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The effectiveness of root canal treatments with different file systems in primary teeth is important in terms of clinical practice and the use of file systems that work with different principles in primary tooth pulpectomy is becoming widespread. The amount of remaining dentin in the coronal region of the root is important in terms of the prognosis of the tooth and the long-term success of the treatment in teeth that have undergone root canal treatment. The aim of this study was to evaluate the remaining dentin volume in the coronal part of the root after the use of rotary, reciprocating, and conventional hand files in primary tooth pulpectomy. A total of 30 primary molars were divided into three groups. In each group, the preparations were made with three different file types: WaveOne Gold, which works with reciprocating motion; TruNatomy, which works with rotational motion; and conventional hand files. The three-dimensional images were evaluated for remaining dentin volume in the 2-mm coronal part of the root. Group means were compared using one-way analysis of variance, and post hoc analyses were performed with the Tukey test. There was no statistically significant difference between the groups in terms of preoperative and postoperative dentin volume (P > 0.05). The mean difference after preparation was observed the most in the WaveOne Gold group and the least in the TruNatomy group. When the mean percentage differences were evaluated, it was observed that statistically significantly more dentin volume was preserved after the preparation with TruNatomy than with WaveOne Gold (P = 0.021). In primary tooth pulpectomy, file systems working with rotational motion can be preferred over file systems working with reciprocating motion in preserving the amount of dentin in the 2-mm coronal part of the root. [ABSTRACT FROM AUTHOR]

Objective Pediatric endodontics has become popular due to advancements in cleaning, shaping, and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular canine using nano-computed tomography (nano-CT). This study aims to evaluate the efficacy of rotary file systems (Kedo S plus, Kedo SG blue) against traditional hand files in root canal preparation of primary mandibular canines using nano-CT. Materials and Methods This in vitro study was performed in extracted primary mandibular canine based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the preoperative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo S plus, Kedo SG blue, and hand K-files. A postoperative scan was performed similar to preoperative scan. Image reconstruction was performed with NRecon software for three-dimensional volumetric visualization and analysis of the root canals. Results Kedo S plus displayed significant alterations in volumetric, surface area, and instrumented areas postpreparation compared with Kedo SG blue and hand files. Statistical analysis revealed significant differences in volumetric and surface changes between Kedo S plus and hand files. Conclusion Rotary file systems, especially Kedo S plus, resulted in increased canal volume and surface area with minimal uninstrumented areas, showing promise for primary dentition root canal preparations. Further clinical assessments are warranted to validate these findings. [ABSTRACT FROM AUTHOR]

Background/purpose: The effectiveness of root canal treatments with different file systems in primary teeth is important in terms of clinical practice and the use of file systems that work with different principles in primary tooth pulpectomy is becoming widespread. The amount of remaining dentin in the coronal region of the root is important in terms of the prognosis of the tooth and the long-term success of the treatment in teeth that have undergone root canal treatment. The aim of this study was to evaluate the remaining dentin volume in the coronal part of the root after the use of rotary, reciprocating, and conventional hand files in primary tooth pulpectomy. Materials and methods: A total of 30 primary molars were divided into three groups. In each group, the preparations were made with three different file types: WaveOne Gold, which works with reciprocating motion; TruNatomy, which works with rotational motion; and conventional hand files. The three-dimensional images were evaluated for remaining dentin volume in the 2-mm coronal part of the root. Group means were compared using one-way analysis of variance, and post hoc analyses were performed with the Tukey test. Results: There was no statistically significant difference between the groups in terms of preoperative and postoperative dentin volume (P > 0.05). The mean difference after preparation was observed the most in the WaveOne Gold group and the least in the TruNatomy group. When the mean percentage differences were evaluated, it was observed that statistically significantly more dentin volume was preserved after the preparation with TruNatomy than with WaveOne Gold (P = 0.021). Conclusion: In primary tooth pulpectomy, file systems working with rotational motion can be preferred over file systems working with reciprocating motion in preserving the amount of dentin in the 2-mm coronal part of the root.

Objective: The aim of this in vitro study was to assess the stress distribution of novel endodontic rotary files of different cross sections and metallurgy against the root canal wall at three different levels by using finite element analysis. Methods: A total of 60 novel NiTi rotary files were included in this study after being scanned for any surface deformities using a scanning electron microscope. The scanned files were assigned into 4 groups of 15 samples each based on their metallurgy and design: Group A-TruNatomy, Group B-XP-endo Shaper, Group C-F360, and Group D-2shape files. ANSYS® 15 Workbench finite element software (Canonsburg, Pennsylvania, United States) was used to numerically analyse the stress created by computer-aided models of these instruments on the dentinal wall of a simulated root canal to test the mechanical behaviour of these files. All data were analysed using one-way ANOVA with post hoc Tukey analysis, the Shapiro Wilk test, and Levene's test. The significance level was set at 5%. Results: XP-endo Shaper files employed minimal stress on the surface of dentine during instrumentation, and F360 files exerted maximum stress on the dentinal wall. However, no statistically significant difference was found among the groups in relation to the amount of stress produced at the distinct levels of the root canal wall (p>0.05). Conclusion: There was no discernible difference in stress generation among the four groups in the current investigation. Therefore, it can be inferred that the upgrade in design and metallurgy of rotary files has the potential to downgrade the stress during the shaping of the canal and the menace of instrument breakage during their clinical usage. [ABSTRACT FROM AUTHOR]

Introduction: In contemporary dentistry, nickel–titanium (NiTi) rotary instrumentation is the standard of care. General dental practitioners (GDPs) should acquire and adopt rotary root canal instrumentation in their practices. Therefore, this study aimed to investigate the application of rotary root canal instrumentation among GDPs in the Qassim region of Saudi Arabia. Materials and Methods: This cross-sectional survey was conducted in the Qassim region of Saudi Arabia. An online survey was sent to GDPs registered in the Qassim region through the Saudi Dental Society contact list. It consisted of 15 questions about gender, demographics, sector, and the extent of rotary root canal instrumentation adoption in their daily practices. The Chi-square test was used to compare the frequency responses between the groups. Fisher’s exact test was used when the expected outcome was

Objective: This study aimed to examine the shaping ability of six rotary and reciprocating file systems, as well as hybrid techniques in simulated S-shaped root canals. Methods: A hundred and twenty S-shaped radiopaque thermosetting epoxy resin blocks were grouped according to the system used for biomechanical preparation. Six groups of 15 canals each were prepared using TruNatomy, Procodile, VDW Rotate, Hyflex CM, OneCurve, and WaveOne Gold, respectively. Two additional hybrid (Procodile/Hyflex CM and Procodile/TruNatomy) groups (n=15 each) were added after evaluating the results of individual systems. All canals were enlarged to 0.25 mm apically. Canal transportation, centering ability, diameter increase, and iatrogenic errors were assessed by superimposed pre-operative and post-operative images. AutoCAD was used for data analysis. All groups were statistically compared with analysis of variance and Tukey honest significant difference test (p<0.05). Results: Hyflex CM resulted in the most conservative diameter increase in all thirds (coronal, middle, and apical; p<0.001). Procodile showed the best (p<0.001) centering ability in the coronal and middle thirds, while TruNatomy resulted in the least canal transportation and most centering preparation in the apical third (p<0.001). Hybridisation of Procodile and Hyflex CM produced the least canal transportation and best centering ability in the middle third (p<0.001). No instrument breakage occurred, and no ledge, elbow, or apical zip formation was observed during canal preparation. Conclusion: Hybridisation of Procodile and Hyflex CM showed remarkable results in preserving the canal diameter in all thirds and resulted in the least canal transportation and best centering ability in the middle third of the canal. However, when treatment cost and duration limit the clinical applicability of the hybrid technique, clinicians can use a single file system (Hyflex CM or TruNatomy) since it shows satisfactory results in all parameters when compared with a hybrid system. [ABSTRACT FROM AUTHOR]

Aim: The current research set out to examine and contrast the amounts of apically extruded debris produced by two distinct rotary files and hand files used in pulpectomy procedures. Materials and Methods: Forty-five extracted primary mandibular molars were randomly divided into three groups for instrumentation. Prime Pedo™ files are in Group 1, DXL-Pro Pedo files are in Group 2, and H and K files are in Group 3. Debris that had been apically extruded and collected in preweighed Eppendorf tubes was incubated for five days at 70°C. The weight of the Eppendorf tubes before and after instrumentation was subtracted to get the weight of the debris that was gathered. Results: It was noted that all three groups had significantly different amounts of material ejected from the tip. The groups with the lightest amounts of extruded debris were 1, 2, and 3, in that order. The most debris was extruded from the apex in Group 3. Conclusion: This suggests that rotary files are preferable to hand files because they reduce debris extrusion, which in turn reduces postoperative events following pulpectomy procedures.

Aim: The current research set out to examine and contrast the amounts of apically extruded debris produced by two distinct rotary files and hand files used in pulpectomy procedures. Materials and Methods: Forty‑five extracted primary mandibular molars were randomly divided into three groups for instrumentation. Prime Pedo™ files are in Group 1, DXL‑Pro Pedo files are in Group 2, and H and K files are in Group 3. Debris that had been apically extruded and collected in preweighed Eppendorf tubes was incubated for five days at 70°C. The weight of the Eppendorf tubes before and after instrumentation was subtracted to get the weight of the debris that was gathered. Results: It was noted that all three groups had significantly different amounts of material ejected from the tip. The groups with the lightest amounts of extruded debris were 1, 2, and 3, in that order. The most debris was extruded from the apex in Group 3. Conclusion: This suggests that rotary files are preferable to hand files because they reduce debris extrusion, which in turn reduces postoperative events following pulpectomy procedures. [ABSTRACT FROM AUTHOR]

Background and Objective: One of the most important stages of root canal treatment is the correct and complete preparation of the root canal. This study aimed to compare the amount of canal transportation in two nickel titanium files, OneShape and Neolix. Materials and Methods: In this experimental study, 30 extracted mandibular first molar teeth with 25-35-degree curvature were selected for periodontal reasons and randomly divided into two groups (n=15 each). A cone beam computed tomography (CBCT) scan was obtained from the teeth before the intervention. Followingly, the teeth of each group were prepared by the desired file (OneShape and Neolix) according to the manufacturer's instructions. Another CBCT scan was obtained from the teeth at the same angle. The amount of transportation was analyzed from the mesiodistal aspect at two distances of 3 and 9 mm from the apex. The preparation time of each tooth was also recorded by a chronometer. Data were analyzed by independent t-tests (α=0.05). Results: The mean transport at a distance of 3 mm from the apex in the OneShape and Neolix groups was 0.19 and 0.1 mm, respectively. The mean transport at a distance of 9 mm from the apex was 0.2 and 0.1 mm in the OneShape and Neolix groups, respectively. Statistically, there was no significant difference in the amount of transportation between the two groups at the distance of 3 mm (P=0.055) and 9 mm (P=0.39). The mean preparation time was longer in the OneShape group than in the Neolix one; however, it did not show a statistically significant difference (P=0.73). Conclusion: Both Neolix and OneShape files can maintain the curvature of the canal and are suitable for curved canals in terms of shaping ability.

Objective: This study aimed to evaluate the cyclic fatigue resistance (CFR) of three different heat-treated nickel-titanium (NiTi) files in rotary motion utilizing a cyclic fatigue testing device.Methods: Three NiTi rotary systems, Hero Gold, NeoEndo Flex, and T-Pro were used in this study. Ten files from each system (4% taper, #25 size, 21mm length) were tested for CFR. The test was conducted in an artificial canal in a customized cyclic fatigue device. The canal system is comprised of a 60° angle of curvature located 8 mm from the orifice. All files were rotated until fracture at the rotation per minute (RPM) and torque settings according to the manufacturer's recommendation. The time to fracture (TTF) was recorded in seconds for each instrument and then multiplied by (RPM/60) to obtain the number of cycles to fracture (NCF). The fracture length of each instrument fragment was recorded. Data were analyzed by one-way ANOVA and Tukey test and P-value

Irreversible pulpitis and pulp necrosis resulting from severe carious lesions or dental trauma, represent the most frequent clinical diagnoses in the indication of pulpectomies. In the realization of this therapy, pediatric rotary systems are gaining more and more acceptance due to the benefits they provide compared to the classic manual files. The present study has dual purpose: to present to the international scientific community the Endo Kids rotary system and to evaluate its effectiveness in the mechanical instrumentation of temporary teeth, based on the presentation of clinical cases and opinions of users on the advantages and disadvantages of this pediatric file system. According to the results obtained, it is concluded that the rotary file system Endo Kids provides effectiveness for mechanical instrumentation in temporary teeth, even in young children, because thanks to its design characteristics and ease of use, they allow pulpectomies to be performed in a single session and without complications. [ABSTRACT FROM AUTHOR]

Introduction: Rotary nickel-titanium files for root canal therapy have become standard treatment modalities in general practice and specialized dental centers. Undergraduate dental students should receive proper training in using rotary files before graduation. Therefore, this study aimed to provide detailed insight into the implementation of rotary root canal instruments in the clinical training of undergraduate students in Saudi Arabia. Materials and Methods: Two randomly selected private schools and 13 government-owned schools were selected to represent all administrative regions in Saudi Arabia. The SurveyMonkey® questionnaire was sent to each dental school through direct communication. It covered most aspects of the rotary root canal instruments used in the clinical training of undergraduate students before graduation. Results: Approximately 92.9% of the included dental schools reported using rotary files in undergraduate teaching; however, only 57.1% had specific clinical requirements for rotary root canal instrumentation in their curricula. Laboratory simulation sessions were the most commonly used preclinical training methods for rotary instrumentation (85.7%). Most dental schools implemented rotary file training in the 4th and 5th years (53.8% and 38.5%, respectively). The ProTaper® (Universal, Next, Gold) was the most commonly used rotary system. Most dental schools had an instructor-to-student ratio of 1:5. Conclusion: Most Saudi dental schools have adopted rotary files during their undergraduate training. However, the curricula of some dental schools do not include a predetermined number of clinical cases treated with rotary instrumentation to ensure better training for students before graduation. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the cyclic fatigue resistance (CFR) of three different heat-treated nickeltitanium (NiTi) files in rotary motion utilizing a cyclic fatigue testing device. Methods: Three NiTi rotary systems, Hero Gold, NeoEndo Flex, and T-Pro were used in this study. Ten files from each system (4% taper, #25 size, 21mm length) were tested for CFR. The test was conducted in an artificial canal in a customized cyclic fatigue device. The canal system is comprised of a 60° angle of curvature located 8 mm from the orifice. All files were rotated until fracture at the rotation per minute (RPM) and torque settings according to the manufacturer's recommendation. The time to fracture (TTF) was recorded in seconds for each instrument and then multiplied by (RPM/60) to obtain the number of cycles to fracture (NCF). The fracture length of each instrument fragment was recorded. Data were analyzed by one-way ANOVA and Tukey test and P-value <0.05 was considered statistically significant. Results: The NiTi rotary systems demonstrated significantly different TTF values (P=0.001). Hero Gold exhibited a significantly higher TTF (114.13±4.21), followed by NeoEndo Flex (65.24±2.20) and T-Pro (40.50±3.45). The difference in TTF was also significant between NeoEndo Flex and T-Pro groups (P<0.05). There was no statistically significant difference in the length of the fractured fragments between the three groups (P=0.08). Conclusion: The Hero Gold file system demonstrated significantly superior CFR compared to the NeoEndo Flex and T-Pro systems, possibly due to differences in manufacturing processes for different file systems. [ABSTRACT FROM AUTHOR]

The use of file systems that work with different principles in root canal treatment is becoming widespread. The aim of this study was to evaluate the remaining dentine volume in the coronal region of the root and preparation efficiency after the use of conventional hand files, WaveOne Gold; which works with reciprocating motion, and TruNatomy; which works with rotational motion in the root canal treatment of mandibular molar teeth. All canals of permanent mandibular molars (n = 36) were used. Root canals in each group (n = 12) were prepared with conventional hand files, WaveOne Gold, and TruNatomy. The three-dimensional images were evaluated for remaining dentine volume in the coronal two-millimeter region of the root and change in volume of the entire root canal space. There was no statistically significant difference between the groups in terms of mean differences pre and postpreparation (P >.05). The mean differences after preparation were observed the most in the WaveOne Gold group and the least in the TruNatomy group in the coronal two-millimeter region of the root and entire canal volume, but the differences were not significant (P >.05, P >.05, respectively). Conventional hand files, WaveOne Gold working with reciprocating motion, and TruNatomy working with rotational motion, which are the file systems used in the study, are not superior to each other in terms of remaining dentin volume in the coronal two-millimeter region of the root and preparation efficiency in the entire root canal space in mandibular molars. [ABSTRACT FROM AUTHOR]

Aim: To assess the canal transportation and centering ability in the mandibular first molars' curved mesiobuccal canals after instrumentation with file systems XP endo Shaper, self-adjusting File (SAF), Hyflex EDM, Pro Taper NEXT, WaveOne Gold, and K files with the help of Cone-Beam Computed Tomography (CBCT). Materials and Methods: Ninety recently extracted mandibular first molars with mesiobuccal roots that had a 25-30 degree canal curvature were assessed. Following preoperative CBCT scans, teeth were allocated randomly to six experimental groups of fifteen. After preparation with XP endo Shaper, SAF, Hyflex EDM, Pro Taper Next, WaveOne Gold, and K files, post-instrumentation scans were taken using same parameters as pre operative scans. At 3 mm, 6 mm, and 9 mm from the apex, samples were assessed for canal transportation and centering ratio. Results: Apical transportation was least for XP endo Shaper as compared to other groups except SAF and the results were statistically significant. K file showed the highest apical transportation toward the lateral wall of the root canal. XP endo Shaper was better in maintaining centering ability of middle and apical third of canal and SAF was better in maintaining centering ability of coronal third. Conclusion: In root canal preparation, least apical transportation and better centering ability with XP endo Shaper than other file systems compared. K file showed the highest transportation. [ABSTRACT FROM AUTHOR]

It is very important for clinicians to provide restorative treatments that provide durability for endodontically treated teeth. Trauma, occlusal premature contact, and features of teeth are some of the issues that can cause vertical root fractures (VRFs) in root canal-treated teeth. The aim of this 3-D study was to compare stress distribution on mandibular premolar teeth when using a variety of post designs instrumented with different rotary systems. Six mandibular premolar teeth were instrumented with the following tools: ProTaper Next, WaveOne (WO), Reciproc (R), ReciprocBlue (RB), F6-Skytaper, and TF-Adaptive. Teeth were scanned using cone beam computed tomography (CBCT) and the images were transferred to the Catia V5R25 software. Data were recorded in a stereolithography (STL) format. Four different post systems were used, fabricated from metal, fiber, zirconia, and titanium, respectively. Dentin, gutta, post, core, and crown models were added to the solid model. ANSYS V17.2 finite element analysis (FEA) software was used to determine stress distribution on each assembly. Finite analysis models were created that allowed for the calculation of stress distribution of 250-N loading at a 45° angle and vertical in relation to the roots. The maximum principal stress and von Mises values were higher under oblique loading on the roots. The F6-Skytaper and WO systems showed lower stress than other systems. The TF-Adaptive instrument showed higher stress distribution than the other models. Fiber and titanium posts showed lower stress than others. The F6-Skytaper, R, and RB instruments were found to be most effective in terms of displacement of the crown, resulting in the lowest stress values. Fiber and titanium posts showed better results than other post systems, while root canals instrumented with the F6-Skytaper and WO instruments were less likely to result in root fractures. [ABSTRACT FROM AUTHOR]

Introduction: The endodontic preparation depends largely on the file systems that are used in the canal preparations. The amount of the intracanal debris that is extruded from the apex may be influenced by the file systems. Hence, the present in vitro study evaluated the amount the debris that is extruded for the two file systems at different working lengths. Methods: Forty human mesiobuccal canals of the first molars were collected that were extracted for various causes. They were equally divided to four groups of Reciproc (full length), Reciproc (short by 1 mm), WaveOne Gold (full length), and WaveOne Gold (short by 1 mm). Routine crown-down technique was followed for the canal preparation with the intermittent irrigation. The extruded debris was weighed and compared for the significance. Results: The amount of the debris that was extruded weighed similarly in all the four groups with no significant variations. The Reciproc extruded lesser material than the WaveOne Gold. Conclusions: The file systems seem not to affect the debris extrusion irrespective of the files' physical properties. Further studies in a clinical setup are warranted.

Aim: To assess the canal transportation and centering ability in the mandibular first molars' curved mesiobuccal canals after instrumentation with file systems XP endo Shaper, self-adjusting File (SAF), Hyflex EDM, Pro Taper NEXT, WaveOne Gold, and K files with the help of Cone-Beam Computed Tomography (CBCT). Materials and Methods: Ninety recently extracted mandibular first molars with mesiobuccal roots that had a 25-30 degree canal curvature were assessed. Following preoperative CBCT scans, teeth were allocated randomly to six experimental groups of fifteen. After preparation with XP endo Shaper, SAF, Hyflex EDM, Pro Taper Next, WaveOne Gold, and K files, post-instrumentation scans were taken using same parameters as pre operative scans. At 3 mm, 6 mm, and 9 mm from the apex, samples were assessed for canal transportation and centering ratio. Results: Apical transportation was least for XP endo Shaper as compared to other groups except SAF and the results were statistically significant. K file showed the highest apical transportation toward the lateral wall of the root canal. XP endo Shaper was better in maintaining centering ability of middle and apical third of canal and SAF was better in maintaining centering ability of coronal third. Conclusion: In root canal preparation, least apical transportation and better centering ability with XP endo Shaper than other file systems compared. K file showed the highest transportation.

Introduction: Multiple systems are available for chemo-mechanical preparation during pulpectomy, but an evolution of the exclusive paediatric rotary single file system has opened new doors in paediatric endodontics. The aim was primarily to compare the quality of obturation and instrumentation time and secondarily to report pain perception between manual files and rotary file systems in deciduous molars. Materials and Methods: Pulpectomy was performed in 60 carious mandibular primary molars indicated for pulpectomy in children aged 4–8 years after considering the selection criteria. These teeth were divided randomly into three groups of 20 each, wherein canals were prepared using Hand K files in Group 1, HeroShaper Rotary File System in Group 2 and Kedo S Square single paediatric rotary file in Group 3. The quality of obturation was assessed using intraoral radiographs, and instrumentation time was recorded in seconds using a stopwatch. Pain during instrumentation was assessed using Wong Baker's FACES Pain Scale. Collected data were subjected to analysis using the Chi-square test, one-way ANOVA and Honestly Significant Difference post hoc test. Results: Mean instrumentation time was least for the Kedo-S Square file system (57.47 ± 9.26), followed by the HeroShaper group (99.6 ± 23.62), and maximum time was recorded for Hand files (255.99 ± 46.20), and this difference was statistically significant (P = 0.00), whereas there was no significant difference regarding the quality of obturation and pain perception between the three groups. Conclusion: As the Kedo S Square system showed the fastest canal preparation, it can be recommended for pulpectomy procedures in primary teeth because the length of appointment is directly proportional to the behaviour of the child.

Aim: The aim of the present study was to compare postoperative pain in single visit endodontics using heat-treated nickel − titanium file systems (ProTaper Gold, HyFlex EDM, V Taper 2H). Methods: Sixty patients requiring endodontic treatment in vital permanent lower molars with irreversible pulpitis were included in the study. Patients were divided into three groups each containing 20 patients: Group 1 teeth prepared with ProTaper Gold (Dentsply), Group 2 HyFlex EDM (Coltene), and Group 3-V Taper 2H (SS WHITE). Treatment was performed in a single visit. The severity of the postoperative pain was assessed by the Visual Analog Scale after 2, 4, 8, 12, 24, and 48 h. Data were analyzed using the Kruskal–Wallis tests. Results: There was no significant difference in the incidence of postoperative pain among the three groups. There was significant reduction in pain from preoperative till the end of 2 days, irrespective of the file systems used. When compared between the three groups. There was no significant difference in pain scores at different time intervals. When change in pain from preoperative to different time intervals was compared, there was no significant difference between all three groups. V Taper 2H files showed increased pain scores from 4 to 12 h, however, the pain reduced thereafter till 48 h with no significant statistical difference. Conclusion: Results of this in vivo study showed that there was no significant difference in the incidence of postoperative pain among the three groups.

Introduction: Multiple systems are available for chemo-mechanical preparation during pulpectomy, but an evolution of the exclusive paediatric rotary single file system has opened new doors in paediatric endodontics. The aim was primarily to compare the quality of obturation and instrumentation time and secondarily to report pain perception between manual files and rotary file systems in deciduous molars. Materials and Methods: Pulpectomy was performed in 60 carious mandibular primary molars indicated for pulpectomy in children aged 4-8 years after considering the selection criteria. These teeth were divided randomly into three groups of 20 each, wherein canals were prepared using Hand K files in Group 1, HeroShaper Rotary File System in Group 2 and Kedo S Square single paediatric rotary file in Group 3. The quality of obturation was assessed using intraoral radiographs, and instrumentation time was recorded in seconds using a stopwatch. Pain during instrumentation was assessed using Wong Baker's FACES Pain Scale. Collected data were subjected to analysis using the Chi-square test, one-way ANOVA and Honestly Significant Difference post hoc test. Results: Mean instrumentation time was least for the Kedo-S Square file system (57.47 ± 9.26), followed by the HeroShaper group (99.6 ± 23.62), and maximum time was recorded for Hand files (255.99 ± 46.20), and this difference was statistically significant (P = 0.00), whereas there was no significant difference regarding the quality of obturation and pain perception between the three groups. Conclusion: As the Kedo S Square system showed the fastest canal preparation, it can be recommended for pulpectomy procedures in primary teeth because the length of appointment is directly proportional to the behaviour of the child. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to compare postoperative pain in single visit endodontics using heat-treated nickel - titanium file systems (ProTaper Gold, HyFlex EDM, V Taper 2H). Methods: Sixty patients requiring endodontic treatment in vital permanent lower molars with irreversible pulpitis were included in the study. Patients were divided into three groups each containing 20 patients: Group 1 teeth prepared with ProTaper Gold (Dentsply), Group 2 HyFlex EDM (Coltene), and Group 3-V Taper 2H (SS WHITE). Treatment was performed in a single visit. The severity of the postoperative pain was assessed by the Visual Analog Scale after 2, 4, 8, 12, 24, and 48 h. Data were analyzed using the Kruskal-Wallis tests. Results: There was no significant difference in the incidence of postoperative pain among the three groups. There was significant reduction in pain from preoperative till the end of 2 days, irrespective of the file systems used. When compared between the three groups. There was no significant difference in pain scores at different time intervals. When change in pain from preoperative to different time intervals was compared, there was no significant difference between all three groups. V Taper 2H files showed increased pain scores from 4 to 12 h, however, the pain reduced thereafter till 48 h with no significant statistical difference. Conclusion: Results of this in vivo study showed that there was no significant difference in the incidence of postoperative pain among the three groups. [ABSTRACT FROM AUTHOR]

Background. This in vitro investigation aimed to determine the influence of multiple autoclave cycles on the cyclic fatigue resistance of three heat-treated nickel-titanium (NiTi) files: EdgeTaper Platinum (ETP), ProTaper Gold (PTG), and TruNatomy Prime (TN). Materials. Sixty NiTi files, twenty of each NiTi file type: ETP 25/.06, PTG 25/.08, and TN 26/.04 were randomly divided into four equal subgroups (nD5). The files for the control group were left un-autoclaved. Different autoclave sterilization cycles (one, five, and ten) were used for the other three groups. The files were then placed in a metal canal block and rotated according to the manufacturer's instructions until fracture. The length of the broken segment and the time taken for fracture were measured. The fractured surfaces were subsequently subjected to SEM imaging. The Kruskal-Wallis test was used to analyze the data, followed by Dunn-Bonferroni pairwise comparisons. Statistical significance was set at p<0:05. Results. ETP showed significantly greater resistance to cyclic fatigue than TN in all autoclave groups and PTG after five autoclave cycles (p D 0:014). Fatigue resistance was not affected by the number of autoclaving cycles, except for ETP. After the first and tenth autoclaving cycles, they required significantly more rotations to failure than the non-sterilized files (pD0:039 and pD0:021, respectively). The fractured segments of the ETP files in these two groups were also longer than those in the control group (pD0:010). Conclusion. The cyclic fatigue resistance of ETP was greater than that of TN in all tested conditions. Repeated autoclave cycles of sterilization improved the cyclic fatigue resistance of the ETP files only and did not affect the cyclic fatigue resistance of TN and PTG. However, the ETP files separated at a longer distance from the tip with increased autoclaving cycles. [ABSTRACT FROM AUTHOR]

This study aimed to compare the amount of debris extrusion of four endodontic systems made of Nickle‐Titanium alloy. This in vitro study was done on 80 extracted primary molars. They were selected by cone‐beam computed tomography and randomly divided into four groups (n = 20) to be prepared to the apical size of 25 by one of the systems: Reciproc, Protaper Universal, Neolix, or Hyflex CM. Debris was collected into Eppendorf microtubes and placed in an incubator to evaporate the washing solution. Debris was weighed by a digital scale of 0.01 g precision. Data were statistically analysed using SPSS software. Tukey's comparison was used to determine the difference between the four file systems (α = 0.05). Debris extrusion after Reciproc preparation (0.00320) was significantly higher than the other (P < 0.05), with no significant difference having been observed among the other systems (P > 0.05). It can be concluded that all systems under investigation exhibited debris extrusion. [ABSTRACT FROM AUTHOR]

Introduction: To meet the demand of pediatric endodontists, exclusive pediatric rotary file systems have been recently introduced by the manufactures. However, no study has been conducted to compare the clinical efficiency between pediatric rotary file systems. Aim: To determine the clinical efficiency (instrumentation time, obturation time, quality of obturation and postoperative pain) of two pediatric rotary file systems following the root canal preparation of primary molars. Materials and Methods: A total of 75 primary molars requiring pulpectomy were selected from children aged 4 to 7 years. These teeth were divided into three groups of 25 teeth each. In the first, second, and third groups, the cleaning and shaping of the root canals were carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-S pediatric rotary files (Group KS), and, manual nickel-titanium K-files (Group MF), respectively. Obturation was carried out with zinc oxide eugenol cement with an engine-driven Lentulo spiral. The instrumentation and obturation times were recorded. The quality of the root filling was radiographically assessed immediately after obturation. The postoperative pain was evaluated at time intervals of 6, 12, 24, 48, 72 h, and 1 week. Results and Discussion: The instrumentation and obturation times were significantly less with the use of pediatric rotary file systems compared to the manual file system. The quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to manual files. There was decreased postoperative pain with the use of pediatric rotary file systems as compared to manual files. In all three groups, postoperative pain decreased over time. The optimally filled root canals showed a significant correlation with the absence of postoperative pain. Conclusions: The use of pediatric rotary file systems for root canal instrumentation of primary molars resulted in the superior quality of obturation in decreased instrumentation and obturating times with the least postoperative pain. The overfilled root canals were not associated with significant postoperative pain.

Background: Using hand files in primary teeth is time-consuming, can lead to the formation of unwanted curvatures, and can cause iatrogenic errors. To overcome these difficulties, rotary instrumentation using nickel-titanium files was done. Aims: The present study was conducted to clinically evaluate and assess the difference in manual versus rotary instrumentation in root canals of primary teeth concerning instrumentation duration, obturation duration, quality of fills, and complications encountered. Also, the success of pulpectomy using hand files versus rotary files was assessed. Materials and Methods: 40 primary mandibular molars were randomly allocated to two groups namely control group subjects (n=20) that were treated using manual instrumentation and intervention group (n=20) using rotary instrumentation. The success was established in absence of excessive tooth mobility, sinus tract presence, gingival abscess/swelling, tenderness on percussion, and/or pain history. The collected data were subjected to statistical evaluation for results formulation. Results: The mean time for instrumentation was 25.69±3.82 minutes for the manual instrumentation group, whereas, for the rotary group it was significantly lesser (19.35±4.92) with p<0.0001. Mean obturation time for the manual group was 5.21±0.89 minutes and was lesser for the rotary group with 4.71±0.97 minutes (p=0.09). At 3 and 6 months, 97.36% (n=37) cases were considered successful in the manual instrumentation group, whereas 92.10% (n=35) cases in the rotary group were successful. At 18 months, 91.66% (n=33) pulpectomies were considered clinically successful in the manual group and 86.11% (n=31) cases in the rotary group were successful clinically. Conclusion: The present study concludes that less instrumentation time is needed with rotary instruments than manual instruments. Obturation quality and clinical success were similar in both manual and rotary instrumentation. [ABSTRACT FROM AUTHOR]

The aim of the present systematic review was to perform a qualitative synthesis of in vitro studies that assess the cyclic fatigue resistance of rotary glide path (GP) files of endodontic applications. Systematic electronic searches were performed in the Medline, Embase, Scopus, SciELO, and Web of Science databases on 15 February 2022, and were last updated on 1 April In vitro studies that evaluated and compared the cyclic fatigue resistance of at least one rotary GP file system with another rotary GP file system were included. A total of 25 studies were included in the qualitative synthesis. All studies assessing the difference in the cyclic fatigue resistance between continuous and reciprocating rotation in rotary glide path files found that the latter resulted in a significantly higher cyclic fatigue resistance, as evidenced by a higher number of cycles until fracture and/or time until fracture. Within the limitations of this review and the in vitro nature of the included studies, the results indicate that the cyclic fatigue resistance of rotary GP files may be influenced by several intrinsic factors of the files, such as their taper, cross-sectional design, alloy properties, kinematics, and external factors, such as the curvature and radius at which the file is activated, the irrigation or lubricant used, and the temperature. [ABSTRACT FROM AUTHOR]

This article reviews the historical development, properties, and trends of nickel titanium rotary instrumentation use for the veterinary endodontist. [ABSTRACT FROM AUTHOR]

The accomplishment of a successful pulpectomy depends on multiple factors that involve targeted removal of the causative irritants and soft and hard tissue debris by mechanical and chemical means. Compare and evaluate the efficacy of canal preparation and volumetric filling using conventional files and two rotary file systems using cone beam computed tomography (CBCT). Thirty freshly extracted human primary second molars were randomly divided into three groups of 10 teeth each. After access opening and working length determination, pre-operative volume analysis was done using CBCT. The canals were then instrumented by either hand K-files, ProTaper rotary files or Kedo-SG Blue rotary files. Post-operative volume analysis was performed using CBCT. All the canals were obturated using Metapex and scanned again using CBCT. Mean values of the pre- and post-operative canal volumes were analyzed using one-way Analysis of Variance (ANOVA). Inter- and intra-group volumetric changes were analyzed statistically using a post hoc test. The mean difference in volume after canal preparation and obturation was the highest in the Kedo-SG Blue group, followed by the ProTaper group and the least in the hand K group ( p = 0.001). Inter-group comparison showed statistically significant differences between the hand K group and ProTaper group ( p = 0.001), the ProTaper group and Kedo-SG Blue group ( p = 0.001), and the hand-K group and Kedo-SG Blue group ( p = 0.02). The volume of preparation and obturation was the highest using Kedo-SG Blue, followed by the ProTaper file systems., Competing Interests: The author declares no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

Aim: Our study aims to characterize the differential efficacy of martensitic and austenitic files in root canal retreatment regarding defiling ability, debris management and morphometric features. Materials and methods: A total of 10 human premolar teeth with two separate fully formed roots were selected, prepared with BioRace system (BR) up to a size BR2 (0.04/25). Root canals were filled and then divided according to the file type into two groups (n = 10). Two geometrically identical files have been used with the only difference between them is heat treatment; One Curve (OC) martensitic and One Shape (OS) austenitic. Preoperative and postoperative Micro-CT scans were done for all the samples, and the percent volume of residual filling materials was calculated. Canals reshaping and remaining debris in the canals were assessed by calculating the volume of the canals before and after retreatment using Micro-CT software. Results: The percentages of removed filling materials were similar between both groups (97.2% OC vs 97.8% OS). OS was significantly faster than OC (P < 0.05). Retreatment procedure did not significantly change volume, structure model index, surface area, and canal curvature. OS group transported the canals more than OC at the apical third (P < 0.05). There were no significant differences between both groups concerning un-instrumented surface area and accumulated hard tissue debris (AHTD) (P > 0.05). Conclusion: Under the circumstances of this study, neither file systems could completely remove the filling materials. However, OC resulted in less transportation than OS in the apical one third (P < 0.05). Also, OC resulted less AHTD than OS but with no statistical difference.

The apically extruded debris caused by TruNatomy System (TRN), RACE EVO system (RE) and VDW Rotate (VR) systems in mandibular anterior teeth with ribbon‐shaped root canals were compared. The root canals (n = 20 in each group) were irrigated with NaOCl 2.5%, and the extruded debris was collected at pre‐weighted Eppendorf tubes. The amount of apically extruded debris (mg) and the treatment time (s) were recorded. Tukey pairwise comparisons were performed to compare groups with a 95% confidence level. VR had significantly less debris extrusion values and treatment time than RE and TRN (P < 0.05). Although no difference was observed between RE and TRN in terms of apically extruded debris (P > 0.05), a significant difference in favour of RE was observed in terms of treatment time (P < 0.05). All the instruments extruded debris at varying weights. [ABSTRACT FROM AUTHOR]

Introduction: Sodium hypochlorite solution apical extrusion leads to life-threatening sequelae. Gel-type has been suggested as a safer alternative during intra-canal irrigation due to its' higher viscosity. Objectives: To compare the apical extrusion of three sodium hypochlorite viscosities in primary molars prepared with two different instrumentation techniques. Material and methods: This was an in-vitro crossover study. Sixty human primary molar roots were divided into two groups (n = 30), depending on physiological root resorption, and each group was further divided into two sub-groups (n = 15) based on instrumentation technique. Manual instruments (K-file) and rotary files (ProTaper) were used for root canal instrumentation. Each group was irrigated with 5 ml of sodium hypochlorite solution and two different viscosities of sodium hypochlorite gel after preparation. The extruded volume was collected and calculated using Myers and Montgomery model. Statistical analysis was performed by applying Kolmogorov-Smirnov test and Kruskal-Wallis test. Results: A statistically significant difference was found between sodium hypochlorite solution and gel in manual instrumentation groups. No statistically significant difference was observed between the extruded volumes in the rotary instrumentation groups. Conclusions: Sodium hypochlorite gel is a safer alternative for primary molars prepared by stainless steel K-file. Preparation technique used in primary molars affects extruded irrigant volume more compared with physiologic root resorption. [ABSTRACT FROM AUTHOR]

Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator's own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment. [ABSTRACT FROM AUTHOR]

Introduction: This study was directed to evaluate the effect of different operating temperatures on the change in working length when using the XP-endo shaper file. Methods: A total of 20 plastic blocks with16 mm curved canals were used in this study. The working length was adjusted to be 15 mm using a customized Teflon stopper (10mm in length) which was used with all files in the study. The preparation was done using the XP-endo shaper file (FKG, La Chaux-de-Fonds, Switzerland) according to the manufacturer’s instructions. The blocks were divided into 2 groups: Group 1: body temperature, Group 2: room temperature. Pre and post instrumentation imaging of the blocks was done using the stereomicroscopy at 8x. The images were superimposed to create a composite image on which the evaluation of working length change was done. Mann-Whitney U test was used to compare the change in working length in the two groups. Results: There was no statistically significant difference between the two groups (P ≤ 0.05). Conclusions: Within the parameters of this study, although both groups showed an increase in working length when using the XP-endo shaper file, the operating temperature did not have an effect.

Background. Pediatric endodontics is a field with constant evolution, resulting in the shifting of paradigms from the use of conventional hand files to rotary files for biomechanical preparation in primary teeth. Biomechanical preparation plays a crucial role in the success of root canal treatment. Primary teeth need special attention since they differ from permanent teeth in root canal morphology. Cleaning and shaping of the canals damage the root dentin, leading to dentinal cracks. Newer techniques for root canal preparation, including Ni-Ti rotary files and SAF system, have been developed for use in pediatric endodontics to overcome the drawbacks of conventional methods. The present study compared dentinal defects formed by rotary systems in primary teeth. Methods. Eighty primary teeth were included. The teeth were decoronated with a diamond disc. All the roots were inspected for any pre-existing cracks or craze lines under transmitted light under a stereomicroscope. The specimens were then divided into four groups (n=20): group 1: control, group 2: hand files (HF), group 3: ProTaper files, and group IV: SAF files. The samples were instrumented according to the group they were assigned to. Results. The HF and SAF groups exhibited fewer microcracks. Dentinal microcracks were observed in roots prepared with rotary ProTaper files. There were significant differences between HF/SAF and rotary files (P

Introduction: To meet the demand of pediatric endodontists, exclusive pediatric rotary file systems have been recently introduced by the manufactures. However, no study has been conducted to compare the clinical efficiency between pediatric rotary file systems. Aim: To determine the clinical efficiency (instrumentation time, obturation time, quality of obturation and postoperative pain) of two pediatric rotary file systems following the root canal preparation of primary molars. Materials and Methods: A total of 75 primary molars requiring pulpectomy were selected from children aged 4 to 7 years. These teeth were divided into three groups of 25 teeth each. In the first, second, and third groups, the cleaning and shaping of the root canals were carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-S pediatric rotary files (Group KS), and, manual nickel-titanium K-files (Group MF), respectively. Obturation was carried out with zinc oxide eugenol cement with an engine-driven Lentulo spiral. The instrumentation and obturation times were recorded. The quality of the root filling was radiographically assessed immediately after obturation. The postoperative pain was evaluated at time intervals of 6, 12, 24, 48, 72 h, and 1 week. Results and Discussion: The instrumentation and obturation times were significantly less with the use of pediatric rotary file systems compared to the manual file system. The quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to manual files. There was decreased postoperative pain with the use of pediatric rotary file systems as compared to manual files. In all three groups, postoperative pain decreased over time. The optimally filled root canals showed a significant correlation with the absence of postoperative pain. Conclusions: The use of pediatric rotary file systems for root canal instrumentation of primary molars resulted in the superior quality of obturation in decreased instrumentation and obturating times with the least postoperative pain. The overfilled root canals were not associated with significant postoperative pain. [ABSTRACT FROM AUTHOR]

This study evaluated the resistance to flexural fatigue and torsional strength of files for glide path preparation in continuous rotation or Optimum Glide Path motion (OGP). ScoutRace 15.02 and ProGlider 16.02 files were used in a dynamic testing device during preparation of simulating curved root canals (40‐degree curvature and 5 mm radius). For the torsional test, a machine was used to test torsion measured maximum torsional strength (N.cm). Two‐way anova and Tukey's multiple comparisons test were used for statistical analysis. Files in OGP motion had a statistically better resistance to flexural fatigue (P < 0.05). ProGlider files took longer time to failure than ScoutRace files only when OGP was used (P < 0.05). The torsional test revealed that OGP produced significantly less torsional stress than rotary motions for both types of glide path files (P < 0.05) In conclusion, OGP motion increased substantially the mechanical safety of endodontic glide path files. [ABSTRACT FROM AUTHOR]

Abstract Background Flexibility during bending is a critical feature that influences the performance and safety of endodontic nickel-titanium rotary instruments. Flexibility of the endodontic files could be assessed via laboratory test or indicated theoretically by finite element analysis (FEA). The aim of the study is to determine the cantilever load required for bending five different nickel-titanium (NiTi) rotary instruments (laboratory test) and to calculate maximum von Mises stresses due to bending moment and vertical displacement (deflection) (theoretically by FEA) and compare both results. Results TF Adaptive file demonstrates the least cantilever load required for bending, the least von Mises stresses generated and the highest deflection of the endodontic files. Contrary, One Shape file reported the highest cantilever load required for bending, the highest von Mises stresses generated and the least deflection among all the tested endodontic files. Conclusion The finite element analysis validated the results of the laboratory cantilever bending test for the examined nickel-titanium rotary instruments.

Abstract Introduction Geometrical designs of nickel-titanium (NiTi) rotary instruments have a considerable influence on their mechanical performance, and thereby have the tendency to fracture. Aim To evaluate the effect of cross-sectional geometry, pitch, taper, and off-center cross-section on the stress distribution in NiTi instruments under bending and torsion conditions using finite element analysis (FEA). Materials and methods Eleven theoretical three-dimensional finite element (FE) models of rotary instruments were constructed and divided according to the geometric design tested into; group 1 (cross-section geometry): four FE models with four different cross-section designs (triangle, convex triangular, parallelogram, and rectangle). Group 2 (pitch): three FE models with different pitches (5, 10, and 15 threads). Group 3 (taper): two FEA models with two different tapers (0.04 and 0.06). Group 4 (centering): two FEA models (off-centered and centered cross section). The behavior of the instrument under bending and torsional conditions was analyzed mathematically in SolidWorks software package. Results The pattern of stress distribution was varied by altering cross-sectional geometry, pitch, taper, and off-center cross section. Conclusion No single geometrical design could be beneficial for all stress conditions. To decrease the stress accumulation during bending of rotary files in curved root canals, the rotary NiTi instruments should be designed with rectangle cross-section configuration, low pitch, reduced taper, and with centered cross section. This design improved the flexibility of rotary NiTi instruments. However, to improve the torsional resistance during root canal preparation of narrow canals, the file should be designed with parallelogram cross-sectional configuration, low pitch, increased taper, and eccentric cross-section design.

Purpose: The present study evaluated the centering ability of rotary ProTaper NEXT (PTN; Dentsply Tulsa Dental, Tulsa, OK), reciprocating WaveOne (WO; Dentsply Maillefer, Ballaigues, Switzerland) and vibratory Self-Adjusting File (SAF; ReDent Nova, Ràanana, Israel) when used for instrumenting mandibular premolars with oval canals. Materials and Methods: Ninety oval canals (confirmed using radiovisography, buccolingual dimensions were × 2.5 the mesiodistal canal dimensions) were acquired, preinstrumentation cone-beam computed tomography (CBCT) was taken, and divided into three groups (n = 30) for root canal instrumentation: group 1 – PTN; Group 2 – WO; and Group 3 – SAF. The samples were then subjected to postinstrumentation CBCT. The pre- and postinstrumentation scans were compared at 3 mm, 6 mm, and 9 mm from the apex to obtain the centering ability ratio of the three files. The data collected were analyzed using the one-way analysis of variance test and Duncan's multiple comparison tests. Results: The ratio obtained at 6 mm and 9 mm from the apex did not differ for the mesiodistal dimensions (P > 0.05), but a significant difference was observed when the buccolingual dimensions were considered (P < 0.001). The PTN and WO instrumentation were associated with a very high ratio for buccolingual dimensions. However, SAF instrumentation resulted in well-centered preparation for both the dimensions at 6 mm and 9 mm (P < 0.001). At 3 mm from the apex, the files did not differ in canal preparation (P > 0.05). Conclusion: The SAF instrumentation results in centered preparation when used for instrumenting nonround root canals.

Aim: The current research set out to examine and contrast the amounts of apically extruded debris produced by two distinct rotary files and hand files used in pulpectomy procedures., Materials and Methods: Forty-five extracted primary mandibular molars were randomly divided into three groups for instrumentation. Prime Pedo™ files are in Group 1, DXL-Pro Pedo files are in Group 2, and H and K files are in Group 3. Debris that had been apically extruded and collected in preweighed Eppendorf tubes was incubated for five days at 70°C. The weight of the Eppendorf tubes before and after instrumentation was subtracted to get the weight of the debris that was gathered., Results: It was noted that all three groups had significantly different amounts of material ejected from the tip. The groups with the lightest amounts of extruded debris were 1, 2, and 3, in that order. The most debris was extruded from the apex in Group 3., Conclusion: This suggests that rotary files are preferable to hand files because they reduce debris extrusion, which in turn reduces postoperative events following pulpectomy procedures., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Canal curvatures such as dilacerated canals, bayonetshaped canals, and acute curvatures in the apical third pose a therapeutic challenge to the clinician. Pretreatment determination of the degree of curvature, usage of scrupulous instrumentation techniques facilitate successful negotiation of the bends and enhance the quality of the treatment. The following case series chronicles the application of a novel instrumentation technique known as Tactile Controlled Activation(TCA) technique in the management of sharp apical curvatures in a molar and a premolar, thus upholding its accountability in the management of canal curvatures without any iatrogenic mishaps, besides maintaining the original trajectory of the canal. [ABSTRACT FROM AUTHOR]

The aim of the present systematic review was to perform a qualitative synthesis of in vitro studies that assess the cyclic fatigue resistance of rotary glide path (GP) files of endodontic applications. Systematic electronic searches were performed in the Medline, Embase, Scopus, SciELO, and Web of Science databases on 15 February 2022, and were last updated on 1 April In vitro studies that evaluated and compared the cyclic fatigue resistance of at least one rotary GP file system with another rotary GP file system were included. A total of 25 studies were included in the qualitative synthesis. All studies assessing the difference in the cyclic fatigue resistance between continuous and reciprocating rotation in rotary glide path files found that the latter resulted in a significantly higher cyclic fatigue resistance, as evidenced by a higher number of cycles until fracture and/or time until fracture. Within the limitations of this review and the in vitro nature of the included studies, the results indicate that the cyclic fatigue resistance of rotary GP files may be influenced by several intrinsic factors of the files, such as their taper, cross-sectional design, alloy properties, kinematics, and external factors, such as the curvature and radius at which the file is activated, the irrigation or lubricant used, and the temperature.

Aim: To assess postoperative pain and bacterial reduction following the use of XP‐endo Shaper versus conventional rotary files in preparation of oval canals with necrotic pulps. Methodology: This superiority, parallel, randomized, double blinded clinical trial was conducted in the clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Sixty single‐canalled mandibular premolars with necrotic pulps were randomly assigned into two equal groups. Canals were instrumented using XP‐endo Shaper files in the intervention group and iRaCe rotary files in the control group. Bacterial samples were taken before and after canal instrumentation. Incidence and severity of postoperative pain was assessed using a modified VAS after 6, 12, 24 h and daily for 5 days. A culture method was used to assess the number of bacterial colony forming units. Incidence of analgesic intake as well as flare‐ups was recorded. Data were analysed using chi‐square, Fisher Exact, Mann–Whitney, Independent t‐test, and Spearman's correlation for pain and bacterial counts. Results: The XP‐endo Shaper compared with the iRaCe group was associated with a significantly lower incidence of postoperative pain at 6, 12, and 24 h (P = 0.039, 0.047, and 0.026, respectively), and severity of postoperative pain at 6 h (mean difference: 1.33, 95% CI: 0.307–2.352, P = 0.02), 12 h (mean difference: 1.1, 95% CI: 0.26–1.936, P = 0.007), 24 h (mean difference: 0.94, 95% CI: 0.178–1.701, P = 0.008) and 48 h (mean difference: 0.97, 95% CI: 0.192–1.747, P = 0.038). There was a significant decrease in bacterial count following canal instrumentation in both groups (P < 0.001) with no significant difference between them (mean difference: 0.83 × 105, 95% CI: 0.336 × 105–1.996 × 105, P = 0.56). A weak correlation existed between postoperative pain severity and bacterial counts (P = 0.54). There was no significant difference in analgesic intake between the two groups (P = 0.085). Flare‐ups occurred in 3.3% of teeth in the iRaCe group, while no flare‐ups occurred in the XP‐endo Shaper group. Conclusions: XP‐endo Shaper was associated with a significantly lower frequency of postoperative pain for up to 24 h, and lower severity of postoperative pain for up to 48 h compared with iRaCe files. Both systems were equally effective in bacterial reduction from oval root canals with necrotic pulps. [ABSTRACT FROM AUTHOR]

Introduction: This study was directed to evaluate the effect of different operating temperatures on the change in working length when using the XP-endo shaper file. Methods: A total of 20 plastic blocks with16 mm curved canals were used in this study. The working length was adjusted to be 15 mm using a customized Teflon stopper (10mm in length) which was used with all files in the study. The preparation was done using the XP-endo shaper file (FKG, La Chaux-de-Fonds, Switzerland) according to the manufacturer's instructions. The blocks were divided into 2 groups: Group 1: body temperature, Group 2: room temperature. Pre and post instrumentation imaging of the blocks was done using the stereomicroscopy at 8x. The images were superimposed to create a composite image on which the evaluation of working length change was done. Mann-Whitney U test was used to compare the change in working length in the two groups. Results: There was no statistically significant difference between the two groups (P = 0.05). Conclusions: Within the parameters of this study, although both groups showed an increase in working length when using the XP-endo shaper file, the operating temperature did not have an effect. [ABSTRACT FROM AUTHOR]

Introduction: Apart from manual activation methods of irrigants during final irrigation procedure, multiple irrigant activation devices have been introduced which can influence the postoperative pain. Aim: To evaluate postoperative pain after final irrigation with open and closed-ended endodontic needles and Endoactivator during root canal treatment. Materials and Methods: This randomised controlled trial was conducted in Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, from June 2018 to August 2018. Total of 75 symptomatic irreversible pulpitis patients were randomly assigned into three groups. In group EN-1, final irrigation protocol was performed with 30-gauge notched tip needle (Pac-Dent, India), group EN-2 using side-vented, closed 30-gauge needle (Max-i-Probe, Dentsply, USA) and in group EA using Endoactivator (Dentsply, USA). Pain using Visual Analog Scale (VAS) was evaluated at 8, 24 and 48 hours. Participants were prescribed Non-steroidal Anti-Inflammatory Drugs (NSAIDs) as an escape medication. Comparison between the three groups at each time interval was done using Kruskal Wallis test followed by Mann-Whitney U test as post-hoc test. Change in VAS score over different time intervals (8, 24 and 48 hours) in each group was compared using Kruskal Wallis test and Mann-Whitney U test. The p-value less than 0.05 was considered statistically significant. SPSS version 20 was used for statistical analysis. Results: Mann-Whitney U test revealed significant difference between EN-1 and EN-2 (p=0.002) and between EN-1 and EA (p

Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator’s own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment.

Background. Pediatric endodontics is a field with constant evolution, resulting in the shifting of paradigms from the use of conventional hand files to rotary files for biomechanical preparation in primary teeth. Biomechanical preparation plays a crucial role in the success of root canal treatment. Primary teeth need special attention since they differ from permanent teeth in root canal morphology. Cleaning and shaping of the canals damage the root dentin, leading to dentinal cracks. Newer techniques for root canal preparation, including Ni-Ti rotary files and SAF system, have been developed for use in pediatric endodontics to overcome the drawbacks of conventional methods. The present study compared dentinal defects formed by rotary systems in primary teeth. Methods. Eighty primary teeth were included. The teeth were decoronated with a diamond disc. All the roots were inspected for any pre-existing cracks or craze lines under transmitted light under a stereomicroscope. The specimens were then divided into four groups (n=20): group 1: control, group 2: hand files (HF), group 3: ProTaper files, and group IV: SAF files. The samples were instrumented according to the group they were assigned to. Results. The HF and SAF groups exhibited fewer microcracks. Dentinal microcracks were observed in roots prepared with rotary ProTaper files. There were significant differences between HF/SAF and rotary files (P < 0.05). Conclusion. Stainless steel hand K-files and SAF instruments resulted in fewer dentinal damage than the ProTaper Universal files. SAF exhibited satisfactory results with minimal or no crack formation. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to compare the mechanical and structural properties of the nickel-titanium (Ni-Ti) alloy already used in endodontics with titanium-molybdenum (Ti-Mo) and titanium-niobium (Ti-Nb) alloys to determine if these can be suggested in the manufacture of endodontic files. Methods and Materials: Orthodontic wires made of the different alloys were used. The previously mentioned alloys were characterized by energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and torsion tests. Cyclic fatigue tests were performed on a simulated canal with a curvature of 86° to 375 rpm. The fractured surfaces of the wires were observed by means of scanning electron microscopy (SEM). A Kruskal-Wallis test and U Mann Whitney test were used to determine significant differences in cyclic fatigue between groups. Results: In the mechanical tests, similar values of torsion were found for the three alloys. In XRD, the Ti-Nb showed less structural changes. In the cyclic fatigue test, Ti-Nb was found to be significantly more resistant with respect to Ni-Ti and Ti-Mo. Conclusion: Based on our in vitro study, Ti-Nb is suggested as a possible alloy for the manufacture of rotary files due to its impressive [ABSTRACT FROM AUTHOR]