Current Challenges and Concepts of the Thermomechanical Treatment of Nickel-Titanium Instruments

IntroductionThe performance and mechanical properties of nickel-titanium (NiTi) instruments are influenced by factors such as cross-section, flute design, raw material, and manufacturing processes. Many improvements have been proposed by manufacturers during the past decade to provide clinicians with safer and more efficient instruments.MethodsThe mechanical performance of NiTi alloys is sensitive to their microstructure and associated thermomechanical treatment history. Heat treatment or thermal processing is one of the most fundamental approaches toward adjusting the transition temperature in NiTi alloy, which affects the fatigue resistance of NiTi endodontic files. The newly developed NiTi instruments made from controlled memory wire, M-Wire (Dentsply Tulsa Dental Specialties, Tulsa, OK), or R-phase wire represent the next generation of NiTi alloys with improved flexibility and fatigue resistance. The advantages of NiTi files for canal cleaning and shaping are decreased canal transportation and ledging, a reduced risk of file fracture, and faster and more efficient instrumentation. The clinician must understand the nature of different NiTi raw materials and their impact on instrument performance because many new instruments are introduced on a regular basis.ResultsThis review summarizes the metallurgical properties of next-generation NiTi instruments, the impact of thermomechanical treatment on instrument flexibility, and the resistance to cyclic fatigue and torsion.ConclusionsThe aim of this review was to provide clinicians with the knowledge necessary for evidence-based practices, maximizing the benefits from the selection and application of NiTi rotary instruments for root canal treatment.