Evaluation of the Cyclic Fatigue and Torsional Resistance of Novel Nickel-Titanium Rotary Files with Various Alloy Properties

Unveiling the fatigue life of NiTi endodontic files: An integrated computational-experimental study

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.

In Vitro Evaluation of the Dynamic Cyclic Fatigue Resistance of a New TruNatomy Glider File after Different Cycles of Use

INTRODUCTION

Determination of the glide path is recommended before using rotary instruments. This study aimed to evaluate the dynamic cyclic fatigue resistance of new and used glider rotary instruments in up to 6 root canals.

METHODS

Seventy-two TruNatomy Glider files were used for the preparation of root canals of extracted lower molars, which were then submitted to the dynamic cyclic fatigue test carried out in a curved metallic artificial canal. The instruments were divided into 4 groups (n = 18): Control group, new instruments without any use in the root canal; Group 2U, instruments used in 2 mesial canals; Group 4U, instruments used in 4 mesial canals; Group 6U, instruments used in 6 mesial canals. The time to failure (TF) of the instrument was recorded, and the number of cycles to failure (NCF) was calculated. The data were submitted to 1-way analysis of variance and to the Games-Howell test for multiple comparisons, adopting a significance level of 5%.

RESULTS

TF and NCF were significantly affected by the number of file uses. The Games-Howell test revealed that TF and NCF were significantly greater in the control group than in Group 4U. In Group 2U, TF and NCF were intermediate and not significantly different from the control group. Group 6U had significantly lower TF and NCF than all other groups.

CONCLUSION

The TruNatomy Glider can be used as a glide path for up to 2 mesial canals of mandibular molars, whereas its use on 4 or 6 root canals is not suggested.

Phase transformation behavior and mechanical properties of HyFlex EDM nickel-titanium endodontic rotary instrument: Evaluation at body temperature

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.

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

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.

Effect of Heat Treatment on Mechanical Properties of Nickel-Titanium Instruments

INTRODUCTION

The aim of this study was to evaluate the torsional resistance, cyclic fatigue resistance, and bending stiffness of nickel-titanium (NiTi) file systems with different heat treatments and cross-sectional designs.

METHODS

WaveOne Primary treated with memory-triple (MT) heat treatment (WOMT) was compared with WaveOne Primary (WO) and WaveOne Gold Primary (WOG). Torsional resistance test was performed using a customized device, and the distortion angle, ultimate strength, and toughness were evaluated. For cyclic fatigue resistance test, the instruments were reciprocated with continuous 4 mm up-and-down movement until fracture in a customized device, and the time to fracture was compared. Fracture surfaces of each group were examined under the scanning electron microscope. Bending stiffness was measured using a custom-made device. The results were analyzed using one-way analysis of variance and the Tukey's post hoc comparison at a significance level of 95%.

RESULTS

WOMT showed higher ultimate strength and toughness than the other systems (P < .05). WOMT also showed highest cyclic fatigue resistance among the tested groups (P < .05). WO had the highest bending stiffness than others, whereas WOMT had a larger residual angle than others (P < .05).

CONCLUSIONS

This new MT heat treatment technique makes NiTi file more flexible and improves its mechanical properties. In addition, the effect of heat treatment on flexibility was found to be more significant than that of the cross-sectional area.

Cyclic Fatigue Resistance of Different Glide Path Files in Simulated Double Curved Canal in Continuous Rotary Motion: An In Vitro Study

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.

Advancing Nitinol: From heat treatment to surface functionalization for nickel–titanium (NiTi) instruments in endodontics

Nickel-titanium (NiTi) alloy has been extensively researched in endodontics, particularly in cleaning and shaping the root canal system. Research advances have primarily focused on the design, shape, and geometry of the NiTi files as well as metallurgy and mechanical properties. So far, extensive investigations have been made surrounding surface and thermomechanical treatments, however, limited work has been done in the realm of surface functionalization to augment its performance in endodontics. This review summarizes the unique characteristics, current use, and latest developments in thermomechanically treated NiTi endodontic files. It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization. Whilst clinical translation of this technology has yet to be fully realized, future research direction will lie in the use of nanotechnology.

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Nitinol (Nickel Titanium alloy) is widely used to clean/shape root canal system in endodontics.

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To enhance its performance, various thermo-mechanical and nano-engineering modifications have been performed.

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This comprehensive review summarizes the latest advances and future trends relating to functionalized NiTi endodontic files.

Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation

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.

Influence of temperature on the torsional properties of two thermally treated NiTi rotary instruments

This study aimed to evaluate the influence of temperature on torsional strength and angular deflection of two experimental NiTi rotary instruments manufactured from Blue and Gold thermal treatments and with identical cross-sections. A total of 40 experimental NiTi instruments 25.06 and with a triangular cross-section and manufactured from Blue and Gold thermal treatments were used (n=20). The torsional test was performed in the 3 mm from the tip of the instrument according to ISO 3630-1. The torsional test evaluated the torsional strength and angular deflection to failure at room temperature (21°C ± 1° C) and body temperature (36°C ±1°C). The fractured surface of each fragment was observed by using scanning electron microscopy (SEM). Data were analyzed using an unpaired t test for inter and intra-group comparison and the level of significance was set at 5%. The results showed that the body temperature did not affect the torsional strength and angular deflection of the instruments when compared with room temperature (P>0.05). However, at body temperature, the Blue NiTi instruments presented significantly lower angular deflection in comparison with Gold NiTi instruments (P<0.05). There was no significant difference regarding the torsional strength of the instruments at body temperature (P>0.05). The temperature did not affect the torsional strength of the instruments manufactured from Blue and Gold technology. However, the Blue NiTi instruments presented significantly lower angular deflection than Gold instruments at 36°C temperature.

Effect of different axial speed patterns on cyclic fatigue resistance of rotary nickel-titanium instruments

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.

Effect of Rotational Modes on Torque/Force Generation and Canal Centering Ability during Rotary Root Canal Instrumentation with Differently Heat-Treated Nickel-Titanium Instruments

This study aimed to evaluate how various rotational modes influence the torque/force production and shaping ability of ProTaper Universal (PTU; non-heat-treated) and ProTaper Gold (PTG; heat-treated) nickel−titanium instruments. J-shaped resin canals were instrumented with PTU or PTG using an automated instrumentation device operated with reciprocating rotation [150° clockwise and 30° counterclockwise (R150/30) or 240° clockwise and 120° counterclockwise (R240/120)], optimum torque reverse motion (OTR), or continuous rotation (CR) (n = 10 each). Maximum force and torque were recorded, and canal centering ratios were calculated. Statistical analysis was performed with two-way ANOVA and a Bonferroni test (α = 0.05). The results were considered with reference to previous studies on the microstructure of the instruments. The upward force generated by R240/120 and OTR was smaller than that generated by R150/30 and CR in PTG (p < 0.05). The clockwise torque produced by OTR was lower than that produced by R150/30 in PTU and R240/120 and CR in PTG (p < 0.05). R240/120 and OTR induced less canal deviation compared to CR in PTU at 0 mm from the apex (p < 0.05). In conclusion, R240/120 and OTR reduced the screw-in force in PTG and improved the canal centering ability in PTU, which may be associated with the heat treatment-induced microstructural difference of the two instruments.

Effect of nickel-titanium alloys on root canal preparation and on mechanical properties of rotary instruments

The aim of this study was to evaluate the quality of curved root canal preparation, torsional fatigue, and cyclic fatigue of rotary systems manufactured with different NiTi alloys. Ninety single-rooted canals with curvatures of 15° to 30o were scanned and divided into three groups according to the rotary system used: BT-Race (BTR) - 10.06, 35.00, 35.04; SequenceRotaryFile (SRF) - 15.04, 25.06, 35.04; and ProDesignLogic (PDL) - 25.01, 25.06, 35.05. Each system was used on three specimens. The teeth were prepared, scanned, and analyzed to assess increase in volume, transportation, and centering ability of the root canal. Torsional fatigue of glide path instruments (BTR 10.06, SRF 15.04 and PDL 25.01) and cyclic fatigue of the finishing instrument (BTR 35.04, SRF 35.04 and PDL 35.05) were obtained by analyzing completely new instruments (n = 10) and instruments after they had been used three times (n = 10). After the torsional and cyclic fatigue tests, the fractured surface of the new and used instruments were examined by scanning electron microscopy. Increase in volume, canal transportation, and centering ability showed no significant differences among the groups (p > 0.05). The torsional test showed that SRF 15.04 produced the highest torque values for both new and used instruments, followed by PDL 25.01 and BTR 10.06 (p < 0.05). PDL 25.01, both new and used, exhibited higher values of angular deflection followed by SRF 15.04 and BTR 10.06 (p < 0.05). As regards cyclic fatigue, use of PDL 35.05, both new and used, required a longer time and larger number of cycles than did SRF 35.04 and BTR 35.04 (p < 0.05). Clinical use affected the torsional fatigue of BTR; however, cyclic fatigue was not significantly affected (p < 0.05). All rotary systems were able to prepare the curved canals satisfactorily and were used safely on the three specimens. Relative to torsional fatigue, SRF 15.04 exhibited a higher torque, and PDL 25.01, higher angular deflection. BTR 10.06 was the most affected by clinical use. PDL 35.05 showed greater resistance to cyclic fatigue.

What meaningful information are the instruments mechanical testing giving us? A comprehensive review

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.

Multimethod Assessment of Design, Metallurgical, and Mechanical Characteristics of Original and Counterfeit ProGlider Instruments

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.

Endodontic Rotary Files, What Should an Endodontist Know?

Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator’s own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment.

Design, Metallurgical Features, and Mechanical Behaviour of NiTi Endodontic Instruments from Five Different Heat-Treated Rotary Systems

The current study aimed to compare the F1 endodontic instruments from five different heat-treated rotary systems regarding their design, metallurgical properties, and mechanical performance. Five F1 root canal shaping instruments (ProTaper Gold [PTG], Premium Taper Gold, Go-Taper Flex, EdgeTaper Platinum, and Super Files Blue)—plus, a conventional ProTaper Universal (PTU)—which were evaluated regarding their design, nickel/titanium ratio, phase transformation temperatures, microhardness, cyclic fatigue, and torsional and bending strengths. Mood's median test was used for the statistical comparison with a significance set at 5%. The instruments were similar regarding the nickel/titanium ratio and overall design. Go-Taper Flex had the closest transformation temperatures to PTG. PTU and Go-Taper Flex had the highest microhardness (408.3 and 410.5 HVN). The time to fracture of Super Files Blue was three and seven times higher than PTG and PTU, respectively. No difference was observed in the maximum torque to fracture among PTG (1.30 N·cm) and the other systems, except for the Premium Taper Gold (1.05 N·cm) and Go-Taper Flex (1.10 N·cm). Significantly lower bending loads than PTG (269.2 gf) were observed for the EdgeTaper Platinum (158.3 gf) and Premium Taper Gold (103.5 gf) instruments. Super Files Blue outperformed PTG in the cyclic fatigue test, while EdgeTaper Platinum and Premium Taper Gold were more flexible. Premium Taper Gold and Go-Taper Flex showed lower torsional strength.

Nitinol Type Alloys General Characteristics and Applications in Endodontics

A very extensive literature review presents the possibilities and needs of using, in endodontics, the alloys commonly known as nitinol. Nitinol, as the most modern group of engineering materials used to develop root canals, is equilibrium nickel and titanium alloys in terms of the elements’ atomic concentration, or very similar. The main audience of this paper is engineers, tool designers and manufacturers, PhD students, and students of materials and manufacturing engineering but this article can also certainly be used by dentists. The paper aims to present a full material science characterization of the structure and properties of nitinol alloys and to discuss all structural phenomena that determine the performance properties of these alloys, including those applied to manufacture the endodontic tools. The paper presents the selection of these alloys’ chemical composition and processing conditions and their importance in the endodontic treatment of teeth. The results of laboratory studies on the analysis of changes during the sterilization of endodontic instruments made of nitinol alloys are also included. The summary of all the literature analyses is an SWOT analysis of strengths, weaknesses, opportunities, and threats, and is a forecast of the development strategy of this material in a specific application such as endodontics.

A single-file endodontic treatment: A promising endodontic concept

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Influence of operator expertise on glide path and root canal preparation of curved root canals with rotary and reciprocating motions

This study intended to help practitioners selecting the appropriate motion according to their level of expertise for glide path and complete root canal preparation of curved canals in terms of instrument fracture and preparation time. A total of 160 curved root canals (angle >30°, radius <6 mm) were allocated randomly to 4 groups: A/B for expert operators and C/D for nonexpert operators. A/C were shaped with rotary and B/D with reciprocating instruments. Preparation time was registered and compared with Kruskal-Wallis non-parametric test and Dunn's post hoc test. Instrument separation was also registered and compared with chi-square test. A fractographic analysis was performed with scanning electron microscopy. The use of reciprocation motions allowed nonexpert operators to avoid instrument breakage during glide path and to prepare root canals faster. Experts were equally effective in rotary/reciprocating root canal shaping and faster with rotary motions than nonexpert operators, who also fractured significantly more rotary instruments.

Effect of Core Mass and Alloy on Cyclic Fatigue Resistance of Different Nickel-Titanium Endodontic Instruments in Matching Artificial Canals

Instrument failure during root canal preparation is still a concern among endodontists. However, it remains unclear whether the use of more martensitic alloys or the cross-sectional design parameters (i.e., core mass) significantly improve fracture resistance. The aim of the study was to evaluate the impact of core mass and alloy on dynamic cyclic fatigue resistance of nickel-titanium endodontic instruments in matching artificial canals at body temperature. Two groups were tested. (A) taper 0.04: F360 (Komet, Lemgo, Germany), Twisted file (Sybron Endo, Glendora, CA, USA) (=TF), JIZAI (Mani, Tochigi, Japan) (=J_04) (all size #25) and the variable tapered TruNatomy (Dentsply, Ballaigues, Switzerland) (size #26) (=TN). (B) size #25; taper 0.06: (Mtwo (VDW, Munich, Germany), JIZAI (Mani) (=J_06), and variable tapered Hyflex EDM OneFile (Coltene Whaledent, Altstätten, Switzerland) (=HF). Time, number of cycles to fracture (NCF), and number and length of fractured fragments were recorded and statistically analysed using ANOVA Student-Newman-Keuls, Kruskal–Wallis or Chi-square test (significance level = 0.05). (A) TN showed the significantly shortest time until fracture, followed by TF, F360 and J_04 which also differed significantly, while NCF showed the following order: F360 < TN < TF < J_04 (p < 0.05). Only one J_04 but all instruments of the other groups fractured within the test-limit of 10 min. (B) Mtwo was significantly inferior concerning time until fracture and NCF, compared to J_06 and HF (p < 0.05), which did not differ significantly (p > 0.05). While all Mtwo instruments fractured, only four instruments failed in the other groups (p < 0.05). Within the limitations of this study, alloy and cross-sectional design (i.e., core mass) were critical factors regarding instrument failure, but none of these factors could be determined as a main parameter for increased or decreased time, and cycles to fracture. Rather, it seemed to be the interaction of multiple factors (e.g., longitudinal and cross-sectional design, alloy, and rotational speed) that was responsible for differences in the time and cycles to fracture. Nonetheless, all instruments had lifetimes that allow safe clinical use. However, the superiority or inferiority of an instrument with regard to cyclic fatigue based on laboratory results—even when identical trajectories are guaranteed—may be considered questionable, as the characteristics and design parameters of the instruments vary considerably, and the experimental setups lack additional clinical parameters and thus clinical relevance.

Cyclic fatigue resistance for six types of nickel titanium instruments at artificial canals with different angles and radii of curvature

This study evaluated the cyclic fatigue resistance for six types of 25# NiTi instruments. A traditional manufacturing instrument, an M wire instrument, a gold treatment instrument, a controlled memory (CM) wire instrument, a CM wire instrument with electrical discharge machining (EDM), and an R-phase heat treatment instrument, were operated in the different curved artificial canals. The fracture time (FT) and number of cycles to fracture (NCF) of the NiTi instruments were higher at 45° angles and double-curvature canals than at 60° angles. Except for the instruments with gold technology and EDM technology, others showed the longest FT and the highest NCF at an 8 mm radius of curvature. Morphological characteristics of cyclic fatigue were exhibited on the cross-section and lateral view of fracture fragments. The use of M-wire, R-phase wire, CM-wire, gold technology, EDM technology, and reciprocating movement were beneficial to enhance the cyclic fatigue resistance of NiTi files.

Analysis of Torque and Force Induced by Rotary Nickel-Titanium Instruments during Root Canal Preparation: A Systematic Review

The aim of this review was to provide a detailed literature analysis of torque and force generation during nickel-titanium rotary root canal instrumentation. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was performed using in PubMed and in journals for articles published in English from 1987 to June 2020 on studies that investigated dynamic torque and force in vivo or in vitro. We assessed article titles and abstracts to remove duplicates, and the titles and abstracts of the remaining articles were screened for eligibility. Full texts were read to verify eligibility by considering predetermined inclusion and exclusion criteria. Fifty-two out of 4096 studies met the inclusion criteria, from which we identified 26 factors that influence torque or force generation. Factors associated with higher torque or force generation and supported by multiple studies with mostly consistent results included convex triangle cross-sectional design, regressive taper, short pitch length, large instrument size, small canal size, single-length preparation technique, long preparation time, deep insertion depth, low rate of insertion, continuous rotation (torque), reciprocating motion (force), lower rotational speed and conventional alloy. However, several factors are interrelated, which obscured the independent effect of each factor, and there was insufficient scientific evidence supporting the influence of some factors.

Effect of immersion in sodium hypochlorite on the cyclic fatigue resistance of three rotary instruments

Context:

It is essential to know if the immersion in sodium hypochlorite (NaOCl) influences the cyclic fatigue resistance of nickel-titaniumm (NiTi) files.

Aim:

This study was aimed to evaluate the resistance to the cyclic fatigue of three NiTi systems, as well as the influence of 5.25% NaOCl on their resistance.

Methods:

Files from the Sequence Rotary File (MK life, Porto Alegre, Brazil), ProTaper Next (PTN) (Dentsply, Maillefer, Baillagues, Switzerland), and HyFlex EDM (Coltène Whaledent, Allstatten, Switzerland) systems were tested and separated into Group 1)-without immersion in NaOCl solution and Group 2 and Group 3-immersed in 5.25% NaOCl solution, for 1 min, and 5 min, respectively. All instruments were submitted to the cyclic fatigue test. Images of the instruments were observed by scanning electron microscopy, to evaluate the type of defect presented on the fractured surface. The test performed for the analysis of two independent factors was a two-way analysis of variance.

Results:

HyFlex EDM presented a greater number of cycles until fracture when compared to others (P < 0.001). The control group showed a greater number of cycles until fracture than the same instruments submitted to NaOCl (P < 0.001). Sequence instruments showed the lowest values of cycles until fracture (P < 0.001). There was no statistically significant difference between treatments (P = 0.998). PTN, showed intermediate values of fracture resistance when compared to the HyFlex EDM and sequence instruments (P < 0.001), but without intragroup differences (P = 0.437).

Conclusions:

Hyflex EDM instruments were the most resistant to cyclic fatigue.

Preventing nickel-titanium rotary instrument from breakage by continuous irrigation with different fluids during root canal preparation

To study the effect of continuous irrigation of rotating nickel-titanium instrument with several common clinical fluids on the diameter, breaking length and breaking position of nickel-titanium instrument, so as to provide some reference and theoretical basis for clinical operation and instrument improvement.A standardized curved root canal model was established, and ProTaper Universal (PTU) F1 instrument was selected for root canal preparation. The nickel-titanium F1 instrument was flushed with distilled water, 0.9% NaCl, 0.2% chlorhexidine, 1% sodium hypochlorite and 5% sodium hypochlorite, and the diameter, length and position of the instrument before and after breakage were recorded.Only 5% sodium hypochlorite influenced the diameter of 6 mm marker points under different irrigation conditions (P < .05). There was no statistical difference in the length of broken instruments among all the groups, and torsional deformation mainly occurred at the end of broken instruments. The broken positions of instruments in all the groups were located at the bending segment of the root canal. The breaking frequency of the 5% sodium hypochlorite group was the highest in the area 3-5.5 mm away from apical foramen, while the other 4 groups had the highest breaking frequency in the area 0 to 1.5 mm away from apical foramen.External irrigation with different fluids did not influence the breaking length of instruments. The closer to the apical foramen was, the higher the breaking frequency of instruments was. However, only 5% sodium hypochlorite can affect the diameter of rotary nickel-titanium instruments, and may lead to early breakage of the instrument, indicating that the use of disinfectants, except 5% sodium hypochlorite, cannot reduce breakage resistance of nickel-titanium instrument compared with distilled water flushing. Furthermore, 5% hypochlorite could not be recommended for irrigation in clinical practice.

Comparison of design, metallurgy, mechanical performance and shaping ability of replica-like and counterfeit instruments of the ProTaper Next system

AIM

To compare the ProTaper Next (PTN) system with a replica-like and a counterfeit system regarding design, metallurgy, mechanical performance and shaping ability.

METHODOLOGY

Replica-like (X-File) and counterfeit (PTN-CF) instruments were compared to the PTN system regarding design (microscopy), phase transformation temperatures (differential scanning calorimetry), nickel-titanium ratio (energy-dispersive X-ray spectroscopy), cyclic fatigue, torsional resistance, bending strength, and untouched canal areas in extracted mandibular molars (micro-CT). anova, post hoc Tukey's and Kruskal-Wallis tests were used according to normality assessment (Shapiro-Wilk test) with the significance level set at 5%.

RESULTS

Overall similarities in design and nickel-titanium (Ni/Ti) ratio were observed amongst instruments with the X-File having a smoother surface finish. PTN and PTN-CF had mixed austenite plus R-phase (R-phase start approximately at 45 ºC and near 30 ºC, respectively), whilst X-File instruments were austenitic (R-phase started at approximately at 17 ºC) at room temperature (20 ºC). PTN-CF had the greatest inconsistency in the phase transformation temperatures. Time to fracture of PTN-CF X2 and X3 was significantly shorter than PTN and X-File instruments (P < 0.05), whilst no difference was noted in maximum torque to fracture amongst the tested systems (P > 0.05). X-Files and PTN-CF had a stress-induced phase change during bending load. Mean unprepared surface areas of root canals were 25.8% (PTN), 31.1% (X-File) and 32.5% (PTN-CF) with no significant difference amongst groups (P > 0.05).

CONCLUSION

Similarities amongst the systems were noted in the Ni/Ti ratio and maximum torque to fracture, whilst differences were observed in the design, phase transformation temperatures and mechanical behaviour. The ProTaper Next counterfeit instruments could be considered as the less secure system considering its low-cyclic fatigue resistance. Apart from these differences, the unprepared canal surface areas, obtained with the tested systems, were similar.

Mechanical Properties of ProTaper Gold, EdgeTaper Platinum, Flex Gold and Pro-T Rotary Systems

OBJECTIVE

The aim of this study was to evaluate the cyclic fatigue, torsional behavior and bending resistance of EdgeTaper Platinum [ETP (tip 25, taper 0.06)], Flex Gold [FG (tip 25, taper 0.08)], Pro-T [PT (tip 25, taper 0.08)] and ProTaper Gold [PTG (tip 25, taper 0.08)] systems.

METHODS

Rotary instruments of ETP, PT, FG, and PTG were used (n=30). Cyclic fatigue tests were performed using an artificial stainless-steel canal with a 60o angle and a 5-mm radius of curvature at body temperature (35°±1°C). The time and number of cycles to fracture (NCF) was recorded. The torsional test evaluated the torque and angle of rotation to failure at 3 mm from the tip according to ISO 3630-1. The fractured surface of each fragment was observed by using scanning electron microscopy (SEM). The bending test evaluated the torque required to bend the instruments at an angular deflection of 60°. Data were analyzed using one-way ANOVA and Tukey tests, and the level of significance was set at 5%.

RESULTS

The ETP had highest time until fracture and NCF than all the groups (P<0.05). The PTG had the highest torsional strength, followed by FG (P<0.05). The ETP had the highest angular rotation, followed by PT and PTG (P<0.05). The FG showed the highest bending resistance, followed by the PTG (P<0.05).

CONCLUSION

In conclusion, the ETP and PT exhibited higher cyclic fatigue resistance, higher angular deflection values and lower bending force than FG and PTG. The PTG instruments showed the highest torsional strength and the lowest cyclic fatigue resistance.

Shaping and Centering Ability, Cyclic Fatigue Resistance and Fractographic Analysis of Three Thermally Treated NiTi Endodontic Instrument Systems

The better understanding of the clinically important behavioral features of new instrument systems has an important significance for the clinical endodontics. This study aimed to investigate the shaping and centering ability as well as cyclic fatigue resistance of HyFlex CM (CM), HyFlex EDM (EDM) and EdgeFile (EF) thermally treated nickel-titanium (NiTi) endodontic instrument systems. Sixty curved root canals of the mesial roots of mandibular molars were randomly assigned into three groups (n = 20) and shaped using CM, EDM and EF files up to the size 40 and taper 04 of the instruments. µCT scanning of the specimens before and after preparation was performed and the morphometric 2D and 3D parameters were evaluated in the apical, middle and coronal thirds of root canals. In each group, 40.04 instruments (n = 20) were subjected to the cyclic fatigue resistance test in artificial root canals at 37 °C temperature until fractures occurred, and the number of cycles to failure (NCF) was calculated. The fractographic analysis was performed using a scanning electron microscope, evaluating topographic features and surface profiles of the separated instruments. The one-way analysis of variance with post hoc Tuckey's test was used for statistical analysis of the data; the significance level was set at 5%. All systems prepared the comparable percentage of root canal surface with the similar magnitude of canal transportation in all root thirds (p > 0.05), but demonstrated significantly different resistance to cyclic fatigue (p < 0.05). The most resistant to fracture was EF, followed by EDM and CM. The length of the fractured fragments was not significantly different between the groups, and fractographic analysis by SEM detected the typical topographic features of separated thermally treated NiTi instrument surfaces.

Cyclic fatigue resistance of VDW.ROTATE and Reciproc Blue nickel-titanium files at root canal temperature

Background. This study aimed to compare the VDW.ROTATE instruments with the Reciproc Blue instruments in different kinematics in terms of the cyclic fatigue resistance.

Methods. Sixty instruments, 40 VDW.ROTATE and 20 Reciproc Blue instruments, were divided into three groups (n=20): VDW.ROTATE was used in both continuous rotation and reciprocation, and Reciproc Blue was used in reciprocation only. The cyclic fatigue resistance test was carried out in an artificial canal (60°, r=3 mm) at an intracanal temperature of 35±2°C until fracture, and the time to fracture was recorded in seconds. The data were analyzed statistically using Kruskal–Wallis and Tamhane’s T2 tests (P<0.05).

Results. DAll the reciprocating motion groups resulted in a longer mean duration to failure than the continuous rotation motion group (P<0.05).

Conclusion. It was observed that the Reciproc Blue instruments had higher cyclic fatigue resistance than VDW.ROTATE instruments (P<0.05). Recent studies have shown that reciprocal movement increases cyclic fatigue resistance compared to rotational movement. The VDW.ROTATE instrument, which has a similar size, design, and alloy as the Reciproc Blue instrument, can also be used by clinicians in reciprocating motion with endo motors capable of reciprocating in different directions. However, even if the cyclic fatigue resistance increases by using VDW.ROTATE instruments in reciprocation, the cyclic fatigue resistance is lower than Reciproc Blue instruments.

Cyclic Fatigue Resistance of Rotary and Reciprocating Nickel-Titanium Instruments Subjected to Static and Dynamic Tests

INTRODUCTION

This study compared the static and dynamic cyclic fatigue resistance of contemporary nickel-titanium instruments with different kinematic, metallurgic, and design features to establish whether the fatigue-reducing effect of the pecking motion differs among different nickel-titanium instruments.

METHODS

ProTaper Gold (PTG), Hyflex EDM (EDM), Reciproc Blue (RPB), and WaveOne Gold (WOG) files were divided into 2 groups of 10 for the static and dynamic cyclic fatigue resistance tests. A stainless steel artificial canal with 1.5-mm inner diameter, 60° angulation, and 3-mm radius of curvature was used. In the dynamic cyclic fatigue resistance test, speeds were set at 100 and 200 mm/min for the descending and ascending motion, respectively. The number of cycles to fracture (NCF) was calculated, the fractured lengths were recorded, and fractographic analysis of the fractured surfaces was carried out by scanning electron microscopy. Data were analyzed statistically with the Kruskal-Wallis test with Bonferroni correction (alpha = 0.05).

RESULTS

The RPB and EDM showed significantly higher NCF in the static and dynamic cyclic fatigue resistance tests (P < .05). The dynamic cyclic fatigue resistance test showed significantly higher NCF than the static cyclic fatigue resistance test in the PTG and EDM (P < .05). There was no significant difference between the RPB and WOG (P > .05).

CONCLUSIONS

In the experimental condition where the ascending speed was higher than the descending speed, the dynamic cyclic fatigue resistance was significantly higher than the static cyclic fatigue resistance in continuous rotary instruments, but not in reciprocating instruments.

Fracture incidence of WaveOne Gold files: a prospective clinical study

AIM

This prospective clinical study evaluated the incidence of instrument fracture observed after single-file root canal treatment of molars using WaveOne Gold instruments.

METHODOLOGY

Three standardized, experienced and calibrated specialists treated 750 maxillary and mandibular molars with curvatures less than 45° (2691 root canals) over a 12-month period. All the treatments were performed in a single session. A total of 1104 WaveOne Gold instruments were used, including 38 small, 750 primary, 228 medium and 88 large instruments. Intracanal procedures were performed according to the manufacturer's recommendations, and each instrument was used in a single clinical case. The instruments were examined after their removal from the canal, under an operating microscope at 8× magnification.

RESULTS

No fractures were observed in any of the 1104 instruments used.

CONCLUSIONS

No fractures of WaveOne Gold reciprocating instruments occurred during root canal preparations performed in maxillary and mandibular molars with curvatures less than 45° when used strictly according to the manufacturer's recommendations and applied in a single clinical case.

Bending resistance and cyclic fatigue resistance of WaveOne Gold, Reciproc Blue, and HyFlex EDM instruments

Background/purpose

Several single-file systems manufactured using different heat treatment and operated by different kinematics have been released. This study compared the bending resistance and cyclic fatigue resistance of three NiTi files, and examined their phase-transformation behavior.

Materials and methods

WaveOne Gold Primary (WOG), Reciproc Blue R25 (RPB), and HyFlex EDM OneFile (HDM) were tested (N = 40/instrument). A vertical load was applied to a point 3 mm from the tip, and the stress was measured until a displacement of 3 mm. Tests were conducted at either room temperature (RT: 22 °C) or body temperature (BT: 37 °C) (n = 10). Cyclic fatigue resistance tests were performed in an artificial canal, which had a curvature angle of 40° and a 5-mm radius. Tests were conducted at either RT or BT (n = 10). Instruments were operated according to the manufacturers' instructions. Test results were analyzed using the Kruskal–Wallis and the Mann–Whitney tests. Additional three instruments of each brand were subjected to differential scanning calorimetry (DSC).

Results

At RT the bending resistance of three files were not significantly different. However, at BT the bending resistance of RPB was highest, followed by WOG, and HDM (P < 0.05). At RT, RPB demonstrated the longest fracture time, followed by HDM, and WOG (P < 0.05). At BT, HDM had the longest fracture time, followed by RPB, and WOG (P < 0.05). The WOG, RPB consisted of austenite in a considerable proportion, whereas HDM was mainly martensite state at BT.

Conclusion

HDM presented superior flexibility and cyclic fatigue resistance at BT.

Cyclic fatigue resistance of HyFlex EDM, Reciproc Blue, WaveOne Gold, and Twisted File Adaptive rotary files under different temperatures and ambient conditions

Background. This study examined the effects of changes in temperature and environmental conditions on the cyclic fatigue resistance of Reciproc Blue, HyFlex EDM, WaveOne Gold, and Twisted File Adaptive. Methods. Forty-five Reciproc Blue (25/.08), 45 HyFlex EDM (25/.08), 45 WaveOne Gold (25/.07), and 45 Twisted File Adaptive (25/.08) files were tested for cyclic fatigue at room temperature (20°C) in air and water and at body temperature (35°C) in water. All the instruments were rotated in artificial canals made of stainless steel with an inner diameter of 1.5 mm, 60° angle of curvature and a radius of curvature of 5 mm until fracture occurred; the time to fracture was recorded in seconds, using a digital chronometer. Mann-Whitney U test was used for the statistical analysis of data, with SPSS 21.0. Results. Cyclic fatigue resistance was significantly higher in all the groups in water at an ambient temperature of 20°C compared with air and water at temperatures of 20°C and 35°C, respectively (P<0.05). The intragroup analysis revealed that HyFlex EDM had the highest cyclic fatigue resistance, followed by Reciproc Blue, WaveOne Gold, and Twisted File Adaptive in both air and water at 20°C (P<0.05). HyFlex EDM exhibited the highest cyclic fatigue resistance in water at 35°C, whereas there was no significant difference between the other groups (P>0.05). Conclusion. Within the limitations of the present study, an increase in the ambient temperature significantly decreased the cyclic fatigue resistance of the tested NiTi files.

Effect of Shaft Length on the Torsional Resistance of Rotary Nickel-titanium Instruments

INTRODUCTION

This study was conducted to evaluate the effect of file length on the torsional resistance of nickel-titanium rotary files.

METHODS

Forty-five new files with a #25 tip size and variable taper for ProTaper Next (PTN; Dentsply Sirona, York PA), ProTaper Gold (PTG, Dentsply Sirona), and HyFlex CM (HCM; Coltene-Whaledent, Allstetten, Switzerland) were divided into 3 subgroups (n = 15) according to the file length (21, 25, and 31 mm). Torsional tests were performed using a custom-made device (AEndoS; DMJ System, Busan, Korea). The maximum torsional load and distortion angle were measured until file fracture occurred. The toughness was calculated using these data. All data were statistically analyzed using 2-way analysis of variance at a confidence level of 95%. One-way analysis of variance and Duncan post hoc comparison were also conducted to assess the difference among the independent variables, shaft length, and file system.

RESULTS

A statistically significant interaction was observed between the file system and instrument length with respect to the maximum torsional load (P < .05). The 31-mm shaft length of HCM showed higher maximum torsional load than that of the 25- and 21-mm shaft length in the HCM groups (P < .05). Among the instrument systems, PTG showed the significantly highest maximum torsional load followed by PTN and HCM (P < .05). The 31-mm shaft length of PTG showed significantly higher toughness than that of the 21- and 25-mm shaft lengths (P < .05), whereas PTN and HCM did not show any difference in relation to the shaft length.

CONCLUSIONS

Within the limitations of this study, the instrument with a longer shaft may have higher maximum torsional load or toughness than that with a shorter shaft.

Nickel-Titanium Rotary File Systems: What's New?

Ever since their introduction, nickel–titanium (NiTi) alloys have continued to revolutionize the field of endodontics. They have considerable advantages over the conventional stainless steel file in terms of mechanical properties. However, despite of their superior mechanical properties, NiTi alloys still pose some risk of fracture. Consequently, there has been considerable research conducted to investigate the mechanisms behind the occurrence of these procedural errors. Since the last decade, different proprietary processing procedures have been introduced to further improve the mechanical properties of NiTi alloys. These treatments include thermal, mechanical, electropolishing, and recently introduced electric discharge machining. The main purpose of these treatments is to impart a more martensitic phase into the files at normal body temperature, so that the maximum advantage of flexibility can be obtained. These heat-treated instruments also possess improved cyclic fatigue resistance when compared to conventional NiTi alloys. NiTi alloys can be subclassified as the instruments mainly containing austenitic phase (conventional NiTi, M-wire, R-phase), and those containing martensitic phase (controlled memory wire, ProTaper Gold, and Vortex Blue). Instruments based on austenitic alloys possess superelastic properties due to the stress-induced martensitic transformation. Contrary to this, martensitic alloys can easily be deformed due to phase transformation, and they can demonstrate the shape memory effect when heated. This review discusses the different phase transformations and heat treatments that the NiTi instruments undergo.

Effect of Sterilization on Cyclic Fatigue Resistance of Proflexendo Endodontic Rotary Files

Background:

Proflexendo file (Nexen, Houston, TX, USA) is a recently developed, novel nickel-titanium rotary file. However, several physical properties of the Proflexendo system remain to be investigated.

Objectives:

The aim of this study was to determine the effect of sterilization on cyclic resistance of Proflexendo files.

Material and Methods:

A total of 120 unused Proflexendo rotary files (40 each of file sizes 40/0.04, 30/0.04 and 20/0.06) were used in this study. Each set of files was subdivided into four groups of ten files. Group 1 did not undergo any sterilization (control), Group 2 underwent two rounds (2×) of sterilization, Group 3 five rounds (5×) and Group 4 ten rounds (10×). Cyclic fatigue resistance was tested using an artificial canal with a 5-mm radius curve.

Results:

The nonsterilized size 30/0.04 files had the highest cycles to failure, followed by the nonsterilized size 40/0.04 and 20/0.06 files (P < 0.001). With increasing rounds of sterilization, cycles to failure reduced for sizes 40 (2×, 5× and 10×) and 30 (2×) files compared with nonsterilized sizes 40 (P < 0.05) and 30 files (P < 0.001), respectively.

Conclusion:

Under the conditions of the current study, the results provide preliminary evidence that autoclave sterilization of Proflexendo rotary files reduced their cyclic fatigue resistance, except for size 20 (2× and 5×) and 30 (10×) files, in which resistance increased. Single use of this file is recommended to reduce the risk of separation.

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

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

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

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

Torsional resistance of three ProTaper rotary systems

BACKGROUND

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

METHODS

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

RESULT

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

CONCLUSION

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

Cyclic fatigue, bending resistance, and surface roughness of ProTaper Gold and EdgeEvolve files in canals with single- and double-curvature

Objectives

The purpose of this study was to evaluate the cyclic fatigue, bending resistance, and surface roughness of EdgeEvolve (EdgeEndo) and ProTaper Gold (Dentsply Tulsa Dental Specialties) nickel-titanium (NiTi) rotary files.

Materials and Methods

The instruments (n = 15/each) were tested for cyclic fatigue in single- (60° curvature, 5-mm radius) and double-curved (coronal curvature 60°, 5-mm radius, and apical curvature of 30° and 2-mm radius) artificial canals. The number of cycles to fracture was calculated. The bending resistance of both files were tested using a universal testing machine where the files were bent until reach 45°. Scanning electron microscopy and x-ray energy-dispersive spectrometric analysis were used for imaging the fractured segments, while the atomic force microscope was used to quantify the surface roughness average (Ra).

Results

EdgeEvolve files exhibited higher cyclic fatigue resistance than ProTaper Gold files in single- and double-curved canals (p < 0.05) and both files were more resistant to cyclic fatigue in single-curved canals than double-curved canals (p < 0.05). EdgeEvolve files exhibited significantly more flexibility than did ProTaper Gold files (p < 0.05). Both files had approximately similar Ni and Ti contents (p > 0.05). EdgeEvolve files showed significantly lower Ra values than ProTaper Gold files (p < 0.05).

Conclusions

Within the limitation of this study, EdgeEvolve files exhibited significantly higher cyclic fatigue resistance than ProTaper Gold files in both single- and double-curved canals.

Comparison between Single-file Rotary Systems: Part 2-The Effect of Length of the Instrument Subjected to Cyclic Loading on Cyclic Fatigue Resistance

INTRODUCTION

The aim of this study was to compare the cyclic fatigue resistance of XP Shaper (XP), HyFlex EDM One File (EDM), and WaveOne Gold Primary (WOG) when operated according to their manufacturers' recommendations at different lengths and to investigate the cyclic fatigue limit of XP Shaper when operated at 3000 rpm.

METHODS

One hundred fifty instruments from 4 different rotary systems (F2 Protaper Universal [PTU], WOG, EDM, and XP) were tested for their cyclic fatigue resistance in a simulated 90° curved canal at a 37°C water bath temperature at 3 different working lengths (15 mm, 17 mm, and 19 mm). The time taken for instruments to fracture was recorded, and the number of cycles to failure was calculated. Statistical analyses were performed by using Levene's test, Kruskal-Wallis test to identify specific groups with statistically significantly higher cyclic fatigue resistance at 5% significance level. Weibull analysis was performed to determine the predictability of survival for each instrument.

RESULTS

XP Shaper had the highest cyclic fatigue resistance compared with all other instruments, followed by EDM, WOG, and then PTU. There was no statistically significant difference in the number of cycles to failure between the XP operated at 3000 or 1000 rpm in any of the tested working lengths. There was a reduction in the number of cycles to failure when the working length increased from 15 to 19 mm in EDM, WOG, and PTU. Scanning electron microscopy showed ductile fractures with classic dimpled features in all samples.

CONCLUSIONS

XP has a very high resistance to cyclic fatigue compared with WOG, EDM, and F2 PTU. The time to fracture will decrease by almost one third when XP is operated at 3000 rpm. The results of both parts of this study suggest that XP appears to be safe to operate at 3000 rpm in endodontic retreatment.

Fracture and deformation of ProTaper Next instruments after clinical use

Background

The aim of this study was to evaluate the fracture and defects observed in ProTaper Next files discarded after a normal clinical use.

Material and Methods

571 ProTaper Next rotary instruments were collected after clinical use from the clinic of endodontics over 12 months. The length of the files was measured using a digital caliper to determine any fracture, later all the files were evaluated under a stereomicroscope to observe defects such as unwinding, curving or fracture. The data obtained were analyzed using a chi-square and z test.

Results

13.83% of the discarded files showed defects, the most frequent defect was fracture (7.53%). The highest rate of fracture was observed in the X1 (17.04) files (19.87%). The presence of deformations without fracture was also more frequent in the 17.04 file (11.8%).

Conclusions

Because of the relatively high incidence of deformation of smaller files, these instruments should be considered as a single use. It is important not to exceed the maximum uses recommended by the manufacturer to reduce the risk of cyclic fatigue, the main cause of fracture of the files (79.07%). It is also important to observe each file after use to discard small defects or fractures.

Key words:Clinical use, deformation, fracture, M-Wire, ProTaper Next.

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

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

Effect of temperature on the cyclic fatigue resistance of thermally treated reciprocating instruments

OBJECTIVES

The aim of this study was to evaluate the impact of body temperature on the cyclic fatigue resistance of different NiTi alloys used for the manufacturing of Reciproc Blue R25 (RB 25.08; VDW, Munich, Germany), X1 Blue File 25 (X1 25.06; MK Life Medical and Dental Products, Porto Alegre, Brazil) and WaveOne Gold Primary (WOG 25.07; Dentsply Maillefer, Ballaigues, Switzerland).

MATERIALS AND METHODS

Sixty instruments of the RB 25.08, X1 25.06 and WOG 25.07 systems were used (n = 20). Cyclic fatigue tests were performed at room temperature (20° ± 1 °C) and at body temperature (37° ± 1 °C). The instruments were reciprocated until fracture occurred in an artificial stainless steel canal with a 60° angle and a 5-mm radius of curvature. The time to fracture (TTF) was recorded. Also, the number of cycles to fracture (NCF) was calculated. Data were analysed using one-way ANOVA and Tukey's tests for inter-group comparison at both temperatures and for the reduction of cyclic fatigue at body temperature. For intra-group comparison at the different temperatures, the unpaired t test was used.

RESULTS

The cyclic fatigue test at 20 °C showed that RB 25.08 and X1 25.06 presented significantly higher TTF and NCF than WOG 25.07 (P < 0.05). At 37 °C, all groups presented significant reduction of TTF and NCF (P < 0.05). RB 25.08 presented significant higher TTF than WOG 25.07 (P < 0.05). Regarding the NCF, there was no significant difference among the groups (P > 0.05). The WOG 25.07 presented the lowest percentage reduction of cyclic fatigue (P < 0.05).

CONCLUSION

The body temperature treatment caused a marked reduction of the cyclic fatigue resistance for all reciprocating instruments tested. The RB 25.08 and X1 25.06 systems presented similar results at both temperatures tested. However, WOG 25.07 presented the lowest percentage reduction in fatigue resistance at body temperature.

CLINICAL RELEVANCE

The cyclic fatigue resistance of NiTi reciprocating instruments has been evaluated at room temperature. However, the fatigue resistance significantly decreases upon exposure to body temperature, which could affect the mechanical behaviour of the NiTi instruments during root canal preparation.

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

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

Torsional Behavior of WaveOne Gold Endodontic File with the Dedicated Motor of the Original WaveOne File

This study compares the safety limits and torsional resistances of WaveOne Gold (WOG) and WaveOne (WO) endodontic files while using the original motor. The safety limits for reciprocating angles were tested by measuring the torsional limit before plastic deformation (TLP) after repetitive torsional loading at gradually increasing load, and after single continuous rotation. Statistical analysis was performed by independent t-test at 95% confidence level. The tested specimens were observed under a scanning electron microscope (SEM). Regardless of the test mode, the distortion angle at the TLP was higher for WOG than WO (p < 0.05), and all were greater than the 150-degree rotation of the original motor. The mean values of the distortion angle and torque from the single continuous rotation loading were significantly lower than those with repetitive loading movements. Comparing the two systems under SEM, WO showed a catastrophic change in comparison with WOG. Evaluation of the lateral aspects showed longitudinal micro-cracks after 270-degree repetitive movements. After 150-degree repetitive movements, no distorted machining grooves were found in either group, but WO showed evidence of longitudinal micro-cracks. Under the conditions of this study, the torsional loading from the pre-set mode of the dedicated motor for WO was safe for WOG as well.