Influence of rotational speed, torque and operator's proficiency on ProFile failures.
OBJECTIVE
The purpose of this study was to evaluate the influence of rotational speed, torque, and operator experience with a specific Ni-Ti rotary instrumentation technique on the incidence of locking, deformation and separation of instruments.


METHODS
ProFile Ni-Ti rotary instruments (PRI) sizes 40-15 with a 6% taper were used in a crown-down technique. In one group of canals (n = 300) speeds of 150, 250 and 350 rpm (subgroups 1, 2 and 3) were used. Each one of the subgroups included 100 canals. In a second group (n = 300) torque was set at 20, 30 and 55 Ncm (subgroups 4, 5 and 6). In the third group (n = 300) three operators with varying experience (subgroups 7, 8 and 9) were also compared. Each subgroup included the use of 10 sets of PRI and 100 canals of extracted human molars. Each set of PRI was used in up to 10 canals and then sterilized before each case. NaOCl 2.5% was used as an irrigant. The number of locked, deformed, and separated instruments for the different groups, and within each part of the study was analysed statistically for significance with chi-squared tests.


RESULTS
In group 1 only one instrument was deformed in the 150-rpm group and no instruments separated or locked. In the 250-rpm group instrument separation did not occur, however, a high incidence of locking, deformation and separation was noted in the 350-rpm group. In general, instrument sizes 30-15 locked, deformed and separated. Chi-squared statistics showed a significant difference between the 150 and 350 rpm groups but no difference between the 150 and 250 rpm groups with regard to instrument separation. Overall, there was a trend toward a higher incidence of instrument deformation and separation in smaller instruments. Locking and separation occurred during the final passage of the instruments, in the last (tenth) canal in each subgroup. In the second group, neither separation nor deformation and locking occurred during the use of the ProFile instruments, at 150 rpm, and at the different torque values. In the third group, chi-squared analysis demonstrated that significantly more instruments separated with the least experienced operator. Instrument locking, deformation, and separation did not occur with the most experienced operator.


CONCLUSIONS
Preclinical training in the use of the PRI technique with crown-down at 150 rpm were crucial in avoiding instrument separation and reducing the incidence of instrument locking and deformation.
Yared
G M
GM
Discipline of Endodontics (Room 348), Faculty of Dentistry, University of Toronto, Toronto M6P 2R6, Canada. g.yared@utoronto.ca
Bou Dagher
F E
FE
Machtou
P
P
D016009:Chi-Square Distribution; D002983:Clinical Competence; D003722:Dental Alloys / Q000737:chemistry; D003786:Dental Pulp Cavity / Q000473:pathology; D004202:Disinfectants / Q000627:therapeutic use; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D009532:Nickel / Q000737:chemistry; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000295:instrumentation* / Q000379:methods; D012399:Rotation; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D013242:Sterilization; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry; D019415:Torque
D003722:Dental Alloys; D004202:Disinfectants; D012388:Root Canal Irrigants; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium; D012973:Sodium Hypochlorite