Search

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., (© 2024 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

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., (Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

New files (ProTaper Next/HyFlex/OneShape) are made from novel nickel-titanium (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)., (© 2014 Australian Society of Endodontology.)

Introduction: The purpose of this study was to compare the torsional resistance, flexibility, and surface microhardness of ProTaper Next files (PTN) with Twisted Files (TF) and RaCe (RC)., Methods: A metal block with a cubical hole was used to evaluate the torsional resistance. Five millimeters of the tip of each file was securely held in place by filling the mold with a resin composite, and the files were driven clockwise at 300 rpm. The number of load applications before fracture was recorded for each file. A scanning electron microscope was used to characterize the topographic features of the fracture surfaces of the broken files. The files were tested for bending resistance by using cantilever-bending test. Vickers microhardness was measured on the cross section of instruments with 300-g load and 15-second dwell time. Torsional resistance data were analyzed by using the nonparametric Kruskal-Wallis and Mann-Whitney U tests. Bending resistance and microhardness data were analyzed by using analysis of variance and Tukey tests., Results: PTN showed the highest torsional resistance and microhardness, followed by RC (P < .05). The fracture cross sections of all brands showed dimpling near the center of fracture surface. The ranking in the bending resistance values was as follows: RC > PTN > TF., Conclusions: PTN improved its resistance to torsional stresses and wear compared with TF and RC. TF showed improved flexibility compared with other tested brands., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

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., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

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., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

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 © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The maximum removal of root canal filling material is essential for successful endodontic retreatment. The purpose of this study was to assess the efficacy of 2 reciprocating systems (Reciproc [VDW, Munich, Germany] and WaveOne [Dentsply Maillefer, Ballaigues, Switzerland]) compared with a nickel-titanium (NiTi) rotary system (ProTaper Universal Retreatment [Dentsply Maillefer]) in the removal of root canal filling material., Methods: Sixty root canals of extracted human maxillary incisors were prepared using the NiTi ProTaper rotary system with the complementary use of a #40 K-type file and then obturated. The specimens were divided into 3 groups (n = 20) according to the system used for filling removal: group 1: instrument R25 of the Reciproc system, group 2: primary instrument of the WaveOne system, and group 3: NiTi rotary instruments of the ProTaper Universal Retreatment system. The teeth were cleaved longitudinally and photographed under a dental operating microscope with 5 × magnification. Images were transferred to a computer, and residual filling material was quantified using Image Tool software (University of Texas Health Science Center, San Antonio, TX). Results were compared using 1-way analysis of variance (P < .05)., Results: All teeth examined had filling remnants within the canal. No statistically significant difference (P > .05) in residual filling material was observed among the groups, with 4.30% in group 1, 2.98% in group 2, and 3.14% in group 3., Conclusions: The Reciproc and WaveOne reciprocating systems were as effective as the ProTaper Universal retreatment system for gutta-percha and sealer removal., (Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background: Effective endodontic instrumentation aims to remove microorganisms, debris, and tissue from the root canal while maintaining dentinal integrity. This study compares dentinal defect incidence following canal preparation with different hand files, nickel-titanium rotary files, and reciprocating files. Materials and Methods: Eighty single-rooted mandibular premolars with mature apices were collected. Four groups (n = 20) were established based on canal patency establishment, canal preparation technique, irrigation solution, and final irrigation. After root sectioning at 3 mm, 6 mm, and 9 mm from the apex, slices were examined under a stereomicroscope, and dentinal defects were recorded. A second examiner reviewed the images. Results: The results showed significant difference of P = 0.031 among Hand files vs. Rotary ProTaper files: In Hand files vs. Reciprocating WaveOne files significant difference was P = 0.048, and for rotary ProTaper files vs. Reciprocating WaveOne files: No significant difference (P = 0.643). Dentinal defect counts were similar at 3 mm, 6 mm, and 9 mm. Statistically significant variation was observed between hand files and rotary files, as well as hand files and reciprocating files. Conclusion: Both rotary and reciprocating files showed a statistically significant increase in dentinal defect incidence compared to hand files. However, clinical implications should be considered cautiously. Instrumentation technique selection should be based on clinical context, operator experience, and patient factors. Further clinical studies are needed for validation.

Background: Effective endodontic instrumentation aims to remove microorganisms, debris, and tissue from the root canal while maintaining dentinal integrity. This study compares dentinal defect incidence following canal preparation with different hand files, nickel-titanium rotary files, and reciprocating files. Materials and Methods: Eighty single-rooted mandibular premolars with mature apices were collected. Four groups (n = 20) were established based on canal patency establishment, canal preparation technique, irrigation solution, and final irrigation. After root sectioning at 3 mm, 6 mm, and 9 mm from the apex, slices were examined under a stereomicroscope, and dentinal defects were recorded. A second examiner reviewed the images. Results: The results showed significant difference of P = 0.031 among Hand files vs. Rotary ProTaper files: In Hand files vs. Reciprocating WaveOne files significant difference was P = 0.048, and for rotary ProTaper files vs. Reciprocating WaveOne files: No significant difference (P = 0.643). Dentinal defect counts were similar at 3 mm, 6 mm, and 9 mm. Statistically significant variation was observed between hand files and rotary files, as well as hand files and reciprocating files. Conclusion: Both rotary and reciprocating files showed a statistically significant increase in dentinal defect incidence compared to hand files. However, clinical implications should be considered cautiously. Instrumentation technique selection should be based on clinical context, operator experience, and patient factors. Further clinical studies are needed for validation. [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]

In modern dentistry, reliable endodontic treatment is increasingly important. Many procedures have been developed in recent years in order to improve the treatment possibilities. For instance, the laser-supported disinfection of root dentin has brought a major advance. Whatever technique is applied for infection control and the achievement of a tight root canal seal, the indispensable basis for successful endodontic treatment is a dependable root canal preparation. In general, root canal preparation means accessing the root canal system and performing shaping and cleaning of the canals. Nowadays, it is recommended to shape and clean with a combination of chemical and mechanical methods. Another important part is the disinfection protocol using various irrigations, medication, and ultrasonic or laser devices. To use these methods, it is necessary to obtain access to the root canal system and perform a mechanical root canal enlargement. This article presents the preparation of an ideal access cavity and the general working principle of mechanical root canal treatment with nickel-titanium instruments and the crown-down technique. Finally, guidelines for safe working conditions with the presented technique are given. [ABSTRACT FROM AUTHOR]