Effective Establishment of Glide-Path to Reduce Torsional Stress during Nickel-Titanium Rotary Instrumentation

This study compared the torque generation during canal shaping with a nickel-titanium endodontic instrument according to the extent of glide-path establishment. Seventy-five simulated S-shaped canal blocks were divided into five groups (n = 15) according to the number of repetitive insertions to the working length using a One G glide-path instrument: groups with 5, 10, 15, and 20 insertions as well as group Z without glide-path establishment. When the tip of the One G file reached the working length, the file was moved back and forth repetitively at the working length for the designated number of times for each group. The instrumentation procedure with HyFlex EDM had 15 pecking strokes. During instrumentation, the generated torque was transmitted to a customized data acquisition module and collected using customized software. Data were computed to determine the maximum torque and total stress. The maximum screw-in forces were statistically analyzed using one-way analysis of variance and Tukey's post hoc comparison test with a significance level of 95%. While the maximum stress did not have significant differences among the five groups (p > 0.05), groups with more than 10 repetitive insertions generated lower total stress during instrumentation than did the group with 5 insertions and group Z (p < 0.05). Under the limitations of this study, repetitive insertions of glide-path establishment files at the working length reduced stress generation during the shaping using nickel-titanium instruments.