Aim: Complex anatomy of roots requires endodontic rotary instruments that respect and follow that anatomy. The purpose of this study was to compare the shaping ability of three engine-driven nickel-titanium instruments in severely curved simulated canals.
Materials and methods: Forty-eight severely curved simulated canals in resin blocks were prepared to an apical size of 25 using the following systems (n = 16 per group): ProTaper Universal (PTU), ProTaper NEXT (PTN), and WaveOne Primary (WO) (all Dentsply Maillefer, Ballaigues, Switzerland). Composite images were made from the superimposition of pre- and post-instrumentation images. The amount of resin removed by each system was measured by using a digital template and image analysis software. Shaping ability of each system was compared using different parameters: total resin removal, centering ability, canal transportation in the apical, middle and coronal third of canal. Preparation times were also recorded. The data were statistically analyzed by using analysis of variance, paired t-test, and Tukey\'s post hoc test.
Results: Canals prepared with PTN were better centered in the apical part than those prepared with WO and PTU (p < 0.05). WO removed significantly more resin at the outer aspect of the maximum point of curvature. WO and PTU caused similar canal transportations at 7 points out of 11 measuring points. At measuring points 3, 4, and 5 WO caused more canal straightening than PTU. Instrumentation with PTU required more time than with the two other instruments (p <0.05). No preparation error or instrument separation occurred.
Conclusion: In the apical part of the canals PTN obtained the best results with regard to canal transportation.
Clinical Significance: All of the rotary instruments were safe in preparing severely curved canals and PTN showed better preparation of apical part of the canal.
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