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. 2021 Jan 22;100(3):e23865.
doi: 10.1097/MD.0000000000023865.

Preventing nickel-titanium rotary instrument from breakage by continuous irrigation with different fluids during root canal preparation

Changjian Li  1 , Le Liu, Yanfeng Li, Xin Wang, Haiyun Liu, Jiaxin Bao, Jing Wang, Jiadong Fan
Affiliations

Preventing nickel-titanium rotary instrument from breakage by continuous irrigation with different fluids during root canal preparation

Changjian Li et al. Medicine (Baltimore). .

Abstract

To study the effect of continuous irrigation of rotating nickel-titanium instrument with several common clinical fluids on the diameter, breaking length and breaking position of nickel-titanium instrument, so as to provide some reference and theoretical basis for clinical operation and instrument improvement.A standardized curved root canal model was established, and ProTaper Universal (PTU) F1 instrument was selected for root canal preparation. The nickel-titanium F1 instrument was flushed with distilled water, 0.9% NaCl, 0.2% chlorhexidine, 1% sodium hypochlorite and 5% sodium hypochlorite, and the diameter, length and position of the instrument before and after breakage were recorded.Only 5% sodium hypochlorite influenced the diameter of 6 mm marker points under different irrigation conditions (P < .05). There was no statistical difference in the length of broken instruments among all the groups, and torsional deformation mainly occurred at the end of broken instruments. The broken positions of instruments in all the groups were located at the bending segment of the root canal. The breaking frequency of the 5% sodium hypochlorite group was the highest in the area 3-5.5 mm away from apical foramen, while the other 4 groups had the highest breaking frequency in the area 0 to 1.5 mm away from apical foramen.External irrigation with different fluids did not influence the breaking length of instruments. The closer to the apical foramen was, the higher the breaking frequency of instruments was. However, only 5% sodium hypochlorite can affect the diameter of rotary nickel-titanium instruments, and may lead to early breakage of the instrument, indicating that the use of disinfectants, except 5% sodium hypochlorite, cannot reduce breakage resistance of nickel-titanium instrument compared with distilled water flushing. Furthermore, 5% hypochlorite could not be recommended for irrigation in clinical practice.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The method of laser marking.
Figure 2
Figure 2
Method of root canal preparation. Note: (1) refers to 0N when no force is applied, (2) refers to 10N when pressing down.
Figure 3
Figure 3
Measurement at the 6-mm laser marker site.
Figure 4
Figure 4
Measurement at the 9-mm laser marker site.
Figure 5
Figure 5
Measurement at the 12-mm laser marker site.
Figure 6
Figure 6
Measurement at the 15-mm laser marker site.
Figure 7
Figure 7
Distribution of location of broken PTU F1 in area away from the apical foramen. Note: “0 to 1.5 mm” refers to the broken PTU F1 located at area 0 to 1.5 mm from the apical foramen of the module, which is equivalent to 80% to 100% of complete root canal preparation. By inference, “1.5 to 3 mm” is equivalent to 60% to 80% of the complete root canal preparation, “3 to 5.5 mm” is equivalent to 40% to 60% of complete root canal preparation, “5.5 to 8 mm” is equivalent to 20% to 40% of complete root canal preparation, “8 to 10 mm” is equivalent to 0% to 20% of complete root canal preparation, respectively.
Figure 8
Figure 8
Frequency of regional distribution of broken PTU F1 in different groups.
See this image and copyright information in PMC

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