Endodontic rotary and reciprocal file systems

Research comparing Endodontic rotary file systems

Just so you know my bias, I use a mixture of GT and the SX from Protaper.  I tried the GTX and didn’t feel comfortable in my hands.  I also use the Edge clones of these systems at times.

TF = Flexmaster in apical transportation

RaCe=Profile in apical transportation

Vortex (M-wire)=Endosequence in centering and apical transportation but M-wire better fatigue resistance

SAF=WaveOne=K3 in canal cleanliness but WaveOne is worse in isthmus cleaning (Why?)

K3XF (NiTi R-phase)>NiTi and M-wire

SAF=Reciproc=Twisted   All three similar performance Siqueira 2013

HyFlex EDM > Protaper Next Venino 2017 JOE

The HyFlex EDM and WaveOne Gold > Reciproc, WaveONe, F6 SkyTaper in crack formation Pedulla JOE 2017

HyFlex EDM>Reciproc Blue>WaveOne Gold>OneShape in cyclic failure test Gündoğar JOE 2017

Protaper Next > ProTaper Universal in terms of ledges Alemam JOE 2017

Rotary endodontic files in curved canals

TF>Revo-S=GTX>ProTaper in canal transportation and centering ability

Reciproc>WaveOne in cyclic fatigue of 60 degree curvature

WaveOne>TF>Protaper Nov 12 in cyclic fatigue curved canal

GTX=Revo-S=RaCe=Mtwo>Protaper(worse only at 2.5mm) canal transportation 30-40 degree

SAF>>Vortex>Typhoon in S shape canal for transportation

ProTaper Next > WaveOne and ProTaper Universal in apical transportation

ProTaper Gold >ProTaper Universal based on more flexible and more resistant to fatigue

Reciproc>OneShape=Twisted File Adaptive=ProTaper Universal Capar JOE 2014

ProTaper Next>ProTaper Universal and WaveOne Li 2015 JOE

TRUShape > Profile and Vortex Blue in double curvature Shen 2016 JOE

ProTaper Next and Hyflex CM > OneShape and ProTaper Universal Topçuoğlu 2016 JOE

TFA>WaveOne and PTN in transportation in curved canals Liu JOE 2016

WaveOne Gold and HEDM > Reciproc in S shape canal Özyürek JOE 2017

Hyflex EDM > Hyflew CM Uslu JOE 2018

Hyflex EDM > Protaper Gold > Protaper universal Kaval JOE 2016

Reciprocal endodontic systems

More debris out apex with reciprocal vs. rotary June 12

More apical cracks with reciprocal v rotary

Less cyclic fatigue and less canal transportation with reciprocal.  Controversy on apical debris.  Systemic Review Ahn 2016 JOE

Comparison of reciprocal endodontic files

Repciproc Blue > WaveOne Gold and Reciproc in curve canal in terms of separation time. JOE 2017 Keskin

Rotary Path Files 

Scout RaCe>PathFile

ProGlider > G-File > K-files Paleker JOE 2016

ProGlider > G-File Paleker JOE 2017

Hyflex GPF and G-file > Pathfile at centering Shi JOE 2017

Pain and apical extrusion

ProTaper Next=Reciproc=WaveOne Kherlakian JOE 2016


Retreatment of cases

Reciproc faster than TRUShape Zuolo JOE 2016

WaveOne beats ProTaper Jorgensen JOE 2017

File systems using controlled memory and or heat treatments

There are 3 types of heat treated NiTi alloys for endodontic files. M-wire, R-phase, CM-wire.

  • Protaper Next (M-wire NiTi)
  • HyFlex CM and EDM (controlled memory treatment and electrical discharge machining)
  • Reciproc (M-wire)
  • WaveOne and WaveOne Gold (M-wire gold is repeatedly heat treated)

Hyflex EDM and CM is the best Goo JOE 2017

Ninja access or Conservative endodontic access or Orifice-directed dentin conservation access

Not worth a whole other blog so adding the Ninja access to this one. My bias is that most RCT I see fail do so from infection and likely ineffective cleansing. To limit ones ability to effectively clean out the inside to reduce the risk of fracture is something only the most skilled should even bother attempting. The contracted endodontic cavity, basically the ninja access, improves fracture strength in lower molars at the expense of instrumentation efficiency. Krishan JOE 2014 In maxillary molars the contracted endodontic access appears to have no benefit. Moore JOE 2016 Worse yet it results in more transportaion and less canals found with no gain in fracture resistance. Rover JOE 2017

The contracted endodontic cavity results in greater apical transportation and in general result in less preservation of the original canal anatomy. Alovisi JOE 2018

It appears the roots and any isthmus are just as clean in the ninja access as traditional but the chamber is not. Neelakantan JOE 2018

The cervical dentin is what is important not the occlusal enamel and dentin as you can see from this stress concentration image under loading. The conservative access cavity has no impact on fracture resistance in comparison to a traditional access. Sabeti 2018 JOE

Truss endodontic access cavity

This is simialr to above ideas and shows similar results, which means does not appear to be helpful. Corsentino JOE 2018 found the truss did not increase fracture resistance of the tooth. Truss did help increase fracture resistance in MOD cut teeth Abou-Elnaga JOE 2019


Endodontic file separation can occur with any system so must be able to retrieve.

Separated file retrieved from root canal.

We had a separation of an 06 file near the apex. Did not take an x-ray at the time but able to retrieve the file. It was easier because of the small size and was easy to bypass.

Tags: , , , , , , , , , , , , , ,

No comments yet.

Leave a Reply