Efficiency of rotary nickel-titanium FlexMaster instruments compared with stainless steel hand K-Flexofile--Part 2. Cleaning effectiveness and instrumentation results in severely curved root canals of extracted teeth

Abstract

Aim: To determine the cleaning effectiveness and the shaping ability of FlexMaster nickel-titanium rotary instruments and stainless steel hand K-Flexofiles during the preparation of curved root canals in extracted human teeth.

Methodology: A total of 48 root canals with curvatures ranging between 25 degrees and 35 degrees were divided into two groups of 24 canals. Based on radiographs taken prior to the instrumentation with the initial instrument inserted into the canal, the groups were balanced with respect to the angle and the radius of canal curvature. Canals were prepared by FlexMaster instruments using a crown-down preparation technique or by K-Flexofiles using a reaming working motion up to size 35. After each instrument, the root canals were flushed with 5 mL of a 2.5% NaOCl solution and at the end of instrumentation with 5 mL of NaCl. Using the pre- and post-instrumentation radiographs, straightening of the canal curvatures was determined with a computer image analysis program. After splitting the roots longitudinally, the amount of debris and smear layer were quantified on the basis of a numerical evaluation scale, using a scanning electron microscope.

Results: Completely cleaned root canals were not found with any of the two instruments. In general, K-Flexofiles resulted in significantly less debris(P < 0.001) and less smear layer (P < 0.05) than Flex-Master instruments, but these differences were not significant in the apical third of the canals (P > 0.05). FlexMaster instruments maintained the original canal curvature significantly better (P < 0.0001) than K-Flexofiles. No significant differences were detected between the instruments (P > 0.05) for the time taken to prepare the canals.

Conclusions: Under the conditions of this study, K-Flexofiles allowed significantly better canal cleaning than FlexMaster instruments. FlexMaster instruments maintained the original curvature significantly better.