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Moriya PT, de Carvalho KKT, Kishen A, Souza EM, Versiani MA. Dynamic Photoelastic Analysis of Stress Distribution in Simulated Canals Using Rotary Instruments with Varied Tip and Taper Sizes: A Quasi-3D Approach. J Endod 2024:S0099-2399(24)00303-0. [PMID: 38796056 DOI: 10.1016/j.joen.2024.05.008] [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: 01/29/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION To compare the stress produced on the walls of simulated canals by rotary instruments with varied tip and taper sizes. METHODS Ninety isotropic transparent blocks, each containing a 60-degree curved canal, were distributed into 18 groups (n = 5) based on the instrument tip (sizes 10, 15, 20, 25, 30, and 35) and taper (sizes 0.02, 0.04, and 0.06). The blocks were fixed in a circular polariscope setup for dark field analysis. A digital camera was employed to capture the real-time birefringence patterns generated by each instrument. Digital image frames, corresponding to the instrument reaching the end of each canal third, were extracted and evaluated by 2 independent observers for the stress generation on canal walls. The data analysis employed a semi-quantitative scale ranging from 0 to 5. Cohen's Kappa coefficient test was used to determine the inter-observer agreement while the results were compared using Kruskal-Wallis test followed by an all-pairwise posthoc procedure (α = 5%). RESULTS Inter-observer agreement was 0.95. A significant influence of the tip size on stress was observed across the coronal (P = .011), middle (P = .006), and apical (P = .026) thirds. In contrast, taper size did not affect the stress induced at the coronal (P = .509), middle (P = .958), or apical (P = .493) thirds. The variations in tip and taper sizes did not result in a significant stress differences among the thirds (P = .181). CONCLUSIONS The stress significantly increased across all canal thirds with larger tip sizes of rotary instruments, whereas the taper sizes did not influence the stress when compared to the canal thirds.
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Affiliation(s)
| | | | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Erick M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Marco A Versiani
- Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil.
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Martins JNR, Silva EJNL, Marques D, Braz Fernandes FM, Versiani MA. Comprehensive Assessment of Cyclic Fatigue Strength in Five Multiple-File Nickel-Titanium Endodontic Systems. MATERIALS (BASEL, SWITZERLAND) 2024; 17:2345. [PMID: 38793413 PMCID: PMC11123240 DOI: 10.3390/ma17102345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
The resistance of nickel-titanium endodontic instruments against cyclic fatigue failure remains a significant concern in clinical settings. This study aimed to assess the cyclic fatigue strength of five nickel-titanium rotary systems, while correlating the results with the instruments' geometric and metallurgical characteristics. A total of 250 new instruments (sizes S1/A1, S2/A2, F1/B1, F2/B2, F3/B3) from ProTaper Gold, ProTaper Universal, Premium Taper Gold, Go-Taper Flex, and U-Files systems underwent mechanical testing. Prior to experimental procedures, all instruments were meticulously inspected to identify irregularities that could affect the investigation. Using a stereomicroscope, design characteristics such as the number of spirals, length, spirals per millimeter, and average helical angle of the active blade were determined. The surface finishing characteristics of the instruments were examined using a scanning electron microscope. Differential scanning calorimetry was employed to establish the instruments' phase transformation temperatures, while energy-dispersive X-ray spectroscopy was utilized to analyze the elemental composition of the alloy. The instruments were subjected to cyclic fatigue testing within a stainless steel non-tapered artificial canal featuring a 6 mm radius and 86 degrees of curvature. Appropriate statistical tests were applied to compare groups, considering a significance level of 0.05. The assessed design characteristics varied depending on the instrument type. The least irregular surface finishing was observed in U-Files and Premium Taper Gold files, while the most irregular surface was noted in Go-Taper Flex. All instruments exhibited near-equiatomic proportions of nickel and titanium elements, whereas ProTaper Universal and U-Files instruments demonstrated lower phase transformation temperatures compared to their counterparts. Larger-sized instruments, as well as ProTaper Universal and U-Files, tended to display lower cyclic fatigue strength results. Overall, the design, metallurgical, and cyclic fatigue outcomes varied among instruments and systems. Understanding these outcomes may assist clinicians in making more informed decisions regarding instrument selection.
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Affiliation(s)
- Jorge N. R. Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, 1600-277 Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral (GIBBO), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
- Centro de Estudos de Medicina Dentária Baseada na Evidência (CEMDBE), 1600-277 Lisboa, Portugal
| | - Emmanuel J. N. L. Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro 21210-623, Brazil
- Department of Endodontics, Fluminense Federal University, Rio de Janeiro 24220-900, Brazil
- Department of Endodontics, Rio de Janeiro University (UERJ), Rio de Janeiro 20550-013, Brazil
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
- LIBPhys-FCT UID/FIS/04559/2013, 1600-277 Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral (GIBBO), Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), 1600-277 Lisboa, Portugal
- Centro de Estudos de Medicina Dentária Baseada na Evidência (CEMDBE), 1600-277 Lisboa, Portugal
| | - Francisco M. Braz Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal
| | - Marco A. Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte 30350-190, Brazil
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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.
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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.)
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Bürklein S, Maßmann P, Schäfer E, Donnermeyer D. Cyclic Fatigue of Different Reciprocating Endodontic Instruments Using Matching Artificial Root Canals at Body Temperature In Vitro. MATERIALS (BASEL, SWITZERLAND) 2024; 17:827. [PMID: 38399077 PMCID: PMC10890344 DOI: 10.3390/ma17040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Reciprocating motion expands the lifetime of endodontic instruments during the preparation of severely curved root canals. This study aimed to investigate the time to fracture (TTF) and number of cycles to failure (NCF) of different reciprocating instruments (n = 20 in each group) at body temperature using a dynamic testing model (amplitude = 3 mm). Reciproc Blue (RPB), size 25/.08, WaveOne Gold (WOG) 25/.07, Procodile (Proc) 25/.06, R-Motion (RM_06) 25/.06 and R-Motion (RM_04) 30/.04 instruments were tested in their specific reciprocating motion in artificial matching root canals (size of the instrument ± 0.02 mm; angle of curvature 60°, radius 5.0 mm, and centre of curvature 5.0 mm from apical endpoint). The number of fractured instruments, TTF, NCF, the and lengths of the fractured instruments were recorded and statistically analysed using the Chi-Square or Kruskal-Wallis test. Both TTF (median 720, 643, 562, 406, 254 s) and the NCF (3600, 3215, 2810, 2032, 1482 cycles) decreased in the following order RM_06 > RPB > RM_04 > Proc > WOG with partially significant differences. During testing, only six RM_06 instruments fractured, whereas 16/20 (RPB), 18/20 (Proc), and 20/20 (RM_04, WOG) fractures were recorded (p < 0.05). Within the limitations of the present study, blue-coloured RPB and RM instruments exhibited a significantly superior cyclic fatigue resistance compared to SE-NiTi and Gold-wire instruments. Heat treatment, cross-sectional design and core mass significantly influenced the longevity of reciprocating instruments in cyclic dynamic testing.
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Affiliation(s)
- Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, 48149 Münster, Germany; (S.B.); (P.M.); (E.S.)
| | - Paul Maßmann
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, 48149 Münster, Germany; (S.B.); (P.M.); (E.S.)
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, 48149 Münster, Germany; (S.B.); (P.M.); (E.S.)
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, 48149 Münster, Germany
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Weissheimer T, Duarte MAH, Só MVR, da Rosa RA, Espinosa MK, Vivan RR, Alcalde MP. Evaluation of cyclic and torsional fatigue resistance of several heat-treated reciprocating nickel-titanium instruments. AUST ENDOD J 2023; 49:524-529. [PMID: 37439395 DOI: 10.1111/aej.12774] [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: 02/18/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023]
Abstract
This study investigated the cyclic fatigue and torsional resistance of Unicone Plus (UCP 25.06), Unicone (UC 25.06), Reciproc Blue (RB 25.08) and Wave One Gold (WOG 25.07) performed at body temperature (35° ± 1°C). Time and number of cycles to fracture (NCF), as well as torque and angular deflection were recorded. Fractured surfaces were evaluated by scanning electron microscopy (SEM). Data were analysed using one-way ANOVA and Holm-Sidak's tests for multiple comparison. The RB had a significantly higher time to fracture, followed by the WOG and UCP (p < 0.05). Regarding the NCF, there was no significantly difference between RB and WOG (p > 0.05). UC presented highest torque values and the lowest angular deflection (p < 0.05). SEM analysis demonstrated typical failures features in both cyclic and torsional fatigue tests. Overall, UC had the lowest time, NCF and angular deflection at fracture. RB presented the highest time to fracture and angular deflection values.
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Affiliation(s)
- Theodoro Weissheimer
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco Antonio Húngaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Michel Klymus Espinosa
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Moriya PT, de Carvalho KKT, Kishen A, Souza EM, Versiani MA. Quasi-3D dynamic photoelastic analysis of stress distribution during preparation of simulated canals with 13 mechanical preparation systems. Int Endod J 2023; 56:1399-1411. [PMID: 37566206 DOI: 10.1111/iej.13961] [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: 05/17/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
AIM The aim of this study is to compare the stress produced on the internal walls of simulated canals by nine rotary and four reciprocating systems. METHODOLOGY Sixty-five isotropic transparent blocks containing a 60° curved and tapered simulated canal were selected and distributed into 13 groups (n = 5) according to the preparation system: BioRace, HyFlex EDM, iRaCe, Mtwo, One RECI, ProTaper Next, RaCe EVO, Reciproc, Reciproc Blue, R-Motion, VDW.ROTATE, XP-Endo Rise Shaper, and XP-Endo Shaper. Each resin block was mounted in a vice and a digital camera recorded the entire sequence of each preparation system through a circular polariscope set for dark field analysis. The video frames when each instrument reached the end of the coronal, middle, and apical thirds of the canal were extracted from the recordings and analysed by two independent observers regarding the stress generated on the canal walls using a semi-quantitative evaluation on a 0-5 scale. Intra- and inter-observer agreement were subjected to the Cohen's Kappa coefficient test, whilst the experimental results were compared using Kruskal-Wallis test post hoc pairwise comparisons with Bonferroni correction (α = 5%). RESULTS The inter- and intra-observer agreement were 0.98 and 1, respectively. Most instruments demonstrated acceptable performance (scores ≤ 2) in all thirds. Other instruments, such as the HyFlex EDM 25.12 (coronal and middle thirds), Reciproc Blue R25 and Reciproc R25 (coronal and apical thirds), R-Motion 30.04 (apical third), and VDW.ROTATE 20.05 (apical third) showed scores higher than 3. Statistical analysis revealed a significant difference amongst the tested systems at the coronal, middle, and apical thirds (p < .05). CONCLUSION None of the canal instrumentation protocols were stress-free, showing varying levels of stress concentrations. Various factors seemed to influence the magnitude of stress and its distribution pattern on the canal walls. Overall, instruments characterized by a larger taper, lower speed, reciprocating motion, and made of heat-treated NiTi alloy exhibited higher patterns of stress distribution.
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Affiliation(s)
| | | | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Erick M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Brazil
| | - Marco A Versiani
- Dental Specialty Centre, Brazilian Military Police, Minas Gerais, Brazil
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Dos Reis-Prado AH, Abreu LG, de Arantes LC, Dos Santos de Paula K, de Castro Oliveira S, Goto J, Viana ACD, Benetti F. Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies. Clin Oral Investig 2023; 27:6291-6319. [PMID: 37704917 DOI: 10.1007/s00784-023-05243-4] [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: 09/15/2022] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This systematic review/meta-analysis investigated the influence of NaOCl on cyclic fatigue resistance of endodontic NiTi instruments. MATERIALS AND METHODS A systematic search until July 2022 in PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO, Cochrane Library, and grey literature was conducted. According to the PECOS strategy, only in vitro studies evaluating the effects of NaOCl on the cyclic fatigue resistance of NiTi instruments were eligible. Cyclic fatigue resistance was the primary outcome. A modified Joanna Briggs Institute's Checklist was used for risk of bias assessment. RESULTS Of the 2,445 records screened, 37 studies were included. Most studies used simulated canals made of stainless-steel block with severe to moderate curvatures. NaOCl concentration varied from 1-6%, mainly at 37 °C. Regarding fatigue resistance, 23 studies using 1.2% to 6% NaOCl showed a reduction in the resistance compared to the control groups, especially when pre-heated. Four meta-analyses were performed according to the tested NiTi systems. The meta-analyses indicated that the PTU F2 files had higher reduction of fatigue resistance after exposure to 5.25% NaOCl; no differences between NaOCl and no immersion were observed for Reciproc R25, WaveOne 25.08, and WaveOne Gold Primary files. Included studies had low risk of bias. CONCLUSION NaOCl appears to reduce cyclic fatigue resistance of certain NiTi files, especially when they are pre-heated, particularly in conventional NiTi files compared to some heat-treated instruments. It is possible that the temperature of the solution may have a greater influence on resistance than NaOCl itself. Important to note that an overall tendency toward no significant influence was observed among various systems. CLINICAL RELEVANCE Precautions are necessary when a pre-heated high-concentration NaOCl is used to enhance its properties during root canal preparation, mainly using conventional wire.
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Affiliation(s)
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lara Cancella de Arantes
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Kiani Dos Santos de Paula
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sabrina de Castro Oliveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Juliana Goto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, SP, Brazil
| | - Ana Cecília Diniz Viana
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Silva EJNL, Alcalde MP, Martins JNR, Vieira VTL, Vivan RR, Duarte MAH, Belladonna FG, Braz-Fernandes FM, Versiani MA. To flat or not to flat? Exploring the impact of flat-side design on rotary instruments using a comprehensive multimethod investigation. Int Endod J 2023; 56:1301-1315. [PMID: 37594701 DOI: 10.1111/iej.13960] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
AIM To assess the influence of a flat-side design on the geometry, metallurgy, mechanical performance and shaping ability of a novel nickel-titanium rotary instrument. METHODOLOGY Sixty-five new 25-mm flat-side rotary instruments (size 25, taper 0.04) and their nonflat-side prototypes (n = 65) were assessed for major deformations and examined regarding macroscopic and microscopic design, determination of nickel and titanium elements ratio, measurement of phase transformation temperature and evaluation of mechanical performance parameters including time/cycles to fracture, maximum torque, angle of rotation, maximum bending and buckling strengths and cutting ability. Additionally, unprepared canal areas, volume of hard tissue debris and percentage reduction of dentine thickness were calculated for each tested instrument after preparing mesial canals of mandibular molars (n = 12), using micro-CT imaging. Statistical analyses were performed using the U-Mann-Whitney test and independent Student t-test (α = 5%). RESULTS The number of spirals (n = 8) and blade direction (clockwise) were similar between both flat and nonflat instruments, whilst the helical angles were equivalent (⁓25°). Flat-instruments showed inconsistencies in the homogeneity of the gold colour on the flat-side surface, blade discontinuity, and incomplete and variable S-shaped cross-sections. The titanium-to-nickel ratios were equivalent, but significant differences in the R-phase finish and austenitic start phase transformation temperatures were observed between the flat and nonflat-side instruments. The flat-side instruments demonstrated superior cutting ability compared to the nonflat instruments, as well as, significantly lower values for time to fracture, rotation to fracture and maximum torque to fracture (p < .001). No statistical difference was observed between tested instruments regarding angle of rotation (p = .437), maximum bending (p = .152) and buckling load (p = .411). Preparation protocols using flat and nonflat instruments did not show any statistically significant differences (p > .05). All flat-side instruments exhibited deformation after shaping procedures. CONCLUSIONS The flat-side instrument showcased enhanced cutting ability compared to its nonflat counterpart. However, it exhibited inferior performance in terms of time, rotation and maximum torque to fracture, along with distinct phase transformation temperatures. No differences were observed in the titanium-to-nickel ratios, angle of rotation, maximum bending, buckling load, preparation time, percentage of untouched canal walls, volume of hard tissue debris and percentage reduction of dentine thickness.
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Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Fluminense Federal University, Rio de Janeiro, Brazil
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Endodontics, Grande Rio University, Rio de Janeiro, Brazil
| | - Murilo P Alcalde
- Bauru School of Dentistry, University of São Paulo, São Paulo, 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
| | - Victor T L Vieira
- Department of Endodontics, Grande Rio University, Rio de Janeiro, Brazil
| | - Rodrigo R Vivan
- Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco A H Duarte
- Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Felipe G Belladonna
- Department of Endodontics, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco A Versiani
- Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
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Jamleh A, Albanyan H, Alaqla A, Alissa H, Alshetan N, Alraffa S, Alfadley A. Impact of cooling on shaping ability of thermally treated files in canal models with double curvature. PeerJ 2023; 11:e15830. [PMID: 37576504 PMCID: PMC10416767 DOI: 10.7717/peerj.15830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background This study compared the ability of thermally treated files in shaping simulated canals with double curvature. Fifty-six canals were enlarged to a final size of 25 with ProTaper Next (PTN) or ZenFlex (ZF). Materials Half of the samples were shaped with cooled files (n = 14 each). The amount of removed resin was measured and canal deviation was determined at eight levels. Shaping time and maximum shaping torque values were also recorded. Data were statistically analyzed using analysis of variance and LSD, Kruskal-Wallis, and chi-square tests at a 0.05 significance level. Results Compared to PTN and cooled PTN, ZF and cooled ZF required lesser time to shape the canals. The maximum torques were found comparable between the groups. All the groups generated negligible deviations at every canal level evaluated and maintained the canal geometry. Although not significant, the cooled PTN and ZF files exhibited lesser canal deviations than their counterparts. Conclusion All groups demonstrated similar shaping ability whilst maintaining the original curvature of the canal in simulated canals with double curvature. However, ZF groups were able to shape the canals faster than PTN groups. There was a trend that cooled files made lesser canal deviations compared to their counterparts.
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Affiliation(s)
- Ahmed Jamleh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hajar Albanyan
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ali Alaqla
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hamad Alissa
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nawaf Alshetan
- Dr. Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia
| | | | - Abdulmohsen Alfadley
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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10
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Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: A narrative review. Saudi Dent J 2023; 35:468-475. [PMID: 37520597 PMCID: PMC10373078 DOI: 10.1016/j.sdentj.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This review aimed to assess the incidence, anatomical characteristics, identification, and clinical management using conventional techniques and advanced tools to manage MMCs successfully. Methods Medline/PubMed and Scopus databases were searched using "Middle mesial canal," "Middle mesial root canal," OR "Accessory mesial canal" keywords from 1 January 1970 and 1 February 2023. The most pertinent articles were chosen for the review from the retrieved articles. In addition, relevant articles were added by manually searching the list of references. Results The incidence of MMC is noticeable in younger people, and the confluent canal is the most common type. The majority of MMCs merged with mesiobuccal (MB) canals rather than mesiolingual (ML) canals. Clinical management could be employed using the standard endodontics protocol, and recent radiography technologies, magnification, rotary, and obturation materials can facilitate the procedures. Conclusion The possibility of the incidence of MMC is not unusual. Detection and thorough debridement followed by obturation of the canal could increase the success rate of clinical outcomes.
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Affiliation(s)
- Raghavendra Penukonda
- Department of Endodontics, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Harshada Pattar
- Department of Oral Pathology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Phrabhakaran Nambiar
- Head of the Department, Department of Oral Biology, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 42610, Selangor, Malaysia
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11
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Li Y, Wang Z, Bao P, Meng T, Liu M, Li H, Shen Y, Liu D, Jia Z, Liu H. Cleaning and Disinfecting Oval-Shaped Root Canals: Ex Vivo Evaluation of Three Rotary Instrumentation Systems with Passive Ultrasonic Irrigation. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050962. [PMID: 37241194 DOI: 10.3390/medicina59050962] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: Successful root canal treatment depends on the thorough removal of biofilms through chemomechanical preparation. This study aimed to investigate and compare the cleaning and disinfecting efficiency of oval-shaped root canals using XP-endo Shaper (XPS), ProTaper Next (PTN), and HyFlex CM (HCM) in combination with passive ultrasonic irrigation (PUI). Materials and Methods: Ninety extracted teeth were contaminated and randomly divided into three groups: XPS, PTN, and HCM. Each group was assigned to three subgroups: subgroup A (sterile saline), subgroup B (3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid), and subgroup C (3% sodium hypochlorite, 17% ethylenediaminetetraacetic acid, and PUI). Bacterial sampling was conducted both from baseline samples and samples after chemomechanical preparation. Scanning electron microscopy (SEM) was used to evaluate the residue bacterial biofilms, hard tissue debris, and smear layers on the buccolingual walls of oval-shaped root canals. Results: When combined with sterile saline, XPS demonstrated a higher reduction of bacterial counts and was more effective in eradicating Enterococcus faecalis in the middle third of the canals compared to the other instruments (p < 0.05). Additionally, when used with antimicrobial irrigants, XPS was more effective in disinfecting the coronal third of the canals than the other instruments (p < 0.05). Furthermore, XPS reduced hard tissue debris more effectively in the middle third of canals than in the apical third (p < 0.05). Conclusions: XPS outperforms PTN and HCM in disinfecting oval-shaped root canals. Despite the fact that combining XPS and PUI improves cleaning and disinfecting, removing hard tissue debris from the critical apical area remains challenging.
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Affiliation(s)
- Ying Li
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, NanKai University, Tianjin 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Zhengyang Wang
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Pingping Bao
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, NanKai University, Tianjin 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Tingting Meng
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, NanKai University, Tianjin 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Meng Liu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Huixu Li
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, NanKai University, Tianjin 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Dayong Liu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - Zhi Jia
- Department of Endodontics, School of Stomatology, Tianjin Medical University, Tianjin 300070, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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12
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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.
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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
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13
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Santarcangelo F, Dibello V, Garcia Aguilar L, Colella AC, Ballini A, Petruzzi M, Solfrizzi V, Panza F. Buckling Susceptibility of a K-File during the Initial Negotiations of Narrow and Curved Canals Using Different Manual Techniques. J Clin Med 2022; 11:jcm11226874. [PMID: 36431351 PMCID: PMC9695021 DOI: 10.3390/jcm11226874] [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: 10/06/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: One possible way to investigate the potential impact or susceptibility of buckling on different manual techniques is to measure compressive loads during canal negotiation. The higher their values, the easier and quicker the critical load level to buckling is reached, leading to possible instrument lateral deformation. The objective of the present study was to investigate the impacts of compressive loads on a small K-file manipulated with different techniques for canal negotiation in simulated narrow and curved canals. (2) Methods: The tooth model selected was a plastic double-curved premolar 23 mm long (DRSK Group AB, Kasernvagen 2, SE-281 35, Hassleholm, Sweden) with an extremely narrow canal lumen to mimic a very difficult anatomical scenario. An experienced endodontist performed the negotiation of 90 of these artificial teeth randomly assigned to 3 different groups of 30 blocks each, respectively, using 3 different techniques: Group A: watch winding/pull (WW) motion; Group B: balanced forces (BF) technique; Group C: envelope of motion (EOM). The measurement system was based on the use of a dynamometer, Instron, Ltd. (model 2525-818 2kN f.s.), linked to a data acquisition unit HBM MGC+ to test all the compression and tensile loads, including all the peaks. (3) Results: All data acquired were processed by the CATMAN AP HBM software. Multiple comparisons for the highest compressive loads estimated the mean difference between WW vs. BF techniques of 3.60 [95% confidence interval (CI): 2.85 to 4.35, p < 0.001], WW vs. EOM of −1.76 (95% CI: −2.11 to 1.40, p < 0.001), and BF vs. EOM −5.36 (95% CI: −6.04 to −4.67, p < 0.001). (4) Conclusions: In conclusion, among the tested manual motions, the BF technique (Group B) was the most susceptible to buckling with the highest compressive load. WW motion (Group A) and EOM (Group C) were less susceptible to buckling than the BF technique. Therefore, a pressure-free manipulation of manual files, such as WW motion or EOM, can help reduce the susceptibility to buckling during the negotiation of narrow-curved canals.
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Affiliation(s)
| | - Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 Amsterdam, The Netherlands
| | | | - Adriana Carmelita Colella
- Department of Civil, Environmental, Land, Building Engineering and Chemistry, Polytechnic University of Bari, 70125 Bari, Italy
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, 70124 Bari, Italy
| | - Vincenzo Solfrizzi
- Cesare Frugoni Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, 70124 Bari, Italy
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, 70013 Castellana Grotte, Italy
- Correspondence:
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14
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de Matos JDM, Lopes GDRS, Queiroz DA, Pereira ALJ, Sinhoreti MAC, Ramos NDC, Lino V, de Oliveira FR, Borges ALS, Bottino MA. Influence of the Peek Abutments on Mechanical Behavior of the Internal Connections Single Implant. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8133. [PMID: 36431619 PMCID: PMC9696524 DOI: 10.3390/ma15228133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to evaluate the biomechanical behavior of PEEK abutments with different heights on single titanium implants. To investigate the implant surface, different tests (scanning electron microscopy, energy-dispersive X-ray, and X-ray diffraction) were adopted. Herein, 20 implants received the 4.5 × 4.0 mm PEEK short abutment (SA) and 20 received the 4.5 × 5.5 mm PEEK long abutment (LA). The abutments were installed using dual-cure resin cement. To determine the fatigue test, two specimens from each group were submitted to the single load fracture test. For this, the samples were submitted to a compressive load of (0.5 mm/min; 30°) in a universal testing machine. For the fatigue test, the samples received 2,000,000 cycles (2 Hz; 30°). The number of cycles and the load test was analyzed by the reliability software SPSS statistics using Kaplan-Meier and Mantel-Cox tests (log-rank) (p < 0.05). The maximum load showed no statistically significant differences (p = 0.189) for the SA group (64.1 kgf) and the LA group (56.5 kgf). The study groups were statistically different regarding the number of cycles (p = 0.022) and fracture strength (p = 0.001). PEEK abutments can be indicated with caution for implant-supported rehabilitation and may be suitable as temporary rehabilitation.
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Affiliation(s)
- Jefferson David Melo de Matos
- Department of Restorative Dental Sciences, Center for Dental Biomaterials, University of Florida (UF Health), Gainesville, FL 32601, USA
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
| | - Guilherme da Rocha Scalzer Lopes
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
| | - Daher Antonio Queiroz
- Department of Restorative Dentistry & Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77054, USA
| | - André Luiz Jesus Pereira
- Plasmas and Processes Laboratory, Physics Departament, Aeronautics Technological Institute (ITA), 50 Marechal Eduardo Gomes Square, São José dos Campos 12228-900, SP, Brazil
| | - Mário Alexandre Coelho Sinhoreti
- Department of Restorative Dentistry, Dental Materials Division, Piracicaba Dental School (FOP-UNICAMP), Piracicaba 13416-000, SP, Brazil
| | - Nathália de Carvalho Ramos
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
- Department of Dentistry, Universidade São Francisco (USF), Bragança Paulista 12916-900, SP, Brazil
- Department of Dentistry, Postgraduate Program in Dentistry, University of Taubaté (UNITAU), Taubaté 12080-000, SP, Brazil
| | - Vinicius Lino
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
| | - Flavio Rosa de Oliveira
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
| | - Alexandre Luiz Souto Borges
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
| | - Marco Antonio Bottino
- Department of Biomaterials, Dental Materials, and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos 12228-900, SP, Brazil
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