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AIM: To compare the effect of different tapers of the K3XF file system on the fracture resistance of endodontically treated mandibular premolars obturated with a three-dimensional (3-D) obturation system. METHODOLOGY: For the study, 80 freshly extracted human mandibular premolars with single well-developed roots without any curvatures were taken and the tooth roots were wrapped in a single layer of aluminum foil, and they were placed vertically in a plastic mold filled with self-curing acrylic resin. The access was opened, and working lengths were determined. The canals were instrumented keeping an apical size of #30 by different taper rotary files: Group 1: un-instrumented (control group), Group 2: 30/.04, Group 3: 30/.06, Group 4: 30/.08 K3XF file system, and teeth were obturated using a 3-D obturation system, and access cavities were filled using composite. Both experimental and control groups were subjected to fracture load using a conical steel tip (0.5mm) attached to a universal testing machine to record force applied in newton until root fracture. RESULTS: Root canal instrumented groups showed lower fracture resistance than the uninstrumented group. CONCLUSION: Hence it could be concluded that endodontic instrumentation with increased taper rotary instruments caused a decrease in fracture resistance of the teeth, and biomechanical preparation of root canal system with rotary or reciprocating instruments caused a significant decrease in fracture resistance of endodontically treated teeth (ETT), thereby decreasing their prognosis and long-term survival.

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This study compared the amount of apically extruded debris associated with different heat-treated Ni-Ti rotary systems during the preparation of curved root canals of mandibular molars. Sixty extracted human mandibular molars were selected. EdgeFile, K3XF, OneCurve (OC) and ROTATE files were used to prepare both mesial canals of teeth. The initial weight of each Eppendorf tube to be used was calculated using an analytical balance prior to instrumentation. After instrumentation, the tubes were then stored for 5 days in an incubator at 70°C. Each tube was reweighed, and the weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. All files caused apical extrusion of debris. There was no statistical difference between the ROTATE, EdgeFile, OC and K3XF systems (P > 0.05). All the heat-treated Ni-Ti rotary systems led to similar apical debris extrusion during the canal preparation.

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OBJECTIVES: The aim of the present study was to determine the effect of taper (.08, .06, and .04) of separated K3XF instruments on duration taken for the secondary fracture formation during ultrasonic activation. MATERIALS AND METHODS: Ten 25/.08 K3XF (SybronEndo, Orange, CA, USA), ten 25/.06 K3XF, and ten 25/.04 K3XF instruments were used for the study. The apical 5 mm of the instruments was cut to simulate the fragments in root canals. Fragments of the instruments were sandwiched between two straight dentin blocks. An ultrasonic tip was used to cause a secondary fracture of the fragment. The time needed for the secondary fracture was recorded for each instrument. The data were statistically analyzed using the Kruskal-Wallis H test (alpha = 0.05). RESULTS: Secondary fractures occurred in all instruments. In the .08 taper group, secondary fractures took longer than in the case of the .06 and the .04 taper groups (P < 0.05). There were no significant differences between the .06 and the .04 taper groups in terms of the time required for the occurrence of a secondary fracture (P > 0.05). CONCLUSIONS: In the .08 taper group, secondary fracture took longer time than in the case of the .06 and the .04 taper groups due to its larger cross-sectional area involved. CLINICAL RELEVANCE: Typically, when removing separated instruments, a much lower power setting is chosen. The purpose of this in vitro study was to determine which tapered files were more resilient to secondary fracture, thus allowing a higher power setting to be chosen. Thus, the results of the present study cannot be used in clinical practice. If the clinician knows the taper of the broken file, the clinician should be very careful with regard to secondary fractures when using ultrasonics to remove the separated smaller tapered instruments.

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Background. The present study aimed to evaluate the impact of continuous irrigation with saline solution at room temperature or +4°C on the cyclic fatigue resistance of K3XF files. Methods. Forty-eight new K3XF files (#30, .04 taper) were randomly assigned to three groups: control group (no irrigation), continuous irrigation with saline solution at room temperature, and continuous irrigation with saline solution at +4°C. The instruments were tested in an artificial, stainless steel root canal with a double curvature at body temperature (37±1°C). Time to fracture was converted to the number of cycles to fracture (NCF). The lengths of the fractured fragments were recorded. Kruskal-Wallis H test and one-way ANOVA were used to analyze data. Results. K3XF files' cyclic fatigue resistance was significantly higher in the continuous irrigation groups than in the control group. Continuous irrigation with saline solution at +4°C resulted in higher cyclic fatigue resistance than continuous irrigation with saline solution at room temperature. There were no significant differences between the groups in terms of the fractured fragments' length. Conclusion. Within this study's limitations, continuous irrigation with saline solution increased the NCF of NiTi instruments; decreasing the saline solution's temperature increased this effect.

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AIM: This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems. MATERIALS AND METHODS: Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal-Wallis test and Mann-Whitney U test. RESULTS: Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria. CONCLUSION: All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.

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Abstract: Among the most common problems within dental professionals, is the fracture of rotary instruments of nickel and titanium root canal files (NiTi), when performing a procedure on a patient. Therefore, the objective of this work is to compare the in vitro resistance to cyclic fatigue of K3XF and TFA rotatory instruments, in continuous rotation and adaptive motion. For this, a static and cyclic fracture test was used and a fracture pattern was searched. The numbers of cycles until the fracture and the length of the fragments were determined. Of all the groups evaluated, K3XF-A exhibited the best resistance to cyclic fatigue. In future research, it will be performed an autoclaving and immersion cycles in sodium hypochlorite to be able to determine the separation causes of the rotary instruments. As a recommendation, the operator could significantly influence the decrease in resistance to cyclic fatigue due to the misuse of rotary instruments.

Resumen: Entre los problemas más comunes entre los profesionistas dentales, es la fractura de los instrumentos rotatorios de limas de canales radiculares de níquel y titanio (NiTi), cuando se lleva a cabo el procedimiento al paciente. Es por eso, que el objetivo de este trabajo es el comparar la resistencia in vitro de la fractura cíclica entre los instrumentos rotatorios K3XF y TFA, en rotación continua y movimiento adaptativo. Para esto, se utilizó la prueba de fractura cíclica y estática y el patrón de fractura fue evaluado. El número de ciclos hasta la fractura y la longitud de los fragmentos fue determinado. De todos los grupos evaluados, K3XF-A presentó la mejor resistencia a la fractura cíclica. Como trabajo a futuro, se utilizará ciclos de inmersión en hipoclorito de sodio y autoclaveado, para ser capaces de determinar las causas de separación de los instrumentos rotarios. Como recomendación, el operador puede influenciar significativamente la disminución de la resistencia a la fractura cíclica utilizando de una manera errónea el dispositivo.

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BACKGROUND: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. AIM: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. MATERIALS AND METHODS: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. STATISTICAL ANALYSIS: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). RESULTS: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. CONCLUSION: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex.

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INTRODUCTION: This in vitro study was designed to evaluate the amount of apically extruded irrigant and debris during root canal preparation using K3XF instruments (SybronEndo, Orange, CA) with different kinematics and using hand files with a step-back technique. METHODS: A total of 80 extracted mandibular premolars were selected and randomly assigned to 4 groups (n = 20). The root canals were instrumented with K-type stainless steel instruments using a step-back technique and with the K3XF system using the following kinematics: reciprocating motion, adaptive motion, and continuous rotation. Bidistilled water was used as an irrigant. Preweighed Eppendorf tubes were used to collect apically extruded debris during instrumentation. Extruded irrigant was collected from the drainage cannula using a plastic insulin syringe, and the volumes were recorded. After complete evaporation of the liquid inside the tube, the weight of extruded debris was determined for each specimen. Data were analyzed statistically using the Kruskal-Wallis and Mann-Whitney U tests at a significance level of P < .05. RESULTS: Hand file instrumentation was associated with a significantly greater extrusion of debris compared with the K3XF groups (P < .05). Among the different kinematics, the highest mean debris extrusion value was obtained with reciprocating motion and the least with continuous rotation, but this difference was not significant (P > .05). No significant differences were observed between groups in terms of irrigant extrusion (P > .05). CONCLUSIONS: Hand instrumentation extruded more debris than K3XF instruments that were used with different kinematics. All instrumentation kinematics were associated with apical debris and irrigant extrusion.

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OBJECTIVE: The purpose of the present study was to evaluate the cyclic fatigue resistance of F6 SkyTaper (Komet Brasseler, Lemgo, Germany), K3XF (SybronEndo, Orange, CA, USA), new generation OneShape (Micro Mega, Besancon, France) and TRUShape 3D conforming files (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA). MATERIAL AND METHODS: Ten instruments from each group were selected and allowed to rotate using a low-torque motor in a stainless steel block with 1.5 mm diameter, 3 mm radius of 60° angle of curvature at the manufacturer's recommended speed, and the number of cycles (NCF) from the beginning to the fracture was recorded. The data were analyzed using one-way ANOVA followed by post-hoc Tukey's test (P = 0.05). RESULTS: The ranking of the groups from the highest to the lowest NCF was as follows: F6 SkyTaper (959 ± 92), K3XF (725 ± 71), TRUShape (575 ± 84) and OneShape (289 ± 58). Statistically significant differences were detected between all groups (P < 0.05). CONCLUSION: Within the limitations of this study, F6 SkyTaper instruments presented the highest cyclic fatigue resistance among the tested instruments. The S-shaped cross-sectional design of F6 SkyTaper instruments could be the most important factor on the superior cyclic life span of these instruments. CLINICAL RELEVANCE: In endodontic practice, preferring the instruments with higher cyclic fatigue resistance would help to minimize the risk of instrument fractures; therefore especially during the preparation of curved canals, instruments with smaller core area and less cross-sectional metal mass, which could lead higher flexibility, can be proposed.

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AIM: To assess the amount of debris extruded apically during root canal preparation using various nickel-titanium instrumentation systems. METHODOLOGY: Sixty extracted single-rooted mandibular premolar human teeth were randomly assigned to four groups (n = 15 teeth for each group). The canals were then instrumented with the following instrument systems: Vortex Blue (VB; Dentsply Tulsa Dental, Tulsa, OK, USA), K3XF (SybronEndo, Orange, CA, USA), Reciproc (VDW, Munich, Germany) and ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland). Apically extruded debris during instrumentation was collected into pre-weighed Eppendorf tubes. The Eppendorf tubes were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post-instrumentation weight of the Eppendorf tubes for each group. The data were analysed using one-way analysis of variance (anova) and Tukey's post hoc tests. RESULTS: Vortex Blue and PTN files were associated with significantly less apically extruded debris than the K3XF and Reciproc files (P < 0.05), but there was no significant difference between the VB and PTN files or between the K3XF and Reciproc files (P > 0.05). CONCLUSIONS: All instruments were associated with apical extrusion of debris. VB and PTN files were associated with less debris extrusion compared to the other systems.

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AIM: In the present study, the effectiveness of three rotary and two manual nickel titanium instrument systems on mechanical reduction of the intracanal Enterococcus faecalis population was evaluated. METHODS: Mandibular premolars with straight roots were selected. Teeth were decoronated and instrumented until 20 K file and irrigated with physiological saline. After sterilization by ethylene oxide gas, root canals were inoculated with Enterococcus faecalis. The specimens were randomly divided into five groups for canal instrumentation: Manual Nitiflex and Hero Shaper nickel titanium files, and rotary Hyflex CM, ProTaper Next, and K3XF nickel titanium files. Intracanal bacterial sampling was done before and after instrumentation. After serial dilution, samples were plated onto the Mitis Salivarius agar. The c.f.u. grown were counted, and log10 transformation was calculated. RESULTS: All instrumentation systems significantly reduced the intracanal bacterial population after root canal preparation. ProTaper Next was found to be significantly more effective than Hyflex CM and manual Nitiflex and Hero Shaper. However, ProTaper Next showed no significant difference with K3XF. CONCLUSION: Canal instrumentation by all the file systems significantly reduced the intracanal Enterococcus faecalis counts. ProTaper Next was found to be most effective in reducing the number of bacteria than other rotary or hand instruments.

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Biomechanical preparation is one of the most important steps in endodontic therapy. Rotary instrumentation has facilitated this step. Nowadays the market is flooded with different types of rotary instruments. The present study compared the root dentinal crack formation with continuous rotating versus reciprocating root canal preparation methods. One hundred and fifty freshly extracted teeth were used for the study. They were divided into 5 groups with 30 teeth in each group. Thirty teeth were kept under control group A and no root canal preparation was done for this group. Another 30 teeth were prepared with hand files which were kept under control group B. In the experimental groups (sample size, n=30 each) root canals were prepared with ProTaper, K3XF rotary system and WaveOne. Sectioning of these teeth was done at 3, 6 and 9mm from the apex and were evaluated for the presence of any defects. Root dentinal cracks were produced with each type of rotary instruments. Statistical analysis showed no significant difference in root dentinal crack formation between control groups and WaveOne system. There was statistically significant difference in root dentinal crack formation when the canals were prepared with ProTaper and K3XF rotary system. So it was concluded, that continuous rotating instruments could produce dentinal crack formation. Root canal instruments with reciprocating movement appear to be a better option than continuous rotation movement.

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INTRODUCTION: The purpose of this study was to evaluate the effect of various degrees of cyclic fatigue on torsional failure and torsional preloading on the cyclic fatigue life of heat-treated K3XF nickel-titanium (NiTi) instruments (SybronEndo, Orange, CA). METHODS: The mean number of cycles until failure (Nf) of K3XF and K3 NiTi instruments was examined in a 3-point bending apparatus with a 7-mm radius and 45° curve. Torque and distortion angles at failure of new instruments and instruments stressed to 25%, 50%, and 75% of the Nf were measured according to ISO 3630-1. Other new files were preloaded at 25%, 50%, and 75% of the mean distortion angles before the fatigue test. After torsional preloading, the Nf was examined. The fracture surface of each fragment was examined with a scanning electron microscope. RESULTS: The fatigue resistance of K3XF instruments was 2 times higher than that of K3 instruments (P < .05). The torque and angle of rotation at fracture of K3XF instruments were similar to those of K3 instruments. The 25%, 50%, and 75% torsional preloading significantly lowered the Nf of both K3 and K3XF instruments (P < .05). In the fatigue prestressed groups, K3 instruments with 75% preloading had significantly lower torque and distortion angles than unused K3 instruments (P < .05). The fractographic patterns corresponded to the pattern defined by the last stage test. CONCLUSIONS: A low amount of torsional preloading reduced the fatigue resistance of K3 and K3XF instruments. A high amount of precycling fatigue significantly reduced the torsional resistance of K3 instruments. The torsional resistance of K3XF instruments was less affected by previous load cycling even after extensive precycling.

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INTRODUCTION: The aim of the study was to compare the K3 and K3XF systems (SybronEndo, Glendora, CA) after 1 and 2 uses by evaluating apical transportation, working length loss, and working time in a manikin model. METHODS: Mesial canals of 40 extracted first mandibular molars were instrumented. Radiographs taken after instrumentation with #25, #30, #35, and #40 files were superimposed on the preoperative image in both mesiodistal and buccolingual angulations. AutoCAD (Autodesk Inc, San Rafael, CA) was used to measure working length loss and apical transportation at 0, 0.5, and 1 mm from the working length (WL). The working time was measured. Group comparison was analyzed using post hoc Tukey honestly significant difference tests (P < .05). RESULTS: No significant differences were found in apical transportation, working length loss between K3 and K3XF systems, or between the number of uses. Significant differences were found when canal enlargement was performed to a #35-40 (P < .05). K3 instrumentation performed significantly faster (29.6 ± 15.4) than with the K3XF system (40.2 ± 17.7) (P < .05). No differences were observed in working time when comparing the number of uses. CONCLUSIONS: K3 and R-phase K3XF rotary systems shaped curved root canals safely with minimal apical transportation, even up to a 40/04 file.

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AIM: To examine the fatigue behaviour of heat-treated NiTi instruments when immersed in aqueous media and to determine the effect of cyclic fatigue on the hardness and elastic modulus of NiTi instruments using a nanoindentation technique. METHODOLOGY: K3XF and K3 NiTi instruments, both in sizes 25, 0.04 taper and 40, 0.04 taper, were subjected to rotational bending at a curvature of 42° either in air or under deionized water, and the number of revolutions to fracture (Nf ) was recorded. The fracture surface of all fragments was examined with a scanning electron microscope. The hardness and elastic modulus of the fracture surface of instruments sized 25, 0.04 taper were then measured using a nanoindentation test. RESULTS: The K3XF instruments had a fatigue resistance superior to K3 instruments under dry and aqueous environments (P < 0.05). The fatigue life of K3 instruments was similar under both conditions, whereas the Nf of K3XF was greater under water than in air, especially at the size 40, 0.04 taper (P < 0.05). The values for the fraction of the area occupied by the dimple region were significantly smaller in K3XF instruments than in K3 instruments, especially under water (P < 0.05). There was no difference in hardness on K3XF instruments between new files and instruments subjected to the fatigue process. The hardness of instruments subjected to the fatigue process was significantly lower in K3XF than in K3 instruments (P < 0.05). CONCLUSION: The fatigue life of K3XF instruments under water is longer than it is for K3XF instruments in air. There was no work-hardening effect on K3XF instruments subjected to the fatigue process.

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