Nickel-titanium Rotary Instruments Research Articles

Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT.

To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT). Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test. There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation. From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume. The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.

Comparative Analysis of the Efficacy of Various Retreatment File Systems in the Removal of Gutta-Percha in Retreatment Cases and Time Taken During the Procedure: An In Vitro Cone Beam CT Study.

Background Removing gutta-percha manually can be a challenging task, especially when addressing densely packed root-filling material, particularly in cases where resin-based sealers are employed for obturation. The use of nickel-titanium (NiTi) rotary instruments not only effectively shapes the root canal but also efficiently removes the endodontic filling from the curved canal during retreatment. Hence, incorporating rotary NiTi instruments in retreatment cases can alleviate fatigue for both patients and operators. Objectives This study aims to compare the efficacy of Neo-Endo retreatment files, R-Endo retreatment files, and K and H files in the removal of endodontic filling material. Additionally, the remnants of gutta-percha in root canals are evaluated using cone beam computed tomography (CBCT). Materials and methods A total of 60 extracted first maxillary molar teeth were selected for this study. Canal preparation was conducted using the step-back method up to an apical size of 40 K-file. The obturation process involved the use of gutta-percha points and AH Plus sealer in a lateral compaction technique. Post-operative CBCT scans were taken. The samples were randomly divided according to the retreatment files used: group I included Neo-Endo retreatment files, group II included R-Endo retreatment files, and group III included conventional K-files and Hedstroem files (H-Files). The retreatment procedure was considered complete when the last instrument easily reached the working-length range and was physically clean. A stopwatch was used to record the time taken by each file to remove the obturating material. T1 represented the total time (including irrigation and change of file) required to reach the apex, while T2 indicated the complete removal of materials from the canal with the last instrument. The overall time recorded (TT) was calculated as T1 + T2. The removal process was analyzed with CBCT scans. Results The Neo-Endo retreatment files removed the filling materials better and more quickly than the other files. Conclusions Despite the presence of residual filling material in all samples, the Neo-Endo retreatment files left the least amount of residual filling material and achieved the shortest completion time.

The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study.

Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona,Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire,La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.

Comparative Evaluation of the Incidence of Dentin Microcracks Following Biomechanical Preparation Using Four Different Nickel-Titanium Rotary File Systems: An In Vitro Study.

Biomechanical preparation has gotten easier over time with the development of nickel-titanium (NiTi) rotary instruments. Despite their benefits, research has shown that these files frequently result in microcracks in the root canal dentin, which can fracture the roots. Such mishaps should be prevented, as they compromise the integrity of the root and reduce the long-term survival of endodontically treated teeth. This study was conducted at Government Dental College and Hospital, Patiala, Punjab, India. Eighty permanent mandibular premolar teeth were included. All the roots were inspected for any pre-existing cracks or craze lines under a stereomicroscope. The teeth were decoronated and then divided into four groups (n = 20): Group I: TruNatomy, Group II: Neoendo Flex, Group III: ProTaper Gold, and Group IV: 2Shape. The samples were instrumented according to the group to which they belonged. The roots were then sectioned horizontally at 3 mm and 6 mm from the apex and examined under a stereomicroscope at 40xfor the presence of microcracks. The data were analyzed using the IBM SPSS Statistics for Windows, version 26 (released 2019; IBM Corp., Armonk, New York, United States). A chi-square test was applied, and the level of significance was set at p < 0.05. The highest incidence of microcracks was associated with ProTaper Gold (65%), followed by Neoendo Flex (45%), TruNatomy (20%), and 2Shape (20%). All rotary instruments resulted in dentinal damage. ProTaper Gold exhibited the highest frequency of dentin cracks. TruNatomy and 2Shape exhibited satisfactory results with minimal crack formation.

Effect of preset torque setting on torque/force generation, shaping ability and surface changes of nickel titanium rotary instrument in different root canal curvature locations: An ex vivo study.

The aim of this study was to evaluate how preset torque settings influence the torque, vertical force, and root canal-centering ability of ProGlider and ProTaper NEXT nickel-titanium rotary instruments in canals with different curvature locations. Based on micro-computed tomography, mesial roots of human mandibular molars (25°-40° curvature) were allocated to the apical curvature (apical 1-5 mm) or the middle curvature (apical 5-9 mm) groups, and mandibular incisors (curvature <5°) to the straight canal group. Each group was subjected to automated instrumentation and torque/force measurement with the preset torque of 1, 2.5, or 5 N•cm. Canal-centering ratios were determined with micro-computed tomography. Instrument fracture occurred only in the 2.5 and 5 N•cm groups in curved canals. The preset torque setting and curvature location did not influence canal shaping ability.

Analysis of cyclic fatigue resistance of different endodontic nickel-titanium rotary instruments: An in vitro study.

The aim of this in vitro study was to compare the cyclic fatigue resistance of three different endodontic nickel-titanium rotary instruments using a dynamic testing device. Ten files each of ProTaper Gold (PG), Hyflex Electro-discharge Machining (HEDM), and TruNatomy (TN) were tested in a custom-fabricated dynamic cyclic fatigue testing device at 60° curvature having a radius of curvature of 5 mm. The number of cycles to the fracture (NCF) of each instrument was calculated and three continuous groups were compared by the Kruskal-Wallis test and Dunn post hoc test was used for pairwise comparison. Cyclic fatigue resistance of HEDM was the highest, followed by TN. PG had the lowest among the three. Within the limitations of the present in vitro results, it can be concluded that HEDM files appeared to be suitable for shaping complex canals with the greater number of cycles before it fractures.

Impact of Angle of File Access and Location of Canal Curvature on the Dynamic Cyclic Fatigue of Nickel Titanium Rotary Instruments.

To evaluate the impact of different file access angles and root canal curvature's location on the fatigue failure of One Curve (OC) and E3 Azure (EZ) NiTi files using a dynamic model at simulated body temperature. Eighty new instruments with similar tip sizes and taper (#25/0.06) from two NiTi rotary systems, One Curve and E3 Azure, were tested at simulated body temperatures (37°C) using a custom-made dynamic cyclic fatigue device. Instruments were divided into four subgroups according to the location of root canal curvature (a coronal curve 5 mm from the root canal orifice and an apical curve 10 mm from the root canal orifice) and the angle of file access (0° or 30°). Instruments were operated in simulated stainless-steel canals having a 60° curve and a 3 mm radius. A custom-made device produced controlled vertical pecks during file rotation. Time to failure (sec) was registered, and the length of the fragment segments was measured (mm). Data were analysed statistically with One-Way ANOVA and Tukey post hoc tests. The significance level was set at 5%. All separated instruments were examined by scanning electron microscope. One-way ANOVA (p<0.05) found a significant difference among the tested instruments. Post Hoc analysis revealed lower cyclic fatigue resistance when the angle of file access was 30º, and the root canal curvature was located coronally for both files (p<0.0001). Three-way ANOVA showed that the angle of file access was the most influential contributor to cyclic fatigue, followed by the location of file curvature and, finally, the file type (p<0.0001). The fractographic examination revealed a predominantly ductile fracture mode for all tested instruments. The lengths of all fractured segments showed no significant difference (p>0.05), indicating an accurate trajectory during testing. OC files had superior cyclic fatigue resistance than EZ files; coronal curvatures negatively impacted cyclic fatigue resistance compared to apical curvatures, while the angle of file access presented the highest impact on dynamic cyclic fatigue.

Shaping Ability of Novel Nickel-Titanium Rotary Instruments Manufactured With Different Thermal Treatments

Shaping Ability of Novel Nickel-Titanium Rotary Instruments Manufactured With Different Thermal Treatments

Accuracy of an Endodontic Rotary Motor with Integrated Apex Locator to Determine the Root Canal Length

Aim: The purpose of this study was to evaluate the efficacy to determine the root canal length, in vitro, of both the electronic apex locator (M2) and the autostop (AS - M3) functions of the Endus Duo Gnatus endodontic motor (Gnatus, São Paulo, SP, Brazil). Methods: Thirty extracted human single-rooted premolars had their root canal lengths (TLs) up to the apical foramen determined using the Endus Duo Gnatus in two ways: (1) In the stainless steel (SS) control group, the measurement was obtained using a stainless steel hand instrument with the electronic locator mode (M2 function) connected to a stainless-steel hand instrument (K-file #15). In the NiTi rotary instrument (NiTi RI) intervention group, the measurement was obtained during the instrumentation (M3 function) of the root canals with a nickel-titanium rotary instrument (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, USA), size 25/.06. The NiTi manually used instrument (NiTi MUI) Intervention group performed the measurement in locator mode using a Hyflex instrument, placed to true length manually. Statistical analysis was performed using ANOVA followed by the Tukey post-hoc test with a significance level of p &lt; 0.05. Results: The true mean length and standard deviation (SD) of the standardized root canals were 18.40 ± 2.14mm, while the mean lengths and standard deviations (SD) were 18.29 ± 1.89mm, 18.22 ± 1.85mm, and 17.24 ± 2.09mm for the SS, NiTi RI, and NiTi MUI groups, respectively. However, data from the NiTi MUI Intervention group indicated shorter root canal lengths when compared to the SS control group and the NiTi RI Intervention group values, and were significantly shorter than the true canal length (p &lt; 0.001). Conclusions: The use of the motor in NiTi RI Intervention group showed acceptable results. However, the NiTi MUI Intervention group resulted in unacceptable short measurements.

Factors Affecting the Cyclic Fatigue of Heat-Treated NiTi Rotary File: A Review

Clinicians face a major problem when a Nickel-Titanium (NiTi) rotary endodontic instruments fracture occurs inside the canal during treatment. It is time consuming for removal of these separated instruments, in addition to its technical difficulty. So for these reasons it is important to reduce the risk of file fracture. As a sequel, several attempts have been made to improve the mechanical features of NiTi rotary files, like changes in speed of operation, changing the geometric and dimensional characteristics, and several different metal treatments. The revolution of new heat-treated NiTi instruments opens a new era for basic, clinical and scientific research. This article concerns mostly with environmental and heat-treated factors, irrigation and type of rotation and their effects on heat-treated NiTi instruments found in most studies.

Phase transformation and mechanical properties of heat-treated nickel-titanium rotary endodontic instruments at room and body temperatures

BackgroundThe aim of this study was to evaluate the phase composition, phase transformation temperatures, bending property, and cyclic fatigue resistance of different heat-treated nickel-titanium (NiTi) rotary instruments with the same tip diameter and taper at room (RT; 25 ± 1 °C) and body (BT; 37 ± 1 °C) temperatures.MethodsFive heat-treated NiTi rotary instruments, HyFlex EDM (EDM), HyFlex CM (CM), Vortex Blue (VB), RE file CT (RE) and JIZAI, and a non-heat-treated NiTi rotary instrument (Mtwo) with a size 40, 0.04 taper were investigated. Temperature-dependent phase transformation was examined with differential scanning calorimetry (DSC). The bending loads of the instruments at RT and BT were evaluated using a cantilever-bending test. Cyclic fatigue resistance at RT and BT was measured using a dynamic test, during which the instruments were rotated in combination with a 2-mm back-and-forth motion in an artificial curved canal, and the number of cycles to failure (NCF) was determined. The results were analyzed using two-way repeated measures analysis of variance, a simple main effect test, and the Bonferroni test (α = 0.05).ResultsDSC results indicated that EDM and Mtwo were primarily composed of martensite/R-phase and austenite, respectively, while the other heat-treated instruments were composed of a mix of martensite/R-phase and austenite at the tested temperatures. Regardless of the temperature setting, the bending loads of heat-treated instruments were significantly lower than those of Mtwo (p < 0.05). EDM showed the lowest bending loads and highest NCF at both temperatures (p < 0.05). CM, VB, and JIZAI showed significantly higher bending loads at BT than at RT (p < 0.05). The NCF of all the heat-treated instruments, except VB, was lower at BT than at RT (p < 0.05). At BT, the NCF of CM, VB, RE, and JIZAI were not significantly higher than that of Mtwo (p > 0.05).ConclusionsHeat-treated NiTi instruments exhibited lower bending loads and higher NCF values than Mtwo. However, this tendency was less pronounced at BT than at RT, especially in the NCF values of instruments with a mixture of martensite/R-phase and austenite phases at the tested temperatures.

Comparative evaluation of nickel titanium rotary instruments on canal transportation and centering ability in curved canals by using cone beam computed tomography: An in vitro study

The aim of this study was to compare canal transportation and centering ability of different nickle titanium systems using Cone beam computed tomography in curved canals. Ninety mandibular molars with angle of curvature ranging from 10°– 40° were randomly allocated into six experimental groups containing 15 teeth in each group. Preinstrumentation scans were taken with CBCT with constant exposure parameters before and after instrumentation. Six grouped specimens were instrumented with Wave One, Twisted File, Hyflex CM, K3XF, ProTaper Next, NeoNiTi file respectively. Post instrumentation the specimens were scanned by CBCT to obtain postoperative images. The amount of root canal transportation and centering ability of the instrument were determined. Statistical analysis on collected data was performed using One way analysis of ANOVA, and post-hoc Tukey test (p&amp;#60;0.0.5). K3XF group showed significantly higher transportation values in the apical third (2mm) than TF group (p=0.01) and Hyflex CM group (p=0.03). The coronal transportation values are higher than the apical values but with no significant difference between them (p&amp;#62;0.05). There was no significant difference in centering ratio values between the six groups (p&amp;#62;0.05) at any of the level.: All the file systems can be safely used, showing satisfactory preservation to the original canal shape with preference of TF files.

To flat or not to flat? Exploring the impact of flat-side design on rotary instruments using a comprehensive multimethod investigation.

To assess the influence of a flat-side design on the geometry, metallurgy, mechanical performance and shaping ability of a novel nickel-titanium rotary instrument. Sixty-five new 25-mm flat-side rotary instruments (size 25, taper 0.04) and their nonflat-side prototypes (n = 65) were assessed for major deformations and examined regarding macroscopic and microscopic design, determination of nickel and titanium elements ratio, measurement of phase transformation temperature and evaluation of mechanical performance parameters including time/cycles to fracture, maximum torque, angle of rotation, maximum bending and buckling strengths and cutting ability. Additionally, unprepared canal areas, volume of hard tissue debris and percentage reduction of dentine thickness were calculated for each tested instrument after preparing mesial canals of mandibular molars (n = 12), using micro-CT imaging. Statistical analyses were performed using the U-Mann-Whitney test and independent Student t-test (α = 5%). The number of spirals (n = 8) and blade direction (clockwise) were similar between both flat and nonflat instruments, whilst the helical angles were equivalent (⁓25°). Flat-instruments showed inconsistencies in the homogeneity of the gold colour on the flat-side surface, blade discontinuity, and incomplete and variable S-shaped cross-sections. The titanium-to-nickel ratios were equivalent, but significant differences in the R-phase finish and austenitic start phase transformation temperatures were observed between the flat and nonflat-side instruments. The flat-side instruments demonstrated superior cutting ability compared to the nonflat instruments, as well as, significantly lower values for time to fracture, rotation to fracture and maximum torque to fracture (p < .001). No statistical difference was observed between tested instruments regarding angle of rotation (p = .437), maximum bending (p = .152) and buckling load (p = .411). Preparation protocols using flat and nonflat instruments did not show any statistically significant differences (p > .05). All flat-side instruments exhibited deformation after shaping procedures. The flat-side instrument showcased enhanced cutting ability compared to its nonflat counterpart. However, it exhibited inferior performance in terms of time, rotation and maximum torque to fracture, along with distinct phase transformation temperatures. No differences were observed in the titanium-to-nickel ratios, angle of rotation, maximum bending, buckling load, preparation time, percentage of untouched canal walls, volume of hard tissue debris and percentage reduction of dentine thickness.

Phase transformation behavior and mechanical properties of HyFlex EDM nickel-titanium endodontic rotary instrument: Evaluation at body temperature

Background/purposeTemperature-dependent phase compositional changes influence the mechanical properties of heat-treated nickel-titanium (NiTi) rotary instruments. This study evaluated the phase composition, bending properties, and cyclic fatigue resistance of HyFlex EDM NiTi rotary instruments against differently heat-treated and non-heat-treated NiTi instruments at body temperature (BT). Materials and methodsHyFlex EDM OneFile (EDM) instruments, heat-treated HyFlex CM (CM) and Twisted File (TF) instruments, and non-heat-treated K3 instruments (size #25/.08) were subjected to differential scanning calorimetry, and the martensitic, R-phase, and reverse transformation starting and finishing temperatures were determined. A cantilever bending test and a cyclic fatigue test were conducted at BT (37 °C ± 1.0 °C), and the bending load and number of cycles to failure (NCF) were recorded. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney U tests (α = 0.05). ResultsTF and K3 had reverse transformation finishing temperatures lower than BT, while those for EDM and CM were higher than BT. The bending loads at a 0.5 mm deflection were in the order of EDM < TF < CM < K3 (P < 0.05), and those at a 2.0 mm deflection were EDM < CM and TF < K3 (P < 0.05). EDM had the highest NCF among the four instruments (P < 0.05). ConclusionThe EDM instrument had a reverse transformation finishing temperature higher than BT indicating its martensite/R-phase composition at BT. The EDM instrument had superior flexibility and greater resistance to cyclic fatigue than the CM, TF, and K3 instruments at BT.

Impact of endodontic irrigants on surface roughness of various nickel-titanium rotary endodontic instruments

BackgroundThe aim of the current study is to assess the surface roughness of several recent nickel-titanium (Ni-Ti) rotary endodontic instruments, namely: Protaper next (PTN); Hyflex CM (CM); Hyflex EDM (EDM); WaveOne gold (WOG); and trunatomy (TN), before and after application of 5.25% sodium hypochlorite (NaOCl) irrigant solution.MethodsIn this in vitro study, five recently introduced rotary endodontic instruments of different metallurgical properties and designs were subjected to Atomic Force Microscopy (AFM) analysis, and then each file was rotated in 5.25% NaOCl for 15 min., with speed and torque according to manufacturer’s instructions. The instruments were then subjected to AFM analysis again. The surface roughness average (Sa) parameter was calculated. Data were analyzed by Paired T test, One-way ANOVA and Tukey tests.ResultsThere was a statistically significant decrease in the surface roughness of all rotary endodontic instruments after immersion in irrigants (P ≤ 0.05).ConclusionThe new TN and PTN instruments showed the least surface roughness. All tested Ni-Ti rotary endodontic instruments after irrigants exposure showed a varying increase in surface roughness.

The role of micro-endodontics in the management of complex root canal anatomy

Micro-endodontics has emerged as a critical component in endodontics, revolutionizing the management of complex root canal anatomy. It utilizes magnification devices, such as dental operating microscopes or loupes, to enhance visualization and identify intricate anatomical details. Micro-endodontics encompasses advanced techniques and technologies that are utilized alongside the principles of conventional endodontics. While both approaches share common goals of cleaning, disinfection, and obturation of the root canal system, micro-endodontics specifically focuses on managing complex root canal anatomy by utilizing specialized tools and techniques to enhance visualization, instrumentation, disinfection, and obturation. Ultrasonic instruments aid in negotiating challenging canal configurations and removing obstructions. Nickel-titanium rotary instruments offer flexibility and durability for efficient cleaning and shaping. Advanced irrigation techniques, such as ultrasonics and laser-activated irrigation, improve disinfection. Innovative obturation techniques ensure the thorough filling of intricate canals. Despite limitations like cost, learning curve, treatment time, and access limitations, micro-endodontics has a promising future. Technological advancements, minimally invasive approaches, biomaterials, biotechnology, artificial intelligence, robotics, and interdisciplinary collaboration will further enhance micro-endodontics, improving treatment outcomes and expanding its scope in complex root canal anatomy.

A critical evaluation of physical and manufacturing properties of genuine and counterfeit rotary nickel-titanium endodontic instruments.

Rotary nickel-titanium (NiTi) instruments are made to exacting standards and are costly to manufacture, and quality control is paramount. Consequently, unauthorized factories make counterfeit instruments that are less expensive and may therefore be attractive to dentists. Little information exists about the metallurgy and manufacturing quality of such instruments. There is the potential for counterfeit instruments to be at higher risk of fracture during treatment, thereby compromising clinical outcomes. The aim of this study was to evaluate physical and manufacturing properties of genuine and counterfeit ProTaper Next™ and Mtwo® rotary NiTi instruments. This study investigated the metallurgical properties, manufacturing quality, microhardness and number of cycles to failure of two commonly used rotary NiTi systems and compared them with counterfeit products purporting to be genuine articles. Counterfeit instruments were found to be inferior in manufacturing standards and were less resistant to cyclic fatigue when compared to genuine instruments. Counterfeit rotary NiTi instruments may be less efficient at preparing root canals and may be at higher risk of fracture during endodontic treatment. Dentists must be aware that, although less expensive, counterfeit instruments may be of dubious manufacturing quality and at higher risk of fracture if used in patients. © 2023 Australian Dental Association.

Effect from usage and autoclave sterilization on torsional fracture resistance of heat-treated nickel-titanium instruments: an in-vitro study

This study aimed to evaluate the effect from usage and autoclaving on torsional fracture resistance of heat-treated nickel-titanium rotary instruments. ProTaper Gold F2 (PG) and TruNatomy Prime (TN) were selected. For group-N, new files were tested to make a baseline torsional resistance. For group-U, files underwent instrumentation in a J-shaped canal block, and files were tested. For group-S, files underwent instrumentation as in the group-U and followed by autoclave sterilization then were tested. Maximum torsional strength and distortion angel until fracture were measured using a customized device and toughness was calculated. Statistical analysis was conducted at the significance level of 95%. The topographic appearances of torsional fracture fragments were examined under scanning electron microscopy. PG showed significantly higher torsional strength after usage and sterilization; however, TN had reduced torsional strength (p &amp;lt; 0.05). PG showed significantly higher torsional strength in group-S than subgroup-N, while TN showed significantly lower torsional strength in group-U than group-N (p &amp;lt; 0.05). Regardless of the test conditions, PG showed significantly higher torsional strength and toughness than TN while TN had bigger distortion angle than PG (p &amp;lt; 0.05). The mechanical loads from usage and heat application during sterilization may result in alteration of torsional resistances according to geometry and alloy characteristics.

A Novel Endodontic Approach in Removing Smear Layer Using Nano and Submicron Diamonds with Intracanal Oscillation Irrigation.

Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are commonly recommended for effectively removing organic and inorganic components in the smear layer. This layer is found on root canal walls after root canal instrumentation. However, high-concentration EDTA reduces the strength of dentin and the dissolution efficacy of organic substances in NaOCl solution. The objective of this study was to investigate the efficacy of applying nano and submicron diamonds in irrigation solutions with sonic and ultrasonic oscillation for removing the smear layer during endodontic treatment. Extracted single-rooted human teeth were instrumented with ProTaper® Gold (Dentsply Sirona) nickel-titanium rotary instruments. Subsequently, each canal was irrigated with 3% NaOCl, 17% EDTA, distilled water, and 10-1000 nm-sized nano and submicron diamond irrigation solutions, respectively. Sonic and ultrasonic instruments were compared for oscillating the irrigation solutions. The teeth were processed for scanning electron microscopy to observe the efficiency of smear layer removal on the canal walls. Our results indicated that diamond sizes of 50 nm and above irrigation solutions showed significant effectiveness in removing the smear layer following the oscillation of sonic instruments for 10 s. Ultrasonic assisted 500 nm and 1000 nm diamond solutions significantly differed from the other diamond-sized solution in their ability to remove the smear layer. These results suggest that sonic and ultrasonic oscillation with specific sizes of nano and submicron diamond irrigation solution can be used as an alternative approach to removing the smear layer during endodontic treatment. The potential clinical application of root canal treatments can be expected.

Evaluation of cyclic fatigue resistance of nickel titanium rotary instruments: A systematic review and meta- analysis

A number of different thermomechanical treatments of NiTi have been developed to overcome some of the drawbacks of the traditional NiTi alloy, namely, separation and distortion of instruments. The present study analyzes the data on nickel-titanium instruments and their cyclic fatigue resistance. Online electronic data base such as PubMed, Cochrane and Google scholar through 31 January 2000 to 31 January 2020 with only English language literature. Clinical study of 9 article review &amp; stated that the Cyclic Fatigue Resistance Of Nickel Titanium Rotary Instruments tested in artificial blocks or canals ,tested with different NiTi rotary files between 200-500 rpm and accordingly torque under controled/uncntroled temperature in curved canls fracture occure. The findings of this systematic review and meta-analysis point to the possibility that the temperature at which the instruments are tested may affect the results of cyclic fatigue resistance on NiTi files with a different behavior depending on the heat treatment of the alloy and that an increase in the angle of curvature of artificial canals has a detrimental effect on the cyclic fatigue resistance. Reciprocal movement exhibited the best performance with regard to cyclic fatigue resistance. The thermal treatment of the instrument’s alloy, its cross section, and the glide path seem to influence the cyclic fatigue resistance. The cyclic fatigue resistance of instruments manufactured with the gold heat treatment is not influenced by room or intracanal temperature.