ProTaper Gold vs ProTaper Ultimate

Seven comparative full texts were read for this pair: two randomised trials, one micro-CT shaping study, one debris-extrusion study, one retreatment study and two cyclic-fatigue studies. Both systems share the ProTaper sequence logic and variable taper; what differs is the cross-section (convex triangle for Gold, off-centred parallelogram for Ultimate), the motor settings (300 rpm with file-specific torque for Gold, 400 rpm at 4.0 to 5.2 Ncm for Ultimate) and the Slider-first glide path of Ultimate.

The two clinical trials do not agree on pain. In 40 mandibular first molars with symptomatic irreversible pulpitis and symptomatic apical periodontitis, single-visit treatment with either system gave the same pain scores at 24 h, 72 h and 7 days, and both groups reached zero at one week (PMID 41211526). In 56 necrotic maxillary premolars with a normal periapex, Ultimate produced higher pain scores immediately and at 12, 24 and 48 h, and 42.9 % of that group took an analgesic against 17.9 % with Gold; the same trial measured a smaller bacterial reduction after instrumentation with Ultimate, though after sodium hypochlorite both systems exceeded 96 % and no longer differed (PMID 41882642). The authors of the second trial point out that speed, torque and first-file size differ between the systems, so the cross-section cannot be isolated as the cause.

On shaping, a micro-CT study of 30 mesiobuccal roots of maxillary first molars with 10 to 20 degrees of curvature found no difference between Gold and Ultimate in canal volume increase, transportation or centring at any level; Ultimate left thinner dentin on the mesial furcation wall of MB1 at one level (1.32 mm against 1.55 mm), and every group kept more than 0.3 mm (PMID 41934543). In that study MB2 negotiation failed four times with Gold and three times with Ultimate, and two Gold files separated against one Ultimate file, numbers the authors describe as too small to rank the systems.

Ultimate extruded less debris through the apex than Gold in 30 curved mesiobuccal canals prepared at 350 rpm and 2.5 Ncm with distilled water (2.35 mg against 3.25 mg) (PMID 40145483). Whether that laboratory difference reaches the patient is exactly what the two trials above leave open.

On fatigue, the Ultimate F2 survived longer than the Gold F2 in a 90-degree steel canal, while neither fractured within 15 minutes at 60 degrees (PMID 39407799); a second study found the same ranking in a 70-degree canal in both continuous rotation and forward reciprocation, with all files run at 400 rpm and 4 Ncm rather than at each system's own settings (PMID 38667542). Neither study reports torsional strength, and neither was run at body temperature.

In retreatment with the finishing files only, Gold removed AH Plus faster (86.59 s against 109.22 s) with the same residue, while Ultimate left less TotalFill residue (4.43 % against 7.99 %) in the same time; no file fractured, and the authors flag the larger Ultimate finishing taper as a confounder (PMID 42296409).