• Restorative Dentistry and Endodontics
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• v.44 no.2
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• pp.19.1-19.9
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• 2019

Objectives: The purpose of this study was to evaluate the cyclic fatigue, bending resistance, and surface roughness of EdgeEvolve (EdgeEndo) and ProTaper Gold (Dentsply Tulsa Dental Specialties) nickel-titanium (NiTi) rotary files. Materials and Methods: The instruments (n = 15/each) were tested for cyclic fatigue in single- ($60^{\circ}$ curvature, 5-mm radius) and double-curved (coronal curvature $60^{\circ}$, 5-mm radius, and apical curvature of $30^{\circ}$ and 2-mm radius) artificial canals. The number of cycles to fracture was calculated. The bending resistance of both files were tested using a universal testing machine where the files were bent until reach $45^{\circ}$. Scanning electron microscopy and x-ray energy-dispersive spectrometric analysis were used for imaging the fractured segments, while the atomic force microscope was used to quantify the surface roughness average (Ra). Results: EdgeEvolve files exhibited higher cyclic fatigue resistance than ProTaper Gold files in single- and double-curved canals (p < 0.05) and both files were more resistant to cyclic fatigue in single-curved canals than double-curved canals (p < 0.05). EdgeEvolve files exhibited significantly more flexibility than did ProTaper Gold files (p < 0.05). Both files had approximately similar Ni and Ti contents (p > 0.05). EdgeEvolve files showed significantly lower Ra values than ProTaper Gold files (p < 0.05). Conclusions: Within the limitation of this study, EdgeEvolve files exhibited significantly higher cyclic fatigue resistance than ProTaper Gold files in both single- and double-curved canals.

• Restorative Dentistry and Endodontics
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• v.42 no.4
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• pp.301-308
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• 2017

Objectives: It was aimed to compare the cyclic fatigue resistances of ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG) and the effects of sterilization by autoclave on the cyclic fatigue life of nickel-titanium (NiTi) instruments. Materials and Methods: Eighty PTU, 80 PTN, and 80 PTG were included to the present study. Files were tested in a simulated canal. Each brand of the NiTi files were divided into 4 subgroups: group 1, as received condition; group 2, pre-sterilized instruments exposed to 10 times sterilization by autoclave; group 3, instruments tested were sterilized after being exposed to 25%, 50%, and 75% of the mean cycles to failure, then cycled fatigue test was performed; group 4, instruments exposed to the same experiment with group 3 without sterilization. The number of cycles to failure (NCF) was calculated. The data was statistically analyzed by using one-way analysis of variance and post hoc Tukey tests. Results: PTG showed significantly higher NCF than PTU and PTN in group 1 (p < 0.05). Sterilization significantly increased the NCF of PTN and PTG (p < 0.05) in group 2. PTN in group 3 had significantly higher cyclic fatigue resistance than PTN group 4 (p < 0.05). Also, significantly higher NCF was observed for PTG in group 2 than in groups 3 and 4 (p < 0.05). Conclusions: PTG instrument made of new gold alloy was more resistant to fatigue failure than PTN and PTU. Autoclaving increased the cyclic fatigue resistances of PTN and PTG.

• Restorative Dentistry and Endodontics
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• v.41 no.1
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• pp.1-5
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• 2016

Objectives: The purpose of this study was to assess the ability of ProTaper Gold (PTG, Dentsply Maillefer) in maintaining the original profile of root canal anatomy. For that, ProTaper Universal (PTU, Dentsply Maillefer) was used as reference techniques for comparison. Materials and Methods: Twenty simulated curved canals manufactured in clear resin blocks were randomly assigned to 2 groups (n = 10) according to the system used for canal instrumentation: PTU and PTG groups, upto F2 files (25/0.08). Color stereomicroscopic images from each block were taken exactly at the same position before and after instrumentation. All image processing and data analysis were performed with an open source program (FIJI). Evaluation of canal transportation was obtained for two independent canal regions: straight and curved levels. Student's t test was used with a cut-off for significance set at ${\alpha}=5%$. Results: Instrumentation systems significantly influenced canal transportation (p < 0.0001). A significant interaction between instrumentation system and root canal level (p < 0.0001) was found. PTU and PTG systems produced similar canal transportation at the straight part, while PTG system resulted in lower canal transportation than PTU system at the curved part. Canal transportation was higher at the curved canal portion (p < 0.0001). Conclusions: PTG system produced overall less canal transportation in the curved portion when compared to PTU system.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.51.1-51.10
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• 2020

Objectives: No studies have yet assessed vibration characteristics according to endodontic file length. Accordingly, the objective of the present study was to examine the vibration characteristics according to nickel-titanium file length and to compare these characteristics between different file systems. Materials and Methods: A total of 45 root canal models were divided into 3 experimental groups (n = 15 each) based on the file system used (ProTaper Gold [PTG], ProTaper Next, or WaveOne Gold [WOG]). Each experimental group was further divided into 3 subgroups according to file length (21, 25, or 31 mm). An electric motor (X-SMART PLUS) was used in the experiment. For each file system, vibrations generated when using a size 25 file were measured and used to calculate the average vibration acceleration. The differences in vibrations were analyzed using 1-way analysis of variance and the Scheffé post hoc test with a confidence interval of 95%. Results: In the PTG file system, significantly lower vibration acceleration was observed when using a 21-mm file than when using a 31-mm file. In the WOG file system, significantly stronger vibration acceleration was observed when using a 31-mm file than when using 21- or 25-mm files. Regardless of the file length, the WOG group exhibited significantly stronger vibration acceleration than the other 2 experimental groups. Conclusions: In clinical practice, choosing a file with the shortest length possible could help reduce vibrations. Additionally, consideration should be given to vibrations that could be generated when using WOG files with reciprocating motion.

• 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.46 no.1
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• pp.13.1-13.9
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• 2021

Objectives: This study aimed to evaluate and compare the efficacy of the S1 reciprocating system and the D-Race retreatment rotary system for filling material removal and the apical extrusion of debris. Materials and Methods: Sixty-four freshly extracted maxillary canines were shaped with size 10 and size 15 K-files, instrumented using ProTaper Gold under irrigation with 2.5% sodium hypochlorite (NaOCl), obturated according to the principle of thermo-mechanical condensation with gutta-percha and zinc oxide eugenol sealer, and allowed to set for 3 weeks at 37℃. Subsequently, the teeth were divided into a control group (n = 4), the D-Race rotary instrument group (n = 30), and the S1 reciprocating instrument group (n = 30). After classical retreatment, the canals were subjected to a complementary approach with the XP-Endo Shaper. Desocclusol was used as a solvent, and irrigation with 2.5% NaOCl was performed. Each group was divided into subgroups according to the timing of radiographic readings. The images were imported into a software program to measure the remaining filling material, the apical extrusion, and the root canal space. The data were statistically analyzed using the Z-test and JASP graphics software. Results: No significant differences were found between the D-Race and S1 groups for primary retreatment; however, using a complementary cleaning method increased the removal of remnant filling (p < 0.05). Conclusions: Classical removal of canal filling material may not be sufficient for root canal disinfection, although a complementary finishing approach improved the results. Nevertheless, all systems left some debris and caused apical extrusion.

• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.36.1-36.15
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• 2023

Objectives: This study aimed to compare the effectiveness of a single-file reciprocating system (WaveOne Gold, WOG) and a multi-file rotary system (ProTaper Universal Retreatment, PTUR) in removing canal filling from severely curved canals and to evaluate the possible adjunctive effects of XP-Endo Finisher (XPF), the Self-Adjusting File (SAF), and an erbium, chromium: yttrium, scandium, gallium garnet (Er,Cr:YSGG) laser using microcomputed tomography (µCT). Materials and Methods: Sixty-six curved mandibular molars were divided into 2 groups based on the retreatment technique and then into 3 based on the supplementary method. The residual filling volumes and root canals were evaluated with µCT before and after retreatment, and after the supplementary steps. The data were statistically analyzed with the t-test, Mann-Whitney U test, analysis of covariance, and factorial analysis of variance (p < 0.05). Results: PTUR and WOG showed no significant difference in removing filling materials (p > 0.05). The supplementary techniques were significantly more effective than reciprocating or rotary systems only (p < 0.01). The supplementary steps showed no significant differences in canal filling removal effectiveness (p > 0.05), but XPF showed less dentin reduction than the SAF and Er,Cr:YSGG laser (p < 0.01). Conclusions: The supplementary methods significantly decreased the volume of residual filling materials. XPF caused minimal changes in root canal volume and might be preferred for retreatment in curved root canals. Supplementary approaches after retreatment procedures may improve root canal cleanliness.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.2
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• pp.91-99
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• 2023

Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7^th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7^th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.