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Shaping ability and cyclic fatigue resistance between Genius ProFlex, ZenFlex, and TruNatomy rotary systems: an experimental study
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Raimundo Sales de Oliveira Neto, Murilo Priori Alcalde, Pedro Cesar Gomes Titato, Pedro Henrique Souza Calefi, Carlos Alberto Spironelli Ramos, Guilherme Ferreira da Silva, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte
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Restor Dent Endod 2025;50(1):e9. Published online February 13, 2025
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DOI: https://doi.org/10.5395/rde.2025.50.e9
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Abstract
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The aim of this study was to investigate the efficacy of three newly introduced rotary endodontic systems: Genius ProFlex (Medidenta), TruNatomy (Dentsply Maillefer), and ZenFlex (Kerr).
Methods Forty-five mandibular molars with root canal curvatures <5° were utilized. Micro-computed tomography scans were performed pre- and post-preparation to assess apical transportation, centralization, percentage of dentin wear, and canal volume alterations. Eight instruments of each diameter underwent cyclic fatigue testing.
Results The percentage of dentin wear on mesial and distal walls showed no significant differences among ZenFlex, TruNatomy, and Genius ProFlex at 1, 2, 3, and 4 mm from the apical foramen and root canal orifice (p > 0.05). Centering ability varied in the mesiolingual canal (p < 0.05). No notable differences were observed in transportation (p > 0.05). Genius ProFlex demonstrated lower volumetric changes (p < 0.05). There were significant differences in cyclic fatigue, with higher values for Genius ProFlex and lower values for TruNatomy (p < 0.05).
Conclusions The three nickel-titanium rotary instruments are safe and efficient for root canal preparation, with Genius ProFlex exhibiting superior cyclic fatigue resistance.
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Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature
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Abel Teves Cordova, Murilo Priori Alcalde, Michel Espinosa Klymus, Leonardo Rigoldi Bonjardim, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte
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Restor Dent Endod 2024;49(2):e12. Published online March 4, 2024
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DOI: https://doi.org/10.5395/rde.2024.49.e12
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This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Materials and MethodsSixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic– PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. ResultsAll dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. ConclusionsUltramint X resulted in the most significant number of completely clean specimens.
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- A new cleaning protocol in minimally invasive endodontic surgery: RUA (“retro irrigant activation”)
Dina Abdellatif, Davide Mancino, Massimo Pisano, Sara De Fontaine, Alfredo Iandolo Journal of Conservative Dentistry and Endodontics.2025; 28(3): 297. CrossRef - Smear layer removal comparing conventional irrigation, passive ultrasonic irrigation, EndoActivator System, and a new sonic device (Perfect Clean System) by scanning electron microscopy: An ex vivo study
Bruna Fernanda Alionço Gonçalves, Divya Reddy, Ricardo Machado, Paulo César Soares Júunior, Sérgio Aparecido Ignácio, Douglas Augusto Fernandes Couto, Karine Santos Frasquetti, Vânia Portela Ditzel Westphalen, Everdan Carneiro, Ulisses Xavier da Silva Net PLOS ONE.2024; 19(12): e0314940. CrossRef
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Effectiveness of endodontic retreatment using WaveOne Primary files in reciprocating and rotary motions
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Patricia Marton Costa, Renata Maíra de Souza Leal, Guilherme Hiroshi Yamanari, Bruno Cavalini Cavenago, Marco Antônio Húngaro Duarte
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Restor Dent Endod 2023;48(2):e15. Published online April 25, 2023
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DOI: https://doi.org/10.5395/rde.2023.48.e15
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This study evaluated the efficiency of WaveOne Primary files (Dentsply Sirona) for removing root canal fillings with 2 types of movement: reciprocating (RCP) and continuous counterclockwise rotation (CCR). Materials and MethodsTwenty mandibular incisors were prepared with a RCP instrument (25.08) and filled using the Tagger hybrid obturation technique. The teeth were retreated with a WaveOne Primary file and randomly allocated to 2 experimental retreatment groups (n = 10) according to movement type: RCP and CCR. The root canals were emptied of filling material in the first 3 steps of insertion, until reaching the working length. The timing of retreatment and procedure errors were recorded for all samples. The specimens were scanned before and after the retreatment procedure with micro-computed tomography to calculate the percentage and volume (mm3) of the residual filling material. The results were statistically evaluated using paired and independent t-tests, with a significance level set at 5%. ResultsNo significant difference was found in the timing of filling removal between the groups, with a mean of 322 seconds (RCP) and 327 seconds (CCR) (p < 0.05). There were 6 instrument fractures: 1 in a RCP motion file and 5 in continuous rotation files. The volumes of residual filling material were similar (9.94% for RCP and 15.94% for CCR; p > 0.05). ConclusionsThe WaveOne Primary files used in retreatment performed similarly in both RCP and CCR movements. Neither movement type completely removed the obturation material, but the RCP movement provided greater safety.
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Citations
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- Micro-CT evaluation of the removal of root fillings using rotary and reciprocating systems supplemented by XP-Endo Finisher, the Self-Adjusting File, or Er,Cr:YSGG laser
Gülsen Kiraz, Bulem Üreyen Kaya, Mert Ocak, Muhammet Bora Uzuner, Hakan Hamdi Çelik Restorative Dentistry & Endodontics.2023;[Epub] CrossRef
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Comparative analysis of torsional and cyclic fatigue resistance of ProGlider, WaveOne Gold Glider, and TruNatomy Glider in simulated curved canal
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Pedro de Souza Dias, Augusto Shoji Kato, Carlos Eduardo da Silveira Bueno, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte, Pedro Henrique Souza Calefi, Rina Andréa Pelegrine
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Restor Dent Endod 2023;48(1):e4. Published online December 8, 2022
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DOI: https://doi.org/10.5395/rde.2023.48.e4
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This study aimed to compare the torsional and cyclic fatigue resistance of ProGlider (PG), WaveOne Gold Glider (WGG), and TruNatomy Glider (TNG). Materials and MethodsA total of 15 instruments of each glide path system (n = 15) were used for each test. A custom-made device simulating an angle of 90° and a radius of 5 millimeters was used to assess cyclic fatigue resistance, with calculation of number of cycles to failure. Torsional fatigue resistance was assessed by maximum torque and angle of rotation. Fractured instruments were examined by scanning electron microscopy (SEM). Data were analyzed with Shapiro-Wilk and Kruskal-Wallis tests, and the significance level was set at 5%. ResultsThe WGG group showed greater cyclic fatigue resistance than the PG and TNG groups (p < 0.05). In the torsional fatigue test, the TNG group showed a higher angle of rotation, followed by the PG and WGG groups (p < 0.05). The TNG group was superior to the PG group in torsional resistance (p < 0.05). SEM analysis revealed ductile morphology, typical of the 2 fracture modes: cyclic fatigue and torsional fatigue. ConclusionsReciprocating WGG instruments showed greater cyclic fatigue resistance, while TNG instruments were better in torsional fatigue resistance. The significance of these findings lies in the identification of the instruments’ clinical applicability to guide the choice of the most appropriate instrument and enable the clinician to provide a more predictable glide path preparation.
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Citations
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- Comparative evaluation of the remaining dentin volume following instrumentation with rotary, reciprocating, and hand files during root canal treatment in primary molars: An ex vivo study
İrem Eren, Berkant Sezer Journal of Dental Sciences.2024; 19(4): 2126. CrossRef - Screw-in force, torque generation, and performance of glide-path files with three rotation kinetics
Jee-Yeon Woo, Ji-Hyun Jang, Seok Woo Chang, Soram Oh Odontology.2024; 112(3): 761. CrossRef - Evaluation of shaping ability of different glide path instruments: a micro-computed tomography study
Merve Yeniçeri Özata, Seda Falakaloğlu, Ali Keleş, Özkan Adıgüzel, Mustafa Gündoğar BMC Oral Health.2023;[Epub] CrossRef
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Effectiveness and safety of rotary and reciprocating kinematics for retreatment of curved root canals: a systematic review of in vitro studies
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Lucas Pinho Simões, Alexandre Henrique dos Reis-Prado, Carlos Roberto Emerenciano Bueno, Ana Cecília Diniz Viana, Marco Antônio Húngaro Duarte, Luciano Tavares Angelo Cintra, Cleidiel Aparecido Araújo Lemos, Francine Benetti
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Restor Dent Endod 2022;47(2):e22. Published online April 6, 2022
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DOI: https://doi.org/10.5395/rde.2022.47.e22
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This systematic review (register-osf.io/wg7ba) compared the efficacy and safety of rotary and reciprocating kinematics in the removal of filling material from curved root canals. Materials and MethodsOnly in vitro studies evaluating both kinematics during retreatment were included. A systematic search (PubMed/MEDLINE, Scopus, and other databases, until January 2021), data extraction, and risk of bias analysis (Joanna Briggs Institute checklist) were performed. Efficacy in filling removal was the primary outcome. ResultsThe search resulted in 2,795 studies, of which 15 were included. Efficacy was measured in terms of the remaining filling material and the time required for this. Nine studies evaluated filling material removal, of which 7 found no significant differences between rotary and reciprocating kinematics. Regarding the time for filling removal, 5 studies showed no difference between both kinematics, 2 studies showed faster results with rotary systems, and other 2 showed the opposite. No significant differences were found in apical transportation, centering ability, instrument failure, dentin removed and extruded debris. A low risk of bias was observed. ConclusionsThis review suggests that the choice of rotary or reciprocating kinematics does not influence the efficacy of filling removal from curved root canals. Further studies are needed to compare the kinematics safety in curved root canals.
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Citations
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- Fifteen years of engine‐driven nickel–titanium reciprocating instruments, what do we know so far? An umbrella review
Felipe Immich, Lucas Peixoto de Araújo, Rafaella Rodrigues da Gama, Wellington Luiz de Oliveira da Rosa, Evandro Piva, Giampiero Rossi‐Fedele Australian Endodontic Journal.2024; 50(2): 409. CrossRef - Efficacy of Various Heat-treated Retreatment File Systems on the Apical Deformity and Canal Centering Ability in a Single-rooted Teeth using Nano CT
Swathi S, Pradeep Solete, Ganesh Jeevanandan, Delphine Priscilla Antony S, Kavalipurapu Venkata Teja, Dona Sanju The Open Dentistry Journal.2024;[Epub] CrossRef - Micro-CT evaluation of the removal of root fillings using rotary and reciprocating systems supplemented by XP-Endo Finisher, the Self-Adjusting File, or Er,Cr:YSGG laser
Gülsen Kiraz, Bulem Üreyen Kaya, Mert Ocak, Muhammet Bora Uzuner, Hakan Hamdi Çelik Restorative Dentistry & Endodontics.2023;[Epub] CrossRef - Influence of sodium hypochlorite on cyclic fatigue resistance of nickel–titanium instruments: A systematic review and meta-analysis of in vitro studies
Alexandre Henrique dos Reis-Prado, Lucas Guimarães Abreu, Lara Cancella de Arantes, Kiani dos Santos de Paula, Sabrina de Castro Oliveira, Juliana Goto, Ana Cecília Diniz Viana, Francine Benetti Clinical Oral Investigations.2023; 27(11): 6291. CrossRef - Retreatment of XP-endo Shaper and R-Endo files in curved root canals
Hayam Y. Hassan, Fahd M. Hadhoud, Ayman Mandorah BMC Oral Health.2023;[Epub] CrossRef - Advancing Endodontics through Kinematics
Shilpa Bhandi, Dario Di Nardo, Francesco Pagnoni, Rosemary Abbagnale World Journal of Dentistry.2023; 14(6): 479. CrossRef
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Efficacy of reciprocating instruments and final irrigant activation protocols on retreatment of mesiobuccal roots of maxillary molars: a micro-CT analysis
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Lilian Tietz, Renan Diego Furlan, Ricardo Abreu da Rosa, Marco Antonio Hungaro Duarte, Murilo Priori Alcalde, Rodrigo Ricci Vivan, Theodoro Weissheimer, Marcus Vinicius Reis Só
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Restor Dent Endod 2022;47(1):e13. Published online February 15, 2022
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DOI: https://doi.org/10.5395/rde.2022.47.e13
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This study evaluated the efficacy of 3 reciprocating systems and the effects of 2 instruments for irrigant activation on filling material removal. Materials and MethodsForty mesiobuccal roots of maxillary molars were prepared up to size 25.06 and obturated. Micro-computed tomography (micro-CT) examination #1 was performed. Teeth were then divided into 4 groups (n = 10), according to the retreatment protocol: (1) manual, (2) Reciproc Blue, (3) WaveOne Gold, and (4) X1 Blue. Micro-CT examinations #2 and #3 were performed after filling removal and repreparation, respectively. Next, all teeth were divided into 2 new groups (n = 20) according to the irrigant activation protocol: XP Clean (XP Clean size 25.02) and Flatsonic (Flatsonic ultrasonic tip). Micro-CT examination #4 was performed after irrigant activation. Statistical analysis was performed with a significance level set at 5%. ResultsWaveOne Gold removed a significantly greater amount of filling material than the manual group (p < 0.05). The time to reach the WL was similar for all reciprocating systems (p > 0.05). X1 Blue was faster than the manual group (p < 0.05). Only manual group improved the filling material removal after the repreparation stage (p < 0.05). Both activation protocols significantly improved the filling material removal (p < 0.05), without differences between them (p > 0.05). ConclusionsNone of the tested instruments completely removed the filling material. X1 Blue size 25.06 reached the working length in the shortest time. XP Clean and Flatsonic improved the filling material removal.
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Citations
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- Supplementary methods for filling material removal: A systematic review and meta-analysis of micro-CT imaging studies
Bruna Venzke Fischer, Taynara Santos Goulart, Filipe Colombo Vitali, Diego Leonardo de Souza, Cleonice da Silveira Teixeira, Lucas da Fonseca Roberti Garcia Journal of Dentistry.2024; 151: 105445. CrossRef - Evaluation of the Ability of 3 Reciprocating Instruments to Remove Obturation Material: A Micro–Computed Tomography Study
Fábio Luiz Cecagno, Alexandre Sigrist De Martin, Carlos Eduardo Fontana, Bruno Cavalini Cavenago, Wayne Martins Nascimento, Ana Grasiela da Silva Limoeiro, Carlos Eduardo da Silveira Bueno Journal of Endodontics.2024; 50(3): 376. CrossRef - Comparative evaluation of cleaning efficiency of single file NiTi rotary system during root canal treatment procedure - A scanning electron microscope study
Ruchi Vashisht, Umesh Kumar, Swaty Jhamb, Ruchi Singla Journal of Conservative Dentistry.2023; 26(3): 316. CrossRef - Influence of rotary and reciprocating kinematics on the accuracy of an integrated apex locator
Verônica de Almeida Gardelin, Júlia Itzel Acosta Moreno Vinholes, Renata Grazziotin‐Soares, Fernanda Geraldo Pappen, Fernando Branco Barletta Australian Endodontic Journal.2023; 49(S1): 202. CrossRef
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Effect of ultrasonic agitation on push-out bond strength and adaptation of root-end filling materials
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Murilo Priori Alcalde, Rodrigo Ricci Vivan, Marina Angélica Marciano, Jussaro Alves Duque, Samuel Lucas Fernandes, Mariana Bailo Rosseto, Marco Antonio Hungaro Duarte
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Restor Dent Endod 2018;43(2):e23. Published online April 27, 2018
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DOI: https://doi.org/10.5395/rde.2018.43.e23
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This study evaluated the effect of ultrasonic agitation of mineral trioxide aggregate (MTA), calcium silicate-based cement (CSC), and Sealer 26 (S26) on adaptation at the cement/dentin interface and push-out bond strength. Materials and MethodsSixty maxillary canines were divided into 6 groups (n = 10): MTA, S26, and CSC, with or without ultrasonic activation (US). After obturation, the apical portions of the teeth were sectioned, and retrograde cavities were prepared and filled with cement by hand condensation. In the US groups, the cement was activated for 60 seconds: 30 seconds in the mesio-distal direction and 30 seconds in the buccal-lingual direction, using a mini Irrisonic insert coupled with the ultrasound transducer. After the materials set, 1.5-mm thick sections were obtained from the apexes. The presence of gaps and the bond between cement and dentin were analyzed using low-vacuum scanning electron microscopy. Push-out bond strength was measured using a universal testing machine. ResultsUltrasonic agitation increased the interfacial adaptation of the cements. The S26 US group showed a higher adaptation value than MTA (p < 0.05). US improved the push-out bond strength for all the cements (p < 0.05). ConclusionsThe US of retrograde filling cements enhanced the bond to the dentin wall of the root-end filling materials tested.
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Simone Argenta Scalabrin, Lina Naomi Hashizume, Theodoro Weissheimer, Gabriel Barcelos Só, Jefferson Ricardo Pereira, Milton Carlos Kuga, Ricardo Abreu da Rosa, Marcus Vinicius Reis Só Brazilian Dental Journal.2024;[Epub] CrossRef - Impact of different disinfection protocols on the bond strength of NeoMTA 2 bioceramic sealer used as a root canal apical plug (in vitro study)
Nada Omar, Nihal Refaat Kabel, Muhammad Abbass Masoud, Tamer M. Hamdy BDJ Open.2024;[Epub] CrossRef - Effect of Endo-Z bur or Bladesonic ultrasonic tip on the adaptation of filling material. A micro-CT study
Pedro Henrique Fiorin de Souza, Airton Oliveira Santos-Junior, Jáder Camilo Pinto, Karina Ines Medina Carita Tavares, Juliane Maria Guerreiro-Tanomaru, Mário Tanomaru-Filho Brazilian Dental Journal.2023; 34(5): 29. CrossRef - Effect of Different Mixing Methods on Physicochemical Properties of Mineral Trioxide Aggregate: A Systematic Review
Amin Salem Milani, Faraz Radmand, Behrad Rahbani, Mahdi Hadilou, Farnaz Haji Abbas Oghli, Fatemeh Salehnia, Milad Baseri, Stefano Pagano International Journal of Dentistry.2023; 2023: 1. CrossRef - Micro-CT comparative evaluation of porosity and dentin adaptation of root end filling materials applied with incremental, bulk, and ultrasonic activation techniques
Berkan Celikten, Aysenur Oncu, Mehrdad Koohnavard, Mert Ocak, Kaan Orhan Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine.2022; 236(8): 1209. CrossRef - Effect of ultrasonic activation of the adhesive system on dentin tubule penetration and the pushout bond strength of fiber posts
Isabel Verdum, Igor Abreu de Bem, Pedro Henrique Marks Duarte, Lucas Silveira Machado, Jefferson Ricardo Pereira, Marcus Vinícius Reis Só, Ricardo Abreu da Rosa The Journal of Prosthetic Dentistry.2022; 127(2): 295. CrossRef - Influence of Ultrasonic Activation on the Physicochemical Properties of Calcium Silicate-Based Cements
Fredson Márcio Acris De Carvalho, Yara Teresinha Corrêa Silva-Sousa, Carlos Eduardo Saraiva Miranda, Paulo Henrique Miller Calderon, Ana Flávia Simões Barbosa, Luciana Martins Domingues De Macedo, Fuad Jacob Abi Rached-Junior, Boonlert Kukiattrakoon International Journal of Dentistry.2021; 2021: 1. CrossRef - Micro-computed tomographic evaluation of the flow and filling ability of endodontic materials using different test models
Fernanda Ferrari Esteves Torres, Juliane Maria Guerreiro-Tanomaru, Gisselle Moraima Chavez-Andrade, Jader Camilo Pinto, Fábio Luiz Camargo Villela Berbert, Mario Tanomaru-Filho Restorative Dentistry & Endodontics.2020;[Epub] CrossRef - Dental discoloration caused by Grey-MTAFlow cement: analysis of its physicochemical, biological and antimicrobial properties
Lauter Eston PELEPENKO, Flávia SAAVEDRA, Gabriela Fernanda BOMBARDA, Brenda Paula Figueiredo de Almeida GOMES, Adriana DE-JESUS-SOARES, Alexandre Augusto ZAIA, Marco Antonio Hungaro DUARTE, Mario TANOMARU-FILHO, Marina Angélica MARCIANO Journal of Applied Oral Science.2020;[Epub] CrossRef - Effect of Ultrasonic Activation of Endodontic Sealers on Intratubular Penetration and Bond Strength to Root Dentin
Igor Abreu De Bem, Renata Aqel de Oliveira, Theodoro Weissheimer, Carlos Alexandre Souza Bier, Marcus Vinícius Reis Só, Ricardo Abreu da Rosa Journal of Endodontics.2020; 46(9): 1302. CrossRef
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Chelating and antibacterial properties of chitosan nanoparticles on dentin
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Aldo del Carpio-Perochena, Clovis Monteiro Bramante, Marco Antonio Hungaro Duarte, Marcia Regina de Moura, Fauze Ahmad Aouada, Anil Kishen
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Restor Dent Endod 2015;40(3):195-201. Published online March 30, 2015
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DOI: https://doi.org/10.5395/rde.2015.40.3.195
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Abstract
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The use of chitosan nanoparticles (CNPs) in endodontics is of interest due to their antibiofilm properties. This study was to investigate the ability of bioactive CNPs to remove the smear layer and inhibit bacterial recolonization on dentin. Materials and MethodsOne hundred bovine dentin sections were divided into five groups (n = 20 per group) according to the treatment. The irrigating solutions used were 2.5% sodium hypochlorite (NaOCl) for 20 min, 17% ethylenediaminetetraacetic acid (EDTA) for 3 min and 1.29 mg/mL CNPs for 3 min. The samples were irrigated with either distilled water (control), NaOCl, NaOCl-EDTA, NaOCl-EDTA-CNPs or NaOCl-CNPs. After the treatment, half of the samples (n = 50) were used to assess the chelating effect of the solutions using portable scanning electronic microscopy, while the other half (n = 50) were infected intra-orally to examine the post-treatment bacterial biofilm forming capacity. The biovolume and cellular viability of the biofilms were analysed under confocal laser scanning microscopy. The Kappa test was performed for examiner calibration, and the non-parametric Kruskal-Wallis and Dunn tests (p < 0.05) were used for comparisons among the groups. ResultsThe smear layer was significantly reduced in all of the groups except the control and NaOCl groups (p < 0.05). The CNPs-treated samples were able to resist biofilm formation significantly better than other treatment groups (p < 0.05). ConclusionsCNPs could be used as a final irrigant during root canal treatment with the dual benefit of removing the smear layer and inhibiting bacterial recolonization on root dentin.
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