Effect of gamma-ray sterilization on phase transformation behavior and fatigue resistance of contemporary nickel-titanium instruments
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2020
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Springer
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Arias A, Macorra JC, Govindjee S, Peters OA. Effect of gamma-ray sterilization on phase transformation behavior and fatigue resistance of contemporary nickel-titanium instruments. Clin Oral Investig. 2020 Sep;24(9):3113-3120. doi: 10.1007/s00784-019-03185-4
Abstract
Objectives. The aim of this study was to compare body temperature cyclic fatigue resistance (CF) of heat-treated NiTi rotary instruments submitted to gamma-irradiation or autoclave sterilization.
Materials and methods. A total of 176 instruments (88 Hyflex EDM (HEDM) and 88 TRUShape (TS)) were used. Forty-four of each were submitted to gamma-irradiation. Twenty-two in each group were further autoclaved, resulting in a total of eight groups (n = 22 each): TS-γ and HEDM-γ (gamma-irradiated)/TS-γ-ac and HEDM-γ-ac (gamma-irradiated and autoclaved)/TS-non-γ and HEDM-non-γ (non-sterilized controls, non-gamma-irradiated/non-autoclaved)/TS-non-γ-ac and HEDM-non-γ-ac (non-gamma-irradiated and autoclaved). Twenty in each were tested for CF. Weibull parameters were calculated and compared. The remainder was used for differential scanning calorimetry analysis.
Results. TS instruments lasted significantly longer if not submitted to gamma-irradiation (TS-non-γ mean-life = 101.5 s, 95 CI% 91.7–112.3; TS-γ mean-life = 83.2 s, 95 CI% 76–91.1); further autoclaving did not significantly affect CF. Gamma-irradiation did not affect HEDM (HEDM-γ mean-life = 717.9 s, 95 CI% 636.8–809.3; HEDM-non-γ: mean-life = 678.8 s, 95 CI% 595.1–744.2); further sterilization significantly decreased fatigue resistance (HEDM-γ-ac mean-life = 524.1 s, 95 CI% 476.1–576.8; HEDM-non-γ-ac mean-life = 570.6, 95 CI% 512.3–635.5). Gamma irradiation benefited HEDM conversion to martensite state and its maintenance, while further autoclave sterilization reverted the benefit.
Conclusions. Gamma-irradiation and autoclaving differentially affected fatigue life span and transformation temperatures of contemporary martensitic rotary instruments manufactured with different methods.
Clinical relevance. Gamma-ray processing is increasingly utilized by manufacturers for clinician to use fully sterile packaged instruments; however, the sterilization method of choice should vary depending on the effects on the behavior of contemporary martensitic rotary instruments manufactured with different methods.