• Restorative Dentistry and Endodontics
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• v.41 no.3
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• pp.176-181
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• 2016

Objectives: This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickel-titanium (NiTi) instruments for the first time. Materials and Methods: Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students' perception about 'Ease of use', 'Flexibility', 'Cutting-efficiency', 'Screwing-effect', 'Feeling-safety', and 'Instrumentation-time' of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05). Results: Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for 'Screwing-effect' for PTU. The scores for WO in the categories of 'Flexibility', 'Screwing-effect', and 'Feeling-safety' were significantly higher scores than those of PTU. A significant association between the 'Screwing-effect' and students' preference for WO was observed. Conclusions: Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.561-574
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• 1998

The purposes of this study were to observe the difference in the root canal wall after hand instrumentation or engine-driven Ni-Ti instrumentation under the scanning electron microscope, and to evaluate the apical leakage provided by continuous wave of canal filling technique with or without root canal sealer and smear layer. Twenty recently extracted human maxillary anterior teeth were instrumented with K-type files or engine-driven Ni-Ti files, Quantec series 2000$^{TM}$ and irrigated with 5.25% NaOCl alone or 15% EDT A and final flush of 5.25% NaOCl. After the instrumentation and flushing, teeth were split in half with a knife and a mallet. They were then examined with a scanning electron microscope Forty-four recently extracted human maxillary anterior teeth were divided into four groups with and without smear layer and then warm vertical canal filling using System-B with or without sealer. The extent of leakage was scored after immersion in India ink for 1 week. The results were as follows: 1. No significant difference of smear layer was observed between K-type file-instrumented group and engine-driven Ni-Ti file-instrumented group. 2. A group without smear layer showed significantly less apical leakage than a group with smear layer when sealer was used for the canal filling (p<0.01). 3. There was no significant difference between a group without sealer and smear layer and a group without sealer and with smear layer (p<0.01). 4. In groups without smear layer, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01). 5. When root canals were irrigated with NaOCl alone, a group with sealer showed significantly less apical leakage than a group without sealer (p<0.01).

• 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.

• The Journal of the Korean dental association
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• v.54 no.8
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• pp.640-650
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• 2016

Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.257-268
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• 1998

During cleaning and shaping of narrow and curved canals, it is very difficult or nearly impossible to maintain the original canal shape. Procedural accidents such as, ledge, zipping, perforation, and instrument breakage are frequently occurred and even may lead to failure of endodontic therapy. To prevent these kinds of accidents, various instrumentation techniques and materials have been introduced. Recently some nickel titanium (NiTi) files are introduced and it is reported that These NiTi files created rounder preparations with less transportation than conventional instruments in curved canals. This study compared the change of the canal curvature and procedural accidents after instrumentation produced by stainless steel K-flexo file, and NiTi rotary files (Profile 29 and Quantec 2000). Thirty narrow and curved canals (25-45 degree) of extracted human molars were randomly divided into three groups. In group 1, canals were instrumented using a step-back and watch-winding/pull motion with K-flexo files. In group 2, canals were prepared with Profile 29. Group 3, canals were prepared with Quantec 2000 files. Before and after preparation of canals, periapical radiographs were taken and scanned. The change of canal curvature were measured using Photoshop 4.0 program and the incidence of procedural accidents were also evaluated. The results were as follows: 1. All group showed some loss of canal curvature after instrumentation. 2. Average loss of canal curvature was $6.70{\pm}5.31$ degree for group 1, $3.80{\pm}2.57$ degree for group 2, and $5.40{\pm}4.83$ degree for group 3. All group There was significant change in curvature between before and after instrumentation (p<0.05). But there was no statistical difference amoung 3 groups. 3. In group I, there were no procedural accidents, such as ledging, perforation, or instrument fracture. In group 2, two cases of ledge and one case of instrument fracture were produced Goup 3, each one case of ledge, perforation and instrument fracture were occurred. Whthin the limits of above results, It seems that NiTi rotary instrumentation is not All Mighty and if we use uncarefully, it is more dangerous to produce some procedural accidents than conventional hand files. But more studies should be taken to evaluate the exact effects of NiTi rotary instrumentations.

• Restorative Dentistry and Endodontics
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• v.31 no.1
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• pp.11-19
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• 2006

The purpose of this study was to compare and evaluate the shaping abilities of various hybrid instrumentation method using constant tapered file systems with $ProTaper\^{(R)}$ S1 and the difference between experts and inexperienced clinicians in use of NiTi file. Three hybrid methods used in this study were composed of $ProTaper\^{(R)}\;S1\;and\;K-Flexofile\^{(R)}\;(group S),\;ProTaper\^{(R)}\;S1\;and\;HeroShaper\^{(R)}\;(group\;H),\;and\;ProTaper\^{(R)}\;S1\;and\;ProFile\^{(R)}\;(group\;P)$respectively. The $ProTaper\^{(R)}$-alone method (group C) was introduced as a control group. After canal preparation, the lapse of time was recorded. The images of pre- and post-operative canal were scanned and superimposed. Amounts of instrumented canal widths and centering ratio were measured at apical 1, 2 and 3 mm levels and statistical analysis was performed In this study. both of the group C and S took more time to prepare canals than other groups, Inexperienced operators required more time for the entire preparation with the groups C and H than the experienced (p<0.05). And the centering ratio of group P were preferable to $ProTaper\^{(R)}$-alone method or the hybrid technique using stainless steel files. As such, within experienced operators, group H also showed better results in addition to the group P. Under these condition, the hybrid methods of each the $ProFile^{(R)}$ system and $HeroShaper^{(R)}$ with ProTaper are recommendable comparative to $ProTaper\^{(R)}$-alone method. According to the results, the hybrid instrumentation method is a more appropriate method of canal preparation than single file system for narrow or curved canals.

• Restorative Dentistry and Endodontics
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• v.38 no.1
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• pp.31-35
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• 2013

Objectives: This study compared the cyclic fatigue resistance of nickel-titanium (NiTi) files obtained in a conventional test using a simulated canal with a newly developed method that allows the application of constant fatigue load conditions. Materials and Methods: ProFile and K3 files of #25/.06, #30/.06, and #40/.04 were selected. Two types of testing devices were built to test their fatigue performance. The first (conventional) device prescribed curvature inside a simulated canal (C-test), the second new device exerted a constant load (L-test) whilst allowing any resulting curvature. Ten new instruments of each size and brand were tested with each device. The files were rotated until fracture and the number of cycles to failure (NCF) was determined. The NCF were subjected to one-way ANOVA and Duncan's post-hoc test for each method. Spearman's rank correlation coefficient was computed to examine any association between methods. Results: Spearman's rank correlation coefficient (${\rho}$ = -0.905) showed a significant negative correlation between methods. Groups with significant difference after the L-test divided into 4 clusters, whilst the C-test gave just 2 clusters. From the L-test, considering the negative correlation of NCF, K3 gave a significantly lower fatigue resistance than ProFile as in the C-test. K3 #30/.06 showed a lower fatigue resistance than K3 #25/.06, which was not found by the C-test. Variation in fatigue test methodology resulted in different cyclic fatigue resistance rankings for various NiTi files. Conclusions: The new methodology standardized the load during fatigue testing, allowing determination fatigue behavior under constant load conditions.

• Restorative Dentistry and Endodontics
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• v.29 no.4
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• pp.378-385
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• 2004

The purpose of this study was to compare the effects of preparation with GT files and profiles .04 in shaping of root canals and reconstruct the three-dimensional root canal system using micro computed tomography 40 canals of the extracted human mandibular molars were used, and randomly distributed into two experimental groups. In group 1. canals were prepared by GT files. In group 2, Profiles .04. were used. Apical preparation size was #30. For each tooth pre and post operative cross-sectional images were obtained by the micro CT at 50 micron intervals. Pre and post operative cross-sectional images of 1, 2, 3, 5, and 8mm from the apex were compared. For each section. canal area and centering ratio were determined. For each tooth pre- and post-operative root canal volume from the furcation to the apex of the roots was calculated by three-dimensional image software. Following results were obtained: 1. At 8mm from the apex, area of dentin removed by GT rotary file was significantly larger than that by Profile .04. And at the other levels there was not a significant difference. 2. There was a trend for GT rotary file to remain more centered in the canals than Profile .04 at all levels. But at 3mm level. there was a statistically significant difference. 3. In root canal volume increments after instrumentation, there was no significant difference between two groups.

• Restorative Dentistry and Endodontics
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• v.36 no.4
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• pp.300-305
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• 2011

Objectives: The aim of this study was to evaluate the various NiTi rotary instruments regarding their ability to provide a circular apical preparation. Materials and Methods: 50 single canal roots were selected, cut at the cementodentinal junction and the coronal 1/3 of the canals was flared using Gates Glidden burs. Samples were randomly divided into 5 experimental groups of 10 each. In group I, GT files, Profile 04 and Quantec #9 and #10 files were used. In Group II Lightspeed was used instead of Quantec. In Group III, Orifice shaper, Profile .06 series and Lightspeed were used. In Group IV, Quantec #9 and #10 files were used instead of Lightspeed. In Group V, the GT file and the Profile .04 series were used to prepare the entire canal length. All tooth samples were cut at 1 mm, 3 mm and 5 mm from the apex and were examined under the microscope. Results: Groups II and III (Lightspeed) showed a more circular preparation in the apical 1mm samples than the groups that used Quantec (Group I & IV) or GT files and Profile .04 series.(Group V)(p < 0.05) There was no significant difference statistically among the apical 3, 5 mm samples. In 5 mm samples, most of the samples showed complete circularity and none of them showed irregular shape. Conclusions: Lightspeed showed circular preparation at apical 1 mm more frequently than other instruments used in this study. However only 35% of samples showed circularity even in the Lightspeed Group which were enlarged 3 ISO size from the initial apical binding file (IAF) size. So it must be considered that enlarging 3 ISO size isn't enough to make round preparation.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.316-323
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• 2017

Objectives: This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems. Materials and Methods: Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU). Results: The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria. Conclusions: All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.