ORIGINAL ARTICLE 195

Carolina Revilla Snchez-Bretao, Lifong Zou, Sharanbir K Sidhu, Bun San Chong

Surface damage of engine-driven NiTi endodontic

les assessed using 3D coordinate metrology

Carolina Revilla
Key words NiTi les, ProTaper, Reciproc, surface damage, 3D dental scanner Snchez-Bretao, Lic
Odont, PGDip, MSc
Lifong Zou, BSc, MSc,
Aim: To assess, using the principle of three-dimensional (3D) coordinate metrology, the location and PhD
degree of surface damage or wear of two commercially available engine-driven nickel-titanium (NiTi) Sharanbir K Sidhu,
BDS, MSc, PhD,
les after clinical use. MFDS, FADM, SFHEA
Methodology: A total of 24 engine-driven NiTi endodontic les, 12 rotary (ProTaper, Dentsply Bun San Chong, BDS,
MSc, PhD, LDS, FDS,
Maillefer, Ballaigues, Switzerland) and 12 reciprocating (Reciproc, VDW, Munich, Germany), were MRD, FHEA
collected after clinical use. A coordinate measurement dental scanner was used to capture the 3D All at:
coordinate data of each endodontic le surface. The surface data were subjected to 3D analysis Institute of Dentistry, Barts
and The London School of
using a 3D free-form surface analysis software package, which involved the surface interpolation, Medicine and Dentistry,
Queen Mary, University of
registration and subtraction of each image of the scanned surface to a baseline 3D image of a London, London, UK
new, unused le. Three representative points at the coronal, middle and apical third of each sam-
Correspondence to:
ple were selected to assess any differences in surface damage or wear between the two le types. Bun San Chong,
The reproducibility of the methodology, the measurement of new, unused and used engine-driven Institute of Dentistry,
Barts and The London School
NiTi les, was tested. of Medicine and Dentistry,
Results: The reproducibility of the methodology was excellent, with a depth difference of <0.002 mm Turner Street,
London E1 2AD
for the new, unused les and <0.005 mm for used les of both types. Reciprocating les generally Tel: +44 (0) 20 7882 8147
showed greater surface damage in comparison with rotary les. Furthermore, reciprocating les Fax: +44 (0) 20 7377 7064
Email: b.s.chong@qmul.ac.uk
showed greater wear in the apical third and less wear in the coronal third. In contrast, rotary les had
greater surface damage in the coronal third, decreasing towards the apical third.
Conclusions: 3D coordinate metrology provided an objective, reproducible, more economical and
non-destructive method for assessing the surface damage or wear of engine-driven NiTi les after
clinical use. There was more damage seen with les operated in reciprocation compared with those
operated in continuous rotary motion. The le operating motion and surface contact at different
stages of root canal preparation may account for the differences in the degree and location of surface
damage.

Introduction super-elastic properties of NiTi instruments were

Root canal preparation using engine-driven nickel-
titanium (NiTi) les has been widely adopted by
not only endodontic specialists, but also by general
dental practitioners1-3 and it can lead to improve-
ments in the quality of root canal llings4. The
rst described by Walia et al5. The torsional and
exural properties of NiTi help minimise iatrogenic
errors, such as ledges, and reduce the possibility of
unexpected instrument breakage compared with
conventional stainless steel les. Although reduced,
the risk of instrument fracture can never be totally

ENDO (Lond Engl) 2016;10(4):195201

196 Snchez-Bretao et al Surface damage of NiTi files
eliminated. When it occurs, a fractured instrument
can act as an obstacle, hindering thorough canal
decontamination, by preventing access to the root
canal system apical to the blockage. Retrieval of a
fractured intracanal instrument may lead to excessive
tooth tissue removal, which will affect the residual
structural strength of the tooth. Hence, instrument
fracture is to be avoided due to the likely negative
impact on the prognosis of the tooth.
Two modes of engine-driven NiTi instrument frac-
tures have been described: torsional failure and cyclic
fatigue6. Fractures can occur without any visible signs
of wear or deformation, which may not be detected
by the human eye7. The exibility and stiffness of an
endodontic le, dependent on the design of the le,
including taper, cross-sectional shape, length, tip size
and helical angle, are essential characteristics related
to the risk of fracture occurrence6,8-10. The risk of
fracture occurrence is also inuenced by the number
of times a root canal instrument is used; reusing an
instrument carries a potentially higher risk of fracture
compared with using a new instrument each time11.
However, even brand new, unused instruments are
not immune to the risk of fracture12. In their quest
to develop engine-driven NiTi instruments with
increased exibility, improved cutting efciency and
better fracture resistance, manufacturers have made
changes to instrument design, enhanced surface
treatment, altered the microstructure and through
heat treatment adjusted the transition temperature,
of the NiTi alloy10,13. In addition, apart from being
operated in continuous rotary motion, engine-driven
NiTi instruments operated in reciprocating motion
are now also available14.
Imaging techniques utilising, for example, the
scanning electron microscope (SEM) are commonly
used to assess surface characteristics. However, in
order to preserve the sample, a replica is normally
needed. A more economical, non-destructive and
yet reproducible method of assessment of surface
characteristics deserves exploration. Three-dimen-
sional (3D) capture, through optics or mechanics,
allows the surface of any object to be digitised
and the geometry, such as shape and dimensions,
can then be measured. From the digitised data,
the computer algorithm generates a graphic render
and then image analysis software quanties any
geometrical changes between consecutive digitised
ENDO (Lond Engl) 2016;10(4):195201
surfaces. However, optical methods are not suit-
able for reective objects such as engine-driven
NiTi les; light reected on the edges of the le
will be dispersed in various directions, so the data
acquired will not be accurate. A contact method,
based on the principle of 3D coordinate metrology,
is more suitable; typically the scanning probe can
acquire several hundred surface points of an object
in a second.
Therefore, the aim of this study was to use a
newer, more economical and non-destructive
method, based on the principle of three-dimensional
(3D) coordinate metrology, to investigate and com-
pare the surface damage or wear of two commer-
cially available engine-driven NiTi le systems after
clinical use.
Materials and methods
Two types of commercially available engine-driven
NiTi les were assessed: rotary (ProTaper size F2,
Dentsply Maillefer, Ballaigues, Switzerland), and
reciprocating (Reciproc size R25, VDW, Munich,
Germany). The engine-driven NiTi les were used
on similar tooth types only once, according to the
manufacturers recommendations, and collected
from two dental practices in the United Kingdom.
The 24 engine-driven NiTi instruments (12 for each
instrument type) were ultrasonically cleaned and
autoclaved at the collection sites before being used
in the study.
Each of the engine-driven NiTi les was mounted
in a rigid plastic frame lled with silicone putty (Vir-
tual Putty/fast set, Ivoclar Vivadent, Schaan, Liech-
tenstein). In order to ensure the absence of any
gaps between the le and the putty, a light body
impression material (Virtual Light body/regular set,
Ivoclar Vivadent) was carefully syringed around the
mounted le to ensure it was tight, stable and well-
xed (Fig 1).
Three-dimensional coordinate metrology was
used to quantify surface damage and wear of the
engine-driven NiTi les. The Incise Dental Scanner
(Renishaw, Wotton-under-Edge, Gloucestershire,
UK) is a purpose-built surface scanning machine,
based on the novel Triact mechanism, giving high
dynamic performance. A compact three-axis probe
 Snchez-Bretao et al Surface damage of NiTi files 197

Fig 1 Engine-driven NiTi le (ProTaper, Dentsply Maillefer) mounted in a Fig 2 View of a sample placed on the
rigid plastic frame lled with silicone putty prepared for scanning. adjustable platform ready for scanning.

Fig 3 Digitised images of ProTaper (Dentsply Maillefer) les: new, unused (right); used (left). The positioning of these two
les is different since the grooves are not coincident so these two images cannot be compared and was discarded.

performs the scanning with low forces and produces
accurate 3D coordinates. Digitised coordinates
(data) are a string of discrete points; they need to
be interpolated by a mathematical algorithm and
computing to render an image for visualisation and
image analysis. The Incise Dental Scanner (Ren-
ishaw) was used for surface digitisation, and the
data analysed by using 3D free-form surface ana-
lysis software (Cloud, Department of Medical Phys-
ics, University College London, London, UK), which
comprised data interpretation, surface registration
and subtraction, as well as measurements of surface
changes.
Each mounted le was placed on the platform
of the Incise Dental Scanner (Fig 2) and coordi-
nates in XYZ-planes were set up using the com-
puter software to dene the area of interest to be
scanned. The scanning motion of the probe was
bidirectional in the X-axis and the scanning speed
was set at 200 mm/s. For data representation pur-
poses, each le was divided into three sections
coronal, middle and apical third and the high-
est surface wear points selected and recorded for
each of the three sections. A new, unused engine-
driven NiTi le of each type, scanned twice, served
as controls. The mean difference in overall surface
characteristics for each le type, derived from the
digitised images was recorded. The reproducibility
of the methodology, the 3D coordinate measure-
ments of new, unused and used engine-driven NiTi
les, was tested.
To assess the surface damage or wear, each of
the used engine-driven NiTi les was placed in the
mounting putty so that the most coronal groove
where the utes began was positioned upwards;
this was to achieve uniformity in the alignment of
the images and to allow the computer software
to build an accurate superimposition of the 3D
images. Where there was a discrepancy in sample
orientation, the images could not be compared
for assessment purposes and had to be discarded
(Fig 3). To compare the differences of consecutive
scanned images within each le type, common areas
were selected in every image, away from the cut-
ting edges, as they were considered to remain as
unchanged areas and also act as reference points for
the registration procedure. The scanned image of
each used engine-driven NiTi le was superimposed
and then subtracted from the scanned image of the
corresponding, new, unused le. Surface damage or
wear is denoted by any changes detected following
image subtraction.

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198 Snchez-Bretao et al Surface damage of NiTi files
Table 1 Reproducibility of the 3D coordinate measure-
ments of new, unused and used engine-driven NiTi les. The
mean differences for repeated scans of each type of les
were measured over the whole scanning surface of the le
from the digitised images
Scanned engine-driven NiTi le Mean difference in
surface wear
New, unused ProTaper 0.002 mm
Used ProTaper sample 0.005 mm
New, unused Reciproc 0.001 mm
Used Reciproc sample 0.004 mm
Results
The results (Table 1) of the reproducibility test showed
that variations in depth differences between scans
of the new les were <0.002 mm and the same
used, engine-driven NiTi les were <0.005 mm.
Any differences between a used le from a cor-
responding, new, unused le were demonstrated
in a colour-coded image on the computer monitor,
and a value of difference at every pixel was shown
at the bottom of the image. Any value of differ-
ence >0.005 mm was regarded as wear or damage.
Therefore, for each le surface image, thousands
of difference values were calculated and illustrated
by different shades of colours. The red, yellow and
green areas represent positive differences, from
0.5 mm, 0.3 mm and 0.1 mm, respectively, and
the blue and purple represent negative changes in
colour-coded (subtracted) images; the depth differ-
ences at three typical points at the coronal, middle
and apical sections were presented as exemplars in
Figures 4 and 5.
The minimum, maximum, mean and standard
deviation for each section (coronal, middle, apical)
of the two different le types are shown in Table 2.
Graphic representation of the surface changes, such
as wear or damage are exhibited in gures, and each
gure contains hundreds of measured changes in
millimetres; however, for calculation purposes, three
sections (coronal, middle and apical) for each le
type is recorded and shown in Figure 6.
It is noticeable that there is a greater amount of
surface damage in the Reciproc (VDW) les com-
pared with the ProTaper (Dentsply Maillefer) les.
The former showed greater wear in the apical third
and less wear in the coronal third, whereas the latter
ENDO (Lond Engl) 2016;10(4):195201
had greater surface damage in the coronal third,
decreasing towards the apical third.
Discussion
The present study investigated engine-driven NiTi
les and compared the incidence and amount of sur-
face damage these instruments suffered after clinical
use. Some factors may have inuenced the results
of this study, such as operator expertise, instrument
design and the operating sequence recommended
by the manufacturers15. Operator expertise is an im-
portant factor to be considered when these instru-
ments are used16. Other factors such as tooth and
root canal morphology and incorrect or excessive
use can also affect the lifespan of engine-driven
NiTi instruments. It was suggested that instrument
design and the cross-sectional area can affect the
resistance of engine-driven NiTi les to distortion
and damage17. It is accepted that an increase in the
cross-sectional area will provide a greater resistance
to torsional failure but will create a decrease in resist-
ance to general surface wear and fatigue18.
The design and type of operating motion of the
engine-driven NiTi le may have played an important
role in the difference of surface wear or damage for
these two le types. When the surface damage of
ProTaper (Dentsply Maillefer) les after clinical use
was evaluated using atomic force microscopy, it was
reported that the distribution of stress in this le type
was more regular, and hence they were less likely
to become permanently deformed but were more
prone to fatigue failure19. It was conrmed that
fatigue is an important reason for the separation of
ProTaper (Dentsply Maillefer) les during clinical use;
most of the fracture surface examined showed the
presence of fatigue striations20. In another study on
ProTaper (Dentsply Maillefer) les fractured under
clinical conditions, it was reported that the major-
ity (73.9%) fractured without plastic deformation;
this suggests that a single overloading event causing
ductile fracture is the most common fracture mech-
anism under clinical conditions21.
Reciprocation is the oscillating motion when
an instrument rotates in one direction and then
reverses direction22. The use of a reciprocating
motion has been reported to extend the lifespan
 Snchez-Bretao et al Surface damage of NiTi files 199

Protaper 07
0.083 mm 0.007 mm 0.035 mm

0.3 0.1 0.1 0.3

Fig 4 Colour-coded image shows the depth differences, at three typical points (coronal: 0.083 mm, middle: 0.070 mm and
apical: 0.035 mm) between a used and a new, unused ProTaper (Dentsply Maillefer) le.

Reciproc 14
0.056 mm 0.177 mm 0.228 mm

0.3 0.1 0.1 0.3

Fig 5 Colour-coded image showing surface wear (coronal: 0.056 mm, middle: 0.177 mm and apical third: 0.228 mm) of a
Reciproc (VDW) le.

Table 2 Minimum, maximum, mean and standard deviation for each section (coronal, middle, apical) of the two different
le types

Minimum Maximum Mean Standard deviation

ProTaper Coronal 0.027 mm 0.098 mm 0.064 mm 0.020
Middle 0.010 mm 0.086 mm 0.052 mm 0.026
Apical 0.004 mm 0.086 mm 0.038 mm 0.021
Reciproc Coronal 0.056 mm 0.217 mm 0.119 mm 0.053
Middle 0.077 mm 0.177 mm 0.131 mm 0.035
Apical 0.049 mm 0.254 mm 0.133 mm 0.074

of engine-driven NiTi instruments, increasing the

0.14
resistance to fatigue and possible failure in com-
0.12
parison with the more widely used continuous rota-
0.10
tion motion instruments23-26. Other advantages
mm

0.08
reported for reciprocating NiTi instruments include 0.06
less time required to prepare curved canals27 and 0.04
respecting the original canal curvature better28. It 0.02

has also been reported that compared with Pro- 0.00

Coronal (mm) Middle (mm) Apical (mm)
ProTaper 0.064 0.052 0.038
Taper (Dentsply Maillefer) les, the use of Recip- Reciproc 0.119 0.131 0.133

roc (VDW) les was found to result in better canal

cleanliness in the apical part of the canal29. This
may explain the ndings of this study that Reciproc
(VDW) les showed greater wear in the apical third,
while ProTaper (Dentsply Maillefer) les showed
greater wear in the coronal third.
Fig 6 Mean differences in surface wear/damage of the
two different le types.
Manufacturers usually make recommendations
on the clinical use of their engine-driven NiTi les.
For most continuous rotary motion le systems,

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200 Snchez-Bretao et al Surface damage of NiTi files
including ProTaper (Dentsply Maillefer), a glide path
is usually recommended whereas with Reciproc
(VDW), it has been designed to be used as a single
le, without any kind of prior canal preparation14,30.
Hence, the differences in operating sequence may
be an important factor that could have inuenced
the results obtained in this study. On the other hand,
other factors, such as autoclaving, did not appear to
inuence the results obtained in this study; multi-
ple autoclave sterilisation cycles do not signicantly
affect the torsional properties of engine-driven NiTi
les and their fatigue resistance31-34.
The method selected to record and to interpret
the surface damage or wear of these engine-driven
NiTi les is based on the principle of 3D coordinate
metrology and the machine used has been proven
to be accurate in surface registration35-38. Unlike
imaging techniques (e.g. SEM), this newer method
is objective, reproducible, more economical and
non-destructive. This study, as proof of concept,
has shown that this method may be used as an
alternative or supplementary technique to assess
surface damage of engine-driven NiTi les after
clinical use.
Enhancements, updates and newer or improved
engine-driven NiTi le systems are continuing to be
pursued and introduced by manufacturers. Since
completion of this study, there are newer versions
of the two engine-driven NiTi le systems on the
market.
Conclusions
The surface wear registration method based on
3D coordinate metrology provided an objective,
reproducible, more economical and non-destructive
method for assessing the surface damage or wear
of engine-driven NiTi endodontic les after clinical
use. The results showed that engine-driven NiTi
les operated in reciprocation suffered more dam-
age compared with those operated in continuous
rotary motion. The le operating motion and surface
contact at different stages of canal preparation may
account for the differences in the degree and loca-
tion of surface damage.
ENDO (Lond Engl) 2016;10(4):195201
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