In vitro study on cyclic fatigue resistance of three types of nickel titanium files in preparation for bending root canals / 口腔疾病防治

Objective@#The purpose of this study was to investigate the differences in the anti cyclic fatigue performance of Woride KS (WKS), Proteper Gold (PTG), and Hyflex CM (HCM) nickel titanium instruments with different tip diameters in curved root canal models, and to provide reference for the targeted selection of suitable nickel titanium instruments in clinical preparation of curved root canals.

CYCLIC AND TORSIONAL FATIGUE RESISTANCE OF THERMALLY TREATED ROTARY NiTiINSTRUMENTS WITH DIFFERENT DESIGNS

Aims: The aim was to evaluate the cyclic and torsional fatigue resistance among thermally treated NiTi rotary instruments with different design features.Materials and methods: Sixty instruments of three systems were used (n=20): TruNatomy 26.04 (TN 26.04), BassiLogic 25.05 (BL 25.05), and Flat File 25.04 (FF 25.04). The cyclic fatigue test (n=10) was performed to evaluate the time to fracture (s) and the number of cycles until failure (NCF). The torsion test was performed to evaluate the torque (N.cm) and maximum angular deflection until fracture (n=10). The fracture surface of each fragment was examined under a scanning electron microscope. The data were analyzed by Tukey's test (p<0.05).Results: BL 25.05 and FF 25.04 instruments had a higher number of cycles and time to fracture compared with TN 26.04 (p<0.05). TN 26.04 instruments showed lower torque to fracture.Conclusions: Based on the proposed objectives and the methodology used, TruNatomy 26.04 instruments present lower resistance to cyclic fatigue and torsional fatigue when compared to BassiLogic 25.05 and Flat File 25.04 instruments.

ASSESSMENT OF TORSION RESISTANCE OF GLIDE PATH ROTARY INSTRUMENTS

NiTi endodontic instruments for glide path are the most susceptible to fractures inside the root canal, mainly as a result of high torsional stress. Objective: The present study investigated the resistance to torsion and angular deflection of instruments destined for the glide path: ProGlider #16.02; T-File #17.02 and the MK Life #16.02. Materials and methods: Thirty rotating NiTi glide path instruments (n=10) with 25mm lengths were selected. The torsion test was performed based on ISO 3630-01 (1992). Three millimeters from the tip of the instruments, it was attached to a small load cell by a lever arm connected to the torsion shaft. Torsional strength and angular deflection were evaluated. Fracture surfaces were examined by scanning electron microscopy with magnifications of 1000x and 5000x in the cross section, and 50x in the lateral section. Statistical analysis was performed using the Kruskal-Wallis H test, followed by the Down's post hoc test. Results: The ProGlider instrument showed greater torsional strength (p<0.05) compared to the T-File (p<0.05) and MK Life (p<0.05), respectively. However, the T-File showed greater angular deflection (p<0.05) than the other groups tested. Conclusion: It can be concluded that the ProGlider instrument presented greater torque for the fracture, while the T-File instrument presented greater angular deflection.

Endodontic retreatment using a single instrument from four nickel-titanium systems - a micro-ct study

Abstract This study evaluated the efficiency of using a single instrument from three different rotary multi-file systems and compared them with that of a reciprocating single-file for endodontic retreatment by means of micro-CT. Sixty extracted canines were prepared using a size F2 ProTaper Universal file and obturated. After 30 days of storage at 37ºC and 100% humidity, the teeth were randomly divided into four groups (n=15) based on the type of instrument used to retreatment: ProTaper Next (PTN), ProTaper Gold (PTG), TRUShape 3D (TS), and WaveOne (WO). The canals were retreated using only the size 40 instrument from each system according to the manufacturer's recommendations for torque and speed. The time required to remove the filling material was recorded in seconds. The amount of initial and residual filling material and the quantity of dentin removed were assessed by means of micro-CT. Data were statistically analyzed (ANOVA and Kruskal-Wallis) at a 5% significance level. TS instruments required the highest (p<0.05) amount of time (mean, 384.80 ±144.92) compared with the WO (229.67±68.16) and PTG (248.67±64.22) and not so different from PTN instruments (327.67±133.3). No differences in the amount of dentin removed, initial and residual filling volume, and percentages of filling material were observed among the groups. The use of a single rotary instrument from the PTG, TS, and PTN systems was as effective as that of the single-file reciprocating WO system. However, none of the instruments was able to remove the filling materials completely.

Resumo Este estudo laboratorial avaliou por meio de micro-CT a eficiência do uso de um único instrumento de três sistemas rotatórios em retratamentos endodônticos, comparados a um instrumento único reciprocante. Sessenta caninos extraídos foram preparados usando o sistema ProTaper Universal (F2) e obturados. Após 30 dias de armazenamento a 37 ºC e 100% de umidade, os dentes foram divididos aleatoriamente em quatro grupos (n = 15), de acordo com o instrumento utilizado para remover as obturações endodônticas: ProTaper NEXT (PTN), ProTaper Gold (PTG), TRUShape 3D (TS) e WaveOne (WO). Os canais foram retratados usando apenas o instrumento tamanho 40 de cada sistema, seguindo as recomendações do fabricante para torque e velocidade. O tempo necessário para remover a obturação foi registrado em segundos. A quantidade de material remanescente e o volume de dentina removida foram avaliadas por meio de micro-CT. Análise estatística foi realizada (ANOVA e Kruskal-Wallis), com nível de significância de 5%. O tempo de trabalho no grupo TS foi significativamente maior (p<0.05) (média, 384,80 ± 144,92) comparado a WO (229,67 ± 68,16) e PTG (248,67 ± 64,22), e similar a PTN (327,67 ± 133,3). Não houve diferenças entre os grupos na quantidade de dentina removida e nas porcentagens de material obturador residual. O uso de apenas um instrumento rotatório dos sistemas PTG, TS e PTN foi tão eficaz quanto o do sistema WO reciprocante na remoção do material obturador. No entanto, nenhum dos instrumentos conseguiu remover completamente os materiais obturadores.

Comparison of the shaping ability of different nickel-titanium instruments in simulated root canals in resin / 口腔疾病防治

Objective @#To compare the shaping ability of 3 different nickel (Ni)-titanium (Ti) systems in simulated root canals in resin and to provide a reference for clinicians.@*Methods@#Forty-eight resin blocks were prepared using the F360 (Komet, Brasseler GmbH & Co., Lemgo, Germany) (Group 1), F6 SkyTaper (20/06) (Komet, Brasseler GmbH & Co., Lemgo, Germany) (Group 2), F6 SkyTaper (25/06) (Komet, Brasseler GmbH & Co., Lemgo, Germany) (Group 3) and Reciproc R25 systems (VDW, Munich, Germany) (Group 4) (n=12 canals/group). The images taken before and after preparation were superimposed and analyzed by Adobe Photoshop v7.0. The amount of resin removed by each system was measured, and the centering ability was assessed. The data were statistically analyzed using SPSS 20.0.@*Results @#At the 1 mm point, the transportation in Group 4 [(0.10 ± 0.03) mm] was significantly greater than that in Groups 2 [(0.05 ± 0.03) mm] and 3 [(0.05 ± 0.03) mm] (P < 0.05). At the 8 mm and 9 mm points, the transportation values in Group 4 [(0.12 ± 0.06) mm and (0.13 ± 0.05) mm] were significantly higher than those in Groups 2 [(0.05 ± 0.05) mm and (0.05 ± 0.05) mm] and 3 [(0.05 ± 0.04) mm and (0.06 ± 0.05) mm] (P < 0.05). At the 10 mm point, the transportation was significantly greater in Group 4 [(0.13 ± 0.06) mm] than in Group 2 [(0.06 ± 0.06) mm].@*Conclusion@#F6 SkyTaper exhibits better centering ability than Reciproc.

A comparison of the effect of different nickel-titanium instruments combined with ultrasonic irrigation on root canal preparation / 口腔疾病防治

Objective @#To compare the removal efficiency and the amounts of apically extruded debris using Twisted File (TF), Twisted File Adaptive (TFA), ProTaper, and ProTaper Next combined with ultrasonic irrigation and to provide an experimental basis for the selection of root canal instrumentation in the clinic.@*Methods@#Forty mandibular premolars were randomly divided into 4 groups (n=10 teeth per group). The canals were cut using a Twisted File, Twisted File Adaptive, ProTaper, or ProTaper Next nickel-titanium instrument. The canals were irrigated with ultrasonic irrigation. The apically extruded debris were collected in preweighted Eppendorf tubes. The amount of dental tissue removed and extruded debris were assessed with an electronic balance.@*Results @#The amount of tooth tissue removed in groups A, B, C and D was 20.5 ± 2.0 mg, 17.8 ± 4.2 mg, 20.8 ± 3.9 mg and 16.5 ± 2.2 mg, respectively. Combined with ultrasonic irrigation, the Twisted File and ProTaper had a better removal efficiency than the ProTaper Next(P < 0.05). There was no significant difference in the amount of extruded debris (χ2=4.057, P=0.255) among four groups.@*Conclusion@#The Twisted File and ProTaper had a better removal efficiency than the ProTaper Next combined with ultrasonic irrigation. There was no significant difference in the amount of extruded debris using four Nickel-titanium instruments combined with ultrasonic irrigation.

The effect of the modified root canal preparation method with different liquid continuous flushing on the anti-fracture properties of mechanical nickel-titanium file / 实用口腔医学杂志

Objective: To study the effect of the modified preparation method with root canal flushing of different solutions on the anti-fracture properties of mechanical nickel-titanium filings. Methods: A transparent resin model of root canal was established. ProTaper Universal (PTU F1) instrument was used to prepare the root canals. The number of prepared root canals by each PTU F1 with the various solutions(n = 20) was recorded and compared among groups. Results: 6. 13 ± 3. 52 root canals were prepared in distilled water group, 6. 25 ± 1. 76 in 0. 9％saline group, 6. 27 ± 2. 07 of 0. 2％ chlorhexidine group, 6. 88 ± 3. 21 in 1％ sodium hypochlorite group, 4. 31 ± 2. 34 in 5％ sodium hypochlorite group and 3. 26 ± 2. 08 in dry drilling group. The number between each 2 of distilled water, 0. 9％saline group, 0. 2％chlorhexidine group and 1％ sodium hypochlorite group, and the number between 5％ sodium hypochlorite group and dry drilling group was not statistically significant(P＞ 0. 05). The number of prepared root canals in the first 4 groups was more than that in the latter 2 groups(P＜ 0. 05). Conclusion: Distilled water, 0. 9％ saline, 0. 2％ chlorhexidine or 1％ sodium hypochlorite for root canal irrigation can improve mechanical nickel-titanium instrument for fatigue resistance in root canal preparation, but 5％ sodium hypochlorite and dry drilling can not.

Stress analysis of simulated maxillary first molar prepared with three rotary nickel-titanium instruments / 口腔疾病防治

Objective@# To compare the differences in the stress distribution in simulated first molars prepared with three rotary nickel-titanium instruments. @*Methods @#Four simulated first molars were prepared without instruments and with Reciproc, WaveOne and Protaper. Before and after preparation, each simulated molar was scanned by Micro-CT. The data were imported to Mimics 16.0 software to establish three-dimensional models. Finite element analysis was processed with Abaqus 6.14 software under conditions of longitudinal and lateral load. @*Results@# Under vertical load conditions, the maximum von Mises stress of the enamel increased by 1.36%, 21.48% and 20.99% in the Reciproc, WaveOne and Protaper groups, respectively, after preparation, while the maximum von Mises stress of the cementum increased by 55.98%, 41.18% and 33.04%, respectively, and the maximum von Mises stress of the alveolar bone increased by 45.55%, 40.37% and 24.09%, respectively. Under 45° lateral load conditions, the maximum von Mises stress of the enamel increased by 1.79%, -4.58% and 3.82% in the Reciproc, WaveOne and Protaper groups, respectively, after preparation, while the maximum von Mises stress of cementum increased by 16.33%, 7.58% and 4.32%, respectively, and the maximum von Mises stress of the alveolar bone increased by 46.82%, 36.40% and 8.29%, respectively. Under the same conditions, the von Mises stresses of the cementum and alveolar bones of the simulated molars were higher after preparation than before preparation, especially under lateral load conditions. The stress was focused on the border between the crown and the root. The von Mises stress of the cementum and alveolar bones increased much more in the Reciproc group than in the other two groups under both conditions.@*Conclusion@#The von Mises stress of simulated molars was greater after preparation than before preparation. The von Mises stress of the cementum and alveolar bones increased much more in the Reciproc group than in the other two groups.

Comparison of the shaping ability of novel thermally treated reciprocating instruments

OBJECTIVES: The present study aimed to evaluate the shaping ability of 2 thermally treated nickel-titanium reciprocating systems in simulated curved canals. MATERIALS AND METHODS: Forty simulated canals were prepared to apical size 25 using Reciproc Blue R25 (VDW) and WaveOne Gold Primary (Dentsply Sirona) instruments. Standard pre- and post-preparation images were taken and superimposed. The removal of resin material was measured at 5 standard points: the canal orifice, halfway between the canal orifice and the beginning of the curve, the beginning of the curve, the apex of the curve, and the end-point of the simulated canal. The data were analysed using the independent sample t-test with a 5% significance threshold. RESULTS: The canals in which Reciproc Blue R25 was used showed a significantly greater widening than those in which WaveOne Gold was used at 4 of the 5 measurement points (p < 0.05). The Reciproc Blue R25 instrument removed significantly more resin from the inner aspect of the curve at 2 of the 5 points and similar amounts at the remaining 3 points. At the 2 apical points, there was no significant difference between the Reciproc Blue R25 and WaveOne Gold Primary instruments. CONCLUSION: Both instruments respected the original canal anatomy; however, WaveOne Gold resulted in a more conservative shape with less transportation.

Automatic Electronic Device Used for the Evaluation of Cyclic-Fatigue Resistance of Nickel-Titanium Instruments

he aim of this study was to evaluate the cyclic-fatigue fracture of different Nickel-Titanium motor-driven rotary instruments (ProTaper® Universal, ProFile®, and Mtwo® systems) in artificial canals by means of an Automatic Electronic Device (AED). The study was performed using NickelTitanium instruments 25/0.06 evaluated in canals with a 45-degree curvature and 2-mm radius. The analyses evaluated two parameters: fracture by cyclic fatigue, and time of fracture; in addition, the length of separated fragment was evaluated. Medians and range values were calculated for each group. Data were analyzed by the Kruskall-Wallis and Mann-Whitney U tests to determine statistical difference. The ProFile motor-driven rotator system exhibited highest resistance to fracture due to cyclic fatigue and highest fracture time compared with the ProTaper and Mtwo systems (p <0.05). The equipment proposed in this study (AED) demonstrated efficiency for recording information, automation, scheduled work times and durations, cycle number, time of fracture, pressure changes and, principally control of the human factor.

l objetivo del presente estudio fue evaluar la fractura a la fatiga cíclica de diferentes instrumentos rotatorios de Niquel-Titanio (sistemas ProTaper® Universal, ProFile® y Mtwo®) en conductos artificiales por medio de un Dispositivo Electrónico Automático (DEA). Se usaron instrumentos de Niquel-Titanio 25/0.06, los cuales se evaluaron en conductos con una curvatura de 45 grados y 2 milímetros de radio. Se analizaron dos parámetros: Fractura a la fatiga cíclica y tiempo a la fractura; además se evaluó la longitud del fragmento separado. Medianas y rangos fueron calculados para cada uno de los grupos. Los resultados fueron analizados por las pruebas de Kruskall-Wallis y U de Mann-Whitney para determinar diferencias estadísticas. El Sistema ProFile mostró una mayor resistencia y tiempo a la fractura en comparación con los sistemas ProTaper y Mtwo (p <0.05). El equipo propuesto en este estudio (DEA) demostró eficiencia para el registro de la información, tiempos de trabajo y duración, número de ciclos, tiempo a la fractura, cambios en la presión y principalmente control del factor humano.

Centering Ability of Three Rotary Nickel-titanium Instruments in Simulated Canals:A Comparative Study / 华中科技大学学报(医学版)

Objective To compare the centering ability of three rotary nickel-titanium instruments Reciproc,Protaper and WaveOne in resin-simulated curved root canals.Methods A total of 30 resin-simulated curved canals(curvature=30°)were di-vided into 3 groups(n=10 each)using the random number table.They were prepared with Reciproc(group R),Protaper(group P)and WaveOne(group W)respectively.Pre-and post-operative images were obtained by a digital camera at the fixed position, and superimposed through Photoshop.The center displacement between pre- and post-operative images were measured at 10 points beginning at 1 mm from the end point of the canal with the software Digimizer at a ratio of 1 to 1.The data were analyzed through one-way ANOVA and Student-Newman-Kuels at a significance level ofα=0.05.Results The central point was shifted laterally to the curve at 1,2,and 3 mm from the end point of the canal,while it shifted medially to the curve at 6,7,and 8 mm.The centering ability was better in groups R and W than in group P with significant differences noted(P <0.05).No sig-nificant difference was found in the centering ability between group R and group W.Also there were no significant differences in the centering ability at 4,5,9 and 10 mm among the three groups(P >0.05).Conclusion Reciproc and WaveOne have similar centering ability.They preform better in terms of centering location than Protaper,especially at the apex and the most curved part of the canal.

The factors of nickel titanium instrument seperation in posterior tooth root canal therapy / 实用口腔医学杂志

Objective:To study the factors of nickel titanium instrument(NTI)seperation in posterior tooth root canal therapy.Meth-ods:NTIs were used in 1 498 patients with 1 562 involved posterio teeth and 3 518 root canals for RCT from Jun.2009 to May.2012. The relation of instrument seperation(IS)with gender,age,tooth position,working years of the dentists,bending degree of the in-volved tooth canal and the NTI form was analyzed statistically.Results:68 out off 1 198 applied NTIs(5.68%)were seperated in cal-nal preparation.Single factor analysis showed that IS incidence was not statistically different between male and femal(χ2 =0.013,P >0.05),it was statistically different among the patient ages(χ2 =-354.258,P <0.05),between molar and premolar(χ2 =-201.344,P <0.05),among working years of the dentists(χ2 =13.763,P <0.05),bending degree of involved teeth(χ2 =22.414,P <0.05),times of NTI uses(χ2 =16.807,P <0.05),taper of NTIs(χ2 =18.283,P <0.05)and diameter of NTIs(χ2 =21.312,P <0.05).Logistic analysis showed that age,tooth position,working years of dentists,bending degree of involved tooth canal,frequency of NTIs applica-tion and NTI form were independent risk factors for NTI seperation.Conclusion:Dentists should take appropriate technique and stand-ard operation sequence to reduce the incidence of nickel titanium instrument seperation.

Avaliação qualitativa do preparo de canais radiculares realizado "in vitro'' com instrumentos rotatórios de níquel-titânio RaCe e K3 / Qualitative evaluation of root canal preparations performed in vitro with rotary nickel-titanium instruments K3 and RaCe

O objetivo do presente estudo foi analisar a conicidade e regularidade dos canais radiculares preparados com instrumentos rotatórios de níquel-titânio Race® e K3®, utilizando contra ângulo redutor Dentfex®. O experimento envolveu canais me-siais de trinta molares humanos, superiores e inferiores, sendo aleatoriamente distribuídos em dois grupos de quinze, de acordo com os dois tipos de instrumentos rotatórios: RaCe® e K3®. A partir de então, realizou-se a moldagem dos canais radiculares, para em seguida submeter os dentes a desmineralização em ácido clorídrico a 35%, obtendo dessa forma o molde dos mesmos. Esses moldes foram analisados, onde se verifcou a conicidade e regularidade dos canais radiculares preparados. Os dados foram tabulados e submetidos à análise estatística por meio dos testes de Mann-Whitney e Qui-quadrado. Os resultados obtidos indicam a predominância de formas regulares cônicas, em todos os terços (cervical, médio, apical), nos sentidos mésio vestibular e mésio lingual e palatino dos canais preparados com os instrumentos Race® e K3®, mas houve diferença estatisticamente signifcante entre o número de ocorrência da forma irregular cilíndrica nos moldes dos canais mésio-vestibulares inferiores, preparados com os instrumentos RaCe®.

The aim of this study was to analyze the taper and regularity of root canals prepared with rotary nickel-titanium system Race® and K3®, using angle reducer Dentfex®. The experiment involved mesial canals of thirty human molars, upper and lo-wer were randomly assigned to two groups of ffteen, according to the two types of rotary instruments: RaCe® and K3®. Since then, there was casting of root canals, to then subject the teeth to demineralization in 35% hydrochloric acid, thereby obtaining the same mold. These paterns were analyzed, where there was a taper and regularity of root canals prepared. The data were tabulated and analyzed statistically by the Mann-Whitney and Chi-square. The results indicate the predominance of regular conical forms, in all thirds (cervical, middle, apical) in mesial buccal and mesial lingual and palatine canals prepared with Race® and K3®, but statistically signifcant diference between the number of occurrence of irregular cylindrical shape along the lines of mesiobuccal canals below, prepared with RaCe®.

Shaping effects of multi-taper nickel-titanium files combined with nickel-titanium K file in simulated S-shaped canals / 实用口腔医学杂志

Objective:To evaluate the shaping effects of multi-taper ProTaper combined with nickel-titanium(Ni-Ti) K file in simulated S-shaped canals. Methods:Thirty simulated S-shaped resinous canals were randomly divided into three groups and prepared with hand ProTaper, hand Ni-Ti K file, hand ProTaper combined with Ni-Ti K file respectively. The shaping effects were assessed by the amount of material removed from the inner and outer wall of canal as well as the width of canal after instrumentation. Results: The shaping files of ProTaper removed the least material in amount of materials from the same apical dimension. The finishing files of ProTaper removed the most amount of material at the inner side of curvature and outer side of apex. ProTaper combined with Ni-Ti K file removed the least material at the above parts and the widths of canals prepared were gradually decreased from the orifice to the apex. Conclusion:ProTaper combined with Ni-Ti K file exhibited good shaping effects in simulated S-shaped canals.

Shaping ability assessment of Hero 642 in curved canals / 实用口腔医学杂志

Objective: To evaluate shaping ability of nickel-titanium rotary instruments (Hero 642) in curved root canals. Methods:The computer assistant measure system of simulated root canal was used for quantitative analysis of root shape in eight simulated root canals during nickel-titanium rotary instruments (Hero 642) shaping process. Results:Nickel-titanium rotary instruments (Hero 642) could keep the curved angles in simulated canals very well. The cutting of Hero 642 in curved root canals was balanced and there was almost no transportation of canals central lines when the simulated canals were prepared to 0.02 taper 25~# and 30~# files. Conclusion:Nickel-titanium rotary instruments (Hero 642) has good shaping ability. In preparation of highly curved canals, the master apical file (MAF) may be Hero 642 0.02 taper 30# files.