Hero Shaper Instruments Research Articles

Scanning Electron Microscopic Analysis of Deformation of TruNatomy File Systems: An Ex-vivo Study.

Aim The aim of the study was to assess the instrument deformation following the usage of the TruNatomy(Dentsply Sirona, USA) file system in extracted premolars using Scanning Electron Microscopy (SEM). Materials and Methods For the present study, 84 extracted mandibular bicuspids were selected. The teeth were divided into two groups: Group 1, TruNatomy(n=42), and Group 2, Hero Shaper(Micro Mega, France) (n=42).The samples were shaped with 0.03 taper to size 36 with TruNatomy instruments and 0.04 taper to size 30 with Hero Shaper instruments. 5 ml of 5.25% Sodium Hypochlorite (NaOCl) and 2 ml of 17% ethylenediaminetetraacetic acid (EDTA) were used for the final irrigation of root canals. The master apical file was used to instrument seven teeth samples for assessing the safety of the instruments after multiple uses and autoclaving. So, a total of six files per group was used for the analysis of any distortions, cracks or micro-fractures after instrumentation of 42 teeth, at the tip (D0) and 5 mm from the tip (D5) of the rotary file under SEM at 500x magnification. Statistical analysis To determine the significance between the groups, the Mann-Whitney U-testwas applied. Results The mean surface wear of the instruments, at the tip (D0) in Group 1 was 1.2857 and in Group 2 was 1.4762. The mean spiral distortion of the instruments, at the tip (D0) in Group 1 was 1.1905 and in Group 2 was 1.4286. A statistically significant difference (P<0.05) was observed between the groups for surface wear and spiral distortion at the tip of the file (D0). There was no significant difference between groups for surface wear and spiral distortion values of the instruments at 5 mm from the tip (D5) (P>0.05). Conclusion The instrument distortion of the rotary file systems analysed was minimal following the biomechanical preparation of seven mandibular bicuspids without root curvature, using a single file. Therefore, both rotary file systems can be considered safe.

Success Rate and Time for Bypassing the Fractured Segments of Four NiTi Rotary Instruments.

Introduction:The aim of this in vitro study was to compare the success rate and time required for bypassing the fractured segments of four different nickel-titanium (NiTi) rotary systems. Methods and Materials:This study was conducted on the mesiobuccal canals of 60 mandibular molars with fully-formed apices. Fifteen Flex Master, K3, RaCe and Hero Shaper instruments with 0.04 taper and tip size of #30 and 25 mm in length, were obtained. These instruments were notched at a point 3 mm from the tip of the instrument and were driven into the canals using a handpiece until the instruments fractured and became lodged therein. In the next step, an endodontist tried to bypass the fractured segment using K-files. The number of bypassed samples and the time required for bypassing of each sample were recorded. The Chi-square test was used to compare the bypassing rate among the experimental groups. One-way analysis of variance followed by Tukey’s post hoc test was conducted to compare the time taken for bypassing of the fractured fragments. Results:One instrument in Flex Master group and two broken segments in each of the K3 and Hero groups were not bypassed. All of the samples in RaCe group were bypassed. No significant difference was found among four tested groups regarding rate of bypassing (P=0.738). The time taken to bypass fragments in the Hero group was significantly more than in those of K3 (P=0.047) and RaCe (P=0.024). Conclusion:Under the limitations of this study, design features of rotary files can influence the time needed to bypass separated fragments.

Atomic force microscopic evaluation of nanostructure alterations of rotary NiTi instruments after immersion in irrigating solutions

To compare the effect of 5.25% NaOCl or 17% EDTA solutions on the surface topography and roughness of GTX, TF, RaCe and Hero Shaper instruments using atomic force microscopy (AFM) analysis. Four new files of each brand were subjected to AMF analysis; then each group was subdivided into two subgroups (n=2) in which instruments were immersed in either 5.25% NaOCl or 17% EDTA solutions for 5min, thereafter subjected to AFM analysis again. Ra and the RMS values were chosen to investigate the surface features of endodontic files. Before immersion in irrigating solution, TF and Hero Shaper instruments had the significantly highest roughness values and RaCe had the significantly lowest values (P≤0.05). After immersion in NaOCl, GTX and RaCe instruments were not significantly different from the new instruments, nor between them. There was a significant increase in Ra and RMS values for TF and Hero Shaper instruments over that of untreated ones and that of GTX and RaCe instruments. No significant increase in surface roughness of the instruments was recorded with EDTA. 17% EDTA did not significantly affect the surface roughness of the instruments, whilst 5.25% NaOCl increased the surface roughness of TF and Hero Shaper significantly more than that of RaCe and GTX instruments.

A scanning electron microscopic study of smear layer remaining following use of Greater Taper rotary instruments

The aim of this in vitro study was to evaluate the smear layer in the root canal following the use of Ni-Ti hand ProTaper, HERO shaper and Twisted rotary instruments. Fifteen freshly extracted single rooted human mandibular premolar teeth were selected. Crowns of all teeth were cut off at the cemento-enamel junction with a carborundum disc. The roots were then randomly divided into three groups of 5 samples each. The working length of all teeth was established by the insertion of an endodontic instrument into the canal until its tip is visible at the apical foramen and then subtracted by 0.5 mm. A sequential crown down technique was carried out in all the three groups as follows: Group-I- Specimens in this group were instrumented with ProTaper Ni-Ti hand instruments. Group-II- Specimens were instrumented with HERO shapers. Group-III - The specimens in this group were instrumented with Twisted rotary instruments. Irrigation was done with 3% NaOCl and 15% EDTA in all the three groups. Teeth were carefully split with hammer and chisel and stored in small labeled bottles containing normal saline until SEM evaluation. Results showed that when comparing ProTaper files, Twisted rotary instruments and HERO shaper instruments, HERO shaper series of rotary instruments showed maximum amount of smear layer followed by the Twisted rotary instruments. Hand instruments produced least amount of smear layer.

Scanning electron microscopic evaluation of debris and smear layer remaining following use of ProTaper and Hero Shaper instruments in combination with NaOCl and EDTA irrigation

The purpose of this study was to evaluate the amounts of debris and smear layer remaining on canal walls after preparation with ProTaper and Hero Shaper instruments in combination with NaOCl and EDTA irrigation in curved root canals. A total of 55 root canals were randomly divided into 2 instrumentation groups of 20 canals each and 1 negative control group of 15 canals. The canals in each of the 2 instrumentation groups were prepared with ProTaper or Hero Shaper instruments. Irrigation was performed with 5% NaOCl and 17% EDTA solutions. The control group was not instrumented. The remaining debris and smear layer were evaluated from scanning electron photomicrographs at x200 and x1,000 magnification taken in the coronal, middle, and apical thirds of the canals at both inner and outer canal walls. A 5-category scoring system for debris and smear layer was used. Statistical analysis was carried out using the Kruskal-Wallis and Mann-Whitney rank sum tests. Completely clean root canals were not found in either instrumentation group. In the coronal and middle thirds, the canal walls of both instrumentation groups were clean, with no or only small areas of debris and smear layer. In the apical region, there were higher scores in terms of debris and smear layer in both instrumentation groups. No significant difference was found at the inner wall of the 2 instrumentation groups in terms of debris mean score. However, the outer canal walls prepared with ProTaper showed lower debris score compared with those prepared with Hero Shaper (P < 0.001). Concerning the smear layer, both the inner and outer canal walls prepared with ProTaper showed lower mean scores compared with those prepared with Hero Shaper (P < 0.001). Within the limitations of this study, both instruments in combination with NaOCl and EDTA irrigation produced a clean and debris-free canal surface in the coronal and middle thirds, but were unable to produce a canal surface free from debris and smear layer in the apical third. However, the canals prepared with ProTaper instruments showed smaller amounts of debris and smear layer remaining in the apical region.

Comparison of shaping ability of RaCe and Hero Shaper instruments in simulated curved canals

This study compared the shaping ability of Hero Shaper and RaCe instruments in simulated curved canals. Forty simulated canals in resin blocks were divided into 2 experimental groups, each comprising 20 resin blocks, and prepared with Hero Shaper and RaCe using the crown-down technique. Preoperative and postoperative photographs, recorded using a digital camera, were superimposed and aberrations were recorded. Material removal was measured at 10 points beginning 1 mm from the end point of the canal. Mean total widths, outer and inner width measurements, were determined on each central canal path and differences were statistically analyzed using Student t test. The Hero Shaper and RaCe instruments removed almost the same amount of material from the inner side of the simulated canals. On the outer canal wall, the RaCe instruments removed significantly more material from the first 3 mm (P < .05). However, Hero Shaper removed more material from the middle and coronal aspects of the canal and the differences were statistically significant (P < .01). RaCe instruments removed more resin from the outside of the curvature at the apical thirds, while Hero Shaper removed more material from the middle and coronal thirds on the outer canal wall. Hero Shaper instruments showed better centering ability and fewer aberrations. No instrument fractures but some deformations were observed for both systems.

Shaping ability of progressive versus constant taper instruments in curved root canals of extracted teeth

To compare the shaping ability of progressive versus constant taper shaft instruments in curved root canals of extracted human teeth. A total of 40 root canals of mandibular molars with curvatures ranging between 20 degrees and 40 degrees were divided into two groups of 20 canals each and embedded in a muffle system. The root canals sectioned horizontally at three levels before preparation and then remounted into the mould. All root canals were prepared with ProTaper (progressive taper) or Hero Shaper (constant taper) instruments. Pre- and post-instrumentation radiographs and cross-sectional images were obtained. The parameters evaluated were: working safety (instrument failure, apical blockage and loss of working length) and shaping ability (straightening, cross-sectional area, transportation and centring ability). The data were analysed statistically using Student's t-test. No instrument fractured during preparation. One Hero Shaper instrument permanently deformed. Both instrument systems maintained working length well. The canals prepared with Hero Shaper instruments were straightened to a lesser degree (P < 0.05). ProTaper instruments removed more dentine in the coronal and the middle sections of the canals. Canals prepared with Hero Shaper instruments had less transportation (P < 0.01) and better centring ability (P < 0.05) in the apical section. Both instrument systems were safe to use and maintained working length well. The canals prepared with Hero Shaper had less transportation and were better centred in the apical region, possibly because their smaller taper reduced instrument stiffness.

Penetration Depth of Warm Vertical Gutta-Percha Pluggers: Impact of Apical Preparation

The warm vertical gutta-percha compaction technique requires canals to be sufficiently flared to allow the tip of the plugger to penetrate to the apical third. The aim of the present study was to determine whether apical preparation or finishing instruments could be used to improve the penetration depth of pluggers. Single-root canals (48) were prepared using different rotary Ni-Ti instruments: M File System (I), ProTaper (II), HEROShaper (III), and EndoK3 (IV). Finger and heat (Endotwinn) pluggers were introduced into the canals, one after the other, and their penetration depths were measured. The apical thirds of the canals were then flared with specific instrumentation and the penetration depths of the pluggers were once again measured. After the initial preparation, the smallest diameter pluggers (No. 1 and F) could be inserted 5 to 7 mm short of working length without difficulty. Apical flaring improved the maximum penetration depth of the finger plugger by 1.76 mm and the heat plugger by 1.52 mm The deepest penetration was obtained with the EndoK3, ProTaper, and HEROShaper instruments. By accentuating the taper, apical flaring facilitated the penetration of warm vertical gutta-percha compaction pluggers.

Shaping ability of two rotary instruments in simulated canals: stainless steel ENDOflash and nickel‐titanium HERO Shaper

To compare the shaping ability of two rotary instruments in simulated curved canals: stainless steel ENDOflash Files (KaVo, Biberach, Germany) and the recently introduced nickel-titanium HERO Shaper instruments (Micro-Mega, Besançon, France). Simulated root canals with 35 degree curves in resin blocks were prepared to size 30, .04 taper (HERO Shaper) using a crowndown technique or size 30, .02 taper (ENDOflash) using a rotary motion and a rotation speed of 400 or 250 rpm respectively. In both groups, irrigation was performed with 1 mL distilled water after each instrument size and Glyde (Dentsply Maillefer, Ballaigues, Switzerland) were used. Canals (n = 17 per group) were scanned before, during and after preparation. The assessment of preparation shape was carried out with a computer image analysis program. Material removal was measured at seven points beginning 1 mm from the end-point of the canal. Statistical analysis was performed using Wilcoxon's test and Fisher's exact test (P < 0.05). No instrument fractures, apical blockage or loss of working length (WL) occurred. More zips (10 vs. 4) and more strippings (17 vs. 0) were created with ENDOflash compared with the HERO Shaper. There were significant differences in terms of the amount of resin removed on the inner wall of the curvature obtained with the two instruments (P < 0.0001). On average, HERO Shaper instruments removed material more evenly on the outer and inner wall of the curvature. Considering the different points of measurement, there were significant differences between the two systems both on the inner and outer walls at WL-1, 2, 5 and 6 mm (P < 0.05). The HERO Shaper had a more centred enlargement compared with the ENDOflash. Stainless steel rotary ENDOflash instruments did not perform as well as HERO Shaper instruments and created an increased risk of root canal transportation. Nickel-titanium rotary HERO Shaper instruments maintained the original curvature significantly better.

The effect of high‐frequency electrical pulses on organic tissue in root canals

To evaluate debris and smear layer scores after application of high-frequency electrical pulses produced by the Endox Endodontic System (Lysis Srl, Nova Milanese, Italy) on intact pulp tissue and organic and inorganic residues after endodontic instrumentation. The study comprised 75 teeth planned for extraction. The teeth were randomly divided into two groups (60 teeth) and a control group (15 teeth): group 1 (30 teeth) was not subjected to instrumentation; group 2 (30 teeth) was instrumented by Hero Shaper instruments and apical stops were prepared to size 40. Each group was subdivided into subgroups A and B (15 teeth); two electrical pulses were applied to subgroups 1A and 2A (one in the apical third and one in the middle third, respectively, at 3 and 6 mm from the root apices); four electrical pulses were applied to subgroups 1B and 2B (two in the apical third, two in the middle third). The control group (15 teeth) was prepared with Hero Shapers and irrigated with 5 mL of EDTA (10%) and 5 mL of 5% NaOCl at 50 degrees C but not subjected to the electrical pulse treatment. Roots were split longitudinally and canal walls were examined at 80x, 200x, 750x, 1500x and 15,000x magnifications, using a scanning electron microscope. Smear layer and debris scores were recorded at the 3 and 6 mm levels using a five-step scoring scale and a 200-microm grid. Means were tested for significance using the one-way anova model and the Bonferroni post-hoc test. The differences between groups were considered to be statistically significant when P < 0.05. The mean value for debris scores for the three groups varied from 1.80 (+/-0.77) to 4.50 (+/-0.68). The smear layer scores for group 2 and the control specimens varied from 2.00 (+/-0.91) to 2.33 (+/-0.99). A significant difference was found in mean debris scores at the 3 and 6 mm levels between the three groups (P < 0.001). The Bonferroni post-hoc test confirmed that the difference was due to group 1. In the two subgroups treated with four high-frequency pulses (1B and 2B) a substantial reduction in mean debris scores was found at the 3 and 6 mm level; subgroup 2B was practically free of organic residue. No significant differences for mean smear layer and debris scores were recorded between group 2 and the control group at the two levels; a significant difference was found only for mean smear layer scores at the 3 mm level between subgroup 2B and the control group (P < 0.05). The Endox device used with four electrical pulses had optimal efficacy when used after mechanical instrumentation. Traditional canal shaping and cleaning was essential to ensure an effective use of high-frequency electrical pulses in eliminating residues of pulp tissue and inorganic debris.