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121]

Review Article

Rotary science and its impact on instrument

separation: A focused review
Sandhya Anand Khasnis, Prem Prakash Kar, Apoorva Kamal, Jayaprakash D. Patil
Department of Conservative Dentistry and Endodontics, PMNM Dental College, Bagalkot, Karnataka, India

Abstract
Efficient endodontic treatment demands thorough debridement of the root canal system with minimal procedural errors.
The inherent weakness of nickel–titanium alloys is their unexpected breakage. Modifications in the design, manufacturing,
thermomechanical and surface treatment of alloys and advancements in movement kinetics have shown to improve the fatigue
properties of the alloys, reducing the incidence of separation. This review enlightens the impact of these factors on fatigue
properties of the alloy.
Keywords: Fatigue properties; movement kinetics; rotary design; thermally treated alloys

INTRODUCTION design, manufacturing process, and movement kinetics

Separation of rotary nickel–titanium (RNT) has been an
enigma to endodontists and practitioners since their
introduction by  Walia et al. in 1988.[1] The reported incidence
of separation of RNT is 1.3%–10% in the literature,[2,3] 44.3%
of which are attributed to cyclic fatigue and 55.7% to
torsional failure. Cyclic or flexural fatigue occurs when the
instrument rotates freely in a curved canal, with repeated
compression/tension cycles to the point of maximum
flexure to cause fracture of the instrument. Torsional
fatigue failure occurs in a narrow canal, when the tip of a
rotary file binds while the shank of the handpiece continues
to rotate exceeding the elastic limit of the file.[4] Separated
instrument compromises disinfection and obturation
protocols, leading to failure of endodontic treatment.[5]
Removal of RNT is not only challenging, but none of the
retrieval systems ensure 100% success rate.[6]
Hence, “To prevent rather to treat the breakage” is the
dictum among the clinicians. Improvements in instrument
Address for correspondence:
Dr. Sandhya Anand Khasnis, Department of
Conservative Dentistry and Endodontics, PMNM
Dental College, Bagalkot ‑ 587 101, Karnataka, India.
E‑mail: sandhya.khasnis@gmail.com
Date of submission : 27.08.2017
Review completed : 21.11.2017
Date of acceptance : 17.12.2017
Access this article online
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have been attempted to reduce the risk of separation.
This review provides an insight into scientific causes
of instrument separation, prevention strategies, and
clinical recommendations for safer and efficient rotary
endodontics.
MATERIALS AND METHODS
An electronic search was carried out using the following
keywords: “cyclic fatigue/torsional resistance of NiTi
rotary” to collect literature, from Journal of Endodontics,
International and Australian Endodontic Journal, Journal of
Conservative Dentistry, Endodontic Topics, from 2000-2017
July. The abstracts and full text of relevant articles were
obtained to collect comprehensive update on instrument
separation.
DISCUSSION
The review is discussed under the following headings:
• Abbreviations
• Ruddle’s classification
• Nickel–titanium (NiTi) metallurgy, phase transformation,
and properties
This is an open access journal, and articles are distributed under the terms
of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
License, which allows others to remix, tweak, and build upon the work
non-commercially, as long as appropriate credit is given and the new
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For reprints contact: reprints@medknow.com

How to cite this article: Khasnis SA, Kar PP, Kamal A, Patil JD.
DOI:
Rotary science and its impact on instrument separation: A focused
10.4103/JCD.JCD_240_17
review. J Conserv Dent 2018;21:116-24.

116 © 2018 Journal of Conservative Dentistry | Published by Wolters Kluwer - Medknow

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Khasnis, et al.: Instrument separation: An endodontic enigma

• Factors influencing separation Phase transformation and properties

a. Canal curvature
b.  Manufacturing process, heat and surface
treatments
c.  Rotary design which includes cross section, tip,
taper, pitch, radial land, rake angle, and helical angle
d.  Movement kinetics which includes torque,
rotational speed, rotation, reciprocation, and
adaptive motion.
Abbreviations
Cyclic fatigue resistance (CFR), torsional resistance (TR),
superelasticity (SE), shape memory (SM).
Clinically, NiTi exists as one of the three phases:
austenite, martensite, and an intermediate R‑Phase. Their
interconversion is a reversible phenomenon and is a function
of temperature and stress [Figure 1]. Transformation
temperature is influenced by the composition, impurities,
and heat treatment of the alloy, which in turn influences its
mechanical properties[10] [Figure 2].
Factors influencing the separation of rotary
files
Various factors have an impact on the fatigue properties of
rotary NiTi instruments [Table 2].

Clifford Ruddle’s classification of evolution of Fracture of instruments occurs commonly in the

rotary instruments apical one‑third where torsional and flexural stresses
First generation (the mid to late 90s)
Rotary files with passive cutting radial lands and fixed taper
such as 4% and 6% over the length of their cutting blades
are included. For example, profiles 0.04 and 0.06.[7]

Second generation (2001)
Files with active cutting edges, alternating cutting points,
multiple tapers on a single file and electropolished files are a
included; for example: RaCe, EndoSequence and ProTaper.

Third generation (2007)
Thermally treated alloys mark this generation. These alloys
exhibited superior flexibility and remarkable fatigue resistance;
for example: Twisted File, HyFlex® CM, and ProfileVortex.

Fourth generation (2008)
Introduction of reciprocation concept: Endo EZE, M4,
and reciprocating handpieces use equal clockwise/
counterclockwise angles of 300. Yared et  al. advocated
unequal angles of reciprocation; For example: Wave One b
and Reciproc. Self‑adjusting files by ReDent Nova, with
new design and mode of operation, serve as a conservative
approach for root canal preparation.

Fifth generation
Files with offset designs to reduce the screwing in and
breakage mark the fifth generation; for example; ProTaper
Next and Revo‑S.

Nickel–titanium metallurgy
Equiatomic NiTi has 56% Ni and 44% Ti. At this ratio,
NiTi alloys exhibit SE and SM. While SE endows the file
with superior flexibility to negotiate canal curvatures,
SM allows the file regain its original shape. The surface
of RNT has metallic nickel, oxygen, carbon, and oxides
of NiTi.[8] Decrease in the nickel content improves the
fatigue resistance of NiTi alloys. HyFlex® has 52 wt%
Ni (conventional RNT has 54%wt–57%wt), which lowers the
Af to 47°C.[9]
c
Figure 1: (a) Phase transformation of nickel–titanium alloy;
As: Austenitic start, Af: Austenitic finish, Ms: Martensitic
start, Mf: Martensitic finish. (b) Properties of conventional
rotary nickel–titanium (i) Conventional rotary file exhibiting
(ii) superelasticity when stressed in the canal, (iii) shape
memory when the stress is released. (c) Properties of
thermally treated rotary nickel–titanium alloy (i) Controlled
memory file, exhibiting (ii) superelasticity (iii) but no shape
memory when stress is released, also (iv) deformation under
stress and (v) regains shape on heating

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Khasnis, et al.: Instrument separation: An endodontic enigma

Table 1: Impact of surface treatment on properties of nickel‑titanium alloys

Surface treatment of alloy
Plasma ion implantation
Thermal nitridation
Cryogenic treatment
Electropolishing (reverse plating)
CFR: Cyclic fatigue resistance
Mechanism
Exposed to plasma by hot filament/inductively coupled plasma
Titanium nitride coating on alloy
Soaking in liquid nitrogen at−196°C/−320°F
Ionic dissolution of surface imperfections, coating of TiO2 on alloy
Properties
Increases the hardness, wear resistance
Increases corrosion resistance, cutting
efficiency in the presence of NaOCl
Increased strength, hardness and CFR
Corrosion resistance, improved CFR

are highest. Hence, torsional and bending tests are

performed at D3. [11] A flexible file has more CFR but
less TR and enables a smoother preparation in curved
canals without being deformed. Whereas, a rigid file
would be good in torsion than in flexion and performs
better in narrow, constricted canals. Thus, cyclic and
torsional properties are in inverse relationship with
each other.[12]

Canal curvature
As the radius of curvature of canal increases, the frequency
for instrument separation increases.[13] A canal with 50°
curvature gives rise to stress of about 700–800 MPa on the
outermost part of the instrument, whereas ultimate tensile Figure 2: Impact of phase transformation on the properties of
nickel–titanium alloys
strength of NiTi is 1400 MPa.[14]

Alloys with gold thermal treatment

Manufacturing process
Grinding versus twisting: In grinding, NiTi is cut across
grain of the crystalline structure which causes grooves
and microcracks, leading to stress concentration.[15] To
release these stresses or crystalline defects, annealing heat
treatment is given. It increases the flexibility and modifies
the phase transformation behavior.[16]
Thermal treatment of alloys
R‑phase alloys
R‑phase alloys have more flexibility, TR[11] and CFR[17] than
conventional alloys with the same geometry, in both dry
and aqueous environments,[18] and also when used in
reciprocating motion.[19] However, they have low TR than
M‑wire alloys.[20]
M‑wire alloys
They are produced by a series of heat treatment and
annealing cycles which endow them superior strength due
to stable nanocrystalline martensitic structure.[21]
Controlled memory alloys
Unlike conventional rotary files, controlled memory files
do not exhibit SM, and hence do not straighten the canal
or cause ledging [Figures 1b, c and 2]. Instruments with
low transformation temperature exhibit (Hero, K3) higher
maximum torque and resist fracture better than instruments
with high transformation temperature (Endowave, Profile,
and ProTaper).[21]
Files are subjected to a temperature of 370°C–510°C
for 10–60 min depending on the size and taper
of files. Files exhibit two‑stage transformation behavior
and high Af temperature of 50°C; for example ProTaper
Gold.
In WaveOne Gold, a constant strain of 3–15 kg is
applied at a temperature of 410°C–440°C. After
machining, the working portion is again heat treated
at 120°C–260°C. [22]
MaxWire alloys (Martensite‑Austenite Electropolish fleX)
alloys
This new technology allows the file XPendoShaper to
attain martensitic phase when cooled (20°C) and austenitic
phase at body temperature (37°C). At austenitic phase, it
has a snake‑like shape adapting to the canal irregularities,
reducing stress on the file.[23]
T‑wire alloys
The proprietary heat treatment claims to increase the
flexibility and fracture resistance by 40%; for example:
2 shape files, it has two rotary files TS1 and TS2.
The instruments regain their original shape after each
use.[24]
Thermally treated alloys have low modulus of elasticity
(20–40 GPa) than conventional (40–90 GPa) alloys and resist
fracture better under stress.[21]

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Khasnis, et al.: Instrument separation: An endodontic enigma

Table 2: Impact of various factors on cyclic fatigue and torsional resistance: A report of studies from 2010 to 2017
Rotary NiTi CFR TR
Manufacturing TF, Race, Helix, PT Kim et al., 2010[15]
process TF, Race Rodrigues et al., 2011[64]
K3, K4 Gambarini et al., 2011[65]
TF, Race Braga et al., 2013[11]
PTN, TF, Race Elsaka et al., 2014[20]
PTN, TF, PTU Elnaghy et al., 2014[66]
HyFlex® CM
ProDesign R, Reciproc, Unicone Alcalde et al., 2017[67] Same
Thermal Profile Vortex Gao et al., 2010[68]
treatment Profile, TYP‑CM Shen et al., 2011[69]
HyFlex® CM, Profile Ninan and Berzins, 2013[70]
GT Series‑X
TYP, TYP‑CM Campbell et al., 2014[71]
EndoWave, HyFlex®, Profile Vortex, TYP, PTU Braga et al., 2014[72]
PTU, Vortex Blue, Profile Vortex, TYP Pereira et al., 2015[73]
M‑wire alloy Bonessio et al., 2015[74]
PT, HyFlex®‑CM, One Shape, Revo‑S Capar et al., 2015[75]
PTN, One Shape Topçuoğlu et al., 2016[76]
HyFlex® CM, PTU
PT Gold, PTU Elnaghy and Elsaka, 2017[77] Same
Wave One, Wave One Gold Adıgüzel and Capar, 2017[78]
HyFlex® CM, TYP, Race, PT Acosta et al., 2017[79]
Surface BioRace Lopes et al., 2010[80]
treatment Vortex Blue, Profile Vortex Plotino et al., 2014[81]
PTU, PT Gold Hieawy et al., 2015[82]
HyFlex® EDM Pedulla et al., 2016[28] Same
BioRace Lopes et al., 2016[83]
Reciproc Blue, HyFlex® EDM, One Shape, Wave One Gold Gündoğar and Özyürek, 2017[84]
Cross section TF, Race, PT, Helix, Flexmaster Park et al., 2010[34]
M‑two, Mani NRT, Quantec, GT Zhang et al., 2010[14]
GT, GT Series X da Cunha Peixoto et al., 2010[85] da Cunha Peixoto et al., 2010[85]
Different cross sections Baek et al., 2011[12]
TF, Race, PT, Profile, M‑two Yum et al., 2011[86]
TF, Profile Vortex Endosequence Wycoff and Berzins, 2012[87]
Different cross sections Versluis et al., 2012[41]
Movement PT Patino et al., 2010[88]
kinetics Profile Vortex, Vortex Blue Gao et al., 2010[68]
PT De‑Deus et al., 2010[54]
K3, Profile, GT‑X, Safe Sider Wan et al., 2011[89]
TF Gambarini et al., 2012[90]
Reciproc, Wave One Kim et al., 2012[91] Same
Reciproc, Wave One Plotino et al.,2012[92]
K3XF Gambarini et al., 2012[93]
K3XF, Profile Vortex Gambarini et al., 2013[94]
K3, K3XF, TF Pérez‑Higueras et al., 2013[19]
Reciproc, Wave One, M2, TF Pedulla et al., 2013[95]
PT, Profile Lee et al., 2013[96]
Reciproc, Wave One De‑Deus G et al., 2014[97]
Race, M‑two Vadhana et al., 2014[98]
One Shape, Reciproc Wave One Dagna et al., 2014[35]
PT Shin et al., 2014[99]
Reciproc, Wave One, TF‑Adaptive Higuera et al., 2015[100]
One Shape, Wave One Karatas et al., 2016[101]
UnicOne, WaveOne, Reciproc La Silva et al., 2016[102]
Reciproc Arslan et al., 2016[103]
Reciproc Wave One, Wave One Gold Ozyurek, 2016[104]
PTN, M‑two, Wave One Varghese et al., 2016[105] Ferreira et al., 2017[106] (review)
TF: Twisted file, PT: ProTaper, PTN: ProTaper Next, PTU: ProTaper universal, TYP: Typhoon, CM: Controlled memory, CFR: Cyclic fatigue resistance, TR: Torsional resistance,
NiTi: Nickel‑titanium, EDM: Electric discharge machining

Surface treatment of nickel–titanium alloys
Rotary files are subjected to various surface treatments
to improve their properties [Table 1].[8] Implantation of
Argon ion increases the fatigue resistance. Nitrogen ion
implantation has negative effect on fatigue resistance.
Thermal nitridation at 250°C has shown more fatigue
resistance because at 300°C the superelastic behavior is
lost. Deep dry cryogenic treatment of 24  h, at  −185°C,
provides adequate time for transformation of retained
austenite to martensite, improving the fatigue life.[25,26]

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Khasnis, et al.: Instrument separation: An endodontic enigma
Electropolished instruments have more number of cycles to
fracture than that of nonpolished instruments.[8] However,
it does not prevent the development of microcracks on the
instrument surface.[8,27]
Electric discharge machining technology
Electric discharge machining (EDM) technology is a
noncontact thermal erosion process in which electric
sparks are used to melt and vaporize the top layer of
NiTi alloy, reducing the surface defects. This increases
the fracture resistance of files.[28] After cutting, cleaning
is done ultrasonically in an acid bath. Then, they are heat
treated at 300°C–600°C for 10 min, 5 h before and after the
cleaning;[22] for example: HyFlex® EDM
Blue phase treatment
In this, the surface of a NiTi alloy is treated with titanium
oxide by proprietary manufacturing process, which
increases the surface hardness,wear resistance, cutting
efficiency and flexibility of the file; for example: Vortex Blue
and Reciproc Blue.[10]
Design features related to instrument
separation
Cross‑sectional area
Rotary files are manufactured with different cross‑sectional
designs; for example: Convex triangle‑ProTaper, Wave One,
Triple U‑Profile, Equilateral triangle‑Race, S‑type‑M‑two,
Reciproc, and Rectangular–ProTaper Next
• Inner core and CSA: More the core and CSA, more is
the TR but less is the CFR.[12,29,30] This is the reason for
improved fracture resistance of ProTapers than profiles
in narrow canals[31]
• Cross‑sectional design: Instrument separation occurs
in the decreasing order with the following cross
sections
• Square  >  rectangular  >  triangular and slender
rectangular triangle[32,33]
• S‑shaped, H‑file fracture more compared to triangular
cross section[33]
• Alloy type: With the same cross section, M‑wire alloy
resists fracture better than conventional alloy[34]
• Different cross sections along the length of an
instrument improve the fracture resistance; for
example: One shape and WaveOne[35]
• Asymmetric cross sections of ProTaper Next and Revo‑S
also reduce screwing in and breakage[36]
• Protaper universal files (F2, F3, F4, F5) are made more
flexible by incorporating an additional groove in the
middle of side of convex triangular cross section.[31,36]
Tip
In general, NiTi rotary instruments are designed with
noncutting tips to prevent ledging, torsional failure, and
fracture.
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Booster tip is a lead tip, that is incorporated in
XPendoShaper. The lead section enters canal ensuring fit
into the pre-established glide path. There are no cutting
flutes on this section (¼ mm) where as the next ¼ mm has
6 cutting flutes, which shapes canal to #25/.02 to #60/.02
instrument. The repeated use of the shaper prepares the
canal to a taper size consistent with the intracanal dentinal
anatomy and hardness.[37]
Taper
Taper is increase in the diameter of file per mm increase
in length. Fixed taper files cause excessive screwing in and
taper lock than graduating or variable taper files.[36,38,39] An
instrument with larger taper and tip diameter is more likely
to fracture in a canal with more acute and coronally located
curvature.[40]
Pitch
It refers to the number of flutes per unit length of the file.
More the flutes on the file, lesser the pitch and more is the
fracture resistance of the file. Hence, it is recommended to
use a file with smaller pitch (more flutes) for both curved
and straight canals.[41]
Radial land
Radial land is a surface that projects axially from the
central axis between the flutes, it as far as the cutting
edges. Increased width of land increases the peripheral
strength and canal‑centering ability, but induces stresses
due to increased contact with the canal wall causing
fracture.[42] To balance these properties, K3 is designed
with two recessed and one full land: ProTaper and Race
lack radial lands.[36]
Rake angle
It is the angle formed by the cutting edge and cross‑section
taken perpendicular to the long axis of the instrument.
Slight positive rake angle is recommended to for both good
cutting action and reduced screwing in; for example: K3.
Helical angle
Helical angle is the angle that the cutting edge makes with
the long axis of the file. Varying the helical angle through
the working part has been shown to reduce the screwing
in tendency; for example; in K3, helical angle is increased
from tip to the handle. In Race, alternate helical design
reduces the torque.[42]
Movement kinetics
Torque
It is the force that is exerted on an object in rotation. It is
measured in gram centimeters.
In endodontics, torque is related to the apically directed
force and preoperative canal volume.
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Conventional or slow‑speed, high‑torque motors (>3 Ncm)
cause fracture of instruments in curved canals. Slow‑speed,
low‑torque motors provide the right torque for the specific
file.
The values are smaller (low torque) for smaller and less
tapered instruments and higher (high torque) for bigger
and more tapered instrument.[43]
Optimum torque reverse
It is based on the principle of torque‑provoked reversal,
which is activated when preset torque is exceeded
during   1800 forward rotation, and then the file rotates
backward   900 to release itself. It provides high cutting
effectiveness at very low torque values and moderate
speed. Files have shown better fatigue resistance in
Optimum Torque Reverse (OTR) motors.[44]
Safety quotient = RFT/MWT.
Where RFT – “Rotation to failure torque” is measured by
turning a file that has been grasped and immobilized at D3
at a constant revolutions per minute (rpm).
MWT – “Mean working torque”– the torque required for
any given NiTi to cut the dentin.
Ideally, safety quotient should be greater than one to
reduce the risk of file fracture.[45]
Higher is the torque, greater is the breakage. Torque is
higher in the following:
• Narrower canals,[46] large diameter file,[47‑49] acute
canal curvature,[48] and rotary instrumentation without
glidepath.[50]
Rotational speed (revolutions per minute)
The recommended rpm for most of the rotary files is
between 250–500 rpm.
Higher speed causes increased fracture of files due to the
following:
• Increased stress[13] and strain rate and decreased time
for stress relaxation
• Increased chance for taper lock[51]
• More heat is generated during conversion of austenite
to martensite, leading to precocious fatigue of the
metal.[52]
The inverse relationship between speed and torque
As speed increases, torque decreases, which compensates
for negative effect of increased speed on cyclic fatigue.
Hence, endodontic handpieces deliver low speeds for
higher working torque for the individual file to reduce
separation.[51]
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Khasnis, et al.: Instrument separation: An endodontic enigma
Rotation, reciprocation, and adaptive motion
Rotation
It is continuous clockwise rotation of file. Rotary files
undergo plastic deformation when their endurance limit is
exceeded. Endurance limit is the level of stress or strain
at which a file can be subjected to a virtual infinite cycles
without failure.
Reciprocation
It is defined as repeated CW/CCW movements of the file.
Reciprocation can be as follows:
• Complete: Reciprocating angles are same in both CW
and CCW directions
• Partial: It has angles of 3700 in cutting verse CW and
500 noncutting verse CCW
• Hybrid reciprocation: Here, the angles change
depending on the intracanal torque.
In reciprocation, the CW rotation changes to CCW before
the file is subjected to endurance limit, hence reducing the
risk of separation.[53] The reasons include, in reciprocation,
fatigue of file occurs at multiple sites, whereas in rotary,
a single site undergoes repeated fatigue. During one
reciprocation, i.e., CW/CCW motion, crack formed in the file
opens and closes once. A higher number of reciprocating
cycles are required to complete one full rotation, which
extends the CFR.[54]
Heat treatment[55] and reciprocating motion have been
shown to enhance the CFR of some rotary files, such as
ProTaper F2 and K3XF.[56]
Adaptive motion
The feature of this motor is that it changes
kinematics from an interrupted complete rotating
movement (6000 CW and 00 CCW) to a partial reciprocation
(3700 CW/ 500 CCW) according to the intracanal pressure.[53]
Adaptive motion does not improve the CFR.[57]
Other factors affecting fracture resistance
Fracture resistance is not affected by autoclaving of new
files in vitro[58,59] unlike during clinical use.[58] CM and R‑phase
alloys exhibited increased CFR on autoclaving.[59]
A rotary file is often subjected to a combination of torsional
and cyclic stresses in the canal. In vitro studies have shown
that torsional preloads increase the fatigue,[60] but improve
torsional strength,[61] where as cyclic preloads add to
tosional failure.[62]
Clinical recommendations for a safer rotary
• A generous access with flexible files for severe
curvatures and stiffer ones for straight canals
• Stick to the rpm and torque as recommended, no high
rpm for curvatures
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Khasnis, et al.: Instrument separation: An endodontic enigma
• Secure a patent glidepath. It takes off that extra torque
on the files
• Lubrication and light touch, follow the sequence of files
• Monitor the files before reuse, there is no SAFE
NUMBER
• Pecking motion for radial landed and brushing motion
for nonlanded files[40]
• Lateral brushing motion for oval canals[63]
• Small taper and tip diameter file for more coronal
and/or acute curves[40]
• Be selective for single‑visit cases
• Practice hybrid instrumentation, i.e., more than one
rotary system for individual case.
CONCLUSION
Selection of proper file by the clinician, for the individual
case, would balance the conflict between fatigue properties
of the alloy, enabling a more efficient preparation of the
canal with reduced risk of separation.
Acknowledgment
I would like to acknowledge Dr. Shrinivas S Vanaki,
Principal, PMNM Dental College, Bagalkot, for his constant
support and encouragement for the research work.
Also, I would like to thank Mr. Kotambari and Mr. Vijay,
Chief Librarians, for providing us with unmatching library
facilities for this exhaustive piece of research work.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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