1
|
Silva EJNL, Peña-Bengoa F, Ajuz NC, Vieira VTL, Martins JNR, Marques D, Pinto R, Rito Pereira M, Braz-Fernandes FM, Versiani MA. Multimethod analysis of large- and low-tapered single file reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow. Int Endod J 2024; 57:601-616. [PMID: 38376108 DOI: 10.1111/iej.14047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare eight large- and low-tapered heat-treated reciprocating instruments regarding their design, metallurgy, mechanical properties, and irrigation flow through an in silico model. METHODOLOGY A total of 472 new 25-mm E-Flex Rex (25/.04 and 25/.06), Excalibur (25/.05), Procodile (25/.06), Reciproc Blue R25 (25/.08v), WaveOne Gold Primary (25/.07v), and Univy Sense (25/.04 and 25/.06) instruments were evaluated regarding their design (stereomicroscopy, scanning electron microscopy, and 3D surface scanning), metallurgy (energy-dispersive X-ray spectroscopy and differential scanning calorimetry), and mechanical performance (cyclic fatigue, torsional resistance, cutting ability, bending and buckling resistance). Computational fluid dynamics assessment was also conducted to determine the irrigation flow pattern, apical pressure, and wall shear stress in simulated canal preparations. Kruskal-Wallis and one-way anova post hoc Tukey tests were used for statistical comparisons (α = 5%). RESULTS Instruments presented variations in blade numbers, helical angles, and tip designs, with all featuring non-active tips, symmetrical blades, and equiatomic nickel-titanium ratios. Cross-sectional designs exhibited an S-shaped geometry, except for WaveOne Gold. Univy 25/.04 and Reciproc Blue displayed the smallest and largest core diameters at D3. Univy 25/.04 and E-Flex Rec 25/.04 demonstrated the longest time to fracture (p < .05). Reciproc Blue and Univy 25/.04 exhibited the highest and lowest torque to fracture, respectively (p < .05). Univy 25/.04 and Reciproc Blue had the highest rotation angles, whilst E-Flex Rec 25/.06 showed the lowest angle (p < .05). The better cutting ability was observed with E-Flex Rec 25/.06, Procodile, Excalibur, and Reciproc Blue (p > .05). Reciproc R25 and E-Flex Rec showed the highest buckling resistance values (p < .05), with WaveOne Gold being the least flexible instrument. The impact of instruments' size and taper on wall shear stress and apical pressure did not follow a distinct pattern, although Univy 25/.04 and E-Flex Rec 25/.06 yielded the highest and lowest values for both parameters, respectively. CONCLUSIONS Low-tapered reciprocating instruments exhibit increased flexibility, higher time to fracture, and greater angles of rotation, coupled with reduced maximum bending loads and buckling strength compared to large-tapered instruments. Nevertheless, low-tapered systems also exhibit lower maximum torque to fracture and inferior cutting ability, contributing to a narrower apical canal enlargement that may compromise the penetration of irrigants in that region.
Collapse
Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Fernando Peña-Bengoa
- Department of Endodontics, School of Dentistry, Universidad Andres Bello, Viña del Mar, Chile
| | - Natasha C Ajuz
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Victor T L Vieira
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Jorge N R Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Duarte Marques
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Ricardo Pinto
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquimica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Mario Rito Pereira
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco A Versiani
- Oral Health Center, Brazilian Military Police, Minas Gerais, Brazil
| |
Collapse
|
2
|
Silva EJNL, Ajuz NC, Martins JNR, Antunes BR, Lima CO, Vieira VTL, Braz-Fernandes FM, Versiani MA. Multimethod analysis of 3 rotary instruments produced by electric discharge machining technology. Int Endod J 2023; 56:775-785. [PMID: 36942476 DOI: 10.1111/iej.13915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
AIM This study aimed to compare 3 rotary instruments produced by the EDM process with the heat-treated ProTaper Gold system regarding design, metallurgy, mechanical properties and shaping ability. METHODOLOGY HyFlex EDM (25/.~), Neoniti (25/.06), EDMax (25/.06), and ProTaper Gold (25/.08v) instruments (n=58 per group) were compared regarding design, metallurgy and mechanical performance. Unprepared canal areas were calculated for each system after preparation of mesiobuccal, mesiolingual and distal canals of mandibular molars (15 canals per group) using micro-CT technology. Statistical analyses were performed using One-way ANOVA post hoc Tukey and Kruskal-Wallis post hoc Dunn´s tests (α=5%). RESULTS All instruments had asymmetrical blades, no radial lands, no major defects, and almost equiatomic nickel/titanium ratios, but different cross-section designs, tip geometries, and surface appearances. Although instruments had distinct transformation temperature curves, they showed crystallographic martensitic arrangement at 21 °C and mixed austenite plus R-phase at body temperature. Neoniti and HyFlex EDM showed similar results in all mechanical tests (p>0.05), while EDMax and ProTaper Gold had similar time to fracture (p = 0.841), maximum bending load (p = 0.729), and cutting ability (p = 0.985). ProTaper Gold showed the highest torque to failure (p<0.001) and HyFlex EDM the lowest buckling resistance (p<0.001). Mean percentages of unprepared canal areas ranged from 20.4% to 25.7% in the mesial canals, and from 20.8% to 26.2% in the distal canal, with no statistical differences among systems (p>0.05). CONCLUSIONS Instruments' geometry and phase transformation temperatures influenced the results of the mechanical tests, but not their shaping ability.
Collapse
Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
- Departament of Endodontics, Fluminense Federal University (UFF), Rio de Janeiro, Brazil
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Natasha C Ajuz
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Bernardo R Antunes
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Carolina O Lima
- Department of Endodontics, Juiz de Fora Federal University (UFJF), Minas Gerais, Brazil
| | - Victor T L Vieira
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | - Marco A Versiani
- Oral Health Center, Brazilian Military Police, Minas Gerais, Brazil
| |
Collapse
|
3
|
Silva EJNL, Martins JNR, Ajuz NC, Dos Santos Antunes H, Vieira VTL, Braz-Fernandes FM, Belladonna FG, Versiani MA. Design, metallurgy, mechanical properties, and shaping ability of 3 heat-treated reciprocating systems: a multimethod investigation. Clin Oral Investig 2023; 27:2427-2436. [PMID: 36749411 DOI: 10.1007/s00784-023-04899-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to compare 3 reciprocating systems regarding design, metallurgy, mechanical properties, and shaping ability. MATERIALS AND METHODS New Reciproc Blue R25, WaveOne Gold Primary, and REX 25 instruments (n=41 per group) were analyzed regarding design, metallurgy, and mechanical performance, while shaping ability (untouched canal walls, volume of removed dentin, and hard tissue debris) was tested in 36 anatomically matched root canals of mandibular molars. Results were compared using one-way ANOVA post hoc Tukey and Kruskal-Wallis tests with a significant level set at 5%. RESULTS All instruments showed symmetrical cross sections with asymmetrical blades, no radial lands, no major defects, and an almost equiatomic nickel and titanium ratio. The highest R-phase start temperatures were observed with WaveOne Gold (46.1°C) and REX (44.8°C), while Reciproc Blue had the lowest R-phase start (34.5°C) and finish (20°C) temperatures. WaveOne Gold had the lowest time to fracture (169 s) and the highest maximum load (301.6 gf) (P <0.05). The maximum torque of Reciproc Blue (2.2 N.cm) and WaveOne Gold (2.1 N.cm) were similar (P >0.05), but lower than REX (2.6 N.cm) (P <0.05). No statistical differences were observed among instruments in the angle of rotation (P >0.05) and in the shaping ability in both mesial and distal canals (P >0.05). CONCLUSION Although the overall design, temperature transition phases and mechanical behavior parameters were different among tested instruments, they were similar in terms of shaping ability. CLINICAL RELEVANCE All tested heat-treated NiTi reciprocating systems showed similar shaping ability, without clinically significant errors.
Collapse
Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil. .,Departament of Endodontics, Fluminense Federal University (UFF), Niterói, RJ, Brazil. .,Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.
| | - Jorge N R Martins
- Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.,Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Natasha C Ajuz
- Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | | | | | - Francisco Manuel Braz-Fernandes
- CENIMAT/I3N, Department of Materials Science, NOVA School of Science and Technology, Universidade NOVA de Lisboa, Caparica, Portugal
| | | | | |
Collapse
|
4
|
Silva EJNL, Pinto KP, Ajuz NC, Sassone LM. Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies. Restor Dent Endod 2021; 46:e42. [PMID: 34513648 PMCID: PMC8411007 DOI: 10.5395/rde.2021.46.e42] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Objectives This study aimed to analyze the main features of the 25 most-cited articles in minimally invasive access cavities. Materials and Methods An electronic search was conducted on the Clarivate Analytics' Web of Science ‘All Databases’ to identify the most-cited articles related to this topic. Citation counts were cross-matched with data from Elsevier's Scopus and Google Scholar. Information about authors, contributing institutions and countries, year and journal of publication, study design and topic, access cavity, and keywords were analyzed. Results The top 25 most-cited articles received a total of 572 (Web of Science), 1,160 (Google Scholar) and 631 (Scopus) citations. It was observed a positive significant association between the number of citations and age of publication (r = 0.6907, p < 0.0001); however, there was no significant association regarding citation density and age of publication (r = −0.2631, p = 0.2038). The Journal of Endodontics made the highest contribution (n = 15, 60%). The United States had the largest number of publications (n = 7) followed by Brazil (n = 4), with the most contributions from the University of Tennessee and Grande Rio University (n = 3), respectively. The highest number of most-cited articles were ex vivo studies (n = 16), and ‘fracture resistance’ was the major topic studied (n = 10). Conclusions This study revealed a growing interest for researchers in the field of minimally invasive access cavities. Future trends are focused on the expansion of collaborative networks and the conduction of laboratory studies on under-investigated parameters.
Collapse
Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Karem Paula Pinto
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Natasha C Ajuz
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Luciana Moura Sassone
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| |
Collapse
|