Assessment of Influence of Flexion Angles of Files in Apical Stop Preparation by Using Manual and Rotary Instrumentation Techniques

• Published in: Journal of endodontics Vol. 38; no. 10; pp. 1383 - 1386
• Main Authors: Pereira, Analice Giovani, DDS, MS, Fagundes dos Santos, Renata Medeiros, DDS, Mendes Azevedo, Kellen Cristina, DDS, Raposo, Luís Henrique Araújo, DDS, MS, Biffi, João Carlos Gabrielli, DDS, MS, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2012
• Subjects: Apical stop; Dental Alloys; Dental Instruments; Dental Stress Analysis; Dentistry; Endocrinology & Metabolism; endodontic files; Equipment Design; flexion angles; Humans; Incisor; instrumentation; Mandible; Nickel; Radiography; root canal deformation; Root Canal Preparation - instrumentation; Root Canal Preparation - methods; rotary files; Rotation; Stainless Steel; Statistics, Nonparametric; Titanium; Tooth Apex - diagnostic imaging; Torsion, Mechanical; instrumentation; rotary files; endodontic files; root canal deformation; flexion angles; Apical stop
• ISSN: 0099-2399; 1878-3554
• DOI: 10.1016/j.joen.2012.06.041

Abstract Introduction This study aimed to evaluate the influence of flexion angles produced by files during root canal instrumentation on the final form of the apical stop. Methods Sixty human lower incisors were divided into 3 groups (n = 20). After access preparation and working length determination, radiographs were taken from a mesiodistal and buccolingual direction with #15 K-file inserted to working length. Teeth from FlexM group were instrumented with stainless steel Flexofiles up to #40 file. For ProM and ProR groups, hand ProTaper Universal and ProTaper Universal rotary files were used, respectively, up to file F4. New radiographs were taken as previously described. After gutta-percha insertion, the apex of each specimen was ground, allowing gutta-percha visualization, and an image of the apex was captured to identify root canal deformation with computer software. The flexion of files was evaluated from both initial and final radiographs as the angle formed between the divergence of the file path and its virtual image represented by the direction taken by the file in the absence of curvature. Results FlexM group presented the highest variation in flexion angles compared with ProM ( P = .112) and ProR ( P  = .024) groups. Nickel-titanium rotary system (ProR) reduced apical stop deformation compared with the manual techniques that used nickel-titanium ( P  = .011) or stainless steel ( P = .025) files. Conclusions Force vectors caused by the flexion angles of the files during the instrumentation of curved canals promoted apical stop deformation. ProTaper Universal rotary files showed less apical deformation than hand ProTaper Universal and stainless steel files.