IMR Press / FBL / Volume 26 / Issue 12 / DOI: 10.52586/5062
Open Access Review
Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis
Show Less
1 Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
2 Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
3 Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
4 U.S.C.A. “Unità Speciali di Continuità Assistenziale” Troia 2, ASL “Azienda Sanitaria Locale” Foggia Troia, Italy
*Correspondence: (Mario Dioguardi)
Academic Editor: Luigi Santacroce
Front. Biosci. (Landmark Ed) 2021, 26(12), 1697–1713;
Submitted: 31 May 2021 | Revised: 29 July 2021 | Accepted: 6 August 2021 | Published: 30 December 2021
(This article belongs to the Special Issue NiTi Rotary Instruments in Endodontics)
Copyright: © 2021 The Author(s). Published by BRI.
This is an open access article under the CC BY 4.0 license (

The fracture of endodontic instruments inside the canal represents a problem that is not always easy to solve. The reutilization of endodontic instruments after sterilization procedures raises the question of how these processes affect their physical and mechanical properties. Alterations can involve the surface of the instruments, as well as their cutting effectiveness, shape and resistance to torsional and cyclic fatigue. The methodology adopted for this systematic review followed the PRISMA guidelines for systematic reviews. The following search terms were used in PubMed and Scopus: “endodontic sterilization”, “endodontic autoclave”, “cyclic fatigue”, “torsional”, “cutting efficiency”, “sterilization”, “surface characteristics” and “corrosion”. After the screening phase, the application of exclusion criteria and the removal of duplicates, 51 studies were identified and divided into four outcomes: cyclic fatigue; deformation and torsional fatigue; corrosion or surface alterations; and cutting efficiency. Our study of the scientific literature highlights disagreements between studies on these effects. After autoclaving, instruments exhibit a reduction in the cutting efficiency, but NiTi alloy instruments have an improved resistance to cyclic and torsional fatigue.

Cyclic fatigue
NiTi alloy
Endodontic instruments
Torsional resistance
Flexural fatigue
Cutting efficiency
Mechanical property
Fatigue properties
Fig. 1.
Back to top