Influence of Optimum Torque Reverse Motion on Dentinal Cracks after Root Canal Preparation with Two Nickel-Titanium Rotary Systems.

Objectives: This study was aimed to evaluate the cause-effect relationship between canal preparation with ProTaper Next (PTN) and ProTaper Gold (PTG) using optimum torque reverse (OTR) motion or continuous rotation and dentinal crack formation. Materials and Methods: Fifty distobuccal roots of human maxillary first molars were divided into five groups; Group I: PTG Full rotation, Group II: PTG in OTR, Group III: PTN Full rotation, Group IV: PTN in OTR, Group V: unprepared (control group). After mechanical preparation, the distobuccal roots were sectioned horizontally at 3, 6, and 9 mm from the apex. Images were captured using a stereomicroscope at 25X to determine the presence or absence of dentinal cracks. Friedman test was used to compare between root sections followed by Wilcoxon signed-rank test for pairwise comparison. Kruskal-Wallis test was used to compare between tested rotary systems followed by pairwise comparison with Dunn Bonferroni correction (α = 0.05). Results: Crack development was significantly higher in PTG using OTR motion 36.7% followed by PTN using OTR 33.3%, while the control group showed no cracks. PTG and PTN with full rotation showed crack development with 23.3% and 13.3%, respectively. Conclusions: The type of motion kinematics used during mechanical preparation have an impact on dentinal crack formation. Nickel-titanium instruments with larger taper tend to induce more cracks.