Giovanni Franciosi

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.

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.