• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.371-383
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• 2012

Shaping the root canal system to maintain original canal curvature is essential to clinical success in endodontic treatment. Opposed to most root canals that are curved, endodontic instruments are made from straight metal blanks. They have a tendency of straightening the root canal during preparation and frequently result in procedural errors. A new treatment method to maintain original canal curvature during shaping has been introduced for preventing procedural errors. The aim of this study was to compare the ability of instruments to maintain original canal curvature of continuous rotary system and single file system. Thirty ISO 15, 0.02 taper, Endo Training Blocks(Dentsplay Maillefer) were used. Specimens were assigned to 1 of 3 groups for shaping: specimens in group 1 were shaped with ProFile #20/.06 at the WL. Specimens in group 2 were shaped with Mtwo #35/.04 at the WL. Specimens in group 3 were shaped with WaveOne Primary reciprocating files at the WL after the glide path was achieved with PathFile. Pre- and postinstrumentation digital images were superimposed and processed with Matlab r2010b(The MathWorks Inc, Natick, MA) software to analyze the curvature-radius ratio(CRr), representing canal curvature modification. Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file were analyzed with 1-way ANOVA(P<.05). Data for comparison on the ability of instruments to maintain original canal curvature depending on each Ni-Ti file system were analyzed with independent t-test(P<.05). A statistically significant difference(P<0.05) was noted on each Ni-Ti file. ProFile and WaveOne instrumentations maintained the original canal curvature significantly better(P<0.05) than Mtwo file. There were no significant difference(P>0.05) between continuous rotary system and single file system. Under the conditions of this study, ProFile and WaveOne instruments maintained the original curvature significantly better than Mtwo file and were less modification of the canal curvature compared. There was no significant difference between continuous rotary system and single file system in shaping of simulated canals. As clinical practitioners, it may be advantages to use hybrid approach when root canal shapes depending on the design and usage of Ni-Ti files.

• Restorative Dentistry and Endodontics
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• v.32 no.4
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• pp.385-396
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• 2007

The aims of this study were to compare the shaping effect and safety between single length technique recommended by manufacturer and crown-down technique using Mtwo rotary file and to present a modified method in use of Mtwo file. Sixty simulated root canal resin blocks were used. The canals were divided into three groups according to instrument and the manner of using methods. Each group had 20 specimens. Group MT was instrumented with single length technique of Mtwo, group MC was instrumented with crown-down technique of Mtwo and group PT was instrumented with crown-down technique of ProTaper. All of the rotary files used in this study were operated by an electric motor. The scanned canal images of before and after preparation were superimposed. These superimposed images were evaluated at apical 1 to 8 mm levels Angle changes were calculated. The preparation time, weight loss, instrument failure and binding, canal aberrations, and centering ratio were measured. Statistical analysis of the three experimental groups was performed with ANOVA and Duncan's multiple range tests for post-hoc comparison and Fisher's exact test was done for the frequency comparison. In total preparation time, group MT and group MC were less than group PT. In the aberrations, group MT had more elbows than those of group MC and group PT. The binding of group MC was least and group MT was less than group PT (P < 0.05). Under the condition of this study, crown-down technique using Mtwo rotary file is better and safer method than single length technique recommended by the manufacturer.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.1-7
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• 2009

The purpose of this study was to compare the stress distributions of NiTi rotary instruments based on their cross-sectional geometries of triangular shape-based cross-sectional design, S-shaped cross-sectional design and modified rectangular shape-based one using 3D FE models. NiTi rotary files of S-shaped and modified rectangular design of cross-section such as Mtwo or NRT showed larger stress change while file rotation during simulated shaping. The stress of files with rectangular cross-section design such as Mtwo, NRT was distributed as an intermittent pattern along the long axis of file. On the other hand, the stress of files with triangular cross-section design was distributed continuously. When the residual stresses which could increase the risk of file fatigue fracture were analyzed after their withdrawal. the NRT and Mtwo model also presented higher residual stresses. From this result, it can be inferred that S-shaped and modified rectangular shape-based files were more susceptible to file fracture than the files having triangular shape-based one.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.140-145
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• 2017

Objectives: The aim of this randomized, controlled, prospective clinical study was to evaluate patients' intraoperative discomfort during root canal preparations in which either multi-file rotary (Mtwo) or single-file reciprocating (Reciproc) systems were used. Materials and Methods: Fifty-five adult patients, aged between 25 and 69 years old, with irreversible pulpitis or pulp necrosis participated in this study. Either the mesiobuccal or the distobuccal canals for maxillary molars and either the mesiobuccal or the mesiolingual canals for mandibular molars were randomly chosen to be instrumented with Mtwo multi-file rotary or Reciproc single-file reciprocating systems. Immediately after each canal instrumentation under anesthesia, patient discomfort was assessed using a 1 - 10 visual analog scale (VAS), ranging from 'least possible discomfort' (1) to 'greatest possible discomfort' (10). The Wilcoxon signed-rank test was used to determine significant differences at p < 0.05. Results: Little intraoperative discomfort was found in all cases. No statistically significant differences in intraoperative discomfort between the 2 systems were found (p = 0.660). Conclusions: Root canal preparation with multi-file rotary or single-file reciprocating systems had similar and minimal effects on patients' intraoperative discomfort.

• Restorative Dentistry and Endodontics
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• v.43 no.1
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• pp.5.1-5.9
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• 2018

Objectives: This study evaluated the amount of remaining root canal filling materials after retreatment procedures performed by undergraduate students using manual, rotary, and reciprocating techniques through micro-computed tomographic analysis. The incidence of instrument fracture and the instrumentation time were also evaluated. Materials and Methods: Thirty maxillary single rooted teeth were prepared with Reciproc R25 files and filled with gutta-percha and AH Plus sealer by the continuous wave of condensation technique. Then, the specimens were assigned to 3 groups (n = 10), according to the retreatment technique used: manual, rotary, and reciprocating groups, which used K-file, Mtwo retreatment file, and Reciproc file, respectively. Retreatments were performed by undergraduate students. The sample was scanned after root canal filling and retreatment procedures, and the images of the canals were examined to quantify the amount of remaining filling material. The incidence of instrument fracture and the instrumentation time were recorded. Results: Remaining filling material was observed in all specimens regardless of the technique used. The mean volume of remaining material was significantly lower in the Reciproc group than in the manual K-file and Mtwo retreatment groups (p < 0.05). The time required to achieve a satisfactory removal of canal filling material and refinement was significantly lower in the Mtwo retreatment and Reciproc groups (p < 0.05) when compared to the manual K-file group. No instrument fracture was observed in any of the groups. Conclusions: Reciproc was the most effective instrument in the removal of canal fillings after retreatments performed by undergraduate students.

• Restorative Dentistry and Endodontics
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• v.48 no.1
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• pp.10.1-10.9
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• 2023

Objectives: This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment. Materials and Methods: The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test. Results: The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05). Conclusions: NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.332-341
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• 2017

Objectives: To determine the incidence of crack formation and propagation in apical root dentin after retreatment procedures performed using ProTaper Universal Retreatment (PTR), Mtwo-R, ProTaper Next (PTN), and Twisted File Adaptive (TFA) systems. Materials and Methods: The study consisted of 120 extracted mandibular premolars. One millimeter from the apex of each tooth was ground perpendicular to the long axis of the tooth, and the apical surface was polished. Twenty teeth served as the negative control group. One hundred teeth were prepared, obturated, and then divided into 5 retreatment groups. The retreatment procedures were performed using the following files: PTR, Mtwo-R, PTN, TFA, and hand files. After filling material removal, apical enlargement was done using apical size 0.50 mm ProTaper Universal (PTU), Mtwo, PTN, TFA, and hand files. Digital images of the apical root surfaces were recorded before preparation, after preparation, after obturation, after filling removal, and after apical enlargement using a stereomicroscope. The images were then inspected for the presence of new apical cracks and crack propagation. Data were analyzed with ${\chi}^2$ tests using SPSS 21.0 software. Results: New cracks and crack propagation occurred in all the experimental groups during the retreatment process. Nickel-titanium rotary file systems caused significantly more apical crack formation and propagation than the hand files. The PTU system caused significantly more apical cracks than the other groups after the apical enlargement stage. Conclusions: This study showed that retreatment procedures and apical enlargement after the use of retreatment files can cause crack formation and propagation in apical dentin.

• Restorative Dentistry and Endodontics
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• v.46 no.1
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• pp.6.1-6.10
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• 2021

Objectives: The aim of this study was to evaluate the corrosion resistance of heat-treated (Reciproc and WaveOne) and non-heat-treated (ProTaper and Mtwo) superelastic nickel-titanium endodontic files when immersed in a 5.25% sodium hypochlorite solution. Materials and Methods: Anodic polarization curves were obtained with potential sweeps that began at the open circuit potential or corrosion potential (E_corr). The pitting potential (E_pit) was identified on the anodic polarization curve as the potential at which a sudden increase in current was observed. The micromorphology of the 28 tested files was analyzed before and after the electrochemical assay using scanning electron microscope (SEM). The data were analyzed using 1-way analysis of variance with the post hoc Bonferroni test (for E_corr) and the Student t-test for independent samples (for E_pit). Results: The mean E_corr values were 0.506 V for ProTaper, 0.348 V for Mtwo, 0.542 V for Reciproc, and 0.321 V for WaveOne files. Only WaveOne and Protaper files exhibited pitting corrosion, with E_pit values of 0.879 V and 0.904 V, respectively. On the SEM images of the ProTaper and WaveOne files, cavities suggestive of pitting corrosion were detected. Conclusions: Signs of corrosion were observed in both heat-treated and non-heat-treated files. Of the evaluated files, WaveOne (a heat-treated file) and ProTaper (a non-heat-treated file) exhibited the lowest corrosion resistance.

• Restorative Dentistry and Endodontics
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• v.35 no.2
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• pp.88-95
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• 2010

The purpose of this study was to compare the root canal shaping ability of 4 rotary NiTi instruments in simulated root canals. For the preparation of thirty two curved root canals, Mtwo instruments using "single length"technique, and Profile, ProTaper Universal, and K3 using crown-down technique (N = 8) were used. All canal samples were prepared by reaching an apical canal size of #30. Pre- and post-instrumentation digital images were recorded and an assessment of canal shape was determined using a computer image analysis program SigmaScan Pro (Systat Software Inc., San Jose, CA, USA). The changes of the dimension of inner walls of canals, (2) the changes of the dimension of outer walls of canals, and (3) the centering ratio were measured at 7 measuring points, and then data were statistically analyzed using one-way ANOVA and Duncan's test. The results were as below; 1. The root canal shaping ability of Profile was significantly faster than that of other rotary NiTi instruments (p < 0.05). 2. The deformation and fracture of all instruments used for this study were not experienced. 3. In the degree of changes of the dimension of inner walls of canals, Profile demonstrated the lowest changes of the dimension of inner walls of canals except at the measuring points of the 1 and 2 mm (p < 0.05). However, the ProTaper Universal showed the highest changes of the dimension of inner walls of canals at all measuring points (p < 0.05). 4. In the degree of changes of the dimension of outer walls of canals, Mtwo demonstrated the lowest changse of the dimension of outer walls of canals except at the measuring point of the 1 mm (p < 0.05). However, Profile exhibited the highest changes of the dimension of outer walls of canals at the measuring points of 3 and 4 mm and ProTaper Universal and K3 showed the largest changes of the dimension of outer walls of canals at the measuring points of 1, 2, 6, and 7 mm (p < 0.05). 5. In degree of centering ratio, Profile demonstrated the least centering ratio comparing with the centering ratio shown by other NiTi instruments at the measuring points of 1, 4, 5, and 6 mm. Results suggest that in the coronal part of canal preparation, active cutting files such as ProTaper Universal may efficiently flare the canal orifice and form a better taper, and in the apical part of the canal, files which have a better centering ability such as Profile may maintain the original canal curvature and reduce the shaping time.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.304-309
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• 2016

Objectives: The purpose of this study was to compare the maximum screw-in forces generated during the movement of various Nickel-Titanium (NiTi) file systems. Materials and Methods: Forty simulated canals in resin blocks were randomly divided into 4 groups for the following instruments: Mtwo size 25/0.07 (MTW, VDW GmbH), Reciproc R25 (RPR, VDW GmbH), ProTaper Universal F2 (PTU, Dentsply Maillefer), and ProTaper Next X2 (PTN, Dentsply Maillefer, n = 10). All the artificial canals were prepared to obtain a standardized lumen by using ProTaper Universal F1. Screw-in forces were measured using a custom-made experimental device (AEndoS-k, DMJ system) during instrumentation with each NiTi file system using the designated movement. The rotation speed was set at 350 rpm with an automatic 4 mm pecking motion at a speed of 1 mm/sec. The pecking depth was increased by 1 mm for each pecking motion until the file reach the working length. Forces were recorded during file movement, and the maximum force was extracted from the data. Maximum screw-in forces were analyzed by one-way ANOVA and Tukey's post hoc comparison at a significance level of 95%. Results: Reciproc and ProTaper Universal files generated the highest maximum screw-in forces among all the instruments while M-two and ProTaper Next showed the lowest (p < 0.05). Conclusions: Geometrical differences rather than shaping motion and alloys may affect the screw-in force during canal instrumentation. To reduce screw-in forces, the use of NiTi files with smaller cross-sectional area for higher flexibility is recommended.