Chen Wenxin, Hou Xiaomei
Second Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100101, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Feb 18;57(1):136-141. doi: 10.19723/j.issn.1671-167X.2025.01.020.
To compare the cyclic fatigue resistance of nickel-titanium files made by 3 new heat treatment in simulated S-shaped root canals at different temperatures.
Gold heat-treated nickel-titanium files TruNatomy (25 mm, tip size 26#/0.04) and ProTaper Gold (25 mm, tip size 25#/0.08) were selected as the experimental group, M wire technique nickel-titanium file ProTaper Next (25 mm, tip size 25#/0.06) was selected as the control group. It was speculated that the Gold technique used in TruNatomy nickel-titanium file was R phase separation technique, which included a complete intermediate R-phase, increasing its flexibility. ProTaper Gold was a CM wire nickel-titanium file and the increased phase transformation temperature by heat treatment introduced martensite at room temperature, while it underwent gold heat treatment on the surface, generating an intermediate R phase during phase transformation, providing hyperelastic. ProTaper Next used M wire technique, M wire included austenite at room temperature, where heat mechanical processing introduced hardened martensite, which was incapable of participating phase transformation. Because of the lower elastic modulus of hardened martensite than austenite, the flexibility of the file was increased. Twenty instruments of each nickel-titanium file were submitted to the cyclic fatigue test by using a simulated canal with double curvatures at room tem-perature (24 ℃) and 65 ℃, 10 instruments of each nickel-titanium file were selected at each temperature (=10). At the same temperature, the number of cyclic fatigue (NCF) and fragment length were analyzed by using One-Way analysis of variance at a significance level of < 0.05. NCF and fragment length of the same nickel-titanium file at room temperature and 65 ℃ were compared by paired sample test and the significance level was α=0.05. Fractured surfaces were analyzed by using scanning electron microscope.
In double-curved canals, all the failure of the files due to cyclic fatigue was first seen in the apical curvature before the coronal curvature. At room temperature, in the apical curvature, NCF of TruNatomy was 344.4±96.6, ProTaper Gold was 175.0±56.1, ProTaper Next was 133.3±39.7, NCF of Tru Natomy was the highest ( < 0.05). In the coronal curvature, NCF of TruNatomy was 618.3± 75.3, ProTaper Gold was 327.5±111.8, ProTaper Next was 376.6±67.9, NCF of TruNatomy was also the highest ( < 0.05). There was no significant difference among the apical and coronal fragment length of the 3 nickel-titanium files (>0.05). At 65 ℃, in the apical curvature, NCF of TruNatomy was 289.6±65.8, ProTaper Gold was 187.5±75.4, ProTaper Next was 103.0±38.5, NCF of TruNatomy was the highest ( < 0.05). In the coronal curvature, NCF of TruNatomy was 454.2±45.4, ProTaper Gold was 268.3±31.4, ProTaper Next was 283.8±31.7, NCF of TruNatomy was also the highest ( < 0.05). The apical fragment length of ProTaper Next was the highest ( < 0.05), and there was no significant difference among coronal fragment length of the 3 nickel-titanium files (>0.05). Compared with room temperature, at 65 ℃, in the coronal curvature, NCF of TruNatomy decreased significantly ( < 0.05). The fractured surfaces of the three nickel-titanium files demonstrated typical cyclic fatigue.
Gold heat-treated nickel-titanium file had better cyclic fatigue resistance than M wire nickel-titanium file in S-shaped root canals.
比较3种新型热处理镍钛锉在不同温度模拟S形根管中的抗循环疲劳性能。
选取经金热处理的镍钛锉TruNatomy(25 mm,尖端尺寸26#/0.04)和ProTaper Gold(25 mm,尖端尺寸25#/0.08)作为实验组,选取M线技术镍钛锉ProTaper Next(25 mm,尖端尺寸25#/0.06)作为对照组。推测TruNatomy镍钛锉采用的金技术为R相分离技术,其中包含完整的中间R相,增加了其柔韧性。ProTaper Gold是一种CM线镍钛锉,通过热处理提高相变温度,在室温下引入马氏体,同时其表面进行金热处理,在相变过程中产生中间R相,提供超弹性。ProTaper Next采用M线技术,M线在室温下包含奥氏体,热机械加工引入硬化马氏体,其不能参与相变。由于硬化马氏体的弹性模量低于奥氏体,锉的柔韧性增加。每种镍钛锉各20支器械在室温(24℃)和65℃下使用具有双曲率的模拟根管进行循环疲劳试验,每个温度下每种镍钛锉选取10支(n = 10)。在相同温度下,采用单因素方差分析对循环疲劳次数(NCF)和碎片长度进行分析,显著性水平为P < 0.05。对同一镍钛锉在室温及65℃下的NCF和碎片长度进行配对样本t检验,显著性水平为α = 0.05。使用扫描电子显微镜分析断裂表面。
在双曲根管中,所有因循环疲劳导致的锉折断均首先出现在根尖弯曲处而非冠部弯曲处。在室温下,在根尖弯曲处,TruNatomy的NCF为344.4±96.6,ProTaper Gold为175.0±56.1,ProTaper Next为133.3±39.7,TruNatomy的NCF最高(P < 0.05)。在冠部弯曲处,TruNatomy的NCF为618.3±75.3,ProTaper Gold为327.5±111.8,ProTaper Next为376.6±67.9,TruNatomy的NCF也最高(P < 0.05)。3种镍钛锉的根尖和冠部碎片长度之间无显著差异(P>0.05)。在65℃时,在根尖弯曲处,TruNatomy的NCF为289.6±65.8,ProTaper Gold为187.5±75.4,ProTaper Next为103.0±38.5,TruNatomy的NCF最高(P < 0.05)。在冠部弯曲处,TruNatomy的NCF为454.2±45.4,ProTaper Gold为268.3±31.4,ProTaper Next为283.8±31.7,TruNatomy的NCF也最高(P < 0.05)。ProTaper Next的根尖碎片长度最高(P < 0.05),3种镍钛锉的冠部碎片长度之间无显著差异(P>0.05)。与室温相比,在65℃时,在冠部弯曲处,TruNatomy的NCF显著降低(P < 0.05)。3种镍钛锉的断裂表面均显示典型的循环疲劳。
在S形根管中,经金热处理的镍钛锉比M线镍钛锉具有更好的抗循环疲劳性能。