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Aim: The aim of the present study was to compare the shaping ability of two different nickel-titanium rotary files in the curved root canals of extracted human molar teeth., Methods: Thirty root canals of 17 extracted human molars teeth were randomly assigned to two experimental groups (n = 15): ProTaper Next and ProTaper Universal (PTU), on the basis of the rotary files system used. The final size of all apical foramina was 0.25 mm in diameter. Standardized digital radiographs were taken before and after instrumentation in both clinical and proximal views, with a size 10 K-file inserted into the canal for the determination of the angle of curvature and apical transportation. Preparation time and fractured or deformed instruments were also recorded. The unpaired Student's t-test was used to compare results., Results: There was no significant difference between the two instruments with respect to canal straightening and apical transportation before and after instrumentation (P > 0.05). The use of both instruments resulted in a significant reduction in the angle of curvature after instrumentation (P < 0.05). Instrumentation time was significantly greater for PTU (P < 0.05)., Conclusions: The ProTaper Universal and ProTaper Next systems performed similarly with regard to the straightening of curved root canals and apical transportation. ProTaper Next was significantly faster than ProTaper Universal., (© 2015 Wiley Publishing Asia Pty Ltd.)

Unlabelled: Establishing the working length is an important step in endodontic treatment as inaccurate length determination may lead to failure. There is an ongoing debate regarding the extent of the apical limit of root canal preparation. This controversy is based upon different clinical opinions concerning the distance between the end point of the root canal preparation and the periodontal tissues. In this paper, we review the different schools of thought for working length determination, and how apex locators work and how they must be used for optimal accuracy. The reliability of these devices has been proven; the price is moderate and apex locators are now part of the basic armamentarium in the achievement of quality and predictable endodontic treatment., Clinical Relevance: The technique of determining the working length from a single radiograph remains empirical, and apex locators should be considered an essential aid in establishing working length.

We proposed a new testing setup and in vitro experimental procedure allowing the analysis of the forces, torque, and file displacements during the preparation of root canals using nickel-titanium rotary endodontic files. We applied it to the preparation of 20 fresh frozen cadaveric teeth using ProTaper files (Dentsply Maillefer, Ballaigues, Switzerland), according to a clinically used sequence. During the preparations, a clinical hand motion was performed by an endodontist, and we measured the applied torque around the file axis and also the involved three-dimensional forces and 3-dimensional file displacements. Such a biomechanical procedure is useful to better understand the working conditions of the files in terms of loads and displacements. It could be used to analyze the effects of various mechanical and geometric parameters on the files' behavior and to get data for modelling purposes. Finally, it could contribute to studies aiming to improve files design in order to reduce the risks of file fractures.

Unlabelled: The fracture of an instrument is a recognized complication in endodontics. The immediate response to a fractured instrument is frequently to regard the treatment as a failure. Several factors must, however, be taken into account to evaluate the prognosis of the tooth in this situation. The objective of the endodontic treatment with or without a fractured instrument remains the same, namely to disinfect the root canal system and prevent its recontamination. The time at which file fracture occurred during treatment and the degree of canal infection should be considered when determining the potential effect of instrument fracture on treatment outcome. Patients must be informed about an instrument fracturing in their tooth for ethical and legal reasons. The aim of this paper is to attempt to place fractured instruments in context, not to provide an in depth description of fractured instrument management techniques., Clinical Relevance: To understand the influence of fractured instruments on prognosis in endodontics.

Unlabelled: Crown down preparation is the most known and described technique since the introduction of Nickel Titanium (NiTi) rotary instruments in endodontics. This technique gives good results but has limitations, such as not addressing the initial anatomy of oval or dumb-bell shaped canals. The specific design of the Protaper instruments allows use of them with a different technique and, specifically, with a brushing motion in the body of the canal. The recent introduction of hand Protaper files has expanded the range of application of this system, especially in curved canals. The 'hybrid technique', using rotary and hand files, and the advantages of the combination of both instruments, are clearly described in this article. Used with this technique, the Protaper is a very safe system to use, and more controllable, for both inexperienced and experienced practitioners alike, than other systems., Clinical Relevance: To understand the precautions needed with rotary files, and how to use them to preserve the anatomy of the canal and get a tapered shaping, even in severely curved canals.

In recent years, an important innovation in the field of dentistry has been the introduction of nickel-titanium alloy instruments. Superelasticity and shape memory are the main mechanical properties of this alloy which prompted its use in endodontics. Due to these characteristics, NiTi instruments have been demonstrated to preserve the original anatomy, the shape and position in space of the apical foramen. This literature review of mechanical properties of NiTi endodontic instruments aims to provide clinicians with a better understanding of their advantages and limits.