Surface tension comparison of four common root canal irrigants and two new irrigants containing antibiotic

The aim of this study is to compare the surface tension of four common endodontic irrigants: Moltendo EDTA 17%, Cetrexidin, Smear Clear, Sodium hypochlorite 5.25%, with the surface tension of MTAD and Tetraclean. Freshly produced MilliQ water was used as a reference. All measurements were performed following the Wilhelmy plate technique, using a Cahn DCA-322 Dynamic Contact Angle Analyzer at the temperature of 22 degrees C. MilliQ water, sodium hypochlorite 5.25%, and EDTA 17% had the highest surface tension, whereas those of Cetrexedin and Tetraclean has shown the lowest surface tension value. Both new irrigants, MTAD and Tetraclean, are capable of removing the smear layer. Thanks to their low surface tension, increasing the intimate contact of irrigant solutions with the dentinal walls, they may permit deeper penetration.     

A Comparative Study of Smear Layer Removal and Erosion in Apical Intraradicular Dentine With Three Irrigating Solutions: A Scanning Electron Microscopy Evaluation

IntroductionThis study compared the efficacy of BioPure MTAD (Dentsply Tulsa, Tulsa, OK), 17% EDTA, and 42% citric acid in endodontic smear layer removal and degree of erosion in the apical third of endodontic canals.MethodsNinety-six extracted single-rooted human teeth were randomized into four groups (n = 24) and instrumented using System GT nickel-titanium rotary instruments (Dentsply Tulsa, Tulsa, OK). Each canal was irrigated with one of the following solutions: BioPure MTAD, 17% EDTA, 42% citric acid, or 5.25% NaOCl (control). Next, all specimens were irrigated with 5.25% NaOCl.ResultsEvaluation by scanning electron microscopy showed no significant differences among test irrigants in removing the smear layer. However, the efficacy of BioPure MTAD and 17% EDTA in removing the smear layer was significantly greater than 5.25% NaOCl (control). The erosive effects of irrigating solutions could not be evaluated.ConclusionsIn conclusion, the protocols used in this study were not sufficient to completely remove the smear layer in the apical third of prepared root canals.     

Effects of different irrigation solutions on root dentine microhardness,smear layer removal and erosion

This study aimed to compare the effects of different irrigants on root dentine microhardness, erosion and smear layer removal. A total of 72 root dentine slices were divided into six groups, according to the final irrigants used: Group 1: 17% ethylenediamine tetra‐acetic acid (EDTA) + 2.5% NaOCl, Group 2: 7% maleic acid (MA) + 2.5% sodium hypochloride (NaOCl), Group 3: 1.3% NaOCl + mixture of tetracycline, acid and detergent (MTAD), Group 4: Smear Clear + 2.5% NaOCl, Group 5: 5% NaOCl, Group 6: saline. Vickers microhardness values were measured before and after treatment. In total, 42 root‐halves were prepared for scanning electron microscope to evaluate the amount of smear and erosion in the coronal, middle and apical thirds. Data were analysed using two‐way anova , Duncan and two‐proportion z‐tests. Maleic acid showed the greatest reduction in dentine microhardness (P < 0.05), followed by EDTA and MTAD. EDTA, maleic acid, MTAD and Smear Clear removed smear layer efficiently in the coronal and middle thirds of root canal. However, in the apical region, maleic acid showed more efficient removal of the smear layer than the other irrigants (P < 0.05).     

Comparative evaluation of antimicrobial efficacy of sodium hypochlorite, MTAD, and Tetraclean against Enterococcus faecalis biofilm

The aim of this study was to compare the antimicrobial efficacy of 5.25% NaOCl, BioPure MTAD (Dentsply Tulsa Dental, Johnson City, TN), and Tetraclean (Ogna Laboratori Farmaceutici, Milano, Italy) against Enterococcus faecalis biofilm generated on cellulose nitrate membrane filters. After incubation, the membrane filters were transferred into tubes containing 5 mL of the selected antimicrobial solution test agent or NaCl 0.9% (positive control) and incubated for 5, 30, and 60 minutes at 20 degrees C. After each period of time, the test agents were vortexed for 60 seconds to resuspend the microorganisms. Ten-fold serial dilutions were generated in reduced transport fluid. Each dilution was plated onto a brain heart infusion plates. The plates were then incubated for 48 hours in an aerobic atmosphere at 37 degrees C and colony-forming units per membrane was calculated. Statistical analysis showed that only 5.25% NaOCl can disgregate and remove the biofilm at every time; however, treatment with Tetraclean caused a high degree of biofilm disgregation in every considered time intervals as compared with MTAD (T5 p < 0.05, T30 p < 0.01, and T60 p < 0.001).     

Evaluation of the antifungal activity of four solutions used as a final rinse in vitro

The aim of the study was to compare the antifungal activity of 1.3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), MTAD and Tetraclean as a final rinse against Candida albicans in a human tooth model in vitro. Ninety extracted human maxillary central and lateral incisor teeth were randomly divided into four groups each with 20 teeth, a positive and a negative control each with five teeth. After preparing the root canals, teeth were inoculated with Candida albicans (ATCC 10261) and incubated for 72 h. Teeth were divided into four experimental groups according to the irrigation solution as follows: NaOCl, CHX, MTAD and Tetraclean. After culturing aliquots from the experimental teeth on Sabouraud 4% dextrose agar, colony‐forming units were counted. The results showed that 1.3% NaOCl and 2% CHX were equally effective and significantly superior to MTAD and Tetraclean (P < 0.05). Furthermore, antifungal efficacy of Tetraclean was significantly superior to MTAD (P < 0.05).     

The antimicrobial effect of new and conventional endodontic irrigants on intra-orally infected dentin

Abstract

Objectives. To evaluate if the incorporation of antimicrobial compounds to chelating agents or the use of chelating agents with antimicrobial activity as 7% maleic acid and peracetic acid show similar disinfection ability in comparison to conventional irrigants as sodium hypochlorite or iodine potassium iodide against biofilms developed on dentin. Materials and methods. The total bio-volume of live cells, the ratio of live cells and the substratum coverage of dentin infected intra-orally and treated with the irrigant solutions: MTAD, Qmix, Smear Clear, 7% maleic acid, 2% iodine potassium iodide, 4% peracetic acid, 2.5% and 5.25% sodium hypochlorite was measured by using confocal microscopy and the live/dead technique. Five samples were used for each irrigant solution. Results. Several endodontic irrigants containing antimicrobials as clorhexidine (Qmix), cetrimide (Smear Clear), maleic acid, iodine compounds or antibiotics (MTAD) lacked an effective antibiofilm activity when the dentin was infected intra-orally. The irrigant solutions 4% peracetic acid and 2.5–5.25% sodium hypochlorite decrease significantly the number of live bacteria in biofilms, providing also cleaner dentin surfaces (p < 0.05). Conclusions. Several chelating agents containing antimicrobials could not remove nor kill significantly biofilms developed on intra-orally infected dentin, with the exception of sodium hypochlorite and 4% peracetic acid. Dissolution ability is mandatory for an appropriate eradication of biofilms attached to dentin.     

Antibacterial substantivity of a new antibiotic‐based endodontic irrigation solution

The aim of this study was to evaluate the residual antibacterial activity of Tetraclean, MTAD and 5.25% sodium hypochlorite (NaOCl) in bovine root dentin in vitro. One hundred and ten dentin tubes prepared from bovine incisor teeth were infected in vitro for 14 days with Enterococcus faecalis. Thereafter, the specimens were divided into five groups as follows: Tetraclean; MTAD; 5.25% NaOCl; infected dentin tubes (positive control); and sterile dentin tubes (negative control). Dentin chips were collected using round burs into tryptic soy broth and after culturing, the number of colony‐forming units (CFU) was counted. The number of CFU in all experimental groups was minimum after treatment, and the results obtained were significantly different from each other at any time period (P < 0.05). The Tetraclean group showed the most effective antibacterial action at all five experimental periods (P < 0.05). MTAD group showed the least antibacterial activity after treatment. However, at days 7, 14, 21 and 28 MTAD showed more effective antibacterial action than NaOCl. In each group, the number of CFU increased significantly by time‐lapse (P < 0.05). In conclusion, the residual antibacterial activity of Tetraclean was significantly greater than MTAD and 5.25% NaOCl.     

The effect of QMix, an experimental antibacterial root canal irrigant, on removal of canal wall smear layer and debris

Introduction

This study examined the ability of two versions of QMix, an experimental antimicrobial irrigant, on removal of canal wall smear layers and debris using an open canal design.

Methods

Cleaned and shaped single-rooted human root canals were irrigated with NaOCl as the initial irrigant and one of the following as the final irrigant: (1) QMix I (pH = 8), (2) QMix II (pH = 7.5), (3) distilled water, (4) 17% EDTA, and (5) BioPure MTAD (Dentsply Tulsa Dental Specialties, Tulsa, OK). Smear and debris scores were evaluated in the coronal, middle, and apical thirds of longitudinally fractured canal spaces using scanning electron microscopy and analyzed using Cochran-Mantel-Haenszel statistic.

Results

Smear scores, when the overall canal was considered, differences were observed among groups except groups 1 versus 4 and groups 2 versus 4. After adjusting for canal levels, all groups differed significantly from each other (p < 0.005) with the exception of groups 2 versus 5. For the debris scores, no significant difference was observed among the treatment groups when the overall canal was considered and after adjusting for the effect of canal level.

Conclusion

Within the limitations of an open-canal design, the two experimental QMix versions are as effective as 17% EDTA in removing canal wall smear layers after the use of 5.25% NaOCl as the initial rinse.     

Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms

The aim of this study was to compare the efficacy of root canal irrigants against E. faecalis biofilms using a novel in vitro testing system. Biofilms grown in a flow cell system were submerged in test irrigants for either 1 or 5 minutes. Statistical analysis revealed a significant relationship between test agent and percentage kill of the biofilm bacteria (P < 0.05). No statistically significant relationship between time and percentage kill was found. The percentage kill of the biofilm bacteria was: 6% NaOCl (>99.99%), 1% NaOCl (99.78%), Smear Clear (78.06%), 2% chlorhexidine (60.49%), REDTA (26.99%), and BioPure MTAD (16.08%). Post-hoc analysis showed a significant difference between 1% and 6% NaOCl, and all other agents including Smear Clear, 2% chlorhexidine, REDTA, and BioPure MTAD (P < 0.05). Within the parameters of this study, both 1% NaOCl and 6% NaOCl were more efficient in eliminating E. faecalis biofilm than the other solutions tested.     

Effect of MTAD on flexural strength and modulus of elasticity of dentin

The purpose of this study was to evaluate the effect of MTAD on the flexural strength and modulus of elasticity of dentin. Dentin bars were randomly assigned to eight groups treated with various concentrations of NaOCl (5.25%, 2.65%, 1.31%, 0.66%), 17% EDTA, MTAD, saline, or according to a clinical protocol with 1.3% NaOCl and then 5 min of MTAD. Specimens were subjected to flexural strength and modulus of elasticity tests. Two-sample t test (alpha = 0.05) showed no statistically significant differences between various groups except for a reduction in flexural strength for the 2-h MTAD group (p = 0.002) and the EDTA group (p = 0.002). A significant reduction of modulus of elasticity for the 2-h MTAD group (p < 0.001), EDTA group (p < 0.001), and 0.6% NaOCl (p < 0.002) also was noted. There was no significant difference in flexural strength and modulus of elasticity between the dentin bars exposed to saline or MTAD when applied according to the clinical protocol (p > 0.05). These results indicate that MTAD can be used as prescribed for clinical use without affecting the physical properties of the dentin.     

Soft chelating irrigation protocol optimizes bonding quality of Resilon/Epiphany root fillings

This study was designed to test the impact of either a strong (MTAD) or a soft (1-hydroxyethylidene-1, 1-bisphosphonate [HEPB]) chelating solution on the bond strength of Resilon/Epiphany root fillings. Both 17% EDTA and the omission of a chelator in the irrigation protocol were used as reference treatments. Forty extracted human upper lateral incisors were prepared using different irrigation protocols (n = 10): G1: NaOCl, G2: NaOCl + 17% EDTA, G3: NaOCl + BioPure MTAD (Dentsply/Tulsa, Tulsa, OK), and G4: NaOCl + 18% HEPB. The teeth were obturated and then prepared for micropush-out assessment using root slices of 1 mm thickness. Loading was performed on a universal testing machine at a speed of 0.5 mm/min. One-way analysis of variance and Tukey multiple comparisons were used to compare the results among the experimental groups. EDTA- and MTAD-treated samples revealed intermediate bond strength (0.3-3.6 MPa). The lowest bond strengths were achieved in NaOCl-treated samples (0.3-1.2 MPa, p < 0.05). The highest bond strength was reached in the HEBP-treated samples (3.1-6.1 MPa, p < 0.05). Under the present in vitro conditions, the soft chelating irrigation protocol (18% HEBP) optimized the bonding quality of Resilon/Epiphany (Resilon Research LLC, Madison, CT) root fillings.     

Effect of EDTA with and without surfactants or ultrasonics on removal of smear layer

This study compared the in vitro efficacy of Smear Clear (Sybron Endo, CA), a 17% ethylenediaminetetraacetic acid (EDTA) solution with surfactants, to 17% EDTA, with and without the use of ultrasonics, in removal of the smear layer. Seventy-five extracted teeth, randomly distributed into 5 test groups, were prepared by using ProFile rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland) and subjected to different final irrigating regimes; group A, 1% sodium hypochlorite; group B, 17% EDTA; group C, 17% EDTA with ultrasonics; group D, Smear Clear; and group E, Smear Clear with ultrasonics. Samples were examined under the scanning electron microscope and scored for debris and smear layer removal. Statistical analysis showed that groups D and E did not perform significantly better than groups B and C. Group C performed significantly better than group B. Addition of surfactants to EDTA in Smear Clear did not result in better smear layer removal. The use of ultrasonics with 17% EDTA improved smear layer removal.     

The effects of calcium hydroxide removal methods on bond strength of Epiphany SE with two irrigation protocols

Abstract

Objective: The purpose of this study was to compare the effects of five calcium hydroxide removal methods on the bond strength of Epiphany SE sealer after canal irrigation with NaOCl+EDTA or NaOCl+MTAD. Materials and methods: The 120 roots were instrumented by using the ProTaper rotary system under irrigation with 2.5% sodium hypochlorite and randomly divided into two major groups according to the final irrigation: 1.3% NaOCl + MTAD and 5% NaOCl + 17% EDTA. For controls, 10 roots from each of the final irrigations with NaOCl + MTAD and NaOCl + EDTA (20 roots) were not filled with Ca(OH)₂. The intra-canal paste, Ca(OH)₂ was applied to each of the 100 remaining roots and stored at 37°C for 7 days. Each group was sub-divided into five sub-groups (n = 10) according to the removal technique for the intra-canal dressing: Group-1: recapitulation with size 30 K file + 3 ml of saline solution, Group-2: recapitulation with size 30 K file + 3 ml of 5% NaOCl, Group-3: using 5% NaOCl + 17% EDTA, Group-4: using 5%NaOCl + 15% citric acid, and Group-5: using 1.3% NaOCl + 5 ml MTAD. The root canals were filled with Resilon and Epiphany SE sealer. The bond strength was measured. Results: The mean bond strength of Epiphany SE to root dentine irrigated with NaOCl + MTAD was lower than that of NaOCl + EDTA. The highest bond strengths were 3.31 ± 0.057 and 2.60 ± 0.054 in the NaOCl + citric acid group when Ca(OH)₂ was applied to roots treated with NaOCl + EDTA and NaOCl + MTAD, respectively (p < 0.05). Conclusion: For root canals treated with NaOCl + EDTA or NaOCl + MTAD, the use of NaOCl + chelating agent for Ca(OH)₂ removal does not adversely affect the bond strength of Epiphany SE to dentin.     

The antimicrobial effect of MTAD: an in vitro investigation

Pulp and periradicular diseases are of microbial origin. To effectively clean the root canal system a disinfecting agent must be able to penetrate into difficult-to-reach areas and kill microorganisms with minimal damage to the host tissues. The purpose of this investigation was to test the ability of a mixture of a tetracycline isomer, an acid, and a detergent (MTAD) to kill Enterococcus faecalis and compare its efficacy to that of sodium hypochlorite (NaOCl) and ethylene diamine tetraacetic acid (EDTA). The zones of inhibition and minimum inhibitory concentrations were measured for these solutions. Measurement of zones of inhibition and determination of the minimum inhibitory concentrations showed that MTAD is as effective as 5.25% NaOCl and significantly more effective than EDTA (p < 0.0001). Furthermore, MTAD is significantly more effective in killing E. faecalis than NaOCl when the solutions are diluted (p < 0.0001). Measurement of the minimum inhibitory concentrations demonstrated that although MTAD is still effective in killing E. faecalis at 200x dilution, NaOCl ceases to exert its antibacterial activity beyond 32x dilution. EDTA did not exhibit any antibacterial activity. Based on the results of this study, it seems that MTAD is an effective solution in eradicating E. faecalis.     

The Effect of Endodontic Irrigants on the Microtensile Bond Strength of Dentin Adhesives

IntroductionThe purpose of this study was to evaluate the microtensile bond strength of a total etch (XP-Bond) and a self-etch (Clearfil SE Bond) adhesive system to dentine surfaces treated using endodontic irrigants.MethodsTwenty-four freshly extracted third molars were used. After creating a smear layer on the coronal midthird portion of the crowns, the teeth were divided into three groups and surfaces were irrigated with distilled water, 5.25% NaOCl + 17% EDTA, and 1.3% NaOCl + BioPure MTAD, respectively. Each group was divided into two subgroups, and a self-etching adhesive and an etch-and-rinse adhesive were applied respectively. The teeth were restored with a composite material and sectioned to produce sticks for microtensile bond testing.ResultsThe microtensile bond strength of the MTAD + Clearfil SE group was found to be significantly lower than the microtensile bond strength of the distilled water + Clearfil SE Bond group and the NaOCl, EDTA, + Clearfil SE Bond group (p = 0.0001, p = 0.009).ConclusionsBecause of the significant reduction of Clearfil SE Bond to coronal dentine after MTAD application, an etch-and rinse adhesive such as XP-Bond may be preferred if this irrigant has been chosen during endodontic treatment.     

The effect of Morinda Citrifolia juice as an endodontic irrigant on smear layer and microhardness of root canal dentin

PurposeThe purpose of this study was to evaluate the effect of Morinda Citrifolia Juice (MCJ) on smear layer removal and microhardness value of root canal dentin in compared with various endodontic irrigants.Material and methodsEighty-four single-rooted human teeth were prepared to apical size of #35. Since decoronation, samples were divided into seven groups of 12 in each (n = 12). Specimens were finally irrigated by either 1: 2.5% NaOCl, 2: 6% MCJ, followed by a final flush of 17% ethylene diaminetetraacetic acid (EDTA), 3: 6% MCJ, 4: 2.5% NaOCl then17% EDTA, 5: MTAD, 6: 2% chlorhexidine (CHX), and 7: saline. After irrigation, all samples were subjected to Vickers microhardness test at 100 and 500-μm depths and then were examined under scanning electron microscopy (SEM) and ImageJ program was used to calculate open dentinal tubules. One way ANOVA and post hoc Tukey tests were used to reveal any significant differences among and between groups respectively.ResultsThe microhardness values at 100 μm and 500 μm for MTAD were significantly lower than for NaOCl + EDTA and MCJ + EDTA groups (p < 0.05). MCJ + EDTA, NaOCl + EDTA, and MTAD protocol significantly removed smear layer in compared with control group (p < 0.05), with no significant differences among these three groups.ConclusionsIt was concluded that 6% MCJ followed by a final flush of 17% EDTA can be regarded as an effective solution on smear layer removal without any adverse influence on microhardness property of root canal dentin.     

Effect of Smear Layer against Disinfection Protocols on Enterococcus faecalis–infected Dentin

IntroductionThis study examined the effect of the smear layer on the antibacterial effect of different disinfecting solutions in infected dentinal tubules.MethodsCells of Enterococcus faecalis were forced into dentinal tubules according to a previously established protocol. After a 3-week incubation period of infected dentin blocks, a uniform smear layer was produced. Forty infected dentin specimens were prepared and subjected to 3 and 10 minutes of exposure to disinfecting solutions including sterile water, 2% and 6% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), 17% EDTA, and QMiX (Dentsply Tulsa Dental, Tulsa, OK). The following combinations were also included: 2% NaOCl + 2% CHX, 2% NaOCl + QMiX, 6% NaOCl + QMiX, and 6% NaOCl + 17% EDTA + 2% CHX. Four other dentin specimens similarly infected but with no smear layer were subjected to 3 minutes of exposure to 2% CHX and 6% NaOCl for comparison. Confocal laser scanning microscopy and viability staining were used to analyze the proportions of dead and live bacteria inside the dentin.ResultsIn the presence of a smear layer, 10 minutes of exposure to QMiX, 2% NaOCl + QMiX, 6% NaOCl + QMiX, and 6% NaOCl + 17% EDTA + 2% CHX resulted in significantly more dead bacteria than 3 minutes of exposure to these same disinfecting solutions (P < .05). No statistically significant difference between 3 and 10 minutes was found in other groups (P > .05); 6% NaOCl + QMiX and 6% NaOCl + 17% EDTA + 2% CHX showed the strongest antibacterial effect. In the absence of a smear layer, 2% CHX and 6% NaOCl killed significantly more bacteria than they did in the presence of a smear layer (P < .05).ConclusionsThe smear layer reduces the effectiveness of disinfecting agents against E. faecalis in infected dentin. Solutions containing 6% NaOCl and/or QMiX showed the highest antibacterial activity.     

An In Vitro Comparison of New Irrigation and Agitation Techniques to Ultrasonic Agitation in Removing Bacteria From a Simulated Root Canal

IntroductionThis in vitro study compared 3 agitation and 2 irrigation devices to ultrasonic agitation at mechanically removing bacteria from a plastic simulated canal, instrumented to 35/.06.MethodsThe plastic blocks were divided into seven groups. The control (C) group with brain-heart infusion (BHI) broth (sterile) received only needle irrigation. The remaining groups were incubated with BHI inoculated with Enterococcus faecalis. Irrigation and agitation techniques were ultrasonic, needle irrigation, EndoVac irrigation (Smart Endodontics; Discus Dental, Culver City, CA), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK), F-File (Plastic Endo, Lincolnshire, IL), and sonic. Sterile water was the irrigant in all treatments. Remaining bacteria were stained with 0.1% crystal violet. The crystal violet was extracted using a detergent and measured spectrophotometrically.ResultsThe results of this study show that ultrasonic agitation was not significantly different (p > 0.05, Tukey test) from the control. There was no significant difference (p > 0.05, Tukey test) between the ultrasonic agitation and the use of EndoActivator, F-File, and sonic agitation. Ultrasonic agitation was significantly more effective at removing bacteria than needle irrigation and EndoVac irrigation (p < 0.05, Tukey test).ConclusionIn a plastic simulated canal, ultrasonic agitation was significantly more effective than needle irrigation and EndoVac irrigation at removing intracanal bacteria. Ultrasonic, EndoActivator, F-File, and sonic agitation are similar in their ability to remove bacteria in a plastic simulated canal.     

Effect of endodontic irrigants on the shear bond strength of epiphany sealer to dentin

This study examined the effects of commonly employed endodontic irrigants on Epiphany-dentin bond strengths. Smear layers were created on dentin discs obtained from human third molars. Five groups of 10 discs each were treated with one of the following: (a) water; (b) 2% chlorhexidine; (c) 6% sodium hypochlorite (NaOCl); (d) 6% NaOCl followed by EDTA and water; or (e) 1.3% NaOCl followed by MTAD. The treated surfaces were air-dried and treated with Epiphany primer. Hollow steel tubes were placed on the dentin surfaces, and Epiphany sealer was applied to dentin inside the tubes. Samples were tested for shear bond strengths after 7 days of storage. Representative specimens were examined using scanning electron microscopy. One-way ANOVA and Tukey's test revealed significant differences among the groups (p<0.05). Using water or chlorhexidine as an irrigant resulted in significantly lower bond strengths when compared with NaOCl, NaOCl/EDTA, or NaOCl/MTAD. Neither EDTA nor MTAD significantly improved Epiphany-dentin bond strengths when compared with NaOCl used alone.     

Micro–computed Tomographic Assessment and Comparative Study of the Shaping Ability of 6 Nickel-Titanium Files: An In Vitro Study

IntroductionThis research studies and compares the shaping ability of WaveOne Gold (WG; Dentsply Tulsa Dental Specialties, Tulsa, OK), the Reciproc Blue (RB; VDW, Munich, Germany), TRUShape (TS, Dentsply Tulsa Dental Specialties), XP-endo Shaper (XP; FKG, La Chaux-de-Fonds, Switzerland), iRace (IR, FKG), and TruNatomy (TN; Dentsply Sirona, Ballaigues, Switzerland) in the preparation of moderately curved canals and using micro–computed tomographic technology.MethodsSixty lower molars with 2 mesial canals were randomly distributed into 6 groups of 10 molars and 20 canals per group (n = 20). Specimens were scanned before and after preparation using the SkyScan 1275 (Bruker microCT, Kontich, Belgium). Group 1 was treated with WG, group 2 with RB, group 3 with TS, group 4 with XP, group 5 with IR, and group 6 with TN. After instrumentation, researchers quantified the changes produced in the canal geometry in terms of surface, volume, structure thickness, surface convexity index, structure model index, percentage of surface touched, and centroids. Wilcoxon and analysis of variance tests were performed to compare the values before and after preparation and the differences between groups. The significance level was established at 5%.ResultsThere were no significant differences between WG and RB (P > .05) and between TN and XP (P > .05). TN had significant differences with WG, RB, TS, and IR (P < .05). All the files produced similar apical transportation (P > .05).ConclusionsWG and RB and TN and XP had similar shaping effectivity. TS and WG touched the highest percentages of canal surfaces (81% and 73%, respectively) but produced the biggest changes in the canal anatomy. TN and XP better kept the canal anatomy, but TN touched the lowest percentage of canal surface (50%). All the files used were able to clean and to shape moderately curved canals with minimal apical transportation.