The Influence of NiTi Alloy on the Cyclic Fatigue Resistance of Endodontic Files

Phase Transformation and Mechanical Behaviour of Different Heat-Treated Nickel-Titanium Rotary Instruments

OBJECTIVES

This study evaluated the phase composition, phase transformation behaviour, and mechanical properties of five heat-treated NiTi instruments.

METHODS

ProTaper NEXT (M-wire, PTN), ProTaper Gold (Gold-wire, PTG), One Curve (C-wire, OC), EdgeTaper Platinum (Fire-wire, ETP), NeoNiTi (electrical discharge machining-wire, NNA), and ProTaper Universal (conventional wire, PTU, control) with #25-tip size were tested (n = 12/group) for cyclic fatigue resistance (number of cycles to failure; NCF) and torsional resistance (angle of rotation to fracture and maximum torque at fracture [ultimate torsional strength]). The geometry and fracture surfaces of the tested instruments were examined by scanning electron microscopy. The phase transformation temperature and phase composition of the instruments were evaluated using differential scanning calorimetry and X-ray diffraction. Data were statistically analysed using one-way ANOVA and Tukey's post hoc test, with the significance level set at 5%.

RESULTS

PTG showed the highest NCF (P < .05) at 37°C, while ETP exhibited the highest angle of rotation to fracture, ultimate torsional strength, and stiffness (P < .05). Scanning electron microscopy demonstrated typical clusters of fatigue striations and numerous cracks after cyclic fatigue fracture, whereas there was a concentric abrasion pattern with a dimple and microvoids at the centre after torsional fracture. In differential scanning calorimetry curves, austenite-finishing temperatures of heat-treated instruments were higher than 37°C, whereas that of PTU was lower than 37°C. PTU showed strong peaks of austenite at 25 and 37°C, whereas ETP showed a strong peak of R-phase at 25°C, but mostly austenite phase at 37°C in X-ray diffraction.

CONCLUSIONS

Geometry, alloy type, and phase transformation temperatures of NiTi instruments affected their mechanical behaviour.

CLINICAL RELEVANCE

PTG showed the highest NCF, suitable for markedly curved canals. ETP had the highest torsional resistance, appropriate for narrow and constricted canals.

Perception of Dental House Officers regarding Endodontic File Separation during Endodontic Treatment

Background

Despite of having improved endodontic file designs as well as the reinforced metal alloy file structure, intracanal endodontic file separation (EFS) is still a very problematic and worrisome dental incident, which usually occurs without any visible signs of permanent deformation. Further, there have been conflicting reports regarding the clinical significance of leaving separated files within root canals.

Aims

The aim of this study was to look into the current perceptions and awareness about file separation during endodontic treatment among the dental house officers (DHOs).

Materials and Methods

A novel validated questionnaire comprising of 15 close-ended questions was distributed anonymously via Google Forms through email to 1100 DHOs across Pakistan. The questionnaire consisted of two parts: the first component (Section I) collected demographic data and the second component (Section II) investigated the causes of EFS during root canal treatment. Following the completion of socioeconomic information, including age and gender, the DHOs were asked to answer a few questions about the various reasons for endodontic instrument fracture.

Results

A total of 800 responses were recorded, with an effective rate of 72.8%. The majority of the DHOs (p value < 0.001) perceived that endodontic instrument fracture occurred in the posterior (61.5%) and apical third of the canal (50.5%) and in older permanent dentition (67.3%), possibly due to patient anxiety (62%). Better choice of instrument (61.15%), operators' experience (95.3%), knowledge (87.5%), and proper root canal cleaning (91.1%) are believed to be the vital steps in reducing endodontic file separation/fracture. Furthermore, majority of them (p value < 0.001) perceived that stainless steel was a superior alloy for filing instruments. Manual files tend to be more prone to fractures due to repeated use than rotary files.

Conclusion

This study demonstrated that young DHOs had adequate knowledge and awareness regarding the potential predisposing factors and handling techniques for EFS. This study thereby provides an evaluating tool to access the insights of the current perceptions and awareness of DHOs concerning EFS.

Fabrication of a Potential Electrodeposited Nanocomposite for Dental Applications

In the present study, a nanocrystalline Ni-Fe matrix with reinforced TiO2 nanoparticles as a functional nanocomposite material was fabricated by pulsed current electroforming in UV-LIGA (lithography, electroplating, and molding). The influences of TiO2 nanoparticles on the Ni-Fe nanocomposite deposition were also investigated using scanning electron microscopy, transmission electron microscopy, and in vitro cytotoxicity assay. It was found that the Ni-Fe nanocomposite with 5 wt.% TiO2 nanoparticles showed a smooth surface and better dispersion property. When the Ni-Fe nanocomposite is combined with 20 wt.% TiO2, it resulted in congeries of TiO2 nanoparticles. In addition, TiO2 nanoparticles possessed better dispersion properties as performed in pulse current electrodeposition. The microstructure of the electrodeposited Ni-Fe-TiO2 nanocomposite was a FeNi3 phase containing anatase nano-TiO2. Moreover, the electrodeposited Ni-Fe-5 wt.% TiO2 nanocomposite exhibited a smooth surface and structural integrity. Cytotoxicity assay results also proved that the Ni-Fe nanocomposite with different concentrations of TiO2 nanoparticles had good biocompatibility. Therefore, the optimization of pulse current electroforming parameters was successfully applied to fabricate the Ni-Fe-TiO2 nanocomposite, and thus could be used as an endodontic file material for dental applications.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable

The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

A comparative study of cyclic fatigue of 6 endodontic systems. An in vitro study

Background

Mechanical preparation and the formation of space for adequate obturation are included in root canal shaping, but the complex root canal anatomy may be affect it. Manufacturers have created different alloys like M-Wire, Blue-Wire, Gold-Wire or R-phase. Objective: This investigation was performed to verify the null hypothesis that there were not significant differences between size 25 instruments ESP Files Thermoflex, Protaper Ultimate, Protaper Next, Blueshaper, One Curve and 2Shape about cyclic fatigue and length of broken fragments.

Material and Methods

180 new size 25 files of the systems investigated were selected (n=30). Files were used with Endo Mate DT endo motor with speed and torque recommended by manufacturers, holding the instruments with clamping mechanism, with passive adjustment, glycerine and without pressure in a stainless-steel block. The time was calculated in seconds until fracture. Number of fatigue cycles was determined as (Resistance (s) x Speed)/60. Separated fragment lengths were calculated with digital Vernier caliper. Statistical analysis was carried out with the SPSS 18 programme at a 95% confidence level, using Levene´s Test to compare variances, Welch’s Test to compare means, and Games-Howell´s Test to reveal differences between groups.

Results

Levene’s Test determined no equal variances (P<0.05). Welch’s Test and ANOVA (P<0.05) showed significant differences in cyclic fatigue and separated fragment lengths. Games-Howell’s and Bonferroni´s Test established significant differences in multiple comparisons (P<0.05).

Conclusions

ESP Files Thermoflex was superior in cyclic fatigue. About separated fragment lengths, ESP Files Thermoflex, Protaper Ultimate and Blueshaper obtained longer lengths.

Key words:Cyclic fatigue, continuous movement, separated fragment lengths, rotary systems.

Analysis of the Importance of the Motion Used in the Resistance of Different Mechanical Instrumentation Systems in Endodontics: A Comparative Study

Aim: The aim of this study was to compare the cyclic fatigue strength of different reciprocating rotary systems depending on the movement used. Methods: Four study groups were analyzed (n = 30): (1) Reciproc®, (2) Reciproc Blue®, (3) Wave One Gold® and (4) Procodile®. Each group was divided into three subgroups according to the motion used: (A) Reflex Dynamic® (n = 10), (B) ReFlex Smart® (n = 10) and (C) conventional reciprocating motion (n = 10). They were used in a dynamic cyclic fatigue prototype until their fracture, and the time was measured in seconds. The results obtained were analyzed with the ANOVA method, and for two-to-two comparisons, the Tukey method and Weibull statistics were used. Results: Procodile ReFlex Smart had the longest time to failure, and statistically significant differences were found between Procodile ReFlex Smart and the other files and motions (p < 0.05). Conclusion: Smart motions increase cyclic fatigue strength. ReFlex Smart® motion increases the cyclic fatigue strength of reciprocating rotary systems, and Procodile® ReFlex Smart was the most resistant system file.

Influence of Cross-Section and Pitch on the Mechanical Response of NiTi Endodontic Files under Bending and Torsional Conditions—A Finite Element Analysis

In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations of two cross-sections(square and triangular) and four pitches. Each file was subjected to bending and torsional analyses, simulating the testing conditions indicated in the ISO 3630 Standard, in order to assess their stiffness and mechanical strength. The results indicate that endodontic files with a square cross-section have double the stiffness of those with triangular cross-sections, both in terms of bending and torsion. For both loading modes, endodontic files with a triangular cross-section can undergo larger deformations before overload failure than those with a square cross-section: up to 20% more in bending and 40% in torsion. Moreover, under equivalent boundary conditions, endodontic files with triangular cross-sections present a higher fatigue life than those with square cross-sections: up to more than 300% higher for small pitches. The effect of pitch on the stiffness and strength of the file is smaller than that of the cross-section shape, but smaller pitches could be beneficial when using a triangularcross-section, as they increase the bending flexibility, fatigue life, and torsion stiffness. These results suggest a clinical recommendation for the use of files with a triangular-shaped cross-section and a small pitch in order to minimize ledging and maximize fatigue life. Finally, in this study, we reveal the sensitivity of the orientation of files with respect to the bending direction, which must be taken into account when designing, reporting, and interpreting test results under such loading conditions.

A Novel Digital Technique to Analyze the Wear of CM-Wire NiTi Alloy Endodontic Reciprocating Files: An In Vitro Study

The present study seeks to describe a novel digital measurement technique for analyzing the wear volume of controlled memory (CM)-wire NiTi alloy endodontic reciprocating files after clinical use. Material and Methods: Ten CM-wire NiTi endodontic reciprocating files were randomly used in ten first upper molar teeth within four root canals. The CM-wire NiTi alloy endodontic reciprocating files were subjected to preoperative and postoperative micro-computed tomography (micro-CT) scans to obtain accurate digital imaging and communication on medicine (DICOM) digital files, which were segmented using intensity-based thresholding and an exclusive OR (XOR) logical operation (Boolean algebra logical operator) to obtain a mask of the location to localize and quantify the wear volume of the CM-wire NiTi alloy endodontic reciprocating files. Gage repeatability and reproducibility statistical analysis was applied to assess the reproducibility and repeatability of this measurement technique. Results: The analysis showed a repeatability and reproducibility of 0.00% for the digital measurement technique used to analyze the wear volume of CM-wire NiTi alloy endodontic reciprocating files after clinical use. Wear was mostly identified at the tip and cutting edges of the CM-wire NiTi alloy endodontic reciprocating files. Conclusions: This novel digital measurement technique is a repeatable, reproducible, and accurate method of quantifying the wear volume of CM-wire NiTi alloy endodontic reciprocating files after clinical use.

The Effect of Taper and Apical Diameter on the Cyclic Fatigue Resistance of Rotary Endodontic Files Using an Experimental Electronic Device

The aim of this study was to analyze the effect of the taper and apical diameter of nickel–titanium (NiTi) endodontic rotary files on the dynamic cyclic fatigue resistance. A total of 50 unused conventional NiTi wire alloy endodontic rotary instruments were used in this study. All NiTi endodontic rotary files were submitted to a custom-made dynamic cyclic fatigue device until fracture occurred. The time to failure, the number of cycles to failure, the number of pecking movements, and the length of the fractured file tip were analyzed using the analysis of variance (ANOVA) test. In addition, the Weibull characteristic strength and Weibull modulus were also calculated. The paired t-test revealed statistically significant differences between the time to failure, number of cycles to failure, and number of cycles of in-and-out movement of both the apical diameter (p ˂ 0.001) and the taper (p ˂ 0.001) of NiTi endodontic rotary files; however, the results did not show statistically significant differences between the mean length of the fractured files regarding the apical diameter (p = 0.344) and taper study groups (p = 0.344). Increased apical diameter and taper of NiTi endodontic rotary files decreased their dynamic resistance to cyclic fatigue.