Advantages and disadvantages of new torque-controlled endodontic motors and low-torque NiTi rotary instrumentation.

Abstract

The main problem with the NiTi rotary instrumentation technique is instrument failure. During shaping procedures, rotary instruments might lock and/or screw into canals and, consequently, be subjected to high levels of stress. This may frequently lead to instrument separation or deformation. If a high-torque motor is used, the applied forces are usually very high and the instrument-fracture limit is often exceeded, thus increasing the risk of intracanal failure. A possible solution of this problem is to use a low-torque endodontic motor, which operates below the maximum permissible torque limit of each and every rotary instrument. During clinical instrumentation of root canals, if a torque-controlled motor is loaded right up to the instrument-specific torque, the motor stops momentarily and/or starts rotating counter-clockwise (auto-reverse function) to disengage the locked instrument. These safety mechanisms were developed to reduce the risk of instrument fracture. The author fully discusses the rationale for selecting lower torque values in everyday endodontic practice, and provides clinicians with useful information on the advantages and disadvantages of new endodontic motors with torque control.