The permanent deformation of the self-adjusting files when used in canals of extracted teeth

Abstract

Aim: To examine the permanent deformation of self-adjusting files (SAF) when used by endodontists with no previous experience with this system.

Methodology: The canals of extracted human molars were initially prepared with glide path up to size 20 K-file. The operators were first instructed on the use of the SAF in simulated canals in plastic blocks then applied the SAF in natural root canals of extracted teeth. Every 4 min, each file was withdrawn from the canal and inspected for integrity. If intact, it was used in another canal for an additional 4 min and checked again. This was repeated until all 19 SAF files were deformed. The files were collected for inspection at ×50 magnification. All teeth were then examined radiographically for the presence of any metal fragments in the root canals. Permanent deformation was categorized according to the type and location occured. Three types were defined as follows: (i) detachment of one component of the file at one end while the component is retained (ii) detachment of a component at both ends and the component missing and (iii) permanent twisting of the component. Recordings were made and statistically analysed using McNemar's test.

Results: Mechanical failures on the 5-arch-side of SAF (odd side) were significantly more frequent in comparison with the even side (P = 0.039). Similarly, mechanical failures in arches on the odd side were also significantly more frequent compared with the even ones (P = 0.012) Longitudinal beams fractured significantly less often compared with arcs or struts (P < 0.001). In no case did complete file fracture occur, nor were metal fragments retained in the root canal.

Conclusions: Deformation of SAF files occurred mainly as detachment of one of the arches or struts at connection points on the odd side of the file. In no case did its mechanical failure result in metal fragment retention in the root canal.

Keywords: deformation; endodontic file; nickel-titanium instruments; self-adjusting file.