Advertisement

Odontology

, Volume 100, Issue 2, pp 130–136 | Cite as

Impact of nickel–titanium instrumentation of the root canal on clinical outcomes: a focused review

  • Edgar Schäfer
  • Sebastian Bürklein
Review Article

Abstract

Nickel–titanium (NiTi) root canal instruments have improved the technical quality of enlarging and shaping. These instruments have been shown to prepare even severely curved root canal with fewer procedural errors than traditional stainless steel hand instruments. While it would appear that these instruments might enhance clinical outcomes, very few studies have assessed their impact when used in primary root canal treatment. Clinical studies investigating the outcome of primary root canal treatment using nickel–titanium hand or rotary instruments were identified (MEDLINE database) using appropriate key words in an attempt to determine if there have been enhanced outcomes with these instruments. Evidence from one clinical trial suggests that (i) better maintenance of the original canal curvature and shape results in increased success rates and (ii) that ledging of root canals results in reduced success rates. Evidence from two studies indicates that the use of NiTi—either hand or rotary—instruments significantly increases success rates of primary nonsurgical root canal treatment compared with the use of stainless steel hand instruments, while three investigations failed to show any significant differences.

Keywords

Flare-up Periapical health Prognosis Success rate Survival 

References

  1. 1.
    Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature—Part 2: influence of clinical factors. Int Endod J. 2008;41:6–31.PubMedCrossRefGoogle Scholar
  2. 2.
    Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod. 2005;31:271–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Marending M, Peters OA, Zehnder M. Factors affecting the outcome of orthograde root canal therapy in a general dentistry hospital practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:119–24.PubMedCrossRefGoogle Scholar
  4. 4.
    de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study—Phase 4: initial treatment. J Endod. 2008;34:258–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I, Nakagaki H, Nakamura H. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:95–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Ørstavik D, Qvist V, Stoltze K. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci. 2004;112:224–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Storms JL. Factors that influence the success of endodontic treatment. J Can Dent Assoc. 1969;35:83–97.PubMedGoogle Scholar
  8. 8.
    Matsumoto T, Nagai T, Ida K, Ito M, Kawai Y, Horiba N, Sato R, Nakumara H. Factors affecting successful prognosis of root canal treatment. J Endod. 1987;13:239–42.PubMedCrossRefGoogle Scholar
  9. 9.
    Friedman S, Löst C, Zarrabian M, Trope M. Evaluation of success and failure after endodontic therapy using glass ionomer cement sealer. J Endod. 1995;21:384–90.PubMedCrossRefGoogle Scholar
  10. 10.
    Hoskinson SE, Ng YL, Hoskinson AE, Moles DR, Gulabivala K. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:705–15.PubMedCrossRefGoogle Scholar
  11. 11.
    Byström A, Happonen RP, Sjogren U, Sundqvist G. Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis. Endod Dent Traumatol. 1987;3:58–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16:498–504.PubMedCrossRefGoogle Scholar
  13. 13.
    Ørstavik D, Horsted-Bindslev P. A comparison of endodontic treatment results at two dental schools. Int Endod J. 1993;26:348–54.PubMedCrossRefGoogle Scholar
  14. 14.
    Smith CS, Setchell DJ, Harty FJ. Factors influencing the success of conventional root canal therapy—five-year retrospective study. Int Endod J. 1993;26:321–33.PubMedCrossRefGoogle Scholar
  15. 15.
    Dammaschke T, Steven D, Kaup M, Ott KHR. Long-term survival of root-canal-treated teeth: a retrospective study of 10 years. J Endod. 2003;29:638–43.PubMedCrossRefGoogle Scholar
  16. 16.
    Fouad AF, Burlesco J. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record. J Am Dent Assoc. 2003;134:43–51.PubMedGoogle Scholar
  17. 17.
    Wang CH, Chueh SC, Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment. J Endod. 2011;37:1–5.PubMedCrossRefGoogle Scholar
  18. 18.
    Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod. 2006;32:828–32.PubMedCrossRefGoogle Scholar
  19. 19.
    Strindberg LZ. The dependence of the results of pulp therapy on certain factors—an analytical study based on radiographic and clinical follow-up examination. Acta Odontol Scand. 1956;14:1–175.CrossRefGoogle Scholar
  20. 20.
    Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod. 1979;5:83–90.PubMedCrossRefGoogle Scholar
  21. 21.
    Kirkevang LL, Horsted-Bindslev P. Technical aspects of treatment in relation to treatment outcome. Endod Top. 2002;2:89–102.CrossRefGoogle Scholar
  22. 22.
    Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Top. 2005;10:30–76.CrossRefGoogle Scholar
  23. 23.
    Schäfer E, Dammaschke T. Development and sequelae of canal transportation. Endod Top. 2009;15:75–90.CrossRefGoogle Scholar
  24. 24.
    Kleier DJ, Averbach R. Comparison of clinical outcomes using a nickel titanium rotary or stainless steel hand file instrumentation technique. Compend Contin Educ Dent. 2006;27:87–91.PubMedGoogle Scholar
  25. 25.
    Schäfer E, Schulz-Bongart U, Tulus G. Comparison of hand stainless steel and nickel–titanium rotary instrumentation: a clinical study. J Endod. 2004;30:432–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30:559–67.PubMedCrossRefGoogle Scholar
  27. 27.
    Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? J Am Dent Assoc. 2005;136:187–93.PubMedGoogle Scholar
  28. 28.
    Friedman S, Mor C. The success of endodontic therapy—healing and functionality. Can Dent Assoc J. 2004;32:496–503.Google Scholar
  29. 29.
    Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44:583–609.PubMedCrossRefGoogle Scholar
  30. 30.
    Pettiette MT, Metzger Z, Philips C, Trope M. Prognosis of root canal therapy performed by dental students with stainless steel K-files and NiTi hand files. J Endod. 1999;25:230–4.PubMedCrossRefGoogle Scholar
  31. 31.
    Pettiette MT, Delano O, Trope M. Evaluation of success rate of endodontic treatment performed by students with stainless-steel K-files and nickel–titanium hand files. J Endod. 2001;27:124–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Ørstavik D. Radiographic evaluation of apical periodontitis and endodontic treatment results: a computer approach. Int Dent J. 1991;41:89–98.PubMedGoogle Scholar
  33. 33.
    Iqbal M, Kurtz E, Kohli M. Incidence and factors related to flare-ups in a graduate endodontic programme. Int Endod J. 2009;42:99–104.PubMedCrossRefGoogle Scholar
  34. 34.
    Fleming CH, Litaker MS, Alley LW, Eleazer PD. Comparison of classic endodontic techniques versus contemporary techniques on endodontic treatment success. J Endod. 2010;36:414–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Cheung GSP, Liu CSY. A retrospective study of endodontic treatment outcome between nickel–titanium rotary and stainless steel hand filing techniques. J Endod. 2009;35:938–43.PubMedCrossRefGoogle Scholar
  36. 36.
    Peters OA, Barbakow F, Peters CI. An analysis of endodontic treatment with three nickel–titanium rotary root canal preparation techniques. Int Endod J. 2004;37:849–59.PubMedCrossRefGoogle Scholar
  37. 37.
    http://www.cebm.net/index.aspx?o=1025. Accessed on 20 March 2012.

Copyright information

© The Society of The Nippon Dental University 2012

Authors and Affiliations

  1. 1.Central Interdisciplinary Ambulance in the School of DentistryUniversity of MünsterMünsterGermany

Personalised recommendations