Comparison of two stainless steel files to shape simulated root canals

The aim of this study was to compare the shaping ability of two stainless steel files using simulated canals. A total of 80 simulated canals of various angles and positions of curvature were prepared by hand using either Mani K-Files or Micro Mega K-Files. Following orifice enlargement each file type was used to prepare 40 canals employing a linear filing motion and an anticurvature stepback technique. Pre- and post-operative longitudinal images of the canals were taken with a video camera and stored and manipulated in a computer with image analysis software. The presence of canal aberrations and the amount of material removed as a result of preparation were determined from composite images of superimposed pre- and post-operative views. Overall, canal preparation with Mani K-Files was significantly quicker (P7<0.0O5) and was associated with fewer instrument failures. Zips and elbows were observed in 70% of specimens with significantly more (P<0.05) occurring following preparation with Micro Mega K-Files. Mani K-Files created significantly more (P<0.01) danger zones. Micro Mega K-Files created significantly wider (P<0.001) zips with significantly more (P<0.01) resin removed from the outer aspect of the curves and, thus, significantly more (P<0.01) transportation. Canal shape had a significant influence on preparation time (P<0.001), the incidence of zips (P<0.05) and danger zones (P<0.005), the width of zips (P<0.001) and transportation at the zips (P<0.001). Under the conditions of this study, Mani K-Files were more effective than Micro Mega K-Files and produced canals with better shapes. Original canal shape had a substantial influence on the outcome of shaping procedures.     

Comparison of six files to prepare simulated root canals. Part 1

A total of 300 simulated root canals of various angles and positions of curvature in clear resin blocks were prepared by hand using either K-files, K-Flex files, Flexofiles, Flex-R files, Hedstrom files or Unifiles. Each file type was used to prepare 50 canals employing a linear filing motion and an anticurvature stepback technique. Part 1 of this two-part report describes the efficacy of the files in terms of preparation time, instrument failure, loss of canal length and weight loss from the blocks. Two-way analysis of variance confirmed that there was significant variation for each parameter between instruments, between canal types, and with interaction between instruments and canal types. Overall, preparation with Hedstrom files was significantly quicker than with any other file, whilst preparation with K-files and K-Flex files took significantly longer. Fracture and deformation of instruments occurred substantially less often with Flex-R and Hedstrom files, but significantly more often with Unifiles. Loss of working distance occurred with all file types, but was significantly greater in canals prepared with K-files. Unifiles and Hedstrom files were responsible for significantly more weight loss than the other files, whilst K-files produced significantly less weight loss. Canals with rough undulating walls were created most often by Hedstrom files and Unifiles. Overall, under the conditions of this study, Flexofiles, Flex-R files and Hedstrom files appeared to be substantially more effective than K-files, K-Flex files and Unifiles.     

Shaping of curved root canals instrumented with stainless steel and nickel titanium files

The cleaning efficiency and the quality of the surgical preparation is mainly conditioned by root canal anatomy, the instruments and the technique employed. The purpose of the present study was to evaluate the extent of straightening of curved root canals and the changes in endodontic anatomy caused by the use of Flex-R, Onyx-R and Nitiflex files with the balanced forces technique. Sixty mandibular molars were selected for evaluation of angulation and transportation. Pre and post instrumentation radiographs were taken of the mesiodistal and buccolingual aspects of each tooth. The radiographs were projected on a transparent sheet, the contours of each tooth and file were outlined and the canal curvature was measured. Pre and post instrumentation tracings were overlaid and the extent of transportation was measured with a micrometric caliper. Statistical analysis of the data was performed employing Student's "t" test, Analysis of Variance and Bonferroni's test. The results showed that all the instruments reduced canal curvature significantly. Transportation in the mesiodistal direction did not reach statistical significance whereas transportation in the buccolingual direction was statistically significant.     

Shaping ability of .04 and .06 taper ProFile rotary nickel–titanium instruments in simulated root canals

AIM: The aim of this study was to determine the shaping ability of ProFile .04 and .06 taper rotary nickel-titanium instruments in simulated canals. METHODOLOGY: A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared using the 'crowndown' approach recommended by the manufacturer. Pre-operative pictures of each canal were recorded on optical discs using an image analysis package. The simulated canals were prepared and postoperative pictures superimposed on the original images. RESULTS: No instrument fractures occurred and none deformed; none of the canals became blocked with debris. Change in working distance was, on average, 0.063 mm with 33 canals retaining the correct length. Overall, five zips (12.5%) were created and 24 (60%) canals demonstrated a widened area on the outer aspect of the canal between the end-point and the curve. Two danger zones (5%) were created and two perforations but no ledges were found. Between canal shapes there were highly significant differences (P < 0.0001) for the incidence of zips and elbows but not for the other aberrations. There were highly significant differences (P < 0.0001) for the total width of the canals between the various canal shapes at the apex of the curve, the beginning of the curve and half way to the orifice, and a significant difference (P < 0.05) at the end-point. There were highly significant differences (P < 0.0001) for the amount of resin removed from the outer aspect of the curve at the end-point and at the beginning of the curve, and significant differences (P < 0.05) at the apex of the curve and half way to the orifice. There were highly significant differences (P < 0.0001) for the amount of resin removed from the inner aspect of the curve at the beginning of the curve and half way to the orifice. Overall, transportation was towards the outer aspect of the canal except at the beginning of the curve. CONCLUSIONS: Under the conditions of this study the combined use of .04 and .06 taper ProFile instruments was rapid, effective and produced good canal shapes except in those specimens with short curves that began near the end-point.     

Effectiveness of different endodontic files for preparing curved root canals: a scanning electron microscopic study

Abstract In this study, the effect of using four endodontic files from different manufacturers on the final shape of 80 prepared curved root canals of extracted single-rooted teeth were comparatively analyzed with scanning electron microscopy. The instruments tested were Tri-files, Flex-R files, Flexofiles and conventional K-type files. All files were used with in and out linear movements with a circumferential motion starting with a size 15 file. Final preparation of the apical thirds was performed with a size 30 file. Shaping effectiveness of the tested files was qualitatively evaluated in terms of respect for conservation of the apical constriction and the presence or absence of ledging, specially in the apical third of the root canals. A well-centered and tapered preparation without apical transportation or ledging was detected when Tri-file or Flex-R files were used. Conversely, the use of Flexofile or conventional K-type files resulted in frequent alteration of the initial pattern of the root canals, showing an hourglass preparation with alteration of the apical constriction and ledge formations.     

Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: Part 1

AIM: To determine the general efficacy and shaping ability of Hero 642 nickel-titanium rotary instruments during the preparation of simulated canals. Part 1 of this two-part report describes the efficacy of the instruments in terms of three-dimensional canal form. METHODOLOGY: A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by Hero 642 instruments using a crown-down preparation sequence. The efficacy of the instruments was assessed in terms of preparation time, instrument failure, canal blockages and loss of canal length. Intra-canal impressions were taken of the prepared canals in order to assess three-dimensional canal form. RESULTS: The mean time for canal preparation was 8.6 min and was influenced significantly (P < 0.05) by canal shape. Two instruments fractured and eight instruments deformed; significant differences were observed between canal shapes (P < 0.05). All of the canals remained patent. Fifteen canals (39.5%) maintained the correct working distance, 15 lost distance and eight canals gained length. Examination of intracanal impressions demonstrated that the majority of canals (79%) had apical stops; canal shape had a significant influence (P < 0.001) on the quality of apical stops. With one exception all canals had smooth canal walls and all of the canals showed good flow characteristics. Taper was poor in 30 canals (79%) and good in eight canals (21%). CONCLUSIONS: Hero 642 rotary nickel-titanium instruments prepared simulated canals rapidly but with a three-dimensional form that lacked adequate taper.     

The use of computed tomography when comparing nickel-titanium and stainless steel files during preparation of simulated curved canals

AIM: The aim of this study was to compare canal preparations completed with Hedstrom and K-files of ISO size 15 - 40, made of nickel-titanium (Ni-Ti) and stainless steel (SS). METHODOLOGY: Eighty simulated canals with 200 and 30 degrees C curvatures were prepared using the step-back technique and quarter turn/pull instrument manipulation. Middle and apical level canal sections were taken using computed tomography. RESULTS: No significant difference was found between any of the file types at either level with respect to canal curvature (20 degrees or 30 degrees). At the middle level, the stainless steel files caused more enlargement toward the inner part, compared to nickel-titanium files. At the apical level, nickel-titanium canal files caused more enlargement toward the inner part, whereas more outward enlargement was caused by stainless steel instruments. No significant difference could be observed at the middle level (P > 0.05) related to the enlargement toward the outer side of the canal curvature. Transportation at both levels was significantly less (P < 0.001) for the Ni-Ti files than the SS ones. Centring ratios of the file types at the middle level were low, but not significantly different (P > 0.05), whereas at the apical level the centring ratios were significantly higher for the Ni-Ti files (P < 0.001). CONCLUSIONS: Ni-Ti instruments produced preparations with adequate enlargement, less transportation, and a better centring ratio.     

A comparison of stainless steel and nickel-titanium K-files in curved root canals

The purpose of this study was to determine the effects of hand instrumentation using traditional stainless steel K-files and nickel-titanium K-files on the final shape of curved root canals. A total of 24 moderately curved canals in the mesial roots in extracted human mandibular first molars were randomly divided into two groups. These were instrumented manually using either stainless steel or nickel-titanium, K-files with the stepdown technique. The cross-sectional shape of each canal at three different horizontal levels were captured, before and after instrumentation, into a computer for comparison using image analyser software. Three parameters at each level were evaluated: (i) amount of dentine removed; (ii) least remaining dentine thicknesses on mesial and furcal aspects; and (iii) the amount and direction of canal transportation. The results showed that the two file types removed similar amounts of dentine at all three levels examined. The nickel-titanium files left a thicker layer of dentine on both the mesial and furcal aspects than stainless steel files. However, the difference was not significant (pooled T-test, P > 0.05). Both types of files transported the centre of the canals but the nickel-titanium instrument seemed to be safer because of the reduced amount of transportation towards the danger areas.     

The standardized-taper root canal preparation--part 6. GT file technique in abruptly curved canals

AIM: To describe the application of GT files in roots with abrupt curvatures. SUMMARY: Most dentists interpret obstructions to instrument progress as calcification, rather than abrupt curvature. Basically, there are not any apically calcified canals, only clinicians who are not clever enough or patient enough to sneak to patency. Dentists should be on their guard and sensitive to the 'rubber band' sensation of residual pulp tissue, and the 'loose resistance' sensation of the curved or ledged canal. Residual pulp tissue should be removed and the canal lubricated. The ledged or curved canal will only be helped by file bending. The size 10 file test is the key to identify canals requiring pre-bent instruments.The canal should first be flared short of the obstruction, before shaping the canal after it with regular, pre-bent K-files. Pre-bent GT hand-files can then be used with care to blend the apical and more coronal regions for final shape. Cone-fit may then require chilling and pre-bending GP cones (pre-bend more than one), before packing the canal. KEY LEARNING POINTS: Root canals do not calcify apically. File progress is prevented by pulp tissue, abrupt curvatures or ledging. Loose resistance to the passage of a size 10 file shows the canals that require instrument pre-bending. This test should be repeated at intervals during the preparation. Even NiTi GT files can be pre-bent for use in abrupt curves. Gutta percha cones can be pre-bent after chilling.     

不锈钢K锉预备弯曲根管时根管不良形态形成的实验研究

目的:探讨弯曲根管预备时根管不良形态形成的特点与规律。方法:使用手用不锈钢K锉,按逐步后退法预备8个弯曲人工根管,根管预备过程中对根管及根尖孔进行微距摄影,用图像分析软件Image-ProPlus对根管的形态与位置变化进行测量、分析;实验数据采用SPSS10.0统计软件包进行统计学分析,选用配对t检验比较组间差异。结果:根管预备完毕,根管弯曲角度均值从预备前的36.21°(Schneider法)逐渐减小至21.98°,弯曲半径均值从6.28mm增大至11.35mm;根管长轴发生了偏移,与预备前原根管长轴形成2个交点,3个相交区。根管的连续锥度被破坏,并出现一系列预备缺陷。结论:弯曲根管预备时,根管器械在弯曲应力与切削力的共同作用下发生动态的根管偏移,是导致一系列根管不良形态的根本原因。     

Shaping ability of ProFile rotary nickel-titanium instruments with ISO sized tips in simulated root canals: Part 2

The aim of this study was to determine the shaping ability of ProFile 0.04 taper rotary nickel-titanium instruments with ISO sized tips in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by ProFile instruments using the 'crown down' approach recommended by the manufacturer. Part 2 of this two-part report describes the efficacy of the instruments in terms of prevalence of canal aberrations, the amount and direction of canal transportation and the overall post-operative shape. Out of 37 completed specimens 9 zips (24%) and one ledge (3%) were created, but no perforations or danger zones were found. There were significant differences ( P < 0.01) between canal shapes for the incidence of zips and elbows but not for their distance from the end-point of preparation. At specific positions along the canal length there were significant differences between the canal types in terms of their mean total width; overall, at the end-point of preparation and along the curved portion of the canals those specimens with 40° curves were widest. This trend continued for the width of material removed from the outer aspect of the canal curves, whereas along the inner aspect of curves more material was removed in the 20° canals. Overall, transportation was towards the outer aspect of the curve at the end-point of preparation and along the curved portion of canals but more balanced along the straight coronal section. Absolute transportation was small and below 0.1 mm at every position including the zips. Under the conditions of this study, ProFile nickel-titanium rotary instruments with ISO sized tips produced a larger number of zips than expected; however, the degree of zipping was limited and relatively minor.     

Root canal shaping with manual stainless steel files and rotary Ni-Ti files performed by students

AIM: To investigate root canal shaping with manual stainless steel files and rotary Ni-Ti files by students. METHODOLOGY: Two hundred and ten simulated root canals with the same geometrical shape and size in acrylic resin blocks were prepared by 21 undergraduate dental students with manual stainless steel files using a stepback technique or with rotary Ni-Ti files in crown-down technique. Preparation length, canal shape, incidence of fracture and preparation time were investigated. RESULTS: Zips and elbows occurred significantly (P < 0.001) less frequently with rotary than with manual preparation. The correct preparation length was achieved significantly (P < 0.05) more often with rotary Ni-Ti files than with manual stainless steel files. Fractures occurred significantly (P < 0.05) less frequently with hand instrumentation. The mean time required for manual preparation was significantly (P < 0.001) longer than that required for rotary preparation. Prior experience with a hand preparation technique was not reflected in an improved quality of the subsequent engine-driven preparation. CONCLUSIONS: Inexperienced operators achieved better canal preparations with rotary Ni-Ti instruments than with manual stainless steel files. However, rotary preparation was associated with significantly more fractures.     

Shaping ability of Profile rotary nickel-titanium instruments with ISO sized tips in simulated root canals: Part 1

The aim of this study was to determine the shaping ability of ProFile 0.04 taper rotary nickel-titanium instruments with ISO sized tips in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by ProFile instruments using the 'crown down' approach recommended by the manufacturer. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, loss of canal length and three-dimensional canal form. The time necessary for canal preparation was on average 5.2 min and was not influenced significantly by canal shape. Three instrument fractures occurred and a further 3 instruments deformed; size 35 instruments failed the most (4) followed by size 30 (2), four of the failures occurred in canals with 40° curves. None of the canals became blocked with debris and change in working distance was minimal. Intra-canal impressions of canal form demonstrated that most canals had apical stops and smooth canal walls whereas all canals had good flow and taper. Under the conditions of this study, ProFile 0.04 taper rotary nickel-titanium instruments with ISO sized tips prepared simulated canals rapidly and created good three-dimensional form.     

Preparation of curved root canals with rotary FlexMaster instruments compared to Lightspeed instruments and NiTi hand files

AIM: To compare the recently introduced rotary FlexMaster instruments with Lightspeed instruments and NiTi hand files in preparing curved root canals. METHODOLOGY: Root canals of extracted molars were shaped with rotary FlexMaster instruments ('FM': n = 45), Lightspeed instruments ('LS': n = 46), and NiTi hand files (n = 45) using the balanced-force technique. The apical preparation size was 40. Root canal instrumentation was carried out in a phantom head under clinical conditions. A re-assembly technique allowed a comparison of the canal outline before and after preparation. Root sections 2.5 mm short of working length were used to calculate the percentage of prepared canal outline (= PPO) and the amount of root canal transportation. Loss of working length, fracture rate and time spent on complete preparation were also recorded. RESULTS: The highest PPO values were found in the LS group (mean = 63% [95% CI: 55%; 70%]). Although not statistically significant, lower PPO values were detected for FM instruments (mean = 55% [95% CI: 49%; 62%]) and for hand files (mean = 53% [95% CI: 47%; 59%]). The incidence of root canal transportation exceeding 0.1 mm was significantly lower in the LS group than in the FM group. Loss of working length of 0.5 mm occurred in five cases (LS group: 4x; FM group: 1x). Two LS instruments fractured. Half the time was needed for root canal preparation with FM instruments than with hand files. CONCLUSIONS: Rotary FM instruments are suitable for preparing curved root canals. They provided results similar to LS instruments with minimal risk of instrument fracture but increased risk of root canal transportation.     

Shaping ability of Quantec Series 2000 rotary nickel-titanium instruments in simulated root canals: Part 1

The aim of this study was to determine the shaping ability of Quantec Series 2000 nickel-titanium instruments in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by Quantec instruments using the technique recommended by the manufacturer. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, change in canal length and three-dimensional canal form. The time necessary for canal preparation was on average 5.7 min and was significantly influenced ( P < 0.01) by canal shape. One instrument fractured and three size nine instruments deformed; however, canal shape did not influence significantly instrument failure. All of the canals remained patent, none became blocked with debris. The majority of the canals maintained working distance (26 out of 40), however the mean change in length differed significantly ( P < 0.05) between canal types. Overall, canals with 40° curves lost length whilst those with 20° curves gained in length. Examination of intracanal impressions revealed that preparation with Quantec Series 2000 instruments produced canals with definite apical stops, smooth canal walls and good flow and taper. However, the quality of apical smoothness and flow was influenced significantly ( P < 0.0001) by canal shape with specimens having 40° canals displaying less desirable qualities. Under the conditions of this study, Quantec Series 2000 rotary nickel-titanium instruments prepared simulated canals rapidly, safely and with good three-dimensional form.     

Effectiveness of nickel-titanium files for preparing curved root canals

Abstract In this study, the effect of 2 different endodontic files on the final shape of curved root canals of extracted single rooted teeth were examined in the scanning electron microscope. The instruments tested were a newly designed nickel-titanium endodontic file and a conventional K-type file. The files were used with in and out linear movements with a circumferential motion starting with a size 15 file. Final preparation of the apical thirds of the canals was performed with a size 35 file. Shaping effectiveness of the tested instruments was evaluated in terms of respect for conservation of the apical constriction and the presence or absence of ledging. Our observations revealed that more centered and tapered preparations were obtained with the use of the nickel-titanium files than with the conventional K-type files.     

Influence of operator experience on canal preparation time when using the rotary Ni-Ti ProFile system in simulated curved canals

AIM: The aim of this study was to determine the influence of operator experience on the time needed for canal preparation when using a rotary nickel-titanium (Ni-Ti) system. METHOD: A total of 100 simulated curved canals in resin blocks were used. Four operators prepared a total of 25 canals each. The operators included practitioners with prior experience of the preparation technique, and practitioners with no experience. The working length for each instrument was precisely predetermined. All canals were instrumented with rotary Ni-Ti ProFile Variable Taper Series 29 engine-driven instruments using a high-torque handpiece (Maillefer, Ballaigues, Switzerland). The time taken to prepare each canal was recorded. Significant differences between the operators were analysed using the Student's t-test and the Kruskall-Wallis and Dunn nonparametric tests. RESULTS: Comparison of canal preparation times demonstrated a statistically significant difference between the four operators (P < 0.001). In the inexperienced group, a significant linear regression between canal number and preparation time occurred. CONCLUSION: Time required for canal preparation was inversely related to operator experience.     

Shaping ability of ProFile.04 Taper Series 29 rotary nickel-titanium instruments in simulated root canals. Part 1

The aim of this study was to determine the shaping ability of ProFile.04 Taper Series 29 nickel-titanium instruments in simulated canals. A total of 40 simulated root canals made up of four different shapes in terms of angle and position of curvature were prepared by ProFile instruments using a step-down approach. Part 1 of this two-part report describes the efficacy of the instruments in terms of preparation time, instrument failure, canal blockages, loss of canal length and three-dimensional canal form. The time necessary for canal preparation was not influenced significantly by canal shape. No instrument fractures occurred but a total of 52 instruments deformed. Size 6 instruments deformed the most followed by sizes 5, 3 and 4. Canal shape did not influence significantly instrument deformation. None of the canals became blocked with debris and loss of working distance was on average 0.5 mm or less. Intracanal impressions of canal form demonstrated that most canals had definite apical stops, smooth canal walls and good flow and taper. Under the conditions of this study, ProFile.04 Taper Series 29rotary nickel-titanium instruments prepared simulated canals rapidly and created good three-dimensional form. A substantial number of instruments deformed but it was not possible to determine whether this phenomenon occurred because of the nature of the experimental model or through an inherent design weakness in the instruments.     

Effectiveness of two different methods for preparing curved root canals

Abstract In this study, the effect of using two different methods for preparing curved root canals of extracted, single-rooted teeth were analyzed with the scanning electron microscope. The instrumentation systems tested were the Canal Master and a standard circumferential filing technique in which conventional K-files were used. Shaping effectiveness was qualitatively evaluated in terms of respect for conservation of the apical constriction and the presence or absence of ledging, specially in the apical third of the root canals. As a result of our observations, it appeared that the Canal Master instrumentation technique provided well-centered and tapered preparations. Conversely, the use of conventional K-files with a standard circumferential filing technique resulted in frequent alterations of the initial pattern of the root canals, showing transportation of the apical foramen and ledge formation.     

Efficiency of rotary nickel-titanium FlexMaster instruments compared with stainless steel hand K-Flexofile--Part 1. Shaping ability in simulated curved canals

AIM: The purpose of this study was to compare the shaping ability of FlexMaster rotary nickel-titanium instruments with stainless steel hand K-Flexofiles. This part of the two-part report describes the efficiency of these two instruments in simulated curved root canals. METHODOLOGY: Simulated 28 degree- and 35 degree-curved canals were prepared by the FlexMaster instruments with a rotational speed of 250 rpm using a crown-down preparation technique. and by the K-Flexofiles using a reaming motion (n = 24 canals in each case). All canals were prepared up to size 35. The pre- and post-instrumentation images were recorded and assessment of the canal shape was completed with a computer image analysis program. The material removal was measured at 20 measuring points, beginning 1 mm away from the apex. Incidence of canal aberrations, preparation time,changes of working length and instrument failures were also recorded. RESULTS: In comparison with stainless steel K-Flexofiles, the rotary FlexMaster instruments achieved bet-ter canal geometry, showed less canal transportation and created fewer canal aberrations in both the canal types. Two FlexMaster instruments were separated, and 15 FlexMaster instruments and 11 K-Flexofiles were permanently deformed during preparation. However, these differences were not significant (P > 0.05).Between both the canal types, FlexMaster was significantly faster (P < 0.001) than K-Flexofiles. Both instruments maintained a good working distance. CONCLUSIONS: FlexMaster instruments prepared curved canals rapidly, and with minimal transportation towards the outer aspect of the curve.