Effect of body temperature on the cyclic fatigue resistance of the nickel”titanium endodontic instruments: A systematic review and meta-analysis of in vitro studies

Influence of the Brushing Motions on the Dynamic Cyclic Fatigue Resistance of the Reciproc Blue Instrument: In vitro Study

INTRODUCTION

This study aimed to evaluate the dynamic cyclic fatigue resistance of Reciproc Blue files subjected to brushing motion.

METHODS

Twenty Reciproc Blue files (R25, VDW, Munich, Germany) were employed for chemical-mechanical preparation in root canals of 3D printed replicas of mandibular molars. The instruments were divided into two groups (n = 10): Group brushing motion, instrumentation with brushing motions; Group without brushing motion , instrumentation without brushing motions. Subsequently, the same instruments underwent cyclic fatigue testing using artificial canals consisting of a stainless-steel plate and an apical segment with a 45° curvature. Data regarding the time to fracture, number of cycles to fracture, and length of the fractured fragment were collected and subjected to statistical analysis using the t-test or Mann-Whitney test, with a significance level of 5%. Additionally, the fractured fragments were examined under a scanning electron microscope.

RESULTS

No statistical differences were observed between the groups in terms of time to fracture (P < .05), number of cycles to fracture (P < .05) and length of the fractured fragment (P < .05).

CONCLUSION

The brushing motion did not affect the dynamic cyclic fatigue resistance of Reciproc Blue files.

Comparison of cyclic fatigue resistance of four pediatric rotary file systems at body temperature: an in vitro study

BACKGROUND

The aim of this study was to compare the cyclic fatigue resistance (CFR) of the newly developed pediatric nickel-titanium (NiTi) rotary file systems for root canal preparation of primary teeth.

METHODS

Eighty pediatric NiTi rotary file systems files were used in this study, including 20 EasyInSmile X-Baby (25/0.04), 20 Scope miniScope (25/0.04), 20 EndoArt Pedo Gold (25/0.04), and 20 EndoArt Pedo Blue (25/0.04) files. Static CFR tests; performed on a custom-made stainless steel block with an inner diameter of 1.5 mm, an angle of curvature of 60° and a curved artificial canal with a radius of curvature of 5 mm. The test system was filled with distilled water and the temperature was kept constant at 35 ± 1 °C. The files were rotated in the simulated canal until fracture occurred. The number of cycles to failure (NCF) data was recorded, and all the fracture surfaces of the files were evaluated using scanning electron microscopy (SEM). One-way ANOVA and Tukey tests were used for statistical analysis of the data, and the significance level was set at p < 0.05.

RESULTS

EndoArt Pedo Blue showed the highest NCF values (2668.10 ± 755.26), while the miniScope showed the lowest NCF values (453.65 ± 72.51), with a statistically significant difference between all the tested file systems (p < 0.05). There was no statistical difference in terms of fractured fragment lengths among all tested files (p > 0.05).

CONCLUSION

The EndoArt Pedo Blue file system showed the best CFR performance among the four file systems specifically designed for primary teeth.

Fifteen years of engine-driven nickel-titanium reciprocating instruments, what do we know so far? An umbrella review

Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed.

Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review

INTRODUCTION

Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics.

AIM

The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture.

RESULTS

At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy.

CONCLUSIONS

The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

In Vitro Evaluation of the Dynamic Cyclic Fatigue Resistance of a New TruNatomy Glider File after Different Cycles of Use

INTRODUCTION

Determination of the glide path is recommended before using rotary instruments. This study aimed to evaluate the dynamic cyclic fatigue resistance of new and used glider rotary instruments in up to 6 root canals.

METHODS

Seventy-two TruNatomy Glider files were used for the preparation of root canals of extracted lower molars, which were then submitted to the dynamic cyclic fatigue test carried out in a curved metallic artificial canal. The instruments were divided into 4 groups (n = 18): Control group, new instruments without any use in the root canal; Group 2U, instruments used in 2 mesial canals; Group 4U, instruments used in 4 mesial canals; Group 6U, instruments used in 6 mesial canals. The time to failure (TF) of the instrument was recorded, and the number of cycles to failure (NCF) was calculated. The data were submitted to 1-way analysis of variance and to the Games-Howell test for multiple comparisons, adopting a significance level of 5%.

RESULTS

TF and NCF were significantly affected by the number of file uses. The Games-Howell test revealed that TF and NCF were significantly greater in the control group than in Group 4U. In Group 2U, TF and NCF were intermediate and not significantly different from the control group. Group 6U had significantly lower TF and NCF than all other groups.

CONCLUSION

The TruNatomy Glider can be used as a glide path for up to 2 mesial canals of mandibular molars, whereas its use on 4 or 6 root canals is not suggested.

Evaluation of cyclic fatigue behavior of RACE EVO rotary Files: In-vitro comparative study

Introduction

Comparative evaluation of the newly introduced; RACE EVO file system to the currently well-performing file systems like HyFlex EDM OneFile, Vortex Blue, ProTaper Gold (PTG) with regards to the cyclic fatigue resistance.

Materials

&Methods.The endodontic rotary files under evaluation were segregated into four groups as follows:; RACE EVO, PTG, Vortex Blue, and HyFlex EDM OneFile. A detailed physical analysis of the cyclic fatigue resistance was performed in 15 files of each type (n = 60). Under the test conditions of 37 °C the test samples were subjected to continuous motion at the manufacturer recommended speed within an artificial curved canal until it fractured. For all the test samples, with the recording of time of fracture, calculation was done for number of cycles to fracture (NCF). In addition, the length of the fractured segment was determined. The fractured surface was further evaluated with scanning electron microscopic (SEM) images.

Results

Highest significance for NCF was seen in HyFlex EDM OneFile followed by the Vortex Blue, PTG, and; RACE EVO (p < 0.05) by analyzing the data statistically. Significant differences among the lengths of the fractured segments were evident among tested files, ranging between 4.73 and 6.3 mm (p < 0.05) with HyFlex EDM OneFile uniquely differentiating from the others showing the fracture at 6.3 mm. The common features of cyclic fatigue failure was further substantiated by SEM images.

Conclusions

Compared to the HyFlex EDM OneFile, Vortex Blue, and PTG files; RACE EVO demonstrated significantly lower resistance to cyclic fatigue.

Comparative evaluation of cyclic fatigue resistance of thermomechanically treated NiTi rotary instruments in simulated curved canals with two different radii of curvature: An in vitro Study

Background

This study aimed to compare the effect of heat treatment on the cyclic fatigue resistance of three different nickel-titanium rotary file systems: TruNatomy, HyFlex CM, and NeoEndo flex in simulated curved canals at two different radii of curvatures.

Materials and Methods

A total of 60 NiTi rotary files of three types were used, and the samples were divided into three groups TruNatomy, HyFlex CM, and NeoEndo flex. All the instruments were subjected to cyclic fatigue testing using a stainless steel custom-made canal model with a 60° angle of curvature and two radii of curvature 5 mm and 3 mm; the number of cycles to fracture and length of the fractured segment was measured. The separated instruments were subjected to fractographic analysis under scanning electron microscope.

Results

The number of cycles to failure to fracture a file at a 3 mm radius of curvature is significantly less as compared to a 5 mm radius of curvature (HCM > TRN > NE).

Conclusion

Within the limitation of the present study, there was a positive correlation between the radius of curvature and fatigue life of NiTi files.

Impact of pecking amplitude on cyclic fatigue of new nickel-titanium files

OBJECTIVES

The aim of this study is to determine the cyclic fatigue resistance of Mtwo Minimal in static and dynamic tests, with different amplitudes of pecking movements, at intracanal temperature.

MATERIALS AND METHODS

Two hundred new 25-mm Mtwo Minimal rotary files (#10/0.035, #17.5/0.045, #25/0.05, #40/0.03, #45/0.03) were tested in static and dynamic cyclic fatigue tests at 35°C (±1°C). An artificial stainless-steel canal was used. In the dynamic mode, axial movements were set at 1 and 3 mm. The number of cycles to fracture (NCF) was recorded and statistically analyzed by one-way analysis of variance (p < 0.05).

RESULTS

The 3-mm dynamic test showed significantly increased NCF than the other tests for the #10/0.035, #17.5/0.045, and #25/0.05 files (p < 0.05). The #40/0.03 and #45/0.03 files showed no significant differences in all the tests (p > 0.05).

CONCLUSION

Mtwo Minimal showed higher cyclic fatigue resistance in the dynamic test than the static test, except for the larger instruments. The 3-mm pecking amplitude increased the cyclic fatigue resistance of the smaller instruments.

Comparing Cyclic Fatigue Resistance and Free Recovery Transformation Temperature of NiTi Endodontic Single-File Systems Using a Novel Testing Setup

The aim of this study was to assess the effect of body temperature (37 °C) on the cyclic fatigue resistance of three endodontic single-file systems using a new testing setup. One Shape® new generation (OS), WaveOne™ (WO) and WaveOne® GOLD (WOG), which are made from different NiTi alloys and operated in different motions (rotation/reciprocation), were evaluated. The study design included four groups. Each group comprised 30 files, 10 files of each of the three file systems, tested at 20 ± 2 °C (group 1 and 3) and at 37 ± 1 °C (group 2 and 4). All files were tested in a custom-made metal block with artificial canals of 60° angle, and a 5 mm and 3 mm radius of curvature, respectively. A heating element was attached to replicate a temperature of 37 °C. Files were introduced 18 mm into the canals and operated until failure. Transformation temperatures of five samples of each of the tested file systems were determined via the bend and free recovery (BFR) method. With the exception of WOG in canals with a 3 mm radius of curvature (p = 0.075), all the tested file systems showed statistically significantly less time needed to fracture when operated at 37 ± 1 °C compared to at 20 ± 2 °C in canals with a 5 mm and 3 mm radius of curvature using Mann-Whitney U test (p < 0.05). All file systems showed transformation temperatures below the body temperature. We concluded that body temperature directly affects the cyclic fatigue resistance of all tested file systems. Bend and free recovery can be suitable for the determination of austenite finish temperatures (Af) of endodontic instruments as it allows testing a longer portion of the instrument.

Evaluation of cyclic and torsional fatigue resistance of several heat-treated reciprocating nickel-titanium instruments

This study investigated the cyclic fatigue and torsional resistance of Unicone Plus (UCP 25.06), Unicone (UC 25.06), Reciproc Blue (RB 25.08) and Wave One Gold (WOG 25.07) performed at body temperature (35° ± 1°C). Time and number of cycles to fracture (NCF), as well as torque and angular deflection were recorded. Fractured surfaces were evaluated by scanning electron microscopy (SEM). Data were analysed using one-way ANOVA and Holm-Sidak's tests for multiple comparison. The RB had a significantly higher time to fracture, followed by the WOG and UCP (p < 0.05). Regarding the NCF, there was no significantly difference between RB and WOG (p > 0.05). UC presented highest torque values and the lowest angular deflection (p < 0.05). SEM analysis demonstrated typical failures features in both cyclic and torsional fatigue tests. Overall, UC had the lowest time, NCF and angular deflection at fracture. RB presented the highest time to fracture and angular deflection values.