UNIVERSIDADE ESTADUAL PAULISTA

“JÚLIO DE MESQUITA FILHO”

Instituto de Ciência e Tecnologia

Campus de São José dos Campos

ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2024.e4270

Braz Dent Sci 2024 July/Sept;27 (3): e4270

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in

any medium, provided the original work is properly cited.

Compatibility between variable taper mechanized instruments and

corresponding gutta-percha cones: photomicrograph analysis

Compatibilidade entre instrumentos mecanizados com conicidade variável e cones de guta-percha correspondentes: análise

por meio de fotomicrograﬁas

Márcia Eugênia de Sousa Damasceno Feitosa1 , Gabriela Martins Rodrigues Rosa2 , Suyane Maria Luna-Cruz1 ,

Elilton Cavalcante Pinheiro-Júnior3 , Nilton Vivacqua-Gomes2 , Bruno Carvalho de Vasconcelos1 

1 - Universidade Federal do Ceará, Programa de Pós-graduação em Odontologia. Fortaleza, CE, Brazil.

2 - Faculdade São Leopoldo Mandic, Escola Cearense de Odontologia. Fortaleza, CE, Brazil.

3 - Universidade de Fortaleza, Curso de Odontologia. Fortaleza, CE, Brazil.

How to cite: Feitosa MESD, Rosa GMR, Luna-Cruz SM, Pinheiro-Júnior EC, Vivacqua-Gomes N, Vasconcelos BC. Compatibility

between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis. Braz Dent Sci.

2024;27(3):e4270. https://doi.org/10.4322/bds.2024.e4270

ABSTRACT

Objective: This study aimed to assess the compatibility between variable taper NiTi instruments and corresponding

gutta-percha cones. Material and Methods: Protaper Gold F2 (F2/PTG), Wave One Gold Primary (PRI/WOG),

and Reciproc Blue R25 (R25/RB) instruments (n = 3) were included, along with corresponding gutta-percha

cones (n = 10), produced by the manufacturers and from three other brands (Diadent, MK Life, and Tanari).

Images of both instruments and cones were obtained through photomicrographs using a digital microscope (500x).

The instruments were photographed at seven angles, rotating on their axis to record the maximum diameter

at desired levels; the gutta-percha cones, due to their cross-section, were photographed only once. The images

were analyzed using Image J software by a blinded operator at 1.0 (D1), 6.0 (D6), and 12.0 (D12) millimeters

from their tip. ANOVA and Tukey tests were employed for statistical analysis, with signicance set at 5.0%.

Results: Considering the correspondence between F2/PTG and PRI/WOG instruments, signicant differences

were observed when the manufacturer’s cones were analyzed (P < 0.05). In relation to R25/RB instruments,

statistical differences were observed only for the Tanari cone at D1 (P < 0.05). Conclusion: Within the study’s

limitations, it can be concluded that the tested instrument systems and dedicated gutta-percha cones exhibited

some dimensional variability among them. Furthermore, among the evaluated cones, the cones corresponding

to F2/PTG and PRI/WOG instruments from the manufacturer itself showed the greatest discrepancies.

KEYWORDS

Endodontics; Gutta-Percha; Photomicrography; Root canal preparation; Root canal obturation.

RESUMO

Objetivo: O presente estudo teve como objetivo avaliar a compatibilidade entre instrumentos de NiTi de conicidade

variável e cones de guta-percha correspondentes. Material e Métodos: Foram incluídos instrumentos Protaper

Gold F2 (F2/PTG), Wave One Gold Primary (PRI/WOG) e Reciproc Blue R25 (R25/RB) (

= 3); ainda, cones de

guta-percha correspondentes (

= 10), produzidos pelos fabricantes e de outras três marcas (Diadent, MK Life

e Tanari). Imagens tanto dos instrumentos quanto dos cones foram obtidas por meio de fotomicrograas com

microscópio digital (500x). Os instrumentos foram fotografados sete angulações, com giros em seu próprio eixo,

a m de registrar-se o maior diâmetro nos níveis desejados; os cones de guta-percha, em função de sua secção

transversal, foram fotografados uma única vez. As imagens foram analisadas por meio do

software

Image J, por

um operador cego, a 1,0 (D1), 6,0 (D6) e 12,0 (D12) milímetros de sua ponta. Para análise estatística foram

empregados os testes ANOVA e Tukey, com signicância estabelecida em 5,0%. Resultados: Considerando a

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

INTRODUCTION

Root canal obturation is characterized by

the filling, whenever possible hermetic and

three-dimensional, of the pulp space with

biocompatible obturation materials (gutta-percha

and endodontic cements). The primary aim of this

phase is to maintain the disinfection achieved

during cleaning and shaping by closing all access

routes to the canal system, favoring the biological

process of periapical tissue repair [1].

Many techniques have been suggested for this

purpose, ranging from “classic” techniques that do

not use heat to the most currently recommended

ones that seek, through plasticization, better

adaptation of the obturation material to the canal

walls [2,3]. Among the more recent suggestions

is the use of instrumentation/obturation systems,

which provide corresponding gutta-percha cones

theoretically designed similarly to mechanized

preparation instruments [4]. However, variations

in gutta-percha cone tip diameters or mismatches

in their taper compatibility with the preparations

performed may pose difficulties in achieving

working length by the cones or, conversely, provide

a thicker cement layer. Both occurrences could

hinder the treatment and jeopardize its success [5].

Over the years, Endodontics has undergone

significant changes due to the incorporation

of technological innovations. Companies

increasingly invest in creating and launching

new mechanized instruments, both rotary

and reciprocating, some with very distinct

characteristics. The Protaper Gold rotary system

(PTG; Dentsply/Tulsa Dental Specialties, Tulsa,

OK, USA), and the reciprocating systems,

WaveOne Gold (WOG; Dentsply/Maillefer,

Ballaigues, Switzerland) and Reciproc Blue (RB;

VDW GmbH, Munich, Germany), are examples

of systems that feature instruments with variable

tapers and also offer clinicians the option of

corresponding gutta-percha cones [6].

However, despite discussions about

standardization of instruments and corresponding

gutta-percha cones, clinical everyday practice

raises questions about the accuracy of this

correspondence. The study conducted by

Vieira et al. 2019 [7] aligns with such inquiries,

with their results pointing to signicant differences

when verifying this compatibility. Sometimes,

after canal shaping and instrumentation, the

corresponding cone does not match the diameter

and taper of the last instrument used at the

working length, potentially hindering canal

obturation [7].

Due to the aforementioned issues, this study

aimed to evaluate the compatibility of Protaper

Gold F2, WaveOne Gold Primary, and Reciproc

Blue R25 instruments with corresponding gutta-

percha cones, both from the manufacturers

themselves and from three other commercially

available brands: Diadent, MK Life, and Tanari.

MATERIAL AND METHODS

Study type

This study is an experimental evaluation

conducted in a laboratory setting, utilizing

mechanized endodontic preparation systems’

instruments and corresponding gutta-percha

cones to investigate their compatibility in vitro

through analysis via photomicrographs using a

digital microscope.

Sample selection

Three instruments (n = 3) belonging to

three mechanized instrumentation systems were

selected based on their variable taper throughout

the instruments. Protaper Gold F2 (#25/.08;

F2/PTG), WaveOne Gold Primary (#25/.07;

PRI/WOG), and Reciproc Blue R25 (#25/.08;

R25/RB) instruments were evaluated, and all

included rotary and reciprocating instruments

correspondência entre os instrumentos F2/PTG e PRI/WOG, diferenças signicantes foram observadas quando

os cones do próprio fabricante foram analisados (

< 0,05). Em relação aos instrumentos R25/RB, diferenças

estatísticas foram observadas unicamente para o cone Tanari em D1 (

< 0,05). Conclusão: Nas limitações do

estudo pode-se concluir que os sistemas de instrumentos e cones de guta-percha dedicados testados apresentaram

alguma variabilidade dimensional entre eles. Ainda, dentre os cones avaliados, os cones correspondentes aos

instrumentos F2/PTG e PRI/WOG do próprio fabricante foram os que apresentaram as maiores discrepâncias.

PALAVRAS-CHAVE

Endodontia; Guta-Percha; Fotomicrograa; Preparo do canal radicular; Obturação do canal radicular.

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

were new. Next, ten gutta-percha cones (n =

10) from the respective manufacturers of the

preparation systems, PTG (Dentsply/Tulsa Dental

Specialties), WOG (Dentsply Ind. Com. LTDA,

Petropolis, Brazil), and RB (VDW GmbH), were

selected.

Additionally, gutta-percha cones from

three other commercial brands producing cones

compatible with the selected instruments were

included: Diadent (Burnaby, BC, Canada),

MK Life (Porto Alegre, RS, Brazil), and Tanari

(Amazonas, AM, Brazil). Cones from two distinct

lots, without deformities, with ve cones acquired

from each lot, were included. Cones displaying

noticeable inclinations or imperfections during

photomicrography were discarded.

Records of instruments and gutta-percha

cones

The selected instruments were longitudinally

arranged on a protractor individually and

secured with utility wax for recording through

photomicrographs using the digital microscope

(FX-500; BWX, Shandong, China) (Figure 1).

A millimeter ruler was used in parallel to the object

under study for software calibration (Figure 2).

Photographic records of each instrument were

taken at angles of 0°, 30°, 60°, 90°, 120°, 150°,

and 180° to capture the maximum diameter at

each level due to their cross-sectional shape.

Cones, having a circular cross-section, were

photographed only once (Figure 3).

Determination of instrument and gutta-per-

cha cone design

The captured images of both instruments

and gutta-percha cones were then analyzed by a

single calibrated and blinded operator regarding

the cone’s brand, using Image J software

(NIH, Bethesda, MA, USA). The analyses were

conducted at 1.0 mm (D1), 6.0 mm (D6), and

12.0 mm (D12) from the tips of the instruments

and gutta-percha cones, aiming to determine the

diameter in mm of the samples at these positions,

as specied by ISO 6877:2006 standards.

Analysis of discrepancies between instru-

ments and gutta-percha cones

After obtaining the diameter measurements,

the data were tabulated and analyzed separately.

For the instruments, the seven images of each

instrument were analyzed at the three positions to

determine the largest measured diameter at each,

recorded as the instrument’s diameter. This value

was statistically considered when comparing with

the other two evaluated instruments to obtain an

average value for each tested instrument. For the

gutta-percha cones, the measured diameters at

each position for each specimen in the sample were

considered to determine the discrepancy (mm)

Figure 1 - Reciproc Blue ﬁle instrument positioned parallel to a millimeter ruler for calibrating the measurement software.

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

between the gutta-percha cones and the mean of

the corresponding instruments.

Statistical analysis

For statistical analysis, conducted using

Stat Plus for Windows software (Analyst Soft,

Walnut, CA, USA), the average error values,

considered as discrepancies measured in mm

between the mean of the instruments and each

gutta-percha cone, were subjected to a normality

curve to determine the data’s parametric nature.

Accordingly, the values underwent evaluation

through analysis of variance (ANOVA) and

Tukey’s individual comparison test, both at a

signicance level of 5.0%.

Figure 2 - Photomicrograph and calibration using Image J software of the gutta-percha cone.

Figure 3 - Recording of gutta-percha cone diameters.

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

RESULTS

Tables I, II, and III present, respectively,

the means and standard deviations in mm of

the discrepancy between the F2/PTG, PRI/

WOG, and R25/RB instruments and their

corresponding gutta-percha cones from the

evaluated brands. Analysis of the F2/PTG-

compatible cones indicated that, in D1 and D6,

the manufacturer’s cones showed statistically

signicant discrepancies compared to the other

evaluated brands (P < 0.05).

However, in D12, only the Tanari brand

cone showed closer compatibility to the

ideal, offering the lowest discrepancy values

(P < 0.05). Regarding PRI/WOG instruments,

in all three analyzed positions—D1, D6, and

D12—the manufacturer, Denstply, consistently

presented the highest discrepancy values, with

signicant differences in the conducted analyses

(P < 0.05). Concerning R25/RB instruments, no

statistically signicant differences were observed

between the groups at D6 and D12 (P > 0.05).

However, at D1, the Tanari brand cones showed

a signicant difference compared to the other

groups, presenting the highest discrepancy values

(P < 0.05).

DISCUSSION

The present study aimed to assess the

compatibility of NiTi instruments with variable

tapers F2, Primary, and R25, belonging to the

mechanized preparation systems Protaper Gold,

Wave One Gold, and Reciproc Blue, respectively,

with corresponding gutta-percha cones, from the

manufacturer and three other brands available in

the market. To date, few pieces of information are

available in the literature regarding these systems

and cones evaluated in this study.

Table I - Compatibility analysis of the Protaper Gold instrument and gutta-percha cones

Groups

D1 D6 D12

MEAN sd MEAN sd MEAN sd

DENTSPLY 0.16 ᵇ0.06 0.30 ᶜ0.11 0.28 ᵇ0.10

DIADENT 0.06 ᵃ0.04 0.13 ab 0.03 0.27 ᵇ0.03

MK LIFE 0.03 ᵃ0.03 0.19 ᵇ0.05 0.22 ᵇ0.06

TANARI 0.04 ᵃ0.04 0.10 ᵃ0.04 0.11 ᵃ0.04

a,b Diﬀerent superscript letters demonstrate signiﬁcant diﬀerences between cones at the same level, according to the Tukey test (

< 0,05).

sd: standard-deviation

Table II - Compatibility analysis of the WaveOne Gold instrument and gutta-percha cones

Groups

D1 D6 D12

MEAN sd MEAN sd MEAN sd

DENTSPLY 0.08 ᵇ0.04 0.12 ᵇ0.06 0.17 ᶜ0.04

DIADENT 0.04 ᵃ0.03 0.06 ᵃ0.04 0.08 ab 0.05

MK LIFE 0.03 ᵃ0.02 0.06 ᵃ0.03 0.10 ᵇ0.04

TANARI 0.04 ᵃ0.03 0.05 ᵃ0.02 0.05 ᵃ0.04

a.b Diﬀerent superscript letters demonstrate signiﬁcant diﬀerences between cones at the same level. according to the Tukey test (

< 0.05).

sd: standard-deviation

Table III - Compatibility analysis of the Reciproc Blue instrument and gutta-percha cones

Grupos

D1 D6 D12

MEAN sd MEAN sd MEAN sd

VDW 0.06 ᵃ0.02 0.05 ᵃ0.02 0.03 ᵃ0.01

DIADENT 0.06 ᵃ0.03 0.05 ᵃ0.04 0.05 ᵃ0.02

MK LIFE 0.04 ᵃ0.03 0.04 ᵃ0.03 0.03 ᵃ0.02

TANARI 0.10ᵇ0.03 0.05 ᵃ0.03 0.04 ᵃ0.05

a.b Diﬀerent superscript letters demonstrate signiﬁcant diﬀerences between cones at the same level. according to the Tukey test (

< 0.05).

sd: standard-deviation

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

Given that the goal of root canal obturation is

to efciently ll its space, preventing reinfection,

and restoring periapical tissue health [8,9], the

possibility of discrepancies between mechanized

instruments and their corresponding gutta-

percha cones, findings already reported in

the literature [9], might become problematic

considering the increasingly frequent suggestion

of simplifying treatment steps [8,10]

In 1955, Ingle suggested that root canal

instruments and filling materials should be

standardized, ensuring that the gutta-percha cone

matched the size of the last instrument used, thus

ensuring better adaptation to the canal walls [11].

However, manufacturing failures of these cones

have been previously reported by Mayne et al. [12],

raising concerns. Consequently, an international

standard (ISO 6877:2006) for gutta-percha

cones for endodontic obturation was adopted in

2006 [13]. The sizes of obturator cones specied

in this standard were aligned with corresponding

sizes of root canal preparation instruments specied

in ISO 3630-1 [14].

ISO 6877:2006 specifies, among other

points, that gutta-percha cones should be tapered

throughout their length, uniform in composition

and color, with smooth surfaces and free from

deformities unless indicated otherwise by the

manufacturer. The standard allows a tolerance

of +/- 0.05 mm in diameter for sizes #10 to

#25 and 0.07 mm for sizes #30 to #140. It also

dictates that the cone should be uniform for a

minimum of 16 mm from the tip [12,15].

According to Hatch et al. [16], there are

several possible reasons for different results in

studies on dimensional variability of instruments

and gutta-percha cones. One reason is that,

even if manufacturers adhere to a standard,

the wide variation allowed by the standards

accepts diameter tolerances of up to 0.05 mm for

cones, depending on the cone’s diameter. Thus,

cones of the same diameter may encompass a

diameter above or below the stated size, resulting

ultimately in unsatisfactory cone adaptation to

the root canal wall.

Regarding the observed results, concerning

F2 and Primary instruments from PTG and WOG

systems, it was noted that the corresponding

cones from the manufacturers themselves

presented the largest discrepancies at the three

evaluated levels, being signicant in PTG both

in D1 and D6 (P < 0.05). The Tanari cones

showed the smallest diameter differences

compared to F2 les. In the case of the Primary

instrument from WOG, signicant differences

were observed at the three tested levels, also

presenting the highest discrepancy values for the

manufacturer’s cones. Among the other brands

tested, no consistent differences were observed.

These ndings raise concerns about the quality

of t of these cones in clinical conditions, mainly

because they are the manufacturers’ own cones.

The analysis of discrepancies between

R25 cones and instruments from the RB system

showed the smallest differences in diameters,

presenting signicance only in D1, where Tanari

cones significantly diverged from the others,

showing higher discrepancy values.

In Vieira et al.’s study [7], reciprocating

instruments R25 (Reciproc; VDW GmbH) and

#25/.06 (X1 Blue File; MK Life Dental Products)

and corresponding gutta-percha cones from

the manufacturers and Diadent brand were

evaluated. It was observed that the instruments

did not show statistically signicant differences

among themselves, but all gutta-percha cones,

in all diameters, showed statistical differences

in their dimensions.

The observed differences here are also in

line with the studies of Mirmohammadi et al. [8],

and Chesler et al. [10], where it was observed

that the diameters of gutta-percha cones were

significantly larger than the diameters of the

corresponding instruments at all levels and for all

brands. According to Mirmohammadi et al. [8],

even though these ndings may not be a signicant

problem for a skilled endodontist, an inexperienced

clinician may nd it frustrating and time-consuming.

This is because having a larger diameter than

the last instrument used in preparation would

result in poor cone adaptation inside the canal,

leading consequently to underllings and thereby

compromising the treatment’s success.

On the other hand, smaller diameters could

lead to recontamination problems inside the root

canals. According to Chybowski et al. [17], the

inability to effectively ll and seal anatomical

spaces can have a detrimental effect on the

success of endodontic treatment. Therefore, the

presence of empty spaces between the obturator

material and the canal walls may adversely affect

the physical properties of the materials and

facilitate the penetration of microorganisms and

metabolites into periapical tissues [18].

Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

Despite limitations as a laboratory study, the

present study reinforces the need for understanding

the materials used in everyday endodontic practice.

Although the preparation and shaping of the canal do

not always correspond solely to the design of the last

instrument used in this phase, such incompatibility

can generate a series of difculties, especially for

less experienced professionals. Undoubtedly, further

investigations are necessary to observe whether such

discrepancies can indeed interfere with the clinical

use of these gutta-percha cones.

CONCLUSION

Under the study conditions and considering

its limitations, it can be concluded that dedicated

instrument systems and gutta-percha cones

showed some dimensional variability among them,

notably among the cones evaluated, with Dentsply

cones exhibiting signicant discrepancies.

AUTHOR’S CONTRIBUTIONS

GMRR, NV-G, BCV: Conceptualization.

MESDF, GMRR, SML-C, NV-G, BCV: Methodology.

MESDF, GMRR, SML-C: Validation. MESDF,

GMRR, SML-C: Investigation. ECP-J, NV-G, BCV:

Formal Analysis. MESDF, GMRR, SML-C: Writing

– Original Draft Preparation. ECP-J, NV-G, BCV:

Writing – Review & Editing. BCV: Supervision.

CONFLICT OF INTERESTS

The authors have no proprietary, nancial,

or other personal interest of any nature or kind

in any product, service, and/or company that is

presented in this article.

FUNDING

This research did not receive any specic

grant from funding agencies in the public,

commercial, or not-for-prot sectors.

REGULATORY STATEMENT

The study does not involve teeth, animals,

or human beings.

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Braz Dent Sci 2024 July/Sept;27 (3): e4270

Feitosa MESD et al.

Compatibility between variable taper mechanized instruments and corresponding gutta-percha cones: photomicrograph analysis

Feitosa MESD et al. Compatibility between variable taper mechanized instruments

and corresponding gutta-percha cones: photomicrograph analysis

Márcia Eugênia de Sousa Damasceno Feitosa

(Corresponding address)

Universidade Federal do Ceará, Programa de Pós-graduação em

Odontologia, Fortaleza, CE, Brasil.

Email: marciaesdfeitosa@gmail.com

Date submitted: 2024 Feb 02

Accept submission: 2024 Aug 28