Mechanical root canal preparation with NiTi rotary instruments: rationale, performance and safety. Status report for the American Journal of Dentistry.

The growing use of NiTi rotary instruments in dental practice demands a good understanding of their concept of alloy and design in relation to improved properties and inherent limitations. Nickel titanium's super elasticity allows more centered canal preparations with less transportation and a decreased incidence of canal aberrations. Furthermore, the production of files with increased taper became possible. This is of special importance because of concerns on the achievement of adequate irrigation and close adaptation of the filling material during endodontic treatment. Unique shaft and tip designs should permit the use of a rotary handpiece allowing different tactile awareness. On the other hand, special attention is paid to maximize cutting efficiency and cutting control throughout instrumentation. NiTi rotary instruments are generally used in a crown-down approach and a continuous reaming motion. Consequently, rounder root canal preparations, with less straightening and a smaller amount of apical extrusion is achievable. In spite of their increased flexibility, separation is still a concern with NiTi files. The phenomenon of repeated cyclic metal fatigue and the variable of torsional loading are two important factors in instrument fracture. However, with awareness of the appropriate manipulation and special attention to the equipment used, NiTi systems are safe with a minimal incidence of instrument failure.