Novel approach for characterizing clinical load application of superelastic orthodontic wires.

OBJECTIVE: Current standardized in vitro bending experiments for orthodontic archwires cannot capture friction conditions and load sequencing during multi-bracket treatment. This means that clinically relevant forces exerted by superelastic wires cannot be predicted. To address these limitations, this study explored a novel test protocol that estimates clinical load range. METHODS: The correction of a labially displaced maxillary incisor was simulated using an in vitro model with three lingual brackets. Deflection force levels derived from four different protocols were designed to explore the impact of friction and wire load history. These force levels were compared in nickel-titanium (NiTi) archwires with three commonly used diameters. The unloading path varied between protocols, with single or multiple sequences and different load orders and initial conditions. RESULTS: Deflection forces from the new protocol, employing multiple continuous load/unload cycles (CCincr), consistently exceeded those from the conventional protocol using a single continuous unloading path (CUdecr). Mean differences in plateau force ranged from 0.54 N (Ø 0.014" wire) to 1.19 N (Ø 0.016" wire). The CCinr protocol also provided average force range estimates of 0.47 N (Ø 0.012" wire), 0.89 N (Ø 0.014" wire), and 1.15 N (Ø 0.016" wire). SIGNIFICANCE: Clinical orientation towards CUdecr carries a high risk of excessive therapeutic forces because clinical loading situations caused by friction and load history are underestimated. Physiological tooth mobility using NiTi wires contributes decisively to the therapeutic load situation. Therefore, only short unloading sequences starting from the maximum deflection in the load history, as in CCincr, are clinically meaningful.

DNA fragmentation of lymphocytes and sperm cells induced by nickel released from orthodontic archwires: A preliminary study.

Orthodontic brackets and archwires placed intraorally are subject to corrosion, leading to the release of cytotoxic metal ions. The aim of this study was to determine whether the use of orthodontic NiTi archwires increases systemic Ni levels and cause alterations on the DNA of cells unrelated to the oral environment such as lymphocytes and sperm cells. Human urine, semen and blood samples were collected before (baseline) sham placement of orthodontic archwires and 15 and 30 days after placement. Lymphocytes and sperm cells cells were evaluated by comet assay. Ni concentration levels in urine increased significantly between baseline and 15 days (p<0.01) and 15 and 30 days of exposure (p<0.01). Progressive decrease in sperm viability and motility was observed between the sampling periods. Lymphocytes and sperm cells showed DNA fragmentation. The increase in systemic concentration of nickel induced structural damage in the DNA of lymphocytes and human sperm cells.

Unveiling the fatigue life of NiTi endodontic files: An integrated computational-experimental study.

Nickel-titanium (NiTi) rotary files used in root canal treatments experience fatigue and shear damage due to the complex curved geometries and operating conditions encountered within the root canal. This can lead to premature file fracture, causing severe complications. A comprehensive understanding of how different factors contribute to file damage is crucial for improving their functional life. This study investigates the combined effects of root canal curvature radius, file canal curvature, and rotational speed on the fatigue life and failure modes of NiTi endodontic files through an integrated computational and experimental approach. Advanced finite element simulations precisely replicating the dynamic motion of files inside curved canal geometries were conducted. Critical stress/strain values were extracted and incorporated into empirical fatigue models to predict the functional life of endodontic files. Extensive experiments with files rotated inside artificial curved canals at various canal curvatures and speeds provided validation. Increasing the canal curvature beyond 60∘ and shorter curvature radii below 5 mm dramatically reduced the functional life of the endodontic file, especially at rotational speeds over 360 rpm. The Coffin-Manson fatigue model based on strain amplitude showed the closest agreement with experiments. Shear stresses dominated damage at low canal curvatures, while the combined shear-fatigue loading effects were prominent at higher canal curvatures. This conclusive study elucidates how operational parameters like canal curvature radii, canal curvature, and rotational speed synergistically influence the fatigue damage processes in NiTi files. The findings offer valuable guidelines to optimize these factors, significantly extending the functional life of endodontic files and reducing the risk of intra-operative failures. The validated computational approach provides a powerful tool for virtual testing and estimation of the functional life of the new file designs before manufacturing.

Surface Treatment Strategies and Their Impact on the Material Behavior and Interfacial Adhesion Strength of Shape Memory Alloy NiTi Wire Integrated in Glass Fiber-Reinforced Polymer Laminate Structures.

Over the past few decades, there has been a growing trend in designing multifunctional materials and integrating various functions into a single component structure without defects. This research addresses the contemporary demand for integrating multiple functions seamlessly into thermoplastic laminate structures. Focusing on NiTi-based shape memory alloys (SMAs), renowned for their potential in introducing functionalities like strain measurement and shape change, this study explores diverse surface treatments for SMA wires. Techniques such as thermal oxidation, plasma treatment, chemical activation, silanization, and adhesion promoter coatings are investigated. The integration of NiTi SMA into Glass Fiber-Reinforced Polymer (GFRP) laminates is pursued to enable multifunctional properties. The primary objective is to evaluate the influence of these surface treatments on surface characteristics, including roughness, phase changes, and mechanical properties. Microstructural, analytical, and in situ mechanical characterizations are conducted on both raw and treated SMA wires. The subsequent incorporation of SMA wires after characterization into GFRP laminates, utilizing hot-press technology, allows for the determination of interfacial adhesion strength through pull-out tensile tests.

Structure and Properties of Bioactive Titanium Dioxide Surface Layers Produced on NiTi Shape Memory Alloy in Low-Temperature Plasma.

BACKGROUND: The NiTi alloy, known for its shape memory and superelasticity, is increasingly used in medicine. However, its high nickel content requires enhanced biocompatibility for long-term implants. Low-temperature plasma treatments under glow-discharge conditions can improve surface properties without compromising mechanical integrity. METHODS: This study explores the surface modification of a NiTi alloy by oxidizing it in low-temperature plasma. We examine the impact of process temperatures and sample preparation (mechanical grinding and polishing) on the structure of the produced titanium oxide layers. Surface properties, including topography, morphology, chemical composition, and bioactivity, were analyzed using TEM, SEM, EDS, and an optical profilometer. Bioactivity was assessed through the deposition of calcium phosphate in simulated body fluid (SBF). RESULTS: The low-temperature plasma oxidization produced titanium dioxide layers (29-55 nm thick) with a predominantly nanocrystalline rutile structure. Layer thickness increased with extended processing time and higher temperatures (up to 390 °C), though the relationship was not linear. Higher temperatures led to thicker layers with more precipitates and inhomogeneities. The oxidized layers showed increased bioactivity after 14 and 30 days in SBF. CONCLUSIONS: Low-temperature plasma oxidation produces bioactive titanium oxide layers on NiTi alloys, with a structure and properties that can be tuned through process parameters. This method could enhance the biocompatibility of NiTi alloys for medical implants.

Comparative evaluation of increase in temperature on the external root surface of teeth during retrieval of broken NiTi instrument using two ultrasonic tips and two power settings: An in vitro study.

Context: An unfavorable event that can hinder endodontic treatment and affect the outcome of root canal treatment is the separation of endodontic instruments. Endodontic instrument separation can occur due to clinical or metallurgical factors. Friction between the ultrasonic tip and the remaining dentin generates heat, which is subsequently transferred to the external root surface. Elevated temperatures exceeding 10°C above body temperature for more than a minute may result in injury to periodontal or bone tissue. Aim: The aim of this study was to evaluate and compare temperature rise on the external root surface of teeth during retrieval of broken NiTi instrument using two different ultrasonic tips and two power settings. Materials and Methods: In each group, a sample size of 8 was sufficient to attain a statistical power exceeding 90%, enabling the detection of a minimum mean difference of 0.9204 (delta) through a one-way ANOVA test at a 95% confidence level (alpha 0.05). After access opening and working length determination, samples were randomly distributed into two groups - Group 1 (A and B) - ProUltra tip at high and low power settings and Group 2 (A and B) - Cric Dental IR3 at high and low power settings. The temperature rise was measured using K-type thermocouple thermometer. The comparisons were analyzed using the Kruskal-Wallis test with pairwise comparisons using the Dunn's test. Results: Group 1A and Group 1B resulted in lower heat generation compared to Group 2A and 2B and its difference was statistically significant (P < 0.05). Minimum temperature rise is seen in the ProUltra group at lower power settings (Group 1A) at the apical level and maximum temperature rise is seen in the Cric Dental IR3 group at higher power settings (Group 2B) at the middle third level. Conclusion: It was found that there is a significant temperature rise seen when ultrasonic tips are used for the retrieval of separated files, especially at higher power settings. The ProUltra tip demonstrated the lowest temperature rise at lower power settings, particularly at the apical level, whereas the IR3 Cric Dental tip exhibited the highest temperature rise, notably at higher power settings and the middle third level.

A Comparative Evaluation of Frictional Resistance of Various Lingual Brackets With Nitinol (NiTi) Archwires of Different Dimensions: An In Vitro Study.

Introduction Orthodontic mechanics involves transferring some of the applied force to the tooth's supporting components via friction, which in turn allows the tooth to move more easily. Aim The purpose of this in vitro experiment was to examine the frictional resistance (FR) of different lingual brackets utilizing Instron universal testing machines and nitinol (NiTi) archwires of varying sizes. Materials and methods Twenty-four sectional anterior die stones were replicated from a study model. They were categorized into eight categories, with the Libral lingual bracket and the JJ lingual bracket having 0.012" and 0.014" inch NiTi archwire, which were further subdivided into six subgroups. Three brackets were bonded to the anterior teeth of the upper and lower segments and replicated on other models with the help of silicon putty. Elastomeric modules were ligated to two diameters of NiTi wire (0.012" and 0.014") in each model. An Instron universal testing machine was used to measure the frictional force. Numerical data and descriptive statistics such as mean and standard deviation have been shown. Results In the overall analysis, it was observed that among JJ Orthodontics samples using 0.012" NiTi archwires, the maxilla exhibited a higher FR (4.205N) compared to the mandible (4.092N). Similarly, in the case of Libral Orthodontics samples with 0.012" NiTi archwires, the maxilla also demonstrated a higher FR (5.10N) than the mandible (4.97N). However, this trend did not hold for samples using 0.014" NiTi archwires. There was a statistically nonsignificant difference (p > 0.05) in the values between all the pairs of groups. Conclusion The present study concludes that Libral lingual brackets produced overall more FR than JJ lingual brackets.

Relevant Aspects in the Mechanical and Aging Degradation of NiTi Alloy with R-Phase in Endodontic Files.

One of the most important challenges in endodontics is to have files that have excellent flexibility, toughness, and high fatigue life. Superelastic NiTi alloys have been a breakthrough and the new R-phase NiTi alloys promise to further optimize the good properties of NiTi alloys. In this work, two austenitic phase endodontic files with superelastic properties (Protaper and F6) and two austenitic phase files with the R-phase (M-wire and Reciproc) have been studied. The transformation temperatures were studied by calorimetry. Molds reproducing root canals at different angles (30, 45, and 70°) were obtained with cooling and loads simulating those used in the clinic. Mechanical cycles of different files were realized to fracture. Transformation temperatures were determined at different number of cycles. The different files were heat treated at 300 and 500 °C as the aging process, and the transformation temperatures were also determined. Scanning and transmission electron microscopy was used to observe the fractography and precipitates of the files. The results show that files with the R-phase have higher fracture cycles than files with only the austenitic phase. The fracture cycles depend on the angle of insertion in the root canal, with the angle of 70° being the one with the lowest fracture cycles in all cases. The R-Phase transformation increases the energy absorbed by the NiTi to produce the austenitic to R-phase and to produce the martensitic transformation causing the increase in the fracture cycles. Mechanical cycling leads to significant increases in the transformation temperatures Ms and Af as well as Rs and Rf. No changes in the transformation temperatures were observed for aging at 300 °C, but the appearance of Ni4Ti3 precipitates was observed in the aging treatments to the Nickel-rich files that correspond to those with the R transition. These results should be considered by endodontists to optimize the type of files for clinical therapy.

Hexagonal MoO3 Anode with Extremely High Capacity and Cyclability for Lithium-Ion Battery: A Combined Theoretical and Experimental Study.

It is essential and still remains a big challenge to obtain fast-charge anodes with large capacities and long lifespans for Li-ion batteries (LIBs). Among all of the alternative materials, molybdenum trioxide shows the advantages of large theoretical specific capacity, distinct tunnel framework, and low cost. However, there are also some key shortcomings, such as fast capacity decaying due to structural instability during Li insertion and poor rate performance due to low intrinsic electron conductivity and ion diffusion capability, dying to be overcome. A unique strategy is proposed to prepare Ti-h-MoO3-x@TiO2 nanosheets by a one-step hydrothermal approach with NiTi alloy as a control reagent. The density functional theory (DFT) calculations indicate that the doping of Ti element can make the hexagonal h-MoO3-x material show the best electronic structure and it is favor to be synthesized. Furthermore, the hexagonal Ti-h-MoO3-x material has better lithium storage capacity and lithium diffusion capacity than the orthogonal α-MoO3 material, and its theoretical capacity is more than 50% higher than that of the orthogonal α-MoO3 material. Additionally, it is found that Ti-h-MoO3-x@TiO2 as an anode displays extremely high reversible discharge/charge capacities of 1326.8/1321.3 mAh g-1 at 1 A g-1 for 800 cycles and 611.2/606.6 mAh g-1 at 5 A g-1 for 2000 cycles. Thus, Ti-h-MoO3-x@TiO2 can be considered a high-power-density and high-energy-density anode material with excellent stability for LIBs.

Exploring morphometric transformations in temperature-sensitive NiTi instruments alongside real-time intracanal temperature dynamics.

AIM: This study was twofold: (i) it aimed to investigate the morphometric changes of three temperature-sensitive nickel-titanium (NiTi) instruments at different temperatures, and (ii) to conduct an in vivo real-time analysis of intracanal temperature changes. METHODS: Changes in the shape and length of XP-Endo Shaper, XP-Endo Finisher, and XP-Endo Finisher-R were evaluated in real time whilst heated in a temperature-controlled water bath from 22 to 45°C. Instruments were fixed to a laminated water-resistant 1 mm graph paper attached to a stone block. Instruments were imaged whilst subjected to increasing temperature using a digital camera attached to an operating microscope. From recorded videos, still frames were extracted at 10-s intervals and changes in the length and shape of each instrument were measured and changes were plotted against time. Moreover, the intracanal temperature of distal roots of lower molars was measured in vivo for patients attending the clinic for non-surgical root canal treatments. The temperature was measured using a K-type thermocouple probe inserted into the mid-root level after irrigating the canal with a solution set at room temperature (22°C) or heated to 45°C. The intraoral and intracanal temperatures were recorded using a video camera for 180 s at 5-s intervals to plot the change in the intraoral and intracanal temperature, after both irrigation solution temperatures, with time. RESULTS: The shape transformation of XP-Endo Shaper began at 31.5 ± 2.0°C and reached its optimal transformation at 35.1 ± 1.0°C. For the Finisher and Finisher-R, shape transformations began at 29.2 ± 1.9 and 26.9 ± 2.2°C reaching the optimal transformation at 33.9 ± 1.4 and 32.7 ± 1.7°C, respectively. The average decreases in lengths of XP-Endo Shaper, Finisher, and Finisher-R after full transformation were 0.43 ± 0.23, 1.07 ± 0.22, and 1.15 ± 0.22 mm, respectively. The intracanal temperature reached 32.9 ± 0.8 and 33.2 ± 1.0°C after 3 min of application of irrigation solutions set at 22 or 45°C, respectively. CONCLUSION: The tested instruments exhibited diverse changes in their shapes and lengths at varying temperatures. Despite the temperature of the irrigation solution, the intracanal temperature consistently remained lower than the intracanal temperature once equilibrium was reached. This highlights the importance of considering the temperature of irrigation solution during in vitro testing of endodontic instruments.

The Effect of Ageing on Phase Transformations and Mechanical Behaviour in Ni-Rich NiTi Alloys.

In this article, the results of research on a NiTi alloy with a high nickel content (51.7 at.%), produced using the additive technology SLM method and subjected to isothermal ageing after solution annealing, are presented. The study involved the determination of the sequence of phase transformations occurring using differential scanning calorimetry (DSC) and the determination of the temperature range of these transformations. In parallel, the phase composition was determined using the XRD method; the hardness and the Young's modulus were also determined. The analysis of the DSC results obtained indicates the following characteristic features of the NiTi alloy, which change with ageing time: (1) During cooling (from +150 °C to -50 °C), the type of transformation changes from a one-step transformation after solution annealing to a two-step transformation after the ageing process over 1, 20, and 100 h at 500 °C; (2) during heating (from -50 °C to +150 °C) for all the samples, regardless of the ageing time, only a one-step transformation from martensite M(B19') to austenite A(B2) is observed; (3) the temperature at which the transformation starts increases with the ageing time; (4) the width of the total temperature range of the transformation M(B19') → A(B2) during heating changes from large (ΔT = 49.7 °C), after solution annealing, to narrow (ΔT = 19.3 °C and ΔT = 17.9 °C after 20 h and 100 h of ageing); and, most importantly, (5) a comparison with the literature data shows that, irrespective of the composition of the NiTi alloy and the manufacturing technology of the alloy samples (regardless of whether this was traditional or additive technology), a sufficiently long ageing process period leads to the occurrence of the martensite → austenite transformation in the same temperature range.

Comparative evaluation of cyclic fatigue resistance of thermomechanically treated NiTi rotary instruments in simulated curved canals with two different radii of curvature: An in vitro Study.

Background: This study aimed to compare the effect of heat treatment on the cyclic fatigue resistance of three different nickel-titanium rotary file systems: TruNatomy, HyFlex CM, and NeoEndo flex in simulated curved canals at two different radii of curvatures. Materials and Methods: A total of 60 NiTi rotary files of three types were used, and the samples were divided into three groups TruNatomy, HyFlex CM, and NeoEndo flex. All the instruments were subjected to cyclic fatigue testing using a stainless steel custom-made canal model with a 60° angle of curvature and two radii of curvature 5 mm and 3 mm; the number of cycles to fracture and length of the fractured segment was measured. The separated instruments were subjected to fractographic analysis under scanning electron microscope. Results: The number of cycles to failure to fracture a file at a 3 mm radius of curvature is significantly less as compared to a 5 mm radius of curvature (HCM > TRN > NE). Conclusion: Within the limitation of the present study, there was a positive correlation between the radius of curvature and fatigue life of NiTi files.

Robust and Superhydrophobic Polydimethylsiloxane/Ni@Ti3C2Tx Nanocomposite Coatings with Assembled Eyelash-Like Microstructure Array: A New Approach for Effective Passive Anti-Icing and Active Photothermal Deicing.

To solve the problem of ice condensation and adhesion, it is urgent to develop new anti-icing and deicing technologies. This study presented the development of a highly efficient photothermal-enhanced superhydrophobic PDMS/Ni@Ti3C2Tx composite film (m-NMPA) fabricated cost-effectively and straightforwardly. This film was fabricated utilizing PDMS as a hydrophobic agent, adhesive, and surface protector, while Ni@Ti3C2Tx as a magnetic photothermal filler innovatively. Through a simple spraying method, the filler is guided by a strong magnetic field to self-assemble into an eyelash-like microstructure array. The unique structure not only imparts superhydrophobic properties to the surface but also constructs an efficient "light-capturing" architecture. Remarkably, the m-NMPA film demonstrates outstanding superhydrophobic passive anti-icing and efficient photothermal active deicing performance without the use of fluorinated chemicals. The micro-/nanostructure of the film forms a gas layer, significantly delaying the freezing time of water. Particularly under extreme cold conditions (-30 °C), the freezing time is extended by a factor of 7.3 compared to the bare substrate. Furthermore, under sunlight exposure, surface droplets do not freeze. The excellent photothermal performance is attributed to the firm anchoring of nickel particles on the MXene surface, facilitating effective "point-to-face" photothermal synergy. The eyelash-like microarray structure enhances light-capturing capability, resulting in a high light absorption rate of 98%. Furthermore, the microstructure aids in maintaining heat at the uppermost layer of the surface, maximizing the utilization of thermal energy for ice melting and frost thawing. Under solar irradiation, the m-NMPA film can rapidly melt approximately a 4 mm thick ice layer within 558 s and expel the melted water promptly, reducing the risk of secondary icing. Additionally, the ice adhesion force on the surface of the m-NMPA film is remarkably low, with an adhesion strength of approximately 4.7 kPa for a 1 × 1 cm2 ice column. After undergoing rigorous durability tests, including xenon lamp weathering test, pressure resistance test, repeated adhesive tape testing, xenon lamp irradiation, water drop impact testing, and repeated brushing with hydrochloric acid and particles, the film's surface structure and superhydrophobic performance have remained exceptional. The photothermal superhydrophobic passive anti-icing and active deicing technology in this work rely on sustainable solar energy for efficient heat generation. It presents broad prospects for practical applications with advantages such as simple processing method, environmental friendliness, outstanding anti-icing effects, and exceptional durability.

Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review.

INTRODUCTION: Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. AIM: The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. RESULTS: At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. CONCLUSIONS: The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

Effect of different instrumentation techniques on students' performance and outcomes of nonsurgical root canal treatment.

OBJECTIVES: This study compared, retrospectively, the incidence of clinical errors and effects on treatment outcomes, when students were exposed to two different instrumentation techniques: a hybrid rotary technique (HYB), consisting of both hand instrumentation with hand stainless steel and Ni-Ti files plus the use of a rotary system (Vortex Blue, Dentsply Sirona), versus a full reciprocation instrumentation technique (WaveOne Gold [WOG], Dentsply Sirona). METHODS: A total of 368 endodontic cases (n = 184) in anterior and premolar teeth, completed by dental students at the University of Michigan School of Dentistry from 2013 to 2022, were used for the study. The groups were evaluated by two calibrated clinicians, observing the incidence of clinical errors: file separations, over-instrumentation, ledges and transportations. Treatment outcomes were also observed. Data were analyzed statistically by Fisher's exact test and Mann-Whitney U test (p < 0.05). RESULTS: No significant difference in file separations, ledges, and transportation was observed between the two groups. However, the WOG Group experienced significantly more over-instrumentation than HYB group, although this did not significantly affect tooth survival or periapical index (PAI). Cases with PAI scores of 5 were found to have significantly less tooth survival compared to the other PAI scores. CONCLUSIONS: It can be concluded that both techniques in our study are well suited to advancing the endodontic dental education of students and novice operators, anticipating relatively successful outcomes of tooth survival, as long as the cases selected are less severe in progression preoperatively.

In vivo study of porous NiTi cryotweezers for bone tissue cryotherapy.

This study examined the effects of liquid nitrogen vapor on osteogenesis in the rabbit femur. Cryotweezers made of porous nickel titanium alloy (nitinol or NiTi) obtained by self-propagating high temperature synthesis were used in this experiment. The porous structure of the cryotweezers allows them to hold up to 10 g of liquid nitrogen after being immersed for 2 min, which completely evaporates after 160 s. To study the effects of liquid nitrogen evaporation on osteogenesis, a rabbit femur was perforated. The formed holes were subjected to cryotherapy with varying exposure times. It was found that a 3 s exposure time stimulates osteogenesis, which was manifested in a greater number of osteoblasts in the regenerate compared to the control sample without liquid nitrogen. It was observed that increasing the exposure to 6, 9 or 12 s had a destructive effect, to varying degrees. The most severe damage was exerted by a 12 s exposure, which resulted in the formation of osteonecrosis areas. In the samples exposed to 6 and 9 s of cryotherapy, destruction of the cytoplasm of osteocytes and osteoclasts was observed.

Influence of access cavity design on root canal instrumentation efficacy in molars - An in vitro study.

Background: Several designs of access cavity have been evolved in the recent past with the concept of minimal tooth tissue removal which would improve the root canal treated teeth fracture resistance. Aim: To investigate the effect of conservative design access cavity during the instrumentation of maxillary molar root canals. Materials and Methods: Eighty noncarious maxillary molars were assigned to the traditional and conservative access groups (n = 40 each). After designated access preparations, the teeth were immersed in Lugols's solution for staining the pulp tissue. Root canal instrumentation was performed with TruNatomy file system. Pre- and postinstrumentation nano-computed tomography (CT) images were taken and reconstructed using CT-An software. Root canals volumetric analysis was done with CT-Vol software. The analysis of the data was dealt with Shapiro-Wilk test and independent t-test. Results: The volume of pulp canal space before and after instrumentation changed significantly between the traditional and conservative access design groups, according to an independent t-test. In comparison, the mean volume of dentin removed was much larger in the TAC group (P = 0.0016). The independent t-test manifests difference significantly between traditional endodontic access cavity (TAC) and conservative access cavity (CAC) with percentage of unprepared canal walls. The mean percentage of unprepared area was significantly lesser in TAC group as compared to CAC group (P = 0.0022). Conclusion: The volume of dentin removed was greater in TAC than with the CAC design. The amount of untouched canal wall area was significantly higher in conservative access design than with the traditional access design group.

Effect of Coronal Flaring on Initial Apical File Size Estimation in Curved Canals Using Three Distinct Rotary Instruments: A Comparative In Vitro Study.

BACKGROUND AND OBJECTIVES: The initial size of a root canal is established by progressively introducing K-files according to the increase in the International Organization for Standardization (ISO) size in the apical region. The initial file-fit sensation is caused by coronal interferences rather than always occurring at the apex, as is commonly believed. Flaring the canal at its earliest stages enables the practitioner to accurately assess the size of the canal approaching the apex. This enables more informed judgments on the selection of the master apical file required for shaping and cleaning the apex. The aim of this in vitro study is to examine the impact of cervical flaring on the first estimation of apical file size using three distinct rotary instruments. MATERIALS AND METHODS: Sixty-four extracted permanent maxillary first molars with a curvature of between 10° and 20° were chosen. Conventional access openings were made, and the precise length of the canal was determined, leaving it 1 mm short of the apex. The apical fit was deemed to have materialized when the largest file successfully reached the apex, and further progression beyond that depth was unattainable. An initial file that exhibited tactile resistance both before and following expansion at the designated working length (WL) was observed. The initial file that elicited a sensation of being securely attached was affixed using methacrylate into the root canal. A diamond sectioning disc was used to horizontally cut the apical 0.5 mm of the mesiobuccal root. This was done to expose the canal and the instrument at the WL. The uppermost portions were observed using a 3D optical profilometer, and digital photographs were captured for each sample. RESULTS: The occurrence of coronal interferences and the choice of instruments for flaring had a notable impact on the estimation of the initial apical file (IAF) size. The file size frequency was augmented following flaring using various rotary instruments, namely ProTaper, HyFlex CM, and Endoflare. Group 1, which did not undergo preflaring, exhibited the highest disparity of 257.3 ± 54.4. The variation was substantially different (p<0.01) from all the groups that underwent flaring. The use of HyFlex CM (group 3) for preflaring resulted in the smallest average difference (124.4 ± 29.6) between the maximum diameter of the canal at the apex and the diameter of the initial file used. Endoflare (group 4) exhibited the second lowest mean disparity (178.7 ± 46) between the maximum width of the apical root canal and the diameter of the IAF, with the ProTaper group (211 ± 43.5) following closely behind. Nevertheless, there was no statistically significant discrepancy observed in the average differences between groups 2 and 4 (ProTaper and Endoflare groups, respectively). CONCLUSION: Coronal preflaring significantly contributes to minimizing the variation between the IAF and the diameter of the apical canal. Prior coronal expansion using rotary files enables a more precise identification of the IAF. The choice of equipment used for flaring affects the estimation of the IAF size.

In Vitro Comparison to Evaluate Metal Ion Release: Nickel-Titanium vs. Titanium-Molybdenum Orthodontic Archwires.

Background When metals used in orthodontic materials are exposed to the oral environment, teeth, and gingivae over an extended period of time, they may gradually deteriorate. As a result, the patient is exposed to higher concentrations of metals and metal ions than what they would be exposed to through food and other sources. The goal of the current in vitro experiment was to evaluate and contrast the metal ion release from orthodontic archwires made of titanium-molybdenum alloy (TMA) and nickel-titanium (NiTi). Methods For 90 days, 20 orthodontic archwires in each group were immersed in 50 milliliters of simulated saliva using different containers. Atomic Absorption Spectrometry (AAS) (Shimadzu Corporation, Kyoto, Japan) was used to assess and compare metal ion emission. The unit of measurement is parts per million (PPM). Results The findings indicated that the discharge of nickel metal from the NiTi archwire (Group A) was much higher than that from the TMA archwire (Group B), with a statistical significance level of p < 0.001. It was discovered that Group B's release of titanium was statistically significantly (p < 0.05) higher than Group A's titanium release, which did not include the release of any other metals. Conclusion The study findings indicated that the amounts of metal ions released from the orthodontic archwires made of titanium molybdenum and nickel-titanium alloy were within safety limits.

Effect of Sterilization and Irrigating Solutions on Nanostructure Alteration of Ni-Ti Rotary Instruments in Endodontics: An Atomic Force Microscopic Study.

Aim: This study aimed to evaluate the effect of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) and sterilization on the nanostructural alteration of nickel titanium (Ni-Ti) rotary file systems in endodontics using the atomic force microscopy (AFM). Materials and Methods: The study was performed on four commercially available rotary Ni-Ti files: group I-Vortex Blue (Dentsply), group II-ProTaper Next (Dentsply), group III-Mtwo (VDW), and group IV-iRaCe (FKG). Each group was divided into four subgroups (n = 4), that is, subgroup A-control (new rotary file), subgroup B-subjected for five cycles of autoclave, subgroup C-immersed in 5.25% NaOCl for 5 minutes, and subgroup D-immersed in 17% EDTA solutions for 5 minutes. All the specimens were evaluated with AFM using roughness average (RA) and root-mean-square (RMS) values for surface roughness. Results: Among control groups, Vortex Blue showed the least RA and RMS values; the highest surface roughness was seen with Mtwo files. All the Ni-Ti rotary files showed a statistically significant (P <0.05) increase in surface hardness when subjected to autoclave and treatment with different irrigating solutions. In particular, 17% EDTA caused the highest surface deterioration in all the groups. Conclusion: AFM analysis revealed increased surface roughness values recorded for all the rotary files when treated with irrigating solutions and autoclave cycles.