Micro-XRD and temperature-modulated DSC investigation of nickel-titanium rotary endodontic instruments.

OBJECTIVES: Employ Micro-X-ray diffraction and temperature-modulated differential scanning calorimetry to investigate microstructural phases, phase transformations, and effects of heat treatment for rotary nickel-titanium instruments. METHODS: Representative as-received and clinically used ProFile GT and ProTaper instruments were principally studied. Micro-XRD analyses (Cu Kalpha X-rays) were performed at 25 degrees C on areas of approximately 50 microm diameter near the tip and up to 9 mm from the tip. TMDSC analyses were performed from -80 to 100 degrees C and back to -80 degrees C on segments cut from instruments, using a linear heating and cooling rate of 2 degrees C/min, sinusoidal oscillation of 0.318 degrees C, and period of 60s. Instruments were also heat treated 15 min in a nitrogen atmosphere at 400, 500, 600 and 850 degrees C, and analyzed. RESULTS: At all Micro-XRD analysis regions the strongest peak occurred near 42 degrees , indicating that instruments were mostly austenite, with perhaps some R-phase and martensite. Tip and adjacent regions had smallest peak intensities, indicative of greater work hardening, and the intensity at other sites depended on the instrument. TMDSC heating and cooling curves had single peaks for transformations between martensite and austenite. Austenite-finish (A(f)) temperatures and enthalpy changes were similar for as-received and used instruments. Heat treatments at 400, 500 and 600 degrees C raised the A(f) temperature to 45-50 degrees C, and heat treatment at 850 degrees C caused drastic changes in transformation behavior. SIGNIFICANCE: Micro-XRD provides novel information about NiTi phases at different positions on instruments. TMDSC indicates that heat treatment might yield instruments with substantial martensite and improved clinical performance.

Personality traits of endodontic residents indicate potential for becoming endodontic faculty.

Dental schools across America are challenged by the shortage of qualified faculty to fill vacant positions. This project, conducted through survey methodology, focused on obtaining a basic understanding of the personality types that seek out and maintain positions as full-time endodontic educators and compared those educators with endodontic residents to define similarities and differences that could lead to strategies to recruit those residents into academic endodontic education to assist in alleviating the faculty shortage in dentistry. All full-time endodontic faculty and residents were invited to participate. The Myers Briggs type indicator form M was administered electronically to faculty and postgraduates/residents. A 38.8% faculty and 21.3% resident response rate was achieved. Survey results were analyzed by using description statistics and chi-square tests. Results of the study indicate that there are parallel personality preferences of residents and faculty resulting in recommendations of early identification of academic interest, structured mentoring, faculty development of residents, and the implementation of debt-reduction strategies to ease entry into academic dentistry.

Vickers hardness investigation of work-hardening in used NiTi rotary instruments.

A contributing mechanism for clinical failure of NiTi rotary instruments might be excessive work hardening. Vickers hardness was measured with 300 gm load near the flutes in three regions (D2-D4, D6-D10, and D14 towards the shank) for nine representative clinically used ProFile GT instruments that had been axially sectioned (10 measurements in each region). Consistent values could not be obtained at D1. Minimum hardness occurred at D2 to D4, with means from 313 to 324 (SD from 7 to 16). Maximum hardness with means ranging widely from 330 to 481 was found beyond D14. Mean hardness at D2 to D4 was 320 for an as-received ProFile instrument. Because a mean Vickers hardness of 326 has been reported for a shape-memory NiTi orthodontic wire product, it can be concluded that the NiTi instruments did not experience substantial work hardening at D2 to D4 during clinical use, in agreement with previous differential scanning calorimetric analyses.

Remaining dentin thickness in the apical 4 mm following four cleaning and shaping techniques.

The aim of this study was to determine the remaining dentin thickness (RDT) in the apical 4 mm following four cleaning and shaping techniques. Sixty human adult extracted mandibular incisors and 60 mesial buccal canals of mandibular molars were assigned to five groups of 12 teeth for each tooth type: Step-down stainless steel hand instrumentation, Lightspeed, Profile GT and 0.4 taper, K3 "g pack," control group. After instrumentation the teeth were sectioned at 0.5, 1.5, 2.5, and 3.5 mm short of working length (WL) and evaluated for the minimum RDT at each level. ANOVA of RDT showed significant differences among levels and techniques. For incisors, no technique yielded greater RDT than the other techniques (p < 0.0001). For molars, K3 had greater RDT than the other techniques (p = 0.0006) at the 1.5, 2.5, and 3.5 mm levels. While there were significant statistical differences in RDT among techniques at different levels, further study would be required to determine any significant clinical difference in RDT.

SEM observations of nickel-titanium rotary endodontic instruments that fractured during clinical Use.

Numerous discarded ProFile GT, ProFile, and ProTaper nickel-titanium rotary instruments obtained from two graduate endodontic clinics were examined by scanning electron microscopy. These instruments had an unknown history of clinical use and had fractured or experienced considerable permanent torsional deformation without complete separation. The failure processes generally exhibited substantial ductile character, evidenced by a dimpled rupture fracture surface. Crack propagation at grain boundaries and cleavage surfaces indicative of transgranular fracture were observed for some specimens. It appeared that oxide particles from the manufacturing process served as nucleating sites for the microvoids, leading to dimpled rupture. A previously unreported fracture mode also was observed, in which crack propagation, approximately parallel to the local flute orientation, connected pitted regions on the surface. Combining present and previous scanning electron microscopy observations of clinically failed instruments, suggestions are offered for improving their fracture resistance.

Proposed role of embedded dentin chips for the clinical failure of nickel-titanium rotary instruments.

Discarded ProFile and ProTaper nickel-titanium rotary instruments, with unknown history of clinical use, were obtained from graduate endodontic clinics at Ohio State University and University of Texas Health Science Center at Houston Dental Branch. These discarded instruments and as-received instruments of both types were examined with a scanning electron microscope to investigate effects of clinical use and causes of failure. For used ProTaper instruments, dentinal debris was wedged mostly in narrow, radial, land-type regions and less on convex flute surfaces. For used ProFile instruments, dentinal debris was wedged mostly in the metal rollover and on concave flute surfaces. Used instruments of both types exhibited widened machining grooves, and elongated and stretched roll-over. Dentin chips were wedged in surface micro-cracks that appeared to propagate from original machining flaws and widen during in vivo root canal preparation. From our observational study, wedged dentinal deposits seem to play a pivotal role for clinical failure of these instruments.

Scanning electron microscope observations of new and used nickel-titanium rotary files.

The appearances of the tip sections of ProFile 0.04 taper and Lightspeed 25-mm long, ISO size 25, nickel-titanium rotary instruments were compared with a scanning electron microscope in the as-received condition and after one, three, and six simulated clinical uses to prepare mesial canals of extracted mandibular molars. For the used ProFile instruments, there was some flattening of the characteristic material rollover and minor apparent wear at the edges of the flutes, but there was little change in the tip regions of the used Lightspeed instruments. Deposits on the surfaces of the instruments were attributed to the manufacturing processes and the in vitro preparation of root canals in the extracted teeth. The simulated clinical use did not cause substantial changes in the regions of these two brands of rotary instruments that are involved in the clinical preparation of root canals.

The deterioration of rotary nickel-titanium files under controlled conditions.

It has been shown that rotary nickel-titanium files cannot be used indefinitely. Researchers and clinicians have not been able to agree on how many times a file can be used before being discarded, except if a file has fractured or become visibly distorted. This study used ISO size 20 files of 0.04 taper in the curved canals of extracted mandibular molars. The canals had been previously instrumented to an ISO size 15 with stainless steel hand files. The irrigant used during rotary and hand instrumentation was Glyde. The rotary files were closely examined with scanning electron microscopy before use to detect any defects. They were then reexamined after each of five uses to document deterioration. An electric handpiece was configured to rotate at 150 rpm and secured to the testing device, which also held the extracted tooth. The testing device controlled the load at 8 N, the depth of penetration for each canal and the rate of penetration (12 mm/min). Used instruments demonstrated surface fatigue wear and cracking. Torsional moment at failure was determined on a torsiometer for used and new instruments. Data (n = 10) were analyzed by analysis of variance. The torsional moment for used and new instruments was not affected by use (p = 0.25).