Current Challenges and Concepts in the Preparation of Root Canal Systems: A Review

Abstract

Nickel-titanium rotary instruments are important adjuncts in endodontic therapy. This review attempts to identify factors that influence shaping outcomes with these files, such as preoperative root-canal anatomy and instrument tip design. Other, less significant factors include operator experience, rotational speed, and specific instrument sequence. Implications of various working length definitions and desired apical widths are correlated with clinical results. Despite the existence of one ever-present risk factor, dental anatomy, shaping outcomes with nickel-titanium rotary instruments are mostly predictable. Current evidence indicates that wider apical preparations are feasible. Nickel-titanium rotary instruments require a preclinical training period to minimize separation risks and should be used to case-related working lengths and apical widths. However, and despite superior in vitro results, randomized, clinical trials are required to evaluate outcomes when using nickel-titanium instruments.

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

“…The anatomical complexity of root canals found in molars is a challenge for root disinfection since microorganisms can be hidden in the canal niches. The anatomical and morphological complexities of root canal systems represented by isthmus, lateral canals and curvatures are significant challenges for effective root canal disinfection (37,38).…”

Welding and Joining of NiTi Shape Memory Alloys: A Review

“…An interesting issue about this study was the fact that the oral temperature only increase by 4°C due to the laser; as such, no harm would be done to the patient. This innovative technique may soon start being used in dental clinics, as fracture of such NiTi files inside root canals is considered a problem of major importance for the industry, the clinics and the patients [286,287].…”

WaveOne: A Simple and Safe Way to Perform an Endodontic Treatment

“…This rotational technique is safe and more reproducible with less procedure errors compared with the manual technique. The high elasticity of the rotatory NiTi files allow the use of less force on the canal walls, especially in highly curved canals (Peters, 2004). However, the manufacturers have recently introduced into the market new instruments designed with a special alloy to improve resistance to fracture.…”