'Screw-in' tendency of rotary nickel-titanium files due to design geometry

To examine the effect of several standard geometric characteristics of rotary instruments on the 'screw-in' forces and stresses generated on root dentine using 3D finite element analysis (FEA). Methodology: Four cross-sectional designs (triangular, slender-rectangular, rectangular and square) were evaluated. The area of the triangular cross-section and of the slender-rectangular model were the same. Another rectangular model had the same centre-core diameter as the triangular one. Each design was twisted into a file model with 5, 10 or 15 threads over its 16-mm-long working section. Three curved root canals were simulated as rigid surface models: θ = 15 degrees/R = 36 mm radius; θ = 30/R = 18; and θ = 45/R = 12. A commercial FEA package was used to simulate the file rotating in the canal to determine the 'screw-in' force and reaction torque on the instrument. Results: Instruments of a square cross-section had the highest 'screw-in' force and reaction torsional stresses followed by the rectangle, the triangle design and the slender-rectangle design, respectively. The file with closer pitch generated lower stresses, compared with that with longer pitch. The greater the root canal curvature, the higher the 'screw-in' force and reaction torque generated. Conclusion: This study demonstrated that the 'screw-in' tendency depends on both the instrument geometry and canal curvature. Clinicians should be aware that certain instrument designs are prone to develop high 'screw-in' forces, requiring the operator to maintain control of the handpiece or to use a brushing action to prevent instruments being pulled into the canal.