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Background Nickel titanium (NiTi) rotary files have drastically altered the treatment protocol in endodontics, allowing for faster and easier preparation and more thorough irrigation of the root canal system. Despite the advantages of the NiTi files, instrument separation still remains a major concern. The aim of this study was to compare the cyclic fatigue resistance of three different single-file NiTi systems after clinical use: WaveOne Gold (WOG, Dentsply Maillefer, Ballaigues, Switzerland), One Curve (OC, Micro Mega, Besancon, France), and Reciproc Blue (RPC Blue, VDW, Munich, Germany). Methods A total of 120 patients requiring endodontic treatment to first or second mandibular molars, were randomly divided into three groups (patient n  = 40) and root canals were prepared with WOG, OC or RPC Blue. Each group consists of 2 subgroups: first use (file n  = 10, patient n  = 10) and third use of file (file n  = 10, patient n  = 30). In control group, files were subjected to cyclic fatigue test without use (file n  = 10). Cyclic fatigue resistance of files was assessed by groove method. The data was evaluated by two-way ANOVA, Games & Howell post hoc and Weibull reliability analyses ( p  < .05). Results RPC Blue files showed the highest failure time value in all groups. In third use group, OC and RPC Blue files showed significantly higher failure time values compared to WOG files ( p  < .05). In general, RPC Blue files show the highest values in terms of number of cycles to fracture (NCF) in all groups, while OC and WOG files follow RPC Blue files respectively. There was statistically significant difference among groups considering the fragment length ( p  < .05). Conclusions Within the limitations of this study, RPC Blue files exhibited highest cyclic fatigue resistance after clinical use.

This study aimed to evaluate and compare the quality of matching single-cone obturation using three different single-file systems—WaveOne® Gold (Dentsply Sirona, Bensheim, Germany), Reciproc® blue (VDW GmbH, Munich, Germany), and Procodile® (Komet Medical, Gebr. Brasseler GmbH & Co. KG, Lemgo, Germany). The evaluation focused on the percentage of gutta-percha-filled areas (PGFAs), sealer-filled areas (PSFAs), and unfilled areas (PUAs) across three different sections of curved and straight root canals. Sixty extracted human teeth were categorized into six groups. Based on radiographically determined root canal curvature, thirty curved and thirty straight root canals were prepared using the single-file systems according to the manufacturers’ instructions and obturated with matching gutta-percha cones using AH-Plus sealer. A total of 180 sections were evaluated digitally under the microscope and the results were statistically analyzed. The mean gutta-percha percentages for Reciproc® blue, Procodile®, and WaveOne® Gold were 83%, 82%, and 80%, respectively. No significant (p > 0.05) and relevant (ηp2 < 0.10) differences were found in the proportion of form-fitting gutta-percha cones between the systems in all sections. Similarly, canal anatomy showed no significant influence (p > 0.05). Ex vivo, all three systems showed comparable filling quality in all sections of curved and straight canals. Therefore, it can be concluded that all three file systems, in combination with their corresponding gutta-percha points, might be reliable methods for root canal obturation. Reciproc® Blue, Procodile®, and WaveOne® Gold consistently achieved comparable obturation results across various root configurations and levels of the root canal.

Background and Objectives: Endodontic success depends on eliminating infection and creating a durable seal to prevent recontamination. The goal of this study was to assess the impact of different ISO sizes on the obturation quality using two reciprocating single-file systems, WaveOne® Gold and Procodile®, in two different canal morphologies. Material and Methods: Overall, 140 root canals from human permanent teeth were randomly assigned to 14 groups based on selected ISO sizes and straight and curved canal curvatures, and the two file systems, WaveOne® Gold files in ISO sizes 20, 25, and 45, and Procodile® files in ISO sizes 20, 25, 40, and 45, were employed for canal preparation. These 140 canals were obturated using corresponding gutta-percha points and AH-Plus sealer and the quality of the obturation was assessed after sectioning the roots (apical, middle, coronal third) by evaluating the resulting 420 sections under a digital fluorescence microscope with regard to the proportion of gutta-percha, sealer, and unfilled areas. The results were analyzed using nonparametric tests. Results: For both systems, there was a significant difference in the percentage of gutta-percha-filled areas (PGFA, p < 0.001) and sealer-filled areas (PSFA, p < 0.001 among the different ISO sizes). However, no significant difference was observed in the percentage of unfilled areas (PUA, p = 0.354). ISO 40 demonstrated the best results, with the highest percentage of gutta-percha-filled areas (87%) and the lowest percentages of sealer-filled areas (13%) and voids (0.5%). In contrast, the lowest percentages of gutta-percha filled areas were observed in root canal fillings with ISO 20 (81%) and ISO 25 (81%). Regarding both reciprocating file system sizes, ISO 45 in WaveOne® Gold and ISO 40 in Procodile® demonstrated significantly improved (p < 0.05) filling quality, with PGFA of 85% and 87%, respectively. The differences between both systems were not significant. Conclusions: The results presented suggest that larger sizes provide better filling results, especially in the apical region. These results underline the importance of selecting appropriate preparation sizes adjusted to the initial anatomical specifications to optimize root canal obturation and ensure a high quality and durable seal.

ObjectivesThis study compared canal transportation and centering ratio produced after instrumentation with a single heat-treated reciprocating system, WaveOne Gold (WOG; Dentsply Sirona, Tulsa, OK, USA) and a single heat-treated rotary instrument, XP-endo Shaper (XPS; FKG, La Chaux-de-Fonds, Switzerland), using micro-computed tomographic (micro-CT) imaging, and evaluated the ability of double-digital radiography (DDR) to detect canal transportation.Materials and methodsMesial root canals of mandibular molars with severe curvature (25–70°) were randomly assigned to either WOG or XPS groups for preparation. Centering ratio was measured by micro-CT imaging, while canal transportation was measured by micro-CT and DDR methods at 3, 5, and 7 mm from the apex. Data were statistically compared between groups using the t test (α = 5%).ResultsThe micro-CT method showed that XPS’s shaping ability regarding the centering ability (P = 0.030) and canal transportation (P = 0.028) was significantly better than WOG only at the 7-mm level. The DDR technique detected no difference in canal transportation between groups at any level (P > 0.05); however, a significant difference between evaluation methods was detected at the 5-mm level in the WOG group (P = 0.023).ConclusionsMicro-CT technique revealed a significantly better centering ability and less canal transportation with XPS compared to WOG. The DDR technique was not capable of detecting the significant difference between the tested groups.Clinical relevanceRoot canal curvatures may lead to procedural errors during endodontic treatment. Thus, differences on the shaping ability of single heat-treated reciprocating and rotary systems should be known.

The aim of the present study was to evaluate the difference in cyclic fatigue resistance between OneCurve (OC) and OneShape (OS) endodontic single-file NiTi systems in a severely curved artificial canal. After sample size calculation (α = 0.01; β = 0.20; σ = 20.0; δ = 20.0), 25 OC and 25 OS files were used. An artificial canal with 60° angle and 5-mm radius of curvature was milled in a stainless-steel block reproducing the size and taper of the files used. The test device was electrically heated to maintain the environmental temperature at 37 °C. All files were rotated until fracture; the time to failure was recorded and the number of cycles to fracture (NCF) calculated. The length of the fractured fragments was measured too. Fractographic examination and cross-sectional area calculation were performed by scanning electron microscopy analysis (SEM). Data were statistically analyzed using an independent sample t test. The significance level was set at 0.01. Statistical analysis showed that OC files exhibited significantly greater cyclic fatigue resistance than OS (p < 0.001), with 721 ± 89 NCF and 301 ± 38 NCF, respectively. No significant difference was found in the length of the fractured fragments (p > 0.01). SEM fractographic analysis confirmed that all the scanned samples separated due to cyclic fatigue. Within the limitations of the present study, OC endodontic instruments resisted to cyclic fatigue better than OS. The improved mechanical resistance of OC could be related to new NiTi alloy used for their manufacturing.

Background: In comparison to multiple file systems, recent advancements in single file retreatment systems had reduced the working time and ease of operation for clinicians. Aim: To compare the efficacy of retreatment systems compared with hand instrumentation, by evaluating their removal efficacy, time required for retreatment and assessment of canal transportation. Methods and Material: Forty premolars were instrumented using ProTaper Gold gold files. Post instrumentation, scan was taken, obturated using warm vertical compaction technique, and stored in artificial saliva for three months and randomly divided into four groups for retreatment. Hand instrumentation (Hi), Neoniti (Nn), Mtwo R (Mt), WaveOne Gold (Wg). Post retreatment, scan was taken. Teeth were sectioned longitudinally and photographed under the stereomicroscope. Retreatment time was recorded, and canal transportation was calculated. Statistical Analysis: The results were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's post hoc test at 95% confidence level. Results: The retreatment time was significantly longer in the Hi group. Within the test groups, a significantly longer time has been taken by Wg (p < 0.05) compared to Mt and Nn. There was no difference in the canal transportation between the single file systems at 3 mm, 6 mm and 9 mm from the apex, there was statistically significant higher transportation for the Hi group at 9 mm from the apex (p < 0.05). Conclusions: All techniques were effective in removal of filling material with minimal canal transportation. Wg system was shown to increased time compared to Nn and Mt systems. Hi group was slowest with maximum canal transportation at 9 mm from the apex.

Background: This study compared the shaping ability and apical debris extrusion of four nickel–titanium (Ni–Ti) single‐file systems in simulated curved root canals. Methods: Forty simulated curved root canals in resin blocks were randomly assigned to four groups ( n  = 10): Reciproc Blue (RCB), V‐Blue, One Plex, and S‐ONE. Images of the simulated root canals were captured before and after instrumentation. The two layers were processed and superimposed using specialized software. Eleven points (Levels 0–10) were selected at 1‐mm intervals starting from the apex for evaluation. The amount of resin removed from both the inner (X1) and outer sides (X2) of the root canal, as well as the final canal width (Y), were measured. The centering ratio was calculated using the formula (X1 − X2)/Y to assess the centering ability of the instruments. Apically extruded debris was collected during the root preparation. Results: The preparation times for the root canal were as follows: One Plex > RCB > V‐Blue > S‐ONE ( p < 0.001). All four Ni–Ti files were effective in straightening the root canal, with no significant difference in curvature change ( p > 0.05). At the apex, One Plex exhibited significantly greater deviation compared with the other three groups ( p < 0.05). At Levels 7‐8, the deviation with RCB was significantly greater than with One Plex and S‐ONE ( p < 0.01). The amount of apical debris extrusion in the One Plex group was significantly higher than that in the others ( p < 0.01). Conclusions: S‐ONE demonstrated the best centering ability compared with other groups. In contrast, One Plex produced the highest amount of apical debris extrusion and exhibited transportation at the apical foramen. At Levels 6–8, RCB exhibited excessive removal of the inner canal wall relative to S‐ONE and One Plex.

Background: Cone-beam computed tomography (CBCT) was used for a 1-year follow-up of a randomized clinical trial to compare a stainless-steel Tornado file system with OneShape and WaveOne rotary systems for biomechanical canal preparation, as indicated by radiolucency sizes of periapical lesions. Methods: Lower molars with necrotic pulps and periapical lesions were randomly divided into three groups (n = 20) according to three rotary file systems. After root canal treatment, clinical and assessment of the CBCT periapical index scores were blindly evaluated at one year using pre- and post-instrumentation CBCT images. Statistical analysis was performed to compare the three systems at a p-value of 0.05. Results: The results revealed a significant decrease in the size of apical radiolucency in each group after one-year follow-up, with no statistically significant difference among the three systems (p > 0.05). Conclusions: CBCT is a valuable biomedical imaging modality for assessing periapical lesion healing. Tornado, WaveOne, and OneShape systems can be used with similar efficacy for root canal preparation in teeth with periapical lesions. Clinical Trial Registration: The study was retrospectively registered with ClinicalTrials.gov (NCT06752837). Date of Registration: 30 December 2024. The CONSORT group has identified it as essential.

Background The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel–titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals. Methods A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal–Wallis test (CT, SEM-score), the level of significance was set at α = 0.05. Results There were no significant differences between the five systems regarding the AD, VI, and UTA parameters ( P  > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex ( P  < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending ( P  < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups ( P  < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds ( P  < 0.01 and P  < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds. Conclusion The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.

Objectives The aim was to evaluate ex vivo apical debris extrusion associated with WaveOne and Self-Adjusting File instruments when used in oval canals. Methods Twenty-four extracted human mandibular premolars with oval-shaped canals were assigned in two equal groups. Following coronal cavity preparation, a glide path was created. Group A was subjected to canal preparation using a WaveOne primary file, which was used along with syringe and needle irrigation and 10 mL of 2.4 % NaOCl solution, followed by flushing with 10 mL of 17 % EDTA solution, activation with EndoActivator for 1 min and final flushing with 10 mL of 2.4 % NaOCl solution, and activation for 30 s. Group B, the SAF system was used with continuous simultaneous irrigation, provided by the system’s pump. The irrigant was supplied at 5 mL/min, alternating every minute between 2.4 % NaOCl solution and 17 % EDTA solution, over a total of 4 min followed by final flushing with 10 mL of 2.4 % NaOCl solution. Extruded apical debris from each root canal was collected into a preweighed glass vial and dried. The mean weight of the debris from each group was assessed and analyzed statistically. Both systems resulted in apical debris extrusion. Results The WaveOne system was associated with a statistically significant greater mean mass of apically extruded debris (2.18 ± 0.44 mg) than the SAF system (0.49 ± 0.33 mg, permutation-based Wilcoxon test, p  < 0.001). Conclusion Both WaveOne and the SAF systems were associated with apical debris extrusion. The amount of debris extruded by the WaveOne system was 4.4 times greater than that extruded by the SAF system. Clinical relevance The results of the present ex vivo comparative study cannot be directly applied to the clinical situation. Difference between both groups remains completely unclear; maybe the amount of extrusion is harmless in both groups or similarly deleterious for the periradicular tissues in both groups or may be dose-related to the amount of the extruded material.