RESUMO
AIM: The aim of this study is to compare the stress produced on the internal walls of simulated canals by nine rotary and four reciprocating systems. METHODOLOGY: Sixty-five isotropic transparent blocks containing a 60° curved and tapered simulated canal were selected and distributed into 13 groups (n = 5) according to the preparation system: BioRace, HyFlex EDM, iRaCe, Mtwo, One RECI, ProTaper Next, RaCe EVO, Reciproc, Reciproc Blue, R-Motion, VDW.ROTATE, XP-Endo Rise Shaper, and XP-Endo Shaper. Each resin block was mounted in a vice and a digital camera recorded the entire sequence of each preparation system through a circular polariscope set for dark field analysis. The video frames when each instrument reached the end of the coronal, middle, and apical thirds of the canal were extracted from the recordings and analysed by two independent observers regarding the stress generated on the canal walls using a semi-quantitative evaluation on a 0-5 scale. Intra- and inter-observer agreement were subjected to the Cohen's Kappa coefficient test, whilst the experimental results were compared using Kruskal-Wallis test post hoc pairwise comparisons with Bonferroni correction (α = 5%). RESULTS: The inter- and intra-observer agreement were 0.98 and 1, respectively. Most instruments demonstrated acceptable performance (scores ≤ 2) in all thirds. Other instruments, such as the HyFlex EDM 25.12 (coronal and middle thirds), Reciproc Blue R25 and Reciproc R25 (coronal and apical thirds), R-Motion 30.04 (apical third), and VDW.ROTATE 20.05 (apical third) showed scores higher than 3. Statistical analysis revealed a significant difference amongst the tested systems at the coronal, middle, and apical thirds (p < .05). CONCLUSION: None of the canal instrumentation protocols were stress-free, showing varying levels of stress concentrations. Various factors seemed to influence the magnitude of stress and its distribution pattern on the canal walls. Overall, instruments characterized by a larger taper, lower speed, reciprocating motion, and made of heat-treated NiTi alloy exhibited higher patterns of stress distribution.
RESUMO
INTRODUCTION: Structural defects created by endodontic treatment are the most common cause of major dental failures. This study analyzed levels of stress produced by endodontic instruments during the root canal treatment by photoelastic analysis of stress. METHODS: Twenty-four human premolars were randomly divided into 4 groups (n = 6) according to instrumentation protocol: ProTaper Next (GPT), One Shape (GOS), Wave One Gold (GWO), and TF Adaptive (GTF). The evaluation of the photoelastic model was performed at 4 dental zones: dental-crown region, cervical third of root, middle third of root, and apical third of root. Silicone molds were prepared (2 × 15 mm), and pinjets were used inside the root canals to fixate teeth. Photoelastic resin (2:1 ratio) was poured into the silicone molds to form photoelastic models. A transmission polariscope was used to analyze the positions of interest and recorded with a digital camera. Tardy's method was used to quantify the fringe order (n) and calculate the maximum stress value (τ) at each selected point. Data were analyzed with two-way analysis of variance, Tukey test (P < .05), fringe descriptive analysis. RESULTS: All groups showed a significant increase in the level of stress created during biomechanical preparation of the root canals. In the quantitative analysis, there was no statistically significant difference among the groups (P > .05). In the qualitative analysis, GPT and GTF instruments achieved greater levels of stresses compared with GWO and GOS instruments. At the beginning of instrumentation, stresses were concentrated at the coronary level and the end of instrumentation at the middle and apical root level. CONCLUSIONS: All endodontic systems resulted in accumulation of stress along the dental structure. Stress was found in different concentrations along the tooth and at different levels.