Open Access

Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis

Mario Dioguardi1,*,Claudia Arena1,Diego Sovereto1, Riccardo Aiuto2,Luigi Laino3,Gaetano Illuzzi1,Enrica Laneve1,Bruna Raddato1,Vito Carlo Alberto Caponio1,Antonio Dioguardi4,Khrystyna Zhurakivska1,Giuseppe Troiano1, Lorenzo Lo Muzio1
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
U.S.C.A. “Unità Speciali di Continuità Assistenziale” Troia 2, ASL “Azienda Sanitaria Locale” Foggia Troia, Italy
DOI: 10.52586/5062 Volume 26 Issue 12, pp.1697-1713
Submited: 31 May 2021 Revised: 29 July 2021
Accepted: 06 August 2021 Published: 30 December 2021
*Corresponding Author(s):  
Mario Dioguardi
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.

Key words

Cyclic fatigue; Endodontics; NiTi alloy; Endodontic instruments; Torsional resistance; Flexural fatigue; Corrosion; Cutting efficiency; Mechanical property; Fatigue properties

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Mario Dioguardi, Claudia Arena, Diego Sovereto, Riccardo Aiuto, Luigi Laino, Gaetano Illuzzi, Enrica Laneve, Bruna Raddato, Vito Carlo Alberto Caponio, Antonio Dioguardi, Khrystyna Zhurakivska, Giuseppe Troiano, Lorenzo Lo Muzio. Influence of sterilization procedures on the physical and mechanical properties of rotating endodontic instruments: a systematic review and network meta-analysis. Frontiers in Bioscience-Landmark. 2021. 26(12); 1697-1713.