Skip to main content

Advertisement

Log in

Impact of nickel–titanium instrumentation of the root canal on clinical outcomes: a focused review

  • Review Article
  • Published:
Odontology Aims and scope Submit manuscript

Abstract

Nickel–titanium (NiTi) root canal instruments have improved the technical quality of enlarging and shaping. These instruments have been shown to prepare even severely curved root canal with fewer procedural errors than traditional stainless steel hand instruments. While it would appear that these instruments might enhance clinical outcomes, very few studies have assessed their impact when used in primary root canal treatment. Clinical studies investigating the outcome of primary root canal treatment using nickel–titanium hand or rotary instruments were identified (MEDLINE database) using appropriate key words in an attempt to determine if there have been enhanced outcomes with these instruments. Evidence from one clinical trial suggests that (i) better maintenance of the original canal curvature and shape results in increased success rates and (ii) that ledging of root canals results in reduced success rates. Evidence from two studies indicates that the use of NiTi—either hand or rotary—instruments significantly increases success rates of primary nonsurgical root canal treatment compared with the use of stainless steel hand instruments, while three investigations failed to show any significant differences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature—Part 2: influence of clinical factors. Int Endod J. 2008;41:6–31.

    Article  PubMed  Google Scholar 

  2. Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod. 2005;31:271–4.

    Article  PubMed  Google Scholar 

  3. Marending M, Peters OA, Zehnder M. Factors affecting the outcome of orthograde root canal therapy in a general dentistry hospital practice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:119–24.

    Article  PubMed  Google Scholar 

  4. de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study—Phase 4: initial treatment. J Endod. 2008;34:258–63.

    Article  PubMed  Google Scholar 

  5. Kojima K, Inamoto K, Nagamatsu K, Hara A, Nakata K, Morita I, Nakagaki H, Nakamura H. Success rate of endodontic treatment of teeth with vital and nonvital pulps. A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:95–9.

    Article  PubMed  Google Scholar 

  6. Ørstavik D, Qvist V, Stoltze K. A multivariate analysis of the outcome of endodontic treatment. Eur J Oral Sci. 2004;112:224–30.

    Article  PubMed  Google Scholar 

  7. Storms JL. Factors that influence the success of endodontic treatment. J Can Dent Assoc. 1969;35:83–97.

    PubMed  Google Scholar 

  8. Matsumoto T, Nagai T, Ida K, Ito M, Kawai Y, Horiba N, Sato R, Nakumara H. Factors affecting successful prognosis of root canal treatment. J Endod. 1987;13:239–42.

    Article  PubMed  Google Scholar 

  9. Friedman S, Löst C, Zarrabian M, Trope M. Evaluation of success and failure after endodontic therapy using glass ionomer cement sealer. J Endod. 1995;21:384–90.

    Article  PubMed  Google Scholar 

  10. Hoskinson SE, Ng YL, Hoskinson AE, Moles DR, Gulabivala K. A retrospective comparison of outcome of root canal treatment using two different protocols. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:705–15.

    Article  PubMed  Google Scholar 

  11. Byström A, Happonen RP, Sjogren U, Sundqvist G. Healing of periapical lesions of pulpless teeth after endodontic treatment with controlled asepsis. Endod Dent Traumatol. 1987;3:58–63.

    Article  PubMed  Google Scholar 

  12. Sjogren U, Hagglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16:498–504.

    Article  PubMed  Google Scholar 

  13. Ørstavik D, Horsted-Bindslev P. A comparison of endodontic treatment results at two dental schools. Int Endod J. 1993;26:348–54.

    Article  PubMed  Google Scholar 

  14. Smith CS, Setchell DJ, Harty FJ. Factors influencing the success of conventional root canal therapy—five-year retrospective study. Int Endod J. 1993;26:321–33.

    Article  PubMed  Google Scholar 

  15. Dammaschke T, Steven D, Kaup M, Ott KHR. Long-term survival of root-canal-treated teeth: a retrospective study of 10 years. J Endod. 2003;29:638–43.

    Article  PubMed  Google Scholar 

  16. Fouad AF, Burlesco J. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record. J Am Dent Assoc. 2003;134:43–51.

    PubMed  Google Scholar 

  17. Wang CH, Chueh SC, Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment. J Endod. 2011;37:1–5.

    Article  PubMed  Google Scholar 

  18. Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod. 2006;32:828–32.

    Article  PubMed  Google Scholar 

  19. Strindberg LZ. The dependence of the results of pulp therapy on certain factors—an analytical study based on radiographic and clinical follow-up examination. Acta Odontol Scand. 1956;14:1–175.

    Article  Google Scholar 

  20. Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod. 1979;5:83–90.

    Article  PubMed  Google Scholar 

  21. Kirkevang LL, Horsted-Bindslev P. Technical aspects of treatment in relation to treatment outcome. Endod Top. 2002;2:89–102.

    Article  Google Scholar 

  22. Hülsmann M, Peters OA, Dummer PMH. Mechanical preparation of root canals: shaping goals, techniques and means. Endod Top. 2005;10:30–76.

    Article  Google Scholar 

  23. Schäfer E, Dammaschke T. Development and sequelae of canal transportation. Endod Top. 2009;15:75–90.

    Article  Google Scholar 

  24. Kleier DJ, Averbach R. Comparison of clinical outcomes using a nickel titanium rotary or stainless steel hand file instrumentation technique. Compend Contin Educ Dent. 2006;27:87–91.

    PubMed  Google Scholar 

  25. Schäfer E, Schulz-Bongart U, Tulus G. Comparison of hand stainless steel and nickel–titanium rotary instrumentation: a clinical study. J Endod. 2004;30:432–5.

    Article  PubMed  Google Scholar 

  26. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30:559–67.

    Article  PubMed  Google Scholar 

  27. Lin LM, Rosenberg PA, Lin J. Do procedural errors cause endodontic treatment failure? J Am Dent Assoc. 2005;136:187–93.

    PubMed  Google Scholar 

  28. Friedman S, Mor C. The success of endodontic therapy—healing and functionality. Can Dent Assoc J. 2004;32:496–503.

    Google Scholar 

  29. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44:583–609.

    Article  PubMed  Google Scholar 

  30. Pettiette MT, Metzger Z, Philips C, Trope M. Prognosis of root canal therapy performed by dental students with stainless steel K-files and NiTi hand files. J Endod. 1999;25:230–4.

    Article  PubMed  Google Scholar 

  31. Pettiette MT, Delano O, Trope M. Evaluation of success rate of endodontic treatment performed by students with stainless-steel K-files and nickel–titanium hand files. J Endod. 2001;27:124–7.

    Article  PubMed  Google Scholar 

  32. Ørstavik D. Radiographic evaluation of apical periodontitis and endodontic treatment results: a computer approach. Int Dent J. 1991;41:89–98.

    PubMed  Google Scholar 

  33. Iqbal M, Kurtz E, Kohli M. Incidence and factors related to flare-ups in a graduate endodontic programme. Int Endod J. 2009;42:99–104.

    Article  PubMed  Google Scholar 

  34. Fleming CH, Litaker MS, Alley LW, Eleazer PD. Comparison of classic endodontic techniques versus contemporary techniques on endodontic treatment success. J Endod. 2010;36:414–8.

    Article  PubMed  Google Scholar 

  35. Cheung GSP, Liu CSY. A retrospective study of endodontic treatment outcome between nickel–titanium rotary and stainless steel hand filing techniques. J Endod. 2009;35:938–43.

    Article  PubMed  Google Scholar 

  36. Peters OA, Barbakow F, Peters CI. An analysis of endodontic treatment with three nickel–titanium rotary root canal preparation techniques. Int Endod J. 2004;37:849–59.

    Article  PubMed  Google Scholar 

  37. http://www.cebm.net/index.aspx?o=1025. Accessed on 20 March 2012.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Edgar Schäfer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schäfer, E., Bürklein, S. Impact of nickel–titanium instrumentation of the root canal on clinical outcomes: a focused review. Odontology 100, 130–136 (2012). https://doi.org/10.1007/s10266-012-0066-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10266-012-0066-1

Keywords

Navigation