Effect of Sterilization on Cyclic Fatigue Resistance of Proflexendo Endodontic Rotary Files

Current Endodontic Practices among Romanian Dental Practitioners: A Cross-Sectional Study

Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or knowledge; therefore, this study aims to investigate current endodontic practices in Romania. Materials and Methods: A cross-sectional study was conducted via a questionnaire distributed to 400 randomly selected Romanian dentists, with 285 fully validated completed responses (71.25% response rate). Respondents were grouped by speciality, and statistical analysis, including cross-tabulation and the χ2 (chi-square) test, was used, with a significance level set at p ≤ 0.05 for all tests. Results: Significant differences were found in the use of magnification, rubber dam, sodium hypochlorite concentration, and bioceramics (p < 0.001). No significant differences were observed in preferences for measuring working length (p = 0.166) or rotary instrument motion (p = 0.289). Approximately 6% of the respondents used laser technology with no significant difference across specialities (p = 0.571). Additionally, 77.9% preferred using sodium hypochlorite, with no significant difference between groups (p = 0.006) regarding concentration. Conclusions: Most participants, including GDPs, use modern equipment and techniques during RCT, indicating their awareness and competence in current endodontic practices.

An in vitro comparative evaluation of cyclic fatigue resistance of two rotary and two reciprocating file systems

Context

Root canal instrumentation is one of the important procedures for successful endodontic therapy. Unexpected fracture of files occurs during root canal instrumentation without any visible signs of deformation compromising the success of root canal treatment.

Aims

The aim of the study was to evaluate and compare cyclic fatigue resistance (CFR) of rotary and reciprocating files in simulated canals with 45°, 60°, and 90° angle of curvature.

Settings and Design

The study design was an In vitro study.

Subjects and Methods

Sixty nickel-titanium files, 30 each of rotary and reciprocating files were selected and divided into four groups (n = 15) of Neoendo Flex, ProTaper Next, WaveOne Gold (WOG), and Reciproc Blue (RPB) files. Each group was further subdivided into three subgroups containing five samples each based on their use in simulated canals with 45°, 60°, and 90° angle of curvature. To simulate root canals with 45°, 60°, and 90° angle of curvature, three artificial canals were designed in a stainless steel metal block. Each file was autoclaved, immersed in 3% sodium hypochlorite (NaOCl), and coated with 17% ethylenediaminetetraacetic acid (EDTA). Each file was tested for CFR using a torque-controlled reduction handpiece by instrumenting in a simulated canal for 10 s until fracture. The cycle of autoclaving, exposure to NaOCl, EDTA, and testing of CFR for 10 s per canal as per groups and subgroups was repeated again and again until the respective file fracture. The time taken to file fracture was recorded using a digital chronometer. The time taken for each file fracture (in minutes) was multiplied by the number of rotations per minute to attain the number of cycles to failure (NCF).

Statistical Analysis Used

The obtained results were subjected to statistical analysis using one-way analysis of variance and independent t-test.

Results

One-way ANOVA test showed a statistically significant difference between the four groups, P < 0.001. Independent "t"-test between individual subgroups showed a statistically significant difference, as P < 0.05.

Conclusions

WOG and RPB reciprocating file systems showed superior CFR, more especially in canals with abrupt 90° angle of curvature compared to both rotary file systems tested. Among rotary file systems tested, Neoendo Flex showed greater CFR than ProTaper Next.

Effect of autoclave sterilization on the cyclic fatigue resistance of EdgeFile X7, 2Shape, and F-one nickel-titanium endodontic instruments

Background

Rotary nickel-titanium files have become the most commonly used engine-powered endodontic instruments due to their improvement in fatigue resistance and flexibility. The autoclaving is the most commonly used method for sterilization. However, the risk of instrument fracture, mainly due to cyclic fatigue during rotation within a curved canal, is still a matter of critical concern.

Aims

This study aimed to measure and compares the cyclic fatigue resistance of EdgeFile X7, 2Shape, and F-One files in a single curved simulated canal before and after autoclave sterilization.

Materials and Methods

Twenty-four files each of EdgeFile X7, 2Shape, and F-One files were used in this study. They were grouped as group A: EdgeFile X7, group B: 2Shape, and group C: F-One files. Then, each group was subdivided into two, sterilized and nonsterilized, subgroups. The files were tested using a custom-made artificial canal. The number of cycles to fracture (NCF) was calculated.

Statistical Analysis Used

One-way analysis of variance, post hoc Tukey's test, and independent t-test were used.

Results

In nonsterilized instruments, the NCF of the EdgeFile X7 group was significantly higher than that in the other groups (P < 0.05). In sterilized instruments, there was a nonsignificant difference in NCF between EdgeFile X7 and F-One files (P > 0.05). The NCF of 2Shape was significantly lower than other files (P ≤ 0.05) in sterilized and nonsterilized groups. The autoclaving significantly decreased (P ≤ 0.05) the cyclic fatigue resistance of the tested files.

Conclusions

EdgeFile X7 was the most fatigue resistant. Autoclaving reduced the cyclic fatigue resistance of the tested files.

Nitinol Type Alloys General Characteristics and Applications in Endodontics

A very extensive literature review presents the possibilities and needs of using, in endodontics, the alloys commonly known as nitinol. Nitinol, as the most modern group of engineering materials used to develop root canals, is equilibrium nickel and titanium alloys in terms of the elements’ atomic concentration, or very similar. The main audience of this paper is engineers, tool designers and manufacturers, PhD students, and students of materials and manufacturing engineering but this article can also certainly be used by dentists. The paper aims to present a full material science characterization of the structure and properties of nitinol alloys and to discuss all structural phenomena that determine the performance properties of these alloys, including those applied to manufacture the endodontic tools. The paper presents the selection of these alloys’ chemical composition and processing conditions and their importance in the endodontic treatment of teeth. The results of laboratory studies on the analysis of changes during the sterilization of endodontic instruments made of nitinol alloys are also included. The summary of all the literature analyses is an SWOT analysis of strengths, weaknesses, opportunities, and threats, and is a forecast of the development strategy of this material in a specific application such as endodontics.

Effect of autoclaving on the cyclic fatigue resistance of nickel-titanium rotary instruments: An in vitro study

Aim:

The aim of the study is to determine the effect of autoclaving on the cyclic fatigue resistance (CFR) in respect to three different rotary nickel-titanium (NiTi) systems.

Methods:

Three rotary NiTi files with different manufacturing process were selected and arranged into three groups. Group 1: Neolix Neoniti files (n = 15), Group 2: Edge Files (n = 15), Group 3: NeoendoFlex files (n = 15). Each group was then subdivided into three subgroups containing 5 samples each based on the number of cycles of autoclaving (0, 1, 5 cycles). The instruments were subjected to autoclave without usage. The files of size 25, taper 6%, and 25 mm length were taken. After the autoclaving cycles, the files were rotated in cyclic fatigue testing device with simulated canal curvature of 60° until file separation. Time taken for the instrument separation (in minutes) was multiplied by the number of rotations per minute to attain the mean number of cycles to failure for every file. The obtained results were subjected to statistical analysis using two-way ANOVA and Newman–Keuls multiple post hoc procedures.

Results:

Neolix Neoniti files exhibited the maximum CFR (98.80) than EdgeFiles (80.47) and Neoendo Flex files (41.80) (P = 0.0001). Reduction in CFR was observed with increase in the number of cycles of autoclaving (i.e., 0, 1, 5 cycles).

Conclusion:

Autoclaving has a negative influence on the CFR of the rotary NiTi files used. Neolix Neoniti files exhibited greater CFR than EdgeFiles and Neoendo Flex files.