BASIC RESEARCH – TECHNOLOGY

, DDS, MSc,
Eugenio Pedulla
Torsional, Static, and Dynamic PhD,* Naji Kharouf, DDS, MSc,
PhD,†‡ Simone Caruso, DDS,*
Cyclic Fatigue Resistance of Giusy Rita Maria La Rosa, DDS,
PhD,* Hamdi Jmal, PhD,§
Reciprocating and Continuous Youssef Haikel, DDS, MSc,
PhD,†‡ and Davide Mancino,
Rotating Nickel-Titanium DDS, MSc, PhD†‡

Instruments

ABSTRACT
SIGNIFICANCE
Introduction: The aim of this study was to evaluate torsional, dynamic, and static cyclic
fatigue resistance of the reciprocating One RECI (OR; Micromega, Besançon, France), Within the study limitations, the
WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland), rotary One Curve (OC, nickel-titanium reciprocating
MicroMega), and ProTaper Next X2 (PTN X2; Dentsply Sirona, Charlotte, NC) instruments. instrument One RECI exhibited
Methods: A total of 120 OR (n 5 30), WOG (n 5 30), OC (n 5 30), and PTN X2 (n 5 30) mechanical features suitable
nickel-titanium instruments were used. Torque and rotation angle until failure under static for clinics. The use of One
torsion loading were measured according to ISO 3630-1. Static and dynamic fatigue resis- RECI could be advantageous
tance was measured as the time to fracture in an artificial stainless steel canal with a 60 angle in curved canals with caution
and 5-mm radius of curvature at intracanal temperature. The results were analyzed with 1-way for plastic deformation, which
analysis of variance and the post hoc Tukey test. The alpha-type error was set at 5%. Fracture could be an early indicator of
instruments from torsion and fatigue tests were examined with a scanning electron micro- file separation.
scope. Results: OR showed higher static fatigue resistance and rotation angle at fracture
than WOG, OC, and PTN X2 (P , .05). WOG exhibited higher torsional resistance than the
others (P , .05). The cyclic fatigue tests in dynamic mode had higher TTF than static for the
PTN X2 and WOG groups (P , .05). In the dynamic tests, OR and WOG showed higher TTF
than OC and PTN X2 (P , .05). Conclusions: Under these experimental conditions, One
RECI exhibited suitable mechanical properties with the highest cyclic fatigue resistance and
angle of rotation among the tested instruments. (J Endod 2022;48:1421–1427.)

KEY WORDS
Continuous rotation; cyclic fatigue resistance; One RECI; reciprocating motion; torsional
resistance From the *Department of General Surgery
and Medical-Surgical Specialties,
University of Catania, Catania, Italy; and
†
Department of Bioengineering and
Nickel-titanium (NiTi) rotary instruments are widely used for root canal preparation because of their many
Biomaterials, INSERM (French National
advantages in reducing procedural errors and working time. However, they are susceptible to fracture, Institute of Health and Medical Research)
especially when dealing with narrow and curved canals1. NiTi intracanal instrument separation can occur 1121, ‡Department of Endodontics,
due to torsional or cyclic fatigue2,3. Torsional fracture occurs when the tip of the instrument locks into the Faculty of Dental Medicine, and §ICube
canal while the shank continues to rotate, and, consequently, the torque exceeds the elastic limit of the Laboratory, UMR 7357 CNRS, Mechanics
Department, University of Strasbourg,
metal resistance4,5. Cyclic fatigue failure more frequently occurs in curved canals, especially in the
Strasbourg, France
maximum point of curvature because of the alternate and repeated compression and tensile stresses
Address requests for reprints to Dr
generated during file rotation2,6. In static fatigue tests, instruments are rotated in an artificial canal at a
, Department of General
Eugenio Pedulla
fixed length with no axial motion. In dynamic ones, instruments are subjected to an axial pecking motion Surgery and Medical-Surgical Specialties,
with a predetermined amplitude simulating a clinical situation7. University of Catania, Via Santa Sofia, 78,
Several instrument features such as the NiTi core diameter, cross-sectional shape, helical angle, 95123, Catania, Italy.
pitch, tip design, surface treatments, and kinematics can influence their performance under torsional and E-mail address: eugeniopedulla@gmail.
com
cyclic fatigue stresses8. The mechanical behavior of the NiTi alloy is linked to its temperature-dependent 0099-2399/$ - see front matter
proportions of the microstructural phases with the martensitic phase softer and more ductile than
Copyright © 2022 American Association
austenitic9,10. One RECI (OR; Micro-Mega, Besançon, France) is a reciprocating single-file system of Endodontists.
featured with a heat-treatment (C-wire) and variable off-centered cross section, starting as a triple helix https://doi.org/10.1016/
and progressively changing to an S-shape toward the shank. The instrument is designed to work in j.joen.2022.08.005

JOE  Volume 48, Number 11, November 2022 Fatigue Resistance of NiTi Instruments 1421

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
reciprocation with specific angles (170
counterclockwise [CCW] and 60 clockwise
[CW]) generating a CCW cutting action11.
WaveOne Gold (WOG; Dentsply
Maillefer, Ballaigues, Switzerland) is also a
reciprocating single-file system made from a
“gold” alloy with a parallelogram cross section
and an off-centered design with 2 cutting
edges12. One Curve (OC, Micro-Mega) is a
single-file shaping system with exactly the
same characteristics as OR, except that it
works in rotation with a CW cutting action11.
ProTaper Next X2 (PTN X2; Dentsply Sirona,
Charlotte, NC) is a rotating root canal
instrument developed using M-Wire heat
treatment technology and designed with an
off-centered rectangular cross section3.
To date, no studies are available on the
mechanical properties of the OR file. Hence,
the aim of this work was to investigate static
and dynamic cyclic fatigue at body
temperature as well as the maximum torsional
torque and torsional angle at failure of OR and
to compare the findings with the ones of the
WOG, OC, and PTN X2 files. The null
hypotheses tested were as follows:
(1) there is no difference in the static and
dynamic cyclic fatigue resistance
among the instruments, and
(2) there is no difference in the torsional
resistance among the instruments.
MATERIALS AND METHODS
Two continuous rotary instruments (OC 25.06
and PTN X2 25.06) and 2 reciprocating
instruments (OR 25.06 and WOG 25.07) were
tested under the torsional resistance test and
cyclic fatigue loading conditions until failure. A
sample of 30 files of each brand, 25 mm in
length (OR, WOG, OC, and PTN X2), were
consumed in torsional resistance (n 5 10) as
well as in static (n 5 10) and dynamic (n 5 10)
cyclic fatigue tests. Sample size calculation
was based on a pilot study. Considering a test
power of 0.80 (G*Power 3.1.9.2 software;
Heinrich-Heine-Universit€at Du€sseldorf,
Du€sseldorf, Germany) with a 5 0.05, the
minimum sample size was established at 10
instruments for each group. All instruments
were previously inspected using a
stereomicroscope (Optika szr 10; Optika Srl,
Ponteranica, Bergamo, Italy) with 45!
magnification for any signs of visible
deformation, and none was discarded.
Cyclic Fatigue Analysis Testing
Machine
A customized testing apparatus was used to
perform cyclic fatigue resistance tests (Fig. 1A).
A platform was composed of a fixed block
1422
et al.
Pedulla
Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
containing the electric handpiece and a mobile
support on rails for the insertion/withdrawal of
the file. The block ensured that the electric
handpiece was maintained in a fixed 3-
dimensional position. This mobile platform
contained and maintained the entrance of the
instrument perpendicular to the 16-mm-long
stainless steel artificial canal with a 60 angle
and a 5-mm radius of curvature. All
instruments were activated using a 6:1
reduction handpiece (Sirona Dental Systems
GmbH, Bensheim, Germany) and were tested
at an intracanal temperature of 35 C (61 C)13
following a procedure previously described14.
In the dynamic cyclic fatigue resistance test,
the amplitude of the axial movements was 3
mm, and the descending and ascending
speed was set at 100 and 200 mm/min,
respectively12. A special high-flow synthetic oil
(Super Oil; Singer Co Ltd, Elizabeth, NJ) was
applied as a lubricant. The OR files were
powered by a torque-controlled motor (AI-
Motor; Woodpecker, Guilin, China) in
reciprocation motion (170 CCW and 60 CW)
at 400 rpm and 4 Ncm as recommended by
the manufacturer11. The X-Smart Plus motor
(Dentsply Maillefer) was used for WOG files
with the “WaveOne Gold” program. The
continuous files were rotated at a constant
speed of 300 rpm powered by the same X-
Smart Plus motor. Torque was set at 2.5 Ncm.
The time to fracture (TTF) in seconds from the
start of the test until the fracture was detected
visually and/or audibly was recorded with a
chronometer to an accuracy of 0.1 second. To
avoid human errors, video recording was also
performed, and the recordings were checked
to confirm the time of file separation. The
length of the fractured file tip was measured by
using a digital microcaliper (Digimatic; Mitutoyo
Co, Kawasaki, Japan).
Torsional Test
The torsional test was performed on a tensile
torsion electromechanical single-column
device (Model 5944; Instron, Norwood, MA),
which permitted the conduction of a torsion
test according to ISO 3630-1 (Fig. 1B and C).
Each file was clamped at 3 mm from the tip
using an opposing pneumatic grip connected
to the torque sensor. The device
displacement controller enabled precise and
reproducible positioning of each file within the
clamps. The torsional load at 2 rpm was
applied until fracture to estimate the mean
ultimate torsional torque (Ncm) and torsional
angle ( ) of the instruments using Bluehill
Universal software (Instron). The CW files (OC
and PTN X2) were rotated to the right
direction, whereas the CWW files (OR and
WOG) were rotated to the left.
Scanning Electron Microscopic
Analysis
The broken fragments were analyzed using a
scanning electron microscope (SEM) (Quanta
250 FEG scanning electron microscope; FEI
Company, Eindhoven, Netherlands) at 400!
and 1000! magnification.
Statistical Analysis
Data were subjected to the Shapiro-Wilk test
to verify their normality and statistically
analyzed using 1-way analysis of variance and
the Tukey multiple comparison post hoc test
(Prism 8.0; GraphPad Software, Inc, La Jolla,
CA) with the significance level established at
95% (P , .05).
RESULTS
The means and standard deviations of TTF in
static and dynamic cyclic fatigue resistance,
the length of the fractured fragments, the
maximum load torque, and the angular rotation
to torsional fracture are shown in Table 1. In
the static cyclic fatigue resistance test, the OR
showed the significantly highest TTF (P , .05).
The OC and WOG showed a significantly
higher TTF than the PTN X2 (P , .05) without a
difference between them.
In the dynamic cyclic fatigue resistance
test, OR and WOG did not show any significant
differences (P . .05). Both instruments were
significantly more resistant than OC and PTN
X2 (P , .05), with OC more resistant than PTN
X2 (P , .05). When comparing the results from
static and dynamic tests, the fatigue life was
significantly prolonged in the dynamic model
only for PTN X2 and WOG (P , .05). There
were no significant differences in the mean
length of the fractured fragments of all the
instrument systems in both the static and
dynamic fatigue tests (P . .05).
WOG showed the significantly highest
maximum torsional load (P , .05) with no
difference among the other groups (P . .05).
OR showed the significantly highest torsional
angle (P , .05) with no difference among the
other groups (P . .05).
The SEM analysis showed the crack
initiation area, the overload fast fracture zone
with no morphologic differences in the fracture
surfaces of all instruments fractured at fatigue
(Fig. 2A–H). Moreover, the SEM image
presented concentric abrasion marks and
fibrous dimple marks at the center of rotation
of the files fractured at torsion (Fig. 3A–H).
DISCUSSION
The present study was designed to compare
torsional property, static and dynamic cyclic
fatigue resistance of the NiTi reciprocating
JOE  Volume 48, Number 11, November 2022

FIGURE 1 – A representative picture of the laboratory testing devices used for (A ) the cyclic fatigue test and (B ) the
torsional test with (C ) a WOG file clamped at 3 mm from the tip using an opposing pneumatic grip connected to the
torque sensor.
instrument OR, and 3 other reciprocating or
continuous rotating instruments (WOG, OC,
and PTN X2). In this study, dynamic and static
cyclic fatigue was tested in a steel artificial
canal with 60 of curvature and a 5-mm radius
of curvature because these dimensions have
been previously used10,15. The artificial steel
canal maintaining the temperature at
35 C 6 1 C (as the intracanal temperature)
seems to decrease the cyclic fatigue life of NiTi
instruments16,17. In the static test model,
alternating compressive and tensile stresses
are concentrated in only 1 area of the
instrument, which induces microstructural
changes in the alloy. Conversely, in the
dynamic model, the instrument moves axially
along the curvature, which allows stresses to
be distributed along the instrument, extending
the file’s fatigue life18. Although the dynamic
model simulates the clinical pecking motion
performed during root canal preparation, a
static model was used to reduce some
variables, such as the amplitude of axial motion
and speed, which are subjective and could be
performed in different forms by clinicians19,20.
Although a comparison among the different
instruments is difficult to make because of the
differences in the thermomechanical treatment
and design features, instruments with the
same tip diameter (#25) and similar taper were
chosen to minimize variables. The OR
instrument showed significantly higher static
cyclic fatigue resistance than the other file
systems tested, whereas the OR and WOG
instruments performed significantly better in
terms of dynamic cyclic fatigue resistance than
the OC and PTN X2 instruments. Thus, the first
null hypothesis was rejected.
In the current study, various instruments
with different cross-sectional designs were
used. WOG has a parallelogram cross
section12, and PTN X2 has a rectangular
cross-sectional design3, whereas OR and OC
have a variable cross-sectional design with a
triple helix cross section in the apical area and
an S-shaped design in the medium and
coronal parts11,21. In previous studies, a
decreased core area has been recommended
to enhance the fatigue resistance of the
instruments22,23. Triangular cross-sectional
instruments have a lower core area
(OR 5 146.231 mm2 and OC 5 149.512 mm2)
compared with rectangular (PTN
X2 5 151.972 mm2) and parallelogram
(WOG 5 155.910 mm2) cross-sectional
designs as confirmed by the measure of the
core area of each file at 5 mm from the tip
under a scanning electron microscope and
using AutoCAD software (Autodesk Inc, San
Rafael, CA). This may be 1 of the reasons for
the higher cyclic fatigue resistance of the OR
instruments in static tests. However, the fact
that no statistical difference occurred between
OC and WOG when assessing static cyclic
fatigue resistance and that OR and WOG
showed significantly higher dynamic cyclic
fatigue resistance than OC proves that even
kinematics is a determining factor influencing
cyclic fatigue resistance24. The enhanced

TABLE 1 - The Mean and Standard Deviation of the Time to Failure (Seconds), Fragment Length (mm), Torque (Ncm), and Angle of Rotation ( ) of the Tested Instruments

Dynamic cyclic fatigue

Static cyclic fatigue resistance resistance Torsional test
Fragment Fragment Maximum
Time to length Time to length load torque Angle of
Instruments fracture (s) (mm) fracture (s) (mm) (Ncm) rotation ( )
One RECI 155.50 6 3.89a1 4.75 6 0.50 177.20 6 4.71a1 4.67 6 0.58 0.65 6 0.06a 647.79 6 62.90a
WaveOne 107.50 6 7.89b1 5.38 6 0.52 183.80 6 3.43a2 5.20 6 0.45 1.51 6 0.21b 461.99 6 105.68b
Gold
One Curve 94.20 6 3.01b1 4.75 6 0.96 108.20 6 3.91b1 4.67 6 0.58 0.69 6 0.16a 379.03 6 39.78b
ProTaper 48.60 6 2.72c1 4.80 6 0.84 78.20 6 2.70c2 4.75 6 0.50 0.56 6 0.13a 398.68 6 101.66b
Next X2

Superscript letters indicate significant differences in each column (P , .05). Superscript numbers indicate significant differences between the static and dynamic cyclic fatigue tests
(P , .05).

JOE  Volume 48, Number 11, November 2022 Fatigue Resistance of NiTi Instruments 1423

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
FIGURE 2 – Scanning electron microscopic images (400! magnification) of (A and E ) OR, (B and F ) OC, (C and G ) WOG, and (D and H ) PTN X2 in (A–D ) the static cyclic fatigue
resistance test and (E–H ) the dynamic cyclic fatigue resistance test. The white arrows indicate crack initiation areas, and the white circles indicate the fast fracture zone.

cyclic fatigue life in reciprocation is imputable
to the completion of a full rotation in 3 cycles
rather than a single one, decreasing the
number of openings and closings of a single
crack that might cause file separation25.
Moreover, the difference in the thermal
treatment of the NiTi alloy in each system could
have influenced the final results. OR
instruments are made from C-wire technology,
and they are stabilized in the martensitic phase
at room and intracanal temperature26.
Previous studies stated that martensitic files
are more flexible and resistant to cyclic fatigue
than austenitic ones26,27. Furthermore, OR
performed significantly better than WOG in the
static test, whereas no significant difference
emerged between them in the dynamic test.
This different behavior could be explained by
the design of the 2 files. Indeed, the stiffer
parallelogram section of WOG could benefit
more from the axial movement of the dynamic

1424
et al.
Pedulla JOE  Volume 48, Number 11, November 2022

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
FIGURE 3 – Scanning electron microscopic images (400! and 1000! magnification) of the fractured surfaces of separate fragments after torsional testing of (A and E ) OR, (B and
G ) OC, (C and F ) WOG, and (D and H ) PTN X2. This cross-sectional view showed typical features of torsional failure as multiple skewed dimples near the center of rotation and circular
abrasion marks. The white arrows indicate the magnification for each instrument.

test than the triangular section, which results in
more resistance to the flexural stress22. The
reason why WOG showed similar results
compared with OR but not OC is imputable to
the fact that OC works in continuous rotation,
whereas OR is a reciprocating file.
The different behavior in the static and
dynamic tests for PTN X2 could be explained
by the benefit of the dynamic model, which
ensures more homogenous stress distribution
compared with the static model, which causes
the concentration of stresses in a single area of
the instrument19,28. It is plausible that the more
rigid files, such as PTN X2, benefit most from
the dynamic model compared with more
flexible files, such as OC and OR. In addition,
the dynamic model associated with the
advantage of reciprocation could explain the
higher cyclic fatigue resistance observed for
WOG in the dynamic test compared with the
static.
The torsional test showed that the
angular rotation of OR and the maximum
torsional load of WOG instruments were
significantly higher than the other systems.
Thus, the second null hypothesis was rejected.
The angular rotation is a parameter associated
with the ductile fracture of NiTi files29. This
finding for OR was probably linked with the
reduced dimension of 1.0 mm NiTi wire by
which these files are manufactured30
combined with the small cross section and the
benefit provided by the C-wire11. In addition,
the highest torsional angle of OR could be an
advantage in clinics because plastic
deformation could predict an imminent
fracture, which suggests discarding the
instrument31.
On the other hand, these results
suggest that WOG requires a high torque to
fracture by torsion compared with C-wire
files as previously reported32. The
differences in the maximum torque recorded
could be imputable to the influence of the
cross-sectional design33 and heat
treatment34 on mechanical resistance.
Instruments with higher flexural resistance,
such as OR, could be used for more curved
canals in which the NiTi instrument is subject
to major cyclic load stresses35. Instruments
with higher maximum torque could be used
in constricted canals where torsional load
stress is higher36; yet, the maximum torque
load and deflection angle are both related to
the torsional fracture in a constructed canal.
Thus, clinical inferences should be made
with caution.
In accordance with previous studies,
fractographic analysis by SEM revealed typical
crack initiation areas and fast fracture zones for
cyclic fatigue failure and multiple skewed
dimples near the center of rotation and circular
abrasion marks for torsional20,37.
One of the limitations of the present
study was not including other evaluations,
such as cutting efficiency, microhardness,
buckling assessment, and fine geometric
variations or dimensions of the new OR tested
instruments. These further investigations as
well as clinical studies for determining the root
canal treatment outcomes associated with this
system are recommended to be conducted in
future studies.
In conclusion, within the limitations of
this study, OR instruments had mechanical
properties suitable for clinical practice. In
particular, OR instruments exhibited higher
static cyclic fatigue resistance and torsion
angle at fracture but lower torsion resistance
than WOG. Among the other tested files, OC
showed significantly higher cyclic fatigue
resistance than PTN X2.
ACKNOWLEDGMENTS
Naji Kharouf and Eugenio Pedulla
contributed
equally to this study.
The authors deny any conflicts of
interest related to this study.

JOE  Volume 48, Number 11, November 2022 Fatigue Resistance of NiTi Instruments 1425

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
REFERENCES
1. Lopes HP, Elias CN, Vieira MV, et al. Fatigue life of Reciproc and Mtwo instruments subjected to
static and dynamic tests. J Endod 2013;39:693–6.

2.
E, La Rosa GR, Virgillito C, et al. Cyclic fatigue resistance of nickel-titanium rotary

Pedulla
instruments according to the angle of file access and radius of root canal. J Endod 2020;46:
431–6.

3. Koçak S, S €
x ahin FF, Ozdemir O, et al. A comparative investigation between ProTaper Next, Hyflex
CM, 2Shape, and TF-Adaptive file systems concerning cyclic fatigue resistance. J Dent Res Dent
Clin Dent Prospects 2021;15:172–7.

4. Keskin C, Inan U, Demiral M, et al. Cyclic fatigue resistance of Reciproc Blue, Reciproc, and
WaveOne Gold reciprocating instruments. J Endod 2017;43:1360–3.

5. € S, Keskin C, Aydemir H. Comparison of the torsional resistance of 4 different glide path

Yilmaz O
instruments. J Endod 2021;47:970–5.
6. Cheung GS. Instrument fracture: mechanisms, removal of fragments, and clinical outcomes.
Endod Topics 2007;16:1–26.

7. Rodrigues RC, Lopes HP, Elias CN, et al. Influence of different manufacturing methods on the
cyclic fatigue of rotary nickel-titanium endodontic instruments. J Endod 2011;37:1553–7.

8. Kuhn G, Tavernier B, Jordan L. Influence of structure on nickel titanium endodontic instruments

failure. J Endod 2001;27:516–20.
9. Zupanc J, Vahdat-Pajouh N, Sch€afer E. New thermomechanically treated NiTi alloys - a review.
Int Endod J 2018;51:1088–103.

10. Klymus ME, Alcalde MP, Vivan RR, et al. Effect of temperature on the cyclic fatigue resistance of
thermally treated reciprocating instruments. Clin Oral Invest 2019;23:3047–52.

11. Kharouf N, Pedulla
E, Nehme W, et al. Apically extruded debris in curved root canals using a new
reciprocating single-file shaping system. J Endod 2022;48:117–22.
12. Thu M, Ebihara A, Maki K, et al. Cyclic fatigue resistance of rotary and reciprocating nickel-
titanium instruments subjected to static and dynamic tests. J Endod 2020;46:1752–7.

13. de Hemptinne F, Slaus G, Vandendael M, et al. In vivo intracanal temperature evolution during
endodontic treatment after the injection of room temperature or preheated sodium hypochlorite.
J Endod 2015;41:1112–5.

14. La Rosa GR, Shumakova V, Isola G, et al. Evaluation of the cyclic fatigue of two single files at body
and room temperature with different radii of curvature. Materials (Basel) 2021;14:2256.

15. Alfawaz H, Alqedairi A, Alsharekh H, et al. Effects of sodium hypochlorite concentration and
temperature on the cyclic fatigue resistance of heat-treated nickel titanium rotary instruments. J
Endod 2018;44:1563–6.
16. Dosanjh A, Paurazas S, Askar M. The effect of temperature on cyclic fatigue of nickel-titanium
rotary endodontic instruments. J Endod 2017;43:823–6.
17. Shen Y, Huang X, Wang Z, et al. Low environmental temperature influences the fatigue resistance
of nickel-titanium files. J Endod 2018;44:626–9.

18. Arias A, Hejlawy S, Murphy S, et al. Variable impact by ambient temperature on fatigue resistance
of heat-treated nickel titanium instruments. Clin Oral Investig 2019;23:1101–8.

19. Li UM, Lee BS, Shih CT, et al. Cyclic fatigue of endodontic nickel titanium rotary instruments:
static and dynamic tests. J Endod 2002;28:448–51.
20. Alcalde MP, Duarte MA, Bramante CM, et al. Cyclic fatigue and torsional strength of three
different thermally treated reciprocating nickel-titanium instruments. Clin Oral Investig
2018;22:1865–71.
21. Topçuog lu HS, Topçuog lu G, Kafdag € et al. Effect of two different temperatures on resistance
 O,
to cyclic fatigue of one Curve, EdgeFile, HyFlex CM and ProTaper next files. Aust Endod J
2020;46:68–72.

22. Micoogullari Kurt S, Kaval ME, Serefoglu B, et al. Cyclic fatigue resistance and energy dispersive
X-ray spectroscopy analysis of novel heat-treated nickel-titanium instruments at body
temperature. Microsc Res Tech 2020;83:790–4.

23. Gambarini G, Grande NM, Plotino G, et al. Fatigue resistance of engine-driven rotary nickel-
titanium instruments produced by new manufacturing methods. J Endod 2008;34:1003–5.

1426
et al.
Pedulla JOE  Volume 48, Number 11, November 2022

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.
 24. Cheung GS, Darvell BW. Low-cycle fatigue of NiTi rotary instruments of various cross-sectional
shapes. Int Endod J 2007;40:626–32.

25. Keskin C, Yilmaz O€ Sivas, Kelesx A, et al. Comparison of cyclic fatigue resistance of Rotate
instrument with reciprocating and continuous rotary nickel-titanium instruments at body
temperature in relation to their transformation temperatures. Clin Oral Investig 2021;25:151–7.

26. Staffoli S, Grande NM, Plotino G, et al. Influence of environmental temperature, heat-treatment
and design on the cyclic fatigue resistance of three generations of a single-file nickel-titanium
rotary instrument. Odontology 2019;107:301–7.

27. Plotino G, Grande NM, Testarelli L, et al. Cyclic fatigue of Reciproc and WaveOne reciprocating
instruments. Int Endod J 2012;45:614–8.
28. Kelesx A, Eymirli A, Uyanık O, et al. Influence of static and dynamic cyclic fatigue tests on the
lifespan of four reciprocating systems at different temperatures. Int Endod J 2019;52:880–6.

29.
E, La Rosa GR, Franciosi G, et al. Cyclic fatigue and torsional resistance evaluation of
Pedulla
Reciproc R25 instruments after simulated clinical use. Minerva Dent Oral Sci 2022;71:174–9.

30. MicroMega. MicroMega One RECI, unique reciprocating file for exploring opposite directions.
Available at: https://micro-mega.com/shaping/one-reci/?lang5en. Accessed July 4, 2022.
31. Plotino G, Grande NM, Cordaro M, et al. A review of cyclic fatigue testing of nickel titanium rotary
instruments. J Endod 2009;35:1469–76.

32. Jo HJ, Kwak SW, Kim HC, et al. Torsional resistance of heat-treated nickel-titanium instruments
under different temperature conditions. Materials (Basel) 2021;14:5295.

33. Roda-Casanova V, Pe rez-Gonza lez A, Zubizarreta-Macho A, et al. Influence of cross-section and

pitch on the mechanical response of NiTi endodontic files under bending and torsional conditions-
a finite element analysis. J Clin Med 2022;11:2642.

34. Shim KS, Oh S, Kum K, et al. Mechanical and metallurgical properties of various nickel-titanium
rotary instruments. Biomed Res Int 2017;2017:4528601.
35. Plotino G, Grande NM, Melo MC, et al. Cyclic fatigue of NiTi rotary instruments in a simulated
apical abrupt curvature. Int Endod J 2010;43:226–30.

36. Alfouzan K, Jamleh A. Fracture of nickel titanium rotary instrument during root canal treatment
and re-treatment: a 5-year retrospective study. Int Endod J 2018;51:157–63.

37. Pedulla
E, Lo Savio F, Boninelli S, et al. Torsional and cyclic fatigue resistance of a new nickel-
titanium instrument manufactured by electrical discharge machining. J Endod 2016;42:156–9.

JOE  Volume 48, Number 11, November 2022 Fatigue Resistance of NiTi Instruments 1427

Descargado para Anonymous User (n/a) en University of Rosario de ClinicalKey.es por Elsevier en noviembre 02, 2022. Para uso
personal exclusivamente. No se permiten otros usos sin autorización. Copyright ©2022. Elsevier Inc. Todos los derechos reservados.