Comparative Analysis of Ni-Ti Rotary Files in Severely Curved Root Canals

A recent study conducted by Almnea et al. compared three nickel-titanium (Ni-Ti) rotary files – ProTaper (pictured), ProTaper Next (PTN), and WaveOne (WO) – in the context of preparing severely curved L-shaped root canals. The study aimed to assess preparation time, aberrations, width measurements, and fracture rates associated with each file system.

Methodology

Thirty simulated L-shaped root canals were divided into three groups, with each group being prepared using one of the three Ni-Ti rotary file systems. Pre- and post-operative views were captured for each sample to assess changes in canal shape. Preparation time, aberrations, width measurements, and fractured files were recorded and analyzed.

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Key Findings

The study revealed significant differences in preparation time among the three file systems. ProTaper Next (PTN) was the fastest, followed by WaveOne (WO), while ProTaper required the longest preparation time. Despite differences in preparation time, no significant variance was observed in width measurements among the different file systems.

In terms of aberrations, ProTaper exhibited the highest incidence, with nine cases recorded, including zips, ledges, and outer widening. PTN and WO systems also exhibited aberrations, albeit to a lesser extent, with PTN showing an outer widening and ledge, and WO experiencing a ledge and a fractured file. However, only one WO file fractured, with no deformations observed in the other instruments.

Conclusion

The study concluded that ProTaper Next (PTN) demonstrated faster cutting compared to ProTaper and WaveOne (WO). Additionally, PTN maintained the best apical termination position and produced the least canal aberration. Despite these differences, no significant variation was found in width measurements among the different file systems.

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Implications

Understanding the performance characteristics of different Ni-Ti rotary file systems is crucial for effective root canal preparation. While each system offers unique advantages, clinicians should consider factors such as preparation time, aberrations, and fracture rates when selecting the most suitable file system for specific clinical scenarios.

The findings of this comparative analysis provide valuable insights into the efficacy and safety of ProTaper, ProTaper Next, and WaveOne rotary file systems in preparing severely curved root canals, contributing to the optimization of endodontic treatment protocols.