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 6 publications

(7 citation statements)

References 98 publications

(132 reference statements)

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“…In conclusion, there is a potential shape recovery effect and increased cyclic fatigue resistance after autoclaving. However, not all studies agree ( Dioguardi et al, 2021 )…”

Section: Discussionmentioning

confidence: 99%

Effect of simulated clinical use and sterilization on the cyclic fatigue resistance of nickel titanium files

Alajemi,

AbuMostafa

2024

PeerJ

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Aim Assess the effect of simulated clinical use and sterilization on the cyclic fatigue resistance of Race Evo and Tia Tornado Blue nickel titanium (NiTi) files. Materials and Methods For this study, a total of sixty-four NiTi files were selected, with thirty-two files each from two different manufacturers. Files from each manufacturer were subdivided into four subgroups (n = 8) based on the test parameters. The control groups included files that were neither used nor sterilized. Files from the test groups were used to prepare the root canals of extracted mandibular premolars and then sterilized. This procedure was repeated once, twice, or thrice, depending on the test group. All files were then subjected to a cyclic fatigue test. Data was statistically analyzed using the Kruskal–Wallis and Mann–Whitney U tests. Results No significant difference was observed in the number of cycles to failure (NCF) among the subgroups for both types of files (P = 0.869 for Tia Tornado Blue, P = 0.626 for Race Evo). Tia Tornado Blue files displayed significantly higher NCF values in the control (P = 0.021), once (P = 0.027), and thrice (P = 0.031) usage groups when compared to Race Evo files. Conclusions Repeated clinical use and sterilization for up to three cycles did not affect the cyclic fatigue resistance of Race Evo and Tia Tornado Blue files.

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“…In conclusion, there is a potential shape recovery effect and increased cyclic fatigue resistance after autoclaving. However, not all studies agree ( Dioguardi et al, 2021 )…”

Section: Discussionmentioning

confidence: 99%

Effect of simulated clinical use and sterilization on the cyclic fatigue resistance of nickel titanium files

Alajemi,

AbuMostafa

2024

PeerJ

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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%

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

Cited by 6 publications

References 98 publications

Effect of simulated clinical use and sterilization on the cyclic fatigue resistance of nickel titanium files

Effect of simulated clinical use and sterilization on the cyclic fatigue resistance of nickel titanium files

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

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