Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis.

Bruna Raddato,Enrica Laneve,Vito Carlo Alberto Caponio,Riccardo Aiuto,Antonio Dioguardi,Lorenzo Lo Muzio,Khrystyna Zhurakivska,Gaetano Illuzzi,Luigi Laino,Giuseppe Troiano,Claudia Arena,Diego Sovereto,Mario Dioguardi

doi:10.52586/5062

Abstract

The fracture of endodontic instruments inside the canal represents a problem that is not always easy to solve. The reutilization of endodontic instruments after sterilization procedures raises the question of how these processes affect their physical and mechanical properties. Alterations can involve the surface of the instruments, as well as their cutting effectiveness, shape and resistance to torsional and cyclic fatigue. The methodology adopted for this systematic review followed the PRISMA guidelines for systematic reviews. The following search terms were used in PubMed and Scopus: "endodontic sterilization", "endodontic autoclave", "cyclic fatigue", "torsional", "cutting efficiency", "sterilization", "surface characteristics" and "corrosion". After the screening phase, the application of exclusion criteria and the removal of duplicates, 51 studies were identified and divided into four outcomes: cyclic fatigue; deformation and torsional fatigue; corrosion or surface alterations; and cutting efficiency. Our study of the scientific literature highlights disagreements between studies on these effects. After autoclaving, instruments exhibit a reduction in the cutting efficiency, but NiTi alloy instruments have an improved resistance to cyclic and torsional fatigue.

Highlights

The sterilization process includes several phases: pre-sterilization, drying, packaging, heat sterilization and storage of the sterile material [5]
Among these the prions which represent one of the contaminants that can resist decontamination procedures and are only partially inactivated and denatured at the temperatures reached by autoclaves used in dentistry; remember that prions are responsible for spongiform encephalopathy disease in humans [9,10,11,12]
After the application of the eligibility criteria, we arrived at 161 articles, and 103 articles remained after the elimination of duplicates

Summary

Introduction

The sterilization process includes several phases: pre-sterilization, drying, packaging, heat sterilization and storage of the sterile material [5]. An important limit to the reuse of endodontic instruments after sterilization lies in the inability to perfectly clean the blades from the debris created following the canal shaping phase [8]; the removal of debris by manual cleaning or with the help of ultrasonic trays does not allow to remove all debris of an organic and inorganic nature Among these the prions which represent one of the contaminants that can resist decontamination procedures and are only partially inactivated and denatured at the temperatures reached by autoclaves used in dentistry; remember that prions are responsible for spongiform encephalopathy disease in humans [9,10,11,12]

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Conclusion