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Micro-CT Evaluation of the Shaping Ability of

XP-endo Shaper, iRaCe and EdgeFile Systems
in Long Oval-Shaped Canals

Article in Journal of Endodontics · July 2017

DOI: 10.1016/j.joen.2017.09.008

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Micro–computed Tomographic Evaluation of the
Shaping Ability of XP-endo Shaper, iRaCe, and
EdgeFile Systems in Long Oval-shaped Canals
Marco A. Versiani, PhD, Kleber K.T. Carvalho, MSc, Jardel F. Mazzi-Chaves, MSc,
and Manoel D. Sousa-Neto, PhD
Abstract
Introduction: This study evaluated the shaping ability
of the XP-endo Shaper (FKG Dentaire SA, La Chaux-
de-Fonds, Switzerland), iRaCe (FKG Dentaire SA), and
EdgeFile (EdgeEndo, Albuquerque, NM) systems using
micro–computed tomographic (micro-CT) technology.
Methods: Thirty long oval-shaped canals from mandib-
ular incisors were matched anatomically using micro-CT
scanning (SkyScan1174v2; Bruker-microCT, Kontich,
Belgium) and distributed into 3 groups (n = 10) accord-
ing to the canal preparation protocol (ie, XP-endo
Shaper, iRaCe, and EdgeFile systems). Coregistered im-
ages, before and after preparation, were evaluated for
morphometric measurements of the volume, surface
area, structure model index (SMI), untouched walls,
area, perimeter, roundness, and diameter. Data were
statistically compared between groups using the 1-way
analysis of variance post hoc Tukey test and within groups
with the paired sample t test (a = 5%). Results: Within
groups, preparation significantly increased all tested pa-
rameters (P < .05). No statistical difference was
observed in the mean percentage increase of the volume
(〜52%) and surface area (10.8%–14.2%) or the mean
percentage of the remaining unprepared canal walls be-
tween groups (8.17%–9.83%) (P > .05). The XP-endo
Shaper significantly altered the overall geometry of
the root canal to a more conical shape (SMI = 2.59)
when compared with the other groups (P < .05). After
preparation protocols, changes in area, perimeter,
roundness, and minor and major diameters of the root
canals in the 5 mm of the root apex showed no differ-
ence between groups (P > .05). Conclusions: The XP-
endo Shaper, iRaCe, and EdgeFile systems showed a
similar shaping ability. Despite the XP-endo Shaper
had significantly altered the overall geometry of the
root canal to a more conical shape, neither technique
was capable of completely preparing the long oval-
shaped canals of mandibular incisors. (J Endod
2017;-:1–7)
From the Department of Restorative Dentistry, Dental School of Ribeir~ao Preto, University of S~ao Paulo, Ribeir~ao Preto, SP, Brazil.
Address requests for reprints to Dr Marco A. Versiani, Dental School of Ribeir~ao Preto, University of S~ao Paulo, Av do Cafe, s/n , Ribeir~ao Preto, SP, Brazil, CEP 14049-
904. E-mail address: marcoversiani@yahoo.com
0099-2399/$ - see front matter
Copyright ª 2017 American Association of Endodontists.
https://doi.org/10.1016/j.joen.2017.09.008
JOE — Volume -, Number -, - 2017
Basic Research—Technology
Key Words
Micro–computed tomography, nickel-titanium instruments, reciprocating motion, root
canal preparation, single-file system
T he main goal of root
canal preparation is to
remove the inner layer of
Significance
The concept of using a single nickel-titanium in-
strument to mechanically prepare the entire root
the dentin while allowing
canal is interesting because it may be cost-
the irrigant to reach the
effective and may shorten the learning curve for
entire length of the canal
practitioners to adopt the new technique. In this
space, eradicating bacte-
study, the single-file XP-endo Shaper showed a
rial populations or at least
similar shaping ability as the EdgeFile and iRaCe
reducing them to levels
multiple-file systems.
that allow for periradicu-
lar tissue healing (1, 2).
However, it is widely recognized that fulfilling this goal with the available endodontic
armamentarium may be a challenging task when preparing flattened or oval-shaped
root canals (2–5). Therefore, to make canal shaping more efficient and predictable,
several nickel-titanium (NiTi) instruments with an optimal geometry and surface
have been developed within the last decades.
The iRaCe system (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) was intro-
duced as a simplified sequence of the original RaCe system (FKG Dentaire SA). Its
active cutting regions are electrochemically polished and have twisted areas with
alternating cutting edges (6). Research findings on iRaCe instruments have shown
some advantageous properties compared with other systems regarding the mainte-
nance of the canal curvature (7). In recent years, the EdgeEndo company (Albuquer-
que, NM) has launched 4 different constant tapered systems (X1, X3, X5, and X7) to
be used with the same handpiece, speed, kinematics, and torque as their specified
competitor’s recommended settings. The reciprocating (X1) and rotary (X3, X5,
and X7) instruments are made of an annealed heat treated NiTi alloy brand named
Fire-Wire (EdgeEndo), which has been claimed to increase the cyclic fatigue resis-
tance and torque strength of the instruments (8). More recently, a new file system
known as the XP-endo Shaper (FKG Dentaire SA) was introduced. This snake-
shaped instrument is made of a proprietary alloy (MaxWire [FKG Dentaire SA]
[Martensite-Austenite electropolish-fleX]) that reacts at different temperature levels
(9). The file has an initial taper of .01 in its M phase when it is cooled, but, upon
exposure to body temperature (35 C), the taper changes to .04 according to the mo-
lecular memory of the A phase (10). As stated by the manufacturer, the tip of the XP-
Shaping Ability of NiTi Systems 1
Basic Research—Technology
endo Shaper, the Booster Tip, has 6 cutting edges and enables the in-

P value
strument to start shaping after a glide path of at least ISO 15 and to

1.40
.57
.63
.30
.83
.40
.07
.22
.41
.68
.04

.09
gradually increase its working field to achieve ISO 30 (9).
Several methodologies were developed to evaluate the shaping
ability of NiTi systems, but currently 3-dimensional nondestructive
high-resolution X-ray micro–computed tomographic (micro-CT) imag-

38.4 (25.6–104.0)
20.60 (18.6–21.7)
3.05 (1.68–3.76)

32.77 (23.7–44.5)
36.05 (26.6–48.6)
Median (range)
ing is considered the gold standard (11). Even though there is accumu-

12.0 (6.2–22.9)

12.7 (8.6–37.0)
7.47 (2.0–30.0)
3.78 (2.9–5.7)
6.05 (4.1–7.6)

1.91 (1.3–2.3)
2.31 (1.8–2.6)
Group 3 (EdgeFile, n = 10)
lating evidence on the efficacy of several rotary and reciprocating
systems, comprehensive knowledge regarding the shaping ability of
the XP-endo Shaper, iRaCe, and EdgeFile (EdgeEndo) systems is still
lacking. Therefore, the purpose of this ex vivo study was to evaluate
the shaping ability of these instruments in long oval-shaped root canals
of mandibular incisors using micro-CT imaging technology.

2.28 ± 0.30b
20.30  0.98
2.76  0.68

6.17  1.28
52.2  28.1
34.01  7.15
38.24  7.72

1.96  0.32

17.7  10.9
9.83  8.18
Mean ± SD

4.13  1.0

12.7  5.9
Material and Methods
Tooth Specimen Selection and Groups

TABLE 1. Pre- and Postoperative Parameters Evaluated in the Root Canal System of 30 Mandibular Incisors after Different Root Canal Preparation Protocols
After local ethics committee approval, 100 noncarious, straight,
single-rooted human mandibular incisors with fully formed apices

21.55 (20.6–22.8)
2.93 (1.73–3.84)

44.9 (25.6–90.5)
34.77 (25.8–60.1)
37.54 (30.2–66.7)
were randomly selected from a pool of extracted teeth, mounted on a

Median (range)

6.04 (4.7–12.2)

14.3 (7.3–22.3)

19.9 (9.9–86.5)
6.65 (3.8–14.5)
4.10 (3.4–8.4)

1.94 (1.5–2.5)
2.36 (1.8–2.6)
custom attachment, and imaged separately at an isotropic resolution
of 26.7 mm using a micro-CT device (SkyScan 1174v.2; Bruker mi-

Group 2 (i-RaCe, n = 10)

croCT, Kontich, Belgium). The scanner parameters were set at 50 kV,
800 mA, 180 rotation around the vertical axis, and a rotation step of
0.7 using a 1-mm-thick aluminum filter. The acquired projection im-
ages were reconstructed into cross-sectional slices using NRecon

Bold values with different superscript letters in the same line indicate a statistically significant difference between groups (1-way analysis of variance, P < .05).
v.1.6.9 software (Bruker-microCT) with a beam hardening correction

2.34 ± 0.28a,b
35.72  10.04
40.73  11.23
of 10%, smoothing of 3, ring artifact correction of 3, and an attenuation
Mean ± SD
21.58  0.74
2.81  0.75
4.39  1.52
6.65  2.23
52.5  21.9

2.02  0.42

18.1  22.8
8.17  4.01
14.2  4.8
coefficient ranging from 0.002 to 0.120.
Preoperative 3-dimensional (3D) models of the root and root ca-
nals were rendered (CTVol v.2.2.1, Bruker microCT) for qualitative
evaluation of the canal configuration. Then, 3D and 2-dimensional
(2D) parameters of the root canals were calculated according to a pre-
vious publication (12) using CTAn v.1.14.4 software (Bruker mi-
21.84 (18.1–22.8)
2.59 (1.55–3.40)

52.1 (22.1–82.0)
32.93 (22.2–43.4)
38.67 (24.5–45.6)
Group 1 (XP-endo Shaper, n = 10)
Median (range)

9.8 (1.5–24.9)

19.9 (9.9–86.5)
5.88 (2.6–23.2)
croCT). 3D measurements (root canal length, volume, surface area,
3.67 (2.4–7.8)
6.18 (3.4–9.6)

2.24 (1.2–2.5)
2.68 (2.1–2.8)
and the structure model index [SMI]) were based on a surface-
rendered volume model of the root canal in the 3D space extending
from the cementoenamel junction level on the buccal aspect of the
root to the apex, whereas 2D morphometry (area, perimeter, round-
ness, and minor and major diameters) was performed at a 1-mm
interval in the 5 mm of the root apex on individual binarized cross-
sectional images of the root canal starting 0.5 mm from the apical fo-
2.59 ± 0.25a
21.28  1.68
2.55  0.52
4.26  1.59
6.35  1.77
52.9  19.0
33.44  6.74
36.77  6.67

2.11  0.42

26.2  22.8
9.42  7.67
Mean ± SD

10.8  7.1

ramen. The canal shape was classified by calculating the mean aspect
ratio, defined as the ratio of the major to the minor diameter, of all slices
in the 10 mm of the root apex. A canal was identified as a long oval-
shaped canal when the ratio of the long to short canal diameter was
>2 (ie, when 1 dimension was at least 2 times that of a measurement
made at right angles) (13).
Increase (D%)

Increase (D%)

Increase (D%)
Before (mm3)

Before (mm2)

Aiming to enhance the internal validity of the experiment, 30

Before (mm)

After (mm3)

After (mm2)

mandibular incisors with a single long oval-shaped root canal were

After (%)
SD, standard deviation; SMI, structure model index.

selected and matched to create 10 groups of 3 teeth based on the

Before

Before
After

morphologic aspects of the root canal systems. Then, 1 tooth from

Parameters

each group was randomly assigned to 1 of the 3 experimental groups

(n = 10) according to the canal preparation protocol (ie, XP-endo
Shaper, iRaCe, or EdgeFile). After checking the normality assumption
Unprepared area

(Shapiro-Wilk test) and homoscedasticity (Levene test), the degree of

Surface area

homogeneity (baseline) of the 3 groups with respect to the 2D (area,

Aspect ratio

perimeter, roundness, and diameter) and 3D root canal (length, vol-

Volume
Length

ume, surface area, and SMI) morphometric parameters was statistically

SMI

confirmed at a significance level of 5% (P > .05, 1-way analysis of vari-

ance test) (Tables 1 and 2).

2 Versiani et al. JOE — Volume -, Number -, - 2017

JOE — Volume -, Number -, - 2017

TABLE 2. Pre- and Postoperative 2-dimensional Parameters Evaluated in the Root Canal System of 30 Mandibular Incisors after Different Root Canal Preparation Protocols
Group 1 (XP-endo
Shaper) Group 2 (i-RaCe) Group 3 (EdgeFile) Group 1 (XP-Shaper) Group 2 (i-RaCe) Group 3 (EdgeFile)
Levels Before preparation After preparation
Area (mm2)
WL – 5 0.22  0.06 0.22  0.08 0.23  0.09 0.36  0.07 0.35  0.09 0.39  0.08
WL – 4 0.17  0.05 0.17  0.08 0.19  0.08 0.28  0.06 0.28  0.07 0.30  0.06
WL – 3 0.12  0.04 0.12  0.06 0.12  0.06 0.19  0.05 0.20  0.06 0.22  0.04
WL – 2 0.07  0.02 0.08  0.05 0.08  0.03 0.13  0.03 0.15  0.04 0.15  0.03
WL – 1 0.06  0.01 0.06  0.03 0.06  0.02 0.11  0.02 0.11  0.04 0.11  0.02
WL 0.06  0.03 0.07  0.04 0.06  0.02 0.10  0.04 0.10  0.04 0.09  0.03
Perimeter (mm)
WL – 5 2.19  0.46 2.30  0.71 2.41  0.80 2.40  0.30 2.67  0.68 2.78  0.68
WL – 4 1.85  0.37 1.81  0.53 1.95  0.67 2.10  0.26 2.27  0.51 2.33  0.54
WL – 3 1.45  0.36 1.40  0.42 1.48  0.52 1.70  0.26 1.81  0.37 1.91  0.40
WL – 2 1.14  0.17 1.20  0.38 1.19  0.41 1.41  0.19 1.52  0.28 1.53  0.31
WL – 1 1.01  0.13 0.97  0.27 1.03  0.34 1.28  0.21 1.25  0.29 1.32  0.27
WL 0.98  0.30 1.03  0.30 1.00  0.17 1.21  0.27 1.24  0.26 1.18  0.19
Roundness (mm)
WL – 5 0.39  0.13 0.37  0.20 0.34  0.12 0.62  0.12 0.50  0.20 0.51  0.16
WL – 4 0.45  0.17 0.43  0.18 0.44  0.15 0.63  0.14 0.56  0.19 0.59  0.20
WL – 3 0.53  0.20 0.50  0.15 0.52  0.16 0.72  0.12 0.62  0.15 0.66  0.20
WL – 2 0.49  0.18 0.52  0.17 0.55  0.23 0.74  0.14 0.71  0.18 0.70  0.22
WL – 1 0.44  0.13 0.57  0.20 0.53  0.24 0.67  0.17 0.74  0.16 0.68  0.20
WL 0.63 ± 0.16 0.57 ± 0.10 0.58 ± 0.11 0.64 ± 0.15 0.61 ± 0.10 0.59 ± 0.13
Minor diameter (mm)
WL – 5 0.36  0.08 0.31  0.11 0.32  0.05 0.61  0.05 0.58  0.05 0.60  0.04
WL – 4 0.31  0.06 0.29  0.08 0.32  0.02 0.55  0.05 0.53  0.02 0.53  0.05
WL – 3 0.28  0.07 0.27  0.07 0.28  0.04 0.47  0.07 0.45  0.04 0.48  0.05

Basic Research—Technology
WL – 2 0.24  0.05 0.24  0.07 0.24  0.05 0.40  0.04 0.40  0.03 0.41  0.05
WL – 1 0.19  0.05 0.21  0.07 0.21  0.07 0.34  0.04 0.33  0.03 0.33  0.02
WL 0.23  0.05 0.23  0.08 0.23  0.05 0.30  0.07 0.30  0.07 0.28  0.07
Major diameter (mm)
WL – 5 0.88  0.20 0.94  0.33 0.97  0.33 0.87  0.15 1.01  0.32 1.04  0.31
WL – 4 0.73  0.18 0.72  0.24 0.77  0.29 0.76  0.13 0.83  0.23 0.85  0.26
WL – 3 0.56  0.18 0.55  0.19 0.57  0.24 0.59  0.11 0.65  0.17 0.68  0.20
Shaping Ability of NiTi Systems

WL – 2 0.45  0.09 0.47  0.18 0.46  0.20 0.49  0.09 0.54  0.15 0.55  0.17
WL – 1 0.41  0.06 0.37  0.12 0.40  0.16 0.46  0.11 0.44  0.13 0.48  0.14
WL 0.36  0.13 0.39  0.11 0.38  0.07 0.45  0.12 0.46  0.09 0.44  0.07

WL, working length.

Bold values indicate no statistical difference within groups (paired sample t test, P > .05).
3
Basic Research—Technology
Root Canal Preparation
Conventional access cavities were prepared, canals were accessed,
and patency was confirmed with a size 10 K-file (FKG Dentaire SA). When
the tip of the instrument was visible through the main foramen, 0.5 mm
was subtracted to determine the working length (WL). No coronal flaring
was performed, and a glide path was achieved to the WL with a size 15 K-
file (FKG Dentaire SA). Then, root canal preparations were performed by
previously trained operators in each system. In group 1 (n = 10), the tip
of the XP-endo Shaper instrument was inserted into the canal, and the
instrument was activated in the rotate mode (Rooter, FKG Dentaire SA;
800 rpm and 1.0 Ncm), applying long and light up-and-down move-
ments. Once it reached the WL, 5 more up-and-down movements were
applied over the entire WL, and the instrument was removed from the ca-
nal while it was rotating. In group 2, iRaCe R1 (15/.06), R2 (25/.04), and
R3 (30/.04) instruments were sequentially used in rotary motion up to
the WL (FKG Rooter motor, 600 rpm and 1.5 Ncm). In group 3, the Edge-
File X1 instrument (25/.06) was activated in reciprocating motion using
the WaveOne motor setting (VDW Silver motor; VDW GmbH, Munich,
Germany) until it reached the WL. The final apical preparation was
then performed using the EdgeFile X7 rotary instrument (30/.04)
(VDW Silver motor; 350 rpm and 3 Ncm). In the iRace and EdgeFile
groups, after instruments had negotiated to the WL, they were used
with a light brushing motion. Irrigation was performed throughout the
preparation procedure with a total of 18 mL of a preheated 2.5% sodium
hypochlorite solution (38 C  1 C) delivered using a 30-G NaviTip nee-
dle (Ultradent, South Jordan, UT) adapted to a disposable plastic syringe
placed up to 2 mm short of the WL, with a gentle in-and-out movement. In
all groups, the preparation protocol was repeated over the entire length
of the canal until a size 30/.04 gutta-percha master point fit at the WL.
Then, canals were flushed with 3 mL 17% EDTA (5 minutes), 3 mL so-
Figure 1. Mesial and buccal 3D reconstructions and cross-sectional views of the coronal (c), middle (m), and apical (a) thirds of 2 representative mandibular
incisors before (in green) and after (in red) preparation in each experimental group. Canals presenting a more flatlike geometry or a larger buccolingual extension
showed more areas of untouched canal walls after preparation.
4 Versiani et al.
dium hypochlorite 2.5% (5 minutes), and 2 mL distilled water (1 minute)
and dried with paper points. Roots were then submitted to a postopera-
tive scan and reconstruction applying the initial parameter settings.
Micro-CT Analysis
Pre- and postoperative models of the canals were rendered with
CTAn v.1.14.4 software and coregistered with their respective preoper-
ative data sets using the rigid registration module of the 3D Slicer 4.3.1
software (available from http://www.slicer.org). A qualitative compari-
son between groups was performed using color-coded models of the
matched root canals (green and red colors indicate pre- and postoper-
ative canal surfaces) with CTVol v.2.2.1 software (Bruker microCT)
(Fig. 1).
Postoperative parameters (volume, surface area, SMI, area,
perimeter, roundness, and minor and major diameters) were acquired
with CTAn v.1.14.4 software (12). Then, the increment in diameter per
millimeter in the apical canal (taper) was determined before and after
preparation in both the mesiodistal and buccolingual directions. The
mean percentage increases (D%) of the volume, surface area, and
SMI parameters were calculated according to the formula ([Pa–Pb]/
Pb)*100, where Pb and Pa represent the parameters’ values assessed
before and after preparation, respectively. Spatially registered surface
models of the roots were also compared regarding the unprepared
area of the root canal, which was calculated by using the distances be-
tween the surface of the root canals before and after preparation deter-
mined at every surface point (14). Then, the percentage of the
remaining unprepared surface area was calculated using the formula
(Au/Ab)*100, where Au represents the unprepared canal area and Ab
the root canal area before preparation (14). An examiner blinded to
the preparation protocols performed the analyses.
JOE — Volume -, Number -, - 2017

Statistical Analysis
Data were normally (Shapiro-Wilk test) and homoscedastically
(Levene test) distributed regarding the canal length, surface area,
SMI, area, perimeter, roundness, and diameter and compared between
groups using the 1-way analysis of variance post hoc Tukey test, whereas
the statistical analyses of the volume and untouched canal walls were
performed with the Kruskal-Wallis test. The paired sample t test was
used to compare the pre- and postpreparation parameters within
groups. The significance level was set at 95% (SPSS v17.0; SPSS Inc,
Chicago, IL).
Results
Tables 1 and 2 display the analysis of the tested 3D (canal length,
volume, surface area, SMI, and unprepared area) and 2D (area,
perimeter, roundness, and minor and major diameters) parameters,
respectively, before and after root canal preparation of 30 mandibular
incisors using different systems. In general, the preparation protocols
significantly increased all measured parameters in each group
(P < .05). Qualitative evaluation, displayed as superimpositions of
unprepared (green) and prepared (red) areas, showed that all
groups maintained the overall canal shape. Canals presenting a more
flatlike geometry or a larger buccolingual extension showed more
areas of untouched canal walls after preparation (Fig. 1).
No statistical difference was observed between groups regarding
the mean percentage increase of the volume (〜52%) and surface
area (10.8%–14.2%) or the mean percentage of the remaining unpre-
pared surface area (8.17%–9.83%) (Table 1, P > .05). Regarding the
percentage increase of the SMI parameter, the XP-endo Shaper system
significantly altered the overall 3D geometry of the root canal (SMI) to a
more conical shape (2.59) when compared with the iRaCe (2.34) and
EdgeFile (2.28) systems (Table 1, P < .05). A comparison of the 2D
morphometric parameters of the root canals in the 5 mm of the root
apex showed no difference between groups (Table 2, P > .05). After
Figure 2. The mean apical canal taper determined before and after preparation with the XP-endo Shaper, iRaCe, and EdgeFile systems in both the mesiodistal and
buccolingual directions. In the mesiodistal direction, the mean taper increased 3 times in all groups, whereas no significant variation was observed in the bucco-
lingual direction.
JOE — Volume -, Number -, - 2017
Basic Research—Technology
preparation, the mean apical canal taper increased 3 times in the me-
siodistal direction in all groups (from .02–.06), whereas no significant
variation was observed in the buccolingual direction (Fig. 2).
Discussion
This study evaluated the effects of 2 recently launched preparation
systems (XP-endo Shaper and EdgeFile) on root canal geometry using
micro-CT technology. The iRaCe rotary system was used as a reference
technique for comparison. Despite dissimilarities in the cross-sectional
design and kinematics reported to affect the shaping ability of NiTi prep-
aration systems (2, 3, 15, 16), a comparison between groups after
preparation revealed no differences in the percentage increase of the
volume and surface area, the unprepared canal surfaces, and some
2D parameters (area, perimeter, roundness, and diameter) in this
study. These results may be explained by the mode action of the XP-
endo Shaper and the similar dimensions of the final instruments used
in the other experimental groups. The manufacturer has claimed that
the NiTi alloy that the XP-endo Shaper is made of can shift its crystalline
structure at body temperature to adapt to the root canal wall (9). Oper-
ating at 800 rpm, its adaptive core design (ISO size 30/.01) is able to
start shaping a root canal at ISO size 15 and to achieve ISO size 30,
and also increase the taper from .01 to at least .04, reaching a final canal
preparation of a minimum 30/.04 in size (17, 18), which are the
dimensions of the final instruments used in the EdgeFile and iRace
groups.
The surface convexity (3D geometry) of the root canal and the
cross-sectional shape at the apical third in this study were evaluated us-
ing SMI and roundness morphometric parameters. An ideal plate, cyl-
inder, and sphere have SMI values of 0, 3, and 4, respectively (19),
whereas the roundness value of a discreet 2D object ranges from
0 to 1, with 0 signifying a line and 1 a perfect circle (12). At the apical
third, the similarity of the groups regarding the roundness values after
preparation (Table 2) can be justified because the root canals used to
Shaping Ability of NiTi Systems 5
Basic Research—Technology
be anatomically more round in shape at this level (13). Additionally, as
it would be expected after using tapered rotary and reciprocating instru-
ments, the increasing of the SMI values showed that the long oval-
shaped root canals became more cone frustum shaped after prepara-
tion. Interestingly, despite its specific preset shape, small diameter,
and narrow taper, the XP-endo Shaper instrument significantly changed
the root canal to a more conical shape (SMI = 2.59) than the EdgeFile
(SMI = 2.28) and iRace (SMI = 2.34) systems (Table 1). This may be
explained because the XP-endo Shaper instrument must be activated at a
high rotational speed using long up-and-down movements throughout
canal preparation (10, 17, 18).
Even with the progress made with the development of NiTi instru-
ments with different metallurgical properties and geometric designs, in
this study the quality of the root canal preparation was less than ideal. In
agreement with previous reports (3–5, 20), all tested systems have left a
relatively high mean percentage of untouched canal walls (8.17%–
9.83%), mostly when the canal shape had a flatlike geometry, which
confirms a previous statement that variations in canal geometry before
shaping procedures have more influence on the changes that
occurred during preparation than the instrumentation techniques
themselves (11). Untouched areas in necrotic canals may harbor unaf-
fected residual bacterial biofilms and serve as a potential cause of persis-
tent infection (4, 21). Considering that the remaining infection is an
important risk factor for post-treatment apical periodontitis, chemome-
chanical preparation assumes a pivotal role in treatment because it acts
mechanically and chemically on bacterial communities colonizing the
main canal (1, 4, 21). The mean range of the untouched canal areas
in this study was lower compared with previous reports using a
similar methodology (15, 16), probably because of the differences in
the sampling approaches and the preparation protocols; however, no
difference was observed among the experimental groups, possibly
because of the light brushing motion used after the iRaCe and
EdgeFile instruments reached the WL (2).
In the present study, the major diameter of the root canal was
defined as the distance between the 2 most distant pixels in the binarized
canal image, whereas the minor diameter was the longest chord through
the root canal that could be drawn in the direction orthogonal to that of
the major diameter (12). After preparation, the minor and major diam-
eters at the apical canal increased from 0.23–0.30 mm and from 0.36–
0.45, respectively (Table 2). This means that the final preparation diam-
eter at the WL was equivalent to ISO sizes 30 and 45 in the mesiodistal
and buccolingual directions, respectively, which may be also explained
by the brushing motion used with the final instruments. On the other
hand, the average canal taper increased mostly in the mesiobuccal di-
rection, but, as it would be expected after using constant tapered instru-
ments, a continuous taper increasing progressively from the apical to
the coronal direction was not possible to be observed (Fig. 2). This
may be explained by anatomic irregularities on the original shape of
the root canal system, which avoid instruments to touch all canal wall
surfaces (Fig. 1 and Table 1).
The key role of laboratory-based studies is to develop well-
controlled conditions that can reliably compare certain factors (5).
Therefore, in the present study, care was taken to ensure that the sample
was anatomically matched in terms of preoperative geometric parame-
ters determined by micro-CT imaging (15). This procedure creates a
reliable baseline and ensures the comparability of the groups by stan-
dardization of the canal morphology in each sample, enhancing internal
validity and potentially eliminating significant anatomic biases that may
confound the outcomes (12). In addition, long oval-shaped canals were
selected because this anatomic variation has been considered a difficult
challenge in clinical practice (13, 22), and root canals were prepared
by dentists with expertise in each 1 of the tested protocols (23).
6 Versiani et al.
The concept of using a single NiTi instrument to prepare the entire
root canal was proposed a few years ago (24). In several clinical situ-
ations, this is an interesting proposal because it may be cost-effective
and may shorten the learning curve for practitioners to adopt the
new technique. Lately, several manufacturers have been developing in-
struments following this ‘‘one file shaper’’ proposal, such as the Self-
Adjusting File (ReDent-Nova, Ra’anana, Israel), Reciproc (VDW), and
WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) systems (5).
In this study, the single-file XP-endo Shaper was as effective in preparing
long oval-shaped canals of mandibular incisors as the other tested
multiple-file systems. However, it was unable to reach areas that the
other instruments could not access despite its extreme flexibility and ca-
pacity to contract and expand within the root canal, as stated by the
manufacturer (9). Nonetheless, it is also important to point out that
in this study the XP-endo Shaper protocol was finished when a size
30/.04 gutta-percha master point fit at the WL, which happened very
fast in most of the samples as soon as the instrument reached the WL
and 5 more up-and-down movements were applied. Therefore, it is
plausible to hypothesize that the shaping ability of the XP-endo Shaper
could be optimized by increasing the preparation time, the number of
up-and-down movements, and/or its rotational speed. This remains to
be determined by further studies.
Conclusions
Within the limitations of this study, it can be concluded that the
XP-endo Shaper, iRaCe, and EdgeFile systems showed a similar shaping
ability. Despite the XP-endo Shaper system significantly altering the
overall geometry of the root canal to a more conical shape, neither tech-
nique was capable of completely preparing the long oval-shaped canals
of mandibular incisors.
Acknowledgments
The authors deny any conflicts of interest related to this study.
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