Effect of A Clinical-Replicable Cooling Protocol on the Cyclic Fatigue Resistance of Heat-Treated Nickel-Titanium Instruments.

Introduction: The aim of this study was to evaluate the bending and cyclic fatigue resistance of Wave One Gold (WOG) and X1 Blue (X1B) instruments when tested at body temperature (36°C ± 1°C) with and without subjected to an alloy cooling protocol. Materials and Methods: A total of sixty instruments (n=30) were tested. Forty instruments (n=20) were randomly selected and divided into two groups: body temperature (BT; n=20) and body temperature with cooling protocol (CP; n=20). Cyclic fatigue test was performed until fracture in a conventional stainless-steel device with water bath equipment to simulate body temperature. CP group instruments were subjected to 5 seconds of spray cooling every 30 seconds. Time to fracture was recorded in seconds. Resistance to bending at an angle of 45 degrees was evaluated using twenty instruments (n=10). Fractured surfaces were examined under scanning electron microscopy (SEM). Statistical analysis was performed at a 5% significance level. Results: There was no difference in the cyclic fatigue resistance between instruments in BT groups (P>0.05). Cooling protocol significantly increased the cyclic fatigue resistance of X1B instruments (P=0.0003) and WOG instruments (P=0.0003). Results: WOG instruments had a significantly lower cyclic fatigue resistance compared to X1B instruments in CP group (P=0.0001). There were no significant differences between the values of resistance increase presented by the instruments after cooling (P>0.05). Bending test presented no statistically significant differences between the tested instruments (P>0.05). Both instruments in both groups showed typical features of cyclic fatigue behavior under SEM. Conclusions: X1 Blue #25.06 and WaveOne Gold #25.07 instruments presented similar cyclic fatigue resistance. The investigated clinical-replicable cooling protocol improved the cyclic fatigue resistance of the tested instruments, with X1 Blue #25.06 presenting a greater cyclic fatigue resistance after cooling. Both instruments presented a similar bending capacity.

Evaluation of the mechanical properties of different nickel-titanium retreatment instruments.

This study investigated the cyclic fatigue, bending, torsional resistance and angular deflection of Pro-R 25.08, Logic RT 25.08, MK Retreatment 25.08 (MK RT) and ProTaper Retreatment D2 instruments. Cyclic fatigue test was performed until fracture in a custom stainless-steel device with water bath equipment to simulate body temperature. Fracture time was recorded. A number of cycles were calculated. Resistance to bending at 45°, torsional resistance and angular deflection were evaluated. The fracture surfaces were examined by scanning electron microscopy. Statistical analysis was performed with one-way ANOVA and Tukey and Kruskal-Wallis and Dunn tests. Pro-R and Logic RT presented the highest cyclic fatigue (P < 0.05). D2 had higher strength to bend than Pro-R and Logic RT (P < 0.05). Logic RT showed the highest torque and angular deflection (P < 0.05), without differences when compared to D2 (P > 0.05). Instrument performances were dependent on their geometrical features and heat treatments.

Successful revascularization procedure in an immature permanent necrotic second lower molar: a case report with 4. 5- years follow- up

Background: Infection control is mandatory for revascularization procedures, enabling to eliminate patient's clinical symptoms and signs. Despite presenting a complex morphology when compared to anterior teeth, if a strict disinfection protocol is adopted and the revascularization procedure's biological principles are followed, the therapy can be successful in molar teeth. Methods: This case report aims to present a clinical case of successful revascularization in an immature permanent necrotic second lower molar. Clinical decisions and explanations regarding possible mechanisms related to the treatment's success in a tooth with complex morphology are discussed. Results: Revascularization procedures were performed on a 12-year-old male patient diagnosed with symptomatic periapical periodontitis in a tooth 37. The case highlights the need for infection control and biological principles that surrounds the success of this therapy. Follow-up times presented in this case were six months, 1, 2, 4 and 4.5-years, respectively. Continued root development was observed, and the tooth remains intact and without symptoms. Conclusion: The association of infection control and the biological principles of revascularization procedures allow the maintenance and continuation of tooth development, even when these present complex morphologies.