Comparison of fracture resistance of teeth with prepared protaper next, protaper gold, and hyflex CM rotary files

https://doi.org/10.22146/majkedgiind.82711

Margareta Rinastiti(1*), Andina Widyastuti(2), Wignyo Hadriyanto(3)

(1) Department of Conservative Denstistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta
(2) Department of Conservative Denstistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta
(3) Department of Conservative Denstistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Preparation of the root canal system is a crucial step in root canal treatment. Endodontically treated teeth differ structurally from healthy, untreated teeth. This can lead to root cracking by creating pressure on the canal wall, reducing the fracture resistance of the tooth. Different designs, including cross-sectional shape, tip, taper, flute, radial land, helix angle, rake angle, and pitch, can influence the outcome of the root canal preparation and the risk of root fracture. The purpose of this study was to evaluate the fracture resistance of teeth after root canal preparation using three different NiTi rotary files: ProTaper Next (PN), ProTaper Gold (PG), and HyFlex CM (HC). Thirty premolars with a single and straight root canal were decoronated at the cementoenamel junction, leaving 14 mm of the root. The subjects were divided into 3 groups. Group 1 (n = 10) was prepared using PN, group 2 (n = 10) was prepared using PG, and group 3 (n = 10) was prepared using HC. After instrumentation and irrigation, the specimens were subjected to a continuous vertical compressive force (crosshead-speed of 2.28 mm/sec) in order to record the force (in newtons) until root fracture. To describe the surface characteristic of the dentinal root after the preparation, a section fragment from the apical third of the specimens was observed using a scanning electron microscope (SEM) at 2500x magnification. The micrographs were analyzed according to the Hulsman’s method. The results demonstrated that there was a statistically significant difference in root fracture resistance among the three groups. (p = 0.043). The LSD post hoc test indicated that HC showed a higher root fracture resistance (p < 0.05) compared to both PN and PG. In conclusion, the different file systems of PN, PG, and HC instruments generate different root fracture resistance of teeth. In comparison to PN and PG, HC instruments tend to result in increased fracture resistance.


Keywords


endodontics; fracture strength; root canal preparation; rotary files

Full Text:

PDF


References

1. Kumari MR, Krishnaswamy MM. Comparative analysis of crack propagation in roots with hand
and rotary instrumentation of the root canal -an ex-vivo study. J Clin Diagn Res. 2016; 10(7):
ZC16-19. doi: 10.7860/JCDR/2016/17576.8122

2. Ivancik J, Majd H, Bajaj D, Romberg E, Arola D. Contributions of aging to the fatigue crack
growth resistance of human dentin. Acta Biomater. 2012; 8(7): 2737-2746.
doi: 10.1016/j.actbio.2012.03.046

3. Kansal R, Rajput A, Talwar S, Roongta R, Verma M. Assessment of dentinal damage
during canal preparation using reciprocating and rotary files. J Endod. 2014; 40(9): 1443-
1446. doi: 10.1016/j.joen.2014.02.015

4. Acharya N, Hasan MR, Kafle D, Chakradhar A, Saito T. Effect of hand and rotary instruments
on the fracture resistance of teeth: An in vitro study. Dent J (Basel). 2020; 8(2): 38.
doi: 10.3390/dj8020038

5. Tsesis I, Rosen E, Tamse A, Taschieri S, Kfir A. Diagnosis of vertical root fractures in
endodontically treated teeth based on clinical and radiographic indices: a systematic review.
J Endod. 2010; 36(9): 1455-1458. doi: 10.1016/j.joen.2010.05.003

6. Mikrogeorgis G, Eirinaki E, Kapralos V, Koutroulis A, Lyroudia K, P d fbb itas
I. Diagnosis of vertical root fractures in endodontically treated teeth utilising Digital
Subtraction Radiography: A case series report. Aust Endod J. 2018; 44(3): 286-291.
doi: 10.1111/aej.12240

7. Yoshino K, Ito K, Kuroda M, Sugihara N. Prevalence of vertical root fracture as the
reason for tooth extraction in dental clinics. Clin Oral Investig. 2015; 19(6): 1405-1409.
doi: 10.1007/s00784-014-1357-4

8. Ashraf SAF, Shankarappa P, Misra A, Sawhney A, Sridevi N. A Stereomicroscopic evaluation of dentinal cracks at different instrumentation lengths by using different rotary files (ProTaper Universal, ProTaper Next, and HyFlex CM): An Ex Vivo Study. Scientifica (Cairo). 2016; 2016: 8379865. doi: 10.1155/2016/8379865

9. Shen Y, Zhou HM, Zheng YF, Campbell L, Peng B, Haapasalo M. Metallurgical characterization of controlled memory wire nickel-titanium rotary instruments. J Endod. 2011; 37(11): 1566-1571. doi: 10.1016/j.joen.2011.08.005

10. Zupanc J, Vahdat-Pajouh N, Schäfer E. New thermomechanically treated NiTi alloys – a
review. Int Endod J. 2018; 51(10): 1088-1103. doi: 10.1111/iej.12924

11. Ruddle CJ. The ProTaper endodontic system: geometries, features, and guidelines for use.
Dent Today. 2001; 20(10): 60-70.

12. Patnana A, Chugh A. Endodontic management of curved canals with protaper next: A case series. Contemp Clin Dent. 2018; 9(Suppl1): S168-S172. doi: 10.4103/ccd.ccd_54_18

13. Nishad S, Shivamurthy GB. Comparative analysis of apical root crack propagation
after root canal preparation at different instrumentation lengths using protaper universal, protaper next and protaper gold rotary files: An in vitro study. Contemp Clin Dent. 2018; 9(Suppl 1): S34-S38. doi: 10.4103/ccd.ccd_830_17

14. Plotino G, Grande NM, Bellido MM, Testarelli L, Gambarini G. Influence of temperature
on cyclic fatigue resistance of protaper gold and protaper universal rotary files. J Endod.
2017; 43(2): 200-202. doi: 10.1016/j.joen.2016.10.014

15. Shi L, Wagle S. Comparing the centering ability of different pathfinding systems and
their effect on final instrumentation by Hyflex CM. J Endod. 2017; 43(11): 1868-1871. doi:
10.1016/j.joen.2017.05.022

16. Koçak S, Şahin FF, Özdemir O, Koçak MM, Sağlam BC. A comparative investigation
between protaper next, hyflex cm, 2shape, and tf-adaptive file systems concerning
cyclic fatigue resistance. J Dent Res Dent Clin Dent Prospects. 2021; 15(3): 172-177.
doi: 10.34172/JODDD.2021.029

17. Ninan E, Berzins DW. Torsion and bending properties of shape memory and superelastic
nickel-titanium rotary instruments. J Endod. 2013; 39(1): 101-104.
doi: 10.1016/j.joen.2012.08.010

18. Singh H. Hyflex CM and EDM files: revolutionizing the art and science of
endodontics. J Dent Heal Oral Disord Ther. 2016; 5(7): 385-387.
doi: 10.15406/jdhodt.2016.05.00182

19. Łęski M, Radwański M, Pawlicka H. Comparison of the shaping ability of hyflex®
CMTM files with protaper next® in simulated l-curved canals. Dent Med Probl. 2015;
52(1): 54-61.

20. Saber SEDM, Nagy MM, Schäfer E. Comparative evaluation of the shaping
ability of ProTaper Next, iRaCe and Hyflex CM rotary NiTi files in severely curved root
canals. Int Endod J. 2015; 48(2): 131-136. doi: 10.1111/iej.12291

21. Milani AS, Ganjpou S, Dehghani F, Rahimi S, Pouya S. Comparison of the fracture
resistance of the teeth prepared with ProTaper Universal, ProTaper Next, and ProTaper Gold rotary files. Clin Exp Dent Res. 2022; 8(6): 1421–1425. doi: 10.1002/cre2.660

22. Hülsmann M, Rümmelin C, Schäfers F. Root canal cleanliness after preparation with different endodontic handpieces and hand instruments: a comparative SEM investigation. J Endod. 1997; 23(5): 301-306. doi: 10.1016/S0099-2399(97)80410-4

23. Soares CJ, Rodrigues MdeP, Faria-E-Silva AL, Santos-Filho PCF, Verissimo C, Kim HC, Versluis A. How biomechanics can affect the endodontic treated teeth and their restorative procedures?. Braz Oral Res. 2018; 32(suppl 1): e76. doi: 10.1590/1807-3107bor-2018.vol32.0076

24. Heberer MT, Roggendorf HC, Faber FJ, Lawrenz NA, Frankenberger R, Roggendorf
MJ. Longitudinal craze line propagation in human root dentin after instrumentation with
NiTi rotary files of different instrument tapers after long-term chewing simulation. Clin Oral
Investig. 2022; 26(3): 2671-2679. doi: 10.1007/s00784-021-04238-3

25. Liu R, Hou BX, Wesselink PR, Wu MK, Shemesh H. The incidence of root microcracks caused by 3 different singlefile systems versus the protaper system. J Endod. 2013; 39(8): 1054-1056.
doi: 10.1016/j.joen.2013.04.013

26. Jacob J, Paul M, Sara B, Steaphen P, Philip N, Mathew J. Comparative analysis
of dentinal crack formation following root canal instrumentation with hand K-Flex files, ProTaper Next, and self-adjusting files. J Contemp Dent Pract. 2019; 20(8): 935-939. doi: 10.5005/jp-journals-10024-2625

27. Khoshbin E, Donyavi Z, Atibeh EA, Roshanaei G, Amani F. The effect of canal preparation
with four different rotary systems on formation of dentinal cracks: An in vitro evaluation. Iran
Endod J. 2018; 13(2): 163–168. doi: 10.22037/iej.v13i2.16416

28. Nasr HMAE, Abd El Kader KG. Dentinal damage and fracture resistance of oval
roots prepared with single-file systems using different kinematics. J Endod. 2014; 40(6):
849-851. doi: 10.1016/j.joen.2013.09.020

29. Khan S, Nagpal R, Singh U, Mehmood N, Agarwal M, Khan Z. Fracture resistance
of endodontically treated teeth after instrumentation with different nickel titanium
systems. Endodontology. 2020; 32(3): 118. doi: 10.4103/endo.endo_23_20

30. Gagliardi J, Versiani MA, De Sousa-Neto MD, Plazas-Garzon A, Basrani B. Evaluation of
the shaping characteristics of ProTaper Gold, ProTaper NEXT, and ProTaper Universal in
curved canals. J Endod. 2015; 41(10): 1718-1724. doi: 10.1016/j.joen.2015.07.009

31. Kılıç Y, Karataşlıoğlu E, Kaval ME. The effect of root canal preparation size and taper of
middle mesial canals on fracture resistance of the mandibular molar teeth: an in vitro study.
J Endod. 2021; 47(9): 1467-1471. doi: 10.1016/j.joen.2021.06.002

32. Gambarini G, Testarelli L, Luca MD, Milana V, Plotino G, Grande NM, Rubini AG, Sudani DA,
Sannino G. The influence of three different instrumentation techniques on the incidence
of postoperative pain after endodontic treatment. Ann Stomatol (Roma). 2013; 4(1):
152-155. doi: 10.11138/ads/2013.4.1.152

33. Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J. 2010;
43(1): 2-15. doi: 10.1111/j.1365-2591.2009.01627.x

34. Gambarini G, Rubini AG, Sannino G, Giorgio GD, Piasecki L, Al-Sudani D, Plotino G,
Testarelli L. Cutting efficiency of nickel–titanium rotary and reciprocating instruments after prolonged use. Odontology. 2016; 104(1): 77-81.
doi: 10.1007/s10266-014-0183-0



DOI: https://doi.org/10.22146/majkedgiind.82711

Article Metrics

Abstract views : 405 | views : 298

Refbacks

  • There are currently no refbacks.




Copyright (c) 2023 Majalah Kedokteran Gigi Indonesia

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


Currently, Majalah Kedokteran Gigi Indonesia indexed by:

        

 

 

 

 

 

 View My Stats


real
time web analytics