NiTi Rotary Systems: From Revolution to the “More of the Same” Phenomenon

The impact triggered by the introduction of nickel-titanium (NiTi) instrument-driven mechanical preparation in endodontics was significant. From that point on, several concepts, clinical practice, and how new professionals were educated have changed the specialty forever, resulting in an unprecedented scientific and clinical revolution. A new era of courses, meetings and scientific advancements rapidly arose in the field, boosted by a fast-paced release of new instruments and systems into the market. Nevertheless, since its inception, root canal preparation with NiTi rotary systems has been haunted ghosted by a high incidence of instrument fracture. Together with the recognized difficulty in a fast-progressing root canal enlargement toward the apex, the risk of instrument fracture has triggered the industry into a constant and hurried seek for advancements in designs and metallurgical properties in order to increase their safety and cutting efficiency. The present chapter describes this revolution by making a historical categorization of the major thoughts driving the industrial and the scientific progress of mechanical preparation of root canals. The logical thinking grounded on the need to find the best design and safest NiTi alloy coupled with a major lack of in-depth discussions around the topic has led to the rise of hundreds of NiTi systems now available on the market, without any real innovations. Therefore, the initial revolution driven by rotary movement was progressively dominated by the “more of the same” phenomenon, a modern capitalist-based narrative grounded on a heavy and easy marketing and advertising approaches responsible for making dentists believe that a huge availability of instruments is in fact good for the specialty. We aim to demonstrate how far it is from the truth as the developments of new rotary systems are so speedy and market-driven that they indeed lack real innovation and scientific scrutiny before becoming available.