Ra values of the control file were 1.37 and 0.607, respectively. The mean RMS (3.70 ± 1.41) and mean Ra (2.89 ± 1.41) in EDTA group were significantly higher than the control file (p < 0.05). The mean RMS in the S. mukorossi group (1.77 ± 0.66) did not show any significant difference with the control (p > 0.05). The Ra of S. mukorossi group (1.09 ± 0.05) was significantly higher than the control file (p < 0.05). Moreover, the mean RMS and Ra were found to be significantly higher in the EDTA group compared to the S. mukorossi group (p < 0.05). The mean Ra and RMS values of the ProTaper Gold files used to prepare canals using 17% EDTA and S. mukorossi irrigation were significantly higher than the control files. The EDTA-treated ProTaper Gold rotary files demonstrated higher surface Ra and RMS than the S. mukorossi files.
Collapse
|
32
|
Setzer FC, Kratchman SI. Present Status and Future Directions - Surgical Endodontics. Int Endod J 2022; 55 Suppl 4:1020-1058. [PMID: 35670053 DOI: 10.1111/iej.13783] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.
Collapse
Affiliation(s)
- F C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - S I Kratchman
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| |
Collapse
|
33
|
What meaningful information are the instruments mechanical testing giving us? A comprehensive review. J Endod 2022; 48:985-1004. [PMID: 35667567 DOI: 10.1016/j.joen.2022.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/21/2022] [Accepted: 05/26/2022] [Indexed: 11/22/2022]
Abstract
Instruments mechanical strength and flexibility are traditionally tested by running cyclic fatigue, torsional, bending, buckling and microhardness tests. Several cyclic fatigue test models have been used in endodontics, all capable of providing a curved trajectory for the instrument to rotate. The cyclic fatigue testing allowed to identify conditions that may affect the fatigue strength outcomes, such as canal radius and degree of curvature, handpiece static vs dynamic motions, test temperature, kinematics, instrument previously wear and sterilization cycles, or instrument's size and metal alloy features. Due to the international test specifications for both torsional and bending tests, the variations of their models are not as many as for cyclic fatigue. These tests have also identified conditions capable of affecting the outcomes, such as kinematics, instrument's preloading, cross-sectional diameters, or alloy heat treatments. Buckling and microhardness are less common, with the metal alloy being considered to have a major influence on the results. Instruments mechanical testing, having all these individual conditions as independent variables, allowed to understand them and moulded the way the technical procedures are performed clinically. Even though the artificiality and simplicity of these tests will hardly mimic real working situations, and independently of being capable of producing cornerstone knowledge, these tests are also associated with inconsistency, lack of reproducibility and low external validity. Several attempts have been made to increase the generalizability of the outcomes by adding test settings that intend to mimic the clinical condition. Although pertinent, these settings may also add variabilities inherent to their concepts and practical applications in the laboratory environment. Although the actual studies should be seen as laboratory mechanical tests that measure very specific parameters under very particular conditions and that by far do not mimic the clinical condition, the lower validity drawback seems to be possible to be minimized when achieving a comprehensive understanding of the instrument behaviour. A Finite Elements Method and/or a multimethod research approach may lead to superior data collection, analysis, and results' interpretation, which when associated with a reliable confounding factors control and proper study designs may be helpful tools and strategies in order to increase the reliability of the outcomes.
Collapse
|
34
|
Multimethod Assessment of Design, Metallurgical, and Mechanical Characteristics of Original and Counterfeit ProGlider Instruments. MATERIALS 2022; 15:ma15113971. [PMID: 35683270 PMCID: PMC9182015 DOI: 10.3390/ma15113971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022]
Abstract
A multimethod study was conducted to assess the differences between original (PG-OR) and counterfeit (PG-CF) ProGlider instruments regarding design, metallurgical features, and mechanical performance. Seventy PG-OR and PG-CF instruments (n = 35 per group) were evaluated regarding the number of spirals, helical angles, and measuring line position by stereomicroscopy, while blade symmetry, cross-section geometry, tip design, and surface were assessed by scanning electron microscopy. Energy-dispersive X-ray spectroscopy and differential scanning calorimetry were used to identify element ratio and phase transformation temperatures, while cyclic fatigue, torsional, and bending testing were employed to assess their mechanical performance. An unpaired t-test and nonparametric Mann−Whitney U test were used to compare instruments at a significance level of 5%. Similarities were observed in the number of spirals, helical angles, blade symmetry, cross-sectional geometries, and nickel−titanium ratios. Measuring lines were more reliable in the original instrument, while differences were noted in the geometry of the tips (sharper tip for the original and rounded for the counterfeit) and surface finishing with PG-CF presenting more surface irregularities. PG-OR showed significantly more time to fracture (118 s), a higher angle of rotation (440°), and a lower maximum bending load (146.3 gf) (p < 0.05) than PG-CF (p < 0.05); however, maximum torque was similar for both instruments (0.4 N.cm) (p > 0.05). Although the tested instruments had a similar design, the original ProGlider showed superior mechanical behavior. The results of counterfeit ProGlider instruments were unreliable and can be considered unsafe for glide path procedures.
Collapse
|
35
|
Yadav S, Nawal RR, Talwar S. Nonsurgical Management of a Large Periapical Lesion Following Instrument Retrieval From the Apical Third: A Case Report With a Three-Year Follow-Up. Cureus 2022; 14:e24995. [PMID: 35719824 PMCID: PMC9191266 DOI: 10.7759/cureus.24995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/15/2022] Open
Abstract
Instrument separation in the apical third of the tooth, which is associated with a large periapical lesion, presents an arduous task for the clinician. This case report presents nonsurgical endodontic management of a maxillary central incisor associated with a large periapical lesion and a separated instrument in the apical third of the root canal. A 28-year-old male patient presented with pain and labial swelling in the left maxillary central incisor region. Pulp sensibility testing showed no response. The radiograph revealed the presence of a separated instrument in the apical third of the root canal and periapical radiolucency. A diagnosis of previously initiated therapy with acute apical abscess was made. In the first visit, instrument retrieval was done using ProUltra Endo tips (Dentsply Sirona, York, Pennsylvania) under a dental operating microscope. In the subsequent visit, obturation was done as the patient was asymptomatic. The patient was recalled for follow-up at six, 12, 18, 24, and 36 months. Complete healing of the periapical tissues was evident on the radiograph, and the tooth remained functional for the entire follow-up period of three years. The successful outcome seen in this case shows that even large periapical lesions can be managed conservatively by nonsurgical endodontic treatment
Collapse
|
36
|
Roda-Casanova V, Pérez-González A, Zubizarreta-Macho A, Faus-Matoses V. Influence of Cross-Section and Pitch on the Mechanical Response of NiTi Endodontic Files under Bending and Torsional Conditions—A Finite Element Analysis. J Clin Med 2022; 11:jcm11092642. [PMID: 35566767 PMCID: PMC9101501 DOI: 10.3390/jcm11092642] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations of two cross-sections(square and triangular) and four pitches. Each file was subjected to bending and torsional analyses, simulating the testing conditions indicated in the ISO 3630 Standard, in order to assess their stiffness and mechanical strength. The results indicate that endodontic files with a square cross-section have double the stiffness of those with triangular cross-sections, both in terms of bending and torsion. For both loading modes, endodontic files with a triangular cross-section can undergo larger deformations before overload failure than those with a square cross-section: up to 20% more in bending and 40% in torsion. Moreover, under equivalent boundary conditions, endodontic files with triangular cross-sections present a higher fatigue life than those with square cross-sections: up to more than 300% higher for small pitches. The effect of pitch on the stiffness and strength of the file is smaller than that of the cross-section shape, but smaller pitches could be beneficial when using a triangularcross-section, as they increase the bending flexibility, fatigue life, and torsion stiffness. These results suggest a clinical recommendation for the use of files with a triangular-shaped cross-section and a small pitch in order to minimize ledging and maximize fatigue life. Finally, in this study, we reveal the sensitivity of the orientation of files with respect to the bending direction, which must be taken into account when designing, reporting, and interpreting test results under such loading conditions.
Collapse
Affiliation(s)
- Victor Roda-Casanova
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castelló de la Plana, Spain; (V.R.-C.); (A.P.-G.)
| | - Antonio Pérez-González
- Department of Mechanical Engineering and Construction, Universitat Jaume I, 12071 Castelló de la Plana, Spain; (V.R.-C.); (A.P.-G.)
| | - Alvaro Zubizarreta-Macho
- Department of Dentistry, Alfonso X el Sabio University, 28691 Madrid, Spain
- Department of Orthodontics, University of Salamanca, 37008 Salamanca, Spain
- Correspondence:
| | - Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| |
Collapse
|
37
|
Basturk FB, Özyürek T, Uslu G, Gündoğar M. Mechanical Properties of the New Generation RACE EVO and R-Motion Nickel-Titanium Instruments. MATERIALS 2022; 15:ma15093330. [PMID: 35591664 PMCID: PMC9105925 DOI: 10.3390/ma15093330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to evaluate and compare the dynamic cyclic fatigue, torsional and bending resistance of two novel RACE EVO (FKG Dentaire SA, La Chaux de Fonds, Switzerland) and R-Motion (FKG) nickel−titanium instruments with traditional RaCe (FKG) instruments. RACE EVO, R-Motion and RaCe instruments with a size of 25 and taper of 0.06 were used. A dynamic cyclic fatigue test was used to assess the time to fracture. The fractured surfaces were further analyzed using scanning electron microscopy at ×350 and ×3000 magnifications. A torsional resistance test was performed to measure the maximum torsional strength and angle of rotation. Phase transformations with temperature were evaluated using differential scanning calorimetry. The results were statistically analyzed with a Kruskal−Wallis test at a 5% significance level. R-Motion had the highest time to fracture and the lowest torsional and bending resistance, whereas RaCe had the lowest time to fracture and the highest torsional and bending resistance (p < 0.05). In relation to the angle of rotation, RACE EVO instruments had the highest deformation capacity followed by R-Motion and RaCe instruments (p < 0.05). The greater cyclic fatigue resistance and lower torsional and bending resistance results indicate that the novel R-Motion and RACE EVO instruments are less rigid and more flexible than RaCe instruments.
Collapse
Affiliation(s)
- Fatima Betul Basturk
- Department of Endodontics, Istanbul Gelişim University, Istanbul 34310, Turkey
- Correspondence:
| | - Taha Özyürek
- Department of Endodontics, Bahçeşehir University, Istanbul 34734, Turkey;
| | - Gülşah Uslu
- Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale 17100, Turkey;
| | - Mustafa Gündoğar
- Department of Endodontics, Istanbul Medipol University, Istanbul 34083, Turkey;
| |
Collapse
|
38
|
Gouédard C, Pino L, Arbab-Chirani R, Arbab-Chirani S, Chevalier V. Comparison of the cyclic fatigue resistance of One Curve, F6 Skytaper, Protaper Next, and Hyflex CM endodontic files. Restor Dent Endod 2022; 47:e16. [PMID: 35692224 PMCID: PMC9160766 DOI: 10.5395/rde.2022.47.e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/18/2021] [Accepted: 11/03/2021] [Indexed: 11/11/2022] Open
Abstract
Objectives This study compared the cyclic fatigue resistance of One Curve (C wire) and F6 Skytaper (conventional austenite nickel-titanium [NiTi]), and 2 instruments with thermo-mechanically treated NiTi: Protaper Next X2 (M wire) and Hyflex CM (CM wire). Materials and Methods Ten new instruments of each group (size: 0.25 mm, 6% taper in the 3 mm tip region) were tested using a rotary bending machine with a 60° curvature angle and a 5 mm curvature radius, at room temperature. The number of cycles until fracture was recorded. The length of the fractured instruments was measured. The fracture surface of each fragment was examined with a scanning electron microscope (SEM). The data were analyzed using one-way analysis of variance and the post hoc Tukey test. The significance level was set at 0.05. Results At 60°, One Curve, F6 Skytaper and Hyflex CM had significantly longer fatigue lives than Protaper Next X2 (p < 0.05). No statistically significant differences were found in the cyclic fatigue lives of One Curve, F6 Skytaper, and Hyflex CM (p > 0.05). SEM images of the fracture surfaces of the different instruments showed typical features of fatigue failure. Conclusions Within the conditions of this study, at 60° and with a 5 mm curvature radius, the cyclic fatigue life of One Curve was not significantly different from those of F6 Skytaper and Hyflex CM. The cyclic fatigue lives of these 3 instruments were statistically significantly longer than that of Protaper Next.
Collapse
Affiliation(s)
- Charlotte Gouédard
- Department of Pediatric Dentistry, Dental School-Hospital of Brest, France
- University of Bretagne Occidentale, Brest, France
| | - Laurent Pino
- Ecole Nationale d'Ingénieurs de Brest, Brest, France
| | - Reza Arbab-Chirani
- Department of Endodontics and Restorative Dentistry, Dental School-Hospital of Brest, University of Bretagne Occidentale, Brest, France
- Laboratory of Medical Information Processing, Brest, France
| | | | - Valérie Chevalier
- University of Bretagne Occidentale, Brest, France
- Ecole Nationale d'Ingénieurs de Brest, Brest, France
| |
Collapse
|
39
|
Faus-Matoses V, Pérez García R, Faus-Llácer V, Faus-Matoses I, Alonso Ezpeleta Ó, Albaladejo Martínez A, Zubizarreta-Macho Á. Comparative Study of the SEM Evaluation, EDX Assessment, Morphometric Analysis, and Cyclic Fatigue Resistance of Three Novel Brands of NiTi Alloy Endodontic Files. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074414. [PMID: 35410096 PMCID: PMC8998441 DOI: 10.3390/ijerph19074414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
In this study, we compare and analyze the scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), morphometry and cyclic fatigue resistance of Endogal, PathMax, and Smarttrack novel brands of nickel−titanium (NiTi) alloy endodontic files. Material and Methods: Thirty sterile NiTi endodontic rotary files were randomly selected and assigned to one of the following study groups: A: 25.08 F2 Endogal (EDG) (n = 10); B: 25.08 F2 Path Max Pro (PMP) (n = 10); and C: 25.06 Smarttrack (ST) (n = 10). Dynamic cyclic fatigue tests were conducted using a cyclic fatigue device in stainless steel artificial root canal systems with an apical diameter of 250 µm, curvature angle of 60°, radius of curvature of 3 mm, and taper of 6%. Additionally, we analyzed the NiTi endodontic rotary files using EDX, SEM, and morphometry after micro-CT scanning. The results were analyzed using Weibull statistical analysis and ANOVA testing. Results: SEM, EDX, and morphometric analyses showed differences between the three novel brands of NiTi endodontic rotary files. Moreover, statistically significant differences were observed between the number of cycles to failure and time to failure of the three novel brands of NiTi endodontic rotary files (p < 0.001). Conclusions: Smarttrack NiTi alloy endodontic reciprocating files display greater resistance to cyclic fatigue than Endogal and Path Max Pro NiTi alloy endodontic rotary files, due to the reciprocating movement and metallurgical composition.
Collapse
Affiliation(s)
- Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Raúl Pérez García
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Vicente Faus-Llácer
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (V.F.-M.); (R.P.G.); (V.F.-L.)
- Correspondence:
| | - Óscar Alonso Ezpeleta
- Department of Endodontics, School of Health Sciences, University of Zaragoza, 22006 Zaragoza, Spain;
| | - Alberto Albaladejo Martínez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); or (Á.Z.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (A.A.M.); or (Á.Z.-M.)
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
| |
Collapse
|
40
|
The Effect of Cone-Beam Computed Tomography (CBCT) Evaluation on Treatment Planning after Endodontic Instrument Fracture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074088. [PMID: 35409771 PMCID: PMC8998552 DOI: 10.3390/ijerph19074088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023]
Abstract
Intracanal instrument fracture is a procedural iatrogenic event during endodontic treatment that may affect treatment planning and eventually treatment outcome. Cone Beam Computed Tomography (CBCT) has offered several advantages, especially in endodontic cases in which information from conventional periapical radiograph may not be adequate to allow a precise treatment planning decision and a subsequent appropriate management of the cases. The present study was firstly conducted to assess the effect of CBCT evaluation on the decision-making process after instrument fracture; secondly, to introduce a new clinical approach in cases with fractured instruments located in the mesial roots of mandibular and maxillary molars. The study design was observational. The sample comprised all cases of mandibular and maxillary molars where an instrument fracture had occurred in the mesial roots. Two qualified (National and Kapodistrian University of Athens, Greece) and experienced (more than fifteen years of daily practicing) endodontists evaluated all the cases. The initial treatment plan made by evaluating periapical radiographs of each case was compared to the final plan set after CBCT evaluation. A marginal homogeneity test for paired data was conducted to test the concordance of treatment planning with periapical radiographs versus CBCT. Multivariable logistic regression was structured to identify predictors of modification in treatment planning following CBCT assessment, and to record estimators for decision to remove, bypass or retain the fragment. The level of statistical significance was pre-specified at p < 0.05. Of a total 52 cases evaluated, change in treatment planning with conventional periapical radiograph as a reference, following evaluation of CBCT, was observed in more than half of the teeth. The difference was statistically significant (p < 0.001). Apical location of the fragment was more likely to induce a perceived change in treatment planning after CBCT evaluation (p < 0.01). Canal merging induced 95% lower odds (p = 0.01) for taking a decision to remove or bypass, revealing that retaining the fragment was by far a more likely decision. A significant impact of CBCT preoperative evaluation on treatment planning for the management of such cases was demonstrated. Apical location of the fragment and canal merging seem to influence the decision-making process.
Collapse
|
41
|
ŞANAL ÇIKMAN A, CEYHANLI T. COMPARISON OF FOUR DIFFERENT ENDODONTIC ROTARY SYSTEMS IN TERMS OF CYCLIC FATIGUE. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1032472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
42
|
A Rare Case of Orthograde Retrieval of Extruded Instrument following Periapical Tissue Healing. Case Rep Dent 2022; 2022:2589021. [PMID: 35127180 PMCID: PMC8808125 DOI: 10.1155/2022/2589021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
The ideal retrieval protocol of separated instruments reverts the case to the initial situation prior to the fracture incidence while preserving the tooth hard tissue and the integrity of the supporting structures. When a patient presented for emergency treatment of tooth #37 diagnosed with acute suppurative apical periodontitis, radiographic examination revealed a fractured instrument extruded into the periapex. The treatment options for retrieval were limited to replantation. The initial emergency treatment which consisted of orthograde pus drain, radicular disinfection, and intracanal calcium hydroxide dressing completely resolved patient's symptoms. The follow-up radiographs revealed an interesting finding: gradual shift in the separated fragment position into the radicular space allowing a successful nonsurgical removal of the broken instrument. In conclusion, the reaction of periodontal tissues to an extruded instrument fragment remaining in situ may be favourable; thus, a risk and benefit analysis approach is essential to fractured instrument retrieval.
Collapse
|
43
|
Gavini G, Candeiro GTDM, Potgornik Ferreira F, Rubino GA, Aun CA, Bezerra AG, Malavasi M, Lemos ÉM, Caldeira CL, Akisue E. Retrospective study of endodontic treatment performed by undergraduate students using reciprocating instrumentation and single‐cone obturation. J Dent Educ 2022; 86:751-758. [DOI: 10.1002/jdd.12884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2021] [Accepted: 12/23/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Giulio Gavini
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | | | | | - Gustavo Alberto Rubino
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | - Carmo Antônio Aun
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Alexandre Gomes Bezerra
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Maurílio Malavasi
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Érico Melo Lemos
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| | - Celso Luiz Caldeira
- Department of Restorative Dentistry Faculty of Dentistry University of São Paulo São Paulo Brazil
| | - Eduardo Akisue
- Department of Restorative Dentistry Faculty of Dentistry ‐ Discipline of Endodontics University Santa Cecília Santos Brazil
| |
Collapse
|
44
|
Mohamed RH, Abdelrahman AM, Sharaf AA. Evaluation of rotary file system (Kedo-S-Square) in root canal preparation of primary anterior teeth using cone beam computed tomography (CBCT)-in vitro study. BMC Oral Health 2022; 22:13. [PMID: 35042489 PMCID: PMC8764846 DOI: 10.1186/s12903-021-02021-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
Background In recent years, pediatric endodontics has witnessed various advances including use of rotary files in pulpectomy. This study aimed to comparatively evaluate taper, amount of dentin removal and instrumentation time of the pediatric rotary Kedo-S Square file,
hand K-files and H-files in primary canines using cone beam computed tomography (CBCT). Methods 60 primary canines were randomly assigned into three groups; A1 Kedo-S-Square rotary file (group I), hand stainless steel K file (group II) and hand stainless steel H file (group III). Teeth were mounted in vinyl poly siloxane impression material templates to be scanned before and after instrumentation by CBCT scans using Ondemand 3D software. Shaping ability of the files were evaluated in terms of taper of the canal and amount of dentin remaining of each group. Instrumentation time was recorded using a digital stopwatch. Results Kedo-S Square removed a significantly less amount of dentin in both apical (P < 0.002) and coronal thirds (P < 0.014). Taper of the preparations showed significant differences as Kedo-S Square file showed good taper in maximum number of root canals, while maual K- and H-files showed poor taper in maximum number of root canals (P < 0.0001). Rotary Kedo-S Square files required less instrumentation time (P < 0.0001). Conclusion The use of rotary Kedo-S Square files resulted in better conservation of tooth structure, superior tapering ability and least instrumentation time compared to hand K- and H-files.
Collapse
|
45
|
Mehrotra A, Gutte N, Mishra R, Ughade S, Nanditha SK, Shankar. Sealing ability of different obturating techniques in apically separated rotary files: An In Vitro study. J Pharm Bioallied Sci 2022; 14:S884-S887. [PMID: 36110826 PMCID: PMC9469406 DOI: 10.4103/jpbs.jpbs_911_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/07/2022] [Indexed: 11/08/2022] Open
Abstract
Aim: Testing whether two sealant systems (cold laterally compacted gutta-percha and Obtura II) can be used with extraction across two apically separated rotational nickel-titanium files was the primary objective of this study (RACE and K3). Materials and Methods: Both the positive and negative control teeth were randomly distributed among 62 mandibular premolars to create two groups of 30 each. Following the RACE and K3 approaches, four subgroups were created from the roots. Subgroups A1, B1, and A2, B2 (n = 10 each) were formed in the apical thirds of the canal at 3 mm from the tip. There was no division of instruments between groups A3, B3, B4, and A4. When it came to obturation, the Obtura II method was used for A2, A4, B2, B4, and A1, A3. A dye extraction process was employed to determine whether the specimens had been obliterated. Analysis of variance (ANOVA), Student t test (two-tailed, independent), and Leven's test were used to ascertain the values for each of the study groups. Results: Group A1 had a substantially lower leakage rate than group B1. Groups A2, B2 and A3, B3 had no statistically significant differences. Group A4 had a substantially lower leakage rate than group B4. Conclusion: Even when the cracked NiTi rotary system was not present, Obtura II-obturated groups had less leakage than the lateral condensation approach.
Collapse
|
46
|
Sarfaraz D, Hasheminia S, Farhad A, Davoudi H. Microleakage of five separated nickel-titanium rotary file systems in the apical portion of the root canal. Dent Res J (Isfahan) 2022. [DOI: 10.4103/1735-3327.346404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
47
|
Hirani A, Arora A, Hadwani K, Cherian A. Cyclic and spontaneous movement of a fractured and extruded instrument back into the root canal: A rare case report. J Conserv Dent 2022; 25:105-108. [PMID: 35722080 PMCID: PMC9200180 DOI: 10.4103/jcd.jcd_303_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Retreatment of endodontically involved teeth may require the removal of obstruction from root canal space. Instrument fracture is an undesirable and stressful incident which can negatively affect the prognosis of the tooth. Any corrective step taken should be performed with utmost care to prevent extrusion of the fragment into periapex. This case report describes a rare occurrence of movement of a fractured instrument during inter-appointment period. A previously treated left mandibular first molar with a fractured instrument was taken up for retreatment. During the course of treatment, the fractured fragment which was previously located in the apical third of the distal canal was dislodged into the periapical region. However, it was found that fragment moved back inside the canal after the inter-appointment period. The same sequence of events repeated before the instrument could be retrieved. Hydrostatic and vascular pressure build due to periapical inflammation could be cited reasons for such a movement.
Collapse
|
48
|
Vatanpour M, Toursavadkouhi S, Sajjad S. Comparison of three irrigation methods: SWEEPS, Ultrasonic, and Traditional irrigation, in smear layer and debris removal abilities in the root canal, beyond the fractured instrument. Photodiagnosis Photodyn Ther 2021; 37:102707. [PMID: 34971819 DOI: 10.1016/j.pdpdt.2021.102707] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/23/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study compared the effectiveness of three irrigation methods in removing smear layer and debris in the presence of the fractured instrument. The three compared irrigation methods were conventional syringe irrigation, passive ultrasonic irrigation, and SWEEPS (Shock wave enhanced emission photoacoustic streaming) irrigation. METHODS AND MATERIALS Sixty-three permanent mandibular molars with moderate curvature were included in this experimental study. Mesiobuccal root canals were prepared with Race files (FKG Dentaire. Switzerland) up to #25, 4%. A #30, 6% Race file was used to simulate file fracture 3 mm short of working length. The prepared samples, randomly divided into three groups, and final irrigation was separately done in each group. Group 1 conventional syringe irrigation (CSI) as the control group, Group 2 passive ultrasonic irrigation (PUI), and Group 3 Shock wave enhanced emission photoacoustic streaming or SWEEPS Irrigation (SI). Smear layer and debris removal beyond separated file scored with scanning electron microscope(SEM) images. Data were analyzed using the nonparametric tests to compare the smear layer and debris scores. RESULT SWEEPS and passive ultrasonic irrigation significantly removed smear layer and debris, better than conventional syringe irrigation (p<0.001). The smear layer and debris removal efficiency between passive ultrasonic Irrigation and SWEEPS were not significantly different (p=0.629). CONCLUSION In the face of the irretrievably broken instrument in the root canal, passive ultrasonic irrigation and the SWEEPS method can enhance smear layer and debris removal compared to conventional syringe irrigation.
Collapse
Affiliation(s)
- Mehdi Vatanpour
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran
| | - Sohrab Toursavadkouhi
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran
| | - Shirin Sajjad
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran.
| |
Collapse
|
49
|
Ruivo LM, Rios MDA, Villela AM, de Martin AS, Kato AS, Pelegrine RA, Barbosa AFA, Silva EJNL, Bueno CEDS. Fracture incidence of Reciproc instruments during root canal retreatment performed by postgraduate students: a cross-sectional retrospective clinical study. Restor Dent Endod 2021; 46:e49. [PMID: 34909413 PMCID: PMC8636080 DOI: 10.5395/rde.2021.46.e49] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. Materials and Methods From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ2 test (p < 0.01). Results Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. Conclusions The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.
Collapse
Affiliation(s)
- Liliana Machado Ruivo
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil
| | - Marcos de Azevedo Rios
- Department of Endodontics, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil
| | | | | | - Augusto Shoji Kato
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Rina Andrea Pelegrine
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, SP, Brazil
| | | | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.,Department of Endodontic, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | |
Collapse
|
50
|
Zanza A, D’Angelo M, Reda R, Gambarini G, Testarelli L, Di Nardo D. An Update on Nickel-Titanium Rotary Instruments in Endodontics: Mechanical Characteristics, Testing and Future Perspective-An Overview. Bioengineering (Basel) 2021; 8:bioengineering8120218. [PMID: 34940371 PMCID: PMC8698980 DOI: 10.3390/bioengineering8120218] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Since the introduction of Nickel-Titanium alloy as the material of choice for the manufacturing of endodontic rotary instruments, the success rate of the root canal therapies has been significantly increased. This success mainly arises from the properties of the Nickel-Titanium alloy: the biocompatibility, the superelasticity and the shape memory effect. Those characteristics have led to a reduction in time of endodontic treatments, a simplification of instrumentation procedures and an increase of predictability and effectiveness of endodontic treatments. Nevertheless, the intracanal separation of Nickel-Titanium rotary instruments is still a major concern of endodontists, with a consequent possible reduction in the outcome rate. As thoroughly demonstrated, the two main causes of intracanal separation of endodontic instruments are the cyclic fatigue and the torsional loads. As results, in order to reduce the percentage of intracanal separation research and manufacturers have been focused on the parameters that directly or indirectly influence mechanical properties of endodontic rotary instruments. This review describes the current state of the art regarding the Nickel-Titanium alloy in endodontics, the mechanical behavior of endodontic rotary instruments and the relative stresses acting on them during intracanal instrumentation, highlighting the limitation of the current literature.
Collapse
|