Evolution of Nickel-titanium Alloys in Endodontics.

To improve clinical use of nickel-titanium (NiTi) endodontic rotary instruments by better understanding the alloys that compose them. A large number of engine-driven NiTi shaping instruments already exists on the market and newer generations are being introduced regularly. While emphasis is being put on design and technique, manufacturers are more discreet about alloy characteristics that dictate instrument behavior. Along with design and technique, alloy characteristics of endodontic instruments is one of the main variables affecting clinical performance. Modification in NiTi alloys is numerous and may yield improvements, but also drawbacks. Martensitic instruments seem to display better cyclic fatigue properties at the expense of surface hardness, prompting the need for surface treatments. On the contrary, such surface treatments may improve cutting efficiency but are detrimental to the gain in cyclic fatigue resistance. Although the design of the instrument is vital, it should in no way cloud the importance of the properties of the alloy and how they influence the clinical behavior of NiTi instruments. CLINICAL SIGNIFICANCE: Dentists are mostly clinicians rather than engineers. With the advances in instrumentation design and alloys, they have an obligation to deal more intimately with engineering consideration to not only take advantage of their possibilities but also acknowledge their limitations.

Cyclic fatigue resistance of nickel-titanium instruments after immersion in irrigant solutions with or without surfactants.

INTRODUCTION: The aim of the study was to assess cyclic fatigue resistance of reciprocating (Reciproc and WaveOne) and continuous rotating (ProTaper) nickel-titanium files after immersion in different irrigation solutions with or without surfactants during several short time periods. METHODS: A total of 270 new Reciproc R25, WaveOne Primary, and ProTaper F2 files were tested. Instruments of each brand were divided into 1 control group (n = 10) formed by new files and 4 test groups (n = 20) formed by instruments dynamically immersed at 37°C for 16 mm in 5.25% sodium hypochlorite (NaOCl), Hypoclean (5.25% NaOCl with surfactant), 17% EDTA, or EDTA Plus (17% EDTA with surfactant). Each test group was subdivided into 2 subgroups (n = 10) on the basis of the time of dynamic immersion in the endodontic irrigant solution (45 seconds or 3 minutes). Resistance to cyclic fatigue was determined by recording time to fracture in a stainless steel artificial canal with a 60° angle of curvature and 5-mm radius of curvature. The fracture surface was examined by using scanning electron microscopy. RESULTS: Immersion in NaOCl did not reduce the cyclic fatigue of reciprocating or continuous nickel-titanium files. The 17% EDTA reduced the fatigue resistance of all instruments after 3 minutes. The immersion in irrigants with surfactants did not influence the cyclic fatigue of instruments except for Reciproc immersed in Hypoclean solution. CONCLUSIONS: EDTA immersion reduced the cyclic fatigue resistance of all instruments after 3 minutes. Addition of surfactants did not influence the cyclic fatigue of files except when added to NaOCl when it contacts Reciproc instruments.

Comparison of two techniques for assessing the shaping efficacy of repeatedly used nickel-titanium rotary instruments.

INTRODUCTION: The shaping capacity of nickel-titanium (NiTi) rotary instruments is often assessed by photographic or micro-computed tomography (micro-CT) measurements, and these instruments are often used more than once clinically. This study was conducted to compare photographic and micro-CT measurements and to assess if the repeated use of NiTi instruments affected the shape of canal preparation. METHODS: Ten new sets of ProTaper Universal instruments (Dentsply-Maillefer, Ballaigues, Switzerland) were used in 60 resin blocks simulating curved root canals. Groups 1 to 6 (n=10) represented the first to sixth use of the instrument, respectively. Digitized images of the prepared blocks were taken in both mesiodistal (MD) and buccolingual (BL) directions and area measurements (mm(2)) were calculated using AutoCAD (Autodesk Inc, San Rafael, CA). The volumes of the same prepared canals were measured using micro-CT (mm(3)). Statistical analysis was performed to detect differences between photographic and volumetric measurements and differences between uses. RESULTS: Two-way repeated-measures analysis of variance revealed significant differences between groups (P < .001). Regarding measurement type, there were no significant differences between BL and MD measurements, but there were significant differences between micro-CT and BL measurements (P < .001) and micro-CT and MD measurements (P=.001). Significant differences were also noted between uses. CONCLUSIONS: Within the limitations of the present study, micro-CT scanning is more discriminative of the changes in canal space associated with repeated instrument use than photographic measurements. Canal preparations are significantly smaller after the third use of the same instrument.

Quantitative and qualitative elemental analysis of different nickel-titanium rotary instruments by using scanning electron microscopy and energy dispersive spectroscopy.

This study was designed to determine if the alloy composition shares an influence with the geometric design on the physical behavior of nickel-titanium rotary endodontic instruments. ProTaper, HERO, and K3 files were selected. After sterilized and cleaning with alcohol, surface analysis was performed using energy dispersive spectroscopy. Measurements were performed on the active part and on the shank. SEM images of fractured instruments were also obtained and assessed. All three types of instruments were composed mainly of Nickel (54.3%, SD +/- 0.8) and Titanium (45.2%, SD +/- 0.9). SEM images revealed similar aspect with the presence of Kirkendall voids regularly distributed in the alloy. The results indicate that the difference in properties and behavior of these three endodontic rotary shaping instruments is solely related to the respective geometric characteristics of the instrument design.

Effect of clinical use on the cyclic fatigue resistance of ProTaper nickel-titanium rotary instruments.

The resistance of ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) nickel-titanium rotary instruments to cyclic fatigue was examined after their initial use in straight or curved canals in vivo. These instruments were rotated freely inside a steel phantom until separation. The number of rotations before failure and the lengths of the separated fragments were compared with data derived from new instruments under the same experimental setup (n = 20). With the exception of F1 and F3, instruments previously used in curved canals were more susceptible to cyclic fatigue than those previously used in straight canals (p < 0.05). Separation occurred predominantly at the D10 to D12 level. For the F series, a negative correlation (p < 0.05) was observed between the number of rotations before failure and the file diameters at their separation levels. ProTaper F3 instruments are highly susceptible to cyclic fatigue failure and should be reused with caution irrespective of whether they are initially used for shaping straight or curved canals.