Single-file Rotary Systems Research Articles

A quantitative comparison of apically extruded debris during root canal preparation using NiTi full-sequence rotary and single-file rotary systems: An in vitro study

ABSTRACT Aim: The purpose of this study was to compare quantitatively the apically extruded debris during root canal preparation using NiTi full-sequence rotary and single-file rotary systems. Methods: Sixty extracted mandibular premolar teeth with single canals and similar lengths were used and divided into four groups. Groups A and B are NiTi full-sequence rotary systems and Groups C and D are single-file rotary systems. In Group A, the canals were prepared using V-Taper 2H file (up to 25/0.06), Group B: TruNatomy file (up to 26/0.04), Group C: OneShape file (25/0.06), and Group D: OneCurve file (25/0.04). The initial weight of each Eppendorf tube to be used was calculated using an analytical balance before instrumentation. After instrumentation, the tubes were then stored for 15 days in an incubator at 37°C. The Eppendorf tubes were weighed again to determine their final weight which contained the extruded debris. The data were statistically analyzed using a one-way ANOVA test and Tukey’s post hoc test. Results: The OneCurve single-file system resulted in statistically significant less debris extrusion than the OneShape single-file system, TruNatomy multifile system, and V-Taper 2H multifile system (P < 0.001). Among the full-sequence rotary file systems, the TruNatomy rotary file system produced statistically significantly less debris extrusion than the V-Taper 2H rotary file system (P = 0.01). Conclusion: All the instrumentation systems caused apical extrusion of debris. OneCurve system showed least debris extrusion, followed by OneShape, TruNatomy, and V-Taper 2H systems. Thus, single-file rotary instruments performed better with the less extrusion of debris when compared to multifile rotary systems.

Evaluation of Canal Transportation Using Single File Rotary Systems, One Shape, Waveone GOLD and Reciproc in Simulated Curved Canals (in Vitro Study)

Objectives maintaining root canal anatomy through minimal canal transportation by using Rotary single file systems: One Shape, Wave One Gold and Reciproc systems used in simulated artificial curved root canals. Materials and Methods 30 simulated curved root canals in clear resin blocks were used in this s tudy and divided into three groups containing 10 samples each: group (1) represented canals instrumented with Rotary One Shape files, group (2) canals instrumented with reciprocating Wave One Gold files while Group (3) canals were prepared with Reciproc files. All canals were imaged pre- and post- instrumentation at three levels, 2,3 and 5 mm apically and compared using Adobe Photoshop software program. Amount of transportation were assessed. The three groups were compared with ANOVA and LSD statistic tests Results the mean transportation at 3mm level of the canal had no significant difference among all groups, all shown transportation. At 2mm, and 5mm levels there were significant difference between groups, G2 shown the least transportation among all groups. Conclusions Within the limits of this study, the canal preparation with Wave One Gold files showed lesser transportation than One Shape and Reciproc files.

Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial.

Single-visit pulpectomy (SVP) protocol with rotary files is highly recommended for the treatment of teeth with irreversible pulpitis. Various rotary endodontic files specially designed for use in the pediatric population are available. The aim is to clinically assess the parameters related to the time required for biomechanical preparation (TBMP) and quality of filling using a single file system vs a sequential multi-file system in infected primary mandibular molars. A total of 45 infected primary molars were allocated to three groups (two experimental groups (n = 15) and a control group. The first experimental group was instrumented using NiTi K-Flex files, the second group with a single file rotary system with variably variable (VV) taper, and the third with a sequential multi-file system with constant taper. Biomechanical preparation time was recorded and standardized digital radiograph (RVG) were taken pre- and postinstrumentation. The data recorded was sent for statistical analysis. There is a substantial reduction of TBMP in primary molars using single file VV taper and multi-sequential file constant taper. Obturation time for all three file systems was comparable and there were no differences between the three file systems used (p > 0.05). Multi-sequential file constant taper files showed a higher probability of optimal obturations and minimal voids followed by NiTi "K-Flex" files and single file system but the difference was nonsignificant (p > 0.05). However, using a rotary in primary teeth results in better canal shape, and less TBMP leading to a better quality of treatment in less time. Shetty B, Singh R, Patil V, et al. Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(S-3):S247-S252.

Influence of heat-treated single file rotary systems on remaining dentin thickness in the danger zone of the mandibular first molar. An in-vitro CBCT study

Influence of heat-treated single file rotary systems on remaining dentin thickness in the danger zone of the mandibular first molar. An in-vitro CBCT study

Cleaning efficiency of NiTi single file rotary system with a novel design in oval shaped root canals; A comparative in vitro study

Cleaning efficiency of NiTi single file rotary system with a novel design in oval shaped root canals; A comparative in vitro study

Comparative evaluation of canal cleanliness at apical third using Self-Adjusting File and Wave One File with different irrigants: an in vitro scanning electron microscopic study.

To evaluate the cleaning ability of two single-file rotary systems- Self-Adjusting File (SAF) and Wave one (WO) systems in removing the smear layer using sodium hypochlorite (NaOCl) + ethylene diamine tetraacetic acid (EDTA) and NaOCl + Qmix as irrigants at apical one-third of the root canal. Forty extracted human mandibular premolars were selected and working length was determined. The canal was manually instrumented up to a number 25 size K-file. The roots were divided into the following groups with 10 samples each - Group 1 using SAF: Group 1a- 3% NaOCl + 17% EDTA, Group 1b- 3% NaOCl + Qmix. Group2 using WO: Group 2a- 3% NaOCl + 17% EDTA, Group 2b- 3% NaOCl + Qmix. In the SAF group, the irrigation was performed continuously using the special irrigation apparatus. In the WO group, syringe irrigation was done followed by final irrigant activation using passive ultrasonic irrigation (PUI). The roots were sectioned longitudinally and subjected to scanning electron microscopic (SEM) examination. The amount of smear layer was evaluated using a five score index at the apical third level. Statistical analysis was performed using the Chi-square test. Group 1 (SAF) showed better canal cleanliness at apical third compared to Group 2 (WO) with both irrigant combinations and the results were statistically significant (p<0.05). 3% NaOCl + Qmix was equally as effective as 3% NaOCl + 17% EDTA in removing the smear layer with no significant difference between them. Within the limitation of this study, SAF in combination with 3% NaOCl + Qmix or 3% NaOCl + 17% EDTA should be used for removing smear layer in critical areas of the root canal.

Comparison of the incidence of postoperative pain in single sitting root canal treatment after using two reciprocating systems and two continuous rotary systems: An in vivo study.

The aim of the present study was to compare the incidence of postoperative pain in single sitting root canal treatment after using two reciprocating and two continuous rotating file systems. One hundred and four permanent mandibular canine and first premolar teeth were selected for the study and were divided into two groups 1 and 2 comprising 52 teeth each. Group 1 was treated using reciprocating file systems and was subdivided into two subgroups A and B using WaveOne Gold (WOG) and Reciproc Blue (RB), respectively. Group 2 was treated using continuous rotating file systems and was divided into two subgroups A and B using One Curve (OC) and Vortex Blue (VB), respectively. Treatments were performed in a single sitting. After the visit, the patients were given a prescription for ibuprofen 400 mg to be taken every 6 h if they experience pain. Participants were asked to rate the intensity of the postoperative pain on a visual analog scale according to four classes (no pain, mild pain, moderate pain, and severe pain) after 24 h, 48 h, 72 h, and 7 days. Patients were also asked to record the number of prescribed analgesic medication tablets taken at these time points. There was a statistically significant difference (P = 0.00) among the reciprocating file systems and continuous file systems regarding the incidence of postoperative pain after 24, 48, and 72 h which signifies that pain incidence and duration is less with respect to reciprocation instrumentation as compared to continuous instrumentation. The use of Reciproc instrumentation system (WOG and RB) showed significantly less intensity and duration of posttreatment pain compared to the single-file rotary system (OC and VB) in patients with symptomatic irreversible pulpitis with apical periodontitis.

Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis.

This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.

Comparative Evaluation of Root Reinforcement Using MTA-based, Epoxy Resin-based, and Silicone-based Endodontic Sealers in Canals Instrumented with Single-file Rotary System: An In Vitro Study

To evaluate root reinforcement by four different sealers, namely, AH Plus, MTA Fillapex, Dia-ProSeal, and GuttaFlow 2, on endodontically treated teeth. Sixty human mandibular premolars were randomly divided into four groups of 15 teeth each, according to the type of sealer used: Group I AH Plus, Group II MTA Fillapex, Group III Dia-ProSeal, and Group IV GuttaFlow 2. All samples were decoronated to a length of 13 mm from the apex. Root canals were prepared by OneShape, 25/0.06 taper file and obturated with a matching single cone gutta percha (25/0.06) using the above-mentioned sealers. All samples were subjected to load by universal testing machine until a point at which root fractured, which was recorded. Teeth obturated with GuttaFlow 2 showed the maximum fracture resistance followed by AH Plus, Dia-ProSeal, and MTA Fillapex. There was no significant difference in fracture resistance between AH Plus and Dia-ProSeal. Teeth obturated with GuttaFlow 2 sealer, which has powdered gutta percha particles, showed the highest fracture resistance. According to the results obtained from this study, obturation of roots with GuttaFlow 2 increased the resistance of root canal-filled teeth to vertical root fracture.

Endodontic Management of Four-Rooted Maxillary Second Molar using A Novel Single-File Rotary System : ACase Report

Endodontic Management of Four-Rooted Maxillary Second Molar using A Novel Single-File Rotary System : ACase Report

Micro-CT evaluation of 'danger zone' and microcrack formation in mesial root canals of primary teeth with single-file rotary and reciprocating systems.

Although single-file rotary systems are accepted in the field of paediatric dentistry in terms of providing time advantage, research works continue due to the variable anatomical structure of the root canal. This study aimed to evaluate rotary systems in different kinematics in terms of microcracks and the shaping of the danger zone in primary molars by micro-CT. The mesial canals of primary molars (n=30) were used. Root canals in each group (n=10) were prepared with single-file rotary systems (One Shape®, OS; XP-endo® Shaper, XP-ES; WaveOne Gold, WOG). The images were evaluated for dentin thickness in the danger zone and microcrack formation. WOG caused the highest dentin reduction in the danger zone area. OS led to significantly less dentin reduction than XP-ES and WOG (P<.05). The XP-ES showed the highest number of microcracks (P<.05). No statistically significant difference was found between WOG and OS (P>.05). In all systems, more microcracks were observed in the middle third than coronal and apical. Within the limitations of this study, the rotary systems were superior to reciprocating in terms of shaping ability in the danger zone. It is thought that further studies with different systems should be designed considering the anatomical variations and chemical composition of primary teeth.

Shaping ability of different single-file rotary systems in simulated S-shaped canals by a new investigation approach: An in vitro study

Introduction: The aim of this study was to compare the shaping ability of single-file nickel–titanium systems in simulated S-shaped canals. Materials and Methods: Sixty simulated S-shaped canals were photographed and 12 levels along their length were determined. They were divided into four groups: A and B where the WaveOne Gold and Reciproc Blue reciprocating systems were used and Groups C and D for the OneCurve and Fanta-AF F-one rotary systems. Blocks were re-photographed and the before- and after-preparation photos were superimposed. Canals' widths were measured at each canal's level before and after preparation to calculate canals' deviations. The preparation times were recorded, and the data were analyzed by one-way ANOVA and Chi-square tests (P = 0.050). Results: The mean deviation in the middle third (0.14 mm) was greater than those in the coronal (0.08 mm) and apical thirds (0.09 mm) (P = 0.000). Furthermore, in this third, the OneCurve system caused the lowest greatest deviation (0.13 mm) but not different from the WaveOne Gold system (0.18 mm). At the apical third, the OneCurve showed the least mean deviation (0.07 mm) (P = 0.001) and the lowest mean of the greatest deviation (0.12 mm) (P = 0.000). Significantly, the highest percentage of the greatest deviations located within the canals' middle third (68.4%). The Fanta-AF-F-one and Reciproc Blue systems had higher percentages of the greatest deviation within the middle third (86.7% and 85.7%, respectively) than the OneCurve (42.9%) and WaveOne Gold systems (57.1%) (P = 0.013). The OneCurve and WaveOne Gold systems needed the least shaping times (57.15 and 63.07 s, respectively). Conclusions: The OneCurve system followed by the WaveOne Gold system had better shaping ability than other systems. The OneCurve and WaveOne Gold systems required shorter shaping times. The “greatest-deviation” can be more appropriate analysis than the mean deviation when the shaping ability is investigated.

Simulated Evaluation of Tooth Fracture Resistance during Instrumentation with Single-and Multi-file Rotary Systems.

Use of rotary files in root canal preparation is inevitable due to their high speed and reduced duration of treatment. However, microcracks and even root fracture may sometimes occur in teeth where canal(s) is/are prepared using these devices. The purpose of the current study was to compare NeoNiti single-file with RaCe multi-file rotary systems. An accurate scanner designed detailed three-dimensional file models, and a simulated model was developed using canal-specific features; including dentin thickness, root canal length, taper rate and root canal curvature. Cleaning and shaping conditions were simulated with appropriate speed and crack conditions for both types of files on the computer. Strain accumulation sites in the root dentin wall where microcracks was likely to occur were simulated and investigated. Abaqus and ANSYS software were used to perform finite element simulations. RaCe files with 0.04 taper caused the lowest level of stress (34.33 MPa) to the simulated canal. Conversely, the highest level of stress (62.35 MPa) was applied by 8% NeoNiti file to the simulated canal. Based on the present experimental study, it can be concluded that RaCe multi-file rotary system may better be used in endodontic therapy, and the risk of microcracks in the tooth wall is less than that of NeoNiti single-file rotary system.

Effect of XP-endo Finisher on Post-Instrumentation Pain after Using Different NiTi Rotary Systems

Purpose: This study was conducted to assess and compare the effect of XP-endo Finisher on post-instrumentation pain after using either One Shape single-file rotary system or ProTaper Universal multi-file rotary system in root canal preparation. Materials and Methods: Forty-eight consented patients, with 52 single-rooted teeth requiring endodontic treatment were selected for this study based on inclusion/exclusion criteria. Teeth were randomly assigned into two equal groups according to the NiTi rotary system used for root canal preparation, Group (I), One Shape rotary system was used and Group (II), ProTaper Universal rotary system was used. Each group was further subdivided into two equal subgroups (A and B) according to whether XPendo Finisher was used in finishing the root canal preparation or not. Pain Intensity was measured using modified visual analogue scale at 6, 12, 24 and 72 hours after root canal instrumentation. Results: The patients’ highest mean pain scores occurred in the first 24 hours and significantly declined at the subsequent observation time of 72 hours. ProTaper Universal groups showed the highest mean pain scores, while the lowest mean pain scores were found in One Shape groups with no significant difference. The highest mean pain scores were found in XP-endo Finisher subgroups, while the lowest were found in No XP-endo Finisher subgroups with no significant difference. Conclusion: One Shape system produced less postoperative pain when used in conjunction with XP-endo Finisher.

Effect of heat treatment on the centering ability and dentin removal of a nickel–titanium single file rotary system

Aim The aim of this study was to investigate the effect of heat treatment on the centering ability and amount of dentin removal of OneShape single file rotary system (OS) by cone beam computed tomography. Materials and methods Twenty human premolars with single root canals were allocated into two equal groups (n = 10) according to the used rotary system: group 1: OS system, group 2: One Curve which is heat-treated OS single file rotary system. Preinstrumentation and postinstrumentation images were obtained at 3, 6, and 9 mm from the apex and assessed to determine canal centering ability. Amount of removed dentin was estimated by difference between preinstrumentation and postinstrumentation root canal volumes. Data were analyzed using t-test and significance level was set at P value less than or equal to 0.05. Results The results showed that One Curve file has higher mean centering ratio and more dentin removal than OS file with no statistically significant difference between them (P > 0.05). Conclusion It was concluded that heat treatment did not have significant effect as both files could maintain the original canal path without significant differences in centering ability and amount of removed dentin.

Comparison between Single-file Rotary Systems: Part 2—The Effect of Length of the Instrument Subjected to Cyclic Loading on Cyclic Fatigue Resistance

IntroductionThe aim of this study was to compare the cyclic fatigue resistance of XP Shaper (XP), HyFlex EDM One File (EDM), and WaveOne Gold Primary (WOG) when operated according to their manufacturers' recommendations at different lengths and to investigate the cyclic fatigue limit of XP Shaper when operated at 3000 rpm. MethodsOne hundred fifty instruments from 4 different rotary systems (F2 Protaper Universal [PTU], WOG, EDM, and XP) were tested for their cyclic fatigue resistance in a simulated 90° curved canal at a 37°C water bath temperature at 3 different working lengths (15 mm, 17 mm, and 19 mm). The time taken for instruments to fracture was recorded, and the number of cycles to failure was calculated. Statistical analyses were performed by using Levene's test, Kruskal-Wallis test to identify specific groups with statistically significantly higher cyclic fatigue resistance at 5% significance level. Weibull analysis was performed to determine the predictability of survival for each instrument. ResultsXP Shaper had the highest cyclic fatigue resistance compared with all other instruments, followed by EDM, WOG, and then PTU. There was no statistically significant difference in the number of cycles to failure between the XP operated at 3000 or 1000 rpm in any of the tested working lengths. There was a reduction in the number of cycles to failure when the working length increased from 15 to 19 mm in EDM, WOG, and PTU. Scanning electron microscopy showed ductile fractures with classic dimpled features in all samples. ConclusionsXP has a very high resistance to cyclic fatigue compared with WOG, EDM, and F2 PTU. The time to fracture will decrease by almost one third when XP is operated at 3000 rpm. The results of both parts of this study suggest that XP appears to be safe to operate at 3000 rpm in endodontic retreatment.

Comparison between Single-file Rotary Systems: Part 1—Efficiency, Effectiveness, and Adverse Effects in Endodontic Retreatment

IntroductionThe aim of this study was to evaluate in vitro the performance of 3 single-file systems: WaveOne Gold Primary (WOG; Dentsply Sirona, Ballaigues, Switzerland), Hyflex EDM “one file” (EDM; Coltene/Whaledent, Alstatten, Switzerland), and XP Shaper (XP; FKG, La Chaux de Fonds, Switzerland), for nonsurgical endodontic retreatment on mandibular anterior teeth in regard to the amount of remaining filling material inside the canal, debris extrusion, and operation time. MethodsSixty extracted standardized mandibular incisors presenting with a single oval canal were prepared to size 30.04 and obturated using warm vertical condensation. After 30 days (37°C, 100% humidity), teeth were randomly divided into 3 groups (n = 20) according to the file used for retreatment (WOG, EDM, or XP operated at 3000 rpm). During the retreatment procedures, preweighed vials were used to collect apically extruded debris, and the time required to remove the filling material was recorded in seconds. Cone-beam computed tomographic scans were taken before and after the retreatment to determine the amount of remaining filling material inside the root canal space. Statistical analysis was performed using the Kruskal-Wallis test, 1-way analysis of variance, and the Pearson test at a 5% significance level. ResultsThere was a statistically significant difference among the groups regarding the instrumentation time (P < .05). XP was the fastest to remove gutta-percha from the canals (40.54 ± 28.03 seconds) followed by EDM (55.77 ± 19.76 seconds) and WOG (105.92 ± 53.92 seconds). The percentage of remaining filling was significantly greater for WOG (26.65% ± 14.63%) (P < .05). No difference was found between EDM (13.51% ± 9.53%) and XP (8.60% ± 7.28%). No difference was found regarding the amount of extruded debris among the 3 groups (P > .05). ConclusionsXP was the most efficient in gutta-percha removal from the canals when operated at a higher speed (3000 rpm) followed by EDM and WOG.

Comparative Evaluation of Root Canal Transportation by Three NiTi Single-File Systems in Curved Canals: A Cone Beam Computed Tomography Study.

Introduction This study is aimed at evaluating root canal transportation in the mesiobuccal canal of mandibular first molars prepared with One Shape, Reciproc, and M-One nickel titanium (NiTi) single-file rotary systems using cone beam computed tomography (CBCT). Materials and Methods In this ex vivo study, CBCT scans of 45 extracted human mandibular first molars with 20–40° curvature were obtained. The teeth were randomly divided into three groups (n=15) for preparation of the mesiobuccal canal with One Shape, Reciproc, and M-One rotary systems according to the manufacturers' instructions. CBCT scans were obtained again after canal preparation. Changes caused by preparation in the coronal, middle, and apical thirds were determined on CBCT scans and analyzed using the Kruskal–Wallis test at P ≤ 0.05 level of significance. Results No significant difference was noted in the amount of canal transportation among the three groups (P > 0.05). M-One caused greater transportation in the apical third compared with Reciproc and One Shape, and One Shape caused greater transportation in the coronal third compared with other groups, although its magnitude was less than 0.3 mm. Conclusion Reciproc, One Shape, and M-One are not significantly different in terms of canal transportation.

Comparative evaluation of apically extruded debris during root canal instrumentation using two Ni-Ti single file rotary systems: An in vitro study.

Background:Apical extrusion of debris during instrumentation is detrimental to the patient.Aim:The aim of this study was to evaluate the apical extrusion of debris during root canal instrumentation using two single file rotary Ni-Ti systems.Materials and Methods:Thirty freshly extracted mandibular premolars with straight roots were sterilized and divided into two groups instrumented using: One Shape rotary Ni-Ti system with Endoflare orifice shaper (Group 1) and Neo-Niti rotary Ni-Ti system with C1 orifice shaper (Group 2). Preweighed Eppendorf tubes fitted for each tooth before instrumentation. During instrumentation, 1 mL of distilled water with a 30-gauge needle was used to irrigate after every instrument. Tips of the tooth were irrigated with 2 ml distilled water after removal from Eppendorf tubes. The total volume of irrigant in each group was the same 8 ml. All tubes were incubated at 68°C for 15 days and subsequently weighed. The difference between pre- and post-debris weights was calculated, and statistical analysis was performed using independent t-test and level of significance was set at 0.05.Results:The difference between pre- and post-weights was significantly greater for the One Shape system.Conclusions:The Neolix Niti single file was associated with less extrusion compared to One Shape single file system.

Comparative evaluation of dentinal defects induced by hand files, hyflex, protaper next and one shape during canal preparation: A stereomicroscopic study

Aim: This study aims to evaluate and compare the incidence of dentinal defects induced by Hand Files, HyFlex CM, ProTaper Next (PTN), and One Shape during canal preparation. Materials and Methods: One hundred and fifty extracted mandibular premolar teeth with single root canal were selected. Specimens were then divided into five groups with thirty specimens each. Group I: Specimens were prepared with hand instruments. Group II: Specimens were prepared with HyFlex CM rotary files (Coltene) using a crown-down technique according to the manufacturer's instructions. Group III: Specimens were prepared with PTN rotary files (Dentsply) using a crown-down technique according to the manufacturer's instructions. Group IV: Specimens were prepared with One Shape Single file rotary system (MicroMega) using a crown-down technique according to the manufacturer's instructions. Group V: Specimens were used as a control and left unprepared. All roots were cut horizontally at 3, 6, and 9 mm from the apex. Sections were then viewed under stereomicroscope and dentinal defects were registered as “no defect,” “fracture,” and “other defects.” Statistical Analysis: Results of the study were subjected to Chi-square test. Results: Results were expressed as the number and percentage of defected, partially defected and roots with no defects in each groups. Conclusion: Hand files and One Shape file system caused less root defects compared to PTN and HyFlex file systems.