Restorative Dentistry & Endodontics

Research Articles

Pattern of endodontic instrument separation and factors affecting its retrieval: a 10-year retrospective observational study in a postgraduate institute: Velmurugan Natanasabapathy, Aswathi Varghese, Paul Kevin Abishek Karthikeyan, Srinivasan Narasimhan; Restor Dent Endod 2025;50(1):e7. Published online February 19, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e7

Abstract PDF PubReader ePub: Objectives
This study aimed to assess the pattern of endodontic instrument separation, their retrievability, and factors affecting its retrieval, in a postgraduate institute.
Methods
Cases referred for the management of separated endodontic instruments (SEI) from 2013 to 2023 were considered for this study. Data related to demographics, tooth type, file type, and retrieval were documented in an Excel sheet. Eight prognostic factors assumed to influence the retrieval were analyzed in this study. The secondary aim was to compare the pattern of SEI and retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files. Retrieval was attempted by a senior endodontist under the dental operating microscope. Various ultrasonic tips and a Broken Tool Removal loop system were used during retrieval. Simple descriptive statistics were performed. Binomial logistic regression was done to identify the effect of the eight prognostic factors on the retrieval outcome.
Results
A total of 190 SEI was reported. SEI occurred more often in posterior teeth than anterior teeth, mandibular arch than maxillary arch, and in larger files than smaller files. Separation occurred more often in the apical third compared to the other levels. Retrieval was attempted in 88 cases and successful in 70 cases (79.5%). The larger taper and apical position of the SEI negatively influenced the retrieval by 1.4 and 8.7 times, respectively.
Conclusions
Retrieval of SEI was successful in the majority of the cases. An increase in taper and apically placed SEI negatively impacted the retrieval. There was no difference in the pattern of separation nor retrievability between conventional nickel-titanium files and newer generation heat-treated nickel-titanium files.

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Fracture incidence of Reciproc instruments during root canal retreatment performed by postgraduate students: a cross-sectional retrospective clinical study: Liliana Machado Ruivo, Marcos de Azevedo Rios, Alexandre Mascarenhas Villela, Alexandre Sigrist de Martin, Augusto Shoji Kato, Rina Andrea Pelegrine, Ana Flávia Almeida Barbosa, Emmanuel João Nogueira Leal Silva, Carlos Eduardo da Silveira Bueno; Restor Dent Endod 2021;46(4):e49. Published online September 9, 2021; DOI: https://doi.org/10.5395/rde.2021.46.e49

Abstract PDF PubReader ePub

Objectives

To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program.

Materials and Methods

From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ² test (p < 0.01).

Results

Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal.

Conclusions

The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.

Citations

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Reciprocating Torsional Fatigue and Mechanical Tests of Thermal-Treated Nickel Titanium Instruments
Victor Talarico Leal Vieira, Alejandro Jaime, Carlos Garcia Puente, Giuliana Soimu, Emmanuel João Nogueira Leal Silva, Carlos Nelson Elias, Gustavo de Deus
Journal of Endodontics.2025; 51(3): 359. CrossRef
Neodymium-Doped Yttrium Aluminum Perovskite (Nd:YAP) Laser in the Elimination of Endodontic Nickel-Titanium Files Fractured in Rooted Canals (Part 2: Teeth With Significant Root Curvature)
Amaury Namour, Marwan El Mobadder, Clément Cerfontaine, Patrick Matamba, Lucia Misoaga, Delphine Magnin , Praveen Arany, Samir Nammour
Cureus.2025;[Epub] CrossRef
Temperature-Dependent Effects on Cyclic Fatigue Resistance in Three Reciprocating Endodontic Systems: An In Vitro Study
Marcela Salamanca Ramos, José Aranguren, Giulia Malvicini, Cesar De Gregorio, Carmen Bonilla, Alejandro R. Perez
Materials.2025; 18(5): 952. CrossRef
Multimethod analysis of large‐ and low‐tapered single file reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow
Emmanuel João Nogueira Leal Silva, Fernando Peña‐Bengoa, Natasha C. Ajuz, Victor T. L. Vieira, Jorge N. R. Martins, Duarte Marques, Ricardo Pinto, Mario Rito Pereira, Francisco Manuel Braz‐Fernandes, Marco A. Versiani
International Endodontic Journal.2024; 57(5): 601. CrossRef
Nd: YAP Laser in the Elimination of Endodontic Nickel-Titanium Files Fractured in Rooted Canals (Part 1: Teeth With Minimal Root Curvature)
Amaury Namour, Marwan El Mobadder, Patrick Matamba, Lucia Misoaga, Delphine Magnin , Praveen Arany, Samir Nammour
Cureus.2024;[Epub] CrossRef
Cyclic Fatigue of Different Reciprocating Endodontic Instruments Using Matching Artificial Root Canals at Body Temperature In Vitro
Sebastian Bürklein, Paul Maßmann, Edgar Schäfer, David Donnermeyer
Materials.2024; 17(4): 827. CrossRef
Endodontic Orthograde Retreatments: Challenges and Solutions
Alessio Zanza, Rodolfo Reda, Luca Testarelli
Clinical, Cosmetic and Investigational Dentistry.2023; Volume 15: 245. CrossRef
Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation
Emmanuel J. N. L. Silva, Jorge N. R. Martins, Natasha C. Ajuz, Henrique dos Santos Antunes, Victor Talarico Leal Vieira, Francisco Manuel Braz-Fernandes, Felipe Gonçalves Belladonna, Marco Aurélio Versiani
Clinical Oral Investigations.2023; 27(5): 2427. CrossRef
Noncontact 3D evaluation of surface topography of reciprocating instruments after retreatment procedures
Miriam Fatima Zaccaro-Scelza, Renato Lenoir Cardoso Henrique Martinez, Sandro Oliveira Tavares, Fabiano Palmeira Gonçalves, Marcelo Montagnana, Emmanuel João Nogueira Leal da Silva, Pantaleo Scelza
Brazilian Dental Journal.2022; 33(3): 38. CrossRef

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Influence of glide path size and operating kinetics on time to reach working length and fracture resistance of Twisted File adaptive and Endostar E3 nickel-titanium file systems: Tamilkumaran Ramyadharshini, Inbaraj Anand Sherwood, V Shanmugham Vigneshwar, Prakasam Ernest Prince, Murugadoss Vaanjay; Restor Dent Endod 2020;45(2):e22. Published online March 5, 2020; DOI: https://doi.org/10.5395/rde.2020.45.e22

Abstract PDF PubReader ePub

Objectives

This study investigated the influence of glide path size and operating kinetics on the time to reach the working length and the fracture resistance of Twisted File (TF) and Endostar E3 files.

Materials and Methods

A total of 120 mandibular single-rooted premolars were selected. Two methods of kinetic motion (TF adaptive and continuous rotary motion) and file systems (TF and Endostar E3) were employed. The files were used in root canals prepared to apical glide path sizes of 15, 20, and 25. The time taken to reach the working length and the number of canals used before the instrument deformed or fractured were noted. Fractured instruments were examined with scanning electron microscopy.

Results

The TF system took significantly more time to reach the working length than the Endostar E3 system. Both systems required significantly more time to reach the working length at the size 15 glide path than at sizes 20 and 25. A greater number of TFs than Endostar E3 files exhibited deformation, and a higher incidence of instrument deformation was observed in adaptive than in continuous rotary motion; more deformation was also observed with the size 15 glide path. One TF was fractured while undergoing adaptive motion.

Conclusions

No significant difference was observed between continuous rotary and adaptive motion. The TF system and adaptive motion were associated with a higher incidence of deformation and fracture. Apical glide path sizes of 20 and 25 required significantly less time to reach the working length than size 15.

Citations

Citations to this article as recorded by

Glide Path in Endodontics: A Literature Review of Current Knowledge
Vlad Mircea Lup, Giulia Malvicini, Carlo Gaeta, Simone Grandini, Gabriela Ciavoi
Dentistry Journal.2024; 12(8): 257. CrossRef
Assessment of Different File Systems for Working Time Based on Glide Path, Operating Kinetics, and the Fracture Resistance
Ruchika Gupta, Divya Batra, Debkant Jena, Nandita Bansal, Alka Arora, Divya Gaurav Dudulwar
The Journal of Contemporary Dental Practice.2021; 22(1): 69. CrossRef

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The top 10 most-cited articles on the management of fractured instruments: a bibliometric analysis: Lora Mishra, Hyeon-Cheol Kim, Naomi Ranjan Singh, Priti Pragati Rath; Restor Dent Endod 2019;44(1):e2. Published online December 26, 2018; DOI: https://doi.org/10.5395/rde.2019.44.e2

Abstract PDF PubReader ePub

Objectives

The purpose of this research was to identify the top 10 most-cited articles on the management of fractured or broken instruments and to perform a bibliometric analysis thereof.

Materials and Methods

Published articles related to fractured instruments were screened from online databases, such as Web of Science, Scopus, PubMed, and ScienceDirect, and highly cited papers, with at least 50 citations since publication, were identified. The most-cited articles were selected and analysed with regard to publication title, authorship, the journal of publication, year, institution, country of origin, article type, and number of citations.

Results

The top 10 most-cited articles were from various journals. Most were published in the Journal of Endodontics, followed by the International Endodontic Journal, and Dental Traumatology. The leading countries were Australia, Israel, Switzerland, the USA, and Germany, and the leading institution was the University of Melbourne. The majority of articles among the top 10 articles were clinical research studies (n = 8), followed by a basic research article and a non-systematic review article.

Conclusions

This bibliometric analysis revealed interesting information about scientific progress in endodontics regarding fractured instruments. Overall, clinical research studies and basic research articles published in high-impact endodontic journals had the highest citation rates.

Citations

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A Bibliometric Analysis of the 100 Top-Cited Articles on Vertical Root Fractures
Pillai Arun Gopinathan , Ikram UI Haq, Nawaf Alfahad, Saleh Alwatban, Abdullah Alghamdi, Amal Alamri, Kiran Iyer
Cureus.2024;[Epub] CrossRef
Predictive factors in the retrieval of endodontic instruments: the relationship between the fragment length and location
Ricardo Portigliatti, Eugenia Pilar Consoli Lizzi, Pablo Alejandro Rodríguez
Restorative Dentistry & Endodontics.2024;[Epub] CrossRef
A bibliometric analysis of the top 100 most‐cited case reports and case series in Endodontic journals
Venkateshbabu Nagendrababu, Jelena Jacimovic, Aleksandar Jakovljevic, Giampiero Rossi‐Fedele, Paul M. H. Dummer
International Endodontic Journal.2022; 55(3): 185. CrossRef
The Most Highly Cited Publications on Basketball Originate From English-Speaking Countries, Are Published After 2000, Are Focused on Medicine-Related Topics, and Are Level III Evidence
Zachary D. Griffin, Jordan R. Pollock, M. Lane Moore, Kade S. McQuivey, Jaymeson R. Arthur, Anikar Chhabra
Arthroscopy, Sports Medicine, and Rehabilitation.2022; 4(3): e891. CrossRef
Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies
Emmanuel João Nogueira Leal Silva, Karem Paula Pinto, Natasha C. Ajuz, Luciana Moura Sassone
Restorative Dentistry & Endodontics.2021;[Epub] CrossRef
Publication trends in micro‐CT endodontic research: a bibliometric analysis over a 25‐year period
U. Aksoy, M. Küçük, M. A. Versiani, K. Orhan
International Endodontic Journal.2021; 54(3): 343. CrossRef

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