Analysis of reciprocating system real-time torque variation during root canal preparation

Torque Generation of the Endodontic Instruments: A Narrative Review

As the use of nickel-titanium (NiTi) file systems for root canal therapy has become popular; hence, knowledge and understanding of the characteristics of NiTi files is essential for dentists. Unintended sudden fracture can occur during root canal shaping, and it is important to understand the conditions that may cause instrument fractures. Torque is defined as the force required to rotate the NiTi file and can be considered of as a parameter for the stress generated. The endodontic engine maintains a constant rotational speed by adjusting torque regardless of the root canal conditions. The process of root canal shaping by rotary instruments is a series of actions that requires torque and generates stress to both the teeth and the NiTi instruments. The generated stress may induce the strain accumulation on NiTi instrument and the canal wall and lead to the development of microcrack in the instrument and dentinal wall. Therefore, understanding of torque and stress generated is important to prevent the fractures to the instrument and the teeth. This stress has been measured using various experimental approaches, including microcrack observation by using a microscope or computed tomography, attaching strain gauges to the teeth, and finite element analysis. This review focuses on the stress generated to the teeth and the instrument during instrumentation under various experimental conditions. The factors related to torque generation are also discussed.

Dynamic torque analysis of rotary and reciprocating instruments during root canal instrumentation in simulated canals by an endodontist or a general dentist

Background:

Excessive torque is associated with engine-driven file fracture.

Aims:

The aim of this study to evaluate the real-time torque of rotary and reciprocating instruments, working time, and the occurrence of procedural errors during root canal preparation of simulated canals by an endodontist and a general dentist.

Methods:

Thirty-six commercially available simulated “J-shaped” root canals in resin blocks were used. Instrumentation was performed using WaveOne, WaveOne Gold, ProTaper Next, Reciproc, Reciproc Blue, and Mtwo. The real-time torque analysis and the number of times the maximum torque applied to the instrument were evaluated. Images were obtained to assess the occurrence of procedural errors, and working time was recorded.

Statistical Analysis:

The one-way analysis of variance with a Bonferroni post hoc test, Mann Whitney test and the t-test was used for statistical analysis (P < 0.05).

Results:

Reciprocating instruments showed lower values in the number of times that reached maximum torque and percentage time in the area of critical torque, with significant differences compared to rotary instruments (P < 0.05). Operators influenced torque values only with rotary motion instruments. There was no significant difference in mean working time between the operators or instruments. No fracture of instruments or canal transportation occurred.

Conclusions:

Rotary instruments were associated with higher peaks in real-time torque variation during the preparation of simulated root canals.

Torque Range, a New Parameter to Evaluate New and Used Instrument Safety

The aim of the present study is to evaluate operative torque, torque at failure and the difference between these two values—the “torque range”—of two different NiTi files. We also sought to evaluate and compare these parameters for new and used files. Forty S-One 20.06 and forty M-Two 20.06 were tested, divided in four equal groups (n = 10) for each brand. Ten instruments from each brand performed three root canal treatments each on standardized extracted single-rooted teeth. Afterwards, each group was subjected to the following two tests: operative torque and torsional resistance. Mean values for all the tested groups were calculated. The results for new instruments showed that S-One developed significantly higher operative torque, but higher torsional resistance. The results for used instruments showed that the S-One 20.06 developed less operative torque and higher mean torsional resistance value compared to the M-Two. Moreover, the percentage reduction of both values was significantly higher for M-Two. The results of the present study showed a safer torsional behavior of the S-One. These results could be related to the heat treatment and the manufacturing process.