Abstract

Background/Aim: To investigate the incidence of procedural errors with the use of a novel nickel-titanium rotary system (Hyflex CM, Coltene/ Whaledent, Altstätten Switzerland), evaluate the technical quality of root canal treatments and assess a questionnaire completed by the participants themselves in an undergraduate dental clinic between 2014 and 2017 (Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki). Material and Methods: 118 undergraduate students in their first year of clinical practice performed a root canal treatment on a patient's molar (maxillary/mandibular). None of the participants had previous experience in rotary instrumentation. The periapical radiographs were taken with the use of the paralleling technique for standardization and were collected and evaluated by the investigator. After the root canal treatment was performed the students completed a questionnaire in order to evaluate their training on rotary instrumentation. Results: The overall incidence of instrument separation, apical perforation, root perforation, straightening and ledges was 0.8%, 4.4%, 2.3%, 5.5% and 29% respectively on root canal level. Ledges were detected more often in mandibular mesiobuccal canals. The frequency of root canals with an 'acceptable' filling was 68.4%, while overfilled and underfilled canals were found to be 8.6% and 16.2% respectively. The response rate was high (94.9%), 35% of the participants encountered no difficulty in the use of rotary instrumentation and 98.2% would use it again. Conclusions: The incidence of procedural errors was considerably low and the technical quality of the filled root canals was superior to that of similar studies. The responses of the questionnaire demonstrated a positive attitude toward rotary instrumentation.

Highlights

  • The advent of Ni-Ti rotary instrumentation has improved the quality and speed of cleaning and shaping procedures; simultaneously procedural errors such as transportation, ledging, zipping and perforations are decreased[1,2]

  • Ni-Ti instruments are still susceptible to separation[3]. Their widespread use among clinicians and the need to reduce procedural errors for more predictable results, have led to a rapid development of new endodontic rotary systems while formers are updated at an exponential rate

  • Hyflex CM rotary files (Coltene/Whaledent, Altstätten, Switzerland) are manufactured from a novel type of Ni-Ti wire, namely Controlled Memory (CM) wire, which has undergone a unique proprietary thermomechanical processing[4], that is not disclosed by the manufacturer

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Summary

Introduction

The advent of Ni-Ti rotary instrumentation has improved the quality and speed of cleaning and shaping procedures; simultaneously procedural errors such as transportation, ledging, zipping and perforations are decreased[1,2] Despite their indisputable advantages, Ni-Ti instruments are still susceptible to separation[3]. Hyflex CM rotary files (Coltene/Whaledent, Altstätten, Switzerland) are manufactured from a novel type of Ni-Ti wire, namely Controlled Memory (CM) wire, which has undergone a unique proprietary thermomechanical processing[4], that is not disclosed by the manufacturer. These instruments, as stated by the manufacturer, possess a lower percentage in weight of. Rotary instrumentation is an integral adjunct to endodontic practice, undergraduate programs have gradually included it in their curricula[9,10,11]

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