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Cleaning and Shaping Ability of Gentlefile, HyFlex EDM, and ProTaper Next Instruments: A Combined Micro-computed
Pyae Hein Htun1, Arata Ebihara1, Keiichiro Maki1
1Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Introduction:
This ex vivo study aimed to evaluate the cleaning and shaping ability of a unique stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with 2 nickel-titanium rotary instruments.
Methods:
Thirty human mandibular premolars with a 15° to 25° curvature were equally distributed into 3 groups for final instrumentation with Gentlefile Red (#23/0.04), HyFlex EDM OneFile (#25/0.08∼; Coltene/Whaledent, Altstätten, Switzerland), and ProTaper Next X2 (#25/0.06v; Dentsply Sirona, Ballaigues, Switzerland) (n = 10/each). The untouched canal area, volume changes, and transportation were evaluated on pre- and post-instrumentation micro-computed tomographic images. Five random regions of the canal wall located 1-7 mm from the apical foramen were evaluated with scanning electron microscopy for superficial debris and a smear layer via a 5-point scoring system. Data were compared using the Kruskal-Wallis test with post hoc Dunn's pairwise comparison test with Bonferroni correction and Wilcoxon signed-rank test (α = 5%).
Results:
All instruments generated no overt procedural errors. Untouched area and volume changes did not show any significant differences among the 3 groups (P > .05). The Gentlefile exhibited less transportation at the level of 5-7 mm from the apex compared with ProTaper Next (P < .05). The Gentlefile showed a smaller debris score than ProTaper Next and better smear layer removal than the others (P < .05). Complete cleanliness was not achieved by any of the systems investigated.
Conclusions:
Canals instrumented with the Gentlefile exhibited less transportation at the mid-root level and better cleanliness than those instrumented with HyFlex EDM and ProTaper Next.
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