A Comparative Study of Crack Development in Stainless-Steel Hedstrom Files Used with Step-back or Crown-down Techniques


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Abstract

The purpose of this study was to evaluate the effect of step-back (SB) and crown-down (CD) techniques on crack development of stainless-steel Hedstrom files (H-files). Ninety-seven mesial root canals of freshly extracted human mandibular molars were selected. Six sets of H-files (#15, #20, and #25 ISO size each) were used with SB and CD techniques for the chemomechanical preparation of 8, 16, and 24 root canals using 2.5% NaOCl as an irrigant and EDTA gel as a chelating agent. Files were sterilized in an autoclave between successive uses. A seventh unused set served as control. After macroscopic examination all files were embedded in epoxy resin, ground, polished, and studied under a metallographic microscope. The maximum crack size of each file was measured by means of standard image-analysis procedures. Macroscopically the files presented no signs of plastic deformation, apart from a file #15, used with SB technique, which fractured after 16 root-canal preparations. The microscopic examination showed no cracks: on control files, on files used with the CD technique for 8 and 16 cycles, on file #20 used with the SB technique for 8 and 16 cycles, as well as on file 25 used with the SB technique for 8 cycles. Cracks were found on H-file #15 used with the SB technique for 8 and 16 cycles, on file 25 used with the SB technique for 16 cycles, and on all files used for 24 cycles with both SB and CD techniques. Under the conditions of this study it was concluded that the instrumentation technique is deeply implicated in the crack development. Crack propagation was accelerated when SB technique was used.

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