Cyclic fatigue resistance of two nickel-titanium rotary instruments in interrupted rotation

Cyclic and torsional fatigue resistance of a new rotary file on a rotary and reciprocating motion

This study evaluated the cyclic and torsional fatigue resistance of a new nickel-titanium (Flat File 25.04) instrument on the continuous and reciprocating motion. Sixty instruments of the ProDesign Logic2 25.03 and 25.05 (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil), and MK Flat File 25.04 (n = 20) (MK Life, Porto Alegre, Brazil) were used. For the cyclic fatigue test, an artificial stainless steel simulated canal with an angle of 60° and a radius of curvature of 5 mm located 5 mm from its tip was used. The torque and rotation angle at the instruments' failure on the torsional fatigue test was based on the ISO 3630-1 protocol, in which the 3 mm tip of each instrument was fixed and connected to an electric motor and a load cell. The fractured surface of each fragment was examined by scanning electron microscopy. Data were analyzed using a 1-way analysis of variance and Tukey's test with a significance level of 5%. Flat File 25.04 had lower cyclic fatigue in both kinematics than the Logic instruments (p < .05). Reciprocating motion improved the cyclic fatigue of the tested instruments (p < .05). Flat File 25.04 had similar torque to Logic2 25.05 (p > .05), and both were superior to Logic2 25.03 (p < .05). The angular deflection values were different for the three tested instruments (p < .05), in the decreasing order: Logic2 25.03, 25.05, and Flat File 25.04. Flat File presented good resistance to cyclic and torsional fatigue resistance. Reciprocating motion improved the cyclic fatigue resistance of the instruments and can be considered when using programmable motors. RESEARCH HIGHLIGHTS: Scanning electron microscopy evaluation of different endodontic rotary file and fatigue resistance tests.

Influence of kinematics and incidence angles on the cutting efficiency of two single-file nickel-titanium rotary instruments

To compare the cutting efficiency of F6 Sky Taper (F6ST) and One Curve (OC) with different kinematics and cutting inclinations. Cutting efficiency of 80 new F6ST and OC was tested at 90° and 70° inclination in relation to the sample, in continuous rotation and reciprocation, against standardised gypsum samples for 120 seconds using a customised device. Data expressed as weight loss and length of the sample cut were analysed using two-way analysis of variance and Tukey t-test (P<.05). F6ST showed significantly higher cutting efficiency in reciprocation, while OC in continuous rotation. Regardless of inclination, F6ST showed statistically higher values than OC in reciprocation, while OC exhibited higher cutting ability in continuous rotation. The 70° inclination significantly improved the cutting efficiency of both files. Reciprocation improved the cutting efficiency of F6ST while continuous rotation enhanced cutting ability of OC. An inclined insertion improved the cutting ability, independently from the movement.

A critical analysis of research methods and experimental models to study the physical properties of NiTi instruments and their fracture characteristics

The aim of this review is to provide a critical overview of the physical properties (surface hardness, cutting efficiency, bending properties, flexibility and cyclic fatigue resistance) of NiTi instruments. Frequently used experimental models regarding these aspects will be presented and discussed with regard to their strengths and weaknesses. For all these aspects, a plethora of experimental models have been described. Based on a critical appraisal and especially taking the appropriate translation of experimental findings to clinical endodontics into account, suggestions for future research based on clearly defined and valid experimental methodologies will be provided. Up to now, very few attempts have been made to assess which particular physical properties of NiTi instruments exert an impact on the clinical outcome of root canal treatment. Departure from merely focusing on physical properties and fracture characteristics towards more biological aspects in terms of treatment outcome is essential.

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.

Cutting efficiency of heat-treated nickel-titanium single-file systems at different incidence angles

Cutting efficiency of Reciproc R25 (REC) and Reciproc blue R25 (REB) at different inclinations was evaluated. Sixty new files were tested at 90°, 70° and 45° of inclination in relation to the sample (n = 10), using a customised machine. All files were activated in reciprocation against standardised gypsum blocks for 120 s. Cutting efficiency was determined by measuring the block weight loss with an analytical balance and measuring the length of the block surface cut using a digital calliper. Data were statistically analysed (two-way ANOVA, Bonferroni t-test) with the significance level set at P < 0.05. There was no difference for REC among the tested angles. REB had no statistical difference between 90° and 70°; however, its cutting efficiency significantly increased at 45°. There was a significant difference between REC and REB at 45° only. Under these conditions, increased file inclination to 45° and blue heat treatment improved cutting efficiency of reciprocating files.

Comparison of the cyclic fatigue resistance of VDW.ROTATE, TruNatomy, 2Shape, and HyFlex CM nickel-titanium rotary files at body temperature

Objectives

This study aims to compare the cyclic fatigue resistance of VDW.ROTATE, TruNatomy, 2Shape, and HyFlex CM nickel-titanium (NiTi) rotary files at body temperature.

Materials and Methods

In total, 80 VDW.ROTATE (25/0.04), TruNatomy (26/0.04), 2Shape (25/0.04), and HyFlex CM (25/0.04) NiTi rotary files (n = 20 in each group) were subjected to static cyclic fatigue testing at body temperature (37°C) in stainless-steel artificial canals prepared according to the size and taper of the instruments until fracture occurred. The number of cycles to fracture (NCF) was calculated, and the lengths of the fractured fragments were measured. The data were statistically analyzed using a 1-way analysis of variance and post hoc Tamhane tests at the 5% significance level (p < 0.05).

Results

There were significant differences in the cyclic fatigue resistance among the groups (p < 0.05), with the highest to lowest NCF values of the files as follows: VDW.ROTATE, HyFlex CM, 2Shape, and TruNatomy. There was no significant difference in the lengths of the fractured fragments among the groups. The scanning electron microscope images of the files revealed typical characteristics of fracture due to cyclic fatigue.

Conclusions

The VDW.ROTATE files had the highest cyclic fatigue resistance, and the TruNatomy and 2Shape files had the lowest cyclic fatigue resistance in artificial canals at body temperature.

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.

Evaluation of Mechanical Properties of a Hollow Endodontic Post by Three Point Test and SEM Analysis: A Pilot Study

The aim of this study was to investigate the mechanical properties of a fiber hollow endodontic post characterized by the presence of an empty central cylindrical channel extended along the whole length. This particular shape allows clinicians to use the post also as a cementation resin carrier. Ten hollow posts were divided in two groups: the control group (unfilled hollow posts) (Group 0) and hollow posts filled with dual resin cement (Group 1). The samples of both groups were subjected to mechanical and micromorphological analysis by performing a three-point test and SEM observations. In the three-point test, the Group 1 samples exhibited a fracture load of 57.09 ± 5.06 N, a flexural strength of 1323.53 ± 110.09 MPa, and a Young’s modulus of 42.87 ± 0.86 GPa. The samples of Group 2 exhibited a fracture load of 38.17 ± 1.7 N, a flexural strength of 908.87 ± 30.98 MPa, and a Young’s modulus of 40.33 ± 1.9 GPa. The difference between fracture load, flexural strength, and deflection between the two groups was statistically highly significant (p < 0.01). Further, the difference between the Young’s modulus of the two groups was statistically significant (p < 0.05). The values obtained are similar to those of other posts available on the market.

Dental Restorative Digital Workflow: Digital Smile Design from Aesthetic to Function

Breakthroughs in technology have not been possible without influencing the medical sciences. Dentistry and dental materials have been fully involved in the technological and information technology evolution, so much so that they have revolutionized dental techniques. In this study, we want to create the first collection of articles on the use of digital techniques and software, such as Digital Smile Design. The aim is to collect all of the results regarding the use of this software, and to highlight the fields of use. Twenty-four articles have been included in the review, and the latter describes the use of Digital Smile Design and, in particular, the field of use. The study intends to be present which dental fields use "digitization". Progress in this field is constant, and will be of increasing interest to dentistry by proposing a speed of treatment planning and a reliability of results. The digital workflow allows for rehabilitations that are reliable both from an aesthetic and functional point of view, as demonstrated in the review. From this study, the current field of use of Digital Smile Design techniques in the various branches of medicine and dentistry have emerged, as well as information about its reliability.

The IG- file use to Gauge the Apical Diameter in Endodontics: An In Vitro Study

Aim:

The aim of this study was to evaluate the efficacy of the IG-file, a new instrument designed for apical diameter gauging.

Materials and Methods:

After shaping with F1 Universal Protaper, 60 roots were randomly divided into two groups and assigned to two operators, One Expert in Endodontics (EO) and One Unexpert (UO).

In each sample, after canal curvatures have been detected, the apical diameters were measured with the IG-file and the K-NiTi. The results were compared with the reference value obtained by retrograde apical gauging. The data were statistically analyzed.

Results:

Among 60 samples, 10% of errors were recorded when the IG-files were used; in the K-NiTi group the incorrect measurements were 70%.

In both groups (expert and unexpert) the IG-file measurements were more accurate than the K-NiTi (90 vs 33 and 90 vs 26,7). The differences were statistically significant.

In curved canals, the difference between measurement rates performed with both instruments was statistically significant (85,7% IG-file vs 28,6% K-NiTi) as well as for the samples without curvatures (92,3% IG file vs 30,8% NiTi file).

In root canals without curvatures overestimation errors in K-NiTi file group are more frequent than underestimation errors. This difference was statistically significant.

Conclusion:

A proper gauging of the apical diameter has a key role in endodontic therapy; an incorrect measurement can lead to clinical failures. This “in vitro” study highlights that IG-file improves measurement accuracy independently from clinician experience. Furthermore, in curved canals, the IG-file is more accurate than K-NiTi.

Cyclic Fatigue Resistance of Heat-Treated Nickel-Titanium Instruments

Introduction:

This study compared the cyclic fatigue resistance (CFR) of new instruments manufactured by heat-treated nickel-titanium wire.

Methods and Materials:

Ninety-six new instruments from HyFlex CM (HF), Edge File (EF), Pro Design S (PDS/L) and Mtwo (MT) (20/0.06 and 25/0.06) (n=12) systems were evaluated. A stainless steel device was used and time and number of cycles to fracture (NCF) were observed. Fragments were measured and fracture surface was evaluated using scanning electron microscope (SEM). ANOVA and Tukey’s tests were applied with the level of significance set at 0.05.

Results:

PDS 20/0.06 and PDL 25/0.06 instruments presented the highest CFR. MT 20/0.06 and MT 25/0.06 showed the lowest CFR (P<0.05). The length of fragments was similar for 25/0.06 instruments and HF presented the highest one for 20/0.06 instruments. SEM analyses showed morphology suggestive of ductile fracture.

Conclusion:

Heat treatment increased resistance to cyclic fatigue differently for each type of instrument. PDS 20/0.06 and PDL 25/0.06 present higher cyclic fatigue resistance.

Cyclic fatigue resistance of new reciprocating files (Reciproc Blue, WaveOne Gold, and SmartTrack) in two different curved canals

AIM

In the present study, we compared the cyclic fatigue resistance (CFR) of Reciproc Blue, WaveOne Gold, and SmartTrack files in curved artificial canals.

METHODS

Ninety new Reciproc Blue R25, WaveOne Gold Primary, and SmartTrack X1 files were tested in artificial canals with 45° and 60° angles of curvature. CFR was determined by recording the time to fracture in the artificial canals. Two-way analysis of variance was used to analyze the data.

RESULTS

In the canal with a 45° angle of curvature, no significant differences were observed amongst Reciproc Blue, WaveOne Gold, and SmartTrack (P > .05). In the canal with a 60° angle of curvature, Reciproc Blue and SmartTrack had a greater CFR than WaveOne Gold (P < .05); there was no significant difference between the Reciproc Blue and SmartTrack files (P > .05).

CONCLUSION

The results of the present study showed that Reciproc Blue and SmartTrack files exhibited greater CFR than WaveOne Gold only in canals with a 60° angle of curvature.

Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments

AIM

To examine the efficacy of a novel supplementary irrigant agitating brush (Finisher GF Brush, MedicNRG, Kibbutz Afikim, Israel) on the debridement of root canals prepared with a novel stainless steel rotary instrumentation system (Gentlefile; MedicNRG), or nickel titanium rotary instruments in oval root canals.

METHODOLOGY

Mandibular premolars (n = 72) were selected and divided randomly into three experimental groups (n = 24) after microCT scanning: group 1, canal preparation to rotary NiTi size 20, .04 taper (R20); group 2, rotary NiTi to size 25, .04 taper (R25) and group 3, Gentlefile size 23, .04 taper (GF). Specimens were subdivided into two subgroups: subgroup A, syringe-and-needle irrigation (SNI); subgroup B, Finisher GF Brush (GB). Ten untreated canals served as controls. Specimens were processed for histological evaluation, and the remaining pulp tissue (RPT) was measured. Data were analysed using Mann-Whitney and Kruskal-Wallis tests (P = 0.05).

RESULTS

All experimental groups had significantly less RPT than the control (P < 0.05). Group 3B (GF-GB) had significantly less RPT than groups 1B (R20-GB) and 2B (R25-GF; P < 0.05). When irrigated with SNI, there was no significant difference in the RPT between the three groups (P > 0.05). When instrumented with R20, there was no significant difference between SNI and GF (P < 0.05) whilst GB had significantly less RPT than SNI for R25 (P < 0.05).

CONCLUSIONS

Supplementary irrigant agitation with the Finisher GF Brush improved the debridement of canals prepared with Gentlefile and size 25, .04 taper rotary NiTi. Root canal debridement did not significantly differ between the instruments when syringe irrigation was used.