Basic Research—Technology
Resistance to Cyclic Fatigue Failure of a New Endodontic
Rotary File
Jason Bouska, DDS, Bruce Justman, DDS, Anne Williamson, DDS, MS, Christopher DeLong, BS,
and Fang Qian, PhD
Abstract
Introduction: A new nickel-titanium (NiTi) rotary file
called the ProFile Vortex (PV; Denstply, Tulsa Dental
Specialties, Tulsa, OK) has recently been released for
endodontic use. The purpose of this study was to
compare cyclic fatigue resistance of the new size 30
PV files with size 30 files of other popular brands. Other
files tested include Twisted File (TF; Sybron Dental
Specialties, Orange, CA), ProFile (PF; Denstply Tulsa
Dental Specialties, Tulsa, OK), GTX (GTX, Denstply Tulsa
Dental Specialties), and EndoSequence (ES; Brasseler,
Savannah, GA). Methods: Size 30 files with a constant
.06-mm/mm taper were rotated at manufacturer-
recommended speed and torque settings in a simulated
canal until failure. Results: Significant differences were
found between the various brands of files. The differ-
ences between file brands may be because of a different
manufacturing process or differences in file design.
Conclusions: Based on a simulated canal model,
the PV, TF, and GTX files appear to offer greater cyclic
fatigue resistance than ES and PF files. (J Endod
2012;38:667–669)
Key Words
Cyclic fatigue, EndoSequence, nickel-titanium files,
ProFile, ProFile GTX, ProFile Vortex, Twisted File
From the Department of Endodontics, University of Iowa
College of Dentistry, Iowa City, Iowa.
Address requests for reprints to Dr Anne Williamson,
Department of Endodontics, University of Iowa College of
Dentistry, S435 Dental Science Building, Iowa City, IA 52242.
E-mail address: anne-williamson@uiowa.edu
0099-2399/$ - see front matter
Copyright ª 2012 American Association of Endodontists.
doi:10.1016/j.joen.2012.01.016
JOE — Volume 38, Number 5, May 2012
N ickel-titanium (NiTi) rotary endodontic files are considered to be safe instruments
that exhibit a minimal incidence of failure (1). Clinical incidence of fracture varies
widely in published studies from as low as 0.9% of 786 NiTi instruments used only
once before discarding (2) to as high as 21% of 378 Quantec files (Sybron Endo,
Orange, CA) discarded after normal use (3).
Rotary NiTi file fractures are categorized as being caused by cyclic fatigue, torsional
fracture (3), or both (4). Torsional fracture occurs when the ultimate shear strength of
a file is reached (5). The ability of a file to withstand shear stress depends on the diam-
eter of the file. A small-diameter file has less cross-sectional area of metal than a larger
file, which gives smaller files a decreased resistance to torsional load (5, 6). Clinically,
torsional fracture occurs when part of the instrument engages dentin and becomes
either locked in the canal or has torque applied to the engaged area of the file
greater than its elastic limit, resulting in plastic deformation and, ultimately, failure (3).
Cyclic fatigue occurs as a file rotates freely in a curved canal. Rotation around
a curve results in the file undergoing compressive stress on the inside of the curve
and tensile stress on the outside of the curve. The areas of compression and tension
cycle around the area of the file as it rotates around the curvature, resulting in crack
initiation within the file. There is ultimately failure when the fatigue resistance of the
file is reached (3, 6). Several different methods have been used to test cyclic fatigue
of NiTi files including rotating files in a curved metal or glass tube, rotating files in a
groove in a metal block with a steel rod confining the file to the groove, rotating
a file against polished metal at an angle causing the tip of the file to rotate around
a curve (6), rotating a file in a groove in between 2 steel rods creating a 5-mm arc
of curvature (7), and rotating files in a simulated canal machined in a metal block
with a 60 curvature (8).
In an effort to increase cyclic fatigue resistance of endodontic rotary files, manu-
facturers have researched new manufacturing techniques to improve the physical prop-
erties of their files. One such improved manufacturing technique has been developed by
Dentsply Tulsa Dental Specialties (Tulsa, OK) to produce M-Wire NiTi. This technique
uses thermal processing to improve flexibility and cyclic fatigue resistance of its GTX and
ProFile Vortex (PV) files. Another company, SybronEndo (Orange, CA), combines
a heat treatment with twisting (instead of grinding) of NiTi to produce its Twisted
File (TF). SybronEndo has termed their process ‘‘R-phase’’ and states that it improves
cyclic fatigue resistance as well as superelasticity (9).
Design characteristics can also affect cyclic fatigue resistance of endodontic files.
Files with a larger diameter or cross-sectional area tend to have lower cyclic fatigue
resistance than files with a smaller diameter or cross-sectional area (10, 11). Files
with a small cross-sectional area have also been reported to be more flexible than those
with larger cross-sectional areas (12).
PV files have recently been introduced to the dental market. PV files feature a trian-
gular cross-section and lack radial lands. PV files were designed to operate at higher
speeds to increase cutting efficiency and reduce procedure time. They are manufac-
tured using M-Wire NiTi to increase cyclic fatigue resistance of the files (13). The
purpose of this study was to compare cyclic fatigue resistance of the new PV files
with files of other popular brands. Other files tested include TF, ProFile (PF; Dentsply
Tulsa Dental Specialties, Tulsa, OK), GTX, and EndoSequence (ES; Brasseler, Savannah,
GA). The null hypothesis of this study was that there would be no difference in cyclic
fatigue resistance between PV files and the other brands of files tested.
Cyclic Fatigue Resistance of a New Rotary File 667
Basic Research—Technology
Figure 1. The metal testing block used to test 100 files each of 5 different NiTi
rotary file designs in a simulated canal with a 60 curvature. The files were
rotated until failure at speed and torque settings recommended by their
respective manufacturers. PF and GTX files were rotated at 300 rpm; TF, ES,
and PV files were rotated at 500 rpm. The block is made of stainless steel
and has a clear acrylic cover, which enabled the files to be observed while
rotating and removed from the canal after failure.
Materials and Methods
Five different NiTi rotary file designs were tested in a simulated
canal with a 60 curvature that was machined into a metal block.
One hundred files of each design were rotated until failure at speed
and torque settings recommended by their respective manufacturers.
PF and GTX files were rotated at 300 rpm, whereas TF, ES, and PV files
were rotated at 500 rpm. All files tested were ISO tip size 30 with
a constant .06-mm/mm taper. The working length was standardized
to 19 mm for all files. The time to failure was measured to the hundredth
of a second on a digital stopwatch. The time to failure was then con-
verted to the number of rotations to failure by multiplying the time to
failure by revolutions per minute.
The metal testing block consisted of a 1.5-mm-wide simulated
canal with a 60 and 3-mm radius of curvature. The block was made
of stainless steel and had a clear acrylic cover that enabled the files
to be observed while rotating and removed from the canal after failure
(Fig. 1) (8). The 60 simulated canal was flooded with glycerin before
each file insertion to serve as lubrication. Testing was observed by
viewing the rotating files under a dental operating microscope (OPMI
Pico; Carl Zeiss Meditec, Inc, Dublin, CA) to precisely determine the
moment of failure. All cyclic fatigue testing was performed by 1 operator
while another concurrently operated the stopwatch.
Statistical Methods
One-way analysis of variance based on rank-transformed data
with post hoc Bonferroni test was used to determine whether there
was a significant difference in fatigue resistance among the 5 different
NiTi rotary file designs. The Shapiro-Wilk test was applied to verify
TABLE 1. Descriptive Statistics of the Fatigue Resistance from Rotations to Failure for Five Experimental Groups
n Mean Standard deviation
GTX 100 561.5 100.7
PF 100 369.4 55.7
ES 100 205.9 72.8
TF 100 505.9 123.6
PV 100 504.7 104.2
*Means with the same letter are not significantly different using the post hoc Bonferroni test at P > .05.
668 Bouska et al.
the normality of error distribution whenever an analysis of variance
(ANOVA) model was conducted. A P value of <.05 was used as
a criterion for statistical significance. Statistical analyses were per-
formed with the statistical package SAS System version 9.2 (SAS
Institute Inc, Cary, NC).
Results
The GTX group had a significantly higher mean cyclic fatigue resis-
tance than the other 4 groups. The mean cyclic fatigue resistance results
for the TF and PV groups were not significantly different from each
other, but they were significantly higher than the ES and PF groups.
The PF group’s mean cyclic fatigue resistance was significantly higher
than the ES group. Descriptive statistics for the 5 experimental groups
are listed in Table 1.
Statistical Results
The data were first analyzed using the Shapiro-Wilk test to verify
the assumption of normality. Because the assumption of normality
was violated, the rank transformation was conducted. One-way ANOVA
based on ranked data (ie, equivalent to the nonparametric Kruskal-
Wallis test) was performed to analyze the data.
Results of 1-way ANOVA based on the ranked data revealed that
there was a significant effect of the type of file designs on the fatigue
resistance (P < .0001). The post hoc Bonferroni test indicated that
the mean rank scores of fatigue resistance observed in GTX was signif-
icantly greater than those observed in the other 4 designs, whereas no
significant difference was found between TF and Vortex.
Discussion
The goal of this study was to compare cyclic fatigue resistance of
the recently introduced PV files with 4 other popular file systems on
the market. There are currently no published reports of this compar-
ison. The only study to date testing cyclic fatigue resistance of PV files
did not include files of other brands. This previous study compared
the effects of M-Wire versus standard NiTi wire, rotational speed,
and taper on cyclic fatigue resistance of PV files (13). The present
study cannot make the same comparisons because differences in
the geometric design of the various file systems tested would invalidate
such conclusions.
The GTX, TF, and PV groups had the highest mean cyclic fatigue
resistance and are all made with recent advances in the NiTi metallur-
gical manufacturing process. The PF and ES groups, made with standard
NiTi rotary file manufacturing processes, had a significantly lower mean
cyclic fatigue resistance. The newer manufacturing processes may have
contributed to their greater cyclic fatigue resistance; however, other
changes in the designs of these files may also have contributed to differ-
ences in resistance.
A limitation in the clinical applicability of the present study may be
caused by the overexaggeration of the fatigue life of small files tested in
a large metal tube. The number of revolutions to failure found in this
study is likely higher than would be found if the files were tested in
Minimum Maximum Median Multiple group comparison*
349.1 1,044.0 559.9 A
186.5 485.1 375.3 C
76.5 409.0 197.9 D
223.9 897.4 493.3 B
285.9 806.9 524.9 B
JOE — Volume 38, Number 5, May 2012

curved root canals with a small diameter because of the files fitting
loosely in the tube (14, 15). The differences found between files in
the present study should still be valid because all files tested had the
same tip size and taper and were all tested at the same length in the
same testing apparatus. Ideally, the study would be performed in
curved root canals; however, a new canal would be needed for each
file, making this methodology impractical and difficult to standardize
because of the differences in each canal.
The variables in this study include the geometric design of the files,
manufacturing techniques, differences in NiTi alloys, rotational speed,
and surface finish. No conclusions on the effect of these variables on
cyclic fatigue resistance can be drawn from this study because these
variables were not controlled. The only conclusions that can be drawn
are which brands of files showed a higher or lower cyclic fatigue resis-
tance compared with each other in an in vitro–simulated canal model.
The design characteristics of PV files include M-Wire NiTi alloy,
a triangular cross-section, nonlanded cutting blades, a novel design
in helical angles, and the ability to be operated at a higher speed
(500 rpm) (13). PF files feature a noncutting tip, a U-shaped cross-
sectional geometry, and radial lands (16). TF files are manufactured
with R-phase NiTi alloy by twisting the file blank instead of grinding,
an equilateral triangle cross-section, an electropolished surface (17),
nonlanded cutting blades, and positive rake angles (18). ES files
have a triangular cross-section, nonlanded blades (19), a variable
pitch, an electropolished surface, and alternating points of contact
that keep the file centered in the canal (8). GTX instruments are
made with M-Wire NiTi and have variable-width radial lands, fewer
cutting flutes, more open blade angles, reduced core mass, and wider
flutes (20).
Varying reports exist in the literature as to the effect of electropo-
lishing on cyclic fatigue resistance, with some studies finding that it
increases cyclic fatigue resistance and others showing no increase
(8, 19, 21, 22). Electropolishing, in this study, does not appear to be
significant in increasing cyclic fatigue resistance because ES files had
the lowest fatigue resistance of the files tested.
The manufacturer-recommended speed for PF and GTX files is 300
rpm, whereas PV, ES, and TF all are recommended to rotate at 500 rpm.
This resulted in PF and GTX taking a longer time to fail from cyclic
fatigue than PV, TF, or ES files. By converting the time and rpm of
each file to the number of rotations to failure, direct comparisons
can be made between files operated at different speeds (8).
Conclusion
Cyclic fatigue resistance of PV compares favorably with other
popular NiTi endodontic rotary files. PV files had a significantly greater
cyclic fatigue resistance than PF and ES files, similar cyclic fatigue resis-
tance to TF files, and significantly less cyclic fatigue resistance to GTX
files in an in vitro–simulated canal.
Acknowledgments
The authors thank Dentsply Tulsa Dental Specialties and
Sybron Dental Specialties for donating instruments used in
JOE — Volume 38, Number 5, May 2012
Basic Research—Technology
this study. The authors also thank the AAE Foundation for their
support.
The authors deny any conflicts of interest related to this study.
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