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      Present status and future directions: Canal shaping

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          Abstract

          This narrative review will focus on the evolution, present and future of engine‐driven root canal preparation. Root canal preparation changed drastically when Walia in 1988 introduced the use of nickel‐titanium (NiTi) alloys in Endodontics. In 2013, five generations of NiTi endodontic instruments had been established based on their metallurgical, mechanical properties and design features. Since then, manufacturers have been introducing further major changes in instrument design and characteristics that have not been translated in new recognized generations of instruments. In general, those changes have demonstrated enhanced instrument properties, but it is not clear yet if all those improvements are directly translated to an improvement in clinical success. This narrative review attempts to address the present status of engine‐driven instruments in terms of both evidence from laboratory‐based studies and clinical data, to identify potential further generations of instruments, and last to anticipate future directions for research and development.

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          Most cited references135

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          Cleaning and shaping the root canal.

          H Schilder (1974)
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            Current challenges and concepts in the preparation of root canal systems: a review.

            Nickel-titanium rotary instruments are important adjuncts in endodontic therapy. This review attempts to identify factors that influence shaping outcomes with these files, such as preoperative root-canal anatomy and instrument tip design. Other, less significant factors include operator experience, rotational speed, and specific instrument sequence. Implications of various working length definitions and desired apical widths are correlated with clinical results. Despite the existence of one ever-present risk factor, dental anatomy, shaping outcomes with nickel-titanium rotary instruments are mostly predictable. Current evidence indicates that wider apical preparations are feasible. Nickel-titanium rotary instruments require a preclinical training period to minimize separation risks and should be used to case-related working lengths and apical widths. However, and despite superior in vitro results, randomized, clinical trials are required to evaluate outcomes when using nickel-titanium instruments.
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              New thermomechanically treated NiTi alloys - a review.

              In the past 10 years, several proprietary processing procedures for nickel titanium (NiTi) alloy were developed to improve the mechanical properties of NiTi endodontic instruments. Beside specific thermal and mechanical treatments, manufacturers introduced several machining procedures (e.g. twisting, electrical discharge machining), as well as techniques for final surface finishing. NiTi alloys used for endodontic instruments can be subdivided into instruments that mainly contain the austenite phase (austenitic: conventional NiTi, M-Wire, R-Phase) and those mainly containing the martensite phase (martensitic: CM Wire, Gold and Blue heat-treated NiTi). Thermomechanically treated NiTi alloys have been reported to be more flexible with improved cyclic fatigue resistance and greater angle of deflection at failure when compared to conventional NiTi. These enhanced properties may be attributed to a modified phase composition containing varying amounts of R-phase and martensite. Endodontic instruments made of austenitic alloys possess superelastic properties because of stress-induced martensite transformation and consequently tend to spring-back to their original form after deformation. In contrast, the martensitic instruments can easily be deformed due to the reorientation of the martensite variants and show a shape memory effect when heated. The use of martensitic alloy results in more flexible instruments, with an increased cyclic fatigue resistance compared with austenitic alloy.
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                Author and article information

                Contributors
                o.peters@uq.edu.au
                Journal
                Int Endod J
                Int Endod J
                10.1111/(ISSN)1365-2591
                IEJ
                International Endodontic Journal
                John Wiley and Sons Inc. (Hoboken )
                0143-2885
                1365-2591
                16 February 2022
                May 2022
                : 55
                : Suppl 3 , Present status and future directions in clinical Endodontics, Part 1 ( doiID: 10.1111/iej.v55.s3 )
                : 637-655
                Affiliations
                [ 1 ] School of Dentistry Complutense University Madrid Spain
                [ 2 ] School of Dentistry The University of Queensland Herston Queensland Australia
                Author notes
                [*] [* ] Correspondence

                Ove A. Peters, Oral Health Centre, The University of Queensland, 288 Herston Rd., Herston QLD 4006, Australia.

                Email: o.peters@ 123456uq.edu.au

                Author information
                https://orcid.org/0000-0003-2270-8096
                https://orcid.org/0000-0001-5222-8718
                Article
                IEJ13698
                10.1111/iej.13698
                9303733
                35118683
                b91bc228-abff-4a5d-91e8-fe6e5c2061a0
                © 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 30 January 2022
                : 24 December 2021
                : 01 February 2022
                Page count
                Figures: 6, Tables: 1, Pages: 19, Words: 13076
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                May 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:21.07.2022

                Dentistry
                clinical outcomes,generation of instruments,nickel titanium,shaping goals,test design
                Dentistry
                clinical outcomes, generation of instruments, nickel titanium, shaping goals, test design

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