Structural effects of sodium hypochlorite solution on RaCe rotary nickel-titanium instruments: an atomic force microscopy study

Effect of phytic acid on chemical, structural, and mechanical characteristics of nickel-titanium endodontic files

This study investigated phytic acid (IP6) effect on chemical, structural, and mechanical characteristics of nickel-titanium (NiTi) files. The tested files were equally divided into groups according to the immersion protocol: sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), IP6, EDTA followed by NaOCl, and IP6 followed by NaOCl. These groups were then compared in terms of Ni, Ti, and chromium (Cr) ions release from the files. Microstructural changes using field emission scanning electron microscope (Fe-SEM) and energy dispersive X-ray spectroscopy (EDX) and surface roughness were analyzed. The mechanical characterization was conducted using cyclic fatigue resistance test. Fractured segments were scanned under SEM. Statistical analysis was performed using one-way ANOVA, Tukey test, Kruskal-Wallis test and Mann-Whitney U test. Results showed that NaOCl caused significant release of Cr, followed by IP6 and EDTA (P < 0.05). When files were pre-immersed in EDTA, NaOCl tended to induce less release of Ti and Cr. EDX evaluation revealed that the main surface elements were Ni, Ti, carbon, and oxygen. EDTA group contained the highest amount of carbon, while the control group showed the lowest. Surface roughness evaluation revealed no significant differences between groups despite the minor increases after immersion in certain groups. Black areas were observed in the NaOCl group which indicated corrosion. However, the cyclic fatigue test showed no significant differences between the groups.

Cutting efficiency and corrosion resistance of heat-treated endodontic files after various disinfection protocols

The aim of this study is to evaluate the effect of various disinfection protocols on the cutting efficiency and chemical composition of ProTaper, Twisted File, Twisted File Adaptive, and Hedström files. Four experimental groups (n = 10) were presoaked in either enzymatic solution or 1% sodium hypochlorite for 30 min, followed by either 5 or 15 min of ultrasonic cleaning and then autoclaved. Resin-simulated canals with a single curvature of 38-40° were prepared by each instrument system. Cutting efficiency of each instrument was analyzed by subtracting the final weight from the initial weight of the resin blocks. Chemical compositions were studied by field emission scanning electron microscopy and X-ray energy-dispersive spectrometry. The cutting efficiency of Hedström, ProTaper, and Twisted File instruments decreased compared to their control groups (p < 0.05) whereas it did not change for Twisted File Adaptive. More corrosion was detected with longer ultrasonication time. No difference was observed regarding the pre-soaking media. Disinfection protocols exerted a significant overall effect on the performance of Hedström, ProTaper, and Twisted File instruments. Corrosion, microcracks, and crevices were evident on all tested instruments after disinfection protocols applied. All disinfection protocols, regardless of the pre-soaking media used or the ultrasonic cleaning time applied, have some effect on the cutting efficiency and the surface characteristics of the files.

Effect of Sterilization and Irrigating Solutions on Nanostructure Alteration of Ni-Ti Rotary Instruments in Endodontics: An Atomic Force Microscopic Study

Aim

This study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) and sterilization on the nanostructural alteration of nickel titanium (Ni-Ti) rotary file systems in endodontics using the atomic force microscopy (AFM).

Materials and Methods

The study was performed on four commercially available rotary Ni-Ti files: group I-Vortex Blue (Dentsply), group II-ProTaper Next (Dentsply), group III-Mtwo (VDW), and group IV-iRaCe (FKG). Each group was divided into four subgroups (n = 4), that is, subgroup A-control (new rotary file), subgroup B-subjected for five cycles of autoclave, subgroup C-immersed in 5.25% NaOCl for 5 minutes, and subgroup D-immersed in 17% EDTA solutions for 5 minutes. All the specimens were evaluated with AFM using roughness average (RA) and root-mean-square (RMS) values for surface roughness.

Results

Among control groups, Vortex Blue showed the least RA and RMS values; the highest surface roughness was seen with Mtwo files. All the Ni-Ti rotary files showed a statistically significant (P <0.05) increase in surface hardness when subjected to autoclave and treatment with different irrigating solutions. In particular, 17% EDTA caused the highest surface deterioration in all the groups.

Conclusion

AFM analysis revealed increased surface roughness values recorded for all the rotary files when treated with irrigating solutions and autoclave cycles.

Influence of sodium hypochlorite on cyclic fatigue resistance of nickel-titanium instruments: A systematic review and meta-analysis of in vitro studies

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.

Influence of 17% EDTA and Sapindus mukorossi on the Surface Property of Protaper Gold Rotary Endodontic Instruments

The aim of the study was to evaluate the influence of 17% ethylenediaminetetraacetic acid (EDTA) and ethanolic extract of Sapindus mukorossi (S. mukorossi) in combination with canal shaping on surface properties of ProTaper Gold rotary endodontic file. Sixteen F1 ProTaper Gold rotary files underwent the standard protocol for root canal treatment using two irrigants (S. mukorossi and 17% EDTA) in single-rooted decoronated teeth. Eight unused files were used as a control. All files were examined under an atomic force microscope (AFM) to evaluate surface roughness (Ra) and root mean square (RMS). Data were analyzed using the t-test. RMS and Ra values of the control file were 1.37 and 0.607, respectively. The mean RMS (3.70 ± 1.41) and mean Ra (2.89 ± 1.41) in EDTA group were significantly higher than the control file (p < 0.05). The mean RMS in the S. mukorossi group (1.77 ± 0.66) did not show any significant difference with the control (p > 0.05). The Ra of S. mukorossi group (1.09 ± 0.05) was significantly higher than the control file (p < 0.05). Moreover, the mean RMS and Ra were found to be significantly higher in the EDTA group compared to the S. mukorossi group (p < 0.05). The mean Ra and RMS values of the ProTaper Gold files used to prepare canals using 17% EDTA and S. mukorossi irrigation were significantly higher than the control files. The EDTA-treated ProTaper Gold rotary files demonstrated higher surface Ra and RMS than the S. mukorossi files.

Metallurgical Tests in Endodontics: A Narrative Review

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

Qualitative Assessment of the Surface Topographic Changes of XP-endo Shaper and TruNatomy files after exposure to Sodium Hypochlorite and Ethylenediaminetetraacetic Acid

OBJECTIVE

TruNatomy and XP-endo Shaper are recently introduced file systems showing increased fatigue resistance rate. The present study aims to evaluate the surface topographic changes and nickel (Ni) and titanium (Ti) elemental loss of XP-endo Shaper (XPS) and TruNatomy (TN) files on exposure to conventionally used root canal irrigants; [5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA)] at a 10 minute time frame using atomic force microscopy (AFM) and energy dispersion X-ray spectroscopy (EDX) analytical techniques.

METHODS

Twelve samples for each of XPS (30/.04 taper) and TN (26/.04 taper; prime) instruments were dynamically exposed to 5.25% NaOCl, 17% EDTA separately for 10 minutes and in combination of 5.25% NaOCl (8 minutes)+17% EDTA (2 minutes) for a total of 10 minutes. Post exposure, the files were subjugated to AFM and EDX analysis. Independent t test and one-way ANOVA were used for statistical analysis, and the level of significance was set at 0.05.

RESULTS

XPS and TN showed a significant increase of surface roughness (Ra) and roughness mean square (RMS) on exposure to various irrigants (P<0.05) using AFM analysis. Increased overall roughness was observed with TN in comparison to XPS (P<0.05). Elements Ni and Ti loss was found in both XPS and TN files using EDX analysis. Both files exhibited Ni and Ti loss with the loss of Ni content higher for TN after exposure to 17% EDTA. Loss of Ti was seen for both files on exposure to a combination of 5.25% NaOCl+17% EDTA.

CONCLUSION

After exposure to root canal irrigants, the surface roughness was lesser in XPS compared to TN files. 17% EDTA caused significantly higher surface roughness in both file systems when compared to 5.25% NaOCl. TN exhibited overall higher elemental (Ni and Ti) loss on exposure to 17% EDTA and 5.25% NaOCl+17% EDTA in comparison to XPS files.

Effects of repeated sterilization cycles on the surface alterations of ProTaper Next, TF Adaptive, HyFlex CM, and 2Shape instruments

Background. This study aimed to evaluate the effects of repeated sterilization cycles on the surface alterations of various nickel-titanium instruments, including ProTaper Next (PTN), TF Adaptive (TFA), HyFlex CM (HCM), and 2Shape (2S). Methods. Twenty-four new NiTi files of four different alloys were selected. The instruments in each group were divided into two equal groups, as follows: control and sterilization. The first group was chosen as the control without applying any sterilization procedure, while in group 2, five cycles of sterilization procedures were applied. The surface topographies were evaluated using scanning electron microscope (SEM) and atomic force microscope (AFM). The root mean square (RMS) and maximum height (MH) values and three-dimensional images were recorded. The data were analyzed with the Shapiro-Wilk test, one-way ANOVA, and post hoc Tukey tests. The statistical significance level was set at P ≤ 0.05. Results. Before the experiment, HCM demonstrated the highest RMS value, and 2S showed the lowest. After the procedures, the RMS and MH values deteriorated on the surface of PTX, TFA, and 2S (P < 0.001). The HCM was not affected by sterilization processes (P > 0.05). Conclusion. The initial irregularity on the surface did not affect the rate of alteration. The HCM files demonstrated superior surface properties after several cycles of sterilization. The PTN, TFA, and 2S presented similar surface responses after five cycles of autoclave sterilization.

Topographic changes in NiTi rotary instruments after the clinical use

Surface alterations of instruments were investigated after single and multiple uses in the root canals. XP-endo Shaper (n = 5) and WaveOne GOLD (n = 5) files were used until the separation of the instruments occurred. The apical 3-mm and separated fragments were analysed by SEM to determine the changes in the instruments and the cross-sections of the separated fragments. Each group was divided into five subgroups: control, first, second, third and fourth molar. The results were reported descriptively for each group. In the XP-endo Shaper group, microcracks started to appear after the second use, and pitting and galvanic corrosion occurred after the third use. During the fourth use, microcracks propagated, resulting in ductile fracture while it happened after the third use in the second group. The single use of XP-endo Shaper and WaveOne GOLD was safe without any major changes on their surfaces. Reciprocating motion was not necessarily superior to full rotation motion.

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

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

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

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

The effect of root canal preparation on the surface roughness of WaveOne and WaveOne Gold files: atomic force microscopy study

Objectives

To examine the surface topography of intact WaveOne (WO; Dentsply Sirona Endodontics) and WaveOne Gold (WOG; Dentsply Sirona Endodontics) nickel-titanium rotary files and to evaluate the presence of alterations to the surface topography after root canal preparations of severely curved root canals in molar teeth.

Materials and Methods

Forty-eight severely curved canals of extracted molar teeth were divided into 2 groups (n = 24/each group). In group 1, the canals were prepared using WO and in group 2, the canals were prepared using WOG files. After the preparation of 3 root canals, instruments were subjected to atomic force microscopy analysis. Average roughness and root mean square values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way analysis of variance and post hoc Tamhane's tests at 5% significant level.

Results

The surface roughness values of WO and WOG files significantly changed after use in root canals (p < 0.05). The used WOG files exhibited higher surface roughness change when compared with the used WO files (p < 0.05).

Conclusions

Using WO and WOG Primary files in 3 root canals affected the surface topography of the files. After being used in root canals, the WOG files showed a higher level of surface porosity value than the WO files.

Effect of multiple autoclave cycles on the surface roughness of HyFlex CM and HyFlex EDM files: an atomic force microscopy study

AIM

To compare the effect of autoclave cycles on the surface topography and roughness of HyFlex CM and HyFlex EDM instruments using atomic force microscopy (AFM) analysis.

METHODOLOGY

Eight new files of each brand were subdivided into four subgroups (n = 2/each subgroup). One group was allocated as the control group and not subjected to autoclave sterilization. The other three groups were subjected to different numbers (1, 5, and 10) of autoclave sterilization cycles. After the cycle instruments were subjected to AFM analysis. Roughness average (Ra) and the root mean square (RMS) values were chosen to investigate the surface features of endodontic files. The data was analyzed using one-way ANOVA and post hoc Tamhane tests at 5% significant level.

RESULTS

The lowest Ra and RMS values were observed in the HyFlex EDM files that served as the control and in those subjected to a single cycle of autoclave sterilization (P < 0.05). The highest Ra and RMS values were observed in the HyFlex CM and HyFlex EDM files that were subjected to 10 cycles of autoclave sterilization (P < 0.05). The surface roughness values of the HyFlex CM group showed a significant increase after ten autoclave cycles, whereas those of the HyFlex EDM group exhibited a significant change after five autoclave cycles (P < 0.05).

CONCLUSIONS

Although the initial surface roughness values of the HyFlex EDM files were lower than those of the HyFlex CM files, the surface roughness values of the EDM files showed a statistically significant increase after 5 cycles of autoclave sterilization. In contrast, the surface roughness values of the HyFlex CM files did not increase until 10 cycles of autoclave sterilization.

CLINICAL RELEVANCE

Present study indicated that autoclave sterilization negatively affected the surface roughness of the tested NiTi files.

Evaluation of surface alterations in different retreatment nickel-titanium files: AFM and SEM study

The aim of this study was to evaluate the surface changes of nickel titanium (Ni-Ti) rotary retreatment files after three and five uses. Furthermore, the effects of 2% sodium hypochlorite and chloroform solutions and sterilization procedures on the NiTi rotary retreatment surfaces were investigated. ProTaper Retreatment files, R-endo files, and Mtwo retreatment files were used for this study. The palatinal roots of maxillary molar teeth were obturated with gutta percha and Ah26. Retreatment procedures were performed with these retreatment file systems. The surface changes of untreated NiTi rotary files that were used three and five times, immersed in NaOCl and chloroform and subjected to sterilization procedures were investigated with atomic force microscopy (AFM) and scanning electron microscopy (SEM). The RMS values, three dimensional images and SEM images at various magnifications were obtained. RMS values showed that all three NiTi rotary retreatment file systems showed significant deteriorations after three and five uses. Cracks, damages and spiral construction deteriorations were detected in the SEM images after three and five uses. Furthermore, the Mtwo 15 file was broken off after five uses. AFM data indicated that 2% NaOCl caused significant surface deteriorations on NiTi rotary files and both AFM and SEM evaluation showed that chloroform solution and sterilization procedures did not cause significant surface deteriorations. In conclusion, ProTaper retreatment, R-endo, and Mtwo retreatment files showed surface damages depending on retreatment procedures. Clinicians have to consider that retreatment files always have a tendency to break off after the third time they have been used.

The effect of 5% sodium hypochlorite, 17% EDTA and triphala on two different rotary Ni-Ti instruments: An AFM and EDS analysis

Aim:

To use Atomic Force Microscope and Energy Dispersive X-ray Spectroscopy to evaluate the effect of 5% NaOCl, 17% EDTA and triphala on ProTaper and iRaCe rotary Ni-Ti instruments.

Methodology:

A total of eight Ni-Ti rotary files, four files each of ProTaper - S2 (Dentsply) and iRaCe - R3 (FKG DENTAIRE) were used. Three out of four files each from ProTaper and iRaCe were immersed in 5% NaOCl, 17% EDTA and Triphala separately for five minutes. The Roughness average (Ra), Root Mean Square (RMS) and Mean Height of Roughness Profile Elements (Rc) of the scanned profiles were then recorded using AFM and the elemental composition was evaluated with EDS. Data were analyzed by Student's t test, One Way ANOVA and Duncan's Multiple Range Test.

Results:

Topographic irregularities at the nanometric scale were observed for all files. Files immersed in EDTA and NaOCl showed highly significant surface roughness than untreated files.

Conclusion:

Short-term contact with 17% EDTA and 5% NaOCl can cause significant surface deterioration of ProTaper and iRaCe rotary NiTi files. AFM proves to be a suitable method for evaluating the instrument surface.

Evaluation of surface topography changes in three NiTi file systems using rotary and reciprocal motion: An atomic force microscopy study

AIM

To evaluate the surface topography changes in three nickel-titanium (NiTi) file systems using either rotary or reciprocal motion using atomic force microscopy (AFM), and to determine the effect of scanning area on the AFM results in this study.

METHODOLOGY

Five points on a F2 Protaper file, R25 Reciproc file, and a Primary file from WaveOne systems were scanned preoperatively in 1 × 1 and 5 × 5 µm(2) with an AFM device that can scan an intact (not sectioned) file. One standardized resin block was used for each instrument, according to the manufacturer's recommendations. Points were re-scanned postoperatively using the same AFM and settings. Root-mean-square (RMS) and roughness average (Ra) values were obtained. The preoperative and postoperative surface topographies were compared separately in terms of RMS and Ra values. The surface topography change scores were analyzed using Kruskal-Wallis and Mann-Whitney U tests using a 0.10 significance level.

RESULTS

There were no significant differences preoperatively among the NiTi file systems in 1 × 1 or 5 × 5 µm(2) areas. Postoperatively, the WaveOne Primary had more surface irregularities (significant for 5 × 5 µm(2) scan in Ra evaluation).

CONCLUSIONS

Three-dimensional AFM images of instrument surfaces showed topographic irregularities preoperatively and postoperatively. AFM results differ depending on the scanning area and file used.

Electrochemical corrosion assessment of RaCe and Mtwo rotary nickle-titanium instruments after clinical use and sterilization

Aim: The aim of the present study was to electrochemically evaluate corrosion resistance of RaCe and Mtwo files after repeated sterilization and preparation procedures. Study Design: A total of 450 rotary files were used. In the working groups, 72 files from each file type were distributed into 4 groups. RaCe and Mtwo files were used to prepare one root canal of the mesial root of extracted human mandibular first molars. The procedure was repeated to prepare 2 to 8 canals. The following irrigation solutions were used: group 1, RaCe files with 2.5% NaOCl; group 2, RaCe files with normal saline; group 3, Mtwo files with 2.5% NaOCl; and group 4, Mtwo files with normal saline in the manner described. In autoclave groups, 72 files from each file type were evenly distributed into 2 groups. Files were used for a cycle of sterilization without the use of files for root canal preparation. Nine new unused files from each file type were used as controls. Then the instruments were sent for corrosion assessment. Mann-Whitney U and Wilcoxon tests were used for independent and dependent groups, respectively. Results: Statistical analysis indicated that there were significant differences in corrosion resistance of files associated with working and autoclave groups between RaCe and Mtwo file types (p<0.001). Conclusions: Corrosion resistance of #25, #30, and #35 Mtwo files is significantly higher than that in RaCe files with similar sizes.

Key words:Corrosion, NiTi instruments, autoclave, RaCe, Mtwo.

Alteration in the inherent metallic and surface properties of nickel-titanium root canal instruments to enhance performance, durability and safety: a focused review

The expanded use of nickel-titanium (NiTi) rotary instruments in root canal procedures has led to the development of a wide variety of shapes, designs and applications. Root canal anatomy has not changed, however, and the same challenges exist in both initial treatment and the revision of unacceptable treatment. These challenges include application with high levels of achievement and low to no levels of adverse effects, such as instrument fracture, root canal wall ledging, dentine wall perforation and so forth. To that end, many manufacturers have been seeking ways to alter the presently available and wide range of root canal instrument designs, with a focus on altering the surface of the alloy or altering the alloy microstructure with post-machining or post-twisting heat treatment. This focused review will address the impact that these modifications have had on instrument flexibility, resistance to cyclic fatigue and cutting efficiency.