doi:10.1111/iej.

12432

REVIEW
A review of instrumentation kinematics of engine-
driven nickel–titanium instruments

ß apar1 & H. Arslan2

I. D. C
1 _
Department of Endodontics, Faculty of Dentistry, Izmir Katip C _
ß elebi University, Izmir; and 2Department of Endodontics,
Faculty of Dentistry, Atat€
urk University, Erzurum, Turkey

Abstract the effect of instrumentation kinematics on root canal

C
ß apar ID, Arslan H. A review of instrumentation kinematics
of engine-driven nickel–titanium instruments. International
Endodontic Journal, 49, 119–135, 2016.
Over the years, NiTi alloys have become indispensable
materials in endodontic treatment. With technological
advancements in metallurgy, manufacturers have
attempted to produce instruments with enhanced fea-
tures. In parallel with these developments, endodontic
motors have undergone improvements in terms of tor-
que control and kinematics that are adjustable in dif-
ferent directions. This review presents an overview of
the advancements in instrumentation kinematics and
shaping procedures and instrument performance. The
literature search for this narrative review was con-
ducted in Google Scholar, Scopus, PubMed and Web
of Science using the keywords ‘kinematics and end-
odontics’ and ‘reciprocation and endodontics’. In addi-
tion, historical literature was searched using the
keyword ‘nickel–titanium and endodontics’. Overall,
143 articles were included up to 2015.
Keywords: asymmetrical motion, instrumentation
speed, kinematics, reciprocation, root canal instru-
mentation, torque.
Received 28 August 2014; accepted 24 January 2015

odontic instruments allows for easier and faster

Introduction
Removing pulp tissue remnants, microorganisms and
microbial toxins from the root canal system is essen-
tial for the success of root canal treatment (Basmadj-
ian-Charles et al. 2002). Root canals can be cleaned
by instrumentation supplemented with irrigants and
intracanal medicaments (Bystr€ om & Sundqvist 1985).
Several mechanical devices and techniques have been
developed to further improve the effectiveness of
instrumentation and to make canal preparation eas-
ier. The devices and techniques used for root canal
instrumentation may be classified as either manual or
machine-assisted. The use of machine-assisted end-
_
Correspondence: Asst. Prof. Dr. Ismail Davut Cß apar, Depart-
_
ment of Endodontics, Faculty of Dentistry, Izmir ß elebi
Katip C
University, 35620 Izmir, Turkey (Tel.: +90 232 325 4040-
2602; Fax: +90 232 325 2535; e-mail: capardt@hotmail.
com).
instrumentation (Sch€ afer et al. 2004). Machine-
assisted techniques consist of automated root canal
preparation, sonic and ultrasonic preparation, laser
systems and noninstrumental techniques (H€ ulsmann
et al. 2005).
Traditionally, stainless steel instruments have been
used for root canal instrumentation. However, such
instruments have a tendency to transport the pre-
pared canal away from its original axis (Cheung &
Liu 2009). With the introduction of the more flexible
nickel–titanium (NiTi) instruments (Walia et al.
1988), they have become indispensable. With techno-
logical advancements in metallurgy, manufacturers
have attempted to improve the instruments (easier,
faster and better root canal shaping, greater resis-
tance to fracture), such as those made of M wire
(Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or
control memory wire (CM) (DS Dental, Johnson City,
TN, USA), that incorporated several design features.

© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd International Endodontic Journal, 49, 119–135, 2016 119
 ß apar & Arslan
Instrumentation kinematics C
Additionally, in parallel with these developments,
endodontic motors have undergone enhancement
regarding torque control and kinematics that are
adjustable in several directions. A review of the litera-
ture reveals that the large number of studies on
instrumentation kinematics carried out in the past
decade has not yet been included in a review. This
review presents an overview of the advancements in
instrumentation kinematics and the effects of instru-
mentation kinematics on root canal shaping proce-
dures and instrument performance.
Literature search methodology
A literature search for this narrative review was con-
ducted in Google Scholar, Scopus, PubMed and Web
of Science using the keywords ‘kinematics and end-
odontics’ and ‘reciprocation and endodontics’. Over
2000 articles were found. In addition, historical liter-
ature searching was conducted using the keywords
‘nickel–titanium and endodontics’. This resulted in
the identification of over 10 000 studies for prelimin-
ary analysis. Articles unrelated to the endodontic
instruments were excluded. The included articles were
checked to identify further relevant literature. Overall,
143 articles were included up to 2015.
Endodontic machine-assisted instrumentation can
be classified into five groups according to the instru-
mentation kinematics as follows: rotary motion, rota-
tional reciprocating motion, vertical vibration plus
rotational reciprocating motion, vertical vibration and
rotary motion plus rotational reciprocating motion
(adaptive).
History of instrumentation kinematics
Rotary instrumentation
According to H€ ulsmann et al. (2005), the first refer-
ence to rotary instrumentation was made by Oltramare
(1892), who used fine needles with rectangular cross
sections that could be attached to a dental handpiece.
Rollins (1899) developed the first endodontic hand-
piece for root canal instrumentation that was used
with specially designed needles at 100 rpm (Milas
1987). After the introduction of NiTi endodontic hand
instruments by Walia et al. (1988), many rotary NiTi
instruments have been marketed. Recently, a new type
of rotary motion, asymmetrical rotary motion, has been
introduced (Diemer et al. 2013). Asymmetrical rotary
motion (waves of motion travelling along the active
120 International Endodontic Journal, 49, 119–135, 2016
part of the file) is produced by design features of the file,
including having an off-centred cross section that is not
related to endodontic motors. The first available systems
enabling asymmetrical motion were Revo-S (Micro-
Mega, Besancßon, France), followed by ProTaper Next
(Dentsply Tulsa Dental Specialties), new generation
OneShape (MicroMega) and more recently TRUShape
3D Conforming Files (Dentsply Tulsa Dental Special-
ties).
Rotational reciprocating motion
After reciprocation was first introduced in 1964 with
the Giromatic system (MicroMega), various endodon-
tic reciprocating handpieces have been manufactured
(Prichard 2012). The Giromatic system, Endo-Gripper
(Moyco Union Broach, Montgomeryville, PA, USA),
Intra-Endo 3 LD (KaVo, Biberach, Germany) and
Dynatrak (Dentsply DeTrey, Konstanz, Germany) oper-
ate with equal angles of 90° clockwise (CW) and clock-
wise (CCW) motion. Over time, the Giromatic system
lost popularity because it produced greater procedural
errors than hand filing (Weine et al. 1976).
The M4 (SybronEndo, Orange, CA, USA), Endo-Eze
(Ultradent Products Inc., South Jordan, UT, USA) and
Endo-Express SafeSider (Essential Dental Systems,
South Hackensack, NJ, USA) systems are current
examples of reciprocating handpieces that utilize
small, equal 30° angles of CW and CCW rotation.
These handpieces enable the formation of an end-
odontic glide path using small stainless steel hand
files (Gambarini et al. 2015).
More recently, reciprocating motion regained popu-
larity with the introduction of NiTi alloys and endodon-
tic torque control motors. In 1985, a balanced-force
technique for curved canals was described by Roane
et al. (1985) and included unequal CW and CCW
motions with hand files. Yared (2008) introduced
the concept of single-file reciprocation, which was
based on a balanced-force technique and used the
ProTaper F2 instrument (Dentsply Tulsa Dental
Specialties) (a flute-designed instrument with cross-
sectional geometry that aids in the cutting of the den-
tine in the CW direction) with unequal CW and CCW
rotational motion (144° CW and 72° CCW). This devel-
opment meant that the instruments required five rota-
tions to complete a full 360° rotation. At the same
time, the elastic limit of the instrument was not
exceeded due to this motion (Kim et al. 2014).
Based on these developments, manufacturers
introduced single-file reciprocating systems including
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

WaveOne (Dentsply Tulsa Dental Specialities) and
Reciproc (VDW, Munich, Germany). The major differ-
ence is that these instruments had a CCW cutting
direction, so the instruments could cut if the CCW
movement was greater than the CW movement. How-
ever, except for these reciprocating instruments, all of
the instruments are designed for cutting in the
CW direction. Thus, if a clinician tries to use these
reciprocating instruments with CW rotating motors
or tries to use CW cutting instruments with the recip-
rocating motors (CCW motion is greater than CW
motion), the instrument will neither cut nor penetrate
into the canal.
Reciprocating endodontic motors can be classified
as open or closed motors, with open motors [(ATR
Vision; ATR, Pistoia, Italy), (iEndo Dual; Acteon,
Merignac, France), (SAF pro System; ReDent-Nova,
Ra’nana, Israel)] allowing modification of angles and
speed and closed motors [(WaveOne), (Reciproc),
(Elements motor; SybronEndo), (ATR Technika; ATR)]
which do not allow such modifications.
Vertical vibration plus rotational reciprocating
motion
Various manufacturers have produced handpieces that
are able to produce an up-and-down motion of the file
and a quarter turn rotation (e.g. Canal Finder System:
Societe Endo Technic, Zurich, Switzerland; Endolift:
SybronEndo). Although these handpieces were manu-
factured for use with stainless steel files, NiTi files are
commercially available with the EndoPulse system
(Societe Endo Technic), which is the new version of
the Canal Finder (http://www.endotechnic.com/prod-
ucts/automated-files-/master-file.html).
Vertical vibration
In 2010, the Self-Adjusting File system (SAF) (Re-
Dent-Nova) was introduced. It is operated by vibrat-
ing a slightly abrasive lattice using an in-and-out
motion to remove dentine and provide continuous
irrigation during preparation (Metzger et al. 2010).
Rotary motion plus rotational reciprocating motion
(adaptive motion)
In 2013, a new endodontic motor was introduced by
Sybron Endo (Elements) that aims to combine the
advantages of both rotary and reciprocating motions.
When the instrument is not (or is minimally) stressed,
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
the motion can be described as a rotation of 600° in
the CW direction, a stop and then a restart in the CW
direction. When the instrument engages dentine or
the root canal filling, the motion of the instrument
becomes reciprocal due to the increased stress. The
reciprocal angles are not constant, and the motor
modifies the CW/CCW angles from 600/0° to 370/
50°, depending on the intracanal stress (http://
axis.sybronendo.com/tfadaptive_confidence#tab 2).
An overview of the asymmetrical rotary
motion studies
As mentioned previously, instruments having an off-
centred cross section (Revo-S, ProTaper Next, new
generation OneShape and TRUShape 3D Conforming
Files) result in an asymmetrical rotary motion. How-
ever, there is no available study comparing instru-
ments with similar cross-sectional geometry and
metal alloy to determine the effect of pure asymmetri-
cal motion. Thus, further studies comparing instru-
ments with similar cross-sectional geometry are
required to understand the effect of asymmetrical
motion on debris extrusion, cutting efficacy, cyclic
fatigue and root canal transportation.
Debris extrusion
Kocak et al. (2013) found no significant differences
between Revo-S and other rotary and reciprocating
systems with respect to debris extrusion. However, it
has been found that the ProTaper Next instruments
were associated with less debris extrusion than the
ProTaper Universal instruments (C ß apar et al. 2014a,
Kocak et al. 2014, Ozsu et al. 2014). The different
cross-sectional geometry may lead to increased space
between the file and the dentinal walls, allowing
more coronal flow of the dentinal debris. In particu-
lar, ProTaper Universal instruments have a convex
triangular cross-sectional geometry, whereas the
ProTaper Next instruments have a rectangular
geometry.
Cutting efficacy
With the aid of asymmetric rotary motion, instruments
with an offset rotational mass may describe a larger
envelope of motion than similarly sized files with sym-
metrical mass and axis of rotation. Consistent with this
theory, Cß apar et al. (2014f) revealed that ProTaper
Next X2 instrument that have a 0.06 apical taper
International Endodontic Journal, 49, 119–135, 2016 121
 ß apar & Arslan
Instrumentation kinematics C
removed similar amounts of dentine compared with
other instruments that had a 0.08 apical taper and sim-
ilar tip size. Thus, smaller and more flexible instruments
can cut the same size of preparation as larger and more
rigid files with centred mass and axis of rotation.
Cyclic fatigue
Diemer et al. (2013) reported that the axial stress on
files decreased for asymmetrical prototype instruments.
Asymmetrical motion produces different stress points
during cyclic fatigue, which may contribute to the cyc-
lic fatigue resistance of the instruments (C ß apar et al.
2014e). Numerous studies have reported that instru-
ments with asymmetrical offset design have better cyc-
lic fatigue resistance than instruments with a centred
mass and axis of rotation (Cß apar et al. 2014c, Elnaghy
2014, Nguyen et al. 2014, Perez-Higueras et al. 2014).
Torsional fatigue
Pereira et al. (2013) compared ProTaper Universal
and ProTaper Next instruments with respect to peak
torque and force during root canal preparation; the
ProTaper Next instruments had greater consistency in
peak torque. Pereira et al. (2013) explained this result
as being a consequence of the asymmetric contact
between the ProTaper Next instrument and dentine.
Dentinal defects
The forces generated during instrumentation have
been linked to an increased risk of root fracture (Kim
et al. 2010), and it has been shown that the ProTaper
Next instruments tended to cause fewer dentinal
cracks compared with the ProTaper Universal instru-
ments (C ß apar et al. 2014b, Karatas et al. 2015). How-
ever, Yoldas et al. (2012) reported that root canal
instrumentation with Revo-S caused a similar inci-
dence of dentinal cracks compared to instruments
with a centred mass and axis of rotation.
Root canal transportation and straightening of the
canal curvature
As mentioned previously no studies have evaluated
the effect of pure asymmetrical motion on root canal
transportation. However, it has been shown that
instruments allowing asymmetrical motion caused
ß apar et al. 2014f) or less root canal trans-
similar (C
portation (B€ urklein et al. 2014b, Zhao et al. 2014)
122 International Endodontic Journal, 49, 119–135, 2016
compared with traditional instruments that have sym-
metrical motion.
An overview of studies on reciprocating
motion
Reciprocating angle
Knowing the actual reciprocating angles is important
because it has been shown that decreasing the recip-
rocation range of the instruments results in increased
cyclic resistance with less transportation but with
longer preparation times (Saber & Abu El Sadat
2013). According to the manufacturers, the ‘Wave-
One ALL’ mode generates a rotation of 170° CCW
and 50° CW, and the ‘Reciproc ALL’ mode generates
a rotation of 150° CCW and 30° CW (Kim et al.
2012). Recently, Fidler (2014) investigated the kine-
matics of reciprocating motors using a high-speed
video camera and found that the actual angles of the
WaveOne mode is 160° CCW and 41° CW, those of
the Reciproc mode is 159° CCW and 35° CW, and
those of ATR Technika’s reciprocation mode is 1310°
CW and 578° CCW.
The ATR motors of two different models, the ATR
Technika (old version) and ATR Vision (new version),
were frequently used in previous studies (Yared 2008,
De-Deus et al. 2010b, Varela-Patino et al. 2010, You
et al. 2010, 2011, Paque et al. 2011, Stern et al.
2012, Perez-Higueras et al. 2013, Giuliani et al.
2014, Kansal et al. 2014). ATR Technika has only
one reciprocating mode, such that the reciprocating
angles are not adjustable, whereas the ATR Vision
has an option to adjust the reciprocating angles. In
the first study on the single-file reciprocation concept
by Yared (2008), the ATR Vision was used, and the
reciprocating angle was found to be four-tenths
(144°) and two-tenths (72°) of a circle. Subsequently,
ATR Technika was used in numerous studies, and
conflicting angles (144°–72°, 60°–45°, 140°–45°)
were reported, although reciprocating angles could
not be adjusted with the motor (De-Deus et al. 2010b,
Varela-Patino et al. 2010, You et al. 2010, 2011,
Stern et al. 2012, Kansal et al. 2014). Researchers
should be aware of the actual angles of the recipro-
cating motion when undertaking further studies.
Debris extrusion
The literature includes conflicting results on the effect
of reciprocating instrumentation on debris extrusion.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

Most of the studies are concerned with the effect of
single-file reciprocating instrumentation on debris
extrusion (B€ urklein & Sch€afer 2012, Kocak et al.
2013, B€ urklein et al. 2014a, De-Deus et al. 2014) or
extrusion of bacteria (Tinoco et al. 2014); however,
there are few reports on pure reciprocating motion
(De-Deus et al. 2010a). Previously, rotary instrumen-
tation was associated with less debris extrusion com-
pared with reciprocal instrumentation (B€ urklein &
Sch€ afer 2012, B€ urklein et al. 2014a). In those stud-
ies, single-file reciprocating instruments are compared
with full-sequence (B€ urklein & Sch€afer 2012) or sin-
gle-file rotary instrumentation (B€ urklein et al. 2014a).
Similarly, Robinson et al. (2013) reported that root
canal instrumentation with single-file reciprocating
instruments induced greater debris accumulation
than full-sequence rotary instrumentation. By con-
trast, it has been shown that single-file reciprocating
instruments caused less extrusion of bacteria (Tinoco
et al. 2014) and debris (De-Deus et al. 2014) than
conventional multifile rotary systems. Kocak et al.
(2013) found no significant differences between sin-
gle-file reciprocating instruments and multifile rotary
systems with respect to debris extrusion. Moreover,
Caviedes-Bucheli et al. (2013) showed that Reciproc
instruments produced lower levels of neuropeptide
expression than WaveOne. These discrepancies may
be caused by the use of differently designed instru-
ments, a different number of files or differing root
canal anatomy, and it is not possible to separate the
influence of the reciprocating motion from the results
of the aforementioned studies. In contrast to these
studies, De-Deus et al. (2010a) compared debris extru-
sion associated with ProTaper instruments with full-
sequence rotary motion up to size F2 with that of a
single ProTaper F2 instrument with reciprocating
motion and demonstrated no significant difference
between the instrumentation techniques. Conversely,
in the study by De-Deus et al. (2010a), different num-
bers of files were compared, and it is not known
whether the instruments would cause less debris
extrusion when the instruments were used with a
full-sequence reciprocating motion.
Cutting efficacy
The cutting efficacy of instruments involves a com-
plex interrelationship of several factors such as cross-
sectional design, debris removal capacity, helical and
rake angles, metallurgical properties and surface
treatments (Sch€ afer & Lau 1999, Sch€ afer & Oitzinger
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
2008, Peters et al. 2014). The cutting efficacy of
reciprocating single-file systems has previously been
evaluated, and the Reciproc system was shown to be
more effective than WaveOne instruments (Plotino
et al. 2014) and other rotary instruments (C ß apar
et al. 2014f). As mentioned above, these differences
may be caused by the different cross-sectional designs
rather than by different kinematics. It has been
shown that heat-treated alloys have less stiffness
(Gambarini et al. 2011) and a lower ultimate tensile
strength than do conventional superelastic wires
(Zhou et al. 2012), suggesting that heat-treated alloys
are softer and therefore cut less effectively. The
greater cutting efficacy of the Reciproc instrument is
likely related to its S-shaped cross section having a
double-cutting edge. It has recently been documented
that Reciproc instruments can reach full working
length without a glide path in a large proportion of
straight or moderately curved canals in mandibular
molar (De-Deus et al. 2013b).
Stern et al. (2012) evaluated the effect of instru-
mentation kinematics on cutting efficacy and reported
that the use of single ProTaper F2 Universal instru-
ments with the reciprocating motion of ATR Technika
motors removed a similar dentine volume to that pro-
duced when using a full sequence of the same instru-
ment with rotational motions. Similarly, Giansiracusa
Rubini et al. (2014) compared the cutting efficacy of
Reciproc instruments with the Reciproc All motion
and CCW rotary motion and found no significant
differences between the motions. Saber & Abu El
Sadat (2013) reported that decreasing the reciproca-
tion range of the instruments resulted in increased
cyclic resistance with less transportation but also in
longer preparation times. Moreover, Plotino et al.
(2014) showed that there were no significant differ-
ences between the Reciproc All and WaveOne All
movements in terms of cutting effectiveness.
Cyclic fatigue
The cyclic fatigue resistance of single-file reciprocating
systems has been evaluated previously, showing that
reciprocating instruments had higher cyclic fatigue
resistance than did instruments that used rotary
motion (Castello-Escriva et al. 2012, Pedulla et al.
2013). Perez-Higueras et al. (2013) reported that K3
(SybronEndo), K3XF (SybronEndo) and Twisted File
(SybronEndo) instruments had better cyclic fatigue
resistance when moved with reciprocating motion
(144° CW and 72° CCW) compared to rotary motion.
International Endodontic Journal, 49, 119–135, 2016 123
 ß apar & Arslan
Instrumentation kinematics C
Similarly, Kiefner et al. (2014) evaluated the cyclic
fatigue resistance of Mtwo (VDW) and Reciproc
instruments under rotary motion or reciprocating
movement (Reciproc All mode) and concluded that
the reciprocating movement increased cyclic fatigue
resistance. Additionally, De-Deus et al. (2010b)
reported the increased cyclic fatigue resistance of Pro-
Taper Universal instruments under reciprocating
movement (ATR Technika’s mode). These results sug-
gest that the cyclic fatigue resistance of different types
of instruments (thermal treated or conventional NiTi)
increases when using reciprocating motion.
Gambarini et al. (2012) evaluated the effect of the
reciprocating range on cyclic fatigue resistance of
instruments and concluded that increasing the recip-
rocating range reduced resistance to cyclic fatigue.
However, the rotational speed of reciprocating instru-
ments may not be constant. Electrical engines have
mechanical limitations for converting the rotation
direction, resulting in acceleration and deceleration in
both directions of rotation (Kim et al. 2012). Gamba-
rini et al. (2012) stated that the differences in the cyc-
lic fatigue resistance of different reciprocating angles
may be related to this acceleration and deceleration
phenomenon.
In a recent study, Shin et al. (2014) evaluated the
effect of different periodic angular increments on an
instruments’ cyclic fatigue. The authors compared dif-
ferent stationary reciprocating motions (equal CW
and CCW motion) and different progressive motions
with different angular increments whenever an
instrument completed different reciprocating cycles, a
reciprocating motion similar to that used by Yared
(2008) and rotary motion. It was found that a pro-
gressive reciprocating operation with a 45° recipro-
cating amplitude and a +7° progressive angular
increment every 10 reciprocating cycles increased the
cyclic fatigue life by 990% in rotary motion (Shin
et al. 2014). Moreover, according to Shin et al.
(2014), the use of the progressive reciprocating
motion caused multiple fatigue crack initiation sites,
whereas rotary motion and stationary reciprocating
motions caused single crack initiation sites. Changing
the stress point on the instruments with different
angular increments appears to be a promising devel-
opment in endodontic motors.
Torsional fatigue
Recently, Kim et al. (2014) investigated the torsional
resistance of single-file reciprocating instruments and
124 International Endodontic Journal, 49, 119–135, 2016
showed that the rotation angles at the beginning
point of the plateau, which implicate permanent dis-
tortion, were >170°. The authors concluded that both
single-file reciprocating instruments should be rela-
tively safe when operated with their own motions
because the rotational deformation can be recovered
upon unloading (Kim et al. 2014). Further studies
will be needed to investigate the effect of reciprocating
motion on the permanent deformation of different
brands of NiTi instruments.
Life span
Varela-Patino et al. (2010) reported that root canal
preparation using ProTaper Universal files with full-
sequence reciprocation motion of ATR Technika
motor resulted in a higher mean life span of the
instrument compared with using the same instrument
and full sequence with rotary motion. Moreover, You
et al. (2010) showed that the use of single ProTaper
F2 instruments with the reciprocating motion of the
ATR Technika motor resulted in similar root canal
transportation but shorter preparation time in curved
canals compared with a full sequence with rotary
motion. It also has been reported that a single F2 file
can be used safely in curved canals at least six times
with reciprocating motion (You et al. 2010).
Recently, Plotino et al. (2015) investigated fracture
incidence of the Reciproc instruments after clinical
use and showed that the fracture incidence of the
Reciproc instruments (single usage) was 0.47%. Simi-
larly, Cunha et al. (2014) reported that the instru-
ment fracture incidence was 0.42% of the teeth
enlarged with the reciprocating WaveOne instrument.
Based on these results, the file fracture incidence of
reciprocating instruments is lower than that of rotary
instruments (Ramirez-Salomon et al. 1997, Wu et al.
2011, Ehrhardt et al. 2012).
Dentinal defects
Root canal instrumentation with NiTi instruments
has the potential to induce crack formation in roots
(Bier et al. 2009, Liu et al. 2013, Ashwinkumar et al.
2014). However, there are conflicting results regard-
ing the effect of reciprocating instruments on crack
formation. In a study by B€ urklein et al. (2013b),
reciprocating instruments were associated with more
dentinal cracks than were full-sequence rotary sys-
tems. However, Liu et al. (2013) showed that
Reciproc instruments caused fewer cracks than did
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

full-sequence rotary (ProTaper Universal) or single-file
rotary instruments (OneShape). Similarly, Ashwinku-
mar et al. (2014) reported that WaveOne instruments
caused fewer cracks than did the full-sequence rotary
(ProTaper Universal) instrument. These conflicting
findings may be due to the different instrument sizes
(25 and 40) used in the studies. More recently, Kan-
sal et al. (2014) compared the use of single ProTaper
files F2 files with the reciprocating motion of the ATR
Technika motor and full sequence with the rotary
motion. The authors concluded that reciprocating
motion with a single file caused fewer cracks (Kansal
et al. 2014). However, the use of different numbers of
instruments could affect crack formation. Abou El
Nasr & Abd El Kader (2014) evaluated crack forma-
tion and fracture resistance of oval roots after being
enlarged with the single ProTaper F2 instruments
under rotary or reciprocating motion, and they found
no significant differences between a single F2. How-
ever, in their study, the angles of the reciprocating
motion were not stated; therefore, further studies
should be conducted using the same numbers and
brands of instruments with different motions (rotary
and different range of reciprocation).
Root canal transportation and straightening of the
canal curvature
During root canal preparation, particularly when pre-
paring curved canals, there can be iatrogenic errors
such as ledges, zips, perforations and root canal trans-
portation (Weine et al. 1975). NiTi systems with differ-
ent kinematics have been produced to maintain the
original canal shape and thus keep it better centred
(Sch€afer & Florek 2003). Additionally, similar to stud-
ies on dentinal defect, there are conflicting results
about the effects of reciprocating instruments on root
canal transportation. Marzouk & Ghoneim (2013)
reported that root canal instrumentation with rotary
instruments (Twisted File) caused less transportation
and similar straightening of the root canal compared
with WaveOne instruments. B€ urklein et al. (2012)
evaluated the shaping ability of Reciproc, WaveOne,
Mtwo and ProTaper instruments in the curved root
canals of extracted teeth and found no significant dif-
ferences amongst the systems with respect to the
straightening of canal curvature. More recently,
B€urklein et al. (2014c) evaluated the shaping ability of
Reciproc, WaveOne, HyFlex CM (Coltene-Whaledent,
Allstetten, Switzerland), F360 (Komet Brasseler, Lem-
go, Germany) and OneShape single-file rotary systems
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
in simulated S-shaped canals, and concluded that
F360, OneShape and HyFlex CM caused less straight-
ening than the reciprocating instruments. In another
study by B€ urklein et al. (2013a) in severely curved
canals of extracted teeth, no significant differences
were found amongst Reciproc, OneShape, F360 and
Mtwo with respect to root canal straightening. Simi-
ß apar et al. (2014f) compared the effects of One-
larly, C
Shape, ProTaper Universal, ProTaper Next, Reciproc,
Twisted File Adaptive (SybronEndo), and WaveOne
rotary systems on transportation and canal curvature
in the curved mesiobuccal root canals of mandibular
molar teeth and found no significant differences
amongst the groups. Recently, Saber et al. (2015)
reported that WaveOne and Reciproc instruments
respected the original canal curvature better than One-
Shape instruments. These conflicting results may be
related to the different instruments and methodologies
used (simulated root canals versus natural root
canals). You et al. (2011) investigated the effect of
reciprocating motion on root canal transportation in
curved canals of maxillary molar teeth and reported
that the use of the ProTaper Universal instruments
with full-sequence reciprocating motion of the ATR
Technika motor caused less transportation than with
the full-sequence rotary motion with the ProTaper Uni-
versal instruments, but no significant differences were
obtained. Similarly, Paque et al. (2011) reported that
the use of single ProTaper F2 instruments with recipro-
cating motion created by the ATR Technika motor was
similar to rotary motion with respect to transportation,
but the reciprocating motion with single instruments
was faster. In a recent study, Giuliani et al. (2014)
compared the WaveOne full-sequence reciprocating
motion with ProTaper Universal instruments (144°
CW and 72° CCW) and full-sequence rotary motion
with ProTaper instruments in a simulated canal. The
authors concluded that full-sequence reciprocating
motion with ProTaper Universal instruments was supe-
rior to rotary motion with the same instruments or to
WaveOne instruments with respect to the straighten-
ing of the canal curvature (Giuliani et al. 2014).
Retreatment
The complete removal of Gutta-percha from the root
canal system during retreatment can be time consum-
ing and challenging. Recent studies have shown that
single-file reciprocating instruments are rapid and
effective in root canal retreatment (Zuolo et al. 2013,
Fruchi et al. 2014). Fruchi et al. (2014) reported that
International Endodontic Journal, 49, 119–135, 2016 125
 ß apar & Arslan
Instrumentation kinematics C
Reciproc and WaveOne instruments removed 94%
and 93% of the root fillings in the canals of curved
molars, respectively. A study comparing the retreat-
ment effectiveness of the Reciproc and Mtwo rotary
NiTi instruments revealed that Reciproc instruments
removed more filling material from the canal wall
than did Mtwo instruments (Zuolo et al. 2013). The
effectiveness of reciprocating instruments in root
canal retreatment may be due to many factors, the
most likely being the engagement of the filling mate-
rial with the first motion and the dislodging of the
filling from the canals via the second motion. In con-
trast to the aforementioned studies, R€ odig et al.
(2014) and Rios Mde et al. (2014) demonstrated no
significant differences between the single-file recipro-
cating instruments and the ProTaper Universal re-
treatment instruments (Dentsply Tulsa Dental
Specialties). These conflicting results may be due to
the use of differently designed instruments in the
removal of root canal filling material. Further studies
should be conducted to evaluate the effectiveness of
pure reciprocating motion with the same type of
instrument to clarify this issue.
Bacterial elimination
Numerous studies have reported that single-file recip-
rocating systems and full-sequence rotary systems
have similar disinfection performance (Alves et al.
2012, Machado et al. 2013, Siqueira et al. 2013, Fer-
rer-Luque et al. 2014, Marinho et al. 2015, Martinho
et al. 2014). Marinho et al. (2015) showed that
Reciproc, Mtwo, ProTaper and Race (FKG Dentaire,
La Chaux-de-Fonds, Switzerland) instruments pro-
duced highly significant reductions of the bacterial
load, but no significant differences in endotoxin levels
were found. However, there are no available data
concerning the effect of pure reciprocating motion on
bacterial reduction.
An overview of vertical vibration plus
rotational reciprocating motion
There are limited data about this motion in the cur-
rent literature. H€
ulsmann & Meyer (1989) reported
that the Canal Finder System was a good and suitable
device for the initial instrumentation of narrow and
severely curved canals. However, in another study,
H€ulsmann et al. (1997) demonstrated that the Canal
Finder and Endolift systems resulted in insufficiently
cleaned root canal walls.
126 International Endodontic Journal, 49, 119–135, 2016
An overview of vertical vibration
A finite elemental analysis revealed that the stress
created by the SAF system during operation is less
than the stress resulting from rotary instrumentation
(Kim et al. 2013). Several studies have shown that
root canal instrumentation with SAF caused a lower
incidence of dentinal cracks compared with rotary
systems (Yoldas et al. 2012, Hin et al. 2013, Liu et al.
2013). SAF was introduced to achieve a complete
three-dimensional root canal shaping, cleaning and
irrigation (Metzger et al. 2010). This system allows
for continuous irrigation during preparation and has
beneficial effects for activating the final irrigation
once the canal preparation has been completed (Metz-
ger et al. 2010). The continuous flow of the irrigating
solution through the file, combined with the vibrating
motion, may affect the cleaning ability of the file
(Metzger et al. 2010). Metzger et al. (2010) showed
that using the SAF system combined with NaOCl and
EDTA resulted in a dentinal surface that was mostly
free of a smear layer in all parts of the root canal.
Several recent studies have shown that using the SAF
system enhanced the removal of calcium hydroxide
medicament from apical grooves (C ß apar et al. 2014d),
residual Gutta-percha after retreatment (Abramovitz
et al. 2012), bacterial population from oval shaped
canals (Siqueira et al. 2010) smear layer from the
root canal wall (Cß apar & Ari Aydinbelge 2014), and
biofilm bacteria from within apical grooves (Lin et al.
2013), as well as increasing pulp tissue debridement
(De-Deus et al. 2011) and the bond strength of root
fillings (De-Deus et al. 2013a). Moreover, Kocak et al.
(2013) showed that the SAF system extruded similar
amounts of debris compared with rotary instruments.
The details of the SAF system can be found in previ-
ous reviews (Metzger et al. 2013, Metzger 2014).
An overview of the adaptive motion
studies
This motion is recommended for the Twisted File
Adaptive instrument, which aids in the cutting of
dentine in the CW direction. Most of the rotary
instruments are designed for CW cutting; thus, the
adaptive motion may be used with other instruments.
The speed of the instruments used with adaptive
motion may be reduced due to the changes in the
angle of reciprocating motion, depending on the in-
tracanal stress (particularly in the treatment of
curved canals, retreatment, or calcified or narrow
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

canals). To date, there are limited data about adaptive
motion.
Debris extrusion
Kirchhoff et al. (2015) reported that Twisted File
Adaptive instruments used with adaptive motion
caused similar debris extrusion compared with ProTa-
per Next and WaveOne instruments. Another recent
study reported that Twisted File Adaptive instruments
used with adaptive motion caused less debris extru-
sion than the ProTaper Universal and HyFlex systems
ß apar et al. 2014a).
(C
Postoperative pain
Gambarini et al. (2013) compared Twisted File and
Twisted File Adaptive instruments (Twisted File and
Twisted File adaptive instruments have similar file
designs but are used with different motions) and
found no differences with respect to postoperative
pain.
Cyclic fatigue
Gambarini & Glassman (2013) reported that adaptive
motion increased an instrument’s time to fracture
compared with rotary motion under cyclic fatigue
testing.
Dentinal defects
Karatas et al. (2015) reported that ProTaper Next and
Twisted File Adaptive systems caused fewer cracks
than the WaveOne system.
Root canal transportation and straightening of the
canal curvature
There are conflicting results on the effect of adaptive
motion on root canal transportation. Recent studies
have shown that Twisted File Adaptive instruments
caused less (Gergi et al. 2014, 2015) or similar
ß apar et al. 2014f, Ordinola-Zapata et al. 2014) root
(C
canal transportation compared with other instru-
ments.
Retreatment
ß apar et al. (2015) used the ProTaper Universal re-
C but is instead related to curvature. A study by Daugh-
treatment instruments with adaptive motion and
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
reported that adaptive motion removed more filling
materials from the root canals than rotary motion.
Instrumentation kinematics includes instrumenta-
tion speed and torque and the following sections
describe these factors.
An overview of instrumentation speed
and torque studies
Several factors can affect instrument failure, including
the experience of the operator, the radius of the root
canal curvature, electro-polishing, the diameter of the
instrument, repeated use of the instrument and the
instrumentation speed, force and torque values
(Haikel et al. 1999, Yared & Kulkarni 2003, Schrader
& Peters 2005, Bahia et al. 2006, Anderson et al.
2007).
Instrumentation speed
The optimal speed of rotary instrument varies from
instrument to instrument according to the manufac-
turer’s recommendations. To advance to the canal
terminus safely, using the optimal speed for the
instrument is important. Numerous factors, such as
an instrument’s cross-sectional designs, diameter,
taper, helical angle, pitch number, alloy and tip
design, could affect its advancement in root canals
(Diemer & Calas 2004, McSpadden 2007, R€ odig et al.
2014). Thus, to determine the optimal speed of the
instruments, all of these factors should be considered.
Therefore, each instrument and design should be
evaluated separately to obtain its optimal speed.
Many studies have evaluated instrument speed,
though with conflicting findings. According to the
study by Yared et al. (2001), the use of ProFile instru-
ments (Dentsply Maillefer, Ballaigues, Switzerland)
with a lower speed (150 rpm) did not result in lock-
ing, deformation or fracture; however, instruments
used at higher speeds (250 and 350 rpm) locked fre-
quently. Consequently, Yared et al. (2001) concluded
that higher rotational speeds increased the probability
of instrument fracture. However, Zelada et al. (2002)
concluded that whereas both the instrument rpm and
the curvature of the root canal contribute to an
increased risk of breakage of NiTi rotary instruments,
the curvature was found to be the most important
factor. Based on these data, Zelada et al. (2002) stated
that the instrument rpm is not an independent factor
erty et al. (2001) used mature molars and evaluated
International Endodontic Journal, 49, 119–135, 2016 127
 ß apar & Arslan
Instrumentation kinematics C
the fracture rate, deformation rate and efficiency of
rotary endodontic instruments driven at 150 rpm and
350 rpm. Their findings indicated that ProFile instru-
ments could be used at 350 rpm to produce nearly
double the efficiency and half the deformation rate
compared with the results obtained at 150 rpm. The
study by Bardsley et al. (2011) found that using
ProFile Vortex instruments (Dentsply Tulsa Dental
Specialties) at 400 rpm generated less torque and
force compared with their use at 200 rpm, but an
additional speed increase to 600 rpm did not provide
any further benefit. Moreover, Pruett et al. (1997)
reported that the number of cycles to failure was not
affected by speed when used in artificial metal canals.
Recently, Peters et al. (2014) reported that increased
rotational speed was associated with increased cutting
efficiency. Poulsen et al. (1995) evaluated root canal
morphology after instrumentation using Lightspeed
instruments (Lightspeed Inc., San Antonio, TX, USA)
rotating at 750, 1300 or 2000 rpm and found that
there was no significant difference in instrumentation
at the various rotational speeds in respect of the
amount of dentine removed, canal transportation or
the ability of the instrument to remain centred in the
canal.
Torque values
Torsional loading, also referred to as torsional fracture
or resistance, is expressed as the maximum torque,
and the angular distortion when instrument failure
occurs is caused by torsional overload (Yum et al.
2011).
Gambarini (2000) discussed the rationale for select-
ing lower torque values in endodontic motors. If a
high-torque motor is used, the instrument-specific tor-
que limit (fracture limit) is often exceeded, thus
increasing the risk of intracanal fracture. The author
suggested that a specific torque limit (close to the
limit of elasticity) be set for each instrument size and
type, such that the motor stops if its load reaches this
instrument-specific torque limit.
Torque influences the incidence of locking of the
instrument and thus results in instrument fracture
(Yared et al. 2001). Endodontic motors at a higher
torque setting can result in excessive stress. This
stress is unimportant in straight root canals because
the resistance of dentine removal is very low (Gamba-
rini 2000). However, the resistance can be high in
curved or narrow root canals, resulting in the instru-
ment locking near the apical terminus. If the clinician
128 International Endodontic Journal, 49, 119–135, 2016
does not stop or retract the instrument, it will be sub-
jected to excessive torque (Gambarini 2000). This
problem can be prevented by the use of a low-torque
endodontic motor that operates below the maximum
torque limit of each instrument (Gambarini 2000).
Such torque-controlled motors are designed to stop
and reverse the rotation of the instrument when its
torque value is reached, thus preventing instrument
breakage (Suffridge et al. 2003). Conversely, the
reduced cutting efficiency of the instrument would be
problematic for endodontic motors at lower torque
settings. This makes instrument progression in the
root canal difficult and results in the operator being
more likely to force the instrument. The force applied
by the operator would result in the instrument lock-
ing, followed by deformation and fracture (Yared et al.
2001). A retrospective clinical study by Iqbal et al.
(2006) revealed that there was no significant differ-
ence in instrument fracture between torque-controlled
and non-torque-controlled handpieces. This result was
confirmed by Zarrabi et al. (2010), who concluded
that the use of a torque-controlled handpiece is not
an important factor compared with the instrumenta-
tion technique. Moreover, previous studies (Yared &
Kulkarni 2004a,b,c) evaluated torque output and
examined the accuracy of various torque-controlled
motors, concluding that the actual torque deviated
from the pre-set torque value and was higher than
the torque reported at the fracture of several NiTi
rotary instruments. These results call the usefulness
of low-torque motors into question (Yared & Kulkarni
2004a,b,c). However, another study evaluated the
failure incidence of ProFile NiTi rotary instruments
when used by inexperienced operators as high, low or
very low-torque-control motors or as air-driven hand-
pieces (Yared & Kulkarni 2002). The authors con-
cluded that when used by an inexperienced operator,
very low-torque-control motors were safer than high-
torque-control motors, low-torque-control motors or
air-driven handpieces (Yared & Kulkarni 2002). By
contrast, other studies reported that all of those types
of motors were safe when used by an experienced
operator (Yared 2002, Yared & Sleiman 2002). More-
over, Berutti et al. (2004) reported that the use of
high torque applied to the NiTi instruments signifi-
cantly extended the time before instrument failure
when used by endodontists.
The torque generated by a rotating instrument
during root canal instrumentation depends on the
preoperative canal volume, the apical force applied by
the operator (operator experience), the instrument’s
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

diameter, the cross-sectional design, repeated use of
the instrument, the manufacturing process and the
contact area between the instrument and the root
canal walls (Turpin et al. 2000, Peters et al. 2003,
Yared & Kulkarni 2003, Schrader & Peters 2005, Ba-
hia et al. 2006). Moreover, subjecting instruments to
cyclic fatigue influences their torsional resistance, par-
ticularly in curved root canals (Yared & Kulkarni
2003, Bahia et al. 2006).
There have been several attempts to understand
and reduce the torque values generated by instrumen-
tation. One study showed that torque at failure values
increased regularly with increased file size (Camps &
Pertot 1994). Another study by Peters et al. (2005)
evaluated the effects of lubrication on torque gener-
ated during the rotary preparation of simulated root
canals in dentine using various NiTi instruments. In
that study, the maximum torque values were signifi-
cantly reduced by the aqueous solutions compared
with paste-type products. Similarly, a study by Boess-
ler et al. (2007) concluded that an aqueous chelating
lubricant reduced torque values.
The effect of torque settings on canal transporta-
tion was evaluated previously. Sch€ afer et al. (2005)
compared the shaping ability of FlexMaster (VDW)
instruments in simulated curved canals with three
different torque-limited automated devices and con-
cluded that torque-limited rotary handpieces were
suitable for preparing curved root canals. Similarly,
B€urklein & Sch€afer (2006) compared the shaping
ability of Mtwo instruments in simulated curved
canals with two different torque-limited automated
devices and found that the torque-limited rotary
handpiece was safe and suitable for preparing curved
root canals. Canal centring was compared after the
instrumentation using the ProTaper Universal system
with an electric torque-control motor or an air-dri-
ven handpiece. It was concluded that NiTi instru-
ments can be used with air-driven motors without
any considerable changes in the root canal anatomy,
but the clinician must be an expert (Zarei et al.
2013).
Gambarini (2001) evaluated the cyclic fatigue resis-
tance of NiTi rotary instruments that were operated
clinically and had either a high-torque motor or a
low-torque electric motor. Using an endodontic motor
with lower torque values tended to increase resistance
to cyclic fatigue. Apart from these reports, there are
studies evaluating the effects of different torque set-
tings on dentinal crack formation, cutting efficacy
and further studies should be conducted.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
Conclusions
• Endodontic motors have undergone a revolution
regarding torque control and adjustable kinematics
in different directions;
• Adaptive motion is a novel modified reciprocating
motion that aims to combine the advantages of
rotary and reciprocating motions;
• The literature suggests that adaptive motion has
advantages over simple rotary motion in terms of
removal of filling material and cyclic fatigue;
• The actual speed and angles of reciprocation may
differ from the manufacturers’ declared values;
• Changing the stress point on the instruments with
different angular increments appears to be a prom-
ising development in endodontic motors;
• The instrumentation speed, force, kinematics and
torque values are several factors that affect instru-
ment failure;
• The actual torque deviated from the pre-set torque
and could be higher than the torque reported at
the fracture of several NiTi rotary instruments;
• Decreased axial stress on the file and enhanced
debris removal appear to be advantages of instru-
ments with asymmetrical motion;
• Conflicting results amongst the studies on recipro-
cating motion may be related to the use of differ-
ent instruments. Thus, further studies should be
conducted to evaluate the effectiveness of different
instrumentation kinematics with standardized pro-
totypes of instruments that are designed for use
with both working motions and that are equal in
all design features and alloy properties.
Acknowledgement
The authors deny any conflict of interests related to
this study.
References
Abou El Nasr HM, Abd El Kader KG (2014) Dentinal damage
and fracture resistance of oval roots prepared with single-
file systems using different kinematics. Journal of Endodon-
tics 40, 849–51.
Abramovitz I, Relles-Bonar S, Baransi B, Kfir A (2012) The
effectiveness of a Self-Adjusting File to remove residual
gutta-percha after retreatment with rotary files. Interna-
tional Endodontic Journal 45, 386–92.
Alves FR, Rocas IN, Almeida BM, Neves MA, Zoffoli J,
Siqueira JF Jr (2012) Quantitative molecular and culture
International Endodontic Journal, 49, 119–135, 2016 129
 ß apar & Arslan
Instrumentation kinematics C
analyses of bacterial elimination in oval-shaped root
canals by a single-file instrumentation technique. Interna-
tional Endodontic Journal 45, 871–7.
Anderson ME, Price JW, Parashos P (2007) Fracture resis-
tance of electropolished rotary nickel-titanium endodontic
instruments. Journal of Endodontics 33, 1212–6.
Ashwinkumar V, Krithikadatta J, Surendran S, Velmurugan
N (2014) Effect of reciprocating file motion on microcrack
formation in root canals: an SEM study. International End-
odontic Journal 47, 622–7.
Bahia MGA, Melo MCC, Buono VTL (2006) Influence of sim-
ulated clinical use on the torsional behavior of nickel-tita-
nium rotary endodontic instruments. Oral Surgery, Oral
Medicine, Oral Pathology, Oral Radiology, and Endodontology
101, 675–80.
Bardsley S, Peters CI, Peters OA (2011) The effect of three
rotational speed settings on torque and apical force with
vortex rotary instruments in vitro. Journal of Endodontics
37, 860–4.
Basmadjian-Charles CL, Farge P, Bourgeois DM, Lebrun T
(2002) Factors influencing the long-term results of end-
odontic treatment: a review of the literature. International
Dental Journal 52, 81–6.
Berutti E, Negro AR, Lendini M, Pasqualini D (2004) Influence
of manual preflaring and torque on the failure rate of ProTa-
per rotary instruments. Journal of Endodontics 30, 228–30.
Bier CA, Shemesh H, Tanomaru-Filho M, Wesselink PR, Wu
MK (2009) The ability of different nickel-titanium rotary
instruments to induce dentinal damage during canal prep-
aration. Journal of Endodontics 35, 236–8.
Boessler C, Peters OA, Zehnder M (2007) Impact of lubricant
parameters on rotary instrument torque and force. Journal
of Endodontics 33, 280–3.
B€
urklein S, Sch€afer E (2006) The influence of various auto-
mated devices on the shaping ability of Mtwo rotary
nickel-titanium instruments. International Endodontic Jour-
nal 39, 945–51.
B€
urklein S, Sch€afer E (2012) Apically extruded debris
with reciprocating single-file and full-sequence rotary
instrumentation systems. Journal of Endodontics 38, 850–2.
B€
urklein S, Hinschitza K, Dammaschke T, Sch€ afer E (2012)
Shaping ability and cleaning effectiveness of two single-file
systems in severely curved root canals of extracted teeth:
Reciproc and WaveOne versus Mtwo and ProTaper. Inter-
national Endodontic Journal 45, 449–61.
B€
urklein S, Benten S, Sch€afer E (2013a) Shaping ability of
different single-file systems in severely curved root canals
of extracted teeth. International Endodontic Journal 46,
590–7.
B€
urklein S, Tsotsis P, Sch€ afer E (2013b) Incidence of den-
tinal defects after root canal preparation: reciprocating
versus rotary instrumentation. Journal of Endodontics 39,
501–4.
B€
urklein S, Benten S, Sch€ afer E (2014a) Quantitative evalua-
tion of apically extruded debris with different single-file
130 International Endodontic Journal, 49, 119–135, 2016
systems: Reciproc, F360 and OneShape versus Mtwo.
International Endodontic Journal 47, 405–9.
B€urklein S, Mathey D, Sch€ afer E (2014b) Shaping ability
of ProTaper Next and BT-RaCe nickel-titanium instru-
ments in severely curved root canals. International End-
odontic Journal doi: 10.1111/iej.12375. [Epub ahead of
print].
B€urklein S, Poschmann T, Sch€ afer E (2014c) Shaping ability
of different nickel-titanium systems in simulated S-shaped
canals with and without glide path. Journal of Endodontics
40, 1231–4.
Bystr€ om A, Sundqvist G (1985) The antibacterial action of
sodium hypochlorite and EDTA in 60 cases of endodontic
therapy. International Endodontic Journal 18, 35–40.
Camps J, Pertot WJ (1994) Torsional and stiffness properties
of canal master U stainless steel and nitinol instruments.
Journal of Endodontics 20, 395–8.
ß apar ID, Ari Aydinbelge H (2014) Effectiveness of various
C
irrigation activation protocols and the Self-Adjusting File
system on smear layer and debris removal. Scanning 36,
640–7.
ß apar ID, Arslan H, Akcay M, Ertas H (2014a) An in vitro
C
comparison of apically extruded debris and instrumenta-
tion times with ProTaper Universal, ProTaper Next,
Twisted File Adaptive, and HyFlex instruments. Journal of
Endodontics 40, 1638–41.
ß apar ID, Arslan H, Akcay M, Uysal B (2014b) Effects of
C
ProTaper Universal, ProTaper Next, and HyFlex instru-
ments on crack formation in dentin. Journal of Endodontics
40, 1482–4.
ß apar ID, Ertas H, Arslan H (2014c) Comparison of cyclic
C
fatigue resistance of novel nickel-titanium rotary instru-
ments. Australian Endodontic Journal doi: 10.1111/
aej.12067. [Epub ahead of print].
ß apar ID, Ozcan E, Arslan H, Ertas H, Aydinbelge HA
C
(2014d) Effect of different final irrigation methods on the
removal of calcium hydroxide from an artificial standard-
ized groove in the apical third of root canals. Journal of
Endodontics 40, 451–4.
ß apar ID, Ertas H, Arslan H (2014e) Comparison of cyclic
C
fatigue resistance of nickel-titanium coronal flaring instru-
ments. Journal of Endodontics 40, 1182–5.
ß apar ID, Ertas H, Ok E, Arslan H, Ertas ET (2014f) Com-
C
parative study of different novel nickel-titanium rotary sys-
tems for root canal preparation in severely curved root
canals. Journal of Endodontics 40, 852–6.
ß apar ID, Arslan H, Ertas H, Gok T, Saygili G (2015) Effec-
C
tiveness of ProTaper Universal retreatment instruments
used with rotary or reciprocating adaptive motion in the
removal of root canal filling material. International End-
odontic Journal 48, 79–83.
Castello-Escriva R, Alegre-Domingo T, Faus-Matoses V,
Roman-Richon S, Faus-Llacer VJ (2012) In vitro compari-
son of cyclic fatigue resistance of ProTaper, WaveOne, and
Twisted Files. Journal of Endodontics 38, 1521–4.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

Caviedes-Bucheli J, Moreno JO, Carreno CP et al. (2013) The
effect of single-file reciprocating systems on Substance P
and Calcitonin gene-related peptide expression in human
periodontal ligament. International Endodontic Journal 46,
419–26.
Cheung GSP, Liu CSY (2009) A retrospective study of end-
odontic treatment outcome between nickel-titanium rotary
and stainless steel hand filing techniques. Journal of End-
odontics 35, 938–43.
Cunha RS, Junaid A, Ensinas P, Nudera W, da Silveira Bue-
no C (2014) Assessment of the separation incidence of
reciprocating WaveOne files: a prospective clinical study.
Journal of Endodontics 40, 922–4.
Daugherty DW, Gound TG, Comer TL (2001) Comparison of
fracture rate, deformation rate, and efficiency between
rotary endodontic instruments driven at 150 rpm and
350 rpm. Journal of Endodontics 27, 93–5.
De-Deus G, Brandao MC, Barino B, Di Giorgi K, Fidel RA,
Luna AS (2010a) Assessment of apically extruded debris
produced by the single-file ProTaper F2 technique under
reciprocating movement. Oral Surgery, Oral Medicine, Oral
Pathology, Oral Radiology, and Endodontology 110, 390–4.
De-Deus G, Moreira EJ, Lopes HP, Elias CN (2010b) Extended
cyclic fatigue life of F2 ProTaper instruments used in
reciprocating movement. International Endodontic Journal
43, 1063–8.
De-Deus G, Souza EM, Barino B et al. (2011) The Self-Adjust-
ing File optimizes debridement quality in oval-shaped root
canals. Journal of Endodontics 37, 701–5.
De-Deus G, Accorsi-Mendonca T, de Carvalho e Silva L, Leite
CA, da Silva D, Moreira EJ (2013a) Self-Adjusting File
cleaning-shaping-irrigation system improves root-filling
bond strength. Journal of Endodontics 39, 254–7.
De-Deus G, Arruda TE, Souza EM et al. (2013b) The ability
of the Reciproc R25 instrument to reach the full root
canal working length without a glide path. International
Endodontic Journal 46, 993–8.
De-Deus G, Neves A, Silva EJ et al. (2014) Apically extruded
dentin debris by reciprocating single-file and multi-file
rotary system. Clinical Oral Investigations in press doi:
10.1007/s00784-014-1267-5.
Diemer F, Calas P (2004) Effect of pitch length on the behav-
ior of rotary triple helix root canal instruments. Journal of
Endodontics 30, 716–8.
Diemer F, Michetti J, Mallet JP, Piquet R (2013) Effect of
asymmetry on the behavior of prototype rotary triple
helix root canal instruments. Journal of Endodontics 39,
829–32.
Ehrhardt IC, Zuolo ML, Cunha RS et al. (2012) Assessment
of the separation incidence of mtwo files used with preflar-
ing: prospective clinical study. Journal of Endodontics 38,
1078–81.
Elnaghy A (2014) Cyclic fatigue resistance of ProTaper Next
nickel-titanium rotary files. International Endodontic Journal
47, 1034–9.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
Ferrer-Luque CM, Bejarano I, Ruiz-Linares M, Baca P (2014)
Reduction in Enteroccocus faecalis counts - a comparison
between rotary and reciprocating systems. International
Endodontic Journal 47, 380–6.
Fidler A (2014) Kinematics of 2 reciprocating endodontic
motors: the difference between actual and set values. Jour-
nal of Endodontics 40, 990–4.
Fruchi L, Ordinola-Zapata R, Cavenago BC, Hungaro Duarte
MA, da Silveira Bueno CE, De Martin AS (2014) Efficacy
of reciprocating instruments for removing filling material
in curved canals obturated with a single-cone technique: a
micro–computed tomographic analysis. Journal of Endodon-
tics 40, 1000–4.
Gambarini G (2000) Rationale for the use of low-torque end-
odontic motors in root canal instrumentation. Endodontics
& Dental Traumatology 16, 95–100.
Gambarini G (2001) Cyclic fatigue of nickel-titanium rotary
instruments after clinical use with low-and high-torque
endodontic motors. Journal of Endodontics 27, 772–4.
Gambarini G, Glassman G (2013) In vitro analysis of effi-
ciency and safety of a new motion for endodontic instru-
mentation:TF Adaptive. Roots 3, 12–5.
Gambarini G, Plotino G, Grande NM, Al-Sudani D, De Luca
M, Testarelli L (2011) Mechanical properties of nickel-
titanium rotary instruments produced with a new manu-
facturing technique. International Endodontic Journal 44,
337–41.
Gambarini G, Rubini AG, Al Sudani D et al. (2012) Influence
of different angles of reciprocation on the cyclic fatigue of
nickel-titanium endodontic instruments. Journal of End-
odontics 38, 1408–11.
Gambarini G, Testarelli L, De Luca M et al. (2013) The influ-
ence of three different instrumentation techniques on the
incidence of postoperative pain after endodontic treatment.
Annali di Stomatologia 4, 152–5.
Gambarini G, Plotino G, Sannino G, et al. (2015) Cyclic fati-
gue of instruments for endodontic glide path. Odontology
103, 56–60.
Gergi R, Arbab-Chirani R, Osta N, Naaman A (2014) Micro-
computed tomographic evaluation of canal transportation
instrumented by different kinematics rotary nickel-tita-
nium instruments. Journal of Endodontics 40, 1223–7.
Gergi R, Osta N, Bourbouze G, Zgheib C, Arbab-Chirani R,
Naaman A (2015) Effects of three nickel titanium instru-
ment systems on root canal geometry assessed by micro-
computed tomography. International Endodontic Journal 48,
162–70.
Giansiracusa Rubini A, Plotino G, Al-Sudani D et al. (2014)
A new device to test cutting efficiency of mechanical end-
odontic instruments. International Medical Journal of Experi-
mental and Clinical Research 20, 374–8.
Giuliani V, Di Nasso L, Pace R, Pagavino G (2014) Shaping
ability of WaveOne Primary reciprocating files and ProTa-
per system used in continuous and reciprocating motion.
Journal of Endodontics 40, 1468–71.
International Endodontic Journal, 49, 119–135, 2016 131
 ß apar & Arslan
Instrumentation kinematics C
Haikel Y, Serfaty R, Bateman G, Senger B, Allemann C
(1999) Dynamic and cyclic fatigue of engine-driven rotary
nickel-titanium endodontic instruments. Journal of End-
odontics 25, 434–40.
Hin ES, Wu MK, Wesselink PR, Shemesh H (2013) Effects of
Self-Adjusting File, Mtwo, and ProTaper on the root canal
wall. Journal of Endodontics 39, 262–4.
H€ulsmann M, Meyer G (1989) Root canal preparation with
Canal-Finder system. Scanning electron microscopy and
clinical studies. Zahn€arztliche Welt, Zahn€arztliche Rundshau
Deutsche Zahn€arzteblatt 98, 114–8.
H€ulsmann M, Rummelin C, Schafers F (1997) Root canal
cleanliness after preparation with different endodontic
handpieces and hand instruments: a comparative SEM
investigation. Journal of Endodontics 23, 301–6.
H€ulsmann M, Peters OA, Dummer PM (2005) Mechanical
preparation of root canals: shaping goals, techniques and
means. Endodontic Topics 10, 30–76.
Iqbal MK, Kohli MR, Kim JS (2006) A retrospective clinical
study of incidence of root canal instrument separation in
an endodontics graduate program: a PennEndo database
study. Journal of Endodontics 32, 1048–52.
Kansal R, Rajput A, Talwar S, Roongta R, Verma M (2014)
Assessment of dentinal damage during canal preparation
using reciprocating and rotary files. Journal of Endodontics
40, 1443–6.
Karatas E, Gunduz HA, Kirici DO, Arslan H, Topcu MC,
Yeter KY (2015) Dentinal crack formation during root
canal preparations by the twisted file adaptive, ProTaper
Next, ProTaper Universal, and WaveOne Instruments.
Journal of Endodontics 41, 261–4.
Kiefner P, Ban M, De-Deus G (2014) Is the reciprocating
movement per se able to improve the cyclic fatigue resis-
tance of instruments? International Endodontic Journal 47,
430–6.
Kim HC, Lee MH, Yum J, Versluis A, Lee CJ, Kim BM (2010)
Potential relationship between design of nickel-titanium
rotary instruments and vertical root fracture. Journal of
Endodontics 36, 1195–9.
Kim HC, Kwak SW, Cheung GS, Ko DH, Chung SM, Lee W
(2012) Cyclic fatigue and torsional resistance of two
new nickel-titanium instruments used in reciprocation
motion: Reciproc versus WaveOne. Journal of Endodontics
38, 541–4.
Kim HC, Sung SY, Ha JH et al. (2013) Stress generation dur-
ing Self-Adjusting File movement: minimally invasive
instrumentation. Journal of Endodontics 39, 1572–5.
Kim JW, Ha JH, Cheung GS, Versluis A, Kwak SW, Kim HC
(2014) Safety of the factory preset rotation angle of recip-
rocating instruments. Journal of Endodontics 40, 1671–5.
Kirchhoff AL, Fariniuk LF, Mello I (2015) Apical extrusion of
debris in flat-oval root canals after using different instru-
mentation systems. Journal of Endodontics 41, 237–41.
Kocak S, Kocak MM, Saglam BC, Turker SA, Sagsen B, Er O
(2013) Apical extrusion of debris using Self-Adjusting File,
132 International Endodontic Journal, 49, 119–135, 2016
reciprocating single-file, and 2 rotary instrumentation sys-
tems. Journal of Endodontics 39, 1278–80.
Kocak MM, Cicek E, Kocak S, Saglam BC, Yilmaz N (2014)
Apical extrusion of debris using ProTaper Universal and
ProTaper Next rotary systems. International Endodontic
Journal 48, 283–6.
Lin J, Shen Y, Haapasalo M (2013) A comparative study of
biofilm removal with hand, rotary nickel-titanium, and
Self-Adjusting File instrumentation using a novel in vitro
biofilm model. Journal of Endodontics 39, 658–63.
Liu R, Hou BX, Wesselink PR, Wu MK, Shemesh H (2013)
The incidence of root microcracks caused by 3 different
single-file systems versus the ProTaper system. Journal of
Endodontics 39, 1054–6.
Machado ME, Nabeshima CK, Leonardo MF, Reis FA, Britto
ML, Cai S (2013) Influence of reciprocating single-file
and rotary instrumentation on bacterial reduction on
infected root canals. International Endodontic Journal 46,
1083–7.
Marinho AC, Martinho FC, Goncalves LM, Rabang HR,
Gomes BP (2015) Does the Reciproc file remove root canal
bacteria and endotoxins as effectively as multifile rotary
systems? International Endodontic Journal 48, 542–8.
Martinho FC, Gomes AP, Fernandes AM et al. (2014) Clini-
cal comparison of the effectiveness of single-file reciprocat-
ing systems and rotary systems for removal of endotoxins
and cultivable bacteria from primarily infected root canals.
Journal of Endodontics 40, 625–9.
Marzouk AM, Ghoneim AG (2013) Computed tomographic
evaluation of canal shape instrumented by different kine-
matics rotary nickel-titanium systems. Journal of Endodon-
tics 39, 906–9.
McSpadden JT (2007) Mastering Endodontic Instrumentation.
Canada: Cloudland Institute.
Metzger Z (2014) The self-adjusting file (SAF) system: an evi-
dence-based update. Journal of Conservative Dentistry 17,
401.
Metzger Z, Teperovich E, Zary R, Cohen R, Hof R (2010)
The self-adjusting file (SAF). Part 1: respecting the root
canal anatomy–a new concept of endodontic files and its
implementation. Journal of Endodontics 36, 679–90.
Metzger Z, Solomonov M, Kfir A (2013) The role of mechani-
cal instrumentation in the cleaning of root canals. End-
odontic Topics 29, 87–109.
Milas VB (1987) History. In: Cohen R, Burns R, eds. Path-
ways of the Pulp, 4th edn. St Louis: Mosby, pp. 619–34.
Nguyen HH, Fong H, Paranjpe A, Flake NM, Johnson JD,
Peters OA (2014) Evaluation of the resistance to cyclic
fatigue between ProTaper Next, ProTaper Universal, and
Vortex Blue rotary instruments. Journal of Endodontics 40,
1190–3.
Oltramare, (1892) Pl€ otzliche Exstirpation der Zahnpulpa
mittels einer durch die Bohrmaschine in Rotation
versetzten Nadel. Dtsch Monatsschr Zahnheilk 1892: 32,
407–409.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

Ordinola-Zapata R, Bramante CM, Duarte MAH, Cavenago
BC, Jaramillo D, Versiani M (2014) Shaping ability of
Reciproc and TF adaptive systems in severely curved
canals of rapid microCT-based prototyping molar replicas.
Journal of Applied Oral Science 22, 509–15.
Ozsu D, Karatas E, Arslan H, Topcu MC (2014) Quantitative
evaluation of apically extruded debris during root canal
instrumentation with ProTaper Universal, ProTaper Next,
WaveOne, and self-adjusting file systems. European Journal
of Dentistry 8, 504–8.
Paque F, Zehnder M, De-Deus G (2011) Microtomography-
based comparison of reciprocating single-file F2 ProTaper
technique versus rotary full sequence. Journal of Endodon-
tics 37, 1394–7.
Pedulla E, Grande NM, Plotino G, Gambarini G, Rapisarda E
(2013) Influence of continuous or reciprocating motion on
cyclic fatigue resistance of 4 different nickel-titanium
rotary instruments. Journal of Endodontics 39, 258–61.
Pereira ES, Singh R, Arias A, Peters OA (2013) In vitro
assessment of torque and force generated by novel ProTa-
per Next Instruments during simulated canal preparation.
Journal of Endodontics 39, 1615–9.
Perez-Higueras JJ, Arias A, de la Macorra JC (2013) Cyclic
fatigue resistance of K3, K3XF, and Twisted File nickel-
titanium files under continuous rotation or reciprocating
motion. Journal of Endodontics 39, 1585–8.
Perez-Higueras JJ, Arias A, de la Macorra JC, Peters OA
(2014) Differences in cyclic fatigue resistance between
ProTaper Next and ProTaper Universal instruments at dif-
ferent levels. Journal of Endodontics 40, 1477–81.
Peters OA, Peters CI, Schonenberger K, Barbakow F (2003)
ProTaper rotary root canal preparation: assessment of tor-
que and force in relation to canal anatomy. International
Endodontic Journal 36, 93–9.
Peters OA, Boessler C, Zehnder M (2005) Effect of liquid and
paste-type lubricants on torque values during simulated
rotary root canal instrumentation. International Endodontic
Journal 38, 223–9.
Peters OA, Morgental RD, Schulze KA, Paque F, Kopper PM,
Vier-Pelisser FV (2014) Determining cutting efficiency of
nickel-titanium coronal flaring instruments used in lateral
action. International Endodontic Journal 47, 505–13.
Plotino G, Giansiracusa Rubini A, Grande NM, Testarelli L,
Gambarini G (2014) Cutting efficiency of Reciproc and
WaveOne reciprocating instruments. Journal of Endodontics
40, 1228–30.
Plotino G, Grande N, Porciani P (2015) Deformation and
fracture incidence of Reciproc instruments: a clinical eval-
uation. International Endodontic Journal 48, 199–205.
Poulsen WB, Dove SB, del Rio CE (1995) Effect of nickel-tita-
nium engine-driven instrument rotational speed on root
canal morphology. Journal of Endodontics 21, 609–12.
Prichard J (2012) Rotation or reciprocation: a contempo-
rary look at NiTi instruments? British Dental Journal 212,
345–6.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
Pruett JP, Clement DJ, Carnes DL Jr (1997) Cyclic fatigue
testing of nickel-titanium endodontic instruments. Journal
of Endodontics 23, 77–85.
Ramirez-Salomon M, Soler-Bientz R, de la Garza-Gonz alez R,
Palacios-Garza CM (1997) Incidence of lightspeed separa-
tion and the potential for bypassing. Journal of Endodontics
23, 586–7.
Rios Mde A, Villela AM, Cunha RS et al. (2014) Efficacy of 2
reciprocating systems compared with a rotary retreatment
system for gutta-percha removal. Journal of Endodontics
40, 543–6.
Roane JB, Sabala CL, Duncanson MG Jr (1985) The ‘bal-
anced force’ concept for instrumentation of curved canals.
Journal of Endodontics 11, 203–11.
Robinson JP, Lumley PJ, Cooper PR, Grover LM, Walmsley
AD (2013) Reciprocating root canal technique induces
greater debris accumulation than a continuous rotary
technique as assessed by 3-dimensional micro-computed
tomography. Journal of Endodontics 39, 1067–70.
R€
odig T, Reicherts P, Konietschke F, Dullin C, Hahn W,
H€ulsmann M (2014) Efficacy of reciprocating and rotary
NiTi instruments for retreatment of curved root canals
assessed by micro-CT. International Endodontic Journal 47,
942–8.
Saber SED, Abu El Sadat SM (2013) Effect of altering the
reciprocation range on the fatigue life and the shaping
ability of WaveOne nickel-titanium instruments. Journal of
Endodontics 39, 685–8.
Saber SE, Nagy MM, Sch€ afer E (2015) Comparative evaluation
of the shaping ability of WaveOne, Reciproc and OneShape
single-file systems in severely curved root canals of
extracted teeth. International Endodontic Journal 48, 109–14.
Sch€afer E, Florek H (2003) Efficiency of rotary nickel-tita-
nium K3 instruments compared with stainless steel hand
K-Flexofile. Part 1. Shaping ability in simulated curved
canals. International Endodontic Journal 36, 199–207.
Sch€afer E, Lau R (1999) Comparison of cutting efficiency
and instrumentation of curved canals with nickel-titanium
and stainless-steel instruments. Journal of Endodontics 25,
427–30.
Sch€afer E, Oitzinger M (2008) Cutting efficiency of five differ-
ent types of rotary nickel-titanium instruments. Journal of
Endodontics 34, 198–200.
Sch€afer E, Schulz-Bongert U, Tulus G (2004) Comparison of
hand stainless steel and nickel titanium rotary instrumen-
tation: a clinical study. Journal of Endodontics 30, 432–5.
Sch€afer E, Erler M, Dammaschke T (2005) Influence of differ-
ent types of automated devices on the shaping ability of
rotary nickel-titanium FlexMaster instruments. Interna-
tional Endodontic Journal 38, 627–36.
Schrader C, Peters OA (2005) Analysis of torque and force
with differently tapered rotary endodontic instruments in
vitro. Journal of Endodontics 31, 120–3.
Shin CS, Huang YH, Chi CW, Lin CP (2014) Fatigue life
enhancement of NiTi rotary endodontic instruments by
International Endodontic Journal, 49, 119–135, 2016 133
 ß apar & Arslan
Instrumentation kinematics C
progressive reciprocating operation. International Endodon-
tic Journal 47, 882–8.
Siqueira JF Jr, Alves FR, Almeida BM, de Oliveira JC, Rocas
IN (2010) Ability of chemomechanical preparation with
either rotary instruments or self-adjusting File to disinfect
oval-shaped root canals. Journal of Endodontics 36, 1860–
5.
Siqueira JF Jr, Alves FR, Versiani MA et al. (2013) Correlative
bacteriologic and micro-computed tomographic analysis of
mandibular molar mesial canals prepared by Self-Adjusting
File, Reciproc, and Twisted File systems. Journal of Endodon-
tics 39, 1044–50.
Stern S, Patel S, Foschi F, Sherriff M, Mannocci F (2012)
Changes in centring and shaping ability using three
nickel-titanium instrumentation techniques analysed by
micro-computed tomography (lCT). International Endodon-
tic Journal 45, 514–23.
Suffridge CB, Hartwell GR, Walker TL (2003) Cleaning effi-
ciency of nickel-titanium GT and.04 rotary files when used
in a torque-controlled rotary handpiece. Journal of End-
odontics 29, 346–8.
Tinoco JM, De-Deus G, Tinoco EM, Saavedra F, Fidel RA,
Sassone LM (2014) Apical extrusion of bacteria when
using reciprocating single-file and rotary multifile instru-
mentation systems. International Endodontic Journal 47,
560–6.
Turpin YL, Chagneau F, Vulcain JM (2000) Impact of two
theoretical cross-sections on torsional and bending stresses
of nickel-titanium root canal instrument models. Journal of
Endodontics 26, 414–7.
Varela-Patino P, Ibanez-Parraga A, Rivas-Mundina B,
Cantatore G, Otero XL, Martin-Biedma B (2010) Alter-
nating versus continuous rotation: a comparative study
of the effect on instrument life. Journal of Endodontics
36, 157–9.
Walia HM, Brantley WA, Gerstein H (1988) An initial
investigation of the bending and torsional properties of
Nitinol root canal files. Journal of Endodontics 14, 346–
51.
Weine FS, Kelly RF, Lio PJ (1975) The effect of preparation
procedures on original canal shape and on apical foramen
shape. Journal of Endodontics 1, 255–62.
Weine FS, Kelly RF, Bray KE (1976) Effect of preparation
with endodontic handpieces on original canal shape. Jour-
nal of Endodontics 2, 298–303.
Wu J, Lei G, Yan M, Yu Y, Yu J, Zhang G (2011) Instrument
separation analysis of multi-used ProTaper Universal
rotary system during root canal therapy. Journal of End-
odontics 37, 758–63.
Yared GM (2002) Behaviour of Hero NiTi instruments used
by an experienced operator under access limitations. Aus-
tralian Endodontic Journal 28, 64–7.
Yared G (2008) Canal preparation using only one Ni-Ti
rotary instrument: preliminary observations. International
Endodontic Journal 41, 339–44.
134 International Endodontic Journal, 49, 119–135, 2016
Yared GM, Kulkarni GK (2002) Failure of ProFile Ni-Ti
instruments used by an inexperienced operator under
access limitations. International Endodontic Journal 35,
536–41.
Yared G, Kulkarni GK (2003) An in vitro study of the tor-
sional properties of new and used rotary nickel-titanium
files in plastic blocks. Oral Surgery, Oral Medicine, Oral
Pathology, Oral Radiology, and Endodontics 96, 466–71.
Yared G, Kulkarni GK (2004a) Accuracy of the DTC torque
control motor for nickel-titanium rotary instruments.
International Endodontic Journal 37, 399–402.
Yared G, Kulkarni GK (2004b) Accuracy of the TCM Endo
III torque-control motor for nickel-titanium rotary instru-
ments. Journal of Endodontics 30, 644–5.
Yared G, Kulkarni GK (2004c) Accuracy of the Nouvag tor-
que control motor for nickel-titanium rotary instruments.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology,
and Endodontics 97, 499–501.
Yared G, Sleiman P (2002) Failure of ProFile instruments
used with air, high torque control, and low torque control
motors. Oral Surgery, Oral Medicine, Oral Pathology, Oral
Radiology, and Endodontics 93, 92–6.
Yared GM, Bou Dagher FE, Machtou P (2001) Influence
of rotational speed, torque and operator’s proficiency on
ProFile failures. International Endodontic Journal 34, 47–
53.
Yoldas O, Yilmaz S, Atakan G, Kuden C, Kasan Z (2012)
Dentinal microcrack formation during root canal prepara-
tions by different NiTi rotary instruments and the Self-
Adjusting File. Journal of Endodontics 38, 232–5.
You SY, Bae KS, Baek SH, Kum KY, Shon WJ, Lee W (2010)
Lifespan of one nickel-titanium rotary file with reciprocat-
ing motion in curved root canals. Journal of Endodontics
36, 1991–4.
You SY, Kim HC, Bae KS, Baek SH, Kum KY, Lee W (2011)
Shaping ability of reciprocating motion in curved root
canals: a comparative study with micro-computed tomog-
raphy. Journal of Endodontics 37, 1296–300.
Yum J, Cheung GS, Park JK, Hur B, Kim HC (2011) Tor-
sional strength and toughness of nickel-titanium rotary
files. Journal of Endodontics 37, 382–6.
Zarei M, Javidi M, Erfanian M, Lomee M, Afkhami F (2013)
Comparison of air-driven vs electric torque control motors
on canal centering ability by ProTaper NiTi rotary instru-
ments. The Journal of Contemporary Dental Practice 14, 71–
5.
Zarrabi MH, Javidi M, Vatanpour M, Esmaeili H (2010)
The influence of torque and manual glide path on the
defect or separation rate of NiTi rotary instruments in
root canal therapy. Indian Journal of Dental Research 21,
107–11.
Zelada G, Varela P, Martin B, Bahillo JG, Magan F, Ahn S
(2002) The effect of rotational speed and the curvature of
root canals on the breakage of rotary endodontic instru-
ments. Journal of Endodontics 28, 540–2.
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd

Zhao D, Shen Y, Peng B, Haapasalo M (2014) Root canal
preparation of mandibular molars with 3 nickel-titanium
rotary instruments: a micro-computed tomographic study.
Journal of Endodontics 40, 1860–4.
Zhou HM, Shen Y, Zheng W, Li L, Zheng YF, Haapasalo M
(2012) Mechanical properties of controlled memory and
superelastic nickel-titanium wires used in the manufacture
© 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd
ß apar & Arslan Instrumentation kinematics
C
of rotary endodontic instruments. Journal of Endodontics
38, 1535–40.
Zuolo AS, Mello JE Jr, Cunha RS, Zuolo ML, Bueno CE
(2013) Efficacy of reciprocating and rotary techniques for
removing filling material during root canal retreatment.
International Endodontic Journal 46, 947–53.
International Endodontic Journal, 49, 119–135, 2016 135