Clinical Oral Investigations

https://doi.org/10.1007/s00784-020-03348-8

ORIGINAL ARTICLE

Effect of canal curvature location on the cyclic fatigue resistance

of reciprocating files
Tyler Sobotkiewicz 1 & Xiangya Huang 2 & Markus Haapasalo 1 & Christophe Mobuchon 3 & Ahmed Hieawy 1 &
Jinghao Hu 1 & Huimin Zhou 4 & Zhejun Wang 1 & Ya Shen 1

Received: 18 February 2020 / Accepted: 15 May 2020

# Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract
Objectives To determine the effect of the location of the canal curvature on the fatigue resistance of WaveOne (WO), WaveOne
Gold (WOG), Reciproc (Rec), and Reciproc Blue (RecB) files, and to examine the phase transformation behaviors of the
reciprocating file systems.
Material and methods The instruments were subjected to fatigue testing in five artificial canals with a curvature of 60° angle and a
3-mm radius. The location of the curvature was unique for each canal. Each file was inserted 16 mm into the canal and operated until
fracture occurred. The time to fracture was recorded and the length of the fragment was measured. Differential scanning calorimetry
was used to characterize the thermal behavior of the files. The number of cycles to failure was analyzed using two-way analysis of
variance and the post hoc Tukey test. The Kruskal-Wallis test was used to compare the mean fragment lengths between groups.
Results The instruments had significantly lower fatigue resistance in canals with curvatures in the middle and coronal canals
compared with those with apical curvatures (p < 0.05). At all tested curvature locations, RecB had superior fatigue resistance
compared with WO and Rec (p < 0.05). There were no significant differences between WOG and Rec in canals with curvatures
in the middle and coronal canals. The DSC thermograms for RecB exhibit a single exothermic peak during cooling but double
endothermic peaks during heating indicating that a two-step phase transformation from martensite to R-phase to austenite takes place.
Conclusions The reciprocating instruments experience decreased cyclic fatigue resistance when operated in canals with coronal-
and middle-third curvatures when compared with curvatures in the apical-third. Instrumenting coronally positioned curvatures
with reciprocating files needs to be performed with caution.
Clinical relevance The location of the root canal’s curvature influences the fracture resistance of rotary files that are used with
reciprocating movements. Therefore, caution needs to be exercised when using reciprocating instruments in canals with coronal
or middle curvatures.

Keywords Curvature location . Fatigue resistance . Reciproc . Reciproc Blue . WaveOne . WaveOne Gold

* Ya Shen
Introduction
yashen@dentistry.ubc.ca
Endodontic nickel-titanium (NiTi) rotary instruments fracture
due to torsional overloading or cyclic fatigue [1]. The overall
1
Division of Endodontics, Faculty of Dentistry, The University of prevalence of instrument fracture during root canal treatment
British Columbia (UBC), 2199 Wesbrook Mall, has been found to be between 1.7 and 3.3%, with rotary files
Vancouver V6T1Z3, Canada
responsible for 70–85% of the fractured instruments [2–4].
2
Department of Conservative Dentistry & Endodontics, Guanghua Using microscopic and fractographic analysis, authors have
School of Stomatology, Guangdong Province Key Laboratory of
Stomatology, Sun Yat-Sen University Guangzhou, concluded that 66–93% of rotary instrument fractures were
Guangzhou, China due to cyclic fatigue failure while 7–34% were due to shear
3
Department of Materials Engineering, UBC, Vancouver, Canada failure [5, 6]. Fracture due to fatigue occurs when an instru-
4 ment freely rotates in a curved canal. Unlike torsional
Center for Biomedical Materials and Engineering, College of
Material Science and Chemical Engineering, Harbin Engineering overloading, files subject to cyclic fatigue will not demon-
University, Harbin, China strate visible signs of defects or changes in shape and the

fracture point will occur at the canal’s point of maximum
curvature [1]. The risk of fatigue failure of a NiTi rotary in-
strument is affected by the anatomy of the root canal and the
file’s cyclic fatigue resistance, which is dependent on its met-
allurgy and design. Geometric properties of canals that in-
crease the risk of fatigue failure include short radii of curva-
ture, large angles of curvature, and curvatures with long arc
lengths [1, 7, 8]. Additionally, canals with curvatures located
closer to the canal orifice and canals with double curvatures
(S-shaped canals) have been shown to increase the risk of
fatigue failure of rotary instruments [9, 10]. As evidence of
fatigue cannot be gathered by visual inspection of the file
during treatment, it is important for clinicians to choose a
rotary instrument system with an appropriate fatigue resis-
tance for the root canal anatomy at hand.
Reciprocating motion was applied to NiTi instruments in
2008. Yared [11] was the first author to report the use and effec-
tiveness of reciprocating movements for rotary files, as he dem-
onstrated that a single reciprocating file was sufficient to replace
multiple files used in continuous rotation. Reciprocating files
engage and debride dentine when rotating in the cutting direction
and disengage in the opposite direction. Reciprocating move-
ments appear to decrease the risk of file fracture caused by fa-
tigue failure, when compared with continuous rotation [12, 13].
Reciprocating movements result in the file experiencing fewer
complete rotations and fewer tensile-compressive stress cycles
compared with continuous rotation, which may account for the
increased cyclic fatigue resistance [12]. WaveOne (WO)
(Dentsply Sirona, York, PA, USA) and Reciproc (Rec)
(VDW, Munich, Germany) are among the earliest manufactured
NiTi rotary files intended for reciprocating movements. Years
later, heat-treated reciprocating files, WaveOne Gold (WOG)
(Dentsply Sirona) and Reciproc Blue (RecB) (VDW), were re-
leased and demonstrated increased flexibility compared with
their predecessors. WOG and RecB have been shown to be a
safer alternative to WO and Rec in curved canals due to their
relatively superior cyclic fatigue resistance [14–18]. While fa-
tigue resistance studies of these reciprocating file systems are
available, there is a gap in the literature concerning the effect
of the canal’s curvature location on the fatigue resistance of these
instruments. Therefore, the aim of the study was to examine the
effect of the location of canal curvature on the fatigue resistance
of reciprocating NiTi files, and analyze the thermal behavior and
phase transformation temperatures of Rec, RecB, WO, and
WOG using differential scanning calorimetry (DSC).
Materials and methods
Sample size calculation
Sample size was determined using G*Power version 3.1.9.4
software (Brunsbuttel, Germany). The results reported by
Clin Oral Invest
Ozyurek et al. [14] that studied the fatigue resistance of recip-
rocating instruments were used to calculate effective sample
size while the significance level was set at 0.05 and power was
set at 0.80. The software calculation showed that 8 files per
group were necessary, and the decision was made to include
10 files in each group. As there are 20 groups, 200 total files
(50 of each file system) were used for the experiments.
Cyclic fatigue test
Five ceramic artificial canals were milled in an InCoris ZI
zirconium oxide disc (Dentsply Sirona) using the inLab MC
X5 Digital computer-aided design and computer-aided
manufacturing (CAD/CAM) System (Dentsply Sirona).
Each artificial canal was 16 mm in length and formed a ta-
pered groove on one side of the zirconium oxide block [19].
The most coronal extent of the canal, the canal orifice, was
1.31 mm in diameter and constantly tapered by 0.06 mm per
every millimeter of canal length, resulting in a 0.35-mm di-
ameter for the apical extent of the canal. Each canal had a
single curvature with a radius of curvature of 3 mm and an
angle of curvature of 60°. The five artificial canals differed
only in the location of their curvatures along the length of the
canal. The distance between the canal orifice to the start of the
curve will be abbreviated as DOC (distance from the orifice to
the curvature). The canals were separated into 5 groups, based
on the location of where the curvature began (Fig. 1); group 1:
DOC of 5 mm; group 2: DOC of 6 mm; group 3: DOC of 8
mm; group 4: DOC of 10 mm; group 5: DOC of 11 mm.
Polyvinyl siloxane impression material was used to create a
custom jig that provided reproducible staging for the artificial
canals. The artificial canal was placed inside a glass container
that was filled with deionized water. Within the glass contain-
er, plastic plumber screws were used to stabilize the fiber glass
to the zirconium oxide block. The glass container was placed
on a hotplate (Radnor, PA, USA), which kept the deionized
water at a constant temperature of 37 ± 2 °C [19, 20]. The
following NiTi instruments were subject to fatigue testing:
WO Primary (25/0.08), WOG Primary (25/0.07), Rec-25
(25/0.08), and RecB-25 (25/0.08).
A total of 50 files of each instrument system were used and
all files were 25 mm in length for the fatigue test. Each instru-
ment system was evenly distributed to the five groups of ca-
nals. The hotplate was connected to a stainless steel frame-
work that included a fastened utility clamp, which was used to
secure the motor handpiece in position (Fig. 2). Rec and RecB
files were used with a 6:1 reduction handpiece connected to a
VDW Silver motor (VDW Munich). WO and WOG files were
used with an 8:1 reduction handpiece connected to a ProMark
Endo motor (Dentsply Sirona). As per the manufacturer’s in-
structions, Rec and RecB were operated with “RECIPROC
ALL” settings while WO and WOG were operated with
“WAVEONE ALL” settings. The files were placed to the full
Clin Oral Invest
Fig. 1 Schematic diagrams of five curvature locations of the canals. The distance from the orifice to the curvature of 5 mm (a), 6 mm (b), 8 mm (c),
10 mm (d), and 11 mm (e)
length of the artificial canal and operated until fracture oc-
curred. Each experiment was recorded with a video camera
that was capable of high-definition magnification (Panasonic,
Mississauga, Ontario, Canada); each video was reviewed to
determine the time to fracture (TTF) in seconds. The number
of cycles to fracture (Nf) was calculated by dividing the TTF
by 60 s/min and multiplying by the number of rotations per
minute (rpm) that each file operates at. Rec and RecB operate
at 300 rpm (via the “RECIPROC ALL” setting) while WO
and WOG operate at 350 rpm (via the “WAVEONE ALL”
setting) [14].
Each fractured fragment was collected and its length was
measured under magnification by means of a surgical operat-
ing microscope (Global, St. Louis, MO, USA). Two frag-
ments of each instrument system per group were randomly
chosen for fractographic examination. The fragments were
submerged in absolute alcohol and ultrasonically cleaned
(Endo Ultra, MicroMega, Besancon, France) for 60 sec. The
fragments were mounted with the fractured surface facing
upwards and were submitted for scanning electron microsco-
py (SEM) (Hitachi High-Technologies Canada Inc, Toronto,
Canada) at a magnification of × 110–× 1000 using 3.0 kV.
Fig. 2 The setup of the fatigue
test. a The water container and
thermometer were placed on the
heating device and the handpiece
secured in a utility clamp that was
secured to a stainless-steel frame-
work. b Arrangement of the arti-
ficial canals
DSC
Eight brand new instruments, including two from each of the
reciprocating instrument systems, were subjected for DSC
testing. The instruments were separated into two fragments
using a diamond bur under copious water coolant. The apical
fragments, consisting of D0–D4 of the rotary file, and the
coronal segments, consisting of D7–D11 of the rotary file,
were assessed.
The DSC2500 machine (TA Instruments, New Castle, USA)
was used in this study. The reference sample was an empty Tzero
pan sealed with a Tzero Hermetic Lid. With the use of liquid
nitrogen, the sample was initially cooled to – 75 °C. When the
sample reached – 75 °C, it was then heated at 10 °C/min until it
reached 100 °C. After a brief pause, the sample was then re-
cooled to − 75 °C at a rate of 10 °C/min. The data was transferred
to TRIOS software (TA Instruments, New Castle, USA), which
was used to analyze the thermal behavior of each specimen. The
austenitic transformation start and finish points (As and Af) and
the martensitic reverse transformation start and finish points
(Ms and Mf) were determined on the thermograms by using the
TRIOS software function “Onset Point” [21].

Statistical analysis
Statistical analysis was performed with SPSS software version
3.1.1.0 (IBM, Armonk, NY, USA). The normality of the data
was determined by using the Kolmogorov-Smirnov test. The
equality of variance was assessed with Levene’s test. Two-way
analysis of variance (ANOVA) was used to compare the aver-
age Nf of the study groups. Post hoc multiple comparison with
the Tukey test was used to identify and confirm statistically
significant differences between groups. The Kruskal-Wallis test
was used to compare the mean fragment lengths between
groups. The statistical significance level, α, was set at 0.05.
Results
Comparisons of the Nf between the reciprocating file sys-
tems are presented in Fig. 3. All the reciprocating files
showed significantly lower Nf when they were used in
canals with a DOC of 5 mm, 6 mm, and 8 mm when
compared with canals with a DOC of 10 mm or 11 mm
(p < 0.05). Additionally, WO, Rec, and RecB showed
significantly higher fatigue resistance when used in a ca-
nal with a DOC of 11 mm when compared with a canal
with a DOC of 10 mm (p < 0.05).
The only significant difference in fatigue resistance between
WOG and RecB occurred when the DOC was 11 mm (p <
0.05). RecB had significantly higher Nf than WO and Rec in
Fig. 3 The Nf of reciprocating
instruments at different curvature
locations. Different letters
indicate statistically significant
differences within each group (p <
0.05)
Clin Oral Invest
all groups (p < 0.05). WOG had significantly greater fatigue life
than WO when used in a canal with a DOC of 5 mm, 8 mm, 10
mm, and 11 mm (p < 0.05) while no significant differences
existed between these files when the canal’s DOC was 6 mm
(p > 0.05). WOG had significantly greater fatigue resistance
than Rec in canals with a DOC of 5 mm, 8 mm, and 10 mm
(p < 0.05) while there were no differences between these files
when used in canals with a DOC of 6 mm or 11 mm (p > 0.05).
Compared with WO, Rec had superior fatigue resistance in the
canal with a DOC of 11 mm (p < 0.05).
The mean values of the length of the fractured frag-
ments are displayed in Fig. 4. There were no significant
differences in length of the fractured fragments between
the reciprocating file systems (p > 0.05) except between
WOG and Rec in the canal with a DOC of 11 mm (p < 0.05).
Based on the mean length of the file fragments, the file
fractures occurred at or near the point of maximum
curvature of each canal. The surfaces of the fractured file
fragments all showed evidence of fatigue failure. The
crack initiation points were seen at stress concentration
areas (Figs. 5 and 6).
The DSC thermograms shown in this study include a
cooling curve at the top of the figure and a heating curve
at the bottom of the figure (Fig. 7). The mean phase trans-
formation temperatures for each file system were
determined and are displayed in Table 1. The average aus-
tenite start temperatures (As) found for WO (26.22 °C),
WOG (35.4 °C), Rec (26.6 °C), and RecB (30.2 °C) were
Clin Oral Invest

Fig. 4 The mean length of the

fractured fragments of the
reciprocating instruments at
different curvature location.
Different letters indicate
statistically significant differences
within each group (p < 0.05)

all below body temperature (~ 37 °C). The average austen-
ite finish temperature (Af) of RecB (37.1 °C) approximated
body temperature while the other files, WO (48.7 °C),
WOG (47.3 °C), and Rec (51.4 °C), exceeded body temper-
ature. The thermograms for WO, WOG, and Rec exhibited
single peaks in both the heating and cooling directions. This
suggests that WO, WOG, and Rec undergo a one-step phase
transformation from martensite to austenite during heating
and a one-step phase transformation from austenite to
martensite during cooling. The thermograms for RecB ex-
hibit a single exothermic peak in the cooling direction but
double endothermic peaks in the heating direction (Fig. 7).
It appears that RecB undergoes a one-step phase transfor-
mation from austenite to martensite when cooled while a
two-step phase transformation from martensite to R-phase
to austenite takes place when the file is heated. The phase
transformation peaks associated with WO and Rec were
broad while sharp peaks were noted with RecB.

Fig. 5 Scanning electron micrographs of fracture surfaces of Reciproc (Rec) and Reciproc Blue (RecB) files after fatigue tests at different curvature
locations (arrows point toward crack initiation points)

Fig. 6 The fracture surfaces of WaveOne (WO) and WaveOne Gold (WOG) files after fatigue tests in canals with a DOC of 5 mm, 8 mm, and 11 mm
(arrows point toward crack initiation points)
Discussion
Heat treatment is known to increase the flexibility and fatigue
resistance of NiTi files; therefore, it is anticipated that WOG
and RecB would take longer to fracture in the fatigue test
compared with their predecessors, WO and Rec [22, 23].
While past studies have demonstrated improved fatigue resis-
tance in WOG and RecB compared with WO and Rec, they
tend to use canals that have only apical curvatures [14–18].
There are few studies in the literature that compare the fatigue
resistance of files rotating in canals with different curvature
locations. Two studies compared the fatigue resistance of con-
tinuously rotating files (in a curved cylindrical canal that
Fig. 7 Differential scanning
calorimetry curves of Reciproc,
Reciproc Blue, WaveOne, and
WaveOne Gold instruments.
Cooling (upper) and heating
(lower) curves are shown
Clin Oral Invest
lacked taper) with an apical curvature versus a canal with a
mid-root curvature, in a dry environment at room temperature
[8, 9]. These studies concluded that BioRace and Mtwo had
significantly reduced fatigue resistance in canals with a mid-
root curvature than canals with an apical curvature [8, 9]. A
study by Arias et al. [24] compared the fatigue resistance of
WO and Rec in non-tapered canals with a curvature located at
5 mm or 13 mm from the tip of the instrument and concluded
that the more coronally located curvature (at 13 mm from the
tip of the instrument) significantly decreased the fatigue resis-
tance of these reciprocating files. Apart from the three studies
mentioned, there appears to be an absence of literature regard-
ing the effect of canal curvature location on the fatigue
Clin Oral Invest
Table 1 Mean phase
transformation temperatures (± Cooling
standard deviation) of the
reciprocating instrument systems File system Ms (°C)
when the coronal and apical
fragments were combined into WO 45.10 ± 1.38
one group WOG 44.40 ± 0.30
Rec 44.88 ± 0.64
RecB 32.55 ± 1.00
resistance of new reciprocating files. In addition, recent re-
ports have shown that file fatigue tests done at room temper-
ature do not predict file behavior at body temperature, espe-
cially for heat-treated files [19, 20, 25–28]. In order to mimic
clinical situations where coronal, middle, and apical curved
canals are encountered, the present study included five loca-
tions of curvatures to evaluate fatigue resistance. The artificial
canals were customized to be similar in shape and taper to the
instrument to ensure a close fit without binding. The canals
were designed to have an angle of 60° and a radius of curva-
ture of 3 mm as this was the only possible combination that
allowed the five different curvatures locations to share the
same radius, angle of curvature, and arc length.
In this study, RecB had superior fatigue resistance com-
pared with Rec in all of the artificial canals while WOG had
superior fatigue resistance compared with WO in all canals
except for the canal with a DOC of 6 mm. Differences in
fatigue resistance between instruments may be due to differ-
ences in diameter, taper, metallurgy, and cross-section of the
rotary file [1, 7, 23]. The reciprocating instruments in our
study fractured significantly faster due to fatigue in canals
with a DOC of 5 mm, 6 mm, and 8 mm compared with canals
with a DOC of 10 mm and 11 mm. Studies have shown that
continuous rotary files with a larger diameter and/or taper will
have lower fatigue resistance than rotary files with smaller
diameters and/or tapers [1, 7]. Therefore, caution needs to be
exercised when using reciprocating instruments in canals with
coronal or middle curvatures.
The most important temperature-based characteristic of NiTi
rotary instruments during clinical endodontic treatment is the
potential phase transformation of martensite to austenite. To
achieve maximum possible fatigue resistance, the NiTi instru-
ment should have both the As and Af above 35 ± 1 °C, which is
the clinical intracanal temperature [29]. If the As and/or Af
values of the NiTi are between room temperature (approximate-
ly 23 °C) and the clinical intracanal temperature, the file will
start phase transformation when used in the root canal. The
reciprocating files used in this study had mean As values that
ranged from 26.2 to 35.4 °C and Af values that ranged from
37.18 to 51.4 °C (Table 1). It would be reasonable to assume
that the heat-treated files, WOG and RecB, have high As and Af
values as their superior flexibility and fatigue resistance over
WO and Rec is suggestive of martensitic alloy [21, 30]. WOG
Heating
Mf (°C) Rs (°C) As (°C) Af (°C) ΔH (J/g)
22.54 ± 1.01 N/A 26.22 ± 1.82 48.70 ± 1.67 1.54 ± 0.36
26.26 ± 1.00 N/A 35.36 ± 0.80 47.26 ± 1.02 2.31 ± 0.51
23.72 ± 2.09 N/A 26.76 ± 1.23 51.42 ± 1.62 1.98 ± 0.32
24.09 ± 1.23 12.71 ± 0.90 30.24 ± 0.22 37.08 ± 0.60 9.10 ± 1.08
fulfills this assumption as it should be almost completely in the
martensitic phase with As and Af values of 35.4 °C and 47.3 °C,
respectively, if intracanal temperatures of 35 ± 1 °C are to be
assumed [29]. In a recent paper, Garcia et al. [31] used DSC
and X-ray diffraction to analyze WO and WOG files. In addi-
tion to presenting similar phase transformation values for WO
and WOG as the current study, they also found the presence of
austenite and R-phase in WO and WOG at room temperature
[32]. Unfortunately, due to peak superposition, Garcia et al.
were not able to determine the amount of each phase present
in these files at room temperature [31].
While RecB had a higher As (30.2 °C) than WO and Rec, it
also had the lowest Af of all the tested files in this study with a
value of 37.1 °C. Based on these results, it would seem likely that
RecB would be mostly austenite during clinical root canal treat-
ment, which is unexpected due to its superior fatigue resistance
compared with WO and Rec, which showed higher Af values.
The thermogram for RecB in the current study consists of sharp
peaks, which are characteristic of NiTi with a high R-phase com-
position, whereas broad peaks, which are characteristic of a high-
austenite composition, can be seen with thermograms for WO,
WOG, and Rec [31, 32]. With the use of X-ray diffraction,
Generali et al. [32] found that the major phase composition of
RecB was R-phase and austenite while small amounts of mar-
tensite were present at room temperature. In the same study, they
found that Rec was primarily austenite while R-phase and mar-
tensite could also be detected in the samples [32].
According to the DSC results of the present study, the en-
thalpy changes (ΔH) of RecB were much higher than that of the
other instruments, indicating a greater amount of transformable
martensite and austenite. During the machining of endodontic
files, the austenite and martensite are inevitably stabilized and
are unable to undergo transformation. Compared with Rec, the
heat treatment of RecB helps to relieve stress and eliminate
physical defects arising during processing, which facilitate the
phase transformation. Generali et al. [32] attributed the higher
fatigue resistance of RecB to the grain refinement and different
phase transformation temperatures. Combined with the results
of the present study, we can assume that recrystallization may
occur during heat treatment of RecB, which could produce
small grains with less defects while lowering the material’s
strength and hardness. This was also verified by Generali
et al. who showed that Blue heat-treated (RecB) samples had

a lower elastic modulus and a significantly lower hardness
when compared with their M-wire (Rec) counterparts. While
elevations in phase transformation temperatures are an obvious
benefit of heat-treatment of NiTi rotary instruments, these find-
ings suggest that alteration of the phase composition of these
files may be the most significant benefit of heat treatment when
considering fatigue resistance.
In conclusion, reciprocating instruments experience lower
fatigue resistance in canals with middle- or coronally located
curvatures when compared with canals with apical curvatures.
WOG and REB have superior CFR when compared with WO
and RE. When heated, WO, WOG, and RE undergo a one-
stage phase transformation from martensite to austenite, while
REB undergoes a two-stage phase transformation from mar-
tensite to R-phase to austenite.
Acknowledgment The authors thank VDW for donating the files used in
this study.
Author contribution T. S. and X. H. contributed equally to this work.
Funding information The work was supported by the Canada
Foundation for Innovation (CFI 32623)
Compliance with ethical standards
Conflict of interest The authors declare that they have no conflict of
interest.
Ethical approval This article does not contain any studies with human
participants or animals performed by any of the authors.
Informed consent For this type of study, formal consent is not required.
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