A total of 63 mechanized glide path instruments from three different systems (21 files per group) with a length of 25 mm were assessed regarding their macroscopic and microscopic design, metallurgical features, and cyclic fatigue strength. The systems included were: the ProGlider (Dentsply Sirona), Edge Glide Path (EdgeEndo), and R-Pilot (VDW). Prior to any assessment, the instruments were macroscopically checked for any visible defect that would exclude them from the test. No instrument was discarded.
Proglider
Manufactured by Dentsply
Sourced in Switzerland
The ProGlider is a dental laboratory instrument designed for use in dental clinics and laboratories. It is used to prepare and shape the root canal system during endodontic procedures.
Automatically generated - may contain errors
Lab products found in correlation
X smart plus, by Dentsply (2 mentions)
Glyde, by Dentsply (2 mentions)
Paper points, by Dentsply (1 mentions)
Endoactivator, by Dentsply (1 mentions)
Reciproc r25, by VDW (1 mentions)
Pro taper gold f2, by Dentsply (1 mentions)
Waveone gold primary, by Dentsply (1 mentions)
Ethylenediaminetetraacetic acid, by Merck Group (1 mentions)
X smart, by Dentsply (1 mentions)
10 protocols using proglider
1
Comparative Analysis of Glide Path Instruments
2
Comparative Evaluation of NiTi Rotary Instrumentation Techniques
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Canals were instrumented using I-Endo Dual digital electric motor (Satelec-Acteon, Mérignac, France) and a W & H WD-75M 16:1 reduction contra-angle hand piece (W & H, Bürmoos, Austria). Before using PTN, as recommended by the manufacturer, a glide path was created using ProGlider (Dentsply Maillefer, Ballaigues, Switzerland).[20 (link)]
The following sequence of instrumentation was established with PTN instruments: X1, X2, and X3. Group A was instrumented with an alternating rotation motion of 150° clockwise (CW) followed by 30° counterclockwise (CCW) at a speed of 300 rpm.[21 (link)] Group B was instrumented with continuous rotation motion at a speed of 300 rpm, according to the manufacturer's instructions.
Instrumentation was completed using a gentle in- and out-motion. Instruments were withdrawn from the canal, and dentinal debris was cleaned with gauze soaked in saline when resistance was felt in their progression.[22 (link)] Canal irrigation was performed in both groups with 2 mL of 5.25% NaOCl after the use of each file. Each instrument was used to prepare three canals and was then discarded.
The following sequence of instrumentation was established with PTN instruments: X1, X2, and X3. Group A was instrumented with an alternating rotation motion of 150° clockwise (CW) followed by 30° counterclockwise (CCW) at a speed of 300 rpm.[21 (link)] Group B was instrumented with continuous rotation motion at a speed of 300 rpm, according to the manufacturer's instructions.
Instrumentation was completed using a gentle in- and out-motion. Instruments were withdrawn from the canal, and dentinal debris was cleaned with gauze soaked in saline when resistance was felt in their progression.[22 (link)] Canal irrigation was performed in both groups with 2 mL of 5.25% NaOCl after the use of each file. Each instrument was used to prepare three canals and was then discarded.
3
Intentional Instrument Separation in Root Canals
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Sample size was determined as in Experiment 1 (10 per group).
Forty mature extracted human teeth (mandibular anteriors or premolars) with a single root canal were used under a protocol approved by the Institutional Review Board of our institution (No. D2014-033). Root curvature was measured using Schneider's method,22 (link) and those with a curvature of 0–10° were used in this experiment.
After achieving patency using a #10 K-file (Zipperer, VDW), the teeth were decoronated to adjust their working length to 15 mm. Root canals were then instrumented to a size #16/0.02 taper using a NiTi glide path instrument (ProGlider, Dentsply Sirona) connected to an endodontic motor (X-Smart Plus, Dentsply Sirona) at 300 rpm/2.0 Ncm. Two milliliters of 3% sodium hypochlorite (NaOCl, Nippon Shika Yakuhin, Shimonoseki, Japan) was used as an irrigant during instrumentation. Then, a fragment of WaveOne Gold Primary instrument, 3 mm from the tip, was intentionally separated in each canal at 3 mm from the apical foramen. Saline was injected to confirm its outflow from the apical foramen through the broken segment. If a #10 K-file bypassed the broken instrument, the specimen was excluded. The position of the broken instruments was evaluated using radiography; only specimens with a fractured instrument retained at 3–4 mm from the apical foramen were included.
Forty mature extracted human teeth (mandibular anteriors or premolars) with a single root canal were used under a protocol approved by the Institutional Review Board of our institution (No. D2014-033). Root curvature was measured using Schneider's method,22 (link) and those with a curvature of 0–10° were used in this experiment.
After achieving patency using a #10 K-file (Zipperer, VDW), the teeth were decoronated to adjust their working length to 15 mm. Root canals were then instrumented to a size #16/0.02 taper using a NiTi glide path instrument (ProGlider, Dentsply Sirona) connected to an endodontic motor (X-Smart Plus, Dentsply Sirona) at 300 rpm/2.0 Ncm. Two milliliters of 3% sodium hypochlorite (NaOCl, Nippon Shika Yakuhin, Shimonoseki, Japan) was used as an irrigant during instrumentation. Then, a fragment of WaveOne Gold Primary instrument, 3 mm from the tip, was intentionally separated in each canal at 3 mm from the apical foramen. Saline was injected to confirm its outflow from the apical foramen through the broken segment. If a #10 K-file bypassed the broken instrument, the specimen was excluded. The position of the broken instruments was evaluated using radiography; only specimens with a fractured instrument retained at 3–4 mm from the apical foramen were included.
4
Glide Path Creation and Endodontic Preparation
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A glide path was created by using a ProGlider® instrument (Dentsply Sirona) (a size tip of 16 and progressive taper from 0.02 to 0.08) until the WL was reached. All files from the PTG system, which have a convex triangular cross section and progressive taper [24 (link)], were used up to the WL except the SX file, which was used only for coronal interference removal, in the sequence SX (19/0.04), S1 (18/0.02), S2 (20/0.04), F1 (20/0.07), and F2 (25/0.08). Patency was checked after the use of each instrument with K-file #10. The instruments were used for one tooth preparation; after that, they were discharged. Root canal irrigation was performed between each file with 5 mL of 5.25% NaOCl (Cerkamed, Stalowa Wola, Poland) for NT and 5 mL of distilled water for 3DPT using an Irriflex® (Produits dentaires SA, Vevey, Switzerland) needle and activated with an Endoactivator® at a high frequency with a small tip for 30 s. After preparation, the canals were irrigated two times with 5 mL of irrigant and activated with the Endoactivator® (Dentsply Sirona), so the total volume of irrigation for each canal was 40 mL. In the end, the canals were dried with paper points (Dentsply Sirona).
5
Standardized Endodontic Treatment Procedure
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All specimens underwent endodontic treatment, which was carried out by the same skilled operator with the working length set at 1 mm short of the apparent apical foramen. Proglider and ProTaper Next X1-X2 (Dentsply Maillefer, Ballaigues, Switzerland) were used to perform canal shaping. An amount of 5% NaOCl (Niclor 5, Ogna, Muggi, Italy) and 10% EDTA (Tubuliclean, Ogna, Milan, Italy) were alternately used for irrigation. Then, utilizing Down Pack (Hu-Friedy, Chicago, IL, USA) and an endodontic sealer (Pulp Canal Sealer EWT, Kerr, Orange, CA, USA), canals were obturated with gutta-percha points (GuttaPercha Points Medium, Inline, B.M. DentaleSas, Turin, Italy). Backfilling with gutta-percha (Obtura III system, Analytic Technologies, Redmond, WA, USA) was then performed [29 (link)].
6
NiTi Rotary System Root Canal Treatment
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A single operator performed the root canal procedure according to the manufacturer's instructions for each NiTi rotary system. Electric motor (X-Smart plus; Dentsply Maillefer) with a 16:1 reduction handpiece was used for mechanical instrumentation with NiTi rotary files. As a lubricating agent during instrumentation, Glyde (Dentsply Maillefer) was used. A glide path was performed using ProGlider (Dentsply Maillefer; size 16, 0.02 taper) file to the working length. Apical preparation was completed with a size 25 file using the file order specified by the manufacturer. During instrumentation, irrigation of the canals was done with 2 mL 5% NaOCl. After instrumentation, 1 mL of 17% ethylenediaminetetraacetic acid was applied for 3 min followed by final irrigation with 3 mL of NaOCl. Each instrument was used to prepare three canals and then discarded.
7
Endodontic Instrument Evaluation Study
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Sixteen 25 mm NiTi instruments were used in this study including 2 ProTaper Gold S1 (Dentsply Sirona, Ballaigues, Switzerland; LOT 1725638); 1 ProGlider (Dentsply Sirona, Ballaigues, Switzerland; LOT 1526881); 3 ProTaper Next X2 (Dentsply Sirona, Ballaigues, Switzerland; LOT 1784995); 1 EdgeOne Fire Primary (EdgeEndo, Johnson City, TN, USA; LOT 121719026); 5 Reciproc R25 (VDW, Munich, Germany; LOT 396896); 2 ProFile size 25, taper 0.06 (Dentsply Tulsa, Tulsa, OK, USA; LOT 1784996); 1 ProTaper Gold F2 (Dentsply Sirona, Ballaigues, Switzerland; LOT 1706721); and 1 ProTaper Universal F3 (Dentsply Maillefer, Ballaigues, Switzerland; LOT 4574420).
8
Endodontic Shaping Protocol with WaveOne Gold
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A single experienced operator performed all clinical procedures. The specimens were mounted on protrain (Simit Dental SRL, Italy). After access cavity preparation, distal root canals were shaped using the following protocol. Scouting and glide path were established using a # 10 K file and working length (WL) was determined using the conductive protrain gel and an electronic apex locator (Root ZX; J Morita Co, Kyoto, Japan). Then, the apex was sealed with a cyanoacrylate glue in order to achieve a closed system. Before shaping the root canal, a pre-enlargement was performed using ProGlider (Dentsply Sirona) with an endodontic engine (X-Smart-IQ motor, Dentsply Sirona) at 300 rpm and 4 Ncm at full WL. Each canal was shaped with WaveOne Gold Primary (Dentsply Sirona) using the WaveOne mode of X-Smart-IQ motor.
After every two pecking motions, the reciprocating file was removed from the canal and the flutes cleaned. The canals were then irrigated with 1 mL of 6% NaOCl for (35 ± 5) s, for a total of 3 mL of NaOCl per canal, using a 5-mL syringe (Coltene/Whaledent, Altstatten, Switzerland) with 31-gauge Navitip needles (Ultradent Products, South Jordan, UT, USA) and the apical patency rechecked. This sequence was recapitulated until reaching WL with WaveOne Gold Primary.
After every two pecking motions, the reciprocating file was removed from the canal and the flutes cleaned. The canals were then irrigated with 1 mL of 6% NaOCl for (35 ± 5) s, for a total of 3 mL of NaOCl per canal, using a 5-mL syringe (Coltene/Whaledent, Altstatten, Switzerland) with 31-gauge Navitip needles (Ultradent Products, South Jordan, UT, USA) and the apical patency rechecked. This sequence was recapitulated until reaching WL with WaveOne Gold Primary.
9
Endodontic Instrumentation Techniques
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Canals were instrumented by a single operator (Elnaghy AM) according to the manufacturers' instructions for each system. The files were operated using an electric motor (X-Smart; Dentsply Maillefer) with a 16:1 reduction handpiece. Glyde (Dentsply Maillefer) was used as a lubricant during instrumentation. A glide path was performed using ProGlider (Dentsply Maillefer; size 16, 0.02 taper) file to the working length. Apical preparation was completed with a size 25 file using the file order specified by the manufacturer. In both groups, the root canals were instrumented to the working length using the following sequence: SX, S1, S2, F1, and F2. In both systems, the first three shaping files were used with a brushing action, and the last two finishing files were used with a nonbrushing action until the working length was reached. During instrumentation, the canals were irrigated with 2 mL 5.25% NaOCl. After instrumentation, 1 mL of 17% ethylenediaminetetraacetic acid (Sigma-Aldrich, Riedel-de Haλn, Switzerland) was applied for 3 min followed by final irrigation with 3 mL of NaOCl. Each instrument was used to prepare three canals and then discarded.
10
Evaluating Torque and Apical Force in Simulated Root Canal Preparation
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A simulated straight canal in resin blocks (END3L001, Nissin Dental Products, Kyoto, Japan; 0.2 mm apical foramen diameter, 0.017 taper, and 14-mm length) was negotiated for a patency with a #10 stainless steel K-file (Zipperer, Munich, Germany) followed by a glide path preparation with a #15 stainless steel K-file in group RE R25, or a rotary instrument (ProGlider, Dentsply Maillefer, #16 and 0.02 taper) in groups WOG and WO Primary, according to the manufacturer instructions. An automated root-canal instrument and torque/force analyzing device, which has been described elsewhere 12) , was used to prepare canals. The handpiece of the X-SMART Plus motor was set to rotate in "WaveOne All" mode for WO and WOG Primary, and "Reciproc All" mode for RE R25. RC-Prep (Premier, Plymouth Meeting, PA, USA) was filled in the root canal as a lubricant during instrumentation, and the handpiece was programmed to move in a simulated pecking motion, that is downwards for 2 s and upwards for 1 s with a constant speed of 10 mm/min.
The torque and apical force generated in the blocks during preparation were detected through a torque/force measuring unit which was connected to a personal computer (Vaio VGF-FE, Sony), as described previously 12) . The maximum torque and apical force values were recorded and compared.
The torque and apical force generated in the blocks during preparation were detected through a torque/force measuring unit which was connected to a personal computer (Vaio VGF-FE, Sony), as described previously 12) . The maximum torque and apical force values were recorded and compared.
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