The Current Trends and usage of Nickel-Titanium Engine-driven Endodontic Instruments: A multicenter Survey

Abstract

Background: Due to their properties, Nickle-titanium (NiTi) alloys are used in manufacturing of endodontic instruments, especially rotaries. The first rotary 0.02 taper NiTi was designed by Dr. John MacSpadden and came to the market in 1992. Over the years, NiTi engine-driven instruments (NiTi-EIs) have evolved, and many changes are done to it from the first generation until the fifth generation. Heat-treated metal, different types of motion (rotation, reciprocating and adoptive), and different tapering with different rake angles.

Aim: This questionnaire-based study aimed to assess the extent of adoption, usage, and improvement associated with NiTi-EIs and techniques in endodontists and postgraduate endodontic residents in Kuwait and the United Arab Emirates (UAE), and it was an anonymous survey.

Materials and Methods: A cross-sectional survey of 75 endodontists from Kuwait and the UAE was conducted. Statistical analysis was carried out using Chi-square, t-test, ANOVA, and Pearson’s correlation test. Questions related to the knowledge and practice of NiTi instruments usage and modalities were tabled and cross-tabulated against demographic variables. Statistical significance was set as p <0.05.

Results: The 97% of Kuwait’s participants are using NiTi-EIs in more than 90% of their cases, while in UAE, the percentage was 73%, with a significant difference (p=0.006). In Kuwait,60.6% of the participants preferred NaOCl as a lubricant, while 16.2% in UAE did the same, with a significant difference (p<0.001). Reciprocating motion is the predominant motion of 18.2% of Kuwait’s participants, while no participant from UAE used it predominantly with a significant difference (p=0.006). Dentsply Sirona was the most popular manufacturer in both regions and was chosen by 97.1% of all participants; among their products, ProTaper Universal Gold file was the most popular file in UAE with a significant difference (p<0.001), and ProTaper Next file was the most popular file in Kuwait with as significant difference (p=0.003). From FKG manufacturer iRace file was most popular in UAE than in Kuwait, with a significant difference (p=0.048). Coltene (p=0.004) and VDW® (p=0.002) were familiar in Kuwait more than in UAE.

Conclusion: Within the limitations of the investigation, it can be stated that NiTi-EIs are widely used in the dental practice of both regions. Better education and lower costs, on the other hand, may enhance their use. Overall, endodontists demonstrated a high understanding of NiTi-EIs usage characteristics, which was reflected in usage modalities.