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Dent J. 2015; 26(6):624-9.](https://image.slidesharecdn.com/comparing10files-221209043207-b73aa61b/85/comparing-10-files-pdf-10-320.jpg)
comparing 10 files.pdf
- 1. www.ascro.hr 207 Acta stomatol Croat. 2017;51(3):207-216. DOI: 10.15644/asc51/3/4 IZVORNI ZNANSTVENI RAD ORIGINAL SCIENTIFIC PAPER Jorge Rubio, José Ignacio Zarzosa, Antonio Pallarés Usporedba učinkovitosti 10 rotacijskih i recipročnih endodontskih sustava: in vitro istraživanje u AutoCAD-u Comparison of Shaping Ability of 10 Rotary and Reciprocating Systems: an In Vitro Study with AutoCAD Introduction Biomechanical preparation is one of the most impor- tant procedures in endodontic treatment, influencing irri- gation and root canal filling (1). It is important to preserve the anatomy in order to reduce damage to dental structures when contaminated dentin is removed and the root canals are formed (2). Ideally, root canal shaping should create a continuous tapered preparation from crown to apex while maintaining the original path of the canal and keeping the foramen size as small as is practical (3). However, root ca- nal instrumentation can produce apical transportation (4), changes in the shape of the root canal (5) and even perfora- tions (6). In recent years, clinicians have used different rotary and reciprocating systems that differ in symmetry, cross-section, number of uses, alloy, etc. Currently, a new generation of endodontic systems made from nickel-titanium alloys has ar- Uvod Mehanička obrada kanala jedan je od najvažnijih postu- paka u endodontskom liječenju koji utječe na mogućnost is- piranja i punjenja korijenskog kanala (1). Važno je očuva- ti anatomiju kako bi se smanjilo oštećenje zubne strukture nakon uklanjanja kontaminiranog dentina i oblikovanja ko- rijenskog kanala (2). U idealnom slučaju oblikovanjem ko- rijenskog kanala trebalo bi postići njegov kontinuirano koni- čan oblik od krune do apeksa, zadržavajući izvornu putanju kanala i što manju veličinu apeksnog foramena (3). Među- tim, instrumentacijom korijenskog kanala može doći do transportacije apeksnog foramena (4), promjene oblika kori- jenskog kanala (5), pa čak i perforacije (6). Posljednjih godina kliničari su se koristili različitim rota- cijskim i recipročnim sustavima koji se razlikuju po simetriji, poprečnom presjeku, broju instrumenata, leguri itd. Razvije- na je i nova generacija endodontskih sustava od nikal-titanij- ACTA STOMATOLOGICA CROATICA www.ascro.hr Zavod za endodonciju, Katoličko sveučilište Valencija, Španjolska Department of Endodontics, Catholic University of Valencia Sažetak Cilj: Usporediti reznu površinu, očuvanje anatomije korijenskog kanala i neinstrumentiranu površi- nu nakon instrumentacije sustavima F360® , F6SkyTaper® , HyflexEDM® , iRace® , Neoniti® , O.Shape® , P.Next® , Reciproc® , Revo-S® i WaveOneGold® s veličinom instrumenta 25. Materijali i metode: Tristo zubi s jednim ravnim korijenom i okruglim ili eliptičnim presjekom korijenskog kanala podijeljeno je u 10 skupina (1-F360® , 2-F6SkyTaper® , 3-HyflexEDM® , 4-iRace® , 5-Neoniti® , 6-O Shape® , 7-P.Next® , 8-Reciproc® , 9-Revo-S® i 10-WaveOneGold® ) i poprečno prerezano na trećine ultrafinim reznim disko- vima. Uzorci su fotografirani pod stereomikroskopom i provedena je predinstrumentacijska analiza prije ponovnog spajanja zuba K-instrumentom #10 i epoksi smolom. Ručno je uspostavljena prohod- nost K-instrumentima #10 i #15 te je svaka skupina instrumentirana jednim od rotacijskih ili reciproč- nih sustava. Rezna površina, očuvanje anatomije korijenskog kanala i neinstrumenirana površina analizirani su s pomoću AutoCAD-a 2015. Za statističku analizu korišteni su Leveneov test, Welchov test, Games-Howellsov test i Pearsonov hi-kvadrat test. Rezultati: Leveneov test nije pokazao jedna- kost varijacije (P < 0,05), pa su primijenjeni Welchov i Games-Howellov test u analizi rezne površine, pokazujući statistički značajne razlike za sve trećine i ukupno (P < 0,05). Nisu zabilježene razlike u očuvanju anatomije korijenskog kanala (P > 0,05). Što se tiče neinstrumentirane površine, pronađe- ne su statistički značajne razlike (P < 0,05), pri čemu su u srednjoj trećini bili bolji Reciproc® , Neoni- ti® i WaveOneGold® , a u apikalnoj trećini P.Next® , Reciproc® , HyflexEDM® , Neoniti® i WaveOneGold® . Zaključci: Što se tiče rezne površine, P.Next® i Reciproc® bili su bolji u koronarnoj trećini, Neoniti® i HyflexEDM® u sredini i apikalno, a sveukupno Neoniti® i Reciproc® . Što se tiče očuvanja anatomije korijenskog kanala, svi su sustavi bili slični. S obzirom na neinstrumentiranu površinu, svi su sustavi postigli slične rezultate koronarno, ali Reciproc® , Neoniti® i WaveOneGold® bili su bolji u srednjoj tre- ćini te P.Next® , Reciproc® , HyflexEDM® , Neoniti® i WaveOneGold® apikalno. Zaprimljen: 29. lipnja 2017. Prihvaćen: 1. rujna 2017. Adresa za dopisivanje Jorge Rubio Catholic University of Valencia Spain Department of Endodontics jorrucli@hotmail.com Ključne riječi korijenski kanal, priprema; brzo rotira- juća stomatološka oprema
- 2. www.ascro.hr Učinkovitost oblikovanja 10 sustava Rubio i sur. 208 rived, with changes in design to improve flexibility, cyclic fa- tigue resistance and cutting efficiency, with more predictable results and less iatrogenic damage, but these modifications do not improve all the properties of endodontic files (7, 8). The introduction of single use reciprocating systems has raised new perspectives for the preparation of root canals (9, 10). The learning curve of these systems and the cost sav- ings compared to rotary systems with multiple instruments are arousing interest due to their simplification of the tech- nique, since a single instrument is used to prepare the root canals (11). This movement also disengages the instrument from dentin before it can lock into the canal and reduces the risk of root canal deformation and instrument separa- tion (12, 13). Nowadays, a number of different alloys have improved the properties of conventional NiTi. M-Wire, an alloy creat- ed by applying a heat treatment to conventional NiTi, is pre- sented in Reciproc® (VDW, Munich, Germany) and Wave One® (Dentsply Maillefer, Ballaigues, Switzerland) (14, 15). Gold-Wire is another alloy that has recently appeared, en- hancing the properties of ProTaper Universal® (Dentsply Maillefer, Ballaigues, Switzerland) and Wave One® (Dentsply Maillefer, Ballaigues, Switzerland), to create ProTaper Gold® (Dentsply Maillefer, Ballaigues, Switzerland) and Wave One Gold® (Dentsply Maillefer, Ballaigues, Switzerland) (16, 17), with a new thermal surface treatment (18). CM-Wire is an al- loy that gives Hyflex CM® (Coltene, Altstätten, Switzerland), Hyflex EDM® (Coltene, Altstätten, Switzerland) and Neoni- ti® (Neolix, Chatres-La-Foret, France) instruments controlled memory, which is very useful when treating root canals with severe curvatures (19, 20, 21), manufactured with wire cut electrical discharge machining (EDM) process (22). The cur- rent systems have many different taper, movement, design, alloy, speed and torque characteristics and different numbers of files. Currently, in terms of clinical implications of dentinal de- fects in long-term situations, no definitive conclusions can be made. Moreover, it is not known whether the improvements of nickel titanium alloys avoid the formation of defects. The purpose of this investigation was to examine the cutting area, root canal anatomy preservation and non-instrumented ar- eas using F360® (Komet Dental, Lemgo, Germany), F6 Sky- Taper® (Komet Dental, Lemgo, Germany), Hyflex EDM®, iRace® (FKG Dentaire, La Chaux-de-Fonds, Switzerland), Neoniti®, One Shape® (Micro-Mega, Besançon, France) Pro- Taper Next® (Dentsply Maillefer, Ballaigues, Switzerland), Reciproc®, Revo-S® (Micro-Mega, Besançon, France) and Wave One Gold® size 25 files. Materials and methods Methods similar to those mentioned in another scientif- ic paper, which was published in 2015 by the same authors, were used (23). 300 extracted permanent teeth with similar characteris- tics were divided randomly into 10 groups (n = 30). The se- lection criteria were: teeth with a single straight root and a circular or elliptical root canal. The endodontic opening was skih legura promijenjenog dizajna kako bi se poboljšala flek- sibilnost, otpornost na ciklički zamor i učinkovitost rezanja, s predvidivim rezultatima i manje jatrogenih oštećenja, ali te modifikacije ne poboljšavaju sva svojstva endodontskih in- strumenata (7, 8). Uvođenje recipročnih sustava s jednim instrumentom otvorilo je nove mogućnosti u preparaciji korijenskih kana- la (9, 10). Krivulja učenja tih sustava i ušteda u usporedbi s rotacijskim sustavima s više instrumenata privlače zanimanje zbog pojednostavnjenja tehnike, jer se za obradu korijenskih kanala rabi samo jedan instrument (11). Dodatno, reciproč- na kretnja oslobađa instrument iz dentina prije nego što se može zaglaviti u kanalu i smanjuje rizik od deformacije kori- jenskog kanala i loma instrumenta (12, 13). Danas je niz različitih legura poboljšaoo svojstva kon- vencionalnog NiTi-ja. M-Wire, legura stvorena toplinskom obradom konvencionalnog NiTi-ja, korištena je u sustavi- ma Reciproc® (VDW, München, Njemačka) i Wave One® (Dentsply Maillefer, Ballaigues, Švicarska) (14, 15). Gold- Wire je još jedna legura koja se nedavno pojavila poboljšava- jući svojstva sustava ProTaper Universal® (Dentsply Maillefer, Ballaigues, Švicarska) i Wave One® (Dentsply Maillefer, Ba- llaigues, Švicarska) te stvarajući nove sustave ProTaper Gold® (Dentsply Maillefer, Ballaigues, Švicarska) i Wave One Gold® (Dentsply Maillefer, Ballaigues, Švicarska) (16, 17), s novom termičkom obradom površine (18). CM-Wire legura upotre- bljava se u sustavima Hyflex CM® (Coltene, Altstätten, Švi- carska), Hyflex EDM® (Coltene, Altstätten, Švicarska) i Neo- niti® (Neolix, Chatres-La-Foret, Francuska) koji su korisni za liječenje jako zakrivljenih korijenskih kanala (19, 20, 21), a proizvode se postupkom električnog pražnjenja (22). Aktu- alni sustavi razlikuju se u smislu koničnosti, kretnje, dizaj- na, legure, brzine i okretnog momenta te broja instrumenata. Trenutačno se, s obzirom na kliničke implikacije koje se tiču uzrokovanja dentinskih defekata, ne može donijeti ko- načan zaključak. Štoviše, nije poznato sprječava li NiTi legu- ra stvaranje defekata. Svrha ovog istraživanja bila je analizi- rati reznu površinu, očuvanje anatomije korijenskog kanala i neinstrumentiranu površinu nakon instrumentacije susta- vima F360® (Komet Dental, Lemgo, Njemačka), F6 SkyTa- per® (Komet Dental, Lemgo, Njemačka), Hyflex EDM® , iRa- ce® (FKG Dentaire, La Chaux-de-Fonds, Švicarska), Neoniti® , One Shape® (Micro-Mega, Besançon, Francuska) ProTaper Next® (Dentsply Maillefer, Ballaigues, Švicarska), Reciproc® , Revo-S® (Micro-Mega, Besançon, Francuska) i Wave One Gold® veličinom instrumenta 25. Materijali i metode Primijenjene su slične metode kao u radu istog autora objavljenom 2015. (23). Tristo izvađenih trajnih zubi sličnih značajki podijelje- no je slučajnim odabirom u 10 skupina (n = 30). Kriteriji odabira bili su: zubi s jednim ravnim korijenom i kružnim ili eliptičnim presjekom korijenskog kanala. Zub je trepani- ran okruglim dijamantnim svrdlom (Komet Dental, Lemgo,
- 3. www.ascro.hr Shaping Ability of 10 Systems Rubio et al. 209 performed with a round diamond bur (Komet Dental, Lem- go, Germany) using water cooling, followed by an Endo-Z bur (Komet Dental, Lemgo, Germany). X-rays were used to estimate the working length with hand files. Permanent markers were used to draw a red marking on lingual/palatine and a black marking on vestibular part. Root lengths and section points were estimated in agreement with the length, using a 532 Vernier caliper (Mitutoyo, Takatsu- ku, Japan). A hand piece (KMD Europa, Bilbao, Spain) equipped with ultrafine cutting disc (0.17mm) (Horico, Berlin, Ger- many) was used to section transversely the roots in thirds in the same manner as in Grande et al. (24). A stereo micro- scope (Nikon,Tokyo, Japan) with Nikon camera (Nikon,To- kyo, Japan) was used to take pictures of all thirds (x15 mag- nification). In thirds and overall, all groups were balanced by per- forming preinstrumentation analysis. A caliper was used to calculate mesiodistal width of coronal third of tooth No. 3, transferring to AutoCAD 2015 (Autodesk, San Rafael, USA) this calculation (5mm) to scale up and measure preinstru- mentation areas. Scaling up was performed by loading the image of tooth No. 3 into AutoCAD 2015, after painting a 5mm mesial to distal line and squaring the mesial and distal edges of the coronal third, subsequently validating the sizes of other images against the abovementioned image. The SPSS 18 program (P<0.05) was used to make a preoperative anal- ysis, using Levene´s and Welch´s tests, to evaluate variances and preinstrumentation areas. To balance the groups, some teeth would have been included and others discarded if sig- nificant differences had been achieved. The #10 K-file (Dentsply Maillefer, Ballaigues, Switzer- land) and epoxy glue were used to rebuild all of the teeth. The sections were adapted thanks to black and red markings that had previously been drawn. The 5.25% NaClO solu- tion was used to flush root canals during instrumentation. The #10 K-file was used for patency filing, and #10 and #15 K-files were used to make a glide path. The root canals were instrumented using a circumferential movement. The proto- cols were as follows: - Group 1 (F360®): F360 25/0.04 to 300rpm and 1.8 N·cm. - Group 2 (F6 SkyTaper®): F6 SkyTaper 25/0.06 to 300rpm and 2.2 N·cm. - Group 3 (Hyflex EDM®): Hyflex EDM 25/0.05 to 500rpm and 2.5 N·cm. - Group 4 (iRace®): R1 (15/0.06) and R2 (25/0.04) to 600rpm and 1.5 N·cm. - Group 5 (Neoniti®): A1 (25/0.08) to 400rpm and 1.5 N·cm. - Group 6 (One Shape®): One Shape 25/0.06 to 400rpm and 4 N·cm. - Group 7 (ProTaper Next®): X1 (17/0.04) and X2 (25/0.06) to 300rpm and 2 N·cm. - Group 8 (Reciproc®): R25 (25/0.08) to 300rpm and 2 N·cm. - Group 9 (Revo-S®): SC1 (25/0.06), SC2 (25/0.04) and SU (25/0.06) to 350rpm and 0.8 N·cm. Njemačka) uz hlađenje vodom, a zatim svrdlom Endo-Z (Komet Dental, Lemgo, Njemačka). Digitalni RTG korišten je za procjenu radne duljine s pomoću ručnih instrumenata. Vodootporni markeri korišteni su za ucrtavanje crvene oznake na lingvalnoj/palatinoj i crne na vestibularnoj plohi. Dužine korjenova i točke rezanja procijenjene su prema duži- ni, koristeći se pomičnom mjerkom 532 Vernier (Mitutoyo, Takatsuku, Japan). Kao u radu Grandea i sur. (24), nasadni instrument (KMD Europa, Bilbao, Španjolska) s ultratankim reznim diskom (0,17 mm) (Horico, Berlin, Njemačka) korišten je za poprečno presijecanje korijena na trećine. Za snimanje svih trećina korišten je stereomikroskop (Nikon, Tokyo, Ja- pan) s Nikonovom kamerom (Nikon, Tokio, Japan) (pove- ćanje 15x). Sve su skupine analizirane prije instrumentacije po tre- ćinama i ukupno. Pomična mjerka korištena je za izračuna- vanje meziodistalne širine koronalne trećine zuba br. 3, pre- noseći dimenziju u AutoCAD 2015 (Autodesk, San Rafael, SAD) (5 mm) kako bi se kalibrirala i izmjerila područja ka- nala prije instrumentacije. Kalibracija je provedena učitava- njem slike zuba br. 3 u AutoCAD 2015, nakon ucrtavanja meziodistalne linije od 5 mm i kvadriranja mezijalnog i dis- talnog ruba koronarne trećine, dobivena je referentna vrijed- nost za usporedbu drugih slika. Program SPSS 18 (P < 0,05) korišten je za preoperativnu analizu Leveneovim i Welcho- vim testom kako bi se procijenila varijanca i predinstrumen- tacijski parametri. Kako bi se uravnotežile skupine, neki zubi bili bi uključeni, a drugi odbačeni ako bi se utvrdile značaj- ne razlike. K-instrument #10 (Dentsply Maillefer, Ballaigues, Švi- carska) i epoksi smola korišteni su za ponovno spajanje svih zuba, prilagođavajući sekcije zahvaljujući prethodno ucrta- nim crnim i crvenim oznakama. Otopina NaClO koncen- tracije 5,25 % korištena je za ispiranje korijenskih kanala ti- jekom instrumentacije. K-instrumenti #10 i #15 korišteni su za osiguravanje prohodnosti kanala. Korijenski kanali instru- mentirani su kružnim pokretom. Protokoli su bili sljedeći: - Skupina 1 (F360® ): F360 25/0,04 do 300 rpm i 1,8 N · cm - Skupina 2 (F6 SkyTaper® ): F6 SkyTaper 25/0,06 do 300 rpm i 2,2 N · cm - Skupina 3 (Hyflex EDM® ): Hyflex EDM 25/0,05 do 500 rpm i 2,5 N · cm - Skupina 4 (iRace® ): Rl (15/0,06) i R2 (25/0,04) do 600 rpm i 1,5 N · cm - Skupina 5 (Neoniti® ): A1 (25/0,08) do 400 rpm i 1,5 N · cm - Skupina 6 (One Shape® ): One Shape 25/0,06 do 400 rpm i 4 N · cm - Skupina 7 (ProTaper Next® ): X1 (17/0,04) i X2 (25/0,06) do 300 rpm i 2 N · cm - Skupina 8 (Recipro® ): R25 (25/0,08) do 300 rpm i 2 N · cm - Skupina 9 (Revo-S® ): SC1 (25/0,06), SC2 (25/0,04) i SU (25/0,06) do 350 rpm i 0,8 N · cm - Skupina 10 (Wave One Gold® ): Primary (25/0,07) do 350 rpm i 2 N · cm.
- 4. www.ascro.hr Učinkovitost oblikovanja 10 sustava Rubio i sur. 210 - Group 10 (Wave One Gold®): Primary (25/0.07) to 350rpm and 2 N·cm. In all groups, 2 mL of 5.25% NaClO2 mL of 0.9% saline solution, 2mL of 17% ethylenediamenetetracetic acid (ED- TA) solution (Dentaflux, Algete, Spain) and 2 mL of 5.25% NaClO were flushed to finish the root canal treatments. In the end, a microscope was used to keep the re-sec- tioned thirds, making pictures (x15 magnification). Postop- erative areas of all thirds were calculated using a preoperative scale. The difference between preinstrumentation and postin- strumentation was estimated to determine the cutting areas (Figure 1). Non-instrumented areas and root canal anatomy preservation were studied by superimposing the preoperative and postoperative areas in the AutoCAD 2015 system (Fig- ure 1). These parameters were calculated as the percentage of teeth in each third. The SPSS 18 Statistics software package with normal dis- tribution was used for statistical analysis and Levene´s and Welch´s tests to evaluate variances and cutting surfaces. Pearson´s chi-squared test was used to contrast the percent- ages of teeth of non-instrumented and root canal anatomy preservation. U svim skupinama na kraju obrade korijenskoga kanala za ispiranje je korišteno 2 ml 5,25 %-nog NaClO, 2 ml 5 %-tne otopine etilendiamantetetske kiseline (EDTA) (Dentaflux, Algete, Španjolska) i 2 ml 5,25 %-tnog NaClO. Mikroskop je korišten za snimanje zubi koji su ponov- no podijeljeni na trećine (uvećanje 15 x). Na temelju preope- rativne ljestvice izračunate su postoperativne dimenzije svih trećina. Razlika između preinstrumentacijskog i postinstru- mentacijskog nalaza procijenjena je kako bi se odredila rezna površina (Slika 1.). Neinstrumentirana površina i očuvanje anatomije korijenskog kanala proučavani su preklapanjem preoperativnih i postoperativnih slika u sustavu AutoCAD 2015 (Slika 1.). Ti su parametri izračunati kao postotci za svaku trećinu. Za statističku analizu korišten je program SPSS 18. Pri- mijenjeni su Leveneov i Welchov test radi procjene varijance i reznih površina. Pearsonov hi-kvadrat primijenjen je za ana- lizu razlika postotaka neinstrumentiranih površina i očuvanja anatomije korijenskog kanala. Slika 1. Analiza u AutoCAD-u koronarne (A do C), srednje (D do F) i srednje (G do I) trećine Figure 1. AutoCAD analysis of coronal (A to C), middle (D to F) and apical (G to I) thirds.
- 5. www.ascro.hr Shaping Ability of 10 Systems Rubio et al. 211 Results No file was fractured during the study. There were no sig- nificant differences in preinstrumentation areas (Table 1 and Table 2). The cutting areas were calculated by subtracting the postoperative area from the corresponding preoperative ar- ea (Table 1). The ProTaper Next® system (1.586 ± 0.301 mm2 ) and Reciproc® system (1.510 ± 0.275 mm2 ) produced the larg- est cutting areas in the coronal third, which were significant- ly greater than with F360®, iRace® or One Shape® (Table 2) with both systems. The Neoniti file system (0.789 ± 0.112 mm2 - 0.475 ± 0.059 mm2 )) and the Hyflex EDM® ® file system (0.707 ± 0.109 mm2 - 0.538 ± 0.071 mm2 ) eliminated higher amounts of dentin in the middle and apical thirds. In the middle third (Table 2), both ProTaper Next® and Reciproc® systems were superior to F360®, iRace® and ProTa- Rezultati Nijedan instrument nije slomljen tijekom istraživanja. Nije bilo značajnih razlika u predinstrumentacijskim područ- jima (Tablice 1. i 2.). Rezne površine izračunate su oduzima- njem postoperativnog područja od odgovarajućeg preopera- tivnog područja (Tablica 1). U koronalnoj trećini ProTaper Next® (1,586 ± 0,301 mm2) i Reciproc® (1,510 ± 0,275 mm2 ) imali su najveću reznu površinu, koji su za oba sustava bili- statistički značajno veći nego za F360® , iRace® ili One Shape® (Tablica 2.). Međutim, u srednjim i apikalnim trećinama su- stavi Neoniti® (0,789 ± 0,112 mm2 - 0,475 ± 0,059 mm2 ) i Hyflex EDM® (0,707 ± 0,109 mm2 - 0,538 ± 0,071 mm2 ) eliminirali su veću količinu dentina. U srednjoj trećini (Ta- blica 2.), i ProTaper Next® i Reciproc® bili su bolji od sustava F360® , iRace® i ProTaper Next® , ali Neoniti® je bio bolji od su- stava Reciproc® , F6 SkyTaper® i One Shape® . U apikalnoj tre- ćini (Tablica 2.), rezna površina bila je veće nego kod sustava Predinstrumentacijska površina • Preinstrumentation Rezna površina • Cutting area Trećina • Third Sistema Sredina±SD • Mean±SD Min-Max Test Sredina±SD • Mean±SD Min-Max Koronarna • Coronal F360 F6 Hyflex iRace Neoniti O.Shape P.Next Reciproc Revo-S WOG 1,066±0,106 0,961±0,122 1,003±0,098 0,997±0,101 0,976±0,152 0,995±0,116 1,073±0,103 1,059±0,183 1,038±0,142 1,000±0,121 0,960-1,172 0,839-1,083 0,905-1,101 0,896-1,098 0,824-1,128 0,879-1,111 0,970-1,176 0,876-1,242 0,896-1,180 0,879-1,121 Levene 0.002 0,576±0,102 1,208±0,171 1,083±0,177 0,824±0,099 1,153±0,126 0,938±0,095 1,586±0,301 1,510±0,275 1,137±0,193 1,047±0,193 0,474-0,678 1,037-1,379 0,906-1,260 0,725-0,923 1,027-1,279 0,843-1,033 1,285-1,887 1,235-1,785 0,944-1,330 0,854-1,240 Welch 0.089 Srednja • Middle F360 F6 Hyflex iRace Neoniti O.Shape P.Next Reciproc Revo-S WOG 0,520±0,108 0,551±0,090 0,532±0,134 0,532±0,107 0,517±0,086 0,505±0,093 0,503±0,156 0,547±0,099 0,542±0,151 0,517±0,094 0,412-0,628 0,461-0,641 0,398-0,666 0,425-0,639 0,431-0,603 0,412-0,598 0,347-0,659 0,448-0,646 0,391-0,693 0,423-0,611 Levene 0.005 0,278±0,058 0,522±0,084 0,707±0,109 0,325±0,048 0,789±0,112 0,521±0,081 0,477±0,053 0,538±0,065 0,676±0,085 0,610±0,126 0,220-0,336 0,438-0,606 0,598-0,816 0,277-0,373 0,677-0,901 0,440-0,602 0,424-0,530 0,473-0,603 0,591-0,761 0,484-0,736 Welch 0.095 Apikalna • Apical F360 F6 Hyflex iRace Neoniti O.Shape P.Next Reciproc Revo-S WOG 0,217±0,045 0,222±0,038 0,269±0,082 0,188±0,057 0,273±0,032 0,294±0,075 0,224±0,024 0,234±0,051 0,252±0,043 0,289±0,061 0,172-0,262 0,184-0,260 0,187-0,351 0,131-0,245 0,241-0,305 0,219-0,369 0,200-0,248 0,183-0,285 0,209-0,295 0,228-0,350 Levene 0.003 0,176±0,030 0,352±0,053 0,538±0,071 0,176±0,028 0,475±0,059 0,354±0,035 0,240±0,030 0,355±0,043 0,456±0,051 0,431±0,047 0,146-206 0,299-0,405 0,467-0,609 0,148-0,204 0,416-0,534 0,319-0,389 0,210-0,270 0,312-0,398 0,405-0,507 0,384-0,478 Welch 0.099 Ukupno • Overall F360 F6 Hyflex iRace Neoniti O.Shape P.Next Reciproc Revo-S WOG 0,601±0,064 0,578±0,081 0,601±0,092 0,572±0,072 0,588±0,064 0,598±0,082 0,600±0,102 0,613±0,122 0,610±0,099 0,602±0,082 0,537-0,665 0,497-0,659 0,509-0,693 0,500-0,644 0,524-0,652 0,516-0,680 0,498-0,702 0,491-0,735 0,511-0,709 0,520-0,684 Levene 0.019 0,343±0,052 0,694±0,100 0,776±0,085 0,441±0,068 0,805±0,081 0,604±0,066 0,768±0,157 0,801±0,140 0,756±0,091 0,696±0,095 0,291-0,395 0,594-0,794 0,691-0,861 0,373-0,509 0,724-0,886 0,538-0,670 0,611-0,925 0,661-0,941 0,665-0,847 0,601-0,791 Welch 0.063 Tablica 1. Srednje vrijednosti predinstrumentacijske i rezne površine (mm2 ) i statistička analiza predinstrumentacijskih obilježja Table 1. Means of preinstrumentation and cutting area (mm2 ), and statistical analysis of preinstrumentation area.
- 6. www.ascro.hr Učinkovitost oblikovanja 10 sustava Rubio i sur. 212 per Next®, but Neoniti® was better than Reciproc®, F6 SkyTa- per® and One Shape®. In the apical third (Table 2), the cut- ting areas of Neoniti® and Hyflex EDM® were greater than with F360®, iRace®, ProTaper Next® or One Shape®. Those of Hyflex EDM® were also better than with Reciproc® and F6 SkyTaper®. Overall, Neoniti® system (0.805 ± 0.081 mm2 ) and Reciproc® system (0.801 ± 0.140 mm2 ) obtained better results than other systems, both being superior to F360® and iRace®, while Neoniti was also better than One Shape® (Ta- ble 2). Regarding the preservation of root canal anatomy (Table 3), Neoniti® and Hyflex EDM® obtained higher percentages in the coronal third (100%), Reciproc® and Wave One Gold® in the middle third (100%), and F360®, Reciproc® and Neo- niti® in the apical third. However, there were no significant differences in any of the thirds (P>0.05). In relation to non-instrumented areas (Table 3), ProTa- per Next®, Reciproc® and Hyflex EDM® scored lower per- centages in the coronal third (10%), although there were not significant differences. Reciproc®, Neoniti® and Wave One Gold® were significantly better (P<0.05) in the middle third (3.33%) being significant better (P<0.05); and ProTa- per Next®, Reciproc®, Hyflex EDM®, Neoniti® and Wave One Gold® were significantly superior (P<0.05) in the apical third (0%). Neoniti® i Hyflex EDM® nego kod sustava F360® , iRace® , Pro- Taper Next® ili One Shape® . Rezna površina sustava Hyflex EDM® također je bila veća nego kod sustava Reciproc® i F6 SkyTaper® . Sveukupno, Neoniti® (0,805 ± 0,081 mm2 ) i Reci- proc® (0,801 ± 0,140 mm2 ) postigli su bolje rezultate od osta- lih sustava, pri čemu su oba bila bolja od sustava od F360® i iRace® , dok je Neoniti® bio bolji od One Shapea® (Tablica 2.). Što se tiče očuvanja anatomije korijenskog kanala (Tabli- ca 3.), Neoniti® i Hyflex EDM® imali su veće postotke u koro- nalnoj trećini (100 %), Reciproc® i Wave One Gold® u sred- njoj trećini (100 %) a F360® , Recipro® i Neoniti® u apikalnoj trećini. Međutim, razlike nisu bile statistički značajne ni u jednoj trećini (P > 0,05). Što se tiče neinstrumentirane površine (Tablica 3.), Pro- Taper Next® , Reciproc® i Hyflex EDM® ostvarili su niže po- stotke u koronalnoj trećini (10 %), iako nisu postojale stati- stički značajne razlike. Reciproc® , Neoniti® i Wave One Gold® bili su značajno bolji (P < 0,05) u srednjoj trećini (3,33 %); ProTaper Next® , Reciproc® , Hyflex EDM® , Neoniti® i Wave One Gold® bili su statistički značajno bolji (P < 0,05) u api- kalnoj trećini (0 %). Rezna površina • Cutting area Trećina • Third Test Koronalna • Coronal Srednja • Middle Apikalna • Apical Ukupno • Overall Levene 0.000 0.019 0.006 0.000 Welch 0.000 0.000 0.000 0.000 Games-Howell P.Next-F360 0.000 Reciproc-F360 0.000 F6-F360 0.000 Hyflex-F360 0.000 Neoniti-F360 0.000 O.Shape-F360 0.000 Revo-S-F360 0.000 WOG-F360 0.004 iRace-F360 0.024 P.Next-iRace 0.001 Reciproc-iRace 0.001 F6-iRace 0.009 Neoniti-iRace 0.004 P.Next-O.Shape 0.006 Reciproc-O.Shape 0.010 P.Next-F360 0.000 Reciproc-F360 0.000 F6-F360 0.000 Hyflex-F360 0.000 Neoniti-F360 0.000 O.Shape-F360 0.000 Revo-S-F360 0.000 WOG-F360 0.001 P.Next-iRace 0.002 Reciproc-iRace 0.000 F6-iRace 0.005 Hyflex-iRace 0.000 Neoniti-iRace 0.000 O.Shape-iRace 0.004 Revo-S-iRace 0.000 WOG-iRace 0.005 Hyflex-P.Next 0.013 Revo-S-P.Next 0.007 Neoniti-P.Next 0.000 Neoniti-Reciproc 0.009 Neoniti-F6 0.010 Neoniti-O.Shape 0.008 Reciproc-F360 0.000 F6-F360 0.000 Hyflex-F360 0.000 Neoniti-F360 0.000 O.Shape-F360 0.000 Revo-S-F360 0.000 WOG-F360 0.000 Reciproc-iRace 0.000 F6-iRace 0.000 Hyflex-iRace 0.000 Neoniti-iRace 0.000 O.Shape-iRace 0.000 Revo-S-iRace 0.000 WOG-iRace 0.000 Reciproc-P.Next 0.002 F6-P.Next 0.019 Hyflex-P.Next 0.000 Neoniti-P.Next 0.000 O.Shape-P.Next 0.000 Revo-S-P.Next 0.000 WOG-P.Next 0.000 Reciproc-Hyflex 0.002 F6-Hyflex 0.003 Hyflex-O.Shape 0.001 O.Shape-Neoniti 0.027 O.Shape-Revo-S 0.045 P.Next-F360 0.000 Reciproc-F360 0.000 F6-F360 0.000 Hyflex-F360 0.000 Neoniti-F360 0.000 O.Shape-F360 0.000 Revo-S-F360 0.000 WOG-F360 0.000 P.Next-iRace 0.009 Reciproc-iRace 0.000 F6-iRace 0.002 Hyflex-iRace 0.000 Neoniti-iRace 0.000 O.Shape-iRace 0.029 Revo-S-iRace 0.000 WOG-iRace 0.001 Neoniti-O.Shape 0.008 Tablica 2. Statistička analiza rezne površine Table 2. Statistical analysis of cutting area.
- 7. www.ascro.hr Shaping Ability of 10 Systems Rubio et al. 213 Discussion This study compared the effects of ten endodontic sys- tems (F360®, F6 SkyTaper®, Hyflex EDM®, iRace®, Neoniti®, One Shape®, ProTaper Next®, Reciproc®, Revo-S® and Wave One Gold® )of the same size but with different movements, tapers, designs, file numbers, speeds and torques in the cut- ting area, root canal anatomy preservation and non-instru- mented areas. Three areas of root canal (the coronal, middle and apical thirds) were assessed in a similar fashion to that of Testa et al. (25). Several studies have investigated the shap- ing ability in resin blocks, but the problem of these blocks is their distortion (26, 27). For this reason, the extracted hu- man teeth were used in this study, likewise in Pedullà et al. (28). Regarding the use of AutoCAD in endodontics, this soft- ware was has been used to compare the efficacy of manual in- strumentation and rotary and reciprocating instruments for removing root canal filling material in retreatments (29, 30,) the sealing quality of different systems (31, 32) and the work- ing length loss (33) and apical transportation of multiple in- strumentation systems (34, 35). With regard to similar investigations into the shaping ability, Cabanillas et al. (36) compared manual instrumenta- tion, ProTaper Universal®, ProTaper Next® and Wave One®. They concluded that there were no significant differences in the middle and apical thirds, and that Wave One® was signif- icantly worse in the coronal third (P<0.05), probably due to the design of the file. Iqbal et al. (37) studied the percentage of instrumented areas with ProFile® and a hybrid technique Rasprava U ovom istraživanju uspoređivani su učinci deset endo- dontskih sustava (F360® , F6 SkyTaper® , Hyflex EDM® , iRa- ce® , Neoniti® , One Shape® , ProTaper Next® , Reciproc® , RevoS® i Wave One Gold® ) iste veličine, ali s razlikama u kretnjama, koničnosti, obliku, broju instrumenata, brzini i okretnom momentu na reznu površinu, očuvanje anatomije korijen- skog kanala i neinstrumentiranu površinu. Tri područja kori- jenskih kanala (koronalna, srednja i apikalna trećina) procije- njena su na sličan način kao i kod Testa i sur. (25). Nekoliko istraživanja bavilo se učinkovitošću oblikovanja u blokovima smole, ali problem tih blokova je njihova distorzija (26, 27). Zbog toga su u ovom istraživanju korišteni izvađeni ljudski zubi, kao kod Pedullà i sur. (28). Što se tiče korištenja AutoCAD-a u endodonciji, ovaj sof- tver korišten je za usporedbu učinkovitosti ručne instrumen- tacije te rotacijskih i recipročnih instrumenata za uklanjanje materijala za punjenje iz korijenskog kanala u revizijama en- dodontskog liječenja (29, 30), analizu kvalitete brtvljenja ra- zličitih sustava (31, 32), gubitka radne duljine (33) i tran- sportacije apeksnog foramena (34, 35). Što se tiče sličnih istraživanja učinkovitosti oblikovanja korijenskih kanala, Cabanillas i sur. (36) usporedili su ruč- nu instrumentaciju sa sustavima ProTaper Universal® , ProTa- per Next® i Wave One® . Zaključili su da nema značajnih ra- zlika u srednjim i apikalnim trećinama te da je Wave One® bio znatno lošiji u koronalnoj trećini (P < 0,05), vjerojatno zbog oblika instrumenta. Iqbal i sur. (37) proučavali su po- stotak instrumentiranih površina primjenom sustava ProFile® Očuvanje anatomije korijenskog kanala • Root canal anatomy preservation Sustav • System Koronalno • Coronal Sredina • Middle Apikalno • Apical F360 90 96,67 100 F6 SkyTaper 86,67 90 90 Hyflex EDM 100 96,67 96,67 iRace 80 90 96,67 Neoniti 100 93,33 100 One Shape 93,33 90 93,33 Protaper Next 93,33 93,33 96,67 Reciproc 93,33 100 100 Revo-S 93,33 96,67 93,33 Wave One Gold 86,67 100 93,33 Pearson’s chi-squared 0.149 0.515 0.522 Neinstrumentirana površina • Non-instrumented areas Sustav • System Koronalno • Coronal Sredina • Middle Apikalno • Apical F360 33,33 23,33 13,33 F6 SkyTaper 20 16,67 6,67 Hyflex EDM 10 10 0 iRace 23,33 16,67 13,33 Neoniti 13,33 3,33 0 One Shape 23,33 23,33 6,67 Protaper Next 10 6,67 0 Reciproc 10 3,33 0 Revo-S 30 20 23,33 Wave One Gold 20 3,33 0 Pearson’s chi-squared 0,196 0,033 0,000 Tablica 3. Očuvanje anatomije korijenskog kanala (%), neinstrumentirana površina (%) i statistička analiza Table 3. Root canal anatomy preservation (%), non-instrumented areas (%) and statistical analysis.
- 8. www.ascro.hr Učinkovitost oblikovanja 10 sustava Rubio i sur. 214 i hibridne tehnike koristeći se instrumentima lqFiles i H-in- strumentima 1 i 3 mm od radne dužine; hibridna tehnika s instrumentima lqFiles bila je značajno bolja od ostalih tehni- ka (P < 0,05), ali nije bilo statistički značajne razlike između dviju hibridnih tehnika na 3 mm (P > 0,05). Godine 2015. (23) autori ovog istraživanja koristili su se sličnom metodo- logijom za usporedbu sustava F360® , RaCe® , Mtwo® i Hyflex CM® , bez statistički značajnih razlika (P > 0,05). Međutim, instrumenti korišteni u istraživanju 2015. imali su isti konus (4 %) i veličinu (#35), koji su važni čimbenici u istraživanju učinkovitosti oblikovanja. Za razliku od Iqbala i sur. (37), ni- su korištene hibridne tehnike. Za razliku od Cabanillas i sur. (36), u ovom su istraživanju zapažene statistički značajne ra- zlike u srednjoj i apikalnoj trećini. Što se tiče rezultata rezne površine (Tablica 1.), Reciproc® i ProTaper Next® postigli su najveće prosječne vrijednosti u koronarnoj trećini: 1,510 ± 0,275 mm2 i 1,586 ± 0,301 mm2 . Istodobno, Neoniti® i Hyflex EDM® postigli su najveće vri- jednosti u srednjoj i apikalnoj trećini: 0,789 ± 0,112 mm2 - 0,707 ± 0,109 mm2 i 0,475 ± 0,059 mm2 - 0,538 ± 0,071 mm2 . Reciproc® (0,801 ± 0,140 mm2) i Neoniti® (0,805 ± 0,081 mm2) bili su sveukupno statistički značajno bolji. Ahmetoglu i sur. (38) uspoređivali su Reciproc® , Revo-S® i Se- lf-Adjusting File® (SAF) primjenom μ-CT-a na gornjim pr- vim kutnjacima i nisu pronašli statistički značajne razlike iz- među instrumenata (P > 0,05). U drugom istraživanju, Saleh i sur. (39) istraživali su Reciproc® , Wave One® , One Shape® i F360® veličine 25, koristeći se blokovima smole i preklapaju- ći preoperativne i postoperativne slike. Autori su zaključili da su Reciproc® i Wave One® znatno bolji od sustava One Shape® i F360® (P < 0,05), vjerojatno zbog konusa (8 %) i recipročne kretnje. Nadalje, Zeng i sur. (40) proučavali su reznu površi- nu postignutu sustavima Reciproc® , One Shape® , Mtwo® i Re- vo-S® veličine instrumenta 25 u apikalnoj trećini kutnjaka s pomoću μ-CT-a i zabilježili najbolje rezultate za Reciproc® (P < 0,05). Zaključili su da je sustav s jednim instrumentom dao bolje rezultate od sustava s kontinuiranim rotacijskim kret- njama. U ovom istraživanju korišteni su izvađeni ljudski zu- bi, kao i u istraživanjima Ahmetoglua i sur. te Zenga i sur., ali različito od Saleha i sur. Očuvanje anatomije korijenskog kanala vrlo je važno za trodimenzionalnu obturaciju. Rezultati (Tablica 3.) su poka- zali da su Neoniti® i Hyflex EDM® najbolji u koronarnoj tre- ćini (100 %), Reciproc® i Wave One Gold® bili su najstabilni- ji (100 %), a F360® , Reciproc® i Neoniti® postigli su najbolje postotke u apikalnoj trećini (100 %). Neinstrumentirana po- dručja mogu ugroziti uspjeh endodontske terapije. Zbog to- ga je instrumentacija koja obuhvaća sve stijenke vrlo važna. U ovom istraživanju ProTaper Next® , Reciproc® i Hyflex EDM® postigli su najbolji postotak (10 %) u koronarnoj trećini. U srednjoj trećini, Recipro® , Neoniti® i Wave One Gold® bili su bolji (3,33 %) od ostalih sustava. ProTaper Next® , Reciproc® , Hyflex EDM® , Neoniti® i Wave One Gold® postigli su najbo- lji postotak u apikalnoj trećini (0 %) (Tablica 3.). Gergi i sur. (41) uspoređivali su očuvanje anatomije korijenskog kanala i neinstrumentiranu površinu s instrumentima veličine 25 su- stava Reciproc® , Wave One® i TF® , bez statistički značajnih ra- zlika (P > 0,05), ali s boljim očuvanjem anatomije korijen- using lqFiles and H-files at 1 and 3mm from working length; the hybrid technique with lqFiles was significantly better than the other techniques (P<0.05), but there were no signif- icant differences between the two hybrid techniques at 3mm (P>0.05). In 2015 (23), the authors of the present study used similar methodology to compare (21) F360®, RaCe®, Mtwo® and Hyflex CM® files, obtaining and no significant differenc- es (P>0.05). However, all of the files used in the 2015 study had the same taper (4%) and size (#35), which are important factors in any investigations into the ability. Unlike in Caba- nillas et al. (36), significant differences in the middle and api- cal thirds were observed in the present study. Concerning the cutting area results (Table 1), Reciproc® and ProTaper Next® obtained the highest means in the cor- onal third: 1.510 ± 0.275 mm2 and 1.586 ± 0.301 mm2 re- spectively. On the other hand, Neoniti® and Hyflex EDM® achieved the highest means in the middle and apical thirds: 0.789 ± 0.112 mm2 – 0.707 ± 0.109 mm2 and 0.475 ± 0.059 mm2 – 0.538 ± 0.071 mm2 , respectively. Finally, Reciproc® (0.801 ± 0.140 mm2 ) and Neoniti® (0.805 ± 0.081 mm2 ) were significantly better overall. Ahmetoglu et al. (38) com- pared Reciproc®, Revo-S® and Self-Adjusting File® (SAF) by micro-computed tomography (μ-CT) in maxillary first mo- lars, and found no significant differences between instrumen- tation systems (P>0.05). In another study, Saleh et al. (39) in- vestigated Reciproc®, Wave One®, One Shape® and F360® 25 files using resin blocks and superimposing preoperative and postoperative images. The authors observed that Reciproc® and Wave One® were significantly better than One Shape® and F360® (P<0.05), probably because of the taper (8%) and the reciprocating movement. Moreover, Zeng et al. (40) stud- ied the cutting area of apical third of Reciproc®, One Shape®, Mtwo® and Revo-S® size 25 files in the apical third of mature molars with μ-CT and observed better results for Reciproc® (P<0.05), concluding that the reciprocating single-file system gave better results than continuous rotary systems. Extracted human teeth were used in this study as in those of Ahmetog- lu et al. and Zeng et al. although unlike in Saleh et al., which superimposed preoperative and postoperative images, as in the present study. Root canal anatomy preservation is very important for three-dimensional obturation. The results (Table 3), showed that Neoniti® and Hyflex EDM® were the best systems in the coronal third (100%), Reciproc® and Wave One Gold® were the most stable (100%), and in apical thirds F360®, Recip- roc® and Neoniti® obtained the best percentages in the apical thirds (100%). Non-instrumented areas can also jeopardize the endodontic treatment. For this reason, circumferen- tial instrumentation is very important, and was used in all the groups. In this investigation the present study, ProTaper Next®, Reciproc® and Hyflex EDM® obtained the best per- centage (10%) in the coronal third. In the middle third, Re- ciproc®, Neoniti® and Wave One Gold® were better (3.33%) than the other systems. Finally, ProTaper Next®, Reciproc®, Hyflex EDM®, Neoniti® and Wave One Gold® obtained the best percentage in the apical third (0%), (Table 3). Gergi et al. (41) compared the root canal anatomy preservation and non-instrumented areas with Reciproc®, Wave One® and TF®
- 9. www.ascro.hr Shaping Ability of 10 Systems Rubio et al. 215 size 25 files, finding no significant differences in non-instru- mented areas (P>0.05), but better root canal anatomy preser- vation results with TF® (P<0.05). De-Deus et al. (42) inves- tigated non-instrumented areas for size 25 and 40 Reciproc®, Wave One® and BioRace® files and concluded that there were no significant differences between all any of the systems (P>0.05). Unlike Gergi et al. and De-Deus et al., the present study found significant differences in non-instrumented ar- eas in the middle and apical thirds, but Reciproc® was signifi- cantly better (P<0.05), probably due to its S cross-section, re- ciprocating movement and taper. Conclusions In cutting area, ProTaper Next® and Reciproc® were supe- rior in the coronal third, Neoniti® and Hyflex EDM® in the middle and apical thirds, and Neoniti® and Reciproc® overall. Regarding root canal anatomy preservation, all the systems obtained similar results. In non-instrumented areas, the sys- tems were similar in the coronal third, but Reciproc®, Neo- niti® and Wave One Gold® were better in the middle third, and ProTaper Next®, Reciproc®, Hyflex EDM®, Neoniti®, and Wave One Gold® were better in the apical third. Acknowledgements The authors thank acknowledge Endovations-FKG Den- taire, Komet Dental, Coltene, Dentsply Maillefer, Neolix, VDW and Micro-Mega for providing instruments for this research. Conflict of Interest None declared skog kanala kada je korišten sustav TF® (P < 0,05). De-Deus i sur. (42) analizirali su neinstrumentirane površine nakon instrumentacije instrumentima veličine 25 i 40 sustava Re- ciproc® , Wave One® i BioRace® te zaključili da između susta- va nije bilo statistički značajnih razlika (P > 0,05). Za razliku od Gergija i sur. i De-Deusa i sur., ovo istraživanje pokazalo je statistički značajne razlike s obzirom na neinstrumentira- nu površinu u srednjoj i apikalnoj trećini, pri čemu je Reci- proc® bio bolji (P < 0,05), vjerojatno zbog presjeka u obliku slova S i konusa. Zaključci Što se tiče rezne površine, ProTaper Next® i Reciproc® bi- li su najbolji u koronarnoj trećini, Neoniti® i Hyflex EDM® u srednjoj i apikalnoj trećini, a ukupno su bili najbolji Neoni- ti® i Reciproc® . Što se tiče očuvanja anatomije korijenskog ka- nala, svi sustavi su postigli slične rezultate. S obzirom na ne- instrumentiranu površinu, sustavi su bili slični u koronarnoj trećini, no Reciproc® , Neoniti® i Wave One Gold® bili su bolji u srednjoj trećini, a ProTaper Next® , Recipro® , Hyflex EDM® , Neoniti® i Wave One Gold® u apikalnoj trećini. Zahvala Autori zahvaljuju tvrtkama Endovations-FKG Dentaire, Komet Dental, Coltene, Dentsply Maillefer, Neolix, VDW i Micro-Mega za donaciju instrumenata. Sukob interesa Nema sukoba interesa. References 1. You SY, Kim HC, Bae KS, Baek SH, Kum KY, Lee W. Shaping abil- ity of reciprocating motion in curved root canals: A compara- tive study with micro-computed tomography. J Endod. 2011; 37(9):1296–300. Abstract Objective: The aim of this study was to compare the cutting are, root canal anatomy preservation and non-instrumented areas of F360®, F6-SkyTaper®, Hyflex-EDM®, iRACE®, Neoniti®, O.Shape®, P.Next®, Reciproc®, Revo-S® and Wave-One-Gold® size 25 files. Materials and Methods: 300 teeth with a single straight root and a circular or elliptical root canal were divided into 10 groups (1-F360®, 2- F6-SkyTaper®, 3-Hyflex-EDM®, 4-iRACE®, 5-Neoniti®, 6-O.Shape®, 7-P.Next®, 8-Reciproc®, 9-Revo-S® and 10-Wave-One-Gold®) cut into 3 cross sections using an ultrafine cutting disc. They were photographed under a stereo microscope and preinstrumentation analyses were made before rebuilding the teeth with# 10 K- File and epoxy glue. A glide path was created with #10 and #15 K files and each group was instrumented using rotary or reciprocating systems. Cutting areas, root canal anatomy preservation and non-instrumented areas were analyzed using the AutoCAD 2015 Levene’s test, the Welch´s test, and the Games-Howell´s test. The Pearson’s chi-squared test was used for sta- tistical analysis. Results: Levene’s test showed no equality of variances (P<0.05), therefore Welch´s and Games-Howell’s tests were applied to cutting areas, showing significant differences in all thirds and overall (P<0.05). No differences in root canal anatomy preservation were observed (P>0.05). In non-instrumented areas, significant differences were found (P<0.05) in middle third being better in Reciproc®, Neoniti® and WaveOneGold®, and in apical thirds being higher P.Next®, Reciproc®, HyflexEDM®, Neoniti® and WaveOneGold®. Conclusions: In cutting area, P.Next® and Reciproc® were superior in coronal third, Neoniti® and Hyflex EDM® medially and apically and Neoniti® and Reciproc® overall. Regarding the root canal anatomy preservation, all systems were similar. For non- instrumented areas, all systems achieved similar results coronally, but Reciproc®, Neoniti® and Wave One Gold® were superior in middle third and P.Next®, Reciproc®, Hyflex EDM®, Neoniti® and Wave One Gold® were superior in apically. Received: June 29, 2017 Accepted: September 1, 2017 Address for correspondence Jorge Rubio Catholic University of Valencia Spain Department of Endodontics jorrucli@hotmail.com Key words Root Canal Preparation; Dental High- Speed Equipment 2. Santa-Rosa J, de Sousa-Nieto MD, Versiani MA, Nevares G, Xavi- er F, Romeiro K, et al. Shaping ability of single-file systems with different movements: a micro-computed tomographic study. Iran Endod J. 2016; 11(3):228-33.
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