Introduction: Cyclic fatigue resistance of rotary endodontic instruments has been extensively studied in the last two decades, yet with no standardization. While new low-cost instruments are now manufactured, a standard is lacking to guarantee a minimum quality. This study aimed to validate a new model for CF testing through a fixture proposed for ISO Specification 3630-1 and to establish a minimum quality standard based on testing conditions and material characteristics.Materials and methods: Size 25/0.06 instruments of ProFile Vortex (PF) and Vortex Blue (VB) were run until failure in curved metallic fixtures (5 or 7.5 mm radius) built according to a proposal for an additional test for the ISO 3630-1 standard. High resolution videos were recorded, number of cycles to failure (NCF) registered and apical fragments measured with a digital caliper. Surface strain was determined from test dimensions and fragment lengths. Mean life, β and η parameters were calculated with Weibull analysis. NCF data were compared using student's t-tests and referenced to a minimum required cycles at fracture (Cmin) based on austenite finish temperatures, testing temperature and deformation.Results: VB instruments were statistically more resistant than PF in both 7.5 mm radius curve (p = 0.001) and 5 mm radius curve (p = 0.002) simulated canals. Weibull probability plots showed higher mean life for VB than PV. NCF for both instruments were higher than Cmin.Conclusions: The NCF results in this study support the findings of previous studies where VB and PF were compared. The novel test design appears a suitable addition to ISO 3630-1.
Background: To evaluate the cyclic fatigue resistance of rotary endodontic nickel-titanium instruments using both experimental and finite element methods. Methodology: Four different proprietary rotary endodontic instruments (PTG, PTU, VB, and TRN) were subjected to cyclic fatigue tests through a custom-built fixture (n = 30 for each group) and tested until failure according to the manufacturer’s recommended settings, and the number of cycles to failure (NCF) was measured. Separated fragments were measured to determine the location of the fracture event. Finite element modeling replicated this experiment in silico via a two-step method, modeling the dynamic motion via an initial insertion step, then followed by rotation. Results: TRN showed the highest NCF (2027.94 ± 452.50) with the lowest values for strain (4.49% ± 0.23%) and fragment lengths (3.26 mm ± 0.47 mm), whereas PTU showed the lowest NCF (600.90 ± 80.86) and highest values for strain (6.29% ± 0.47%) and fragment lengths (5.36 mm ± 0.79 mm). All instruments showed an increase in von Mises and maximum principal stress during the insertion step but showed no changes to the maximum stress values during the rotational step. Conclusions: The finite element analysis approach used provided useful insights into the stress evolution and stress distribution of instruments during cyclic fatigue but lacked the ability with existing inputs to predict failure from cyclic fatigue.
Subcutaneous facial emphysema (SFE) following routine dental operative procedure is an uncommon but potentially life‐threatening complication. The present case details a Class V restoration where air was introduced into the fascial tissue planes via the gingival sulcus from the use of an air‐driven dental handpiece. Although the SFE is usually self‐limiting within 3–10 days, such instances should be regarded as a medical emergency as in severe cases, the air may spread to the neck, mediastinum and thorax to result in cervicofacial emphysema with potential pneumomediastinum and pneumothorax.
This study aimed to evaluate and compare the effects of ambient temperature and post-manufacture heat-treatment on the mechanical behavior of nickel-titanium (NiTi) wires. Four types of commercial NiTi variants (Stock NiTi, heat treated “Blue”, “Gold”, “Superflex”, all Dentsply Maillefer, Ballaigues, Switzerland) were stressed in a tensile testing machine in a temperature-controlled water bath at three different temperatures. Stress and strain values were extrapolated from the raw data, and 2-way ANOVA and Tukey’s test for multiple comparisons were performed to compare the differences of the mechanical constants. Differential scanning calorimetry (DSC) tests established the martensitic transformation starting (Ms), finishing (Mf) and austenitic (reverse-martensitic) starting (As) and finishing (Af) points. Austenitic modulus of elasticity and transformation stress values increased with temperature for all NiTi groups. The martensitic modulus of elasticity, maximum transformation strain and ultimate tensile stress were not significantly affected by temperature changes. Stock NiTi and Gold wire samples presented with clearly delineated austenitic and martensitic transformations in the DSC experiments. Differences in manufacturing/heat treatment conditions and ambient temperature affect the mechanical behavior of nickel-titanium and may have clinical implications. Further improvements to the experimental setup could be considered to provide more accurate measurements of strain.
Finite element analysis has been a valuable research tool for rotary nickel-titanium endodontic files over the last two decades. This review aims to summarise and critique the methodology as used in currently available endodontic literature for finite element analysis of rotary nickel-titanium instruments. An electronic literature research in PubMed and Scopus databases was performed using the appropriate search terms, and the titles and abstracts were screened for relevance. The review revealed an inconsistent approach to the finite element method, particularly with regards to the boundary conditions in which the instruments are tested. Moreover, there is a lack of experimental data to validate in silico findings. A standardised protocol to finite element analysis of rotary endodontic instruments could be considered for future studies.
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