title: Assessment of influence of flexion angles of files in apical stop preparation by using manual and rotary instrumentation techniques.
abstract: BACKGROUND
  This study aimed to evaluate the influence of flexion angles produced by files during root canal instrumentation on the final form of the apical stop.
  
  
  METHODS
  Sixty human lower incisors were divided into 3 groups (n = 20). After access preparation and working length determination, radiographs were taken from a mesiodistal and buccolingual direction with #15 K-file inserted to working length. Teeth from FlexM group were instrumented with stainless steel Flexofiles up to #40 file. For ProM and ProR groups, hand ProTaper Universal and ProTaper Universal rotary files were used, respectively, up to file F4. New radiographs were taken as previously described. After gutta-percha insertion, the apex of each specimen was ground, allowing gutta-percha visualization, and an image of the apex was captured to identify root canal deformation with computer software. The flexion of files was evaluated from both initial and final radiographs as the angle formed between the divergence of the file path and its virtual image represented by the direction taken by the file in the absence of curvature.
  
  
  RESULTS
  FlexM group presented the highest variation in flexion angles compared with ProM (P = .112) and ProR (P = .024) groups. Nickel-titanium rotary system (ProR) reduced apical stop deformation compared with the manual techniques that used nickel-titanium (P = .011) or stainless steel (P = .025) files.
  
  
  CONCLUSIONS
  Force vectors caused by the flexion angles of the files during the instrumentation of curved canals promoted apical stop deformation. ProTaper Universal rotary files showed less apical deformation than hand ProTaper Universal and stainless steel files.
authors.affiliation: Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
authors.forename: Analice Giovani
authors.initials: AG
authors.lastname: Pereira
authors.forename: Renata Medeiros
authors.initials: RM
authors.lastname: Fagundes dos Santos
authors.forename: Kellen Cristina
authors.initials: KC
authors.lastname: Mendes Azevedo
authors.forename: Luís Henrique Araújo
authors.initials: LH
authors.lastname: Raposo
authors.forename: João Carlos Gabrielli
authors.initials: JC
authors.lastname: Biffi
mesh_terms: D003722:Dental Alloys; D003762:Dental Instruments; D003799:Dental Stress Analysis; D004867:Equipment Design; D006801:Humans; D007180:Incisor; D008334:Mandible; D009532:Nickel; D011859:Radiography; D018915:Root Canal Preparation / Q000295:instrumentation* / Q000379:methods*; D012399:Rotation; D013193:Stainless Steel; D018709:Statistics, Nonparametric; D014025:Titanium; D019227:Tooth Apex / Q000000981:diagnostic imaging; D054159:Torsion, Mechanical
chemical_list: D003722:Dental Alloys; C040654:titanium nickelide; D013193:Stainless Steel; D009532:Nickel; D014025:Titanium