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Research Articles
Comparative analysis of torsional and cyclic fatigue resistance of ProGlider, WaveOne Gold Glider, and TruNatomy Glider in simulated curved canal
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
Restor Dent Endod 2023;48(1):e4.   Published online December 8, 2022
DOI: https://doi.org/10.5395/rde.2023.48.e4
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to compare the torsional and cyclic fatigue resistance of ProGlider (PG), WaveOne Gold Glider (WGG), and TruNatomy Glider (TNG).

Materials and Methods

A 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%.

Results

The 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.

Conclusions

Reciprocating 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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Effectiveness and safety of rotary and reciprocating kinematics for retreatment of curved root canals: a systematic review of in vitro studies
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
Restor Dent Endod 2022;47(2):e22.   Published online April 6, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e22
AbstractAbstract PDFPubReaderePub
Objectives

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 Methods

Only 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.

Results

The 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.

Conclusions

This 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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Impact of root canal curvature and instrument type on the amount of extruded debris during retreatment
Burcu Serefoglu, Gözde Kandemir Demirci, Seniha Miçooğulları Kurt, İlknur Kaşıkçı Bilgi, Mehmet Kemal Çalışkan
Restor Dent Endod 2021;46(1):e5.   Published online December 17, 2020
DOI: https://doi.org/10.5395/rde.2021.46.e5
AbstractAbstract PDFPubReaderePub
Objectives

The aim of the current study was to assess whether the amount of extruded debris differs for straight and severely curved root canals during retreatment using H-files, R-Endo, Reciproc and ProTaper Universal Retreatment (PTU-R) files. Additionally, the area of residual filling material was evaluated.

Materials and Methods

Severely curved (n = 104) and straight (n = 104) root canals of maxillary molar teeth were prepared with WaveOne Primary file and obturated with gutta-percha and AH Plus sealer. Root canal filling materials were removed with one of the preparation techniques: group 1: H-file; group 2: R-Endo; group 3: Reciproc; group 4: PTU-R (n = 26). The amount of extruded material and the area of the residual filling material was measured. The data were analyzed with 2-way analysis of variance (ANOVA) and 1-way ANOVA at the 0.05 significance level.

Results

Except for Reciproc group (p > 0.05), PTU-R, R-Endo, and H-file systems extruded significantly more debris in severely curved canals (p < 0.05). Each file system caused more residual filling material in severely curved canals than in straight ones (p < 0.05).

Conclusions

All instruments used in this study caused apical debris extrusion. Root canal curvature had an effect on extruded debris, except for Reciproc system. Clinicians should be aware that the difficult morphology of the severely curved root canals is a factor increasing the amount of extruded debris during the retreatment procedure.

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Apical root canal cleaning after preparation with endodontic instruments: a randomized trial in vivo analysis
Volmir João Fornari, Mateus Silveira Martins Hartmann, José Roberto Vanni, Rubens Rodriguez, Marina Canali Langaro, Lauter Eston Pelepenko, Alexandre Augusto Zaia
Restor Dent Endod 2020;45(3):e38.   Published online June 24, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e38
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate vital pulp tissue removal from different endodontic instrumentation systems from root canal apical third in vivo.

Materials and Methods

Thirty mandibular molars were selected and randomly divided into 2 test groups and one control group. Inclusion criteria were a positive response to cold sensibility test, curvature angle between 10 and 20 degrees, and curvature radius lower than 10 mm. Root canals prepared with Hero 642 system (size 45/0.02) (n = 10) and Reciproc R40 (size 40/0.06) (n = 10) and control (n = 10) without instrumentation. Canals were irrigated only with saline solution during root canal preparation. The apical third was evaluated considering the touched/untouched perimeter and area to evaluate the efficacy of root canal wall debridement. Statistical analysis used t-test for comparisons.

Results

Untouched root canal at cross-section perimeter, the Hero 642 system showed 41.44% ± 5.62% and Reciproc R40 58.67% ± 12.39% without contact with instruments. Regarding the untouched area, Hero 642 system showed 22.78% ± 6.42% and Reciproc R40 34.35% ± 8.52%. Neither instrument achieved complete cross-sectional root canal debridement. Hero 642 system rotary taper 0.02 instruments achieved significant greater wall contact perimeter and area compared to reciprocate the Reciproc R40 taper 0.06 instrument.

Conclusions

Hero 642 achieved higher wall contact perimeter and area but, regardless of instrument size and taper, vital pulp during in vivo instrumentation is not entirely removed.

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Comparison of the cyclic fatigue resistance of VDW.ROTATE, TruNatomy, 2Shape, and HyFlex CM nickel-titanium rotary files at body temperature
Mustafa Gündoğar, Gülşah Uslu, Taha Özyürek, Gianluca Plotino
Restor Dent Endod 2020;45(3):e37.   Published online June 22, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e37
AbstractAbstract PDFPubReaderePub
Objectives

This study aims to compare the cyclic fatigue resistance of VDW.ROTATE, TruNatomy, 2Shape, and HyFlex CM nickel-titanium (NiTi) rotary files at body temperature.

Materials and Methods

In total, 80 VDW.ROTATE (25/0.04), TruNatomy (26/0.04), 2Shape (25/0.04), and HyFlex CM (25/0.04) NiTi rotary files (n = 20 in each group) were subjected to static cyclic fatigue testing at body temperature (37°C) in stainless-steel artificial canals prepared according to the size and taper of the instruments until fracture occurred. The number of cycles to fracture (NCF) was calculated, and the lengths of the fractured fragments were measured. The data were statistically analyzed using a 1-way analysis of variance and post hoc Tamhane tests at the 5% significance level (p < 0.05).

Results

There were significant differences in the cyclic fatigue resistance among the groups (p < 0.05), with the highest to lowest NCF values of the files as follows: VDW.ROTATE, HyFlex CM, 2Shape, and TruNatomy. There was no significant difference in the lengths of the fractured fragments among the groups. The scanning electron microscope images of the files revealed typical characteristics of fracture due to cyclic fatigue.

Conclusions

The VDW.ROTATE files had the highest cyclic fatigue resistance, and the TruNatomy and 2Shape files had the lowest cyclic fatigue resistance in artificial canals at body temperature.

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Influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium instruments: a systematic review
Emmanuel João Nogueira Leal Silva, Mayara Zanon, Fernanda Hecksher, Felipe Gonçalves Belladonna, Rafaela Andrade de Vasconcelos, Tatiana Kelly da Silva Fidalgo
Restor Dent Endod 2020;45(2):e25.   Published online March 31, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e25
AbstractAbstract PDFPubReaderePub
Objectives

This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments.

Materials and Methods

A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction.

Results

From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base.

Conclusions

Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.

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Comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit for the removal of separated endodontic instruments
Preeti Jain Pruthi, Ruchika Roongta Nawal, Sangeeta Talwar, Mahesh Verma
Restor Dent Endod 2020;45(2):e14.   Published online February 6, 2020
DOI: https://doi.org/10.5395/rde.2020.45.e14
AbstractAbstract PDFPubReaderePub
Objective

The aim of this study was to perform a comparative evaluation of the effectiveness of ultrasonic tips versus the Terauchi file retrieval kit (TFRK) for the removal of broken endodontic instruments.

Materials and Methods

A total of 80 extracted human first mandibular molars with moderate root canal curvature were selected. Following access cavity preparation canal patency was established with a size 10/15 K-file in the mesiobuccal canals of all teeth. The teeth were divided into 2 groups of 40 teeth each: the P group (ProUltra tips) and the T group (TFRK). Each group was further subdivided into 2 smaller groups of 20 teeth each according to whether ProTaper F1 rotary instruments were fractured in either the coronal third (C constituting the PC and TC groups) or the middle third (M constituting the PM and TM groups). Instrument retrieval was performed using either ProUltra tips or the TFRK.

Results

The overall success rate at removing the separated instrument was 90% in group P and 95% in group T (p > 0.05) The mean time for instrument removal was higher with the ultrasonic tips than with the TFRK (p > 0.05).

Conclusion

Both systems are acceptable clinical tools for instrument retrieval but the loop device in the TFRK requires slightly more dexterity than is needed for the ProUltra tips.

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Cyclic fatigue resistance of M-Pro and RaCe Ni-Ti rotary endodontic instruments in artificial curved canals: a comparative in vitro study
Hadeer Mostafa El Feky, Khalid Mohammed Ezzat, Marwa Mahmoud Ali Bedier
Restor Dent Endod 2019;44(4):e44.   Published online November 7, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e44
AbstractAbstract PDFPubReaderePub
Objectives

To compare the flexural cyclic fatigue resistance and the length of the fractured segments (FLs) of recently introduced M-Pro rotary files with that of RaCe rotary files in curved canals and to evaluate the fracture surface by scanning electron microscopy (SEM).

Materials and Methods

Thirty-six endodontic files with the same tip size and taper (size 25, 0.06 taper) were used. The samples were classified into 2 groups (n = 18): the M-Pro group (M-Pro IMD) and the RaCe group (FKG). A custom-made simulated canal model was fabricated to evaluate the total number of cycles to failure and the FL. SEM was used to examine the fracture surfaces of the fragmented segments. The data were statistically analyzed and comparisons between the 2 groups for normally distributed numerical variables were carried out using the independent Student's t-test. A p value less than 0.05 was considered to indicate statistical significance.

Results

The M-Pro group showed significantly higher resistance to flexural cyclic fatigue than the RaCe group (p < 0.05), but there was no significant difference in the FLs between the 2 groups (p ≥ 0.05).

Conclusions

Thermal treatment of nickel-titanium instruments can improve the flexural cyclic fatigue resistance of rotary endodontic files, and the M-Pro rotary system seems to be a promising rotary endodontic file.

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Comparison of the shaping ability of novel thermally treated reciprocating instruments
Cangül Keskin, Murat Demiral, Evren Sarıyılmaz
Restor Dent Endod 2018;43(2):e15.   Published online March 3, 2018
DOI: https://doi.org/10.5395/rde.2018.43.e15
AbstractAbstract PDFPubReaderePub
Objectives

The present study aimed to evaluate the shaping ability of 2 thermally treated nickel-titanium reciprocating systems in simulated curved canals.

Materials and Methods

Forty simulated canals were prepared to apical size 25 using Reciproc Blue R25 (VDW) and WaveOne Gold Primary (Dentsply Sirona) instruments. Standard pre- and post-preparation images were taken and superimposed. The removal of resin material was measured at 5 standard points: the canal orifice, halfway between the canal orifice and the beginning of the curve, the beginning of the curve, the apex of the curve, and the end-point of the simulated canal. The data were analysed using the independent sample t-test with a 5% significance threshold.

Results

The canals in which Reciproc Blue R25 was used showed a significantly greater widening than those in which WaveOne Gold was used at 4 of the 5 measurement points (p < 0.05). The Reciproc Blue R25 instrument removed significantly more resin from the inner aspect of the curve at 2 of the 5 points and similar amounts at the remaining 3 points. At the 2 apical points, there was no significant difference between the Reciproc Blue R25 and WaveOne Gold Primary instruments.

Conclusion

Both instruments respected the original canal anatomy; however, WaveOne Gold resulted in a more conservative shape with less transportation.

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Original Article
Effect of microleakage of a self-etching primer adhesive according to types of cutting instruments
Yong-Hee Kim, Jae-Gu Park, Young-Gon Cho
J Korean Acad Conserv Dent 2007;32(4):327-334.   Published online July 31, 2007
DOI: https://doi.org/10.5395/JKACD.2007.32.4.327
AbstractAbstract PDFPubReaderePub

The purpose of this study was to evaluate the effect of burs on microleakage of Class V resin restorations when a self-etching primer adhesive was used.

Forty Class V cavities were prepared with four different cutting burs on extracted third molars, and divided into one of four equal groups (n = 10); Group 1-plain cut carbide bur (no. 245), Group 2-cross cut carbide bur (no. 557), Group 3-fine diamond bur (TF-21F), Group 4-standard diamond bur (EX-41).

The occlusal and gingival margin of cavities was located in enamel and dentin, respectively. Cavities were treated with Clearfil SE Bond and restored with Clearfil AP-X. Specimens were thermocycled, immersed in a 2% methylene blue solution for 24 hours, and bisected longitudinally. They were observed leakages at enamel and dentinal margins. Data were analyzed using Mann-Whitney and Wilcoxon signed ranked test.

The results of this study were as follows;

1. At enamel margin, microleakage of group 4 was statistically higher than those of group 1, 2 and 3 (p < 0.01).

2. At dentinal margin, microleakage of group 4 was statistically higher than group 3 (p < 0.01), but group 1 and 2 were not statistically different with group 3 and 4.

3. Enamel microleakage was statistically higher than dentinal microleakage in group 1, 2 and 3 (p < 0.05), but statistical difference between the microleakage of enamel and dentinal margin was not in group 4.

In conclusion, the use of coarse diamond bur showed high microleakage at both enamel and dentinal margin when Clearfil SE Bond was used in class V cavity.

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