Accuracy of an endodontic rotary motor with integrated apex locator to determine the root canal length / Precisão de um motor rotatório endodôntico com localizador apical integrado para determinação do comprimento radicular

Aim: The purpose of this study was to evaluate the efficacy to determine the root canal length, in vitro,of both the electronic apex locator (M2) and the autostop (AS - M3) functions of the Endus Duo Gnatus endodontic motor (Gnatus, São Paulo, SP, Brazil). Methods: Thirty extracted human single-rooted premolars had their root canal lengths (TLs) up to the apical foramen determined using the Endus Duo Gnatus in two ways: (1) In the stainless steel (SS) control group, the measurement was obtained using a stainless steel hand instrument with the electronic locator mode (M2 function) connected to a stainless-steel hand instrument (K-file #15). In the NiTi rotary instrument (NiTi RI) intervention group, the measurement was obtained during the instrumentation (M3 function) of the root canals with a nickel-titanium rotary instrument (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, USA), size 25/.06. The NiTi manually used instrument (NiTi MUI) Intervention group performed the measurement in locator mode using a Hyflex instrument, placed to true length manually. Statistical analysis was performed using ANOVA followed by the Tukey post-hoc test with a significance level of p < 0.05. Results: The true mean length and standard deviation (SD) of the standardized root canals were 18.40 ± 2.14mm, while the mean lengths and standard deviations (SD) were 18.29 ± 1.89mm, 18.22 ± 1.85mm, and 17.24 ± 2.09mm for the SS, NiTi RI, and NiTi MUI groups, respectively. However, data from the NiTi MUI Intervention group indicated shorter root canal lengths when compared to the SS control group and the NiTi RI Intervention group values, and were significantly shorter than the true canal length (p < 0.001). Conclusions:The use of the motor in NiTi RI Intervention group showed acceptable results. However, the NiTi MUI Intervention group resulted in unacceptable short measurements.

Objetivo: O objetivo deste estudo foi avaliar a eficácia na determinação do comprimento do canal radicular, in vitro, das funções localizador eletrônico foraminal (M2) e auto-parada durante a instrumentação (M3) do motor endodôntico Endus Duo Gnatus ( Gnatus, São Paulo, SP, Brasil). Métodos: Trinta pré-molares humanos uniradiculares extraídos tiveram seus comprimentos de canais radiculares (CRTs) até o forame apical determinados usando o Endus Duo Gnatus de duas maneiras: (1) No grupo controle de aço inoxidável (SS), a medida foi obtida usando um instrumento manual de aço inoxidável com modo de localização eletrônica foraminal (função M2) conectado a um instrumento manual de aço inoxidável (lima tipo K #15). No grupo intervenção instrumento rotatório NiTi (NiTi RI), a medida foi obtida durante a instrumentação (função M3) dos canais radiculares com instrumento rotatório de níquel-titânio (Hyflex CM: Coltene Whaledent, Cuyahoga Falls, OH, EUA), tamanho 25/.06. O grupo de intervenção NiTi instrumento usado manualmente (NiTi MUI) realizou a medição no modo localizador foraminal usando um instrumento Hyflex, colocado manualmente no comprimento real do dente. A análise estatística foi realizada por meio de ANOVA seguida do teste post-hoc de Tukey com nível de significância de p < 0,05. Resultados: Os comprimentos reais médios dos dentes e desvios-padrão (DP) dos canais radiculares padronizados foram 18,40 ± 2,14 mm, enquanto os comprimentos médios e desvios- padrão (DP) foram 18,29 ± 1,89 mm, 18,22 ± 1,85 mm e 17,24 ± 2,09 mm para os grupos SS, NiTi RI e NiTi MUI, respectivamente. No entanto, os dados do grupo de intervenção NiTi MUI indicaram comprimentos de canais radiculares mais curtos quando comparados aos valores do grupo controle SS e do grupo de intervenção NiTi RI, e foram significativamente mais curtos que o comprimento real do canal (p < 0,001). Conclusões: A utilização do motor no grupo Intervenção NiTi RI apresentou resultados aceitáveis. No entanto, o grupo de intervenção NiTi MUI resultou em medições curtas inaceitáveis.

Cyclic flexural fatigue resistance of NiTi Controlled Memory and Blue Technology instruments after torsional preloading.

Objective The aim of this study was to evaluate the influence of torsional preloading on the cyclic flexural fatigue resistance of thermally treated NiTi instruments. Material and Methods Ten new instruments New Hyflex CM (HF 30.06; Coltene/Whaladent Inc.), Typhoon CM (TYP 30.06; Clinician's Choice Dental Products) and Vortex Blue (VB 30.06; Dentsply Tulsa Dental) were chosen, based on geometry and specific characteristics of the manufacturing process. The new instruments of each system were tested in a bench device to determine their fatigue resistance through mean value of number of cycles to failure (Nf) (Control Group - CG). Another group of 10 new HF, TYP and VB instruments were submitted to 20 cycles of torsional straining between 0° and 180° (Experimental Group - EG) and then submitted to fatigue until rupture under the same conditions of the CG. Tested instruments were examined by scanning electron microscopy (SEM). Data were analyzed using one-way analysis of variance and post hoc Tukey's test (α=.05). Results Higher fatigue resistance was accomplished by HF instruments, followed by VB and TYP (p<0.05). During the torsional preloading, the lowest mean torque value was observed for TYP instruments (p<0.05). The torsional preload caused a significant reduction in the Nf values (p<0.05) of about 20%, 39% and 45% for instruments HF, VB and TYP, respectively. Longitudinal cracks, generated during the torsional preloading, were present in VB files, but were not observed in the CM instruments (HF and TYP). Conclusions In conclusion, the flexural fatigue resistance of thermally treated instruments is diminished after cyclic torsional loading.

Cyclic flexural fatigue resistance of NiTi Controlled Memory and Blue Technology instruments after torsional preloading

Abstract Objective The aim of this study was to evaluate the influence of torsional preloading on the cyclic flexural fatigue resistance of thermally treated NiTi instruments. Material and Methods Ten new instruments New Hyflex CM (HF 30.06; Coltene/Whaladent Inc.), Typhoon CM (TYP 30.06; Clinician's Choice Dental Products) and Vortex Blue (VB 30.06; Dentsply Tulsa Dental) were chosen, based on geometry and specific characteristics of the manufacturing process. The new instruments of each system were tested in a bench device to determine their fatigue resistance through mean value of number of cycles to failure (Nf) (Control Group - CG). Another group of 10 new HF, TYP and VB instruments were submitted to 20 cycles of torsional straining between 0° and 180° (Experimental Group - EG) and then submitted to fatigue until rupture under the same conditions of the CG. Tested instruments were examined by scanning electron microscopy (SEM). Data were analyzed using one-way analysis of variance and post hoc Tukey's test (α=.05). Results Higher fatigue resistance was accomplished by HF instruments, followed by VB and TYP (p<0.05). During the torsional preloading, the lowest mean torque value was observed for TYP instruments (p<0.05). The torsional preload caused a significant reduction in the Nf values (p<0.05) of about 20%, 39% and 45% for instruments HF, VB and TYP, respectively. Longitudinal cracks, generated during the torsional preloading, were present in VB files, but were not observed in the CM instruments (HF and TYP). Conclusions In conclusion, the flexural fatigue resistance of thermally treated instruments is diminished after cyclic torsional loading.

Influence of Cyclic Flexural Deformation on the Torsional Resistance of Controlled Memory and Conventional Nickel-titanium Instruments.

INTRODUCTION: The aim of this study was to evaluate the influence of cyclic deformation on the torsional resistance of controlled memory (CM) nickel-titanium files in comparison with superelastic (SE) instruments with similar geometric and dimensional characteristics. METHODS: New 30/.06 HyFlex (HF; Coltene/Whaledent, Inc, Cuyahoga Falls, OH), Typhoon (Clinician's Choice Dental Products, New Milford, CT), RaCe (FKG, La-Chaux De Fonds, Switzerland), and ProTaper Universal F2 instruments (F2; Dentsply Maillefer, Ballaigues, Switzerland) were assessed. The diameter and pitch length were measured along the active part of the instruments. The number of cycles to failure (Nf) in flexural fatigue and the torsional resistance were evaluated for new files (n = 10). Ten new instruments of each type were fatigued to 3/4 of their fatigue life and then submitted to torsion until rupture. Data were analyzed using 1-way analysis of variance (α = .05). RESULTS: New CM files had a significantly higher Nf when compared with SE instruments; HF exhibited the highest value (P = .001). The mean torque value for F2 was the highest (P = .001). CM files precycled to 3/4 Nf had a significantly lower torque than the new files (HF: P = .003, Typhoon: P = .001), whereas the SE instruments displayed no significant differences (F2: P = .059, RaCe: P = .079). CONCLUSIONS: Cyclic flexural loading significantly reduced the torsional resistance of CM instruments.

Contemporary Root Canal Preparation: Innovations in Biomechanics.

Root canal preparation must serve the goals of supporting debridement while exerting the least amount of structural damage. Toward those goals, several recent trends for innovation are noted: some changes in instrument design, several of them substantial, whereas others are rather discrete. In vitro testing is ongoing and, because of the lack of consistent methodology, gives only some guidelines for clinical use. Lastly, clinical outcome data are lacking for many current instruments; therefore, it is not clear if improvements in flexibility and resistance to fatigue will translate to better outcomes.

The impact of clinical use on the torsional behavior of Reciproc and WaveOne instruments.

OBJECTIVE: The aim of this study was to assess the influence of clinical use, in vivo, on the torsional behavior of Reciproc and WaveOne instruments considering the possibility that they degraded with use. MATERIAL AND METHODS: Diameter at each millimeter, pitch length, and area at 3 mm from the tip were determined for both types of instruments. Twenty-four instruments, size 25, 0.08 taper, of each system were divided into two groups (n=12 each): Control Group (CG), in which new Reciproc (RC) and WaveOne Primary (WO) instruments were tested in torsion until rupture based on ISO 3630-1; and Experimental Group (EG), in which each new instrument was clinically used to clean and shape the root canals of one molar. After clinical use, the instruments were analyzed using optical and scanning electron microscopy and subsequently tested in torsion until fracture. Data were analyzed using one-way analysis of variance at a=.05. RESULTS: WO instruments showed significantly higher mean values of cross-sectional area A3 (P=0.000) and smaller pitch lengths than RC instruments with no statistically significant differences in the diameter at D3 (P=0.521). No significant differences in torsional resistance between the RC and WO new instruments (P=0.134) were found. The clinical use resulted in a tendency of reduction in the maximum torque of the analyzed instruments but no statistically significant difference was observed between them (P=0.327). During the preparation of the root canals, two fractured RC instruments and longitudinal and transversal cracks in RC and WO instruments were observed through SEM analysis. CONCLUSION: After clinical use, no statistically significant reduction in the torsional resistance was observed.

The impact of clinical use on the torsional behavior of Reciproc and WaveOne instruments

ABSTRACT Torsional overload is a fracture representative parameter for instruments in single-file techniques. Objective The aim of this study was to assess the influence of clinical use, in vivo, on the torsional behavior of Reciproc and WaveOne instruments considering the possibility that they degraded with use. Material and Methods Diameter at each millimeter, pitch length, and area at 3 mm from the tip were determined for both types of instruments. Twenty-four instruments, size 25, 0.08 taper, of each system were divided into two groups (n=12 each): Control Group (CG), in which new Reciproc (RC) and WaveOne Primary (WO) instruments were tested in torsion until rupture based on ISO 3630-1; and Experimental Group (EG), in which each new instrument was clinically used to clean and shape the root canals of one molar. After clinical use, the instruments were analyzed using optical and scanning electron microscopy and subsequently tested in torsion until fracture. Data were analyzed using one-way analysis of variance at a=.05. Results WO instruments showed significantly higher mean values of cross-sectional area A3 (P=0.000) and smaller pitch lengths than RC instruments with no statistically significant differences in the diameter at D3 (P=0.521). No significant differences in torsional resistance between the RC and WO new instruments (P=0.134) were found. The clinical use resulted in a tendency of reduction in the maximum torque of the analyzed instruments but no statistically significant difference was observed between them (P=0.327). During the preparation of the root canals, two fractured RC instruments and longitudinal and transversal cracks in RC and WO instruments were observed through SEM analysis. Conclusion After clinical use, no statistically significant reduction in the torsional resistance was observed.

Constant Insertion Rate Methodology for Measuring Torque and Apical Force in 3 Nickel-Titanium Instruments with Different Cross-sectional Designs.

INTRODUCTION: The aim of this study was to evaluate the cutting characteristics of 3 nickel-titanium instruments with different cross-sectional designs using a recently developed methodology. METHODS: Insertion tests at a constant rate of 5.4 mm/min were performed on a bench test device by measuring the torque and apical force required for penetrating prefabricated acrylic blocks containing an artificial canal preflared with #10 and #15 K-files. Size 20/.06 Mtwo (VDW, Munich, Germany) and RaCe (FKG, La-Chaux De Fonds, Switzerland) instruments, together with ProTaper Universal (PTU) F1 instruments (Dentsply Maillefer, Ballaigues, Switzerland) (10 instruments of each type), were tested using an endodontic motor set at 300 rpm and 5 N·cm. The instruments were characterized with respect to the pitch length, rake angle, and cross-sectional area. Statistical analysis was performed with analysis of variance (α = 0.05). RESULTS: The torque was significantly lower for Mtwo compared with the other 2 groups (P < .05). It was also lower for RaCe in comparison with PTU F1 (P < .05). Regarding the apical force, the RaCe instruments had lower values when compared with the Mtwo and PTU F1 instruments (P < .05). There was no statistically significant difference between the PTU F1 and Mtwo instruments (P > .05). CONCLUSIONS: The methodology allowed the cutting properties of the instruments to be assessed in terms of their different geometric characteristics. The cross-sectional design, especially in Mtwo instruments with 2 sharp edges and great chip removal capability, was a differential factor for their higher cutting action.

Behavior of nickel-titanium instruments manufactured with different thermal treatments.

INTRODUCTION: The purpose of this study was to investigate if nickel-titanium instruments with similar designs manufactured by different thermal treatments would exhibit significantly different in vitro behavior. METHODS: Thirty-six instruments each of ProTaper Universal (PTU F1; Dentsply Maillefer, Ballaigues, Switzerland), ProFile Vortex (PV; Dentsply Tulsa Dental Specialties, Tulsa, OK), Vortex Blue (VB, Dentsply Tulsa Dental Specialties), and TYPHOON Infinite Flex NiTi (TYP; Clinician's Choice Dental Products, New Milford, CT) (all size 25/.06) were evaluated. Bending resistance, torsion at failure, and dynamic torsional tests were performed with the instruments (n = 12). Analysis of variance and Tukey post hoc tests were applied. RESULTS: Flexibility was significantly higher for TYP compared with the other 3 groups (P < .0001). With respect to the maximum torque at failure, PV group showed the highest resistance to twisting (torsional strength) among the analyzed instruments followed by VB, TYP, and PTU. The TYP group exhibited greater angular deflection at failure compared with the other groups (P < .0001). The mean dynamic torque scores during simulated canal preparation were highest for TYP (3.01 ± 0.71 Ncm) and lowest for PV (1.62 ± 0.79 Ncm). However, no significant differences were observed comparing groups PTU with TYP and VB and VB with PV (P > .05). The highest mean forces were recorded with PTU (7.02 ± 2.36 N) and the lowest with TYP (1.22 ± 0.40 N). CONCLUSIONS: TYP instruments were significantly more flexible than the other instruments tested. The PV group had the highest torsional strength and TYP, despite being the most flexible, showed similar torsional moments to the other instruments, whereas its angular deflection was the highest among the groups.

Efeito do tratamento térmico nas propriedades físicas e mecânicas de fios e instrumentos endodônticos de NiTi / Effect of heat treatment on mechanical and physical properties of NiTi wires and endodontic instruments

O objetivo deste trabalho foi comparar as propriedades químicas, físicas e mecânicas de fios de níquel-titânio convencionais (CW) e termomecanicamente tratados (MW), utilizados na fabricação de instrumentos endodônticos por dois fornecedores diferentes (Dentsply Tulsa Dental Specialities, Tulsa - OK, USA e dentsply maillefer - Ballaigues, Switzerland). Foram ainda avaliados o torque e a força apical requerida pelos novos instrumentos endodônticos ProTaper NextÕ. A composição química foi determinada por espectroscopia de energia dispersiva de raios-X, a constituição de fase por difratometria de raio-X e as temperaturas de transformação por calorimetria exploratória diferencial. Ensaios de tração em carga e descarga e até ruptura, flexão em três pontos, flexão rotativa/fadiga e medidas de microdureza Vickers foram realizados para avaliar o comportamento mecânico dos fios. As superfícies de fratura foram observadas por microscopia eletrônica de varredura e as microestruturas não deformadas por microscopia eletrônica de transmissão...

Cleaning the apical third of curved canals after different irrigation protocols.

This study evaluated the protocols of sonic and vacuum irrigation regarding the capacity of debris removal from root canal systems. Canal preparations were carried out on 30 mandibular first molars using the ProTaper Universal System. Teeth were divided into two experimental groups (n=15): Group 1: sonic irrigation and Group 2: vacuum irrigation protocol. Subsequently, the mesial roots were sectioned and observed by stereomicroscopy and scanning electron microscopy. Three independent examiners evaluated images of the apical thirds according to the following scores: 1= small presence of debris, 2= moderate presence of debris, and 3= dense presence of debris. Data were analyzed with ANOVA and Kruskal-Wallis tests (α=0.05). Comparison among the groups revealed that at the apical third, the root halves of Group 1 had significantly less surface debris (p=0.002) than those of Group 2. However, at 2 mm from the working length, Group 2's specimens showed less remaining debris in approximately 75% of the analyzed root canals. At the whole apical third, the sonic irrigation protocol removed significantly more debris than the vacuum protocol. However, in the region at 2 mm from the working length, the second irrigation method demonstrated a better performance.

Cleaning the apical third of curved canals after different irrigation protocols

This study evaluated the protocols of sonic and vacuum irrigation regarding the capacity of debris removal from root canal systems. Canal preparations were carried out on 30 mandibular first molars using the ProTaper Universal System. Teeth were divided into two experimental groups (n=15): Group 1: sonic irrigation and Group 2: vacuum irrigation protocol. Subsequently, the mesial roots were sectioned and observed by stereomicroscopy and scanning electron microscopy. Three independent examiners evaluated images of the apical thirds according to the following scores: 1= small presence of debris, 2= moderate presence of debris, and 3= dense presence of debris. Data were analyzed with ANOVA and Kruskal-Wallis tests (α=0.05). Comparison among the groups revealed that at the apical third, the root halves of Group 1 had significantly less surface debris (p=0.002) than those of Group 2. However, at 2 mm from the working length, Group 2's specimens showed less remaining debris in approximately 75% of the analyzed root canals. At the whole apical third, the sonic irrigation protocol removed significantly more debris than the vacuum protocol. However, in the region at 2 mm from the working length, the second irrigation method demonstrated a better performance.

Este estudo avaliou protocolos de irrigação sônica e a vácuo em relação à capacidade de remoção de debris do sistema de canais radiculares. Trinta primeiros molares mandibulares tiveram seus canais radiculares preparados pela utilização do Sistema ProTaper Universal. Os dentes foram divididos em dois grupos experimentais (n=15): Grupo 1: protocolo de irrigação sônica, e Grupo 2: protocolo de irrigação a vácuo. Posteriormente, as raízes mesiais foram seccionadas e observadas em lupa estereoscópica e microscopia eletrônica de varredura. Três examinadores independentes avaliaram as imagens do terço apical de acordo com as seguintes pontuações: 1. pequena presença de debris; 2: moderada presença de debris; e 3. densa presença de debris. Os dados foram analisados pelos testes estatísticos ANOVA e Kruskal-Wallis (α=0,05). A comparação entre os grupos revelou que, no terço apical, as hemissecções radiculares do Grupo 1 apresentaram debris remanescentes de forma significativamente menor (p=0,002) do que as do Grupo 2. No entanto, a 2 mm do comprimento de trabalho, as amostras do Grupo 2 mostraram menos debris remanescentes em aproximadamente 75% dos canais radiculares analisados. Considerando todo o terço apical, o protocolo de irrigação sônica removeu significativamente mais debris do que o protocolo de irrigação a vácuo. No entanto, na região a 2 mm do comprimento de trabalho, o segundo método de irrigação demonstrou um melhor desempenho.

Flexural fatigue and torsional resistance of ProFile GT and ProFile GT series X instruments.

INTRODUCTION: The purpose of this study was to compare the flexural fatigue and torsional resistance of ProFile GT and GT Series X instruments, taking into account their structural and dimensional characteristics. METHODS: Instrument diameter at each millimeter from the tip and pitch length were the dimensional parameters measured. Chemical composition was determined by energy-dispersive x-ray spectroscopy and phase constitution by x-ray diffraction. Vickers microhardness measurements were performed to assess instrument strength. One group of 20/.06 GT and GTX instruments (n = 10 each) was tested until failure in a flexural fatigue test device, whereas another group of 20/.04 files (n = 10 each) was tested in torsion based on ISO 3630-1. RESULTS: GT and GTX instruments showed approximately the same chemical composition, namely 51at%Ni-49at%Ti (56wt%Ni-44wt%Ti) and contained mainly the beta-phase. GTX instruments showed higher intensity x-ray diffraction peaks and a statistically higher Vickers microhardness. There was a significant decrease in the diameter of GTX in relation to GT instruments from D6 to D9 for 20/.04 instruments and from D4 to D7 for 20/.06 instruments. Pitch length increased along the active part of both instruments, with a steeper increase in GTX. In general, GT Series X instruments were significantly more resistant to flexural fatigue than were similar GT instruments (p < 0.001) but exhibited lower torsional strength (p < 0.001). CONCLUSIONS: Different structural and dimensional characteristics were found in GTX instruments in comparison with GT instruments; this is probably the cause for their higher flexural fatigue resistance and lower torsional strength.