Potential of Operative Torque in Evaluating NiTi Instruments

The role of nickel-titanium (NiTi) in the production of endodontic instruments increased in the last few decades; therefore, the way of evaluation of its performance increased as well. Nowadays, there are several ways to evaluate NiTi instruments, divided into static and dynamic tests. The static ones are cyclic fatigue tests, torsional resistance tests, flexibility, and cutting efficiency tests. These methodologies have been deeply used to evaluate some of the metallurgical properties of the instruments on the market. Up-to-date, we know very well the behavior of NiTi under static conditions, but these knowledges are too fragmented to be relevant for understanding and evaluating the complexities of intracanal instrumentation. Starting from the purpose to introduce the variable of movement in the testing procedure, some dynamic tests have been proposed, such as dynamic cyclic fatigue test.1,2 Although these kinds of studies were capable of evaluating more precisely the behavior of rotary instruments inside the root canal, they could not take into account, at this moment, the complexities of stresses that instruments undergo during the shaping procedure.3-5 Therefore, some of these tests are not accepted anymore by the scientific community and on the contrary they do not help the general practitioner to orientate in the large amount of rotary instruments present on the market.6 This tends to withdraw the general dentistry from the scientific literature, wearing a groove between the practice and the science.7 Starting from these ideas, in the last couple of years some authors started to think the proper way to real-time evaluation of the performance of NiTi rotary instruments inside the root canal. To do so, a countable and repeatable measurement of instrument's developed stresses was needed. Setzer and Böhme8 first used the torque generated by Revo-S, Vortex, and ProFile to evaluate their performance during instrumentation. The so-called "operative torque" is the summation of torque generated in each point of the instrument during its simultaneous movement around its own axis and up and down inside the canal. The recorded values are influenced by both torsional and flexural stresses, becoming this way a reliable method to analyze, evaluate, and compare the performance of NiTi instruments inside the root canal.9 This methodology is applicable for not only in vitro but also in vivo measurement, as demonstrated by Gambarini et al.10 The main drawback of this kind of evaluation is the not well-determined correlation between the torsional and the flexural stresses; therefore, it is still unpredictable how each influence the other. In conclusion, the potential of real-time torque measurement is wide and still unexplored, but further studies are needed to better understand how torque is developed inside the root canal

A comparative study of mechanical resistance of two reciprocating files

To evaluate the cyclic fatigue resistance of two different Nickel-Titanium instruments, Reziflow (Komet, Brasseler GmbH & Co., Lemgo, Germany) and WaveOne Gold (Dentsply Maillefer, Ballaigues, Switzerland). Two groups of 20 different NiTi endodontic instruments of identical tip size of 0.25 mm were tested; Reziflow and Wave-One Gold primary. Cyclic fatigue testing was performed in a stainless steel simulated root canal manufactured by reproducing the instrument?s size and taper. A simulated root canal with a 90 degrees angle of curvature and 5 mm radius of curvature was constructed for the instruments tested. The centre of the curvature was 5 mm from the tip of the instrument and the curved segment of the canal was approximately 5 mm in length. Both the instruments were used in the same preset program specific for the WaveOne instruments. Each instrument was rotated until fracture occurred and the time to fracture (TtF) and the length of the fractured fragment were recorded. Means and standard deviations of TtF and fragment length were calculated and data were subjected to statical analysis (P0.05) in the mean length of the fractured fragments between the instruments. Rezifllow instruments were associated with a significantly higher cyclic fatigue resistance than WaveOne Gold instruments

Surgical and orthodontic rapid palatal expansion in adults using a modified palatal partial osteotomy technique (ppot) : technique description and clinical experience

Transversal hypoplasia of the upper maxilla is a frequent condition between malocclusions. The rapid maxillary expansion (RME) is an already consolidated technique for these types of defects. This case report analyzes the outcome of a novel surgical technique that we named TOPP (Partial Palatal osteotomy technique) aiming to provide scientifically proven data over the percentage of relapse and the long-term stability of this type of surgical assisted palatal expansion. A 24 year old male patient with a hyperdivergent class III, presenting the absence of 1.1 due to a teenage trauma and a transversal contraction of the upper arch was selected for the surgery. The mucoperiosteal flap was performed at a palatal level with a paramarginal arch shape (from region 1.4 to 2.4) due to preserve the nasal-incisal vascular bundle and the mucoperiosteum was detached from the floor of the nose. A horizontal osteotomy was performed at 4-5 mm above the roots apexes; a sagittal osteotomy in a posterior direction was done at the level of the midline to divide the mesiopalatine suture and separate the maxilla in two halves. The only bony attachment that remained was represented by the perpendicular lamina of the palatal bone. The TOPP technique showed that it is possible to have a better control of both the intercanine and intermolar expansion, that is more difficult in the case of a conventional SARME. Other goals were a greater view and access to the site and the reduction of the risk of damaging the palatine fibromucosa. The incision of the archform paramarginal flap improves certainly the conditions of the palatal fibromucosa in the post operative and allows the reduction of the soft tissues? elastic return

Analysis of stability in time of marginal adaptation of endosequence root repair material on biological samples

Introduction: The introduction of mineral trioxide aggregate (MTA) and bioceramic sealers increased the success rate of endodontic surgery and perforation repair. The aim of this study was to evaluate the marginal adaptation at different times of endosequence root repair material (ERMM) in order to evaluate its dimensional stability using variable pressure-scanning electron microscope (VP-SEM). Material and Methods: Fourty-eight teeth were selected shaped up to a master apical size of 25. Then a 3mm cut perpendicular to the long axis and a retrograde cavity preparation were performed. In order to obtain 2mm thick sample a second cut was done and, in this disk, ERMM was inserted. The samples were stored at 37°.The samples were divided into four time-depending groups observed with VP-SE Mat time0 (Group 1) andafter2 (Group2),7(Group 3) and 30 days (Group4) after ERRM setting. Statistical analysis with one way-ANOVA test was performed (95%). Results: None of the four groups analyzed showed a complete marginal adaptation between dentin and ERRM. Instead, in all groups ERRM exhibited a completely preserved marginal adaptation to the dentin wall in all time-dependent groups. The mean (±SD) gap value was fortime0,3.91(±2.55) mmafter2days,4.32(±2.69), after7days4.49(±2.53), and after30days4.81(±2.85) mm. No statistically significant difference was found between the four groups. Conclusions: The results of the present study demonstrate the dimensional stability over time of ERMM