Comprehensive Review of Rotary NiTi Technology and Root Canal Preparation

ITALY: In a comprehensive review led by NM Grande, R Castagnola, I Minciacchi, L Marigo, and G Plotino, researchers from Università Cattolica del Sacro Cuore, Rome, Italy, delve into the transformative journey of nickel-titanium (NiTi) mechanical instruments in clinical endodontics. The review sheds light on the profound impact of NiTi technology on root canal procedures over the past few decades.

NiTi: Transformative Advances in Mechanical Root Canal Preparation

The introduction of NiTi mechanical instruments marked a turning point in clinical endodontics. Before NiTi, creating an ideal root canal shape necessitated the use of multiple instruments, leading to the development of various approaches, sequences, and techniques.

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Recent modifications in design, surface treatments, and thermal treatments have ushered in a new era for NiTi endodontic instruments, focusing on enhancing root canal preparation outcomes and mitigating associated risks during treatment. Notably, heat treatment emerges as a fundamental approach to bolster the fatigue resistance and flexibility of NiTi endodontic instruments.

Understanding NiTi Properties: A Clinician’s Guide

The narrative review presents a detailed exploration of the general properties and manufacturing of NiTi instruments, offering insights into the mechanical system evolution of these instruments. The super-elastic behavior of NiTi, significantly more elastic than stainless steel, influences the manufacturing procedures of endodontic instruments. The alloy’s characteristics, influenced by temperature and thermal history, have led to its varied forms over time.

Addressing the persistent challenge of intracanal fracture during root canal treatment, the review highlights the pivotal role of heat treatment in improving fatigue resistance and flexibility. The incorporation of new kinematics, particularly through reciprocating rotary motion, adds a layer of safety and efficiency. 

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With over 200 brands of instrument systems available in the market, the review categorizes seven generations of instruments based on taper, rake angle, cross-section, type of NiTi alloy, and the year of production.

Clinical Relevance: Empowering Clinicians in Decision-Making

The paper concludes by emphasizing the clinical relevance of the review, presenting the developments and characteristics of NiTi instruments for mechanical root canal preparation. Clinicians are empowered to stay abreast of the latest NiTi alloy advancements, aiding them in choosing instruments best suited for diverse clinical endodontic scenarios.

In summary, the review offers a nuanced understanding of NiTi technology’s evolution, from its inception to the current advancements, providing a valuable resource for clinicians navigating the dynamic landscape of root canal procedures.

Read the full article: A review of the latest developments in rotary NiTi technology and root canal preparation