Incidência de fratura de limas reciprocantes (X1 Blue® e Reciproc®) com até três usos: um estudo retrospectivo

Abstract

Advances in root canal instrumentation, transitioning from manual files to automated nickel-titanium files, in pursuit of heightened clinical efficiency, continue to grapple with the challenge of file fractures. This complication is intertwined with various factors, encompassing operator experience, instrumentation technique, canal anatomy, and the number of file reuses, which remains a topic of controversy within the literature. Despite enhancements in metal alloys and heat treatment applied to these files, the incidence of fractures remains a pertinent issue in the field of endodontics. Therefore, the primary objective of this study is to assess the fracture incidence of reciprocating files, specifically examining instruments that have undergone up to three uses each, within a case series sourced from a private practice specializing in Endodontics. This retrospective study engages an analysis of medical records and radiographs encompassing patients treated over a span of 3 years, during which the X1 (MK Life, Porto Alegre, RS, Brazil) and Reciproc (VDW, Munich, Germany) file systems were utilized. The findings encompass a total of 1720 assessed root canals, with 76.6% treated using the R25 file and 23.4% utilizing the X1 25.06 file. Within this scope, six instances of file fractures were observed during the instrumentation process, accounting for 0.3% with R25 files and 0.5% with X1 files. Among these fractures, five occurred in the apical third of the canals, while one manifested within the middle third. In terms of dental categorization, one file fractured in an anterior tooth, another in a premolar, and four cases emerged in molars. Additionally, regarding the utilization frequency, four file fractures transpired during the initial usage, one during the second utilization, and another during the third usage. In summation, the documented incidence of fractures remains notably low. It was noted that molars were more susceptible to fractures due to their intricate anatomy. Furthermore, in the majority of instances, file fractures manifested following the initial use.