Shaping ability of reciprocating single-file and full-sequence rotary instrumentation systems in simulated curved canals

A Comparative evaluation of the shaping ability, canal straightening, and preparation time of five different NiTi rotary files in simulated canals

Aim

The aim is to compare the shaping ability, canal straightening, and the preparation time of five different nickel-titanium rotary files in simulated J-shaped canals.

Materials and Methods

Ninety J-shaped canals in resin blocks were filled with 2% Methylene Blue solution and pre-instrumentation images were taken using a Leica microscope at a ×10. They were prepared until size 25 taper 0.04 using (n = 18 per group): T-Flex, HyFlex CM, Vortex Blue, S5, and iRace. After instrumentation, images were captured again, and composite images were made using Adobe Photoshop imaging software. The differences in canal width and canal curvature at each respective landmark were measured and compared. The preparation time and canal abbreviations were also recorded. Statistical analyses were performed using one-way ANOVA and post hoc Tukey HSD tests. The level of statistical significance was set to P = 0.05.

Results

HyFlex CM demonstrated the least difference in canal width after instrumentation, but no significant difference (P > 0.05) as compared to T-Flex and Vortex Blue. The mean canal straightening ranged between 0.91° and 7.65°. T-Flex created the least canal straightening after instrumentation which was significantly less (P < 0.05) than S5, but there was no significant difference (P > 0.05) when compared to HyFlex CM. Instrumentation with the S5 file was significantly faster (P < 0.05), whereas HyFlex CM was the slowest.

Conclusion

T-Flex, HyFlex CM, and Vortex Blue demonstrated better shaping ability, whilst T-Flex and HyFlex CM maintained the original canal curvatures well. S5 tended to straighten the canals and caused the greatest canal transportation, but it required the least amount of time to shape the canal.

Experimental Study of the Effects of Torsional Loading on Three Types of Nickel-Titanium Endodontic Instruments

In modern endodontics, nickel-titanium (NiTi) rotary instruments are used on a large scale for root canal shaping. Nevertheless, the separation of an instrument is a serious concern during shaping. The aim of this study is to determine and compare the torsional fracture characteristics of three types of NiTi endodontic instruments, each with different cross-section designs and movements performed during root canal shaping: Endostar E3 (Endostar, Poldent Co. Ltd., Warsaw, Poland); Reciproc R25 (VDW, Munich, Germany); and Protaper Next X2 (Dentsply Maillefer, Ballaigues, Switzerland). Fifteen instruments are used in this study, divided in three groups (n = 5): Group Endostar, Group Reciproc and Group Protaper. For testing, each instrument is used to shape five simulated root canals, following which its torsional stress to failure is measured. The fracture lengths of all three groups are roughly between 2 and 3 mm from the tip. Higher values of the moment of torsion in fracture, and smaller values of the maximum twisting angle are observed for Group Endostar, as well as closer to circular cross-sections. However, the values of the shear tension are similar for all three groups, because the disadvantage given by the fracture section shape for Groups Reciproc and Protaper is compensated either by size or by intrinsic properties of the instrument material. For the shear tension the Endostar values are insignificantly increased (Kruskal–Wallis test, p = 0.207), and in the case of the maximum twist angle the Protaper values are insignificantly increased (Kruskal–Wallis test, p = 0.287). Because of the instruments shape and conicity, the analysis had to be carried out separately with regard to the length of the fractured tip. Rules-of-thumb are extracted from the study for current practice: if a blockage of the first 2 to 3 mm part of the tip can be anticipated (by the excessive curving of the instrument), the handpiece must be adjusted to torque values that do not exceed 1.5 to 2.5 N · cm for Endostar and 1 to 2 N · cm for Reciproc and Protaper instruments.

Reciproc Endodontic File Surface Defects After Single Use: An SEM Analysis

Objective:

The aim of this investigation was to detect defects that may occur to Reciproc endodontic files after a single use.

Materials and Methods:

A sample of convenience of Reciproc files (VDW GmbH, Munich, Germany) that were used to prepare root canals of anterior or posterior teeth were collected. The files were divided equally into two groups: Group 1 (R25) files were used to prepare mesial root canals of 50 human permanent mandibular molars, and Group 2 (R40) included 50 files that were used to prepare permanent maxillary incisor teeth. Files were analyzed after single use by using a scanning electron microscope at X120 to detect changes in surface morphology. The data were statistically analyzed by using the χ² test, and statistical significance was set at P < 0.05.

Results:

A total of 96 Reciproc NiTi files were collected; of those, 67 (70%) were unaffected and 29 (30%) showed overall surface deformations. The types of deformation were blade disruption (22%), surface pitting (12%), and unwinding and tip deformation (1%). No microcracks were detected, and none of the studied files showed fracture. R40 was three times more likely to be deformed and showed blade disruption compared with R25 (P < 0.05).

Conclusions:

Reciproc rotary NiTi files show high resistance to deformation after a single use. Blade disruption was the most frequent defect occurring in both the small and large files.

Apically Extruded Debris following Programmed Over Instrumentation of Curved Canals with Three Nickel Titanium Rotary Instruments

OBJECTIVES

 This in vitro study aimed to compare the amount of mixed and dried debris extruded with three endodontic NiTi (nickel-titanium) systems at three levels beyond the major apical foramen. The null hypothesis is that there would be no differences between the different rotary systems in terms of apically extruded debris.

MATERIALS AND METHODS

 Forty-eight roots of human extracted molars with 20 to 40-degrees curvature were divided randomly into three groups (n = 16) instrumented with ProTaper Next, BT RaCe, and WaveOne Gold, respectively. Instrumentation was performed at the major foramen and over instrumented 0.5 mm, 1.0 mm and 1.5 mm beyond. Irrigation was performed with sodium hypochlorite. Apically extruded debris was collected.

RESULTS

 Comparison of mixed extruded debris (solution/debris)and dried debris according to group and level of instrumentation showed that WaveOne Gold at the foramen and ProTaper Next beyond the foramen (p < 0.0001) resulted in significantly less extruded debris than other files and within the four levels using repeated measures analysis of variance (p < 0.0001b).

CONCLUSIONS

 All systems exhibit extruded debris during instrumentation but in different amounts.

Assessment of the role of cross section on fatigue resistance of rotary files when used in reciprocation

OBJECTIVE

The purpose of this study was to assess the role of cross section on cyclic fatigue resistance of One Shape, Revo-S SU, and Mtwo rotary files in continuous rotation and reciprocating motion in dynamic testing model.

MATERIALS AND METHODS

A total of 90 new rotary One Shape, Revo-S SU, and Mtwo files (ISO size 25, taper 0.06, length 25 mm) were subjected to continuous rotation or reciprocating motion. A cyclic fatigue testing device was fabricated with 60° angle of curvature and 5 mm radius. The dynamic testing of these files was performed using an electric motor which permitted the reproduction of pecking motion. All instruments were rotated or reciprocated until fracture occurred. The time taken for each instrument to fracture was recorded. All the fractured files were analyzed under a scanning electron microscope (SEM) to detect the mode of fracture. Statistical analysis was performed using one-way ANOVA, followed by Tukey's honestly significant difference post hoc test.

RESULTS

The time taken for instruments in reciprocating motion to fail under cyclic loading was significantly longer when compared with groups in continuous rotary motion. There was a statistically significant difference between Mtwo rotary and the other two groups in both continuous and reciprocating motion. One Shape rotary files recorded significantly longer duration to fracture resistance when compared with Revo-S SU files in both continuous and reciprocating motion. SEM observations showed that the instruments of all groups had undergone a ductile mode of fracture.

CONCLUSION

Reciprocating motion improved the cyclic fatigue resistance of all tested groups.

Computed tomography evaluation of root canal transportation using ProTaper, Race and Sendoline rotary systems: an ex vivo study

Background

This ex vivo study aimed to compare transportation of the mesiobuccal root canal of mandibular first molars instrumented with ProTaper, Race and Sendoline rotary systems using cone beam computed tomography (CBCT).

Materials and methods

Forty-five mesiobuccal canals of mandibular first molars were randomly divided into three groups of 15. Root canals in each group were instrumented with the ProTaper, Race or Sendoline rotary system according to the manufacturers’ instructions. Root canal preparations were performed by one operator, while root canal wall measurements were made by another operator blinded to the group allocation of teeth. The pre- and post-chemomechanical preparation CBCT scans were obtained and evaluated at 3, 6 and 9 mm levels from the apex. The amount of root canal transportation at these levels was calculated. Data were analyzed using SPSS version 17 via Mann–Whitney and Kruskal–Wallis tests. P<0.05 was considered significant.

Results

No significant difference was noted in canal transportation among the groups (P>0.05), but ProTaper showed the least and Sendoline caused the most canal transportation in the coronal third.

Conclusion

ProTaper, Race and Sendoline rotary systems are not significantly different in terms of canal transportation. Although all rotary files cause root canal transportation, ProTaper and Race showed the least amount of canal transportation in the coronal and apical thirds, respectively.

Influence of File Motion on Shaping, Apical Debris Extrusion and Dentinal Defects: A Critical Review

Advances in endodontics have enabled the evolution of file manufacturing processes, improving performance beyond that of conventional files. In the present study, systems manufactured using state of the art methods and possessing special properties related to NiTi alloys (i.e., CM-Wire, M-Wire and R-Phase) were selected. The aim of this review was to provide a detailed analysis of the literature about the relationship between recently introduced NiTi files with different movement kinematics and shaping ability, apical extrusion of debris and dentin defects in root canal preparations. From March 2016 to January 2017, electronic searches were conducted in the PubMed and SCOPUS databases for articles published since January 2010. In vitro studies performed on extracted human teeth and published in English were considered for this review. Based on the inclusion criteria, 71 papers were selected for the analysis of full-text copies. Specific analysis was performed on 45 articles describing the effects of reciprocating, continuous and adaptive movements on the WaveOne Gold, Reciproc, HyFlex CM and Twisted File Adaptive systems. A wide range of testing conditions and methodologies have been used to compare the systems. Due the controversies among the results, the characteristics of the files used, such as their design and alloys, appear to be inconsistent to determine the best approach.

Canal Transportation and Centering Ability of Reciproc Blue, WaveOne Gold and ProTaper Next in Simulated Curved Canals

Introduction

The aim of this study was to evaluate the canal transportation and centering ability of ProTaper Next (PTN), WaveOne Gold (WOG) and Reciproc Blue (RCB) in simulated curved resin canals.

Methods and Materials

A total of 43 blocks of simulated resin canals with 40° of curvature were prepared to an apical size of 0.02. Flexofile #15 instruments were used along the root canal to reach patency. The blocks were randomly assessed and sequence instruments were used according to each system: PTN, RCB and WOG. The imposition of pre and post instrumentation images were composited and analyzed. The canal transportation and apical centralization were measured using the software GIMP (2.8.4, Creative Commons - Share Alike 4.0 International License, 2013). Data were statistically analyzed using the Shapiro-Wilk test, ANOVA test and Tukey's test. The level of significance was set at 0.05.

Results

There were no statistical differences in canal transportation between three systems. The general assessment of three systems presented the RCB group with higher values of centralization and more numbers of centralized points with significant differences between the PTN and RCB groups (P<0.05).

Conclusion

In this in vitro study, there were no statistical differences in canal transportation between the RCB, WOG and PTN systems. The lowest transportation was observed in the apical region at 3 mm performed with RCB system, followed by WOG and PTN systems. The RCB demonstrated higher values of centralization and more centralized points when assessed by regions.

Impact of different file systems on the amount of apically extruded debris during endodontic retreatment

Objective:

The goal of present study was to determine the effect of different nickel–titanium file systems on the amount of apically extruded debris during endodontic retreatment: D-RaCe retreatment systems, EdgeFile XR retreatment rotary files, and Reciproc R40.

Materials and Methods:

Thirty-six single-rooted prepared mandibular premolar teeth were filled with Gutta-percha and AH Plus sealer. The teeth were then randomly assigned into three groups (n = 12) for retreatment. The endodontic retreatment was performed as follows: D-RaCe, EdgeFile XR, Reciproc 40. Debris extruded apically during the retreatment was collected into preweighed Eppendorf tubes. An incubator was used to store tubes at 70^° C for 5 days. The initial weight was subtracted from final weight of the Eppendorf tubes to calculate the weight of the dry extruded debris for each group. The data obtained were evaluated using Welch analysis of variance and Games-Howell post-hoc tests (P < 0.05).

Results:

All files resulted in apical extrusion of debris. Reciproc caused significantly less debris extrusion compared to D-RaCe and EdgeFile XR (P < 0.05).

Conclusions:

The findings revealed that during endodontic retreatment, number, and taper of files might have an influence on the amount of apically extruded debris during endodontic retreatment.