Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis
Aim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify art...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Dental Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fdmed.2021.747071/full |
| _version_ | 1819017253267439616 |
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| author | Madeline Jun-yu Yon Mark Ho-yeung Tang Gary Shun-pan Cheung Gary Shun-pan Cheung |
| author_facet | Madeline Jun-yu Yon Mark Ho-yeung Tang Gary Shun-pan Cheung Gary Shun-pan Cheung |
| author_sort | Madeline Jun-yu Yon |
| collection | DOAJ |
| description | Aim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify articles that reported on the defects and/or fracture of NiTi instrument used clinically (Jan 1980 till Aug 2021), with additional search manually by going through the list of references of the initially screened articles. Those satisfying the inclusion and exclusion criteria were entered into the analysis.Study Eligibility Criteria, Participants, and Interventions: All studies from the said databases reporting on NiTi root canal instruments that were deformed or separated during normal clinical use.Study Appraisal and Synthesis Methods: Studies with data available and suitable for meta-analysis were grouped according to the general design of the NiTi instruments for comparison. Safety quotient value was calculated based on the rate of instrument distortion and fracture.Results: Various instrument designs exhibited different incidences of distortion and fracture, hence a different “safety quotient” (ratio of the amount of deformed instruments to that of fractures in use). Heat-treated files showed the highest safety quotient value. All brands of NiTi file demonstrated a statistically significantly lower incidence of fracture, if treated as disposable instruments after clinical use in a patient.Limitations: Inclusion of articles written in English only, and grouping of file systems into general design types in the analysis.Conclusions and Implications of Key Findings: NiTi endodontic files should be scrutinized for defects before being used in the root canal. Disposing the NiTi instruments after clinical use in a patient (so-called “single use”) is recommended for minimizing fracture clinically. Certain instrument designs tend to show discernible deformation before they should fracture in the next use. |
| first_indexed | 2024-12-21T03:00:35Z |
| format | Article |
| id | doaj.art-8270f455a9f2454b9f8f4ee93c840dbf |
| institution | Directory Open Access Journal |
| issn | 2673-4915 |
| language | English |
| last_indexed | 2024-12-21T03:00:35Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Dental Medicine |
| spelling | doaj.art-8270f455a9f2454b9f8f4ee93c840dbf2022-12-21T19:18:11ZengFrontiers Media S.A.Frontiers in Dental Medicine2673-49152021-10-01210.3389/fdmed.2021.747071747071Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-AnalysisMadeline Jun-yu Yon0Mark Ho-yeung Tang1Gary Shun-pan Cheung2Gary Shun-pan Cheung3Division of Restorative Dental Sciences, Prince Philip Dental Hospital (PPDH), Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong, SAR ChinaDepartment of Health, The Government of Hong Kong Special Administrative Region (HKSAR), Hong Kong, Hong Kong, SAR ChinaDivision of Restorative Dental Sciences, Prince Philip Dental Hospital (PPDH), Faculty of Dentistry, University of Hong Kong, Hong Kong, Hong Kong, SAR ChinaDepartment of Dentistry, The University of Hong Kong Shenzhen Hospital, Shenzhen, ChinaAim: To review the reported defect and fracture rates of various NiTi instrumentation systems and identify factors that may influence the chance of NiTi file separation clinically.Data Sources: PubMed, EMBASE, and SCOPUS with controlled vocabulary and keywords in various combinations to identify articles that reported on the defects and/or fracture of NiTi instrument used clinically (Jan 1980 till Aug 2021), with additional search manually by going through the list of references of the initially screened articles. Those satisfying the inclusion and exclusion criteria were entered into the analysis.Study Eligibility Criteria, Participants, and Interventions: All studies from the said databases reporting on NiTi root canal instruments that were deformed or separated during normal clinical use.Study Appraisal and Synthesis Methods: Studies with data available and suitable for meta-analysis were grouped according to the general design of the NiTi instruments for comparison. Safety quotient value was calculated based on the rate of instrument distortion and fracture.Results: Various instrument designs exhibited different incidences of distortion and fracture, hence a different “safety quotient” (ratio of the amount of deformed instruments to that of fractures in use). Heat-treated files showed the highest safety quotient value. All brands of NiTi file demonstrated a statistically significantly lower incidence of fracture, if treated as disposable instruments after clinical use in a patient.Limitations: Inclusion of articles written in English only, and grouping of file systems into general design types in the analysis.Conclusions and Implications of Key Findings: NiTi endodontic files should be scrutinized for defects before being used in the root canal. Disposing the NiTi instruments after clinical use in a patient (so-called “single use”) is recommended for minimizing fracture clinically. Certain instrument designs tend to show discernible deformation before they should fracture in the next use.https://www.frontiersin.org/articles/10.3389/fdmed.2021.747071/fullnickel-titanium (NiTi)engine-fileinstrument separationfracturedeformendodontic |
| spellingShingle | Madeline Jun-yu Yon Mark Ho-yeung Tang Gary Shun-pan Cheung Gary Shun-pan Cheung Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis Frontiers in Dental Medicine nickel-titanium (NiTi) engine-file instrument separation fracture deform endodontic |
| title | Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis |
| title_full | Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis |
| title_fullStr | Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis |
| title_short | Defects and Safety of NiTi Root Canal Instruments: A Systematic Review and Meta-Analysis |
| title_sort | defects and safety of niti root canal instruments a systematic review and meta analysis |
| topic | nickel-titanium (NiTi) engine-file instrument separation fracture deform endodontic |
| url | https://www.frontiersin.org/articles/10.3389/fdmed.2021.747071/full |
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