Exploring access cavity through non-carious cervical lesions: Impacts on instrumentation, obturation, and fracture resistance in mandibular incisors.

AIM: To compare the effects of Cervical Access Cavity (CervAC) and Traditional Access Cavity (TradAC) on root canal preparation, root canal filling, and fracture resistance in mandibular incisors. METHODOLOGY: Twenty recently extracted and intact mandibular incisors were initially scanned using a micro-CT device. The specimens were anatomically matched to create two groups (n = 10). A wedge-shaped non-carious cervical lesion (NCCL) was created on the buccal aspect of all teeth using a double-faced segmented diamond disc. In group 1, a TradAC was prepared, whilst in group 2, access was created through the simulated NCCL using a round diamond bur 1012. After root canal preparation with Rotate instruments sizes 15/0.04, 20/0.04, and 25/0.04, the teeth were scanned again and evaluated for root canal volume and surface area, static voxels, volume of removed dental tissue, and dentine thickness. After that, the root canals were filled using the single-cone technique, teeth were restored with composite resin, and subsequently rescanned to calculate the volume of filling materials and voids. Then, the restored teeth were subjected to fracture resistance tests using a universal testing machine. Statistical comparisons between groups were performed with the Mann-Whitney test or the Student's t-test, with a statistical significance level of 5%. RESULTS: Statistical comparisons indicated no significant differences between groups in terms of root canal volume, surface area, static voxels, removed root dentine, root canal filling volume, percentage of voids, or fracture resistance load (p > .05). Conversely, teeth prepared with TradAC showed a significantly higher percentage of dental tissue removed from the crown (p = .001) and a greater volume of filling material remnants in the pulp chamber (p < .001) compared to the CervAC group. A significantly lower percentage reduction in dentine thickness was observed only on the mesial aspect of root at Level 1 in TradAC group (p = .008). CONCLUSIONS: CervAC can be considered a viable alternative approach in the presence of NCCL in mandibular incisors.

Multimethod analysis of large- and low-tapered single file reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow.

AIM: To compare eight large- and low-tapered heat-treated reciprocating instruments regarding their design, metallurgy, mechanical properties, and irrigation flow through an in silico model. METHODOLOGY: A total of 472 new 25-mm E-Flex Rex (25/.04 and 25/.06), Excalibur (25/.05), Procodile (25/.06), Reciproc Blue R25 (25/.08v), WaveOne Gold Primary (25/.07v), and Univy Sense (25/.04 and 25/.06) instruments were evaluated regarding their design (stereomicroscopy, scanning electron microscopy, and 3D surface scanning), metallurgy (energy-dispersive X-ray spectroscopy and differential scanning calorimetry), and mechanical performance (cyclic fatigue, torsional resistance, cutting ability, bending and buckling resistance). Computational fluid dynamics assessment was also conducted to determine the irrigation flow pattern, apical pressure, and wall shear stress in simulated canal preparations. Kruskal-Wallis and one-way anova post hoc Tukey tests were used for statistical comparisons (α = 5%). RESULTS: Instruments presented variations in blade numbers, helical angles, and tip designs, with all featuring non-active tips, symmetrical blades, and equiatomic nickel-titanium ratios. Cross-sectional designs exhibited an S-shaped geometry, except for WaveOne Gold. Univy 25/.04 and Reciproc Blue displayed the smallest and largest core diameters at D3. Univy 25/.04 and E-Flex Rec 25/.04 demonstrated the longest time to fracture (p < .05). Reciproc Blue and Univy 25/.04 exhibited the highest and lowest torque to fracture, respectively (p < .05). Univy 25/.04 and Reciproc Blue had the highest rotation angles, whilst E-Flex Rec 25/.06 showed the lowest angle (p < .05). The better cutting ability was observed with E-Flex Rec 25/.06, Procodile, Excalibur, and Reciproc Blue (p > .05). Reciproc R25 and E-Flex Rec showed the highest buckling resistance values (p < .05), with WaveOne Gold being the least flexible instrument. The impact of instruments' size and taper on wall shear stress and apical pressure did not follow a distinct pattern, although Univy 25/.04 and E-Flex Rec 25/.06 yielded the highest and lowest values for both parameters, respectively. CONCLUSIONS: Low-tapered reciprocating instruments exhibit increased flexibility, higher time to fracture, and greater angles of rotation, coupled with reduced maximum bending loads and buckling strength compared to large-tapered instruments. Nevertheless, low-tapered systems also exhibit lower maximum torque to fracture and inferior cutting ability, contributing to a narrower apical canal enlargement that may compromise the penetration of irrigants in that region.

To flat or not to flat? Exploring the impact of flat-side design on rotary instruments using a comprehensive multimethod investigation.

AIM: To assess the influence of a flat-side design on the geometry, metallurgy, mechanical performance and shaping ability of a novel nickel-titanium rotary instrument. METHODOLOGY: Sixty-five new 25-mm flat-side rotary instruments (size 25, taper 0.04) and their nonflat-side prototypes (n = 65) were assessed for major deformations and examined regarding macroscopic and microscopic design, determination of nickel and titanium elements ratio, measurement of phase transformation temperature and evaluation of mechanical performance parameters including time/cycles to fracture, maximum torque, angle of rotation, maximum bending and buckling strengths and cutting ability. Additionally, unprepared canal areas, volume of hard tissue debris and percentage reduction of dentine thickness were calculated for each tested instrument after preparing mesial canals of mandibular molars (n = 12), using micro-CT imaging. Statistical analyses were performed using the U-Mann-Whitney test and independent Student t-test (α = 5%). RESULTS: The number of spirals (n = 8) and blade direction (clockwise) were similar between both flat and nonflat instruments, whilst the helical angles were equivalent (⁓25°). Flat-instruments showed inconsistencies in the homogeneity of the gold colour on the flat-side surface, blade discontinuity, and incomplete and variable S-shaped cross-sections. The titanium-to-nickel ratios were equivalent, but significant differences in the R-phase finish and austenitic start phase transformation temperatures were observed between the flat and nonflat-side instruments. The flat-side instruments demonstrated superior cutting ability compared to the nonflat instruments, as well as, significantly lower values for time to fracture, rotation to fracture and maximum torque to fracture (p < .001). No statistical difference was observed between tested instruments regarding angle of rotation (p = .437), maximum bending (p = .152) and buckling load (p = .411). Preparation protocols using flat and nonflat instruments did not show any statistically significant differences (p > .05). All flat-side instruments exhibited deformation after shaping procedures. CONCLUSIONS: The flat-side instrument showcased enhanced cutting ability compared to its nonflat counterpart. However, it exhibited inferior performance in terms of time, rotation and maximum torque to fracture, along with distinct phase transformation temperatures. No differences were observed in the titanium-to-nickel ratios, angle of rotation, maximum bending, buckling load, preparation time, percentage of untouched canal walls, volume of hard tissue debris and percentage reduction of dentine thickness.

Multimethod analysis of three rotary instruments produced by electric discharge machining technology.

AIM: This study aimed to compare three rotary instruments produced by the EDM process with the heat-treated ProTaper Gold system regarding design, metallurgy, mechanical properties and shaping ability. METHODOLOGY: HyFlex EDM (25/~), Neoniti (25/.06), EDMax (25/.06) and ProTaper Gold (25/.08v) instruments (n = 58 per group) were compared regarding design, metallurgy and mechanical performance. Unprepared canal areas were calculated for each system after preparation of mesiobuccal, mesiolingual and distal canals of mandibular molars (15 canals per group) using micro-CT technology. Statistical analyses were performed using One-way anova post-hoc Tukey and Kruskal-Wallis post-hoc Dunn's tests (α = 5%). RESULTS: All instruments had asymmetrical blades, no radial lands, no major defects and almost equiatomic nickel/titanium ratios, but different cross-section designs, tip geometries and surface appearances. Although instruments had distinct transformation temperature curves, they showed crystallographic martensitic arrangement at 21°C and mixed austenite plus R-phase at body temperature. Neoniti and HyFlex EDM showed similar results in all mechanical tests (p > .05), while EDMax and ProTaper Gold had similar time to fracture (p = .841), maximum bending load (p = .729), and cutting ability (p = .985). ProTaper Gold showed the highest torque to failure (p < .001) and HyFlex EDM had the lowest buckling resistance (p < .001). Mean percentages of unprepared canal areas ranged from 20.4% to 25.7% in the mesial canals, and from 20.8% to 26.2% in the distal canal, with no statistical differences among systems (p > .05). CONCLUSIONS: Instruments' geometry and phase transformation temperatures influenced the results of the mechanical tests, but not their shaping ability.

Diamondlike Carbon Surface Treatment Improves the Fatigue Resistance of Ultrasonic Tips.

INTRODUCTION: The aim of this study was to compare E1-Irrisonic (Helse Ultrasonics, Ocoee, FL) and Irri Black (Helse Ultrasonics), a novel ultrasonic tip with diamondlike carbon treatment, regarding their design, metallurgy, microhardness, bending resistance, and time to fracture under the oscillatory fatigue test. METHODS: A total of 17 E1-Irrisonic and 17 Irri Black new ultrasonic tips were selected. The tip geometry and surface finishing were assessed using scanning electron microscopy. The elemental composition was defined by energy-dispersive X-ray spectroscopy. Hardness Knoop was calculated using a microhardness tester. The maximum load required to displace the instrument in 45° was recorded in gram/force, oscillatory fatigue was measured in seconds at the moment of instrument fracture, and the size of the separate fragments was determined in millimeters. The Student t test was used for statistical comparison (α = 5%). RESULTS: Scanning electron microscopic analyses revealed that E1-Irrisonic had a flat end tip, whereas a noncutting rounded tip was observed in Irri Black. The surface of E1-Irrisonic was smoother than Irri Black, which was irregular. Energy-dispersive X-ray spectroscopic analyses showed that the elemental compositions of the E1-Irrisonic and Irri Black tips were consistent with stainless steel and titanium-aluminum alloys, respectively. Irri Black showed significantly higher bending load resistance, time to fracture under oscillatory motion, and hardness Knoop than the E1-Irrisonic tip (P < .05), whereas the length of fragments was similar (P > .05). CONCLUSION: Diamondlike carbon treatment improved hardness Knoop and reduced the flexibility of the Irri Black ultrasonic tip, improving its time to fracture under oscillatory motion compared with the nontreated E1-Irrisonic tip.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable.

The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

A Multimethod Assessment of a New Customized Heat-Treated Nickel-Titanium Rotary File System.

This study aimed to compare three endodontic rotary systems. The new Genius Proflex (25/0.04), Vortex Blue (25/0.04), and TruNatomy (26/0.04v) instruments (n = 41 per group) were analyzed regarding design, metallurgy, and mechanical performance, while shaping ability (untouched canal walls, volume of removed dentin and hard tissue debris) was tested in 36 anatomically matched root canals of mandibular molars. The results were compared using one-way ANOVA, post hoc Tukey, and Kruskal−Wallis tests, with a significance level set at 5%. All instruments showed symmetrical cross-sections, with asymmetrical blades, no radial lands, no major defects, and almost equiatomic nickel−titanium ratios. Differences were noted in the number of blades, helical angles, cross-sectional design, and tip geometry. The Genius Proflex and the TruNatomy instruments had the highest and lowest R-phase start and finish temperatures, as well as the highest and lowest time and cycles to fracture (p < 0.05), respectively. The TruNatomy had the highest flexibility (p < 0.05), while no differences were observed between the Genius Proflex and the Vortex Blue (p > 0.05). No differences among tested systems were observed regarding the maximum torque, angle of rotation prior to fracture, and shaping ability (p > 0.05). The instruments showed similarities and differences in their design, metallurgy, and mechanical properties. However, their shaping ability was similar, without any clinically significant errors. Understanding these characteristics may help clinicians to make decisions regarding which instrument to choose for a particular clinical situation.

Mechanical performance of original; yellowish and blueish ProFile instruments: isolating heat-treatment as a variable

Resumo O presente estudo teve como objetivo realizar dois tratamentos térmicos diferentes em instrumentos de NiTi austenítico ProFile e comparar o desempenho mecânico de instrumentos originais e tratados termicamente. O tratamento térmico dos instrumentos ProFile (tamanho de ponta 25 e conicidade 0.06) foi realizado em um forno em atmosfera de argônio usando uma taxa de aquecimento de 10°C/min. Após atingir as temperaturas programadas de 450 ºC ou 500 ºC o sistema permaneceu em temperatura constante por 10 minutos; seguido de resfriamento em água à temperatura ambiente. Em seguida; os três grupos de instrumentos (n=30 por grupo) foram comparados quanto à fadiga cíclica (n=10 por grupo); flexão (n=10 por grupo) e resistência à flambagem (n=10 por grupo). Após testes de fadiga cíclica; um microscópio eletrônico de varredura foi utilizado para analisar as superfícies de fratura e observar o modo de fratura. A análise estatística foi realizada por meio dos testes de One-way ANOVA e teste de Student-Newman-Keuls; com erro de tipo alfa fixado em 0.05. Coloração amarelada e azulada foi observada nos instrumentos ProFile após tratamentos térmicos a 450 ºC ou 500 ºC; respectivamente. Os instrumentos ProFile originais apresentaram menor fadiga cíclica e maior resistência à flexão e flambagem (P<0.05). Em contraste; os instrumentos ProFile azulados (tratados termicamente a 500°C) apresentaram maior fadiga cíclica e menor resistência à flexão e flambagem (P>0.05). Pode-se concluir que os diferentes tratamentos térmicos realizados nos instrumentos ProFile aumentaram sua resistência à fadiga cíclica e melhoraram a flexibilidade e resistência à flambagem.

Abstract The present study aimed to perform two different heat-treatments in an austenitic NiTi ProFile instrument and to compare the mechanical performance of original and heat-treated instruments. Heat treatment of ProFile (tip size 25 and 0.06 taper) instruments were carried out in a furnace in argon atmosphere using a heating rate of 10° C/min. After reaching the programmed temperatures of 450 ºC or 500 ºC the system remained at a constant temperature for 10 minutes; followed by cooling in water at room temperature. Afterwards; the three groups (n=30 per group) of instruments were compared regarding their cyclic fatigue (n=10 per group); bending (n=10 per group); and buckling resistance (n=10 per group). After cyclic fatigue tests; a scanning electron microscope was used to analyze the fracture surfaces and observe the fracture mode. Statistical analysis was performed using One-way ANOVA and Student-Newman-Keuls test; with an alpha type error set at 0.05. Yellowish and blueish coloration was observed in the ProFile instruments after 450 ºC or 500 ºC heat treatments; respectively. Conventional ProFile instruments showed the lower cyclic fatigue; and the higher bending and buckling resistance (P<0.05). In contrast; yellowish ProFile instruments (heat treated at 500° C) showed the higher cyclic fatigue; and the lower bending and buckling resistance (P>0.05). It can be concluded that the different heat treatments performed on ProFile instruments increased its cyclic fatigue resistance and improved the flexibility and buckling resistance.

Design, Metallurgical Features, and Mechanical Behaviour of NiTi Endodontic Instruments from Five Different Heat-Treated Rotary Systems.

The current study aimed to compare the F1 endodontic instruments from five different heat-treated rotary systems regarding their design, metallurgical properties, and mechanical performance. Five F1 root canal shaping instruments (ProTaper Gold [PTG], Premium Taper Gold, Go-Taper Flex, EdgeTaper Platinum, and Super Files Blue)-plus, a conventional ProTaper Universal (PTU)-which were evaluated regarding their design, nickel/titanium ratio, phase transformation temperatures, microhardness, cyclic fatigue, and torsional and bending strengths. Mood's median test was used for the statistical comparison with a significance set at 5%. The instruments were similar regarding the nickel/titanium ratio and overall design. Go-Taper Flex had the closest transformation temperatures to PTG. PTU and Go-Taper Flex had the highest microhardness (408.3 and 410.5 HVN). The time to fracture of Super Files Blue was three and seven times higher than PTG and PTU, respectively. No difference was observed in the maximum torque to fracture among PTG (1.30 N·cm) and the other systems, except for the Premium Taper Gold (1.05 N·cm) and Go-Taper Flex (1.10 N·cm). Significantly lower bending loads than PTG (269.2 gf) were observed for the EdgeTaper Platinum (158.3 gf) and Premium Taper Gold (103.5 gf) instruments. Super Files Blue outperformed PTG in the cyclic fatigue test, while EdgeTaper Platinum and Premium Taper Gold were more flexible. Premium Taper Gold and Go-Taper Flex showed lower torsional strength.

Mechanical Tests, Metallurgical Characterization, and Shaping Ability of Nickel-Titanium Rotary Instruments: A Multimethod Research.

INTRODUCTION: This study aimed to compare the mechanical and metallurgical properties and shaping ability of different rotary systems using a multimethod approach. METHODS: New NeoNiti A1 (Neolix SAS, Châtres-La-Forêt, France), HyFlex EDM One File (Coltène/Whaledent, Altstätten, Switzerland), ProTaper Gold F2 (Dentsply Maillefer, Ballaigues, Switzerland), and ProTaper Universal F2 (Dentsply Maillefer) rotary instruments were tested regarding cyclic fatigue, torsional resistance, design, and morphologic characteristics using scanning electron microscopy, metal alloy characterization using differential scanning calorimetry, and energy-dispersive X-ray spectroscopy. Additionally, their shaping ability on the preparation of 48 canals of maxillary molars was evaluated using micro-computed tomographic technology. Mechanical and metallurgical analyses were compared using analysis of variance post hoc Tukey tests, whereas the independent Student t test was used to compare the shaping ability of the ProTaper systems or the thermomechanically treated instruments. The significance level was set at 5%. RESULTS: The highest cyclic fatigue was observed with the NeoNiti and HyFlex EDM instruments (P > .05), whereas HyFlex EDM had the highest angular rotation to fracture (P < .05). Scanning electron microscopic/energy-dispersive X-ray spectroscopic analyses confirmed similarities in the instruments' design and an almost equiatomic composition of the systems. Differential scanning calorimetry showed that ProTaper Gold had higher transformation temperatures than ProTaper Universal, whereas a similar transformation was observed between NeoNiti and HyFlex. Micro-computed tomographic analysis revealed that, despite the fact that none of the systems was able to prepare all root canal walls, no statistical differences were observed in either ProTaper systems (P > .05) or the thermomechanically treated instruments (P > .05). CONCLUSIONS: Apart from differences in the mechanical tests and metallurgical characterization, systems with comparable instrument dimensions and preparation protocols showed a similar percentage of untouched surface areas in the root canal preparation of maxillary molars.

Cytotoxicity, antibacterial and physicochemical properties of a new epoxy resin-based endodontic sealer containing calcium hydroxide.

BACKGROUND: This study evaluated the cytotoxicity, antibacterial and physicochemical properties of a new epoxy resin-based endodontic sealer containing calcium-hydroxide Sealer Plus. AH Plus was used as a reference for comparison. MATERIAL AND METHODS: Cytotoxicity evaluation was performed according to ISO-10993-5 specifications using MTT assay to check the 3T3 cells viability at 1- to 4-week periods. Antibacterial activity was evaluated using a direct contact test against Enterococcus faecalis. Radiopacity, solubility and flow evaluations were performed according to ISO-6876/2012 specifications. Setting time was assessed following the ANSI/ADA-standard-n.57. The pH level was measured at 3,24,48,72, and 168 hours. Data were statistically analyzed using t-test. The significance level adopted was P<0.05. RESULTS: AH Plus and Sealer Plus showed cytotoxic effects after 24 hours and 1 week of manipulation and become noncytotoxic after 2 weeks. No differences were observed in the cytotoxicity of both tested sealers (P>0.05). Direct contact results revealed that both freshly prepared sealers has antibacterial effects against Enterococcus faecalis. However, after 7 days both sealers had lost much of their antibacterial effects. Although AH Plus presented higher radiopacity and flow than Sealer Plus (P<0.05), both sealers showed minimum required values. No differences were observed in the solubility of both sealers (P>0.05). AH Plus showed a higher setting time when compared to Sealer Plus (P<0.05). AH Plus and Sealer Plus showed a neutral pH during all tested periods (P<0.05). CONCLUSIONS: It can be concluded that Sealer Plus showed suitable properties to be used as an endodontic sealer, comparable with those obtained by AH Plus. Key words:Cytotoxicity, root canal filling materials, root canal obturation.

Removal of Root Canal Fillings in Curved Canals Using Either Mani GPR or HyFlex NT Followed by Passive Ultrasonic Irrigation.

This study compared the efficacy of HyFlex NT (HF; Coltene, New York, NY) and Mani GPR (MN; Mani Inc, Tokyo, Japan) systems followed by a supplementary approach with passive ultrasonic irrigation (PUI) in removing the filling material from curved root canals during retreatment. The mesial canals from 20 extracted mandibular molars with Vertucci type IV configuration were instrumented and obturated (N = 40). Each mesial canal was retreated using either HF or MN instruments, alternating the system used per canal from root to root. The final preparation size was 40/0.04 for both systems. The volume of canal filling material was assessed by means of micro-computed tomographic (micro-CT) imaging before and after retreatment, and the working time was recorded. Canals still showing remnants of filling material were subjected to a supplementary approach with PUI, and another micro-CT scan was taken. The percentage of filling material removed with MN instruments and HF was similar (95.5% and 92.7%, respectively) (P > .05). MN required significantly less time to remove the filling material (P < .05). The supplementary approach with PUI significantly enhanced the removal of filling material (P < .05). Both systems were equally effective in removing the root canal filling during retreatment. MN was faster than HF. The supplementary approach with PUI significantly improved filling material removal.

Influence of Surface Roughness on the Fatigue Life of Nickel-Titanium Rotary Endodontic Instruments.

INTRODUCTION: The goal of the present study was to evaluate the influence of surface grooves (peaks and valleys) resulting from machining during the manufacturing process of polished and unpolished nickel-titanium BR4C endodontic files on the fatigue life of the instruments. METHODS: Ten electropolished and 10 unpolished endodontic files were provided by the manufacturer. Specimens were from the same batch, but the unpolished instruments were removed from the production line before surface treatment. The instruments were evaluated with a profilometer to quantify the surface roughness on the working part of the instruments. Then the files were subjected to rotating bending fatigue tests. RESULTS: Analysis with the profilometer showed that surface grooves were deeper on the unpolished instruments compared with their electropolished counterparts. In the rotating bending fatigue test, the mean and standard deviation for the number of cycles until fracture (NCF) were greater for instruments with less pronounced grooves. Student t test revealed significant differences in all tests (P < .05). CONCLUSIONS: The results from the present study showed that the depth of the surface grooves on the working part affected the NCF of the instruments tested; the smaller the groove depth, the greater the NCF.

Reciprocating versus rotary systems for root filling removal: assessment of the apically extruded material.

INTRODUCTION: This study was designed to quantitatively evaluate the amount of apically extruded debris by comparing the ProTaper Universal Retreatment system (Dentsply Maillefer, Ballaigues, Switzerland) with 2 reciprocating single-file systems (Reciproc [VDW, Munich, Germany] and WaveOne [Dentsply Maillefer]) during endodontic retreatment. METHODS: Forty-five mandibular premolars with a single canal were prepared with the ProTaper Universal system and then obturated. The specimens were divided into 3 groups (n = 15) according to the system used for filling removal: ProTaper Universal Retreatment system associated with the ProTaper Universal system (until file F4 40/0.06]), Reciproc system (Reciproc R40 [40/0.06]), and WaveOne system (WaveOne Large [40/0.08]). Sodium hypochlorite was used as an irrigant, and the apically extruded debris was collected in glass vials and then dried. The mean weight of debris was assessed with a microbalance and statistically analyzed using 1-way analysis of variance and post hoc Tukey multiple comparison tests (P < .05). RESULTS: The ProTaper Universal Retreatment system produced significantly more debris compared with the Reciproc and WaveOne systems (P < .01). The reciprocating systems showed no significant difference between them (P > .05). CONCLUSIONS: Under the conditions of the present study, all systems caused apical debris extrusion. Reciprocating systems were associated with less debris extrusion when compared with a conventional rotary retreatment system.

Fatigue Life of Reciproc and Mtwo instruments subjected to static and dynamic tests.

INTRODUCTION: This study evaluated the influence of flexibility and reciprocating movement on the fatigue life of endodontic instruments subjected to static and dynamic tests. METHODS: The rotary nickel-titanium instruments used in this study were Reciproc and Mtwo. The instruments were initially subjected to a cantilever-bending test and then to static and dynamic fatigue tests. Reciproc instruments were operated in reciprocating movement, whereas Mtwo instruments were worked in continuous rotation. RESULTS: The means of bending resistance (maximum load in grams) of the instruments were 274.9 for Reciproc and 429 for Mtwo. The mean times (in seconds) to fracture of the instruments subjected to static and dynamic tests were 214.5 (static) and 286.3 (dynamic) for Reciproc and 38.9 (static) and 99 (dynamic) for Mtwo. The Student's t test revealed significant differences in all tests (P < .05). CONCLUSIONS: The results of the present study showed longer fatigue life for instruments with higher flexibility, driven by reciprocating movement, and in the dynamic testing model. These findings reinforce the assumption that use of reciprocating movement is a means to prolong the fatigue life of rotary nickel-titanium endodontic instruments during instrumentation of curved canals.

Influence of the geometry of curved artificial canals on the fracture of rotary nickel-titanium instruments subjected to cyclic fatigue tests.

INTRODUCTION: This study evaluated the influence of different features of canal curvature geometry on the number of cycles to fracture of a rotary nickel-titanium endodontic instrument subjected to a cyclic fatigue test. METHODS: BioRaCe BR4C instruments (FKG Dentaire, La Chaux-de Fonds, Switzerland) were tested in 4 grooves simulating curved metallic artificial canals, each one measuring 1.5 mm in width, 20 mm in total length, and 3.5 mm in depth with a U-shaped bottom. The parameters of curvature including the radius and arc lengths and the position of the arc differed in the 4 canal designs. Fractured surfaces and helical shafts of the separated instruments were analyzed by scanning electron microscopy. RESULTS: The Student's t test showed that a significantly lower number of cycles to fracture values were observed for instruments tested in canals with the smallest radius, the longest arc, and the arc located in the middle portion of the canal. Scanning electron microscopic analysis of the fracture surfaces revealed morphologic characteristics of ductile fracture. Plastic deformation was not observed in the helical shaft of the fractured instruments. CONCLUSIONS: Curvature geometry including the radius and arc lengths and the position of the arc along the root canal influence the number of cycles to fracture of rotary nickel-titanium instruments subjected to flexural load.

Comparison of the mechanical properties of rotary instruments made of conventional nickel-titanium wire, M-wire, or nickel-titanium alloy in R-phase.

INTRODUCTION: This study compared the mechanical properties of endodontic instruments made of conventional nickel-titanium (NiTi) wire (K(3) and Revo-S SU), M-Wire (ProFile Vortex), or NiTi alloy in R-phase (K(3)XF). METHODS: The test instruments were subjected to mechanical tests to evaluate resistance to bending (flexibility), cyclic fatigue, and torsional load in clockwise rotation. Data were statistically evaluated by the analysis of variance test and the Student-Newman-Keuls test for multiple comparisons. RESULTS: In the bending resistance test, flexibility decreased in the following order: K(3)XF > Revo-S SU > ProFile Vortex > K(3). The ranking in the fatigue resistance test was the following: K(3)XF > K(3) > ProFile Vortex > Revo-S SU. In the torsional assay, the angular deflection at failure decreased in the following order: K(3)XF > Revo-S SU > K(3) > ProFile Vortex. For the maximum torque values, the ranking was K(3) > K(3)XF > ProFile Vortex > Revo-S SU. CONCLUSIONS: The results showed that the K(3)XF instrument, which is made of NiTi alloy in R-phase, had the overall best performance in terms of flexibility, angular deflection at failure, and cyclic fatigue resistance. In addition to the alloy from which the instrument is manufactured, the design and dimensions are important determinants of the mechanical performance of endodontic instruments.

Influence of different manufacturing methods on the cyclic fatigue of rotary nickel-titanium endodontic instruments.

INTRODUCTION: The aim of this study was to evaluate, by static and dynamic cyclic fatigue tests, the number of cycles to fracture (NCF) 2 types of rotary NiTi instruments: Twisted File (SybronEndo, Orange, CA), which is manufactured by a proprietary twisting process, and RaCe files (FKG Dentaire, La Chaux-de-Fonds, Switzerland), which are manufactured by grinding. METHODS: Twenty Twisted Files (TFs) and 20 RaCe files #25/.006 taper instruments were allowed to rotate freely in an artificial curved canal at 310 rpm in a static or a dynamic model until fracture occurred. RESULTS: Measurements of the fractured fragments showed that fracture occurred at the point of maximum flexure in the midpoint of the curved segment. The NCF was significantly lower for RaCe instruments compared with TFs. The NCF was also lower for instruments subjected to the static test compared with the dynamic model in both groups. Scanning electron microscopic analysis revealed ductile morphologic characteristics on the fractured surfaces of all instruments and no plastic deformation in their helical shafts. CONCLUSIONS: Rotary NiTi endodontic instruments manufactured by twisting present greater resistance to cyclic fatigue compared with instruments manufactured by grinding. The fracture mode observed in all instruments was of the ductile type.

Torsional properties of pathfinding instruments.

INTRODUCTION: This study compared the torsional properties of 2 stainless steel endodontic pathfinding instruments: C-Pilot (VDW, Munich, Germany) and C(+) files (Maillefer/Dentsply, Ballaigues, Switzerland). Stainless steel conventional K-type instruments (KCC(+), VDW) were used as controls. METHODS: File sizes 10 were subjected to a torsional assay in clockwise rotation. The 2 parameters evaluated were maximum torque and angular deflection at failure. The fractured surfaces and the helical shafts of the fractured instruments were then examined by scanning electron microscopy (SEM). RESULTS: The results indicated that the angular deflection to fracture decreased in the following order: KCC(+) > C-Pilot > C(+). As for the maximum torque values, the results revealed the following descending order: C(+) > KCC(+) > C-Pilot. SEM analysis revealed that plastic deformation occurred along the helical shaft of the fractured instruments and that the fractured surfaces were of the ductile type. CONCLUSIONS: The instruments tested showed different torsional behavior depending on the parameter evaluated. Considering that high angular deflection values may serve as a safety factor for instruments used as pathfinders, the conventional K file showed significantly better results than both C-Pilot and C(+) files.

Effects of electropolishing surface treatment on the cyclic fatigue resistance of BioRace nickel-titanium rotary instruments.

INTRODUCTION: This study evaluated the influence of electropolishing surface treatment on the number of cycles to fracture of BioRace rotary nickel-titanium endodontic instruments. METHODS: BioRace size BR5C instruments with or without electropolishing surface treatment were used in an artificial curved canal under rotational speed of 300 rpm until fracture. Fractured surfaces and the helical shafts of fractured instruments were analyzed by scanning electron microscopy (SEM). RESULTS: Polished instruments displayed a significantly higher number of cycles to fracture when compared with nonpolished instruments (P < .001). Actually, the number of cycles to fracture of a polished BR5C instrument was 124% higher than that of a nonpolished instrument. SEM analysis showed that the fractured surface of both polished and nonpolished BR5C instruments had ductile morphologic characteristics. Evaluation of the separated fragments after cyclic fatigue testing showed the presence of microcracks near the fracture surface. Polished instruments exhibited fine cracks that assumed an irregular path (zigzag crack pattern), whereas nonpolished instruments showed cracks running along the machining grooves. CONCLUSIONS: Electropolishing surface treatment of BioRace endodontic instruments significantly increased the cyclic fatigue resistance.