The use of ultrasound for cleaning the surface of stainless steel and nickel-titanium endodontic instruments

Aim the aim of this study was to evaluate the efficacy of ultrasound in cleaning the surface of stainless steel and Ni-Ti endodontic instruments.Methodology Twenty nickel-titanium instruments (10 Quantec files and 10 Nitiflex) and 20 stainless steel K-files (10 Maillefer-Dentsply and 10 Moyco Union Broach) were removed from their original packages and evaluated using a scanning electron microscope. Scores were given for the presence of residues on the surface or the instruments. The instruments were then cleaned in an ultrasonic bath containing only distilled water or detergent solution for 15 min, and re-evaluated, using scanning electron microscopy.Results Before cleaning, a greater amount of metallic debris was observed on the nickel-titanium Quantec instruments (P < 0.05), when compared to those made of stainless steel. Statistical analysis showed that the use of ultrasound was effective for cleaning the instruments, regardless of the irrigating solution or the instruments type (P < 0.05).Conclusions the use of ultrasound proved to be an efficient method for the removal of metallic particles from the surface of stainless steel and Ni-Ti endodontic instruments.

Wear resistance of nickel-titanium endodontic files after surface treatment

Objectives The purpose of this work was to submit the Nitinol files to plasma immersion ion implantation (PIII) and evaluate the effects of the surface treatment. Materials and Methods Wear resistance was determined in vitro by using an equipment for the application of horizontal movements on previously prepared notched plates made of resin. Vickers microhardness was measured in plates and files, before and after surface treatment and the surface chemical composition of the instruments was determined by X-rays photoelectron spectroscopy. Results The hardness values found for the treated Nitinol files were significantly lower than the hardness values measured before the implantation process. The comparison of commercially available instruments shows that the wear resistance of the stainless steel file is higher than the resistance of the Nitinol. Conclusions The results found led to the conclusion that the surface treatment significantly increased the Nitinol files wear resistance.

The Ability of Different Nickel-Titanium Rotary Instruments To Induce Dentinal Damage During Canal Preparation

The purpose of this study was to compare the incidence of dentinal defects (fractures and craze lines) after canal preparation with different nickel-titanium rotary files. Two hundred sixty mandibular premolars were selected. Forty teeth were left unprepared (n = 40). The other teeth were prepared either with manual Flexofiles (n = 20) or with different rotary files systems: ProTaper (Dentsply-Maillefer, Ballaigues, Switzerland), ProFile (Dentsply-Maillefer), SystemGT (Dentsply-Maillefer), or S-ApeX (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (n = 50 each). Roots were then sectioned 3, 6, and 9 mm from the apex and observed under a microscope. The presence of dentinal defects was noted. There was a significant difference in the appearance of defects between the groups (p < 0.05). No defects were found in the unprepared roots and those prepared with hand files and S-ApeX. ProTaper, ProFile, and GT preparations resulted in dentinal defects in 16%, 8%, and 4% of teeth, respectively. Some endodontic preparation methods might damage the root and induce dentinal defects. (J Endod 2009;35:236-238)

Fatigue life assessment of endodontic instruments subjected to multi planar curvature

This present study aimed to investigate the fatigue life of unused (new) endodontic instruments made of NiTi with control memory by Coltene™ and subjected to the multi curvature of a mandibular first molar root canal. Additionally, the instrument‟s structural behaviour was analysed through non-linear finite element analysis (FEA). The fatigue life of twelve Hyflex™ CM files was assessed while were forced to adopt a stance with multiple radius of curvature, similar to the ones usually found in a mandibular first molar root canal; nine of them were subjected to Pecking motion, a relative movement of axial type. To achieve this, it was designed an experimental setup with the aim of timing the instruments until fracture while worked inside a stainless steel mandibular first molar model with relative axial motion to simulate the pecking motion. Additionally, the model‟s root canal multi-curvature was confirmed by radiography. The non-linear finite element analysis was conducted using the computer aided design software package SolidWorks™ Simulation, in order to define the imposed displacement required by the FEA, it was necessary to model an endodontic instrument with simplified geometry using SolidWorks™ and subsequently analyse the geometry of the root canal CAD model. The experimental results shown that the instruments subjected to pecking motion displayed higher fatigue life values and higher lengths of fractured tips than those with only rotational relative movement. The finite element non-linear analyses shown, for identical conditions, maximum values for the first principal stress lower than the yield strength of the material and those were located in similar positions to the instrument‟s fracture location determined by the experimental testing results.

Removal of fractured endodontic instruments using an Nd:YAG laser.

OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.

Resistance to Flexural Fatigue of Reciproc R25 Files under Continuous Rotation and Reciprocating Movement

Introduction: The aim of the present work was to evaluate the resistance to flexural fatigue of Reciproc R25 nickel-titanium files, 25 mm, used in continuous rotation motion or reciprocation motion, in dynamic assays device. Methods: Thirty-six Reciproc R25 files were divided into 2 groups (n = 18) according to kinematics applied, continuous rotary (group CR) and reciprocation motion (group RM). The files were submitted to dynamic assays device moved by an electric engine with 300 rpm of speed that permitted the reproduction of pecking motion. The files run on a ring's groove of temperate steel, simulating instrumentation of a curved root canal with 400 and 5 mm of curvature radius. The fracture of file was detected by sensor of device, and the time was marked. The data were analyzed statistically by Student's t test, with level of significance of 95%. Results: The instruments moved by reciprocating movement reached significantly higher numbers of cycles before fracture (mean, 1787.78 cycles) when compared with instruments moved by continuous rotary (mean, 816.39 cycles). Conclusions: The results showed that the reciprocation motion improves flexural fatigue resistance in nickel-titanium instrument Reciproc R25 when compared with continuous rotation movement. (J Endod 2012;38:684-687)

Effect of Nitrogen Ion Implantation on the Flexibility of Rotary Nickel-Titanium Instruments

Introduction: The aim of this study was to assess the effect of nitrogen ion implantation on the flexibility of rotary nickel-titanium (NiTi) instruments as measured by the load required to bend implanted and nonimplanted instruments at a 30 degrees angle. Methods: Thirty K3 files, size #40, 0.02 taper and 25-mm length, were allocated into 2 groups as follows: group A, 15 files exposed to nitrogen ion implantation at a dose of 2.5 x 10(17) ions/cm(2), voltage 200 KeV, current density 1 mu A/cm(2), temperature 130 degrees C, and vacuum conditions of 10 x 10(-6) mm Hg for 6 hours; and group B, 15 nonimplanted files. One extra file was used for process control. All instruments were subjected to bend testing on a modified troptometer, with measurement of the load required for flexure to an angle of 30 degrees. The Mann-Whitney U test was used for statistical analysis. Findings with P <.05 were considered significant. Results: The mean load required to bend instruments at a 30 degrees angle was 376.26 g for implanted instruments and 383.78 g for nonimplanted instruments. The difference was not statistically significant. Conclusions: Our findings show that nitrogen ion implantation has no appreciable effect on the flexibility of NiTi instruments. (J Endod 2012;38:673-675)

Flexibility and torsional resistance of three nickel-titanium retreatment instrument systems

Aim To assess the dimensional characteristics, flexibility and torsional behaviour of nickel-titanium retreatment instruments. Methodology Using image analysis software and high-resolution digital images, the instrument length, tip angle, diameter at 3mm from the tip and the distance between the blades (pitch length) of the following eight instruments were measured (n=12 for each measurement parameter): the ProTaper Universal retreatment (PTU-R) D1, D2 and D3 instruments; the R-Endo R1, R2 and R3 retreatment instruments; and the Mtwo retreatment (Mtwo-R) sizes 25 and 15 retreatment instruments. Maximum torque and the angular deflection at fracture as well as the bending moment at 45° were measured (n=12) according to the International Standards Organisation (ISO) specification number 3630-1. Data were analysed using the analysis of variance (α=0.05). Results The length of the active part of the instruments was found to vary according to the depth of the canal into which they were designed to reach. The pitch length also increased along the active length. The PTU-R D1 and the Mtwo-R instruments had active tips. Measurements of the bending moment at 45° revealed that the Mtwo-R 15 instrument was the most flexible, whereas the PTU-R D1 was the least flexible. The maximum torque tended to increase as the instrument diameter at 3mm from the tip increased, whereas the angular deflection at fracture varied in the opposite direction. Conclusions The geometrical characteristics of the retreatment instruments and their flexibility and torsion behaviour were consistent with their intended clinical application. © 2011 International Endodontic Journal.

A method for retrieving endodontic or atypical non-endodontic separated instruments from the root canal: a report of two cases

Aim: This clinical report presents a new method for retrieving separated instruments from the root canal with minimally invasive procedures. Background: The presence of separated instrument in root canal may interfere in the endodontic treatment prognosis. There are several recommended methods to retrieve separated instruments, but some are difficult in clinically practice. Case report: This study describes two cases of separated instrument removal from the root canal using a stainless-steel prepared needle associated with a K-file. Case 1 presented a fractured gutta-percha condenser within the mandibular second premolar, it was separated during incorrect intracanal medication calcium hydroxide placement. Case 2 had a fractured sewing needle within the upper central incisor that the patient used to remove food debris from the root canal. After cervical preparation, the fractured instruments were fitted inside a prepared needle and then an endodontic instrument (#25 K-file) was adapted with clockwise turning motion between the needle inner wall and the fragment. Conclusion: The endodontic or atypical nonendodontic separated instrument may be easily pull on of the root canal using a single and low cost device. Clinical significance: The methods for retrieving separated instruments from root canal are difficult and destructive procedures. The present case describes a simple method to solve this problem.

Clinical microscopic analysis of protaper retreatment system efficacy considering root canal thirds using three endodontic sealers

To evaluate the efficacy of ProTaper Universal rotary retreatment system and the influence of sealer type on the presence of filling debris in the reinstrumented canals viewed in an operative clinical microscope. Forty-five palatal root canals of first molars were filled with gutta-percha and one of the following sealers: G1, EndoFill; G2, AH Plus; G3, Sealapex. The canals were then reinstrumented with ProTaper Universal rotary system. Roots were longitudinally sectioned and examined under an operative clinical microscope (10x), and the amount of filling debris on canal walls was analyzed using the AutoCAD 2004 software. A single operator used a specific software tool to outline the canal area and the filling debris area in each third (cervical, middle, and apical), as well as the total canal area. Data were analyzed by Kruskal-Wallis test and Tukey test at P < 0.05. Sealapex demonstrated significant differences in the average of filling debris area/canal among the 3 thirds. This group revealed that apical third showed more debris than the both cervical and middle third (P < 0.0001). Endofill presented significantly more filling debris than Sealapex in the cervical third (P < 0.05). In the middle (P = 0.12) and apical third (P = 0.10), there were no differences amongst groups. Debris was left in all canal thirds, regardless of the retreatment technique. The greatest differences between techniques and sealers were found in the cervical third. Microsc. Res. Tech. 75:12331236, 2012. (C) 2012 Wiley Periodicals, Inc.

Sistema de instrumentação mecanizada reciprocante

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Avaliação da resistência à fadiga de instrumentos rotatórios do Sistema Pro Taper Universal por meio de ensaio dinâmico

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Sistema de instrumentação mecanizada Hyflex EDM

A Endodontia é uma área em constante evolução. Consideráveis desenvolvimentos nos materiais e técnicas têm sido essenciais para o melhoramento dos resultados nos tratamentos realizados. É exemplo disso mesmo a constituição dos instrumentos Endodônticos primordiais, construídos em cordas de piano, com evolução para aço de carbono, material este que sofria corrosão provocado pelo cloro presente no hipoclorito de sódio. O aço de carbono evoluiu para aço inoxidável e deste as limas endodônticas passaram a ser feitas em níquel-titânio, conferindo-lhes melhor flexibilidade e efeito de memória de forma. Mesmo com todas estas melhorias significativas, fraturas de instrumentos e erros durante a instrumentação continuam a acontecer e com eles veio a necessidade da pesquisa de possíveis melhorias da constituição das limas em NiTi. Como resultado surgiram ligas como o M-wire, fase-R e CM-wire, criadas a partir de tratamentos térmicos, que trouxeram às limas Endodônticas maior flexibilidade e resistência à fratura que os instrumentos feitos em NiTi convencional. A mais recente evolução das limas Ni-Ti, desenvolvida pela Coltene Whaldent (Allstätten, Suiça), são as limas Hyflex EDM, limas para canais radiculares de 5ª geração. O seu processo de fabrico por eletroerosão cria uma superfície única fazendo com que estas limas sejam mais duras e resistam mais à quebra, aliado à sua alta flexibilidade. É possível assim reduzir o número de limas para a limpeza e modelagem dos canais durante os tratamentos endodônticos sem comprometer a preservação da anatomia dos canais. As limas Hyflex EDM possuem, tal como as limas Hyflex CM, o efeito de controle de memória (CM), o que confere propriedades muito similares entre os dois sistemas.