Effects of clinical use of NiTi reciprocating instruments on cyclic and torsional resistance, and on roughness.

The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey's test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.

Effects of clinical use of NiTi reciprocating instruments on cyclic and torsional resistance, and on roughness

Abstrac The aim of the present study was to evaluate the cyclic fatigue, torsional resistance and surface roughness of Reciproc R25 instruments in four different situations, namely as new instruments and as instruments tested after clinical preparation of one, two or three maxillary molars with four root canals. The total time required to perform each root canal preparation was recorded. Cyclic fatigue resistance was determined by the time to fracture using a customized testing device (n = 10 per group). The torsional test evaluated the torque and angle of rotation to failure according to ISO 3630-1 (n = 10 per group). The roughness of the working parts of new and used instruments was evaluated with a profilometer (n = 5 per group). Statistical analysis was performed using one-way ANOVA and Tukey's test. The level of significance was set at 5%. No fractures or deformations were observed after clinical use. Higher preparation time was needed during the third use of the instruments for all root canals (p < 0.05). There were no significant differences among the groups in regard to either cyclic fatigue or torsional resistance (p > 0.05). Regarding the roughness measurements, groove depth was higher on new and one- versus two- or three-maxillary-molar-prepared instruments (p < 0.05). It can be concluded that the clinical use of Reciproc instruments increased preparation time and decreased surface roughness. However, clinical use did not affect the cyclic fatigue or torsional resistance of the Reciproc instruments.

Cyclic Fatigue and Torsional Resistance of Four Martensite-Based Nickel Titanium Reciprocating Instruments.

OBJECTIVE: To evaluate cyclic fatigue and torsional resistance of Reciproc Blue R25 (VDW, Munich, Germany), WaveOne Gold Primary (Dentsply Maillefer, Ballaigues, Switzerland), ProDesign R (Easy Equipamentos Odontológicos, Belo Horizonte, Brazil), and X1 Blue File (MK Life, Porto Alegre, Brazil) nickel titanium (NiTi) martensite reciprocating instruments. METHODS: In each group, ten instruments were tested for cyclic fatigue resistance using a stainless-steel artificial canal (curvature angle of 80° and radius of 3 mm) and ten instruments for torsional failure according to ISO 3630-1 standard. The surface of the fractured instruments was examined under scanning electron microscopy (SEM) at ×250 magnification. The results were compared statistically with one-way ANOVA and post hoc Tukey tests and the alpha-type error was set at 5%. RESULTS: X1 blue file and ProDesign Rinstruments showed highest time to fracture than Reciproc Blue and Wave One Gold (P<0.05). However, no differences were found between X1 Blue File and ProDesign R (P>0.05). In addition, Reciproc Blue demonstrated highest time to fracture than WaveOne Gold (P<0.05). The lowest torsional resistance (1.0±0.2 N.cm) and angle of rotation (412º±46) was observed in the ProDesign R group (P<0.05). SEM analyses of fractured surfaces showed a crack initiation area and overload fast fracture zone after cyclic fatigue test, and concentric abrasion marks with microvoids at the centre of rotation after torsional failure experiment. CONCLUSION: Overall, X1 Blue File and ProDesign R showed higher cyclic fatigue resistance than Reciproc Blue and WaveOne Gold instruments, while ProDesign R had the lowest torsional resistance and angular rotation values to fracture. SEM analysis of all instruments demonstrated typical failures features in both cyclic fatigue and torsional failure tests.

Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals.

BACKGROUND: The aim of this study was to evaluate the dentists' knowledge and practice regarding HIV positive individuals' oral care in Rio de Janeiro State. METHODS: Dentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests. RESULTS: From the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: "Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?" (p = 0.044), and "Do the negative HIV tests surely indicate that the persons are free of viruses?" (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001). CONCLUSION: Most dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.

Avaliação da citotoxicidade in vitro de diferentes pastas endodônticas utilizadas em odontopediatria / In vitro cytotoxic effects of different endodontic pastes used in pediatric dentistry

Objetivo: O presente estudo teve como objetivo avaliar o potencial citotóxico de três diferentes pastas endodônticas em cultura celular de osteoblastos humanos. Material e Métodos: As pastas endodônticas Calen PMCC (SSWhite Artigos Dentários LTDA, Rio de Janeiro, Brasil), Feapex (Fórmula e Ação, São Paulo, Brasil) e CTZ (Lenzafarm, Belo Horizonte, Brasil) foram preparadas e eluídas em meio de cultura celular durante 24 horas em estufa a 37°C e 5% de CO2. Foram realizadas quatro diluições distintas desses meios nas concentrações 1: 1, 1: 2, 1: 4 e 1: 8. Culturas de células de Osteoblastos Humanos da linhagem Saos-2 foram expostas a estas diluições durante 24 horas. O controle negativo foi realizado expondo as células ao meio de cultura sem contato com nenhuma pasta endodôntica. A citotoxicidade desses meios foi avaliada utilizando o ensaio MTT e os resultados foram transformados em porcentagens de células viáveis em relação ao grupo controle negativo. A análise estatística foi realizada com nível de significância de 5%, utilizando ANOVA seguido do teste de Tukey. Resultados: A viabilidade celular foi significativamente alterada de acordo com o material testado (p <0,05) e sua concentração (p <0,05). Em todas as concentrações testadas, a pasta Feapex apresentou maior viabilidade celular comparada aos demais materiais (p <0,05). Embora não tenha sido observada diferença estatisticamente significante entre a pasta Calen PMCC e a pasta CTZ nas concentrações de 1: 1 e 1: 2 (p> 0,05), a pasta CTZ apresentou maior citotoxicidade nas concentrações de 1: 4 e 1: 8 (p <0,05 ). De forma geral, a citotoxicidade diminuiu com o aumento da diluição do material. Conclusão: De acordo com os resultados do presente estudo, a pasta endodôntica Feapex parece ser a melhor opção para utilização entre as pastas analisadas, pois apresentou menor citotoxicidade que as pastas Calen PMCC e CTZ

Objective: The aim of the present study was to evaluate the cytotoxic potential of three different endodontic filling materials on human osteoblast cell cultures. Material and Methods: The endodontic pastes Calen PMCC (SSWhite Dental Articles LTDA, Rio de Janeiro, Brazil), Feapex (Formula and Action, São Paulo, Brazil) and CTZ (Lenzafarm, Belo Horizonte, Brazil) were eluted in cell culture medium during 24 hours in an oven at 37°C and 5% CO2. Four distinct dilutions of these media were performed at the concentrations 1:1, 1:2, 1:4 and 1:8. Cell cultures of Saos-2 Human Osteoblast-like were exposed to these dilutions for 24 hours. The negative control group was performed by exposing the cells to culture medium without contact with any endodontic paste. The cytotoxic potential of these media was evaluated using the MTT assay and the results were transformed into viable cell percentages in relation to the negative control group. Statistical analysis was submitted with a significance level of 5%, using univariate Analysis of Variance (ANOVA) followed by Tukey's test. Results: Cell viability was significantly altered according to the material tested (p<0.05) and its concentration (p<0.05). Feapex samples presented higher cell viability than the other materials in all concentrations tested (p<0.05). Although no statistically significant difference was observed between Calen PMCC paste and CTZ paste at concentrations of 1: 1 and 1: 2 (p>0.05), CTZ paste showed a higher cytotoxicity at concentrations of 1: 4 and 1: 8 (p<0.05). In general, cytotoxicity decreases with increasing material dilution. Conclusion: According to the results of the present study, Feapex endodontic paste seems to be the better option for use among the analyzed pastes, since it presented lower cytotoxicity than Calen PMCC and CTZ pastes

Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars.

OBJECTIVES: This study aimed to compare four final irrigation protocols (passive ultrasonic irrigation [PUI], EndoVac, Self-Adjusting File [SAF] and EasyClean) on the removal of accumulated hard-tissue debris (AHTD) from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis. MATERIALS AND METHODS: Forty mesial roots of mandibular molars presenting isthmuses type I or III were scanned in a micro-CT device and instrumented up to Reciproc R40 instrument. After the completion of canal preparations, root canals of each group were submitted to a final rinse using 20 mL of solution (16 mL of 5.25% NaOCl and 4 mL of 17% EDTA) in a total time of 5 min according to one of the four final irrigation protocols (n = 10): PUI, EndoVac, SAF and EasyClean operated at reciprocating motion. The sample was scanned again after canal preparation and after the use of the final irrigation protocols, and the registered data sets were examined to evaluate the percentage of AHTD. Data were statistically compared using the Tukey test with a significance level set at 5%. RESULTS: All groups presented a decrease on the accumulation of hard-tissue debris after the use of the final irrigation protocols (P < 0.05). No significant differences in the removal of AHTD were observed among the final irrigation protocols (P > 0.05). CONCLUSIONS: All final irrigation protocols showed the same effectiveness in the removal of AHTD. None of them was able to render mesial canals of mandibular molars completely free from packed debris. CLINICAL RELEVANCE: This study highlighted that all final irrigation protocols (PUI, EndoVac, SAF, and EasyClean) promoted a similar removal of AHTD. However, none of the final irrigation protocols was able to render mesial canals of mandibular molars completely free from packed debris.

Mechanical Properties of Anatomic Finishing Files: XP-Endo Finisher and XP-Clean.

The aim of the present study was to evaluate the cyclic fatigue of two anatomic finishing files: XP-Endo Finisher and XP-Clean. Roughness pattern and the micro-hardness of the files were also assessed. Instruments were subjected to cyclic fatigue resistance measuring the time to fracture in an artificial stainless-steel canal with a 60° angle and a 5-mm radius of curvature. The fracture surface of all fragments was examined with a scanning electron microscope. The roughness of the working parts was quantified by using a profilometer and the micro-hardness test was carried out using a Vickers hardness tester. Results were statistically analyzed using a student´s t-test at a significance level of P < 0.05. Weibull analysis was also performed. XP-Endo Finisher presented significantly longer cyclic fatigue life than XP-Clean instruments (P<0.05). XP-Endo Finisher was able to withstand 1000% more cycles to fracture when compared to XP-Clean instruments. SEM visual inspection of the fracture surfaces revealed fractographic characteristics of ductile fracture in all tested instruments; wide-ranging forms of dimples were identified and no plastic deformation in the helical shaft of the fractured instruments was observed. When mean life was compared XP-Endo Finisher lasted longer than XP-Clean with a probability of 99.9%. XP-Endo Finisher instruments also exhibited significantly lower roughness than XP-Clean instruments (P<0.05). No differences in the micro-hardness was observed between the files (P>0.05). It can be concluded that XP-Endo Finisher instruments showed improved performance when compared with XP-Clean instruments, demonstrating higher cyclic fatigue resistance and lower roughness.

Micro-computed tomographic evaluation of canal retreatments performed by undergraduate students using different techniques.

OBJECTIVES: This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated. MATERIALS AND METHODS: Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded. RESULTS: Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups. CONCLUSIONS: Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

Cyclic fatigue using severely curved canals and torsional resistance of thermally treated reciprocating instruments.

OBJECTIVES: To evaluate the cyclic fatigue using severely curved canals and torsional resistance of ProDesign R (Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil), Reciproc Blue (VDW, Munich, Germany), and WaveOne Gold (Dentsply Maillefer, Ballaigues, Switzerland) reciprocating instruments MATERIALS AND METHODS: Twenty instruments of the ProDesign R (25/0.06) system, 20 instruments of the Reciproc Blue (25/0.08v) system, and 20 instrument of the WaveOne Gold (25/0.07v) system were used. Cyclic fatigue resistance was tested measuring the time to fracture and the number of cycles to fracture in an artificial stainless steel severely curved canal with 80° angle and a 3-mm radius of curvature (n = 10). Torque and angle of rotation at failure of new instruments (n = 10) were measured according to ISO 3630-1. The fracture surfaces of all fragments were examined with a scanning electron microscope. Results were statistically analyzed using one-way ANOVA and Tukey's test at a significance level of p < 0.05. RESULTS: ProDesign R instruments showed a significantly longer cyclic fatigue life than the other tested instruments (p < 0.05). Reciproc Blue showed longer cyclic life than WaveOne Gold (p < 0.05). Reciproc Blue showed the higher torsional strength, followed by WaveOne Gold and ProDesign R instruments (p < 0.05). Moreover, Reciproc Blue showed significantly higher angular rotation to fracture than ProDesign R (p < 0.05). WaveOne Gold showed intermediary results regarding angular rotation to fracture with no differences when compared to Reciproc Blue or ProDesign R instruments (p < 0.05). CONCLUSIONS: ProDesign R presented the highest cyclic fatigue resistance in severely curved canals when compared with Reciproc Blue and WaveOne Gold. However, Reciproc Blue showed the higher torsional strength overall and higher angular rotation to fracture when compared to ProDesign R. CLINICAL RELEVANCE: Despite the numerous advantages of reciprocating instruments, these instruments still have some risk of fracture during its use, especially in severely curved canals. The present study evaluated the cyclic fatigue and torsional resistance of thermally treated reciprocating instruments.

Postoperative Pain after Endodontic Retreatment Using Rotary or Reciprocating Instruments: A Randomized Clinical Trial.

INTRODUCTION: The aim of this randomized clinical trial was to evaluate the influence of rotary or reciprocating retreatment techniques on the incidence, intensity, duration of postoperative pain, and medication intake. METHODS: After power analysis calculations, 65 patients who needed endodontic retreatment were randomly assigned to 1 of 2 groups according to the instrumentation system used: Mtwo (VDW, Munich, Germany) or Reciproc (VDW). Retreatments were performed in a single visit by an endodontic specialist. Participants were asked to rate the incidence and intensity of the postoperative pain on a verbal rating scale 24, 48, and 72 hours after treatment. Patients were also asked to record the number of prescribed analgesic medication tablets (ibuprofen 400 mg) taken. A logistic regression analysis was used to assess both the incidence and duration of pain. Differences in the intensity of pain were analyzed using the ordinal (linear) chi-square test, and the Mann-Whitney U test was used to assess differences in the intake of analgesic medication between groups. RESULTS: No statistically significant difference was found among the 2 groups in relation to postoperative pain or analgesic medication intake at the 3 time points assessed (P > .05). Multivariate analysis showed a significantly higher incidence of pain after 24 hours when preoperative pain was present and a significantly longer duration of pain for men than women independently of the retreatment technique used. CONCLUSIONS: The reciprocating system and the continuous rotary system were found to be equivalent regarding the incidence, intensity, duration of postoperative pain, and intake of analgesic medication.

Tratamento de dentes com rizogênese incompleta após procedimentos regenerativos ou de apicificação: uma revisão sistemática de literatura / Treatment of immature permanent teeth with regenerative procedures or apicification: a systematic literature review

Objetivo: realizar uma revisão sistemática de literatura para verificar as taxas de sucesso do tratamento de dentes permanentes imaturos com periodontite apical após procedimentos tradicionais de apicificação ou de procedimentos de regeneração/revascularização pulpar. Material e Métodos: uma busca eletrônica de artigos foi executada em bancos de dados PubMed e Cochrane, usando termos médicos específicos, entre janeiro de 2000 a junho de 2015. Outras publicações presentes na seção de referência de cada artigo relavante foi analisada a partir de uma busca manual e foram acrescentadas na lista de artigos selecionados. Resultados: inicialmente, um total de 114 títulos foi identificado. Um estudo adicional foi identificado como relevantes após uma busca das listas de referência. Após o enquadramento nos critérios de inclusão e exclusão, apenas dois artigos foram selecionados. Os estudos incluídos demonstram resolução dos sinais clínicos, sintomas e radiolucência periapical para ambas as formas de tratamento. Em contrapartida os estudos foram divergentes no que diz respeito ao aumento de comprimento e espessura radicular após terapias regenerativas; enquanto um estudo apresentou dados mais favoráveis à terapia regenerativa, o outro não demonstrou diferenças entre as duas terapias testadas. Conclusão: a presente revisão sistemática indica a existência de poucos estudos comparando diretamente as duas técnicas avaliadas. Além disso, os protocolos de revascularização oferecem o potencial para tratar dentes permanentes com rizogênese incompleta, com o consequente desaparecimento dos sinais e sintomas e uma maior possibilidade de continuidade de formação radicular quando comparados aos tradicionais procedimentos de apicificação.

Objective: to perform a systematic literature review to evaluate the success rates of treatment of immature permanent teeth with apical periodontitis after traditional procedures like apexification or regeneration/pulp revascularization. Materials and Methods: an electronic search was executed in the PubMed and Cochrane databases using specific medical terms. Articles published between January 2000 and June 2015 were evaluated. Other publications in the reference section of each relevant article were analyzed in a manual search and were added to the selected articles list. Results: at first, a total of 114 titles and resumes was identified after an electronic search in both electronic databases, using a specific combination of terms and keywords. An additional study was identified as being relevant after a reference list search. After the framing in the inclusion/exclusion criteria, only two articles were selected. The included studies demonstrated resolution of clinical signs, symptoms, and periapical radiolucencies to both treatments. On the other hand, these studies were divergent in relation to increased length and root thickness after regenerative therapy; while one of the studies presented more favorable outcomes to regenerative therapy, the other one showed no differences between the two tested therapies. Conclusion: although there are few studies performing a direct comparison between conventional therapies and regenerative therapies, the present systematic review indicates that revascularization protocols offer the potential to treat permanent teeth with incomplete root formation, leading to the disappearance of the signals, symptoms, and an increased possibility of continuing root formation.

Quantitative transportation assessment in simulated curved canals after large apical preparations

Aim: To evaluate the ability of rotary (ProTaper Universal [PTU] and ProTaper Next [PTN]), reciprocating (Reciproc [R] and WaveOne [WO]) and adaptive (Twisted File Adaptive [TFA]) systems in maintaining the original canal profile in straight and curved parts after apical preparations up to size 40. Methods: Resin blocks with simulated curved canals were randomly assigned to five groups: PTU, PTN, R, WO and TFA. Images were captured from each block before and after canal preparation (n=10). Assessment of canal transportation was obtained for the straight and curved parts of the canal. ANOVA followed by Tukey's test was used (α = 5%). Results: Transportation values were increased at the curved part (P = .00). For both canal levels, TFA system induced the lowest mean of canal transportation followed by PTN, R, WO and PTU systems. At the straight portion, transportation for R and TFA systems were similar (P > .05), and these values were significantly lower than for WO, PTN and PTU (P = .00). At the curved portion, TFA resulted in less canal transportation, followed by PTN, R, WO and PTU systems (P = .00). Conclusions: TFA system produced less canal transportation than other systems tested during large apical preparations. (AU)

Correlação do diâmetro do preparo de uma nova geração de instrumentos de NiTi com as dimensões de cones de guta-percha de sua antiga geração através de uma análise morfométrica / Correlation of the diameter preparation of a new generation of NiTi instrument with the dimensions of gutta-percha points of its old generation through a morphometric analysis

Objetivo: O presente trabalho teve o objetivo de determinar as dimensões e verificar se os instrumentos X1, X2 e X3 atendem as recomendações da norma ANSI/ ADA nº 101 e se os cones de guta-percha F1, F2 e F3 atendem a norma ANSI/ADA nº 78. Material e Métodos: Os resultados dos instrumentos foram comparados com as dimensões dos cones de guta-percha. Foram utilizados 10 instrumentos e 10 cones de cada tipo. As imagens para análise micromorfométrica foram obtidas com uma lupa Opticam e as medidas determinadas com o software TSView versão 7.2.1.7. Os diâmetros em D3, D6 e D9 reais foram comparados com os nominais pelo teste t-student. Os diâmetros dos instrumentos em D3, D6 e D9 foram comparados com os dos cones pelo teste Anova e complementados com teste de comparações múltiplas SNK. Todos os testes adotaram nível de significância α=5%. Resultados: Os resultados obtidos mostraram que há diferença estatisticamente significante entre as dimensões reais e nominais dos instrumentos (p < 0,05). O instrumento X3 apresentou diferença estatisticamente significante em relação ao cone F1 (p < 0,05), onde os valores do cone são menores do que os dos instrumentos. Conclusão: Dentro das limitações deste estudo pôde-se concluir que: os instrumentos X1 e os cones de guta-percha não atenderam as recomendações de suas normas. O cone F1 pode ser uma opção para obturação dos canais modelados com o instrumento X3, porém a termoplastificação se faz necessária.

Objective: The aim of the present study was to verify if the Protaper Next instruments X1, X2, and X3 and the Protaper Universal gutta-percha cones F1, F2, and F3 meet the ANSI/ADA 101 and 78 recommendations. Material and Methods: The instruments' dimensions were compared with those obtained by the gutta-percha cones. For this, ten instruments and ten cones of each type were used. Micromorphometric images were obtained and analyzed through a stereomicroscope (OptiCam) and measurements were obtained with TSView software, version 7.2.1.7. The D3, D6, and D9 diameters were compared with the nominal diameters using the Student's t-test. After this, the real diameters of the instruments D3, D6, and D9 were compared with the gutta-percha cone diameters by Anova supplemented with SNK test for multiple comparisons. A p ≤0.05 was considered significant. Results: The results showed statistically significant differences between the real diameter and nominal diameter of the instruments (p <0.05). The X3 instrument showed a statistically significant difference when compared to the F1 cone (p <0.05), and the cone values were lower than the instrument values. Conclusion: Within the limitations of this study, it can be concluded that: 1) the X1 instrument and the gutta-percha points did not meet the recommendations, and 2) the F1 cone can be an option for filling the modeled channels with the X3 instrument, but termoplastification is required.

Assessment of apically extruded debris produced by the self-adjusting file system.

INTRODUCTION: This study was designed to quantitatively evaluate the amount of apically extruded debris by the Self-Adjusting-File system (SAF; ReDent-Nova, Ra'anana, Israel). Hand and rotary instruments were used as references for comparison. METHODS: Sixty mesial roots of mandibular molars were randomly assigned to 3 groups (n = 20). The root canals were instrumented with hand files using a crown-down technique. The ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) and SAF systems were used according to the manufacturers' instructions. Sodium hypochlorite was used as an irrigant, and the apically extruded debris was collected in preweighted glass vials and dried afterward. The mean weight of debris was assessed with a microbalance and statistically analyzed using 1-way analysis of variance and the post hoc Tukey multiple comparison test. RESULTS: Hand file instrumentation produced significantly more debris compared with the ProTaper and SAF systems (P < .05). The ProTaper system produced significantly more debris compared with the SAF system (P < .05). CONCLUSIONS: Under the conditions of this study, all systems caused apical debris extrusion. SAF instrumentation was associated with less debris extrusion compared with the use of hand and rotary files.

Bending resistance and dynamic and static cyclic fatigue life of Reciproc and WaveOne large instruments.

INTRODUCTION: The aim of the present study was to evaluate the bending resistance and the dynamic and static cyclic fatigue life of Reciproc R40 and WaveOne large instruments. METHODS: A sample of 68 nickel-titanium instruments (25 mm in length) for use under reciprocation movement (Reciproc and WaveOne) from 3 different lots was tested. Reciproc R40 and WaveOne Large files, both of which had a nominal size of 0.40 mm at D0, were selected. The bending resistance was performed in 10 instruments of each system by using a universal testing machine. Dynamic and static models for cyclic fatigue testing were performed by using a custom-made device. For these tests, an artificial canal measuring 1.4 mm in diameter and 19 mm total length was fabricated from a stainless steel tube. Scanning electron microscopy analysis was performed to determine the mode of fracture. Statistical analysis was performed by using parametric methods, 1-way analysis of variance. Post hoc pair-wise comparisons were performed by using Tukey test for multiple comparisons. RESULTS: WaveOne instruments presented significantly higher bending resistance than Reciproc (P < .05). Moreover, Reciproc revealed a significantly longer cyclic fatigue life (P < .05) in both static and dynamic tests (P < .05). CONCLUSIONS: Reciproc R40 instruments resisted dynamic and static cyclic fatigue significantly more than WaveOne Large instruments. Furthermore, WaveOne instruments presented significantly less flexibility than Reciproc.

Self-adjusting file cleaning-shaping-irrigation system improves root-filling bond strength.

INTRODUCTION: The aim of the present study was to assess the bond strength of root fillings in oval-shaped canals prepared with the self-adjusting file (SAF) system. METHODS: A careful specimen selection resulted in 2 equal groups, each consisting of 12 extracted mandibular canines with oval canals that had vital pulps before extraction. One group was subjected to the SAF protocol, and the other group underwent conventional protocol, which was the ProTaper system with syringe-needle irrigation. Full-strength sodium hypochlorite was used as an irrigant for both groups. The teeth were obturated in a standardized way, filled with a lentulo spiral as the root filling, and then prepared for micropush-out assessment by using root slices of 1-mm thickness. Loading was performed on a universal testing machine at a speed of 0.5 mm/min(-1). The Student's t test for pairwise comparisons was applied to assess the effect of each preparation technique on the push-out bond strength. RESULTS: All specimens showed measurable adhesive properties to root dentin. In addition, no premature failure occurred. The group-by-location interaction was significant (P = .0071); thus, the group comparisons were dependent on the canal third. Overall, the push-out bond strength was the highest in the coronal third and the lowest in the apical third. SAF-prepared specimens displayed significantly higher bond strengths (P = .0012, 0.51-5.9 MPa). CONCLUSIONS: The present study showed that SAF preparation markedly influenced root-filling push-out bond strength in oval-shaped canals. Further investigations are needed to provide a better understanding of the physicochemical modifications of the root dentin prepared with the SAF cleaning-shaping-irrigation system.

Influence of curvature location along an artificial canal on cyclic fatigue of a rotary nickel-titanium endodontic instrument.

OBJECTIVES: This study evaluated the effects of curvature location along an artificial canal on cyclic fatigue (CF) of an Mtwo rotary instrument, verifying the number of cycles to fatigue fracture (NCF) and morphologic characteristics of the fractured instruments. STUDY DESIGN: CF testing of instruments was performed in artificial canals with curvature radii of 10 mm and arc lengths of 11 mm. Mtwo rotary instruments size 40, 0.04 taper were used in 2 groups (n = 10): group A, curvature positioned on middle part; group B, apical curvature. All instruments were rotated until fracture. The number of cycles to failure was registered. Data were analyzed by independent sample t test. Fractured surfaces and the helical shafts of the instruments were analyzed by scanning electron microscopy. RESULTS: NCF for groups A and B had significant statistic differences (P < .05). The highest values were found in the group where the curvature was positioned on the apical part of the canal. No plastic deformation was observed on the helical shafts. CONCLUSIONS: The number of cycles to fracture of the Mtwo instruments increased when the arc was changed from the middle to the apical part of the canal. The morphologic characteristics of the fractured surfaces were of the ductile type.

Um instrumento NiTi fabricado por torção: morfologia e propriedades mecânicas / A NiTi rotary instrument manufactured by twisting: morphology and mechanical properties

A morfologia da superfície dos instrumentos TF® foi estudada utilizando estereomicroscopia e microscopia eletrônica de varredura (MEV). Ensaios mecânicos foram feitos para aferir a flexibilidade e a microdureza. Quatro conicidades de instrumentos TF® foram utilizadas (0,04;0,06; 0,08 e 0,10mm/mm). A estereomicroscopia associada com o programa AxioVision® foi utilizada para medir o ângulo da ponta, a conicidade e o diâmetro da ponta dos instrumentos. A MEV foi utilizada para identificar defeitos na superfície provenientes da fabricação e do acabamento.A flexibilidade e a microdureza foram aferidas com os ensaios de flexão e microdureza Vickers, respectivamente.A análise mostrou que o fabricante atendeu aos valores recomendados pela norma nº 28 ANSI/ADA. Os resultados da microscopia eletrônica de varredura mostraram muitos defeitos de superfície e distorção da aresta lateral dos instrumentos.Foi observado que a flexibilidade do instrumento muda com a conicidade. As forças para induzir a transformação de fase por tensão nos instrumentos com conicidade 0,04; 0,06 e 0,08mm/mm foram de 100gf, 150gf e 250gf,respectivamente. Os valores da microdureza Vickers dos instrumentos são compatíveis com os encontrados nos instrumentos fabricados pelo processo de usinagem.

Objectives: The surface morphology of TF® endodonticinstruments was studied using stereomicroscopy and scanningelectron microscopy (SEM). Mechanical tests weredone for flexibility and microhardness. Methods: Fourtapers of TF® files were used (0.04; 0.06; 0.08 and 0.10mm/mm). The stereomicroscopy associated with the AxioVision® program was used to measure the tip angle, thehelical angle, the taper and the tip diameter of the instruments.SEM was used to identify surface defects due to machiningand finishing. The flexibility and the microhardnesswere measured with bending and microhardness Vickerstests, respectively. Results and Conclusion: The analysisshowed that the manufacturer complied with the valuesrecommended by the ANSI/ADA standard number 28. TheSEM results showed many surface defects and a distortionof the instrument helix. It was observed that the instrumentflexibility changes with its taper. The forces to induce thephase transformation by stress on instruments with taper0.04; 0.06 and 0.08 mm/mm were 100 gf, 150 gf and 250gf, respectively. The values of Vickers microhardness of theinstruments are compatible with rotary instruments manufacturedby the machining process.

Influência da velocidade de rotação no número de ciclos para a fratura de instrumentos endodônticos ProTaper Universal S2 / Influence of rotation speed on the number of cycles to fracture engine-driven ProTaper Universal S2

O presente trabalho avaliou a influência da velocidade de rotação no número de ciclos necessários para fraturar instrumentos endodônticos de NiTi mecanizados. Instrumentos ProTaper Universal S2 de 25 mm de comprimento a 300 e 600 rpm foram usados em um canal curvo. Os resultados indicaram que o número de ciclos requerido para causar a fratura foi influenciado pela velocidade de rotação.

Ampliação do preparo apical de canais curvos em função da flexibilidade dos instrumentos endodônticos / Expansion of the apical preparation in curved canals according to the endodontic instruments flexibility

O objetivo deste trabalho foi avaliar a influência da liga metálica na flexibilidade de instrumentos endodônticos. Foram utilizados instrumentos endodônticos de aço inoxidável e de NiTi de 25 mm de comprimento útil, conicidadede 0,02 mm/mm e de números 40 e 45. A flexibilidade dos instrumentos foi determinada por meio de um ensaio de flexão em cantilever. Com base nos resultados experimentais obtidos, pode-se concluir que entre os instrumentos endodônticos tipo K de mesmo número, os de NiTi são mais flexíveis e menos rígidos do que os de aço inoxidável.