Comparison of Cyclic Fatigue Resistance of Five Heat Treated NiTi Rotary Systems in Single and Double Curved Canals.

Abstract BackgroundThe aim of this study was to compare cyclic fatigue resistance (CFR) and separation patterns during rotating movement of five heat-treated nickel titanium files in both single and double-curved canals. MethodsCFR was compared between five groups of 24 files each: HyFlex® EDM, HyFlex™ CM, Vortex Blue®, Protaper Next®, and One Curve, by determining the time needed to fracture (TTF) and the number of cycles to failure (NCF) in a cyclic fatigue testing device with a single 5-mm radius of curvature (ROC) and 60° angle, and a double curvature; coronal curvature (5 mm ROC and 60° angle) and apical curvature (2 mm ROC and 70° angle). The separation pattern was evaluated, and file fragment separated length were measured. One-way ANOVA and Tukey’s post-hoc were used to compare statistical differences between the groups. Scanning Electron Microscope (SEM) was used to investigate the fracture sites. Results HyFlex™ CM files displayed significantly higher CFR, followed by HyFlex® EDM and Vortex Blue® in single curvature canals, and Protaper Next® (PTN) in the double curvature canals, as observed by TFF and NCF. PTN group had the highest tendency for files to extrude apically after separation in both curvatures. ConclusionHyFlex™ CM instruments have superior resistance to cyclic flexural fatigue within single canals with single and double curvatures, followed by HyFlex® EDM and Vortex Blue® instruments. Protaper Next® files followed by One Curve had the highest tendency to extrude apically after separationClinical relevanceHyFlex™ CM instruments showed the highest safety in preparing canals with single or double curvatures, considering CFR.