[Engine-driven preparation of curved root canals: a platform to assess physical parameters]

The number of engine-driven rotary instruments available on the market is steadily increasing. These instruments enable clinicians to prepare better shaped root canals, however, rotary instruments have a higher risk for fracture than hand instruments. Unfortunately, the stresses placed on engine-driven rotary instruments in curved canals are insufficiently studied. The aim of this study was to develop a device which could measure more accurately the physical parameters influencing rotary instruments in curved canals. For this purpose, a specially designed machine was constructed to measure the torque which develops between the rotary instrument and the motor. Apical forces and penetration depths could also be directly measured in real time. A variety of other measurements was also possible because of other special set-ups integrated into the device. In the current study torque was assessed for GT-Files, size 35 with a .12 and sizes 20 with a .12 to .06 taper. In additions to preparations in simulated canals in plastic blocks, the "ISO 3630-1 specification for fracture moment" and "number of cycles till fatigue fracture" was measured. The findings indicated that when instruments were used for preparations, torques up to 40 Nmm were present. This exceeded the static fracture load, which was less than than 13 Nmm for the size 20 with .12 taper. In contrast, the number of rotations were more than 10 times lower when shaping canals in plastic blocks with a 5 mm radius of curvature than the number of rotations to fracture in the "cyclic fatigue test". This suggests that a GT-instrument could be used in ten canals. The apical force was always greater than 1 N and occasionally, 8 N or more was recorded. Further studies on natural teeth with varying canal geometries are required using the specially developed torsional machine to reduce the incidence of instrument fracture. In this way an efficient clinical potential can be confirmed for engine-driven rotary instruments in canal preparation.