How do reused glide path files affect the cyclic fatigue resistance? / ¿Cómo afecta la reutilización de limas tipo glide path su resistencia a la fatiga cíclica?

ABSTRACT: The aim of this study was to compare the cyclic fatigue resistance (CFR) of PathFile (Dentsply Sirona, Ballaigues, Switzerland) and ScoutRace (FKG Dentaire, La Chaux-de-Fonds, Switzerland) glide path files which were either new or previously used. Forty PathFile (PF) 19/.02 and 40 ScoutRace (SR) 20/.02 instruments were used for this study. Half of the files in each group were used (PF-U and SR-U) in the 3D demo tooth models (FKG Dentaire, La Chaux-de-Fonds, Switzerland) for creating glide paths, while the other half was new (PF-N and SR-N) and directly subjected to the cyclic fatigue test. The new and used files (n=80) were rotated in the cyclic fatigue test device with an artificial stainless-steel canal (60° curvature, 5 mm radius 1.5 mm width and 3.0 mm depth) under the continuous irrigation with distilled water at 37°C until fracture occurred. Time to fracture was recorded and the Weibull reliability analysis was performed. Data were statistically analysed. Conformity to normal distribution was examined using the Shapiro-Wilk test. A paired two-sample t-test was used to compare the TTF values according to the time within the groups. The new instruments (PF-N and SR-N) showed better CFR than the used groups (PF-U and SR-U) (P SR-N>PF-U>SR-U. Reuse of both glide path instruments reduced the time to fracture and the cyclic fatigue resistance of the files.

RESUMEN: El objetivo de este estudio fue comparar la resistencia a la fatiga cíclica (CFR en inglés) de las limas PathFile (Dentsply Sirona, Ballaigues, Suiza) y ScoutRace (FKG Dentaire, La Chaux-de-Fonds, Suiza) de tipo glide path, nuevas o ya previamente utilizadas. Para este estudio se utilizaron 40 instrumentos PathFile (PF) 19/.02 y 40 ScoutRace (SR) 20/.02. La mitad de las limas de cada grupo se utilizaron (PF-U y SR-U) en los modelos dentales de demostración 3D (FKG Dentaire, La Chaux-de- Fonds, Suiza) para crear trayectorias de deslizamiento, mientras que la otra mitad se utilizaron nuevas directamente a la prueba de fatiga cíclica (PF-N y SR-N). Las limas nuevas y usadas (n=80) se hicieron girar en el dispositivo de prueba de fatiga cíclica con un canal artificial de acero inoxidable (curvatura de 60°, radio de 5mm, anchura de 1,5mm y profundidad de 3,0mm) bajo irrigación continua con agua destilada a 37°C hasta que se produjo la fractura. Se registró el tiempo hasta la fractura y se realizó el análisis de fiabilidad de Weibull. Los datos se analizaron estadísticamente. La conformidad con la distribución normal se examinó mediante la prueba de Shapiro- Wilk. Se utilizó una prueba t de dos muestras pareadas para comparar los valores de TTF según el tiempo dentro de los grupos. Los instrumentos nuevos (PF-N y SR- N) mostraron una mejor CFR que los grupos previamente utilizados (PF-U y SR-U) (p SR-N >PF-U >SR-U. La reutilización de ambos instrumentos tipo glide path redujo el tiempo hasta la fractura y la resistencia a la fatiga cíclica de las limas.

Effect of glide path preparation with PathFile and ProGlider on the cyclic fatigue resistance of WaveOne nickel-titanium files.

OBJECTIVES: The aim of this study was to investigate the effect of glide path preparation with PathFile and ProGlider nickel-titanium (NiTi) files on the cyclic fatigue resistance of WaveOne NiTi files. MATERIALS AND METHODS: Forty-four WaveOne Primary files were used and divided into four groups (n = 11). In the first group (0 WaveOne), the WaveOne Primary files served as a control group and were not used on acrylic blocks. In the 1 WaveOne Group, acrylic blocks were prepared using only WaveOne Primary files, and in the PF+WaveOne group and PG+WaveOne groups, acrylic blocks were first prepared with PathFile or ProGlider NiTi files, respectively, followed by the use of WaveOne Primary files. All the WaveOne Primary files were then subjected to cyclic fatigue testing. The number of cycles to failure was calculated and the data were statistically analyzed using one-way analysis of variance (ANOVA) and the Tukey honest significant difference multiple-comparison test at a 5% significance level. RESULTS: The highest number of cycles to failure was found in the control group, and the lowest numbers were found in the 1 WaveOne group and the PF+WaveOne group. Significant differences were found among the 1 WaveOne, PF+WaveOne, and control groups (p < 0.05). No statistically significant differences were found between the PG+WaveOne group and the other three groups (p > 0.05). CONCLUSION: Glide path preparation with NiTi rotary files did not affect the cyclic fatigue resistance of WaveOne Primary files used on acrylic blocks.

Canal Transportation and Centering after Using PathFile and R-Pilot in Mesiobuccal Canals of Maxillary Molars Using Cone-Beam Computed Tomography.

Introduction: This study aimed to compare the changes in root canal anatomy following the use of PathFile and R-Pilot using cone-beam computed tomography (CBCT). Methods and Materials: In this in vitro, experimental study, 60 extracted maxillary first and second molars with 20 to 40° mesiobuccal root curvature, minimum of 19 mm of root length, no calcified root canals and no history of previous treatment were divided into two groups (n=30). CBCT scans were taken before and after the treatment, and sections at 1, 2 and 3 mm from the apex were compared. Pairwise comparisons were carried out using the Mann Whitney-U test. The centering ratio data were analyzed using the Chi-square test and Fisher's exact test. All statistical analyses were carried out using Sigma Stat 4 software. Results: The difference between PathFile and R-Pilot in canal transportation in mesiodistal direction was significant at 1 and 2 mm from the apex (P<0.01). The R-Pilot file was significantly superior to PathFile in centering ability in mesiodistal direction at 1 mm from the apex (P<0.05). Canal transportation direction was towards the mesiolingual and distobuccal in R-Pilot and PathFile groups, respectively. Conclusion: Within the limitations of this study, the results showed that R-Pilot with reciprocal movement is a safe and easy to use instrument for creating a glide path.

Effect of glide path preparation with PathFile and ProGlider on the cyclic fatigue resistance of WaveOne nickel-titanium files

OBJECTIVES: The aim of this study was to investigate the effect of glide path preparation with PathFile and ProGlider nickel-titanium (NiTi) files on the cyclic fatigue resistance of WaveOne NiTi files. MATERIALS AND METHODS: Forty-four WaveOne Primary files were used and divided into four groups (n = 11). In the first group (0 WaveOne), the WaveOne Primary files served as a control group and were not used on acrylic blocks. In the 1 WaveOne Group, acrylic blocks were prepared using only WaveOne Primary files, and in the PF+WaveOne group and PG+WaveOne groups, acrylic blocks were first prepared with PathFile or ProGlider NiTi files, respectively, followed by the use of WaveOne Primary files. All the WaveOne Primary files were then subjected to cyclic fatigue testing. The number of cycles to failure was calculated and the data were statistically analyzed using one-way analysis of variance (ANOVA) and the Tukey honest significant difference multiple-comparison test at a 5% significance level. RESULTS: The highest number of cycles to failure was found in the control group, and the lowest numbers were found in the 1 WaveOne group and the PF+WaveOne group. Significant differences were found among the 1 WaveOne, PF+WaveOne, and control groups (p 0.05). CONCLUSION: Glide path preparation with NiTi rotary files did not affect the cyclic fatigue resistance of WaveOne Primary files used on acrylic blocks.

Comparison of glide paths created with K-files, PathFiles, and the ProGlider file, and their effects on subsequent WaveOne preparation in curved canals.

BACKGROUND: The root canal glide path has been recommended as the foundation for a safer root canal preparation. The aim of this study was to compare glide paths created with K-files, PathFiles, and the ProGlider file, and their effects on subsequent WaveOne preparation regarding canal transportation, canal volume increase, apical extruded debris, and working time in curved canals. METHODS: Sixty mesial canals of extracted human mandibular first molars were randomly assigned to the K-file (KF), PathFile (PF) and ProGlider file (PG) groups for glide path preparation. Then, canals were prepared using WaveOne files. Specimens were scanned (voxel size: 18 µm) three times using micro-computed tomography: pre-glide path, post-glide path, and post-root canal preparation. Canal transportations were measured at 1, 3, and 5 mm levels from the apical foramen, and canal volume increases were also accounted. Apical extruded debris during preparation was collected for measurement. Meanwhile,working time was recorded. Data were analyzed statistically using one-way analysis of variance and Tukey's post hoc tests (p < 0.05). RESULTS: After glide path preparation, the PG and PF groups showed significantly less canal transportation than the KF group at all levels (P < 0.05), while the PG group exhibited a significantly larger canal volume increase than the PF and KF groups (P < 0.05). After the subsequent canal preparation with WaveOne, the PG and PF groups showed significantly less canal transportation than the KF group at 3 and 5 mm levels, and the PG group showed significantly less canal transportation than the PF group at 5 mm level (P < 0.05). However, statistically similar canal volume increases occurred among the three groups. Additionally, the PG and PF groups produced less apical extruded debris compared to the KF group (P < 0.05). The working time of the PG group was the shortest, while that of the KF group was the longest. CONCLUSION: Compared with the PathFiles and K-files, the ProGlider file combined with the WaveOne file showed reduced canal transportation and working time.

Cyclic fatigue resistance of R-Pilot, WaveOne Gold Glider, and ProGlider glide path instruments.

OBJECTIVE: The aim of the present study was to compare the cyclic fatigue resistance of R-Pilot (VDW; Munich, Germany) with ProGlider (Denstply Sirona; Ballaigues, Switzerland) and WaveOne Gold Glider (Denstply Sirona; Ballaigues, Switzerland) glide path instruments. MATERIALS AND METHODS: R-Pilot, ProGlider, and WaveOne Gold Glider instruments were collected (n = 15) and tested in a dynamic cyclic fatigue test device, which has an artificial canal with 60° angle of curvature and a 5-mm radius of curvature. All instruments were operated until fracture occurred, and both time to fracture (TF) and the lengths of the fractured fragments were recorded. Mean and standard deviations of TF and fragment length were calculated for each reciprocating system. TF data and fractured fragment length data were subjected to one-way ANOVA and post-hoc Tukey tests (P < 0.05). Also a Weibull analysis was performed on TF data. RESULTS: The cyclic fatigue resistance values of the WaveOne Gold Glider and R-Pilot were significantly higher than those of the ProGlider (P < 0.05), with no significant difference between them (P > 0.05). Weibull analysis revealed that WaveOne Gold Glider showed the highest predicted TF value for 99% survival rate, which was followed by R-Pilot and ProGlider. Regarding the length of the fractured tips, there were no significant differences among the instruments (P > 0.05). CONCLUSIONS: The reciprocating WaveOne Gold Glider and R-Pilot instruments had significantly higher cyclic fatigue resistance than rotary ProGlider instruments. CLINICAL RELEVANCE: This study reported that novel reciprocating glide path instruments exhibited higher cyclic fatigue resistance than rotating glide path instrument.

Comparison of PathFile and ProFinder Systems to Create a Glide Path in Curved Root Canals.

OBJECTIVE: Root canal shaping is as important as irrigation and filling when attempting to obtain a high success rate in endodontic treatment. The creation of a glide path before the use of rotary instruments reduces the risk of posterior iatrogenic errors. The objective of the present study was to evaluate instrumentation time and root canal transport after using 2 different glide path rotary systems. METHODS: In total, 60 mesiobuccal root canals of mandibular molars, with curvature angles between 11° and 82°, were standardized to measure 15 mm. The specimens were divided into 2 groups, depending on their angles of curvature (11º-38º and 39º-82º), and further divided into 4 groups (n=15). Two groups were instrumented using the PathFile system and the other 2 using the ProFinder system. The angle and radius of curvature were measured at the most abrupt angle of curvature before and after instrumentation. Both measurements were analyzed and compared using AutoCAD software to determine canal transportation. Curvature angles were compared using Student's t test and the radii of curvature using the Wilcoxon test. The time for instrumentation was also evaluated using Student's t tests. RESULTS: There were no statistically significant differences between the two systems with respect to root canal transport (P>0.05); however, the ProFinder system took a longer time to create a glide path (P=0.004). CONCLUSION: Both systems were equally effective in creating a glide path; however, the PathFile system proved to be faster than the ProFinder system.

Comparing the Centering Ability of Different Pathfinding Systems and Their Effect on Final Instrumentation by Hyflex CM.

INTRODUCTION: Recently, different rotary glide path systems have been introduced. The aim of this study was to compare the centering ability of different rotary pathfinding systems and their effect on the final preparation by Hyflex CM files. METHODS: Sixty endodontic training blocks with J-shaped canals were divided into 3 groups according to the pathfinding system used. Instrumentation was done with G-File + Hyflex CM (G-File group), PathFile + Hyflex CM (PathFile group), and Hyflex GPF + Hyflex CM (GPF group). Three images were taken: initial, after glide path preparation, and after final instrumentation. Pre-instrumentation and post-instrumentation images were superimposed, and centering ratio along the J-shaped canal was measured to evaluate the occurrence of deviation. Statistical analysis of the data was performed by using one-way analysis of variance, followed by Tukey test (α = 0.05). RESULTS: The ability of instruments to remain centered in canals at 0-mm level (apex) was significantly lower in PathFile group (P < .05). No significant difference was found at other levels. After final preparation by Hyflex CM no significant difference was found at any level. CONCLUSIONS: The centering abilities of Hyflex GPF and G-Files are better than that of PathFile at apex, but it has no significant effect on final preparation by Hyflex CM.

Surface Changes of PathFile after Glide Path Preparation: An Ex Vivo and In Vivo Study.

INTRODUCTION: The aim of this study was to evaluate the changes in the surface profile of rotary nickel-titanium (NiTi) files designed to prepare a glide path and conventional stainless steel (SS) hand files when used in extremely narrow canals both in clinical and experimental conditions. METHODS: This ex vivo/in vivo study used either SS #10 K hand files or the PathFile system (Dentsply Maillefer, Ballaigues, Switzerland) to establish a glide path in maxillary molars with narrow root canals (defined as canals that bound a #8 K-file at the working length). After treatment, all files were cleaned and scanned using a noncontact laser profilometer. Changes to the surface profile (Ra cutting edge waviness = RaCEW) and roughness (Ra cutting edge roughness = RaCER) of the cutting edges and the surface roughness of the flute area (Sa flute roughness = SaFR) were analyzed. RESULTS: #10 K-files had significant increases in all types of measurements (RaCEW, RaCEW, and SaFR) after the preparation of second mesiobuccal canals compared with the control group (P < .05) in both studies. In the ex vivo study, the PathFile (P1) had no significant changes in the surface profile from baseline but had a significant increase in the surface roughness of the flute (SaFR) (P < .05). PathFiles that were used 3 times in vivo had a significant increase in roughness (flute and cutting edge) values across all PathFile sizes compared with control values. CONCLUSIONS: This study showed that PathFiles had significantly less surface defects compared with SS files after the preparation of narrow canals, indicating their possible benefits when establishing a glide path in extremely narrow canals.

Permeabilización del Canal Radicular y Transporte Apical: Comparación de Tres Sistemas / Root Canal Glide Path and Apical Transportation: Three System Comparison

La mantención de la anatomía original del canal radicular incide directamente en el éxito del tratamiento endodóntico. Para ello, los sistemas rotatorios de instrumentación requieren de canales radiculares permeables. Existen distintas limas y sistemas para la permeabilización o glide path como las limas tipo K manuales de acero inoxidable y los sistemas de NiTi rotatorios PathFile y ProGlider (Dentsply, Maillefer). Así, el objetivo de esta investigación fue comparar la capacidad de distintos sistemas de permeabilización para mantener la anatomía radicular sin producir transporte apical en canales mesiales de molares inferiores humanos extraídos. Se realizó un estudio cuantitativo experimental cuya muestra estuvo conformada por 36 canales mesiales de molares mandibulares humanos extraídos. Las muestras fueron divididas aleatoriamente en tres grupos conformados por 12 canales, cada uno de los cuales fueron sometidos a distintos sistemas de permeabilización (Lima K, PathFile y ProGlider). Las muestras fueron fotografiadas antes y después de la permeabilización utilizando un microscopio con magnificación 30X. Se cuantificó el desplazamiento del canal radicular en sentido mesio - distal y buco - lingual posterior a la permeabilización. Para el análisis de los datos se utilizó el paquete estadístico InfoStat/L y se aplicó la prueba de ANOVA / Tukey. Se observó que el sistema PathFile produce mayor transporte del canal radicular en su tercio apical en la dirección mesio-distal (p=0,77) y el sistema ProGlider en la dirección buco-lingual (p=0,57). Sin embargo, estas diferencias no fueron significativas. En conclusión, los sistemas de permeabilización analizados no presentaron diferencias en cuanto a su capacidad para mantener la anatomía sin producir transporte apical.

Preservation of the original root canal anatomy has a direct influence on the success of an endodontic treatment. In order to achieve this, rotary instrumentation systems require permeable root canals. Different files and systems are used for the establishment of a glide path such as manual stainless steel K files and NiTi rotatory systems like PathFile and ProGlider (Dentsply, Maillefer). Thus, the objective of this research was to compare the ability of different systems to create a glide path and maintain root canal anatomy without producing apical transportation in mesial root canals of extracted human lower molars. A quantitative experimental study was performed with a sample of 36 mesial root canals of extracted human mandibular molars. The samples were randomly divided into three groups consisting of 12 root canals each, which were subjected to different glide path systems (K-Files, PathFile and ProGlider). Samples were photographed before and after creating glide path using a microscope with 30X magnification. The displacement of the root canal in a mesio - distal and bucco - lingual direction was quantified after creating glide path. Data was analyzed using the statistical package InfoStat / L and the ANOVA / Tukey test was applied. The PathFile system produced greater transport of the root canal in its apical third in the mesio-distal direction (p = 0.77) and the ProGlider system in the bucco-lingual direction (p = 0.57). However, these differences were not significant. In conclusion, the glide path systems analyzed do not present any differences in their ability to maintain the anatomy without producing apical transportation.

A Comparison of the Cyclic Fatigue Resistance of Used and New Glide Path Files.

INTRODUCTION: The purpose of this study was to compare the cyclic fatigue resistance of used and new ProGlider (Dentsply Maillefer, Ballaigues, Switzerland) and PathFile (Dentsply Maillefer) rotary glide path files. METHODS: Forty ProGlider and 40 PathFile #2 instruments were used in the present study. In group 1, 20 PathFile #2 files and, in group 2, 20 ProGlider files were used to prepare a total of 40 J-shaped transparent acrylic blocks. In group 3 (control group), 20 new PathFile files and, in group 4 (control group), 20 new ProGlider files were included. Cyclic fatigue testing of instruments was performed in a stainless steel artificial canal with a 5-mm radius of curvature and a 60° angle of curvature. All 80 instruments were rotated until fracture, and the number of cycles to failure (NCF) was recorded. Data were analyzed using 1-way analysis of variance to determine any statistical difference; the significance was determined at the 95% confidence level. RESULTS: The used glide path files' NCF was lower than the new ones; however, this difference was not statistically significant (P > .05). The cyclic fatigue resistance of the used and new PathFile #2 files was statistically significantly higher than that of the ProGlider files (P < .05). CONCLUSIONS: Within the limitations of the present study, the used glide path files' NCF was lower than the new ones; however, this difference was not statistically significant.

Torsional Performance of ProTaper Gold Rotary Instruments during Shaping of Small Root Canals after 2 Different Glide Path Preparations.

INTRODUCTION: The purpose of this study was to assess the ex vivo torsional performance of a novel rotary system in small root canals after 2 different glide path preparations. METHODS: Each independent canal of 8 mesial roots of mandibular molars was randomly assigned to achieve a reproducible glide path with a new set of either PathFile #1 (Dentsply Maillefer, Ballaigues, Switzerland) and #2 or ProGlider (Dentsply Maillefer) after negotiation with a 10 K-file. After glide path preparation, root canals in both groups were shaped with the same sequence of ProTaper Gold (Dentsply Tulsa Dental Specialties, Tulsa, OK) following the directions for use recommended by the manufacturer. A total of 16 new sets of each instrument of the ProTaper Gold (PTG) system were used. The tests were run in a standardized fashion in a torque-testing platform. Peak torque (Ncm) and force (N) were registered during the shaping procedure and compared with Student t tests after normal distribution of data was confirmed. RESULTS: No significant differences were found for any of the instruments in peak torque or force after the 2 different glide path preparations (P > .05). Data presented in this study also serve as a basis for the recommended torque for the use of PTG instruments. CONCLUSIONS: Under the conditions of this study, differences in the torsional performance of PTG rotary instruments after 2 different glide path preparations could not be shown. The different geometry of glide path rotary systems seemed to have no effect on peak torque and force induced by PTG rotary instruments when shaping small root canals in extracted teeth.

Shaping ability of Pathfile and WaveOne in simulated root canals / 口腔疾病防治

Objective @# This study aims to evaluate the shaping capability of Pathfile and WaveOne in simulated root canals. @*Methods@#A total of 20 simulated resin blocks were divided randomly into two groups, group W prepared with WaveOne alone. Group PW prepared with WaveOne and Pathfile. Preparation time and number of separated instruments were measured respectively. Pre-and post-operative images were obtained with a scanner and superimposed through Photoshop and ImageJ2X. The changes in canal bending curvature and material removal from the inner and outer canal walls at 10 points beginning at 1mm from the end point of the canal were measured with ImageJ2X. Centering capability was determined accordingly by comparing and analyzing the material removal from the inner and outer canal walls.@*Results @# Two groups have no occurrence of instrument separation, no statics significance in root canal preparation and the changes of root canal working length differences (P > 0.05). But at position of root canal point 4 to 5 mm, the misalignment of group W were 0.085 ± 0.05 mm and -0.312 ± 0.068 mm, the misalignment of group PW were -0.071 ± 0.042 mm, -0.26 ± 0.103 mm (P < 0.05).@*Conclusion@#Conclusion

Differences in torsional performance of single- and multiple-instrument rotary systems for glide path preparation.

A new rotary instrument has been developed to simplify the glide path preparation in root canals before shaping procedures. The purpose of this study was to compare the peak torque and force induced by nickel-titanium PathFile multiple-instrument system and the recently developed M-Wire ProGlider single instrument during glide path preparation of mesial root canals in extracted mandibular molars. Each independent canal of eight mesial roots of mandibular molars was randomly assigned to achieve a reproducible glide path with a new set of either PathFile #1 and #2 or ProGlider after negotiation with a 10 K-file. Tests were run in a standardized fashion using a torque-testing platform. Peak torque (N cm) and force (N) were registered and analysis of variance and Tukey post-hoc tests were applied. Preliminary data for stationary torque at failure were also obtained and compared with peak torque for each instrument. PathFile #1 and #2 instruments showed statistically lower peak torque (p = 0.001) and peak force (p = 0.008) than ProGlider. Torque at failure according to ADA No. 28/ISO 36030-1 was not significantly different from peak torque during glide path preparation for ProGlider instruments while it was significantly higher for PathFile #1 and #2 (p < 0.001). Under the conditions of this study, PathFile instruments developed significant lower peak torque and force during glide path preparation compared to ProGlider, which is possibly subjected to a greater contact with the canal walls due to the increase in its flute diameter at middle and coronal levels.

Glide Path Management with Single- and Multiple-instrument Rotary Systems in Curved Canals: A Micro-Computed Tomographic Study.

INTRODUCTION: Securing a reproducible glide path before instrumentation is recommended to maintain the original geometry of the root canal system and to prevent file separation. Mechanical glide path management systems have been introduced to expedite this step. The aim of this study was to compare apical transportation, canal volume increase, and working time during glide path management with ProGlider (PG; Dentsply Tulsa Dental Specialties, Tulsa, OK) and PathFiles (PF, Dentsply Tulsa Dental Specialties). METHODS: Forty curved mesial canals of mandibular molars were randomly allocated into 2 experimental groups (n = 20) according to the glide path management system: PG or PF. A glide path was achieved according to the manufacturers' protocol. Micro-computed tomographic analysis was performed to assess apical transportation at 1, 3, and 5 mm and volume increase. The time required to achieve the glide path was measured. RESULTS: The overall apical transportation mean values (± standard error) were 13.33 ± 3.37 µm for PG and 19.21 ± 4.4 µm for PF (P > .05). The mean (± standard error) volume increase values were 0.49 ± 0.06 mm(3) for PG and 0.48 ± 0.06 mm(3) for PF (P > .05). A statistically significant difference in the working time was found between the groups (P < .0001) where the mean (± standard error) values for time were 7.38 ± 1.73 seconds for PG and 20.61 ± 5.54 seconds for PF. CONCLUSIONS: Similar apical transportation and volume increase occurred during glide path management with PG single-file and PF multi-file systems; however, PG achieved glide path faster than PF.

Comparison of the cyclic fatigue resistance of 5 different rotary pathfinding instruments made of conventional nickel-titanium wire, M-wire, and controlled memory wire.

INTRODUCTION: This study compared the cyclic fatigue resistance of current nickel-titanium rotary path-finding instruments. METHODS: Five types of nickel-titanium rotary pathfinding instruments were used in steel canals with a 90° curvature and a curvature radius of 3 mm (n = 10) and 5 mm (n = 10). The cyclic fatigue of the following instruments was tested at 4 mm from the tip: PathFile (#16 and a .02 taper; Dentsply Maillefer, Ballaigues, Switzerland), G-File (#12 and a .03 taper; Micro-Mega, Besançon Cedex, France), Scout Race (#15 and a .02 taper; FKG Dentaire, La Chaux-de-Fonds, Switzerland), HyFlex GPF (#15 and a .02 taper; Coltene-Whaledent, Allstetten, Switzerland), and ProGlider (#16 with a mean taper of .04125 and a .02 at the first 4 mm from the tip, Dentsply Maillefer). The length of the fractured parts was measured, and the number of cycles to fracture (NCF) was calculated. The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (α = .05). After Bonferroni correction, the new P value was set as .005. RESULTS: The difference in the cyclic fatigue of all the files at both curvatures was statistically significant (P values from .0035 to less than .0001). The ranking of the instruments from the highest to the lowest NCF was as follows: HyFlex GPF, G files, ProGlider, PathFile, and Scout Race. The length of the fractured part of the instruments was similar in all the groups (P > .05). All the tested instruments had a lower NCF at a curvature radius of 3 mm when compared with a curvature radius of 5 mm (P < .0001). CONCLUSIONS: Within the limitations of this study, the cyclic fatigue resistance of the HyFlex GPF instrument was the highest, and the curvature radius had a significant effect on the fatigue resistance.

Evaluation of root canal transportation, centering ratio, and remaining dentin thickness associated with ProTaper Next instruments with and without glide path.

INTRODUCTION: The purpose of this study was to evaluate and compare the volume of removed dentin, transportation, and centering ability of ProTaper Next (PTN) system with and without glide path preparation by using cone-beam computed tomography (CBCT) imaging. METHODS: Sixty mesiobuccal canals of mandibular first molars with curvatures of 25°-35° were divided into 3 experimental groups (n = 20) according to the instrumentation technique as follows: group PG/PTN (glide path was created with ProGlider [PG]) and canals were shaped with PTN system), group PF/PTN (glide path was created with PathFile [PF]) and canals were shaped with PTN system), and group PTN (glide path was not performed and canals were shaped with PTN system only). Canals were scanned before and after instrumentation by using CBCT scanner to evaluate root canal transportation and centering ratio at 3, 5, and 7 mm from the apex and volumetric changes. Data were statistically analyzed, and the significance level was set at P < .05. RESULTS: There was no significant difference among the tested groups regarding the volume of removed dentin and centering ratio (P > .05). At 3-mm and 5-mm levels, the PG/PTN group showed a significantly lower mean transportation value among the groups (P < .05). However, at 7-mm level, there was no significant difference in canal transportation among the groups (P > .05). CONCLUSIONS: PG/PTN instrumentation method revealed better performance with fewer canal aberrations when compared with instrumentation performed with PF/PTN or PTN only.

Apical root canal transportation and remaining dentin thickness associated with ProTaper Universal with and without PathFile.

INTRODUCTION: This study aimed to compare, using digital subtraction radiography, apical transportation in mesiobuccal root canals of extracted human maxillary molars instrumented with ProTaper Universal F3 and F4 files (Dentsply Maillefer, Ballaigues, Switzerland) with and without the prior creation of glide paths using the PathFile system and to compare, using cone-beam computed tomographic imaging, remaining dentin thickness (RDT) after complete preparation. METHODS: Forty mesiobuccal roots with curvatures of 20°-35° were used. In group A, glide paths were created with PathFile #1, #2, and #3 to the working length; in group B, no glide paths were used. All canals were instrumented up to F4 to the working length. Digital subtraction radiographic images were obtained in buccolingual and mesiodistal directions. Apical transportation associated with F3 or F4 was calculated based on the difference between the tip of the first and the last instrument analyzed in each group. RDT was calculated based on cone-beam computed tomographic images. RESULTS: Apical transportation was higher after F4 regardless of the use of the PathFile system. No statistically significant differences between groups A and B were observed in apical transportation after instrumentation with F3 or F4 (P > .05). Group A showed greater RDT values at 2 (buccal and mesial walls, P < .05) and 3 mm (buccal and distal walls, P < .05) from the apex but not at 1 mm. CONCLUSIONS: The use of the PathFile system before root canal preparation with ProTaper Universal F3 and F4 did not influence apical transportation but was associated with greater RDTs at 2 and 3 mm from the apex.

Torsional and cyclic fatigue resistances of glide path preparation instruments: G-file and PathFile.

This study aimed to compare cyclic fatigue and torsional resistances of glide path creating instruments with different tapers and tip sizes. Two sizes (G1 and G2) from G-File system and three sizes (PathFile #1, #2, and #3) from PathFile system were used for torsional resistance and cyclic fatigue resistance tests (n = 10). The torsional resistance was evaluated at 2-, 3-, 4-, 5-, and 6-mm from the file tip by plotting the torsional load changes until fracture by rotational loading of 2 rpm. The cyclic fatigue resistance was compared by measuring the number of cycles to failure. Data were analyzed statistically using one-way ANOVA and Duncan's post-hoc comparison. The length of the fractured file fragment was also measured. All fractured fragments were observed under a scanning electron microscope (SEM). Although G-2 file showed a lower torsional strength than PathFile #3 at 2- and 3-mm levels (p < 0.05), they had similar ultimate strengths at 4-, 5-, and 6-mm levels (p > 0.05). The smaller files of each brand had a significantly higher cyclic fatigue resistance than the bigger ones (p < 0.05). PathFile #1 and #2 had higher fatigue resistances than G-files (p < 0.05). While G-1 had a similar fatigue resistance as PathFile #3, G-2 showed the lowest and PathFile #1 showed the highest resistances among the tested groups (p < 0.05). The SEM examination showed typical appearances of cyclic fatigue and torsional fractures, regardless of the tested levels. Clinicians may consider the instruments' sizes for each clinical case in order to get efficient glide path with minimal risk of fracture.

Clinical Evaluation of the Combined Application of Pathfile and Mtwo in Preparing Curved Root Canals / 华中科技大学学报(医学版)

Objective To evaluate the clinical efficacy of combined use of Pathfile and Mtwo in the preparation of curved root canals.Methods This study enrolled a total of 90 teeth(313 root canals)that need root canal therapy because of pulpitis or apical periodontitis from December 2013 to February 2014.All root canals were randomly divided into three groups.In group A,both Pathfile and Mtwo NiTi files were used in root canal preparation.In group B,Pathfile and ProTaper were used.ProTaper was employed alone in root canal preparation in group C.The high temperature thermaplasticized inj ectable ver-tical condensation technique was applied in all the three groups.The time of root canal preparation,the number of separated de-vices,root canal transportation and the quality of root canal filling were obtained and compared among the 3 groups.Results In group A,the time of root canal preparation was shortest,(6.01±1.12)min ;there were no instrument separation and ledge for-mation,and the filling rate was highest in group A.The differences were significantly noted in these indexes between group A and groups B,C.Conclusion Combined use of Pathfile and Mtwo for preparation of curved root canals is fast and safe,and the root canal filling is satisfactory.This method is suitable for clinical application.