Effects of a pre-enlargement on fracture incidence of reused reciprocating instruments: A clinical study.

This study assessed the impact of pre-enlarging the root canal using a size 25 K-file on the fracture incidence of three reciprocating instruments after multiple uses. After a glide path performed with a size 15 K-file, the instruments (Reciproc R25, Reciproc Blue R25, and WaveOne Gold Primary) were initially used in 936 root canals. Then, for the second and third uses (933 and 927, respectively), a pre-enlargement using a size 25 K-file at the working length was done. Periapical radiographs assessed fragment location and length, and chi-square tests compared observed and expected frequencies (α = 5%). The fracture incidence during reuse ranged from 0% to 0.64%. Reciproc did not fracture during reuse (P = 0.99), but experienced two fractures in the third use (P = 0.000). Reciproc Blue and WaveOne Gold each had one fracture during the second (P = 0.000) and third (P = 0.000) uses. Following a pre-enlargement using a size 25 K-file for the second and third uses in 1,860 canals, only 6 instruments fractured (0.32%), suggesting that this approach may prolong the lifespan of these instruments and serve as an alternative for their reuse with a reduced risk of fracture.