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Numerous systematic reviews (SRs) have produced conflicting findings on engine‐driven nickel–titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health‐related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high‐quality evidence, future well‐designed studies and reviews considering core outcome measures are needed. [ABSTRACT FROM AUTHOR]

This study evaluated surface wear and resistance to fracture of reciprocating and novel rotary instruments after use in curved canals. Twenty new instruments (n = 5/each group): Reciproc Blue, WaveOne Gold, XP‐endo Shaper (XPS) and TruNatomy were used twice for the instrumentation of simulated curved canals in plastic blocks. The instrumentation was performed according to the manufacturer's instructions at body temperature. Surface roughness was evaluated, using a profilometer, before instrumentation and twice after the instrumentation. Instruments were, then, subjected to a cyclic fatigue test to evaluate the time to failure. Differences were assessed using ANOVA and post hoc tests (α = 0.05). The XPS instruments showed significantly higher values of roughness compared with TruNatomy at every stage, especially after the second use (p < 0.008). Reciprocating instruments showed superior cyclic fatigue resistance compared with novel rotary instruments (p < 0.05). TruNatomy showed minimal surface roughness, and XPS exhibited significantly higher surface roughness. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To evaluate the resistance to cyclic fatigue of ProTaper Next (PTN; Dentsply Sirona, Ballaigues, Switzerland), Revo‐S (Micro‐Mega, Besançon, France), Mtwo (Sweden & Martina, Padova, Italy), Twisted Files (TF, SybronEndo, Orange, CA, USA) and EndoWave (J Morita Corporation, Osaka, Japan) used in continuous rotation or in reciprocation of Optimum Torque Reverse motion (OTR). Methodology: A total of 120 nickel‐titanium files were tested. Twenty‐four instruments for each brand were divided into two groups (n = 12) on the basis of the motion tested: continuous rotation (Group 1) or reciprocation of OTR motion (Group 2). Resistance to cyclic fatigue was determined by recording time to fracture (TtF) in a stainless steel artificial canal with a 60° angle of curvature and 5 mm radius of curvature. The TtF data were analysed by using two‐way analysis of variance ( anova) and Bonferroni's post hoc tests at 0.05. Results: Mtwo and TF had significantly higher TtF when compared with all other instruments, both in continuous rotation and in reciprocation of OTR motion (P < 0.0001 and P < 0.05, respectively). No difference was observed between Mtwo and TF (P > 0.05), in both motions. PTN was associated with higher cyclic fatigue resistance than Revo‐S and EndoWave, both in continuous rotation and in reciprocation of OTR motions (P < 0.0001). No difference was observed between Revo‐S and EndoWave, in both motions (P > 0.05). Reciprocating OTR motion improved TtF of all instruments (P < 0.0001). Conclusions: Reciprocation of OTR motion improved significantly cyclic fatigue resistance of all instruments tested compared with continuous rotation. Mtwo and TF had significantly higher cyclic fatigue than the other instruments, in both continuous rotation and reciprocation of OTR motion. [ABSTRACT FROM AUTHOR]

Introduction The aims of this study were to determine the flexibility of ProFile Vortex (VX) and Vortex Blue (VB) files (Dentsply Tulsa Dental Specialties, Tulsa, OK) and then to evaluate and compare their fatigue resistance in artificial single curvature and 2 different artificial double curvature canals. Methods Flexibility of the files (size 25/.04) in bending was assessed according to ISO 3630-1. Both files were subjected to fatigue tests inside artificial canals with a single curvature (group 1: 60° curvature, 5-mm radius) and with 2 different double curvatures (group 2: first [coronal] curve of 60° curvature and 5-mm radius and the second one [apical] of 30° curvature and 2-mm radius and group 3: first curve of 60° curvature and 5-mm radius and the second one of 60° curvature and 2-mm radius). The number of cycles to fracture (NCF) was recorded, and the fracture surface of all fragments was examined with a scanning electron microscope. Results The bending load was significantly lower for VB files than VX files ( P < .05), and the 2 types of files followed different trajectories in identical canals. In group 1, the 2 files had significantly higher NCF than in groups 2 and 3 ( P < .05). Both files had significantly higher NCF in group 2 than in group 3 ( P < .05). In group 1, VB files had fatigue resistance superior to VX files ( P < .05), whereas in groups 2 and 3 their fatigue resistance was not statistically different from each other. The crack initiation of a vast majority of files that fractured in double curvature canals (groups 2 and 3) was localized on either 1 of 2 of the 3 cutting edges. Conclusions Double curvature canals represent a much more stressful and challenging anatomy than single curvature canals, and, in them, fatigue resistance may be affected by the degrees and the radii of curvatures as well as by the bending properties of the files. [ABSTRACT FROM AUTHOR]

New files (ProTaper Next/HyFlex/OneShape) are made from novel nickeltitanium (NiTi) alloys/treatments. The purpose of this study was to compare the cyclic fatigue resistance of these new instruments with that of Revo-S instruments. Four groups of 20 NiTi endodontic instruments were tested in steel canals with a 3 mm radius and a 60° angle of curvature. The cyclic fatigue of the following NiTi instruments with a tip size 25 and 0.06 taper that were manufactured with different alloys was tested: ProTaper Next X2 (M-Wire), OneShape (conventional NiTi), Revo-S Shaping Universal (conventional NiTi) and HyFlex 25/0.6 (controlled memory NiTi wire). A one-way ANOVA and post-hoc Tukey's test (α = 0.05) revealed that the HyFlex files had the highest fatigue resistance and the Revo-S had the least fatigue resistance among the groups (P < 0.001). [ABSTRACT FROM AUTHOR]

Aim To compare the cyclic fatigue resistance of Pro- Taper Next files (PTN; Dentsply Maillefer, Ballaigues, Switzerland) with Twisted Files (TF; SybronEndo, Orange, CA, USA), HyFlex CM (HF; ColténeEndo/ Whaledent, Inc, Cuyahoga Falls, OH, USA) and Pro- Taper Universal (PT; Dentsply Maillefer). Methodology Size 25, .06 taper for PTN X2, TF, HF and PT F1 size 20, .07 taper were rotated in simulated canals until failure, and the number of cycles to failure (NCF) was recorded to evaluate their cyclic fatigue resistance. A scanning electron microscope was used to characterize the topographic features of the fracture surfaces of broken files. The data of the NCF and fragment length values were analysed statistically using one-way analysis of variance and Tukey post hoc tests. Statistical significance level was set at P < 0.05. Results Twisted Files had a significantly higher resistance to cyclic fatigue than the other instruments (P < 0.05). No significant difference was found in NCF between PTN and HF (P > 0.05); however, there was a significant difference (P < 0.05) of both these systems with PT, which exhibited the lowest mean NCF. The ranking in the NCF values was: TF > PTN > HF > PT. The fracture cross-sections of all brands revealed similar fractographic features, including crack origins, fatigue zone and an overload fast fracture zone. Conclusions The new ProTaper Next had greater resistance to cyclic fatigue compared with ProTaper and HyFlex CM but not the Twisted Files. [ABSTRACT FROM AUTHOR]

Introduction This study investigated the surface, fractured structure, and physicochemical properties related to cyclic fatigue in various nickel-titanium (NiTi) files. Methods Among a total of 10 groups of NiTi files, conventional NiTi files (ProFile [Dentsply Maillefer, Ballaigues, Switzerland] and K3 [SybronEndo, Orange, CA]) and new-generation NiTi files (ProFile Vortex [PV; Tulsa Dental Specialties, Tulsa, OK], Vortex Blue [VB; Tulsa Dental Specialties], and K3 XF [XF; SybronEndo, Orange, CA]) with the same tip diameter (ISO size 25) and 2 types of taper (0.04 and 0.06) were used in this study. Scanning electron microscopy of the file surface structure, differential scanning calorimetry, and cyclic fatigue resistance tests were conducted. Results Many mechanical grooves were recognized on the file surface. The surface in the ProFile group was extremely smooth compared with that observed for the other files. Many shallow hollows besides mechanical grooves were noted on the surface in the XF group. A smooth curve was observed in the ProFile, K3, and PV groups. Defined peaks in differential scanning calorimetry were observed in the VB and XF groups. The 0.04 taper files exhibited a statistically higher number of cycles to fracture than the 0.06 taper files in all groups ( P < .05). Cracks along the mechanical grooves were observed in the NiTi files, with the exception of the XF group. The start of cracking was detected at U-shape sites in the ProFile group, the cutting edge in the PV and VB groups, and radial islands in the K3 and XF groups. Conclusions The present findings suggest that new-generation NiTi files are not necessarily improved compared with conventional files. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to compare the cyclic fatigue resistance of coronal flaring instruments. Methods Three groups of nickel-titanium (NiTi) endodontic coronal flaring instruments were tested in steel canals with a 3-mm curvature radius and 60° (n = 18) and 45° of curvature (n = 18). The cyclic fatigue of the following NiTi instruments was tested: ProTaper Sx (Dentsply Maillefer, Ballaigues, Switzerland), HyFlex 25.08 (Coltene-Whaledent, Allstetten, Switzerland), and Revo-S SC1 (Micro-Mega, Besancon, France). The length and diameter of the fractured fragment and the total area of the fractured surface of each instrument were measured. The data were then statistically analyzed using a 1-way analysis of variance and the post hoc Tukey test (α = .05). Results At the 60° of curvature, Revo-S had the highest fatigue resistance, HyFlex had the second highest fatigue resistance, and ProTaper Universal had the least fatigue resistance. At the 45° of curvature, the Revo-S and HyFlex showed superior cyclic fatigue resistance compared with the ProTaper. The length of the fracture fragment of the ProTaper instrument was longer than that of the other groups at the 60° of curvature. At the 45° of curvature, the length of the fracture fragment of the ProTaper and HyFlex instruments was longer than that of Revo-S. The mean diameter and surface area of the HyFlex instruments in the fractured part was higher than that of other groups at both angles of curvature. Conclusions The Revo-S SC1 and HyFlex 25.08 instruments showed better cyclic fatigue resistance than the ProTaper Sx instrument. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The purpose of this study was to evaluate and compare the cyclic fatigue resistance of RaCe (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and Mtwo (VDW, Munich, Germany) rotary files in continuous rotation and reciprocating motion. Methods: A total of 60 new rotary Mtwo and RaCe files (ISO size = 25, taper = 0.06, length = 25 mm) were selected and randomly divided into 4 groups (n = 15 each): Mtc (Mtwo NiTi files in continuous rotation), Rc (RaCe NiTi files in continuous rotation), Mtr (Mtwo NiTi files in reciprocating motion), and Rr (RaCe NiTi files in reciprocating motion). A cyclic fatigue testing device was fabricated with a 60° angle of curvature and a 5-mm radius. All instruments were rotated or reciprocated until fracture occurred. The time taken for each instrument to fracture and the length of the broken fragments were recorded. All the fractured files were analyzed under a scanning electron microscope to detect the mode of fracture. The Kolmogorov-Smirnov test was used to assess the normality of samples distribution, and statistical analysis was performed using the independent sample t test. Results: The time taken for the instruments of the Mtr and Rr groups to fail under cyclic loading was significantly longer compared with the Mtc and Rc groups (P < .001). Scanning electron microscopic observations showed that the instruments of all groups had undergone a ductile mode of fracture. The length of the fractured segments was between 5 and 6 mm, which was not statistically significant among the experimental groups. Conclusions: Mtwo and RaCe rotary instruments showed a significantly higher cyclic fatigue resistance in reciprocating motion compared with continuous rotation motion. [Copyright &y& Elsevier]

Introduction In recent years, with the advances in counterfeiting methods, counterfeit products have reached the dental market. The purpose of this study was to compare the cyclic fatigue resistance of original and counterfeit rotary root canal instruments. Materials and methods The cyclic fatigue of original and counterfeit ProTaper F2 endodontic instruments was tested (n = 20) in 3 mm radius steel canals with a 60° angle of curvature. The number of cycles to fracture (NCF) was calculated, and the data were subjected to the Student's t-test (α = 0.05). Results The original instruments showed better cyclic fatigue resistance than the counterfeit ones (p < .001). The mean NCF was 483 ± 84 for the original files and 186 ± 86 for the counterfeit files. Conclusions The cyclic fatigue resistance of the counterfeit instruments was very low. As a result, clinicians should be careful not to purchase counterfeit products. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this in vitro study was to compare the torsional stress and cyclic fatigue characteristics of ProFile GT (Dentsply Tulsa Dental, Tulsa, OK) and ProFile GT Series X (Dentsply Tulsa Dental). Files of 0.04 and 0.06 taper, 25 mm in length, and ISO sizes of 20 and 30 tips were compared (n = 25 per test group). Torque stress resistance was evaluated by measuring the torque in gram-centimeters (g-cm) and angle of deflection (degrees of rotation) required for instrument separation with use of a torsiometer instrument. Cyclic fatigue was determined by recording the time until breakage of a file rotating in a simulated canal with an applied 45° or 60° curve. The files were operated in a cyclic fatigue instrument that simulated clinical rotary file usage with a constant cyclical axial motion. There was no statistical difference (p > 0.05) when comparing the torque (g-cm) required to induce a torsional failure of ProFile GT and ProFile GT Series X files of identical file sizes. The angle of deflection (degrees of rotation) of ProFile GT was significantly greater (p ≤ 0.001) before separation than ProFile GT Series X for all file sizes tested except 20/.04 (p > 0.05). There was no statistical difference (p > 0.05) in cyclic fatigue failure for ProFile GT and ProFile GT Series X in a canal with a curvature of 45°. In the 60° canal curvature, ProFile GT was found to be significantly more resistant (p = 0.005) to fracture because of cyclic fatigue than ProFile GT Series X for file size 30/.06 and significant (p ≤ 0.001) for files sizes 20/.06 and 30/.04. There was no difference (p > 0.05) in cyclic fatigue resistance in the 60° canal for ProFile GT and ProFile GT Series X for file size 20/.04. [Copyright &y& Elsevier]

Abstract: Introduction: A new nickel-titanium (NiTi) rotary file called the ProFile Vortex (PV; Denstply, Tulsa Dental Specialties, Tulsa, OK) has recently been released for endodontic use. The purpose of this study was to compare cyclic fatigue resistance of the new size 30 PV files with size 30 files of other popular brands. Other files tested include Twisted File (TF; Sybron Dental Specialties, Orange, CA), ProFile (PF; Denstply Tulsa Dental Specialties, Tulsa, OK), GTX (GTX, Denstply Tulsa Dental Specialties), and EndoSequence (ES; Brasseler, Savannah, GA). Methods: Size 30 files with a constant .06-mm/mm taper were rotated at manufacturer-recommended speed and torque settings in a simulated canal until failure. Results: Significant differences were found between the various brands of files. The differences between file brands may be because of a different manufacturing process or differences in file design. Conclusions: Based on a simulated canal model, the PV, TF, and GTX files appear to offer greater cyclic fatigue resistance than ES and PF files. [Copyright &y& Elsevier]