A Critical Appraisal of Studies on the Cyclic Fatigue Resistance of HyFlex EDM Nickel-titanium Instrument

Aims: To summarize the currently available evidence to point out the different outcomes of static versus dynamic tests and to assess whether cyclic fatigue tests provide useful data and information for clinical practice.

Study Design: Systematic review.

Place and Duration of Study: From May 2015 to July 2021, a total of 21 studies on HyFlex EDM cyclic fatigue have been published in the Journal of Endodontics and the International Endodontic Jour- nal and Odontology, and the Nigerian Journal of Clinical Practice and Journal of Den- tal Sciences restorative dentistry and endodontic and MDPI.

Methodology: Different studies comparing between Hyflex EDM and other rotary files as in: wave one gold, reciproc blue.

Results: REC showed that HYFLEX EDM has the highest cyclic fa- tigue resistance and conforming that sterilization has no influence in cyclic fatigue resistance.

Conclusion: Non-invasive independent predictors for screening esophageal varices may decrease medical as well as financial burden, hence improving the management of cirrhotic patients. These predictors, however, need further work to validate reliability.