{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:29:42Z","timestamp":1786649382784,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The primary aim of endodontic treatment is to preserve the structural integrity of teeth while enhancing their resistance to fractures. Endodontically treated teeth are more susceptible to fractures due to the removal of tooth structure and radicular dentin. This study evaluates and compares the fracture resistance of teeth instrumented using three rotary file systems: self-adjusting file (SAF), ProTaper NEXT, and Hyflex EDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      Sixty extracted human mandibular premolars were randomly divided into four groups: Group I (control, uninstrumented), Group II (SAF), Group III (ProTaper NEXT), and Group IV (Hyflex EDM). Following instrumentation, root canals were obturated with gutta-percha and AH Plus sealer, except in the control group. Samples were embedded in acrylic resin, and fracture resistance was tested using a universal testing machine. Statistical analysis included analysis of variance and Tukey\u2019s\n                      <jats:italic toggle=\"yes\">post hoc<\/jats:italic>\n                      tests to compare group differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The control group exhibited the highest fracture resistance (560.46 \u00b1 125.0 N). Among the instrumented groups, SAF demonstrated the greatest fracture resistance (537.8 \u00b1 126.3 N), followed by Hyflex EDM (440.7 \u00b1 210.3 N), whereas ProTaper NEXT exhibited the lowest (379.93 \u00b1 130.0 N). Significant differences were noted between groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). SAF preserved dentinal integrity most effectively, whereas ProTaper NEXT induced more structural damage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The SAF system, with its adaptive design and minimal dentin removal, was superior in preserving root strength. ProTaper NEXT, although efficient in shaping, increased fracture risk due to higher stress generation. Hyflex EDM offered intermediate outcomes, combining flexibility and reduced dentin damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ccd.ccd_533_24","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T17:00:14Z","timestamp":1752512414000},"page":"111-116","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Evaluation of Fracture Resistance of Teeth Instrumented by Self adjusting File, Protaper NEXT, and Hyflex EDM: An In vitro Study"],"prefix":"10.4103","volume":"16","author":[{"given":"DM","family":"Yashas","sequence":"first","affiliation":[{"name":"Departmentt of Endodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RS","family":"Basavanna","sequence":"additional","affiliation":[{"name":"College of Dental Sciences, Davangere, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NM Dhanya","family":"Kumar","sequence":"additional","affiliation":[{"name":"College of Dental Sciences, Davangere, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aishwarya","family":"Arya","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodntics, Awadh Dental College and Hospital, Jamshedpur, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poojitha","family":"Jain","sequence":"additional","affiliation":[{"name":"College of Dental Sciences, Davangere, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishaan","family":"Adhaulia","sequence":"additional","affiliation":[{"name":"College of Dental Sciences, Davangere, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"R1-20260421","first-page":"e35477","article-title":"An in-vitro analysis of root fracture strength using single file systems","volume":"15","author":"Batra","year":"2023","journal-title":"Cureus"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"680","DOI":"10.5005\/jp-journals-10024-2579","article-title":"Shaping ability of HyFlex EDM and ProTaper next rotary instruments in curved root canals: A Micro-CT study","volume":"20","author":"Turkistani","year":"2019","journal-title":"J Contemp Dent Pract"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1111\/iej.12470","article-title":"HyFlex EDM: Superficial features, metallurgical analysis and fatigue resistance of innovative electro discharge machined NiTi rotary instruments","volume":"49","author":"Pirani","year":"2016","journal-title":"Int Endod J"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1007\/s10266-018-0340-y","article-title":"Cyclic fatigue resistances of Hyflex EDM, WaveOne gold, reciproc blue and 2shape NiTi rotary files in different artificial canals","volume":"106","author":"\u00d6zy\u00fcrek","year":"2018","journal-title":"Odontology"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/iej.12620","article-title":"Structural analysis of HyFlex EDM instruments","volume":"50","author":"Iacono","year":"2017","journal-title":"Int Endod J"},{"key":"R7-20260421","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.joen.2016.11.022","article-title":"A micro-computed tomography evaluation of the shaping ability of two nickel-titanium instruments, HyFlex EDM and ProTaper next","volume":"43","author":"Venino","year":"2017","journal-title":"J Endod"},{"key":"R8-20260421","first-page":"52","article-title":"Resistance to fracture of teeth instrumented using novel EndoStar E5 rotary versus ProTaper NEXT and WaveOne file systems","volume":"21","author":"Pawar","year":"2018","journal-title":"J Conserv Dent"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"401","DOI":"10.4103\/0972-0707.139820","article-title":"The self-adjusting file (SAF) system: An evidence-based update","volume":"17","author":"Metzger","year":"2014","journal-title":"J Conserv Dent"},{"key":"R10-20260421","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00004770-200203000-00018","article-title":"Effects of root canal sealers on vertical root fracture resistance of endodontically treated teeth","volume":"28","author":"Lertchirakarn","year":"2002","journal-title":"J Endod"},{"key":"R11-20260421","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1067\/moe.2000.108951","article-title":"Evaluation of root reinforcement of endodontically treated teeth","volume":"90","author":"Johnson","year":"2000","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R12-20260421","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1097\/01.don.0000150947.90682.a0","article-title":"Fracture strength of tooth roots following canal preparation by hand and rotary instrumentation","volume":"31","author":"Lam","year":"2005","journal-title":"J Endod"},{"key":"R13-20260421","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.joen.2010.02.010","article-title":"Potential relationship between design of nickel-titanium rotary instruments and vertical root fracture","volume":"36","author":"Kim","year":"2010","journal-title":"J Endod"},{"key":"R14-20260421","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4012\/dmj.24.66","article-title":"Effective factors including periodontal ligament on vertical root fractures","volume":"24","author":"Okitsu","year":"2005","journal-title":"Dent Mater J"},{"key":"R15-20260421","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.joen.2011.10.011","article-title":"Dentinal microcrack formation during root canal preparations by different NiTi rotary instruments and the self-adjusting file","volume":"38","author":"Yoldas","year":"2012","journal-title":"J Endod"},{"key":"R16-20260421","first-page":"25","article-title":"Microleakage comparison of four dental materials as intra-orifice barriers in endodontically treated teeth","volume":"7","author":"Yavari","year":"2012","journal-title":"Iran Endod J"},{"key":"R17-20260421","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/S0099-2399(96)80080-X","article-title":"Evaluation of coronal microleakage after endodontic treatment","volume":"22","author":"Roghanizad","year":"1996","journal-title":"J Endod"},{"key":"R18-20260421","first-page":"21","article-title":"Evaluation of fracture resistance of endodontically treated teeth filled with gutta-percha and resilon obturating material: An in vitro study","volume":"7","author":"Khan","year":"2015","journal-title":"J Int Oral Health"},{"issue":"Special Issue 1","key":"R19-20260421","first-page":"1512","article-title":"Comparative evaluation of fracture resistance of root canal treated teeth obturated with different obturating systems: an in vitro study","volume":"13","author":"Yadav","year":"2022","journal-title":"J Pharm Negat Results"},{"key":"R20-20260421","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1016\/j.joen.2014.02.026","article-title":"Effects of ProTaper universal, ProTaper next, and HyFlex instruments on crack formation in dentin","volume":"40","author":"Capar","year":"2014","journal-title":"J Endod"},{"key":"R21-20260421","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.joen.2015.10.004","article-title":"Torsional and cyclic fatigue resistance of a new nickel-titanium instrument manufactured by electrical discharge machining","volume":"42","author":"Pedull\u00e0","year":"2016","journal-title":"J Endod"},{"key":"R22-20260421","first-page":"53","article-title":"To evaluate and compare canal transportation, canal-centering ability, and vertical root fracture resistance of teeth prepared with three different rotary file systems: An in vitro study","volume":"29","author":"Mitra","year":"2017","journal-title":"Endodontology"},{"key":"R23-20260421","doi-asserted-by":"crossref","first-page":"153","DOI":"10.4103\/JCD.JCD_219_17","article-title":"Comparative evaluation of dentinal crack formation after root canal preparation using ProTaper next, OneShape, and Hyflex EDM","volume":"21","author":"Das","year":"2018","journal-title":"J Conserv Dent"},{"key":"R24-20260421","doi-asserted-by":"crossref","first-page":"e528","DOI":"10.4317\/medoral.17518","article-title":"Fracture resistance of roots filled with three different obturation techniques","volume":"17","author":"Top\u00e7uo\u011flu","year":"2012","journal-title":"Med Oral Patol Oral Cir Bucal"}],"container-title":["Contemporary Clinical Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_533_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:53:25Z","timestamp":1786647205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ccd.ccd_533_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ccd.ccd_533_24","relation":{},"ISSN":["0976-237X","0976-2361"],"issn-type":[{"value":"0976-237X","type":"print"},{"value":"0976-2361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-11-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-12","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}