NiTi instruments in endodontics: contemporary concepts, principles, and practical guidance

Area of Science:

• Endodontics
• Materials Science
• Dental Technology

Background:

• Nickel-titanium (NiTi) instruments have revolutionized endodontic procedures.
• Inconsistencies in research translation and lack of standardization necessitate a synthesis of current evidence.
• Understanding NiTi alloy properties and design is key for optimal clinical outcomes.

Purpose of the Study:

• To synthesize laboratory and clinical evidence on NiTi endodontic instruments.
• To provide guidance for clinical practice based on current research findings.
• To address inconsistencies and promote standardization in the use of NiTi systems.

Main Methods:

• Comprehensive review of laboratory and clinical studies on NiTi endodontic instruments.
• Synthesis of evidence on instrument evolution, metallurgy, heat treatments, and geometric design.
• Analysis of mechanical properties and clinical performance, focusing on shaping outcomes.

Main Results:

• Modern NiTi instruments with advanced heat treatments exhibit enhanced flexibility and cyclic fatigue resistance.
• Continuous rotary systems generally show better canal centering than reciprocating systems.
• Both systems leave unprepared canal walls, underscoring the importance of chemical debridement.

Conclusions:

• NiTi instruments are the standard of care for anatomically respectful canal shaping.
• Clinical success is primarily influenced by biological factors and technique, not solely the instrument system.
• Clinicians should combine knowledge of NiTi properties with conservative techniques for safe and efficient root canal preparation.