Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis

Dioguardi, Mario; Arena, Claudia; Sovereto, Diego; Aiuto, Riccardo; Laino, Luigi; Illuzzi, Gaetano; Laneve, Enrica; Raddato, Bruna; Caponio, Vito Carlo Alberto; Dioguardi, Antonio; Zhurakivska, Khrystyna; Troiano, Giuseppe; Muzio, Lorenzo Lo

doi:10.52586/5062

Cited by 5 publications

(4 citation statements)

References 87 publications

(132 reference statements)

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“…To maximize the benefit of the improved lifespans by reusing these instruments multiple times, autoclave sterilization procedures are essential. However, these procedures may also affect the instruments’ physical and mechanical properties ( Dioguardi et al, 2021 ). Therefore, this study evaluated the effect of multiple autoclave cycles on the cyclic fatigue resistance of three newly developed heat-treated NiTi files (ETP, PTG, and TN).…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of the effects of autoclave sterilization on the cyclic fatigue resistance of heat-treated instruments revealed high investigation method heterogeneity and a general lack of standardization, in turn impairing meaningful comparisons between different studies and/or the formulation of evidence-based conclusions ( Silva et al, 2020 ). Another systematic review similarly reported conflicting findings; however, the authors concluded that NiTi files exhibit a trend toward improved cyclic fatigue resistance following autoclave sterilization ( Dioguardi et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

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Cyclic fatigue resistance of EdgeTaper Platinum, Protaper Gold, and TruNatomy Prime rotary files before and after autoclave sterilization

Almohareb

Barakat

Algahtani

et al. 2023

PeerJ

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Background This in vitro investigation aimed to determine the influence of multiple autoclave cycles on the cyclic fatigue resistance of three heat-treated nickel-titanium (NiTi) files: EdgeTaper Platinum (ETP), ProTaper Gold (PTG), and TruNatomy Prime (TN). Materials Sixty NiTi files, twenty of each NiTi file type: ETP 25/.06, PTG 25/.08, and TN 26/.04 were randomly divided into four equal subgroups (n = 5). The files for the control group were left un-autoclaved. Different autoclave sterilization cycles (one, five, and ten) were used for the other three groups. The files were then placed in a metal canal block and rotated according to the manufacturer’s instructions until fracture. The length of the broken segment and the time taken for fracture were measured. The fractured surfaces were subsequently subjected to SEM imaging. The Kruskal-Wallis test was used to analyze the data, followed by Dunn-Bonferroni pairwise comparisons. Statistical significance was set at p < 0.05. Results ETP showed significantly greater resistance to cyclic fatigue than TN in all autoclave groups and PTG after five autoclave cycles (p = 0.014). Fatigue resistance was not affected by the number of autoclaving cycles, except for ETP. After the first and tenth autoclaving cycles, they required significantly more rotations to failure than the non-sterilized files (p = 0.039 and p = 0.021, respectively). The fractured segments of the ETP files in these two groups were also longer than those in the control group (p = 0.010). Conclusion The cyclic fatigue resistance of ETP was greater than that of TN in all tested conditions. Repeated autoclave cycles of sterilization improved the cyclic fatigue resistance of the ETP files only and did not affect the cyclic fatigue resistance of TN and PTG. However, the ETP files separated at a longer distance from the tip with increased autoclaving cycles.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cyclic fatigue resistance of EdgeTaper Platinum, Protaper Gold, and TruNatomy Prime rotary files before and after autoclave sterilization

Almohareb

Barakat

Algahtani

et al. 2023

PeerJ

View full text Add to dashboard Cite

show abstract

“…Previously published studies indicate the influence of autoclave sterilization on the cyclic fatigue and strength of NiTi instruments, but the results are controversial [24]. The results published in existing studies seem incomplete and the results differ for different types of instruments [25].…”

Section: Discussionmentioning

confidence: 99%

Effects of Autoclave Sterilization on Cyclic Fatigue Resistance in 5 Types of Rotary Endodontic Instruments: An In Vitro Study

et al. 2023

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The research was supported by the funds of the scientific research project of the Faculty of Medicine of the University of Niš, which is financed by the Ministry of Education, Science and Technological Development of the Republic of Serbia (451-03-68/2022-14/200113) Conflict of interest: None declared Background:Rotary endodontic instruments are increasingly used in root canal treatment and have replaced stainless steel manual files. Cyclic fatigue is the cyclic loading of stress to produce deformation or fracture. This study aimed to evaluate and compare the effects of autoclave sterilization on cyclic fatigue in 5 types of rotary endodontic instruments. Material/Methods:ProTaper Universal, BioRace, ProTaper Next, Twisted File, and HyFlex CM instruments were included in this study. Each type included 96 instruments, divided into 4 groups according to the number of sterilization cycles (0, 1, 3, 5). After sterilization, each group of instruments was divided into 2 subgroups and tested for cyclic fatigue in 2 simulated canals (45 degrees both and 2 radii, 2 mm and 5 mm). The number of cycles to failure (NCF) was calculated, and statistical analyses were carried out using the t test, Mann-Whitney U test, and ANOVA, followed by the Tukey post hoc test (p<0.05). Fracture surfaces were analyzed using scanning electron microscopy (SEM). Results:Within the group of non-sterilized instruments, ProTaper Universal showed significantly lower resistance to cyclic fatigue compared to the other types of instruments (p<0.001). After repeated sterilization, a significantly higher mean of NCF was observed for BioRace (p<0.001), ProTaper Next (p<0.001), Twisted File (p<0.001), and HyFlex CM (p<0.001) compared to ProTaper Universal. The resistance of HyFlex CM was significantly higher compared to the other types of instruments (p<0.001). Conclusions:The findings from this study showed that autoclave sterilization of newer rotary endodontic instruments could increase resistance to cyclic fatigue.

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“…Primarily, surface Ra is an important feature that affects the fracture mechanism of rotary instruments being used in the canal system [34]. Moreover, dentin particles also become clogged on the surface irregularities, thus making the sterilization process difficult for these instruments to become completely aseptic [35]. In addition, the canal preparation is also compromised, which affects the quality of root canal treatment, resulting in potential failures.…”

Section: Discussionmentioning

confidence: 99%

Influence of 17% EDTA and Sapindus mukorossi on the Surface Property of Protaper Gold Rotary Endodontic Instruments

et al. 2022

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The aim of the study was to evaluate the influence of 17% ethylenediaminetetraacetic acid (EDTA) and ethanolic extract of Sapindus mukorossi (S. mukorossi) in combination with canal shaping on surface properties of ProTaper Gold rotary endodontic file. Sixteen F1 ProTaper Gold rotary files underwent the standard protocol for root canal treatment using two irrigants (S. mukorossi and 17% EDTA) in single-rooted decoronated teeth. Eight unused files were used as a control. All files were examined under an atomic force microscope (AFM) to evaluate surface roughness (Ra) and root mean square (RMS). Data were analyzed using the t-test. RMS and Ra values of the control file were 1.37 and 0.607, respectively. The mean RMS (3.70 ± 1.41) and mean Ra (2.89 ± 1.41) in EDTA group were significantly higher than the control file (p < 0.05). The mean RMS in the S. mukorossi group (1.77 ± 0.66) did not show any significant difference with the control (p > 0.05). The Ra of S. mukorossi group (1.09 ± 0.05) was significantly higher than the control file (p < 0.05). Moreover, the mean RMS and Ra were found to be significantly higher in the EDTA group compared to the S. mukorossi group (p < 0.05). The mean Ra and RMS values of the ProTaper Gold files used to prepare canals using 17% EDTA and S. mukorossi irrigation were significantly higher than the control files. The EDTA-treated ProTaper Gold rotary files demonstrated higher surface Ra and RMS than the S. mukorossi files.

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Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis

Cited by 5 publications

References 87 publications

Cyclic fatigue resistance of EdgeTaper Platinum, Protaper Gold, and TruNatomy Prime rotary files before and after autoclave sterilization

Cyclic fatigue resistance of EdgeTaper Platinum, Protaper Gold, and TruNatomy Prime rotary files before and after autoclave sterilization

Effects of Autoclave Sterilization on Cyclic Fatigue Resistance in 5 Types of Rotary Endodontic Instruments: An In Vitro Study

Influence of 17% EDTA and Sapindus mukorossi on the Surface Property of Protaper Gold Rotary Endodontic Instruments

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