Cutting efficiency of instruments with different movements: a comparative study.

OBJECTIVES: The aim of the present study was to evaluate the cutting efficiency of two new reciprocating instruments, Twisted File Adaptive and WaveOne Primary. MATERIAL AND METHODS: 10 new Twisted File Adaptive (TF Adaptive) (SybronEndo, Glendora, CA, USA) and 10 new WaveOne Primary files (Dentsply Maillefer, Ballaigues, Switzerland) were activated using a torque-controlled motor, respectively TFA motor (SybronEndo, Glendora, CA, USA) and Silver motor (VDW, Munich, Germany). The device used for the cutting test consisted on a mainframe to which a mobile plastic support for the hand-piece is connected and a stainless-steel block containing a Plexiglas block against which the cutting efficiency of the instruments was tested. The length of the block cut in 1 minute was measured in a computerized program with a precision of 0.1 mm. Mean and standard deviations of each group were calculated and data were statistically analyzed with one-way ANOVA and Bonferroni t test (P < 0.05). RESULTS: TF Adaptive displayed significantly greater maximum penetration depth than WaveOne Primary (P < 0.05). In fact, TF Adaptive instruments (Group 1) cut the Plexiglas block to a mean depth of 8.7 (SD 0.5) mm, while WaveOne Primary instruments cut the Plexiglas block to a mean depth of 6.4 (SD 0.3) mm. CONCLUSIONS: Twisted File Adaptive instruments demonstrated statistically higher cutting efficiency than WaveOne instruments.

Influence of file motion on cyclic fatigue of new nickel titanium instruments.

AIM: The aim of the present study was to compare the resistance to cyclic fatigue of Hyflex® (Coltene-Whaledent, Allstatten, Switzerland) size 40 taper.04 nickel titanium instruments used in continuous rotation versus the use with a reciprocating motion. The null hypothesis was that different file motions had no influence on the lifetime of instruments subjected to a cyclic fatigue test. METHODOLOGY: 24 Hyflex® size 40 taper.04 nickel titanium instruments were randomly divided in two groups (n=12 each), and submitted to a cyclic fatigue test. The first group (CR group) were used with a continuous rotation, while the second one (RCP group) with a reciprocating motion. The cyclic fatigue tests were performed by using a stainless steel block containing an artificial canal shaped with a 135° angle. All instruments were rotated or reciprocated until fracture occurred. The time to fracture was recorded visually with a 1/100 second chronometer. Data were recorded and statistically analysed. RESULTS: Results indicated that instruments used with a reciprocating motion showed a significant increase in the meantime to failure when compared to those used in continuous rotation. CONCLUSIONS: The null hypothesis was rejected. Results of the present study showed that reciprocating motion extended resistance to cyclic fatigue of the tested nickel titanium instruments, when compared to continuous rotation.

The influence of three different instrumentation techniques on the incidence of postoperative pain after endodontic treatment.

AIMS: Apical extrusion of infected debris to the periradicular tissues is one of the principal causes of postoperative pain and discomfort. Recent researches have shown that reciprocating instrumentation techniques seem to significantly increase the amount of debris extruded beyond the apex and, consequently, the risk of postoperative pain. The goal of the present study was to evaluate and compare postoperative pain using three different nickel-titanium instrumentation techniques: a rotary crown-down technique using TF instruments (SybronEndo, Orange, Ca), a reciprocating single-file technique using WaveOne instruments (Maillefer DEntsply, Baillagues, CH), and a novel instrumentation technique (TF Adaptive, SybronEndo, Orange, Ca), using a unique, proprietary movement, combining reciprocation and continuous rotation. METHODS: Ninety patients requiring endodontic treatment on permanent premolar and molar teeth with non vital pulps preoperatively were included in the study. The patients were assigned into three groups of 30 patients each, trying to make the groups very similar, concerning the number of root canals, presence of initial pain and periapical lesions. The teeth in group 1 (n = 30) were instrumented with a crown-down technique using TF instruments, whilst those in group 2 (n = 30) were instrumented with a single-file technique using Waveone 08 25. The third group (n = 30) used the 3-file Tf Adaprtive sequence. All techniques were performed following manufacturers' instructions and all canals were shaped, cleaned and obturated in a single-visit by the same operator. The assessment of postoperative pain was carried out at 3 days by using a visual analogue scale. VAS pain scores were compared using one-way ANOVA post hoc Tukey test. A value of p < 0.05 was required for statistical significance. RESULTS: Results for VAS pain scores showed a statistically significant difference was found between the WaveOne (p=0,021) technique and the other two techniques. No statistical significant differences were found between TF and TF Adaptive (p= 0,087). When evaluating patient experiencing sever pain the incidence of symptoms was significantly higher with the WaveOne technique. CONCLUSIONS: Since the incidence of preoperative pain, the type of tooth and the pulp and periodontal pathology were quite similar between the three tested groups, and all the other variables (operator, irrigation, obturation) were identical, we may conclude that the difference in postoperative pain can be mainly related to the different instrumentation techniques.

Mechanical resistance of carbon and stainless steel hand instruments used in a reciprocating handpiece.

AIM: The manual files are still widely used for initial canal negotiation prior the use of nickel-titanium shaping instruments, to determine working length and to verify patency. A mechanical glide path can be performed using manual files with handpieces, such as M4 Handpiece (SybronEndo, USA) that allows a 30°/30° reciprocating motion. The Pathfinders (SybronEndo, USA) are hand files designed to negotiate complex canals, made from stainless steel (SS) or carbon steel (CS) alloys. The aim of this in vitro study was to compare cyclic fatigue resistance of these two different types of manual Pathfinder instruments used in a M4 reciprocating handpiece in double curved artificial canals. MATERIALS AND METHODS: Manual instruments designed for glide path (size #9 ISO .02 taper) made from different alloys were selected: Group SS -stainless steel Pathfinders (Sybron Endo) and Group CS - carbon steel Pathfinders size K2 (Sybron Endo). Ten instruments of each group were tested for resistance to cyclic fatigue with a reciprocating M4 handpiece inside an artificial S-shaped canal; the time to fracture was recorded for each file and data were statistically analyzed (ANOVA). RESULTS: Mean values (and SD) were 527 (± 89) seconds for the CS instruments and 548 (± 104) seconds for the SS files. No significant differences were observed between groups (p=0,062). CONCLUSIONS: According to the results, both carbon and stainless steel instruments presented similar fatigue resistance when used with M4 reciprocating handpiece in double curved canals.

Influence of different angles of reciprocation on the cyclic fatigue of nickel-titanium endodontic instruments.

INTRODUCTION: The purpose of this study was to evaluate cyclic fatigue fracture resistance of engine-driven nickel-titanium (K3XF) instruments under reciprocating movement in various angles. METHODS: Fifty K3XF size 40 taper 0.06 nickel-titanium instruments were divided randomly into 5 groups of 10 each. All instruments were subjected to cyclic fatigue tests. Instruments in groups 1-4 were tested by using different reciprocating motions, whereas instruments of group 5 (control group) were used in continuous rotation. All instruments were rotated or reciprocated until fracture occurred. Time to fracture was recorded, and data were statistically analyzed by using one-way analysis of variance, followed by Tukey honestly significant difference test for comparison between different groups. RESULTS: All reciprocating groups (groups 1-4) showed a significant increase in time to failure when compared with group 5 (continuous rotation) (P < .05). Mean time was significantly higher in group 1, followed by group 2. No significant difference was found between groups 3 and 4 (P = .251). Increasing the clockwise angle of reciprocation and consequently increasing the angle of progression for each reciprocation cycle reduced the resistance to cyclic fatigue. CONCLUSIONS: Movement kinematics (reciprocating movements in various angles) had a significant influence on the cyclic fatigue life of the tested nickel-titanium instruments.