The self-adjusting file (SAF). Part 1: respecting the root canal anatomy--a new concept of endodontic files and its implementation.

AIM: To introduce a new concept, the self-adjusting file (SAF), and discuss its unique features compared with current rotary nickel-titanium file systems. THE NEW CONCEPT: The SAF file is hollow and designed as a thin cylindrical nickel-titanium lattice that adapts to the cross-section of the root canal. A single file is used throughout the procedure. It is inserted into a path initially prepared by a # 20 K-file and operated with a transline- (in-and-out) vibration. The resulting circumferential pressure allows the file's abrasive surface to gradually remove a thin uniform hard-tissue layer from the entire root canal surface, resulting in a canal with a similar cross-section but of larger dimensions. This holds also for canals with an oval or flat cross-section, which will be enlarged to a flat or oval cross-section of larger dimensions. The straightening of curved canals is also reduced because of the high pliability of the file and the absence of a rigid metal core. Thus, the original shape of the root canal is respected both longitudinally and in cross-section. The hollow SAF file is operated with a constant flow of irrigant that enters the full length of the canal and that is activated by the vibration and is replaced continuously throughout the procedure. This results in effective cleaning even at the cul de sac apical part of the canal. The SAF has high mechanical endurance; file separation does not occur; and mechanical failure, if it occurs, is limited to small tears in the latticework. CONCLUSION: The SAF represents a new step forward in endodontic file development that may overcome many of the shortcomings of current rotary nickel-titanium file systems.

The self-adjusting file (SAF). Part 2: mechanical analysis.

INTRODUCTION: The study was designed to explore the mechanical properties of the self-adjusting file (SAF) and its application in the root canal using continuous irrigation. METHODS: The compressibility of the SAF file and the resulting peripheral force were measured using specially designed systems. The abrasivity of the file was tested on dentin blocks representing a flat root canal. The durability of the SAF file was tested using a functional fatigue-to-failure assay. Degradation of the file was evaluated by using files that were previously used for 10, 20, and 30 minutes and comparing their efficacy with that of new, unused files. The potential of extruding irrigant beyond the apex was explored in roots with an open apical foramen. RESULTS: The SAF file was elastically compressible from a diameter of 1.5 mm to dimensions similar to those of a #20 stainless steel K-file. This compression resulted in an evenly applied force to the root canal walls. The in-and-out vibration of the file and the peripheral force, combined with its abrasivity, allow for hard-tissue removal. Under the conditions of the experiment, no mechanical failure was observed with up to 29 minutes of operation in the root canal. The file loses its efficacy after prolonged use, with a 40% reduction after 30 minutes of operation. The operation of the file with continuous irrigation did not push the irrigant beyond an open apical foramen. CONCLUSIONS: The SAF file is an elastically compressible file that effectively removes dentin and can mechanically endure use under its recommended mode of operation with a minimal loss of efficacy.