The role of nickel-titanium in modern endodontics: a comprehensive review

The introduction of rotary Nickel-Titanium (NiTi) instruments has changed root canal therapy by improving the predictability and quality of root canal shaping. These instruments offer superior flexibility and help maintain the original curvature of the canal, which is particularly useful in complex root canal anatomies. Traditional stainless-steel hand files often lead to procedural errors, such as canal transportation and perforation. However, challenges still exist even with rotary NiTi systems. Issues like instrument separation, inadequate cleaning of canal irregularities, and incomplete removal of dead tissue and microbial biofilms remain. Therefore, while automated instrumentation marks an essential change in endodontic practice, careful case selection and clinical judgment are still necessary. The main goals of canal preparation, such as centered shaping, preservation of the canal's natural path, and thorough cleaning, must work with proper irrigation methods to ensure successful treatment. Ultimately, adequate root canal preparation requires a combination of mechanical precision and biological insight, supported by ongoing research and technological improvements.