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Introduction: Variation in the thickness of commercially available preformed rectangular archwires at the bracket positions has not been thoroughly studied. Therefore, this study measured the edgewise (height) and flatwise (width) dimensions of preformed rectangular nickel-titanium (NiTi) archwires at bracket positions corresponding to the central incisor, canine, and first molar and compared them among bracket positions., Methods: Sixty types of preformed rectangular NiTi mandibular archwires indicated as 0.019 × 0.025-in were obtained from 14 manufacturers. The height and width dimensions of archwires were measured at 4 points (3 bracket positions corresponding to the central incisor, canine, and first molar, and 1 terminal end) of each side of each archwire using a micrometer and compared with the indicated dimensions using 1-sample t tests. Furthermore, the measured dimensions were compared among the 3 bracket positions using a 1-way analysis of variance and Bonferroni post-hoc test., Results: The measured dimensions were significantly smaller than the indicated dimensions for all points except the central incisor point for height and significantly smaller than the indicated dimensions for all points for width. Comparisons among points showed that for height, the central incisor point was significantly larger than the first molar and terminal points. However, no significant differences were found for width at any point., Conclusions: The measured dimensions of preformed NiTi archwires at the bracket positions were generally smaller than the indicated dimensions, with variations observed not only among products but also among manufacturers., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Orthodontic uprighting or traction of an impacted mandibular second molar often necessitates invasive interventions. This report aims to illustrate the utilization of nickel-titanium wire segments inserted into small, simple tubes for uprighting mesially impacted mandibular second molars and also for scissor bite correction. The term "simple tube" refers to a tube without a bonding base attached to a tooth surface by covering it with flowable composite resin. Due to the absence of a bonding base, the simple tube is characterized by its diminutive size and minimal profile height, facilitating placement on partially exposed second molars and unconventional positioning to adjust the force geometry. In this case study, mesially-impacted mandibular second molars with scissor bite were uprighted in a 21-year-old male utilizing simple tubes. Simple tubes can be used for molar uprighting and scissor bite correction buccally and lingually., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: The objective of this study was to determine and compare the moment-to-force (Mc/F) ratio and the type of tooth movement generated in the anterior and posterior segments in orthodontic space closure with stainless steel and titanium-molybdenum alloy loop archwires., Methods: Three-dimensional model of the maxilla from which the first premolar was extracted, 18 × 25-mil slot stainless steel brackets, and 16 × 22-mil stainless steel and β titanium-molybdenum alloy (TMA) closing loop archwires with anterior gable bend of 15° and posterior gable bend of 25° were constructed. The archwires were engaged in the brackets, and 1-mm activations were carried out, which were repeated 5 times. The anterior and posterior segment Mc/F ratio and the type of tooth movement generated by the 2 wires were compared., Results: It was found that the Mc/F ratio for the anterior segment was approximately 5 mm, and for posterior teeth was approximately 10 mm for both stainless steel and TMA closing loop archwire. The anterior teeth exhibited controlled tipping, whereas the posterior teeth showed bodily tooth movement, which was in accordance with the Mc/F ratio that was obtained., Conclusions: The Mc/F ratio and the type of tooth movement exhibited by stainless steel and TMA closing loop archwires were similar in both anterior and posterior segments., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

The present work describes green-mediated copper oxide nanoparticles as a potential corrosion inhibitor for the dental alloy Ti-6Al-4V. The salt of copper was reduced to metal nanoparticles using Murraya koenigii leaves, which helps with the agglomeration and nanocluster formation through a reduction mechanism. The current synthesis is a single-step process and is cost-effective. The synthesized nanoparticle was characterized using UV, FTIR, XRD, Zeta potential and Particle size analyzer, SEM, and EDX. The particles were then electrodeposited on Ti-6Al-4V alloy, and the corrosion resistivity in the dental medium was analyzed using Electrochemical parameters such as Corrosion current, Corrosion potential, and anodic and cathodic intercepts through the Tafel and Nyquist plots. The synthesized nanoparticles showed characteristic absorbance at 359 nm. FTIR peaks confirm the phytochemical constituents present in the Murraya koenigii that accounts for the formation of nanoparticles. The XRD predicts the crystalline nature, which is further studied using SEM and EDX. The Zeta potential and Particle size analyzer confirms the negative-negative interactive nature of the synthesized CuO NPs. The NPs showed explicit corrosion inhibition properties with an overall inhibition efficiency of 58.15% and 25.6%, respectively. The study confirms the advantage of using Copper Oxide nanoparticles as a potential coating agent in dental implant alloys in increasing its corrosion efficiency., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: The authors have been using improved superelastic Nickel-Titanium alloy wire (ISW) to close and align extraction spaces simultaneously, instead of separately using rigid wires for closing extraction spaces and Ni-Ti alloy wires for leveling and aligning. ISW has a low stiffness, which makes it challenging to generate sufficient moments. This study aimed to demonstrate the forces and moments exerted on adjacent brackets using an orthodontic simulator (OSIM) attached to a high-precision 6-axis sensor., Materials and Methods: In experiment 1, a 0.016 × 0.022-inch ISW, stainless steel (SS) wire, and β-titanium wires were ligatured into the two brackets. The 0.018 × 0.025-inch slot self-ligating brackets were bonded to two simulated teeth at the same height, and the experiment was conducted using the high-precision OSIM. The distance between the brackets was 10 mm, the V-bend angles of the installed wires were 10°, 20°, 30°, and 40°, and the apex position was set at the center of the bracket. In experiment 2, 6.0- and 9.0-mm long elastomeric chains were placed on the same brackets as in Experiment 1 to measure forces and moments. The distance between the brackets was increased by 1.0 mm from 6.0 to 15.0 mm. Both experiments were conducted in a 37 °C thermostatic chamber similar to the oral environment., Results and Discussion: In experiment 1, we measured moments on both sides for all the wires. As the V-bend angle increased, the absolute values of the moments also increased. With a V-bend angle of 10°, there was a significant (p < 0.05) difference in the moment generated in the left and right brackets among the three wire types. In the ISW, -1.67 ± 0.38 N・mm was generated in the left bracket, while 0.38 ± 0.26 N・mm was generated in the right bracket at 10°. At 20°, -1.77 ± 0.69 N・mm was generated in the left bracket, while 2.37 ± 0.94 N・mm was generated in the right bracket. At 30°, -2.98 ± 0.49 N・mm was generated in the left bracket, while 3.25 ± 0.32 N・mm was generated in the right bracket. Moreover, at 40°, -3.96 ± 0.58 N・mm was generated in the left bracket, while 3.55 ± 0.53 N・mm was generated in the right bracket. Furthermore, in experiment 2, the moments increased in proportion to the increase in distance between the centers of the two brackets. Absolute values of the moments were approximately equal for the left and right brackets. The 6.0-mm elastomeric chain generated a minimum force of -0.09 ± 0.05 N in the left direction when the distance between brackets was 6.0 mm, while a maximum of 1.24 ± 0.3 N when the distance between brackets was 12 mm in the right bracket. In the left bracket, minimum and maximum forces of -0.09 ± 0.07 and 1.3 ± 0.4 N were generated in the right direction, respectively. The 9.0-mm elastomeric chain generated a minimum force of 0.03 ± 0.07 N in the left direction when the distance between brackets was 9.0 mm, while a maximum of 1.3 ± 0.1 N when the distance between brackets was 15 mm in the right bracket. In the left bracket, minimum and maximum forces of 0.05 ± 0.06 and 0.98 ± 0.2 N were generated in the right direction, respectively., Conclusion: Mechanical data of the ISW have been collected in the study, which was previously difficult to perform owing to the low stiffness of the wire. It is suggested that the ISW can provide sufficient moments with the addition of V-bends to close the space by bodily movement., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Naoaki Mikami reports financial support, equipment, drugs, or supplies, and writing assistance were provided by Tokyo Medical and Dental University. Zuisei Kanno reports a relationship with Japan Society for the Promotion of Science that includes: funding grants., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Intra-canal fracture of rotary NiTi instruments occurs due to torsional stress, cyclic fatigue, or a combination of these two factors. Broken instruments are a serious obstacle to shaping, cleaning, and filling of the root canal and can adversely affect the outcome of endodontic therapy. The aim of this study was to examine the magnetic properties and ultrastructural changes of new, used, and fractured NiTi instruments using opto-magnetic imaging spectroscopy (OMIS). The study included three sets of different types of rotary instruments: MTwo (VDW, Munich, Germany), Pro Taper Universal (Dentsply Maillefer, Ballaigues, Switzerland), and BioRace (FKG DENTAIRE Swiss Dental Products, Le Crêt-du-Locle Switzerland). Root canal shaping was performed on root canals with different curvatures, and after intra-canal fracture, instruments of the same type (new, used, and fractured) were analyzed using OMIS at the Faculty of Mechanical Engineering, University of Belgrade. The obtained results showed a coincidence of peak localization for the used instruments that did not suffer a fracture, as well as for new, unused instruments of all examined groups. Additionally, there was a coincidence of peak intensities for new and fractured instruments in all groups. The specific treatment of electropolishing of the active surface of BioRace instruments caused a completely different electromagnetic response compared to conventional NiTi sets of tested instruments. New, unused BioRace instruments had the most pronounced positive (5.6078 n.a.u. x1000) and negative (-8.5218 n.a.u. x1000) intensity values. The analysis of NiTi instruments using opto-magnetic imaging spectroscopy indicated changes in the magnetic properties after their instrumentation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction: This study evaluated the effect of periodic changes in rotation speed on torsional stress and screw-in force using the dedicated alternative rotation technique (ART) motion of the EQ-M (Metabiomed, Cheongju, Korea) endodontic motor., Methods: Two ART modes of the EQ-M motor in 2 alternative techniques (ART30 and ART50) and continuous rotation were compared using ProTaper Next X2 (Dentsply Sirona, Charlotte, NC) files and simulated resin blocks (n = 12 per group). ART30 and ART50 were operated by continuous rotation of 350 rpm for 360° and then rotated at 30% increased speed from the base speed for 180° and at 50% increased speed for 180°, respectively. Before the test, the simulated resin blocks were pre-enlarged using ProTaper Gold S1 and S2 (Dentsply Sirona) and fixed on a metal stage connected to the force- and torque-measuring unit. During shaping the simulated canal in an automatic up-and-down manner, the parameters of maximum torque, sum of torque, maximum screw-in force, and maximum apical force were measured. The data were statistically analyzed using 1-way analysis of variance and the Tukey post hoc comparison test at the 95% significance level., Results: The ART30 and ART50 groups showed a lower maximum torque, sum of torques, screw-in force, and apical drive force than the continuous rotation group. There was no significant difference between the ART30 and ART50 groups (P > .05). When the screw-in force increased suddenly, the torque correspondently increased., Conclusions: Under the limitations of this study, the ART mode could reduce the torsional stress and apical forces of the screw-in during instrumentation in comparison with continuous rotation., (Copyright © 2022 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study quantifies the effects of material, size of the continuous archwires, and level of overeruption on the loads on teeth in the correction of overerupted canines., Methods: An orthodontic force test (OFT) was used to measure the 3-dimensional loads delivered by the archwires to the brackets attached to the maxillary right incisors, canine, and premolars. Dentoforms simulating canine overeruptions at the 0.5 mm and 1 mm levels were made from computerized tomography scans. Archwires with 2 types of material (stainless steel [SS] and nickel-titanium [NiTi]) and 2 sizes (0.014-in and 0.016-in) were tested, respectively, on the 0.022 × 0.028-in brackets through elastomeric ligatures., Results: The forces were dominantly intrusive on the canines and extrusive on the first premolars and lateral incisors. The magnitudes of the extrusive forces were about 74% and 52% that of intrusive force on the canines, which range from -0.48 ± 0.01 N to -5.70 ± 0.14 N depending on the wire material, size, and severity of overeruption (P <0.01). The canine intrusive forces created by SS wires were about 3 times higher than that of NiTi wires with the same sizes, 0.016-in archwires were about twice higher than that of 0.014-in with the same materials, and 1 mm overeruption level doubled with respect to 0.5 mm. Significant second-order moment as coupled with the intrusive or extrusive forces., Conclusions: The intrusive and extrusive forces on teeth in the correction of canine overeruption can be quantified by the in vitro orthodontic force test, and the effects of the 3 factors significantly affect the loads on the teeth., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

To study the relationship between structural parameters and mechanical properties of endodontic instruments, the T02004B25 nickel-titanium endodontic instrument was selected for bending and torsion tests and finite element simulation analysis, which demonstrated the feasibility of simulation analysis method. Then based on the idea of parametric design, the models of the endodontic instruments with different structural parameters (cross-section, pitch, taper) were established, and the bending-torsion performance simulation analysis was completed. The results showed that the mechanical properties of endodontic instruments with different structural parameters are different. It is necessary to find the optimal parameters for different structure parameters of endodontic instruments to maximize their service life., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

NiTi shape memory alloys (SMAs) are inevitably in contact with hydrogen in specific service environments, which can degrade their mechanical behaviors. In this work, the effect of hydrogen on the super-elasticity of NiTi SMA orthodontic wires is investigated experimentally and theoretically. Firstly, cathodic hydrogen charging was performed for the wires at a current density of 10A/m 2 with various charging times (2.5min, 5min, 7.5min and 10min) and charging lengths (20 mm, 40 mm, 60 mm and 80 mm) in 0.5 mol/L H2SO4+2 g/L CH4N2S electrolyte solution at room temperature. Then, ex-situ tension-unloading tests were carried out shortly after the hydrogen charging. The stress-strain responses showed a two-step martensite transformation (MT), i.e., the start stress of MT for the region with hydrogen charging is much larger than that without hydrogen charging. Based on the experimental observations, a diffusional-mechanically coupled constitutive model is constructed. Elastic strain, transformation strain, transformation-induced plasticity (TRIP) and hydrogen swelling deformation are considered. The effect of hydrogen on the thermo-mechanical behavior of NiTi SMA is taken into account by introducing the hydrogen concentration (HC)-dependent critical temperatures of MT and slip resistance of TRIP. The thermodynamic driving forces of MT and TRIP are derived from the constructed Helmholtz free energy and dissipation inequality. The balance equation of hydrogen diffusion is obtained by the chemical potential and Fick's diffusion law. To obtain the overall response of the wire with a heterogeneous HC field, a scale transition rule is proposed. The capability of the proposed model to describe the super-elasticity of NiTi SMA with various hydrogen charging times and charging lengths is validated by comparing the predicted results with the experimental ones., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Instruments' mechanical strength and flexibility are traditionally tested by running cyclic fatigue, torsional, bending, buckling, and microhardness tests. Several cyclic fatigue test models have been used in endodontics, all capable of providing a curved trajectory for the instrument to rotate. Cyclic fatigue testing allows the identification of conditions that may affect the fatigue strength outcomes, such as the canal radius and degree of curvature, handpiece static versus dynamic motions, test temperature, kinematics, instrument previously wear and sterilization cycles, or instrument's size and metal alloy features. Because of the international test specifications for both torsional and bending tests, the variations of their models are not as many as for cyclic fatigue. These tests have also identified conditions capable of affecting the outcomes, such as kinematics, instruments' preloading, cross-sectional diameters, or alloy heat treatments. Buckling and microhardness are less common, with the metal alloy being considered to have a major influence on the results. Instruments' mechanical testing, having all these individual conditions as independent variables, allowed the understanding of them and molded the way the technical procedures are performed clinically. Even though the artificiality and simplicity of these tests will hardly mimic real working situations, and independent of being capable of producing cornerstone knowledge, these tests are also associated with inconsistency, a lack of reproducibility, and low external validity. Several attempts have been made to increase the generalizability of the outcomes by adding test settings that intend to mimic the clinical condition. Although pertinent, these settings may also add variabilities inherent to their concepts and practical applications in the laboratory environment. Although the actual studies should be seen as laboratory mechanical tests that measure very specific parameters under very particular conditions and that by far do not mimic the clinical condition, the lower validity drawback seems to be possible to be minimized when achieving a comprehensive understanding of the instrument behavior. A finite element method and/or a multimethod research approach may lead to superior data collection, analysis, and interpretation of results, which when associated with a reliable confounding factor control and proper study designs may be helpful tools and strategies in order to increase the reliability of the outcomes., (Copyright © 2022 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

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., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to compare the torque generated by 4 different files in root canals with 4 different curvature angles., Methods: Four brands of nickel-titanium (NiTi) endodontic files were selected: WaveOne Primary (Dentsply Sirona, Ballaigues, Switzerland), WaveOne Gold Primary (Dentsply Sirona), ProTaper Universal F2 (Dentsply Sirona), and ProTaper Next X2 (Dentsply Sirona). A tempered steel block containing artificial canals with 4 different canal curvatures (15°, 25°, 35°, and 45°) was constructed. Each file was used according to the manufacturer's instructions in the dynamic model, with an added 15 axial up-and-down movements of 4 mm at the end of the canal. The generated torque was recorded, and the total and maximum torque values were measured. Two-way analysis of variance and the Duncan post hoc comparison test were performed at a significance level of 95%., Results: A significant correlation between the curvature angle and the type of file system was observed (P < .05). As the degree of canal curvature increased, the generated total and maximum torque increased. At 15° and 25°, the NiTi files with reciprocating motion generated a higher total and maximum torque than files with continuous rotation. ProTaper Universal of conventional NiTi alloy showed the steepest increase in the generated total and maximum torque with the increasing curvature angle. The ProTaper Next file had the lowest torque values at the higher canal angles of 35° and 45° (P < .05)., Conclusions: Despite the study limitations, it can be concluded that root canal curvature, design, and heat treatment of NiTi files and file kinematics affect the generated torque during instrumentation., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to evaluate the metal ion release, cytotoxicity, and surface roughness of clinically used metal orthodontic appliances after immersion in different fluoride product solutions compared with those of new appliances., Methods: Used fixed appliances were debonded from 36 patients after their treatment was done. New appliances were as-received. Each used and new group comprised 36 sets of 20 brackets and 4 tubes that were divided into 3 groups by archwire type; stainless steel, nickel-titanium, and beta-titanium. The samples in each group were divided into 3 subgroups and immersed in solutions of fluoride toothpaste, 1.23% acidulated phosphate fluoride, or artificial saliva without fluoride as a control group. The immersion times were estimated from the recommended time for using each fluoride product for 3 months. The samples were then immersed in Dulbecco's Modified Eagle's Medium for 7 days. The cytotoxicity test was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay using primary gingival fibroblasts. Chromium, nickel, and iron ion release were detected using inductively coupled plasma mass spectroscopy. The surface roughness of the brackets and wires was measured by a scanning electron microscope and a noncontact optical 3-dimensional surface characterization and roughness measuring device. The data were analyzed using the paired t test and 2-way analysis of variance., Results: Used brackets demonstrated a significantly higher ion release, surface roughness, and cytotoxicity than the new brackets. Acidulated phosphate fluoride significantly increased the ion release and surface roughness; however, it significantly decreased cell viability, especially in the titanium molybdenum subgroup., Conclusions: Used brackets were significantly prone to further corrosion. Acidulated phosphate fluoride gel should not be used in orthodontic patients with fixed metal appliances., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to investigate the influence of mass and the polar moment of inertia on the torsional behavior of nickel-titanium rotary instruments to understand which parameter of cross-sectional design had a key role in terms of torsional resistance., Methods: Four different instrument models were designed and meshed using computer-aided engineering software (SolidWorks; Dassault Systems, Waltham, MA). Instrument models shared the same characteristics, except for cross-sectional design; triangle, rectangle, square, and hollow square geometry was selected. Finite element analysis was performed simulating a static torsional test using the FEEPlus internal solver (Solid Works). Von Mises stress and torsional load at fracture were calculated by the software. Linear regression analysis was performed to investigate the relationship of the polar moment of inertia, cross-sectional area, inner core radius, and mass per volume on the torsional resistance of nickel-titanium rotary instruments., Results: The polar moment of inertia positively affected the maximum torsional load with the highest level of correlation (R 2 = 0.917). It could be stated that the higher the polar moment of inertia is, the more maximum torsional load at fracture is present. Mass and cross-sectional area had a lower level of correlation compared with the polar moment of inertia (R 2 = 0.5533). According to this, 2 instruments with the same mass/mm and/or cross-sectional area could have different torsional resistance., Conclusions: The polar moment of inertia can be considered as the most important cross-sectional factor in determining the torsional resistance of rotary instruments over metal mass and cross-sectional area., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

The unique concept of phase reversion involving severe deformation of parent austenite into martensite, followed by annealing for a short duration, whereby the strain-induced martensite reverts to austenite, was adopted to obtain nano-grained/ultrafine-grained (NG/UFG) structure in a Cu-bearing biomedical austenitic stainless steel resulting in high strength-high ductility combination. Work hardening and accompanying deformation mechanism are two important aspects that govern the mechanical behavior of biomedical devices. Thus, post-mortem electron microscopy of the strained region was carried out to explore the differences in the deformation mechanisms induced by grain refinement, while the strain hardening behavior was analyzed by Crussard-Jaoul (C-J) analysis of the tensile stress-strain data. The strain hardening behavior consisted of four stages and was strongly affected by grain structure. Twinning-induced plasticity (TWIP) was the governing deformation mechanism in the NG/UFG structure and contributed to good ductility. In striking contrast, transformation-induced plasticity (TRIP) contributed to high ductility in the coarse-grained (CG) counterpart and was the governing strain hardening mechanism. When the grain size is less than ~1 μm, the increase in the strain energy and the austenite stability significantly reduce the possibility of strain-induced martensite transformation such that there is a distinct transition in deformation mechanism from nanoscale twinning in the NG/UFG structure to strain-induced martensite in CG structure. The differences in the deformation mechanisms are explained in terms of austenite stability - strain energy relationship., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The preparation of severely curved S-shaped double-curved root canals can be technically challenging. A novel root canal instrumentation technique is proposed, which modifies 2 techniques: the McSpadden crown-down technique and the tactile controlled activation technique. In the McSpadden crown-down technique, the root canal is divided into 2 portions: the coronal zone and the apical zone. However, rather than focusing on the length of file engagement, a formula is proposed to calculate the maximum insertion depths of higher tapered instruments to prevent overflaring of the canal and preserve pericervical dentin. Tactile-controlled activation involves activating martensitic nickel-titanium rotary files upon engagement and then immediately withdrawing the files. The proposed technique recommends 3 apical strokes after the initial engagement before withdrawal to minimize instrumentation time. This novel technique is described in a case report involving the management of an S-shaped double-curved maxillary lateral incisor. The technique presents a new method of crown-down instrumentation that prevents overflaring and avoids instrument separation., (Copyright © 2020 American Association of Endodontists. All rights reserved.)

This work aims to assess the influence of corrosion on fracture of nickel titanium (NiTi) superelastic wires in physiological solutions (9 g/l NaCl) with and without addition of 1 g/l NaF. The electrochemical cell was coupled to a Hounsfield Tensiometer tensile machine commonly used for corrosion investigation of alloys under stress and strain. Corrosion tests were performed on unstrained and strained conditions up to 4% total strain. This strain limit corresponds to 50% of the total elongation achieved into the superelastic stress plateau of the alloy. All wire specimens were analyzed after testing by scanning electron microscopy (SEM). The results showed that localized corrosion occurred for NiTi wires in solution containing fluoride, while no corrosion attack was detected in NaCl 9 g/l solution. There was no significant difference between the corrosion resistance of unstrained and strained wires. However, brittle like fracture occurred in NaCl + NaF solution within the superelastic domain of the material. The most relevant conclusion achieved is that the use of superelastically strained NiTi in oral environments in the presence of fluoride is followed by significant risk of corrosion induced fracture., (Copyright © 2021. Published by Elsevier Ltd.)

A comprehensive study of Fe alloying influence on as-cast titanium alloys, including microstructure, mechanical properties, bio-corrosion behavior and in-vitro cell response have been carried out to evaluate the biological application potential of Ti-Fe binary alloys. The results indicate that grain sizes of as-cast Ti-Fe alloys are remarkably refined with Fe addition and the mechanical strength is increased tremendously. For instance, Ti-2Fe alloy presents excellent mechanical properties by elevating the tensile strength to 566 MPa, or 1.5 times over pure Ti, while maintaining a relative high plasticity. All Ti-Fe alloys carried in this study show a higher corrosion resistance in Hank's solution than pure Ti due to the grain refine enhancement and higher oxide film growth kinetics. Ti-2Fe alloy presents the best corrosion resistance among them and higher Fe content could bring more Fe 2 O 3 to the oxidation films that decrease the corrosion resistance accordingly. All Ti-Fe alloys are holding a similar osteoblast cell viability and response to pure Ti which ensure their biocompatibility. The combination of mechanical properties, corrosion resistance and in-vitro response of Ti-2Fe promised its application as dental implants in a near future., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: Previously published studies have deeply investigated the characteristics of flexural and torsional resistance of nickel-titanium rotary instruments, but none of them investigated the relationship between the 2 stresses. The objective of the present study was to evaluate the influence of flexural stresses over torsional resistance., Methods: Sixty S-One 20.04 files (Fanta Dental, Shanghai, China) were used in the present study (N = 60) and divided into 3 test groups of 20 files. A customized device made of a mobile structure with a connection that holds the handpiece and the artificial canal was used for the experiment to make the measurements repeatable. The artificial canals were created with a 90° curvature, a 60° curvature, and lastly a straight canal. Each file was rotated at 300 rpm with a maximum torque value of 5.5 Ncm with the apical 2 mm firmly secured in a vise. The torque at fracture and the time to fracture were recorded by the software integrated in the handpiece and evaluated through statistical analysis., Results: Statistical analysis found significant differences in the values of torque to fracture (TtF) between these 3 groups (P < .05). The 90° curved canal group showed the highest TtF value, and the 60° curved canal group showed a higher TtF value than the straight canal group., Conclusions: The results of the present study demonstrated a positive influence of flexural stresses over torque at fracture of rotary files. When nickel-titanium instruments were used in a 90° or 60° curvature, the values of torque at fracture increased compared with the same instruments that rotated in the straight canal., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The purpose of this study was to investigate if machined springs in nickel-titanium (NiTi) rotary instruments can improve their mechanical properties. The bending and torsion properties were assessed using finite element (FE) model analysis., Methods: A basic 3-dimensional file model without a spring was created with apical size #25, 25-mm full length, and 16-mm cutting flutes. Three other models were created with a spring machined into their shaft portion with different numbers of spring coils: standard (STspr), 10% more (INspr), and 10% less (DEspr). To compare the mechanical responses among the 4 FE models, file bending and torsion were simulated using FE analysis., Results: Spring machined NiTi rotary instruments showed higher torsional resistance and less bending stiffness than the same instrument without. The spring machined models required more torque to bend or rotate the DEspr model than was required for the STspr and INspr models; however, the STSpr and INSpr models were similar., Conclusions: Within the limitations of this study, the FE analysis indicated that machining a spring into the shaft of NiTi rotary instruments improved torsional resistance and bending flexibility. Therefore, spring machining has the potential to increase the durability of the NiTi rotary instruments., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Orthodontic archwire rotation around its long axis, known as third-order torque, is utilised to correct tooth rotational misalignments moving the tooth root closer to or away from the cheek through engagement with an orthodontic bracket. Studying the behaviour of archwire and brackets during an applied rotation can aid in better understanding and appreciating the mechanics of third-order torque, potentially allowing for more effective orthodontic treatment protocols. Mechanically characterising archwire behaviour during third-order torque application is a complex task due to their physical scale and geometries. An advanced measurement technique was needed to address these constraints. A three-dimensional (3D) non-contact optical method using a digital image correlation (DIC) system was developed. An orthodontic torque simulator (OTS) was used to apply and measure third-order torque with 0.483 × 0.635 mm (0.019″ x 0.025″) rectangular archwires in tandem with a 3D DIC system, whereby surface deformations and strains could be computed using correlation algorithms. The 3D DIC system was implemented to enable third-order torque experimentation with the OTS while imaging the archwire and bracket surfaces. The 3D DIC system's ability to measure 3D archwire deformations and strains was verified using a finite element model, where comparisons between 3D DIC measurements and calculated results from the model were made to ensure the measurement capabilities of 3D DIC in the context of third-order torque. The 3D DIC system was then used to compare archwire behaviour between stainless steel (SS) and titanium molybdenum alloy (TMA) archwires to study potential clinical differences in archwire behaviour, in which the archwires were rotated with a custom SS rigid dowel (RD) as well as commercial Damon Q orthodontic brackets. The quantification of third-order torque and archwire deformations and strains led to the conclusion that SS archwires led to larger torque magnitudes compared to TMA archwires. The RD resulted in larger archwire strains compared to Damon Q brackets. The 3D DIC system provides a non-contact measurement technique that can further be used with third-order torque experimentation with the OTS., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The application of digitally manufactured dental metals has aroused the attention on their biocompatibilities. Three-dimensional oral mucosal model (3D OMM) would provide excellent assessments to the biocompatibility. In the current study, we set to measure metal ion release levels in the extracts of cast gold-platinum alloy (Au-Pt), differently manufactured cobalt-chromium alloy (Co-Cr) and commercially pure titanium (cp-Ti). We further tested two scaffold materials of 3D OMM to determine the better one for the succedent work. Lastly, we evaluated the apoptotic and autophagic effects of cast Au-Pt, and differently manufactured Co-Cr and cp-Ti on mucosal cells based on 3D OMM. We found that, in the construction of 3D OMM, Matrigel showed better performance than bovine acellular dermal matrix. Thus, Matrigel was chosen to construct the 3D OMM in the succedent studies. The results of ion release and biological assessments showed that, firstly, cast Au-Pt and cp-Ti triggered less early apoptotic cells and ion release than cast Co-Cr, implying better chemical stability and biocompatibility of them; secondly, digitally manufactured (including CAD/CAM milling and SLM) Co-Cr showed significantly lower ion release levels and lesser early apoptotic effects on 3D OMM as compared to the cast one. Although cast cp-Ti released much more ions than CAD/CAM milling one, manufacturing methods had no impact on apoptotic effect of cp-Ti. Therefore, we believe that digital methods possess same or even better chemical stability and biocompatibility than conventional casting one. Thirdly, although increased autophagic levels are observed in all test groups, so far there is no evidence that the test metals trigger different levels of autophagy as compared to each other. In addition, correlation analysis indicates that Co, W, and Mn appear to be the potential inducements for the apoptotic and autophagic effects of Co-Cr., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In this study, two medium Zr-containing Ti-based alloys with commercially pure titanium as control were systematically investigated to assess their potential biomedical application. After samples subjected to TMP and CR, it was found that the Zr addition significantly affected the microstructure, phase constitutions, mechanical properties and cytocompatibility. The microstructural results showed that increasing Zr concentrations resulted in more refined grains. Furthermore, Zr changed the phase constitution: CR Ti-20Zr was formed by the single α-phase while CR Ti-30Zr alloy was formed by the coexistence of α and deformation-induced FCC phases. The P-type FCC phase was dominant and more prone to occur than the B-type one. The mechanical tests demonstrated that the increasing Zr content led to a simultaneous increase in micro-hardness, strength and plasticity of CR samples due to the combined effects of solution strengthening, work hardening and the FCC phase. The SEM fractography indicated that the brittle fracture of CR Ti-20Zr due to deformation twins and ductile fracture of CR Ti-30Zr because of FCC phase. Furthermore, Ti-Zr alloys presented comparable cytocompatibility to the CP-Ti control based on cell viability, proliferation and intracellular O 2- content of MSCs. Specifically, alkaline phosphatase activity in BMSCs were significantly higher for grain refined CR Ti-30Zr. Considering all these results, CR Ti-30Zr alloy exhibited the optimal comprehensive performance to be potential dental materials., (Copyright © 2020. Published by Elsevier Ltd.)

Introduction: This study aimed to compare the ProTaper Universal (PTU; Dentsply Maillefer, Ballaigues, Switzerland) system with 6 replicalike instruments regarding instrument design, mechanical performance, and alloy characteristics., Methods: New rotary instruments (size 20/.07v) of PTU and 6 replicalike systems (EdgeTaper [EdgeEndo, Johnson City, TN], U-File [Dentmark, Ludhiana, India], Go-Taper Universal [Access, Shenzhen, China], Super Files [Flydent, Shenzhen, China], Multitaper [Proclinic Expert, Besançon, France], and Pluri Taper [Bestdent, Shenzhen, China]) (n = 329) were selected and evaluated regarding their design, mechanical performance, and metallurgical characteristics. The results were compared using the nonparametric Mood median test and 1-way analysis of variance with the significance level set at 0.05., Results: Replicalike instruments were similar to PTU regarding design, maximum torque to fracture (P > .05), and ratio of nickel and titanium elements. Scanning electron microscopy revealed differences in the geometry of the tip and finishing surfaces. Time to fracture of Go-Taper Universal (50.0 seconds) was similar to PTU (44.0 seconds) (P > .05), but the U-File (63.5 seconds), Edge Taper (87.5 seconds), and Super Files (130 seconds) showed significantly higher values (P < .05). The highest maximum torque was observed in the Super Files instrument (P < .05), but no statistical difference was noted among the other instruments (P > .05). The angle of rotation before rupture of the Multitaper (574°) and Pluri Taper (481°) was higher than PTU (354°) (P < .05). Differential scanning calorimetric analysis showed clear differences on the transformation temperatures among the tested instruments. The R-phase start and finish temperatures of PTU were 11.0°C and -18.0°C, respectively., Conclusions: Overall, replicalike instruments were similar to PTU regarding the torsional resistance, geometric design, and near equiatomic proportions of nickel and titanium elements. In 3 of the 4 mechanical tests, the EdgeTaper (torque, angle of rotation, and bending load) and Go-Taper Universal (time to fracture, torque, and angle of rotation) systems were similar to PTU., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Shape memory and super elastic alloys are commonly used in biomedical and engineering areas, due to their higher elastic deformation characteristics and low elastic module when in martensitic state. For biomaterial applications, the alloy must exhibit adequate corrosion resistance and biocompatibility, especially in chloride environments. The addition of ternary elements in NiTi alloys aim to improve the mechanical properties. Addition of Co increases the elastic limit and reduce the transformation temperature while Cr additions increase the yield strength. However, it was demonstrated that this modification can affect the corrosion resistance of the raw materials. This study aims to assess the corrosion and strain induced corrosion resistance of NiTi alloys modified by Co and Cr additions in the presence of 0.9% NaCl solution. Ternary alloys were compared to NiTi binary alloys, when unstrained and strained within the elastic regime where martensitic transformation is induced. Electrochemical impedance spectroscopy (EIS) and anodic polarization tests were performed on both conditions. Straining electrode corrosion tests were performed under constant electrochemical potential being the electrochemical response registered. Tests using wire samples as straining working electrodes permitted the assessment of the correlation between deformation and the anodic current of the alloys immersed in 0.9% NaCl solution. It was concluded that, despite the mechanical benefits provided by the addition of ternary elements, these additions increased the susceptibility to localized corrosion and the pitting corrosion susceptibility enhanced by stress and corresponding strain., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: This study compared the static and dynamic cyclic fatigue resistance of contemporary nickel-titanium instruments with different kinematic, metallurgic, and design features to establish whether the fatigue-reducing effect of the pecking motion differs among different nickel-titanium instruments., Methods: ProTaper Gold (PTG), Hyflex EDM (EDM), Reciproc Blue (RPB), and WaveOne Gold (WOG) files were divided into 2 groups of 10 for the static and dynamic cyclic fatigue resistance tests. A stainless steel artificial canal with 1.5-mm inner diameter, 60° angulation, and 3-mm radius of curvature was used. In the dynamic cyclic fatigue resistance test, speeds were set at 100 and 200 mm/min for the descending and ascending motion, respectively. The number of cycles to fracture (NCF) was calculated, the fractured lengths were recorded, and fractographic analysis of the fractured surfaces was carried out by scanning electron microscopy. Data were analyzed statistically with the Kruskal-Wallis test with Bonferroni correction (alpha = 0.05)., Results: The RPB and EDM showed significantly higher NCF in the static and dynamic cyclic fatigue resistance tests (P < .05). The dynamic cyclic fatigue resistance test showed significantly higher NCF than the static cyclic fatigue resistance test in the PTG and EDM (P < .05). There was no significant difference between the RPB and WOG (P > .05)., Conclusions: In the experimental condition where the ascending speed was higher than the descending speed, the dynamic cyclic fatigue resistance was significantly higher than the static cyclic fatigue resistance in continuous rotary instruments, but not in reciprocating instruments., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Surface finish of NiTi is widely perceived to affect its biocompatibility and corrosion fatigue performance. The aim of this work was to find out, whether a carefully engineered surface oxide shows any beneficial effect over electropolished surface on the fatigue performance of superelastic NiTi wire mechanically cycled in simulated biofluid. Series of corrosion and environmental fatigue tensile tests was performed on superelastic NiTi wire with two different surface finishes frequently used in medical device industry. Open Circuit Potential reflecting the activity of chemical reactions on the surface of the wire cycled in electrochemical cell was continuously monitored during the fatigue tests. Microcracks at the surface of the fatigued NiTi wires were characterized by SEM and TEM. It was found that the carefully engineered 70 nm thick TiO 2 oxide provides the NiTi wire with similar level of protection against the static corrosion as the less than 10 nm thin natural oxide on the electropolished wire and that it does not have any positive effect on its performance in environmental fatigue tests, whatsoever. On the contrary, the wire covered by the carefully engineered 70 nm thick TiO 2 oxide displayed systematically poorer fatigue performance upon tensile cycling under specific critical loading conditions (strain amplitude <0.5% at large mean strains 1-7%)., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: The purpose of this study was to evaluate the effect of 5 different curvature locations on the fatigue resistance of thermomechanically treated nickel-titanium (NiTi) files and superelastic NiTi files at body temperature and to document the corresponding phase transformations., Methods: EndoSequence (ES; Brasseler USA, Savannah, GA), EndoSequence CM (ESCM, Brasseler USA), K3 (SybronEndo, Orange, CA), K3XF (SybronEndo), and Vortex Blue (VB; Dentsply Tulsa Dental Specialties, Tulsa, OK) NiTi files (size 25/.04) were subjected to fatigue tests inside customized artificial canals containing a curvature of 60° and a 3-mm radius. There were 5 different canals based on the location of initial curvature; these included groups in which the distance between the canal orifice and the location of the curvature (DOC) was 5, 6, 8, 10, and 11 mm. The model canal was immersed in water at 37°C ± 1°C. The number of cycles to failure (N f ) was recorded, and the fracture surface of the fragments was examined by scanning electron microscopy. Two unused files of each brand were examined by differential scanning calorimetry., Results: The N f was highest in the 10-mm and 11-mm DOC groups and lowest with the 5-mm and 6-mm DOC groups (P < .05). ESCM files had the highest fatigue resistance followed by the VB, K3XF, K3, and ES files (P < .05). ESCM files had the highest N f (P < .05), and ES and K3 files had the lowest N f (P < .05) depending on the curvature location. Two endothermic peaks were observed on the heating curve of the heat-treated files (ESCM, K3XF, and VB)., Conclusions: The location of the canal curvature had a significant effect on the fatigue resistance of both heat-treated and superelastic NiTi files. The fatigue life of files in the coronal curve was quite short., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study aimed to compare the mechanical and metallurgical properties and shaping ability of different rotary systems using a multimethod approach., Methods: New NeoNiti A1 (Neolix SAS, Châtres-La-Forêt, France), HyFlex EDM One File (Coltène/Whaledent, Altstätten, Switzerland), ProTaper Gold F2 (Dentsply Maillefer, Ballaigues, Switzerland), and ProTaper Universal F2 (Dentsply Maillefer) rotary instruments were tested regarding cyclic fatigue, torsional resistance, design, and morphologic characteristics using scanning electron microscopy, metal alloy characterization using differential scanning calorimetry, and energy-dispersive X-ray spectroscopy. Additionally, their shaping ability on the preparation of 48 canals of maxillary molars was evaluated using micro-computed tomographic technology. Mechanical and metallurgical analyses were compared using analysis of variance post hoc Tukey tests, whereas the independent Student t test was used to compare the shaping ability of the ProTaper systems or the thermomechanically treated instruments. The significance level was set at 5%., Results: The highest cyclic fatigue was observed with the NeoNiti and HyFlex EDM instruments (P > .05), whereas HyFlex EDM had the highest angular rotation to fracture (P < .05). Scanning electron microscopic/energy-dispersive X-ray spectroscopic analyses confirmed similarities in the instruments' design and an almost equiatomic composition of the systems. Differential scanning calorimetry showed that ProTaper Gold had higher transformation temperatures than ProTaper Universal, whereas a similar transformation was observed between NeoNiti and HyFlex. Micro-computed tomographic analysis revealed that, despite the fact that none of the systems was able to prepare all root canal walls, no statistical differences were observed in either ProTaper systems (P > .05) or the thermomechanically treated instruments (P > .05)., Conclusions: Apart from differences in the mechanical tests and metallurgical characterization, systems with comparable instrument dimensions and preparation protocols showed a similar percentage of untouched surface areas in the root canal preparation of maxillary molars., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to evaluate the cyclic fatigue resistance of 3 replicalike rotary instruments compared with their original brand systems using continuous rotation and optimum torque reverse (OTR) kinematics., Methods: New F1 rotary instruments (n = 20 per group) from ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) and ProTaper Gold (Dentsply Maillefer) original brand systems were compared with 3 replicalike instruments (U-File [Dentmark, Ludhiana, India], Super Files [Shenzhen Flydent Medical, Shenzhen, China], and Super Files Blue [Shenzhen Flydent Medical]) regarding cyclic fatigue resistance. In each group, the selected instruments were randomly distributed into 2 subgroups (n = 10) according to the kinematics. In the rotary group (ROT), the instruments were activated with a continuous clockwise rotation (300 rpm, 1.5 Ncm), whereas in the OTR group, asymmetric oscillatory motion was performed setting the OTR function at 300 rpm and adjusting the torque limit at the minimum level using the TriAuto ZX2 motor (J Morita, Kyoto, Japan). The time to fracture was recorded and statistically compared according to the kinematics (ROT × OTR) and the instrument type (replicalike × original brand) using the independent sample t test (α = 0.05). Additionally, the metal alloy characterization of each system was performed by differential scanning calorimetry and energy-dispersive X-ray spectroscopy., Results: Statistical analysis revealed significantly higher time to fracture for all rotary systems tested in OTR motion compared with continuous rotation (P < .05) with a mean percentage increase ranging from 52.1% (ProTaper Gold) to 156.7% (U-File). The replicalike instruments showed a significantly higher time to fracture compared with the respective original brand instruments in either ROT or OTR motion (P < .05). Replicas presented austenitic temperatures above the ones displayed by the original brands and an almost equiatomic ratio between nickel and titanium elements., Conclusions: OTR motion significantly improved the fatigue resistance of both original and replicalike systems. The replicas showed higher cyclic fatigue resistance than original brand instruments and higher transition temperatures to the austenitic phase., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This research aimed to evaluate the effect of titanium dioxide (TiO 2 ) coating on surface roughness (R a ) of nickel-titanium (NiTi) archwires and its influence on Streptococcus mutans (S mutans) adhesion and enamel mineralization at the end of 1 month in orthodontic patients and to evaluate the integrity of the TiO 2 coating., Methods: Twelve patients undergoing orthodontic treatment with preadjusted edgewise appliance formed the sample for this prospective clinical study. Uncoated NiTi archwires and TiO 2 nanoparticle coated NiTi archwires in as-received condition and after 1 month of intraoral use were subjected to R a analysis using surface profilometry, and surface topography using scanning electron microscopy. S mutans adhesion was evaluated on the retrieved archwires using real-time polymerase chain reaction (PCR). Enamel mineral content in the arches related to the uncoated and coated archwires was evaluated using DIAGNOdent., Results: After 1 month of intraoral use, both coated and uncoated archwires exhibited a rougher surface with coated archwires demonstrating greater quantum of increase (control, P = 0.002; experimental, P = 0.002). S mutans adhesion was more in uncoated archwires (P = 0.0005). The TiO 2 nanoparticle coating on the NiTi archwires showed delamination, deterioration and was lost by 60% at the end of 1 month. Laser fluorescence values did not show any significant difference (control, P = 0.182; experimental, P = 0.105)., Conclusions: TiO 2 nanoparticle coating on NiTi archwires causes an initial reduction in roughness; however, at the end of 1 month, the benefit was lost. S mutans adhesion was lesser on the coated wires, which could be attributed to reduced initial R a and antibacterial property of TiO 2 . Orthodontic archwire appears to have a limited role in enamel demineralization., (Copyright © 2020 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to compare the buckling resistance of nickel-titanium (NiTi) instruments for glide path preparation depending on the test mode (static vs dynamic)., Methods: The conventional PathFile (PF; Dentsply Sirona, Ballaigues, Switzerland) and heat-treated ProGlider (PG, Dentsply Sirona) and WaveOne Gold Glider (WG, Dentsply Sirona) were evaluated. The instrument tips were placed in a small dimple prepared in an aluminum cube in a customized device. The file was then pushed in the axial direction at a 1.0-mm/s crosshead speed with rotation (dynamic mode) or without rotation (static mode). The dynamic mode of WG used its dedicated reciprocating rotation, whereas the others were rotated continuously at 300 rpm. The axial load and lateral buckling displacement were simultaneously measured. Data were analyzed statistically using 2-way analysis of variance (P = .05)., Results: The buckling resistance in the dynamic mode was higher than in the static mode for PG and WG (P < .05), whereas PF was not influenced by test modes (P > .05). In the dynamic mode, the PG required the highest buckling load followed by PF and WG (P < .05). In the static mode, the WG showed the lowest load (P < .05). The dynamic mode showed significantly more upper level lateral buckling displacement than in the static mode (P < .05)., Conclusions: When the glide path preparation instruments moved in the dynamic mode as in clinical situations, the buckling resistance of the heat-treated NiTi glide path instruments was higher than in the static condition. The heat-treated instruments may have better buckling resistance than the conventional NiTi instrument in clinical situations., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This ex vivo study aimed to evaluate the cleaning and shaping ability of a unique stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with 2 nickel-titanium rotary instruments., Methods: Thirty human mandibular premolars with a 15° to 25° curvature were equally distributed into 3 groups for final instrumentation with Gentlefile Red (#23/0.04), HyFlex EDM OneFile (#25/0.08∼; Coltene/Whaledent, Altstätten, Switzerland), and ProTaper Next X2 (#25/0.06v; Dentsply Sirona, Ballaigues, Switzerland) (n = 10/each). The untouched canal area, volume changes, and transportation were evaluated on pre- and post-instrumentation micro-computed tomographic images. Five random regions of the canal wall located 1-7 mm from the apical foramen were evaluated with scanning electron microscopy for superficial debris and a smear layer via a 5-point scoring system. Data were compared using the Kruskal-Wallis test with post hoc Dunn's pairwise comparison test with Bonferroni correction and Wilcoxon signed-rank test (α = 5%)., Results: All instruments generated no overt procedural errors. Untouched area and volume changes did not show any significant differences among the 3 groups (P > .05). The Gentlefile exhibited less transportation at the level of 5-7 mm from the apex compared with ProTaper Next (P < .05). The Gentlefile showed a smaller debris score than ProTaper Next and better smear layer removal than the others (P < .05). Complete cleanliness was not achieved by any of the systems investigated., Conclusions: Canals instrumented with the Gentlefile exhibited less transportation at the mid-root level and better cleanliness than those instrumented with HyFlex EDM and ProTaper Next., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Functionally graded NiTi orthodontic archwire was tested to assess the evolution of the actuation force as a function of the temperature. Varying actuation forces on the same orthodontic wire allow the optimization of repositioning of the different types of teeth, according its radicular support. The wire was separated into three segments: Incisive, Premolar and Molar. The functionally graded NiTi orthodontic archwire segments have distinct structural and mechanical behavior as confirmed by differential scanning calorimetry, synchrotron-based X-ray diffraction, and thermomechanical analysis. The mechanical behavior was analyzed by three-point bending tests at four different temperatures (5, 20, 25 and 37 °C). In parallel, three-point bending tests were performed by TMA analysis in a temperature range from 5 °C (from cold water) to 40 °C (hot meal). This study showed the comparison of the different segments on the same archwire, providing a better understanding of the behavior of these functionally graded materials., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: The aim of this review article was to discuss the concept of cryotherapy, its mechanism, physiological effect, and its different applications in the field of endodontics., Methods: The selected articles were limited to those published in the English language using the following key words: cryotherapy, cryogenic treatment of nickel-titanium, cold therapy, and cryotherapy in endodontics. The screening of articles was based on an electronic search of the following databases: PubMed, Scopus, Web of Science, and Egyptian Knowledge Bank., Results: The initial search yielded 98 citations, 78 of which were included. On the basis of the collected data, 32 studies addressed the physiological effect of cryotherapy, 10 focused on illustrating a different application of cryotherapy during root canal treatment, and 36 were concerned with the effect of cryogenic treatment on endodontic instruments., Conclusions: It can be concluded that cryotherapy is a simple and cheap supplementary method for minimizing postoperative pain in cases of symptomatic apical periodontitis and for controlling pulpal hemorrhage during vital pulp therapy. Undoubtedly, it is also an indispensable measure for controlling postsurgical swelling and pain after endodontic surgery. However, further studies are needed to clarify the effect of cryogenic treatment of the recent generations of nickel-titanium rotary instruments., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to describe the mechanical properties both in stationary and dynamic conditions in vitro of the novel TruNatomy (TN; (Dentsply Sirona, Ballaigues, Switzerland) shaping files and compare them with a conventional rotary system, ProTaper Next (PTN, Dentsply Sirona)., Methods: Different sizes of 2 types of rotary files, TN and PTN, were compared for their fatigue limit (n = 20 each size) and torsional resistance (n = 6 each size) and subjected to simulated shaping (n = 6 each size). Fatigue limits were determined in a novel fixture including a tapered simulated curved canal (angle = 75°, radius = 5 mm) with a thermal probe and a cooling airstream (minimum of 2 bars) attached to keep the temperature rise below 2°C. Torsional resistance was tested according to ISO 3630-1. Shaping was simulated in plastic blocks with standardized J-shaped curved root canals in a computer-controlled device to register real-time torque and force. Fracture patterns were assessed using scanning electron microscopy. Parametric statistics and Weibull analysis were used to compare groups., Results: The tested sizes for TN were significantly more fatigue resistant and reliable compared with PTN; torsional limits were similar, but twist angles at failure were larger for TN. No instruments fractured during simulated shaping, and the working torque and the threading-in force were significantly lower for TN., Conclusions: This study showed the mechanical properties of both TN and PTN in terms of fatigue limit and torsional resistance and compared them with simulated canal shaping. TN was found to be more fatigue resistant and showed significantly more predicable torque and threading-in force compared with PTN., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to evaluate the amount of root canal dentin removed and apical transportation occurrence after instrumentation of mesiobuccal canals of maxillary molars with ProTaper Next (PTN [Dentsply Maillefer, Ballaigues, Switzerland]), OneShape (OS [MicroMega, Besançon, France]), and EdgeFile (EF [Edge Endo, Albuquerque, NM]) rotary systems., Methods: Twenty-seven mesiobuccal canals of maxillary molars were used. Canals were randomly divided into 3 groups for canal preparation: PTN, EF X3, or OS (n = 9 for each group). Micro-computed tomographic imaging was used to measure apical transportation (mm) and the volume of dentin removed (mm 3 ). The amount of dentin removed was measured for the coronal portion and for the whole canal length. Superposition of pre- and postoperative cross-sectional apical slices were used to measure apical transportation at 1 mm from the apex; the differences were evaluated using the Kruskal-Wallis test and Wilcoxon analysis. The Spearman correlation coefficient was used to display the relationship between variables for each group. The significance level was set at P < .05., Results: The percentages of the amount of dentin removed on the coronal portion and the amount removed for the whole canal length were statistically similar between groups (P > .05). The average amount of apical transportation for the PTN, OS, and EF X3 were 0.197, 0.263, and 0.218 mm, respectively. Statistically, there were no significant differences between the 3 rotary instruments for apical transportation., Conclusions: The amount of dentin removed for the coronal third portion and the whole canal length was similar for the PTN, OS, and EF X3 rotary instruments. Although there were differences in the sizes of apical enlargement, no apical transportation was observed in any of the instrumentation systems., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to compare the influences from different access angles and curvature radii on cyclic fatigue resistance of nickel-titanium rotary files., Methods: Two file systems (2Shape [TS; MicroMega, Besançon, France] and HyFlex CM [HCM; Coltène/Whaledent, Allstätten, Switzerland]) were used. A total of 192 instruments of TS #25/.04 (TS1), TS #25/.06 (TS2), HCM #25/.04, and HCM #25/.06 were evaluated at 3 insertion angles (0°, 10°, and 20°) and 2 radii (5 mm and 3 mm) in 16-mm stainless steel artificial canals with a 60° curvature. Cyclic fatigue resistance was determined by the number of cycles to failure (NCF) using a customized testing device. Data were analyzed statistically with the significance level established at 95%., Results: In the 3-mm radius canal, the instruments showed lower cyclic fatigue resistance than in the 5-mm radius canal (P < .05). HCM #25/.06 and all .04 taper instruments had a significant NCF reduction at 20° and 10° in the 3-mm radius canal (P < .05), whereas TS2 showed no significant differences. In the 5-mm radius of curvature, although .06 taper instruments had no significant NCF reduction for each angle tested, .04 taper files exhibited significant NCF reduction when tested at 20° (P < .05). Comparing the same size instruments, HCM had higher NCF than TS (P < .05). Instruments with a .04 taper exhibited higher NCF than the .06 ones with the same heat treatment (P < .05)., Conclusions: An inclined insertion into the canals decreased cyclic fatigue resistance of thermal-treated instruments with a .04 taper at all radii of curvature tested. The synergistic effect of a small radius of curvature and access angulation of heat-treated instruments decreases their fatigue resistance., (Copyright © 2019 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Information is scarce regarding current usage practices of nickel-titanium (NiTi) engine-driven instruments in clinical practice. Therefore, the specific purpose of this survey was to assess trends among endodontists regarding the use and reuse of NiTi instruments., Methods: A 16-question survey was sent by e-mail to about 4000 active members of the American Association of Endodontists. Data were collected over a 6-month period and compared using chi-square tests., Results: A total of 957 surveys were collected (response rate = 23%). Of the respondents, 40.2% worked in solo practices; among them, there were significantly fewer recent graduates (<10 years) compared with those who graduated more than 10 years ago. Furthermore, 41.7% were in a group practice, 4.3% in corporate practice, 10.7% in university settings, and 3% in the military. Overall, 98.3% of respondents reported using NiTi instruments. Respondents who graduated less than 25 years ago use NiTi instruments significantly more (99%) than those who graduated more than 25 years ago (92.6%). Although 22.9% of respondents buy presterilized instruments, 41.6% sterilize them before use, and 35.5% do not sterilize new instruments before use; dental officers in the military reported that they use sterile new instruments in 100% of cases. NiTi instruments were reused by 74% of respondents. The 2 largest segments of the specialist endodontic instrument market belonged to Dentsply (York, PA; 56.9%) and EdgeEndo (Albuquerque, NM; 28.8%)., Conclusions: There are significant differences in the use of NiTi instruments among types of practice and years since graduation. There were noticeable changes compared with findings reported about 10 years ago., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study compared three-dimensional forces delivered to the displaced tooth and its adjacent teeth between passive self-ligation (PSL) and conventional elastic ligation (CL) in simulation of mandibular lateral incisor linguoversions., Methods: A multisensor system was used to measure three-dimensional forces delivered to brackets attached to the mandibular left central incisor, lateral incisor, and canine (FDI tooth numbers 31, 32, and 33, respectively). Two ligation methods (PSL and CL), 3 nickel-titanium (0.014-inch) archwires similar to the arch form of normal occlusion, and 2 displacements (1 and 4 mm) were tested., Results: In 1-mm displacement, forces were significantly smaller in CL than in PSL at 32 in the labial direction and larger at 31 in the mesial direction for all 3 types of archwires (P <0.01 for both). For 2 of 3 archwires, forces were larger in CL than in PSL at 33 in the lingual direction (P <0.01). In 4-mm displacement, forces were significantly larger in CL than in PSL at 31 in the mesial direction and significantly smaller in CL than in PSL at 33 in the distal direction for all 3 archwires (P <0.05 and P <0.01, respectively). Mean forces in the vertical direction were small, ranging from -0.05 to 0.05 N., Conclusions: Under a small amount of displacement, force magnitude in PSL was smaller than that in CL at the displaced tooth in labial-lingual directions. Under a large amount of displacement, a more "open coil spring effect" was significantly obtained in CL than PSL at both adjacent teeth of the displaced tooth., (Copyright © 2019 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)