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CONTENTS
• INTRODUCTION
• BASIC INSTRUMENTS
• INSTRUMENTS FOR ACCESS CAVITY PREPARATION
• INSTRUMENTS FOR CLEANING AND SHAPING ROOT CANAL
Classifications
Material sciences
Parts of a file
Instrument standardization
Hand operated instruments
2
INTRODUCTION
3
IMS Instrument cassette
4
BASIC INSTRUMENTS
5
MOUTH MIRROR
Types-(according to reflecting surface)
 Plane/regular surface mirrors
 Front-surface mirrors
 Concave surface mirrors/
magnifying mirrors
According to size
 No.2(5/8th inch)
 No.4(7/8th inch)
 No.5(15/16th inch)
6
ENDODONTIC SPOON
EXCAVATOR
Functions:
• To remove carious
material and excise pulp
tissue.
• They have long offset
from long axis of
instrument compared to
normal spoons.
7
ENDODONTIC LOCKING TWEEZERS
It has a latch that permits materials to be held without
continuous finger pressure
Grooved tip facilitates holding of paper points, gutta
percha points and root canal instruments
8
ANESTHETIC SYRINGE
 2ml syringe is used
 For infiltration, block or intrapulpal injection.
 Disposable & discarded.
9
ENDODONTIC MILLIMETER RULER
 Used to measure endodontic files and
guttapercha cones
10
Rubber dam
11
INSTRUMENTS FOR
ACCESS OPENING
12
Hand piece
 A handpiece is a device for holding rotating instruments,
transmitting power to them, and for positioning them
intraorally.
 It may retain the cutting tool by a screw-in, latch or friction
type of attachment
 Both speed and torque in a handpiece can be modified by
incorporation of the gear system
13
Round burs
 sizes #2, #4, #6
Fissured carbide burs
14
 Safety tip tapered diamond &
fissured carbide burs
 Round diamond burs #2,#4
 Transmetal bur
15
Mueller bur & LN bur
Gates glidden burs 12 taper niti orifice opener
16
Endo Access Bur
17
18
INSTRUMENTS USED FOR
CLEANING AND SHAPING
THE PULP SPACE
19
Instruments for pulp space preparation :
According to ingle 5th edition
ISO Grouping of Instruments
• Group I: Hand operated instruments
Broaches
K type (Kerr) files & reamers
H type (Hedstroem) and,
Pluggers and Spreaders.
• Group II: Engine-driven latch type
same as Group I but made to be attached to a hand piece.
Included are paste fillers.
• Group III: Engine-driven latch type - drills or reamers such as
Gates-Glidden
Peeso reamers
• Group IV: Root canal points-
gutta-percha, silver, paper.
20
FUNCTION INSTRUMENTS
Exploring Smooth broaches and endodontic explorers
(Used to locate canal orifice and to determine the
direction and patency of root canal)
Debriding Barbed broaches
(Used to extirpate the pulp and to remove debris and
other foreign materials )
Shaping Reamers and Files
(Used to shape the canal space laterally and apically )
Obturating Pluggers, spreaders and lentulospirals
(To cement and pack guttapercha points into the canal
space)
Classification According to Function
(Grossman’s Classification)
21
22
Materials Used
NICKEL-TITANIUM
Super-elasticity, Shape
memory
Corrosion Resistance
Less cutting efficiency
In 20th century
STAINLESS STEEL Flexible, Less prone to fracture & corrosion
In 19th century
CARBON STEEL # tendency, Corrosion
TITANIUM & ALUMINIUM ALLOYS
Marketed as Microtitane
Resistance to #, have
Increased flexibility.
Cutting efficiency as SS.
23
STANDARDIZATION:
Was recommended by Ingle and Levine in 1958.
describes 3 features
a) Diameter and width
b) Length of cutting blade
c) Taper
24
1958  Ingle and Levine first proposed standardization
of endodontic instruments and suggested guidelines for
the same
1) The instruments shall be numbered from 10 to 100,
the numbers advance by 5 units to size 60, and
thereby by 10 units to size 100.
2) The instrument number shall be representative of the
diameter of the instrument tip in hundredth of a mm
(1/100). Eg. No. 20 is 0.20 mm (20/100) at the tip.
25
3) The working blades (flutes) shall begin at the tip
designated site D1 and shall exactly 16 mm up to shaft
terminating at designated site D2.
4) The diameter of D2 shall 0.32 mm greater than that of
D1. eg: File no.20 shall have a diameter of 0.20 mm at
D1 and a diameter of 0.52 (0.20 + 0.32) mm at D2
5) This sizing will ensure a constant increase in taper of
0.02 per mm of every instrument regardless of its size.
26
27
Modifications from Ingle’s original
proposal are
6) An additional diameter
measurement point at D3,
3 mm of from tip of
cutting end of instrument
at D0
7) Tip angle of an
instrument should be 75o
 15o
28
COLOUR CODING:
 The International Standards
Organisation (ISO)
recommended a colour
coding system for easier
recognition
 Consists of 6 colours chosen
in ascending order of size
from light to dark
 Small sized instruments (06,
08) & larger (110-150) were
also added.
GROUP 1
29
Instrument length:
• The working end of the
instrument (length of the cutting
segment, l1) remains constant is
16 mm.
• Measured from the instrument tip
to the end of the shank (l2)
• Manufactured in four lengths
Standard  25 mm
Long  31 mm
Short  21 mm
30
 DG 16 and CK 17
 Double ended extra long
sharp instrument
ENDODONTIC EXPLORER
Functions:
•Location of canal orifices
•Determine canal angulation
•CK17 has thin, stiff tip to identify
calcified canals.
31
Profinder file
C+
file
The Profinder files come in sizes 10, 13
and 17, which are all available in lengths
18mm, 21mm and 25mm.
Lengths 18mm, 21mm and 25mm.
32
Micro Openers-
 Find and enlarge orifice
 Combine the canal-finding capabilities of explorer with instrumentation
capabilities of a K-file.
 The series comprises 3 instruments with a tip diameter
respectively of 0.10, 0.15 and 0.10 mm and a taper
.04, .04 and .06 respectively
33
Micro- debriders –
 To debride the orifice
 They are hedstrom files with a
taper of 0.02 characterized by a
short shaft bent at a 200 degrees
angle, and a long grip in plastic.
 Used in a circumferential filing
movement and available in ISO
diameters 20 and 30.
34
BROACHES
SMOOTH BROACHES- used as pathfinder
BARBED BROACHES
 Available sizes XXXfine to Xtra coarse
 Used for pulp tissue extripation
 Also for removal of necrotic debris, absorbent points
and cotton pledgets.
 Break easily if they bind in canal
 Used after enlarging canal
 Selection of size is important
if too wide – force pulp tissue apically
if too narrow – do not allow removal as it will not
engage sufficiently.
35
Dimensional formula for barbed broaches and rasps according to
ANSI specification no. 63.
36
RASPS
 Similar to broaches in design but have shallower and more
round barbs.
 Used to enlarge root canals but usually produce rough
walls hence not preferred.
broach rasp
37
FILES & REAMERS
 FILES -that enlarge canal with reciprocal insertion and
withdrawal motions.
 REAMERS -cut and enlarge canals with rotational motions.
 First mechanical rotary file - from straight piano wire which
were ground and then twisted.
 Files- first manufactured by KERR manufacturing company of
romulus, michigan in 1900s
38
File fabrication by twisting a tapered stainless steel blank
TECHNIQUES OF MANUFACTURING
1. GROUND TWISTING
consists of first grinding, then twisting. Raw wire is ground
into tapered geometric blanks; (square, triangular, and
rhomboid) The blanks are then twisted counterclockwise
to produce helical cutting edges.
2. MACHINING
This technique involves machining(grinding) the instrument
directly on a lathe; an example is the Hedstrom-type file
39
K Reamer
K File
Square cross section Triangular cross section
Tighter flutes Loose spirals
Resists fracture better . Fractures easily
Less cutting efficiency Cutting efficiency is 2.5 times
more
More number of flutes Less number of flutes
Pulling and rasping Pushing and rotating
40
HYBRID INSTRUMENT DESIGNS
Overcome clinical difficulties like ledging, perforation
Modifications
1.Changes in cross sectional design
2.Changes in depth or angle of cutting edges
3.Changes in design tip
K-FLEX FILES
Introduced in 1981
Rhomboid or diamond in cross-section
Alternate high and low flutes
Increased flexibility and cutting efficiency
37.5% reduction in cross sectional area
2 Point contact
41
TRIPLE FLEX FILE
More spiral flutes than K reamer but less than
K file
Made from triangular stainless steel by twisting
More aggressive and flexible than regular K file
42
FLEX -R FILE
Developed by union broach company.
Manufactured – triangular stainless steel blank.
The tip of this file has been modified to have a
compound angle of 70 and 35 degrees.
The cutting tip angle is reduced so that file stays
more centered within the Canal and enables a
more circumferential cutting action.
43
Flex-R-file with noncutting tip. A, Note rounded tip. B, “Nose”
view of a noncutting tip ensures less gouging of the external
wall and reduced cavity transport.
Such design is to guide the tip through
curvatures reduce the risk of ledging and
perforation.
Used in balanced force concept.(Roane)
44
FLEX O FILE
Tip is rounded and blunted - safer during the
shaping of curved canals
Triangular section so less bulky than K-Files,
three angles of contact reduce the friction and
favour penetration in an apical direction
Very similar to K file but made from soft
flexible steel.
Available in ISO diameters of 0.15 to 0.40
mm and lengths 21, 25 and 31 mm.
45
Golden Mediums
identical to the FlexoFiles except that the diameters have
intermediate values compared to those of the ISO
standard.
Available only in ISO diameters 12, 17, 22, 27, 32 and 37;
the lengths remain 21, 25 and 31 mm.
use is recommended for long and calcified or curved canals
where the passage from a 10 to 15 file or from a 15 to a 20
may be difficult.
46
K-Flexoreamers
Obtained by twisting a steel wire with a
triangular cross-section having a pitch
and helical angle analogous to the classic Reamers.
The triangular cross-section even in the smaller
diameters gives the Flexoreamers an increased
flexibility, while the rounded tip (identical to the
Flexofiles) reduces the risk of ledging or apical
transportation when preparing curved canals.
Available in ISO diameters from 15 to 40 and lengths 21,
25 and 31 mm
47
Round stainless steel wire
Spiral flutes, resembles cones
Fragile and fractures easily.
Has higher cutting efficiency than k-
instruments.(+ve rake angle)
Used in one direction only retraction,
Not used in toruqe motion.
Also used to engage and remove retained
instruments, guttapercha, silver cones.
H-FILES [HEDSTROM FILES]
48
Safety hedstroem –
It is hedstroem with non cutting side
in order to prevent ledging in the canals.
Hyflex file-
It has cross section which presents an S shaped
instead of helix teardrop cross section of hedstroem file.
49
Unifiles –
•They are machined from round stainless steel wire by
cutting two superficial grooves to produce flutes in a
double helix design.
•Less subjected to fracture but less efficient.
S file-
• It has double helix cross section and
is variation of unifile.
• It differs from unifile that angles of flutes
remain uniform through the instrument
length and depth of flutes increases
from tip to handle.
H-type root canal files. Hedstrom (left),
Unifile (right). B, S file.
50
SPREADERS
 Long tapered instruments with pointed tip
 Used to condense the filling material laterally
against the canal walls creating space for
insertion of additional auxiliary cones
 Finger spreaders are available in sizes 15 to 45
with color coding.
 Manufactured from SS or NITI
51
PLUGGERS
 Have smooth and flat apical tips.
 Used for condensation of guttapercha during obturation.
 Used primarily for vertical condensation.
 Pack MTA and CaOH in canal
 Types: With handle or finger plugger
52
Schilder pluggers
53
Lentulospiral
 It has long spiral working end.
 Hand instruments or latch type attachment.
 Used with low speed hand piece.
 Sealer or cement is placed into the root canal.
 Available in 21,25, 29 mm lengths
54
55
CLASSIFICATION OF ENDODONTIC INSTRUMENTS
(ON BASIS OF THEIR METHOD OF USE)
according to Grossman 12th edition
GROUPS TYPES OF
INSTRUMENTS –
HAND / ENGINE
DRIVEN
EXAMPLES
I Endodontic
instruments for hand
use only
K-type files
H type file
Barbed broaches
Reamers
spreaders
pluggers
56
TYPES TYPES OF
INSTRUMENTS –
HAND / ENGINE
DRIVEN
EXAMPLE
II Non rotary
endodontic
instruments used
with a handpiece.
Engine driven
instruments
Ultrasonic and sonic
instruments
III Rotary endodontic
instruments used
with handpiece
Low speed
instruments with
latch type of
attachment .
• Gates glidden
drill
• Peeso reamers
• Niti Rotary
instruments
57
Rotary contrangled handpiece
Specially designed handpieces providing a mechanical action to
root canal cutting instrument have been available from 30 yrs.
They reduce time spent in canal preparation.
Main drawbacks -use should be limited in straight canals, often
misdirected and cause perforations
Specially designed to power new NITI instruments in canal.
Speeds vary from 300 to 2000rpm.
 Micromega MM 324 reduction gear handpiece
 Quantec ETM,
 Niti matic
 Anthogyr
 Electronic digital motor handpiece
58
ANTHOGYR TORQUE CONTROL HANDPIECE
Reciprocating handpiece -
Giromatic handpiece-
Uses K file or K reamer with 90degrees
Reciprocating arc, speed 3000cycles/min.
only latch type instruments
M4 safety handpieces
30 degree reciprocation
Uses safety hedstroem instruments.
4:1 gear ratio
Which even at full speed demonstrates
minimal torquing.
Chuck activated mechanism.
M4 Safety Handpiece
GIROMATIC HANDPIECE
59
Endo-gripper
 10:1 gear ratio
 45⁰ turning motion
 uses regular hand files.
Canal finder system
 Contra angled hand piece, speed 3000rpm.
 Used in initial preparation of curved and
narrow canals
 Tendency to straighten the canal and
widen the apical foramen on over
instrumentation.
 Uses A file, variation of H file
60
Racer
•Its a contraangled hand piece that
uses standard file and oscillates the file
in root canal.
•The instrument length can be
preadjusted to the estimated working
length.
Disadvantage- debris may be forced
ahead of instrument into periapical
tissues.
61
Vertical stroke handpiece
 Driven by air or electrically
 vertical stroking range is from 0.3 to 0.1 mm.
 Quarter turn reciprocating arc along with vertical
stroke is seen when instrument starts binding in
the canal.
62
GATES-GLIDDEN DRILL:
 Has a long thin shaft ending in a flame shaped
head with a safe tip to guard against perforations.
 Flame head cuts laterally and is used with gentle,
apically directed pressure.
 The long shaft is designed to break at neck, i.e. the
narrowest diameter that lies adjacent to the hand
piece.
63
• GG drills come in various sizes from ISO 50 ( size
1 ) to ISO 150( size 6 ) lengths 32mm and 28mm.
• Speed 750 to 1500rpm
USES:
 To remove lingual shoulder during
access preparation for anterior teeth
• To enlarge root canal orifices.
• To clean and shape the cervical third
of root canals in step- back preparation.
64
FLEXOGATE:
Used in enlarging apical region of canal.
Noncutting pilot tip.
Advantages: less likely to cause
transportation
It has breakage point 16mm from tip,
so ease of retrival.
Disadvantages: more readily #
Flexogates (aka “Handy Gates”) hand-powered
version of a Gates-Glidden drill used to perfect
apical cavity preparation.
Note the safe noncutting pilot tip. (Courtesy of
Dentsply/Maillefer.)
65
PEESO-
REAMERS
 They differ from GG drills in having
parallel sided cutting flutes.
 Available in sizes ISO 070 ( size 1 ) to
sizes ISO 170( size 6 )
 It cuts laterally.
 As they are less well controlled than GG
drills their use is restricted to post space
preparation .
66
SIZE GATES-GLIDDEN(mm) PEESO REAMERS
(mm)
No.1 0.5 0.7
No.2 0.7 0.9
No.3 0.9 1.1
No.4 1.1 1.3
No.5 1.3 1.5
No.6 1.5 1.7
67
ULTRASONI
CS
 Sound as a energy source activates endo file
resulting in 3D activation of file.
 First used in endodontics by Richmann in 1957
 Martin and cunningham 1st developed a device,
tested it and marketed it in 1976 cavitron endo
system(no longer)
 Followed by Enac, piezon master 400.
 Operate at frequency of 25-30kHz.
 Uses K-files and canal should be enlarged atleast
upto 20 size before size 15 can fully function.
 Delivers irrigant/coolant Naocl, Cleaning and
shaping is carried by k file.
68
A, Cavitron Endo unit with
handpiece (right) and
reservoir hatch (top right). Dials
(front panel) regulate vibratory
settings. Foot control not shown. B,
CaviEndo handpiece mounted
with an Endosonic diamond file.
Irrigating solution emits
through a jet in the head. (Courtesy of
Dentsply/Cavitron.)
69
 Initially it was thought that main debriding
action is due to CAVITATION
 But later its belived that ACOUSTIC
STREAMING is responsible for debridment.
 Small files cause more acoustic streaming –
clean canals.
CAVITATION
ACOUSTIC
STREAMING
70
71
 The ultrasonic files are K-Files without handles, which
can be mounted using appropriate inserts on the
ultrasonic handpiece.
 Until a few years ago they were recommended for
root canal shaping, currently they are used to
passively activate the irrigating solution before canal
obturation.
 use of the ultrasonic files for canal shaping is not
recommended due to their tendency to make ledges in
the canal walls and their structural fragility.
SONIC
INSTRUMENTS
• Prinicipal sonic hand piece is micro mega 1500
sonic air
endo system. Others Megasonic 1400, Endostar.
• Airline pressure is 0.4Mpa.Operate at frequency of
2-3kHz
• Oscillating range is 1500 to 3000c/sec
• Irrigant /coolant is tap water
• 3 choices of files used with sonic handpiece
Rispi sonic - resembles old rat file
Shaper – barbed broach
Trio sonic – triple helix H file
All of them have safe ended non cutting tips.
Primarily used for step down enlargement
72
NICKEL TITANIUM FILES
 NiTi is also known as NiTinol
 In endodontics commonly used NiTi alloys
have NiTi nol (60% weight of Ni, 40% Ti)
 First use of NiTi in endodontics was reported
in 1988, by Walia et al when a 15 No. NiTi
was made from orthodontic wire and it
showed superior flexibility and resistance to
tortional fracture. This suggested the use of
NiTi files in curved canals
73
ADVANTAGES OF NiTi
• More flexible
• Better conformation to canal curvature.
• Resistance to fracture.
• Less wear.
• Superelasticity
• Corrosion resistance
• Faster instrumentation
• No need to pre curve
74
ROTARY NiTi
SYSTEMS
• Since last many years innumerable number of RNT file system
have been made available
• Various rotary NiTi systems available are
1.Profile
2.Pro Taper
3.Greater Taper
4.Quantec
5.Light speed system
6.K3 system
7.Hero shaper 642
8.RACE (Reamers with alternating cutting edges)
9.Flexmaster
10.Rapid body shapers
11.Mtwo rotary niti system
12.SAF
13.Wave
14. Liberartor
15. V taper
16. Endosequence
75
PROFILE
SYSTEM
 Earlier profile was sold as series of 29
instruments in .02 taper, soon became available
in .04 & .06 taper
 The tips of the ProFile Series 29 rotary instruments
(Dentsply–Tulsa) had a constant proportion of tip
diameter increments (29%).
 Because of the nonstandardized diameters,
obturation was performed with nonstandardized
gutta-percha cones, using either lateral compaction
or thermoplastic obturation of gutta-percha
 Later, another ProFile series was developed and
marketed in Europe. This version featured tip sizes
similar to those of ISO-normed instruments
76
77
 ProFiles as rotary instruments in nickel titanium
introduced by Dr.W. Ben Johnson in 1994
 Obtained by micromachining three parallel furrows
on a nickel titanium wire
 Cross-section -defined as a “triple U” with blades
characterized by flat cutting surfaces called “radial
lands”.
 Design is a reduction of the central “core” of
resistance of the instrument with a resulting
structural fragility to torsional stress conditions &
increase in flexibility.
78
79
 ProFiles all present a working surface of 16 mm
and a round non cutting tip
 furthermore along the shaft there are “depth
gages” that are dark grooves placed at 18, 19,
20, 22 and 24 mm from the tip.
 The handle of the ProFile in nickel plated and
has a small ISO standard coloured rings which
are useful to identify both the diameter and the
taper (one small ring for the .02 series, two
small rings for the.04 series, and three small
rings for the .06 series)
 ProFiles are used in a crown down based on
reductions of taper and/or diameter.
80
Advantages:
Safety feature is design: unwind and then windup
backward prior to breaking.
Stresses become evenly distributed along entire
instrument in contrast to conventional instrument
where stresses are more concentrated at tip of narrow
end.
Area of contact is less, so contact pressure is high and
this gives instrument greater cutting efficiency.
Due to pronounced taper of these instrument, canal is
shaped quickly.
81
ProFile Orifice Shapers
82
 series of 6 instruments devised for the elimination
of coronal interferences and for flaring the coronal
one third of the canal
 Characterized by blades and a tip that are identical
to that of the ProFiles, a total length of 19 mm and
an active part that is 10 mm long.
 The diameter at the tip and the taper of the 6
ProFile Orifice Shapers are respectively 20-.05,
30-.06, 40-.06, 50-.07, 60-.07 and 80-.08
 used at the initial phases of the ProFile instrument
sequences
83
ProFile Orifice Shapers
PROTAPER
FILES
 Designed by Dr.cliff ruddle, Dr.john west, Dr.pierre
machtou.
 Triangular cross section and is variably tapered across
its cutting length. A unique feature is each instrument
has changing percentage tapers over the length of
cutting blades. This design improves flexibility, cutting
efficiency and the safety of these files.
 No radial lands - so decreases the friction between
blade of the file and the canal
wall while increasing the cutting
efficiency.
84
 The Protaper system consists of three shaping and
three finishing files. 2 more finishing files are now
added.
 3 shaping files have increasing tapers towards
handle
 5 finishing files have a reverse pattern
 Protaper file has a changing helical
angle and pitch over their cutting
blades which reduces the instrument
from screwing into the canal and
allows better removal of debris.
85
SX:
 D0 diameter is 0.19mm and D9 is 1.1mm
 After D9 the rate of taper drops off
S1:
 Has purple identification ring on its handle
 D0 diameter is 0.17mm and D14 is 1.20mm
 Used to prepare coronal part of the root
S2:
 Has white identification ring on its handle
 D0 diameter is 0.20mm and D14 is 1.20mm
 Used to prepare middle third of the canal
86
SHAPING FILES
87
FINISHING FILES
• Three finishing files F1,F2,F3 are used to prepare
and finish the apical part of the root canal
F1:
• Yellow colored ring
• D0 diameter and apical taper is 20 and 0.07
F2:
• Red colored ring
• D0 diameter and taper is 25 and 0.08
F3:
• Blue colored ring on handle
• D0 diameter and taper is 30 and 0.09
• Each instrument has decreasing percentage of
taper from D4 to D14.This improves flexibility and
decrease the potential for taper lock
88
Advantages
Progressive taper design improves flexibility and
instrumentation in curved canals.
Both shapers and finishers remove debris and finish
preparation with smooth continous taper.
Balanced pitch and helical angle of instrument
prevents threading and optimize cutting action while
effectively removing debris
Triangular crosssection of instrument increases safety,
tactile sense and cutting action.
89
QUANTEC FILE
SYSTEM
 devised by John McSpadden are available in 2 series
of instruments cutting(Quantec SC) and noncutting
tips(Quantec LX)
 Quantec SC has a facetted cutting tip without a
transition angle and with a 60° tip angle. The LX
Quantec instead present a blunt pointed tip at 60°,
which is non cutting.
 Cross section is S shaped & has a positive blade angle
with two wide radial lands and relief behind the lands
 This unique design minimizes its contact with the
canal, thereby reducing the torque, and increases the
strength of the instrument
 Quantec system utilizes the “graduated taper
technique” to prepare a canal
 The instruments are used at 300 to 350 rpm in a high-
90
91
CROSSSECTION OF QUANTEC
92
 The LX Quantec consist of:
 – four 17 mm long instruments with a 0.25 mm tip
diameter and a taper of .06, .08, .10 and .12
which are ideal for removal of coronal
interferences;
 – seven instruments for canal preparation; these
are 21 or 25 mm long with a 0.25 mm tip diameter
and tapers of .03, .04, .05, .06, .08, .10 and .12;
 – ten instruments for apical finishing, which are
21 or 25 mm long having a taper of .02 and ISO
diameters from 15 to 60.
93
 The SC Quantec consist of:
 – two 17mm long instruments with a 0,25 mm tip
diameter to eliminated coronal interferences
 four instruments for canal preparations which are
21 or 25 mm long with a 0.25 tip diameter and a
taper of .03, .04, .05, .06;
 – ten instruments for apical finishing which are 21
or25 mm long having a taper of .02 and an ISO
diameter from 15 to 60.
LIGHT SPEED
FILE
• Developed by Dr.steve senia &
Dr.william widleymin early 1990s
• so called because a “LIGHT” touch
is needed as “SPEED” of
instrumentation is increased.
 very similar to the Gates Glidden
drills with a long shaft and a
working part in the shape of a very
short flame.
 The set of instruments consists of
ISO-sized rotary files from size 20
through 100, including nine half-
sizes ranging from 22.5 through 65
that half size instruments have
white or black rings on their
handles.
94
95
 LightSpeed instruments are made with a point of
separation at 18 mm from the tip, in order to facilitate
their removal incase of endocanal fracture
 The LightSpeed instrument has a cross-sectional U
blade design in which flat radial lands with neutral
rake angles enhance planing of the canal walls and
centering of the instrument within the canal. The helical
blade angle and narrow shaft diameter facilitate debris
removal coronally.
 The length of the working part varies according to the
calibre from 0.25 to 1.75mm, tip is rounded and non
cutting
 LightSpeed instruments available in the 21, 25 and 31
mm lengths, must be used from the smallest to the
largest in a stepback sequence with a typical pecking
movement
 Recommended working speed is 750-2000rpm with
preference towards 1300 to 2000 range.
Advantages
Better preparation of apical portion of canal to a size
larger than what can be normally produced by using
tapered instruments
Results in rounded and centered apical preparations.
96
3
SYSTEM
 Cutting head of K3 show three radial lands with relief
behind two radial lands. Asymmetrically placed
flutes make the K3 system with superior canal
tracking ability, add peripheral strength to K3
system, and prevent screwing into the canal.
97
98
 K3 files have positive rake angle
providing them an effective
cutting surface
 a non working tip, a variable
helical angle, a variable pitch with
less blades on the coronal part to
prevent the screw in effect
 diameter of the core reduces in
the coronal direction so as to
keep the flexibility of the
instrument constant all along its
length.
 Sequence of using the K3 is
crown-down based on decreasing
diameter, taper or on alternate
decreasing of diameter and taper
99
RACE FILES
 Race Files (Reamers with
alternating cutting edges)
 characterised by a triangular
cross-section, cutting blades,
non working tip and
alternating cutting angles that
reduce the risk of screw in,
canal blockage and reduces
the working torque of the
instruments
 Electrochemical treatment of
these files provides better
resistance to corrosion and
metal fatigue.
 can be used either in the
crown-down or step back
100
101
 available in the following tapers and lengths:
 – RaCe .06 taper # 20, 25 and 30 with overall
length
of 19 mm and blade length of 10 mm;
 – RaCe .06 taper # 20, 25 and 30 with overall
length
of 25 mm and blade length of 16 mm;
 – RaCe .04 taper # 25, 30 and 35 with overall
length
of 25 mm and blade length of 16 mm;
 – RaCe .02 Taper from # 15 to # 60 with overall
length
of 25 mm and blade length of 16 mm.
 also includes for flaring the coronal third of the
canal, the Pre-RaCe, availabe in ISO diameters
40 with .10 and .06 taper, ISO 35 with .08 taper
102
GT Files
 devised by Dr. L.S. Buchanan, are instruments in NiTi
with greater taper obtained by machining
 Have sharpened blades which are machined in an
counter-clockwise direction with a pitch and helical
angle that is variable from the tip towards the handle.
 the number of spirals are higher and the cutting angle
wider near the apical part of the instrument, while
coronally the spiral number is reduced and the angle
becomes narrower.
 Clinically the apical part functions like a K-File, while the
coronal part functions like a reamer.
 have the blade direction counter-clockwise, that is
opposite to other hand instruments and therefore to be
able to cut they must be rotated in a counter-clockwise
direction.
103
104
 consist of four instuments with a fixed diameter at the tip
of 0,20 mm, a maximum diameter of the blades of 1.00
mm and a taper respectively of .06, .08, .10 and .12
 the length of the cutting part of the GT Files reduces
from 13.5mm for the .06 taper to 6.7 mm for the .12
taper.
 have a non-cutting tip, depth gages that is dark markings
placed along the shank at 18, 19, 20, 22 and 24 mm
from the tip, that facilitates the positioning of the silicone
stop and allows accurate control of the insertion depth of
the instrument.
 The colours of the handle (white for GT .06, yellow for
GT .08, red for GT .10 and blue for GT .12) do not follow
the ISO system
 useful to bypass the ledges and in the presence of
canals with a severe apical curvature due to the
105
Rotary GT Files
106
 Like the hand instruments, the Rotary GT Files
present a non cutting tip, a prefixed tip diameter
and a prefixed maximum flute diameter (MFD),
multiple tapers and a blade length inversely
proportional to the taper.
 Differences include
-blade direction which is clockwise in the Rotary
GT and counter-clockwise in the Hand GT
-Rotary GT blades are classical “radial lands”
without the sharp cutting angles found in the
Hand GT Files
107
 Rotary GT Files are at present available in 4
principal series, each one of which comprises 4
instruments:
 – GT 20 Series comprises 4 instruments with a 0.20
mm tip diameter and tapers of .04, .06, .08 and .10
 – GT 30 Series comprises 4 instruments with a 0.30
mm tip diameter and tapers of .04. .06, .08 and .10
 – GT 40 Series comprises 4 instruments with a 0.40
mm tip diameter and tapers of .04, .06, .08 and .10
 – GT Accessory comprises 3 instruments with a
taper of .12 and a tip diameter respectively of 0.50,
0.70 and 0.90 mm
The maximum blade diameter is 1.00 mm
for all GT’s 20 and 30 Series and for GT 40 Series
with of .04,.06 and .08 taper, it is 1.25 mm for GT 40
Series with .10 taper and is 1.5 mm for GT
108
109
 The blade length varies according to the tip
diameter, to the maximum diameter and
according to the taper.
 The Rotary GT Files are generally used in a
crown down sequence progressively reducing
their taper and/or their diameter
HERO 642
 Mechanical instruments derived from the Helifiles
 a triple helix cross-section with three positive rake
angles; no radial cutting lands but there are cutting
angles.
 – a higher “ residual core” inside the blades which
increases the resistance to torsional loads
diminishing the risk of fracture
110
111
 a progressive sequence of the blades to reduce the
tendency to screw in
 three tapers which permit the reduction of the
contact surfaces between the blades and the canal
walls
 a tip that remains centred in the canal
 Hero are used in a crown down sequence based
on the reduction of the taper (6-4-2) and/or of the
diameters.
112
Hero Shaper
113
 derived directly from the 642 Hero’s
and they have the same triple helix
cross-section,with positive rake angles
 differs from the 642 Hero in that
- the rake angle (helical angle) of the
blades is variable and increases from
the tip towards the handle,
- the pitch (distance between two
spirals) increases with the taper of the
instruments,
-the shorter handle allows an easier
access to the posterior teeth & tip is
completely inactive and self guiding
 These changes in the geometry of the
Hero Shaper reduce the risk of
instrument screw in, increases the
flexibility and optimizes the removal of
the debris.
114
 The Hero Shaper series comprises three
instruments with a taper of .06 (20, 25
and 30) and three instruments with a
taper of .04 (20, 25 and 30), available in
lengths 21, 25 and 29 mm.
Endoflare
 designated for the enlargement of the
coronal one third of the canal for the
elimination of coronal interferences.
 They have a tip diameter of 0.25 mm and
.12 taper.
 The Endoflare have the same tip
characteristics, helical angle, pitch and
cross-section as the Hero Shaper.
115
Hero Apical
 for the enlargement of the apical one third in
canals
 series comprises two instruments both with tip
diameter of 0.30 mm with a taper of .06
and .08 respectively
 have the same characteristics regarding tip,
helical angle, pitch and cross-section as the Hero
Shaper
Flexmaster
 The FlexMasters available with tapers .02, .04 and
.06 in
lengths 21 and 25 mm
 Tip diameter 0.15 to 0.7mm for 0.02 file
0.15 to 0.4mm for .04 & .06files
 Flex master has a triangular cross-section with
convex angles, cutting blades and a tip very similar
to that of the ProTaper, however, it differs by the
multiple taper, helical angle and pitch.
116
117
flexmaster
Rapid Body
Shapers,
118
 instruments feature the
patented nonledging Roane
bullet tip and allow the
practitioner to rapidly shape
the body of the canal without
the problems that can occur
using Gates-Glidden drills.
 develop a parallel-walled
canal shape.
 RBS series consists of four
instruments: No. 1 (0.61 mm at
the tip), No. 2 (0.66 mm at the
tip), No. 3 (0.76 mm at the tip),
Pow-R Nickel-Titanium Rotary
Files
119
 also with a nonledging Roane bullet tip, are
available in both 0.02 and 0.04 tapers
 to clean and shape the middle and apical regions
of the canal in a conservative manner.
 Available in standard ISO instrument sizes as
well as in half sizes 17.5, 22.5, 27.5, 32.5, and
37.5 for more precise apical refinement. follow
standard ISO color codes as well.
 Both the RBS files and Pow-R instruments are
used in high-torque, gear-reduction handpieces
with rpm ranging from 300 to 400.
Endosequence
 Manufactured by FKG in switzerland & In US by
brassler
 It has precision tip which is noncutting tip that results in
safety combined with efficiency.
 Instruments are electropolished – remove imperfections
that leads to seperation.
 Variable pitch and helical angles which gives more
control.
 Because of reamer like design i.e, alternate
Contact ponts and sharp edges it has superior
cutting efficiency .
 available in both.04 (size 15–80) and .06
(size 15–50) taper instruments, in lengths of
21, 25 and 31mm instruments.
 speed 500-600 rpm
120
V taper files
121
 Set of 3 variable taper NiTi roary files.
 Facilitates to attain deeper apical shapes with fewer
instruments and conservative access.
 Most cases completed with 2-3 files
 Parabolic crosssection – highly efficient and flexible
cutting instrument with being extremely safe and
resistant to #
 Neutral rake angle – very efficient in cutting
 No land – reduces friction, heat buildup in file.
LIBERATOR
122
 Straight fluted file unlike the others
which are helically fluted
 Triangular in crosssection
 Lack of radial lands so reduces friction
 saftey tip keep file centered in canal
 Efficient in removal of dentin
 Manufacturing process eliminates
transverse microcracks
 Speed 1000-2000rpm
Wave NiTi files
123
 new endodontic system that uses
reciprocating technology
 innovative thermal treatment process to
create the M-Wire NiTi material.
 resulting characteristics provide overall
flexibility and greater resistance to cyclic
fatigue.
 Available in 21, 25 & 40 tip diameters with
6%, 8%, 6% tapers respectively.
 Perfect canal shapes are achieved with just
1 single file
Mtwo NiTi rotary system
124
 standard set for this system includes four
instruments with variable tip sizes ranging from
#10 to #25, and tapers ranging from .04 to .06
(size 10/.04 taper, size 15/.05 taper, size 20/.06
taper, size 25/.06 taper).
 The colored ring on the handle identifies the size,
accordingto ISO standards.
 number of grooved rings on the handle identifies
the instrument taper: one ring means .04 taper,
two rings mean .05 taper, three rings mean .06
taper and four rings mean .07 taper.
 available in 21 mm, 25 mm, and 31 mm lengths.
125
 cross-section of Mtwo is an “italic S”
with two cutting blades
 RA is one of the most effective,
enhancing the cutting efficiency of
this instrument The tip is non-
cutting.
 The Mtwo NiTi rotary instruments
are used at 300 rpm.
 operative sequence suggested for
these instruments is a crown-down
technique.
SELF ADJUSTING
FILES
Hollow, NiTi files with slight abrasive surface
Operated by KaVo handpiece
5000 vibrations/min & 0.4mm amplitude
File get compressed and adapts to canal walls & apply
uniform cutting action.
Continous irrigation
One file is used through out the procedure.
126
Thank you..
127

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1 endodontic armamentarium.pptx

  • 1. 1
  • 2. CONTENTS • INTRODUCTION • BASIC INSTRUMENTS • INSTRUMENTS FOR ACCESS CAVITY PREPARATION • INSTRUMENTS FOR CLEANING AND SHAPING ROOT CANAL Classifications Material sciences Parts of a file Instrument standardization Hand operated instruments 2
  • 6. MOUTH MIRROR Types-(according to reflecting surface)  Plane/regular surface mirrors  Front-surface mirrors  Concave surface mirrors/ magnifying mirrors According to size  No.2(5/8th inch)  No.4(7/8th inch)  No.5(15/16th inch) 6
  • 7. ENDODONTIC SPOON EXCAVATOR Functions: • To remove carious material and excise pulp tissue. • They have long offset from long axis of instrument compared to normal spoons. 7
  • 8. ENDODONTIC LOCKING TWEEZERS It has a latch that permits materials to be held without continuous finger pressure Grooved tip facilitates holding of paper points, gutta percha points and root canal instruments 8
  • 9. ANESTHETIC SYRINGE  2ml syringe is used  For infiltration, block or intrapulpal injection.  Disposable & discarded. 9
  • 10. ENDODONTIC MILLIMETER RULER  Used to measure endodontic files and guttapercha cones 10
  • 13. Hand piece  A handpiece is a device for holding rotating instruments, transmitting power to them, and for positioning them intraorally.  It may retain the cutting tool by a screw-in, latch or friction type of attachment  Both speed and torque in a handpiece can be modified by incorporation of the gear system 13
  • 14. Round burs  sizes #2, #4, #6 Fissured carbide burs 14
  • 15.  Safety tip tapered diamond & fissured carbide burs  Round diamond burs #2,#4  Transmetal bur 15
  • 16. Mueller bur & LN bur Gates glidden burs 12 taper niti orifice opener 16
  • 18. 18
  • 19. INSTRUMENTS USED FOR CLEANING AND SHAPING THE PULP SPACE 19
  • 20. Instruments for pulp space preparation : According to ingle 5th edition ISO Grouping of Instruments • Group I: Hand operated instruments Broaches K type (Kerr) files & reamers H type (Hedstroem) and, Pluggers and Spreaders. • Group II: Engine-driven latch type same as Group I but made to be attached to a hand piece. Included are paste fillers. • Group III: Engine-driven latch type - drills or reamers such as Gates-Glidden Peeso reamers • Group IV: Root canal points- gutta-percha, silver, paper. 20
  • 21. FUNCTION INSTRUMENTS Exploring Smooth broaches and endodontic explorers (Used to locate canal orifice and to determine the direction and patency of root canal) Debriding Barbed broaches (Used to extirpate the pulp and to remove debris and other foreign materials ) Shaping Reamers and Files (Used to shape the canal space laterally and apically ) Obturating Pluggers, spreaders and lentulospirals (To cement and pack guttapercha points into the canal space) Classification According to Function (Grossman’s Classification) 21
  • 22. 22
  • 23. Materials Used NICKEL-TITANIUM Super-elasticity, Shape memory Corrosion Resistance Less cutting efficiency In 20th century STAINLESS STEEL Flexible, Less prone to fracture & corrosion In 19th century CARBON STEEL # tendency, Corrosion TITANIUM & ALUMINIUM ALLOYS Marketed as Microtitane Resistance to #, have Increased flexibility. Cutting efficiency as SS. 23
  • 24. STANDARDIZATION: Was recommended by Ingle and Levine in 1958. describes 3 features a) Diameter and width b) Length of cutting blade c) Taper 24
  • 25. 1958  Ingle and Levine first proposed standardization of endodontic instruments and suggested guidelines for the same 1) The instruments shall be numbered from 10 to 100, the numbers advance by 5 units to size 60, and thereby by 10 units to size 100. 2) The instrument number shall be representative of the diameter of the instrument tip in hundredth of a mm (1/100). Eg. No. 20 is 0.20 mm (20/100) at the tip. 25
  • 26. 3) The working blades (flutes) shall begin at the tip designated site D1 and shall exactly 16 mm up to shaft terminating at designated site D2. 4) The diameter of D2 shall 0.32 mm greater than that of D1. eg: File no.20 shall have a diameter of 0.20 mm at D1 and a diameter of 0.52 (0.20 + 0.32) mm at D2 5) This sizing will ensure a constant increase in taper of 0.02 per mm of every instrument regardless of its size. 26
  • 27. 27
  • 28. Modifications from Ingle’s original proposal are 6) An additional diameter measurement point at D3, 3 mm of from tip of cutting end of instrument at D0 7) Tip angle of an instrument should be 75o  15o 28
  • 29. COLOUR CODING:  The International Standards Organisation (ISO) recommended a colour coding system for easier recognition  Consists of 6 colours chosen in ascending order of size from light to dark  Small sized instruments (06, 08) & larger (110-150) were also added. GROUP 1 29
  • 30. Instrument length: • The working end of the instrument (length of the cutting segment, l1) remains constant is 16 mm. • Measured from the instrument tip to the end of the shank (l2) • Manufactured in four lengths Standard  25 mm Long  31 mm Short  21 mm 30
  • 31.  DG 16 and CK 17  Double ended extra long sharp instrument ENDODONTIC EXPLORER Functions: •Location of canal orifices •Determine canal angulation •CK17 has thin, stiff tip to identify calcified canals. 31
  • 32. Profinder file C+ file The Profinder files come in sizes 10, 13 and 17, which are all available in lengths 18mm, 21mm and 25mm. Lengths 18mm, 21mm and 25mm. 32
  • 33. Micro Openers-  Find and enlarge orifice  Combine the canal-finding capabilities of explorer with instrumentation capabilities of a K-file.  The series comprises 3 instruments with a tip diameter respectively of 0.10, 0.15 and 0.10 mm and a taper .04, .04 and .06 respectively 33
  • 34. Micro- debriders –  To debride the orifice  They are hedstrom files with a taper of 0.02 characterized by a short shaft bent at a 200 degrees angle, and a long grip in plastic.  Used in a circumferential filing movement and available in ISO diameters 20 and 30. 34
  • 35. BROACHES SMOOTH BROACHES- used as pathfinder BARBED BROACHES  Available sizes XXXfine to Xtra coarse  Used for pulp tissue extripation  Also for removal of necrotic debris, absorbent points and cotton pledgets.  Break easily if they bind in canal  Used after enlarging canal  Selection of size is important if too wide – force pulp tissue apically if too narrow – do not allow removal as it will not engage sufficiently. 35
  • 36. Dimensional formula for barbed broaches and rasps according to ANSI specification no. 63. 36
  • 37. RASPS  Similar to broaches in design but have shallower and more round barbs.  Used to enlarge root canals but usually produce rough walls hence not preferred. broach rasp 37
  • 38. FILES & REAMERS  FILES -that enlarge canal with reciprocal insertion and withdrawal motions.  REAMERS -cut and enlarge canals with rotational motions.  First mechanical rotary file - from straight piano wire which were ground and then twisted.  Files- first manufactured by KERR manufacturing company of romulus, michigan in 1900s 38
  • 39. File fabrication by twisting a tapered stainless steel blank TECHNIQUES OF MANUFACTURING 1. GROUND TWISTING consists of first grinding, then twisting. Raw wire is ground into tapered geometric blanks; (square, triangular, and rhomboid) The blanks are then twisted counterclockwise to produce helical cutting edges. 2. MACHINING This technique involves machining(grinding) the instrument directly on a lathe; an example is the Hedstrom-type file 39
  • 40. K Reamer K File Square cross section Triangular cross section Tighter flutes Loose spirals Resists fracture better . Fractures easily Less cutting efficiency Cutting efficiency is 2.5 times more More number of flutes Less number of flutes Pulling and rasping Pushing and rotating 40
  • 41. HYBRID INSTRUMENT DESIGNS Overcome clinical difficulties like ledging, perforation Modifications 1.Changes in cross sectional design 2.Changes in depth or angle of cutting edges 3.Changes in design tip K-FLEX FILES Introduced in 1981 Rhomboid or diamond in cross-section Alternate high and low flutes Increased flexibility and cutting efficiency 37.5% reduction in cross sectional area 2 Point contact 41
  • 42. TRIPLE FLEX FILE More spiral flutes than K reamer but less than K file Made from triangular stainless steel by twisting More aggressive and flexible than regular K file 42
  • 43. FLEX -R FILE Developed by union broach company. Manufactured – triangular stainless steel blank. The tip of this file has been modified to have a compound angle of 70 and 35 degrees. The cutting tip angle is reduced so that file stays more centered within the Canal and enables a more circumferential cutting action. 43
  • 44. Flex-R-file with noncutting tip. A, Note rounded tip. B, “Nose” view of a noncutting tip ensures less gouging of the external wall and reduced cavity transport. Such design is to guide the tip through curvatures reduce the risk of ledging and perforation. Used in balanced force concept.(Roane) 44
  • 45. FLEX O FILE Tip is rounded and blunted - safer during the shaping of curved canals Triangular section so less bulky than K-Files, three angles of contact reduce the friction and favour penetration in an apical direction Very similar to K file but made from soft flexible steel. Available in ISO diameters of 0.15 to 0.40 mm and lengths 21, 25 and 31 mm. 45
  • 46. Golden Mediums identical to the FlexoFiles except that the diameters have intermediate values compared to those of the ISO standard. Available only in ISO diameters 12, 17, 22, 27, 32 and 37; the lengths remain 21, 25 and 31 mm. use is recommended for long and calcified or curved canals where the passage from a 10 to 15 file or from a 15 to a 20 may be difficult. 46
  • 47. K-Flexoreamers Obtained by twisting a steel wire with a triangular cross-section having a pitch and helical angle analogous to the classic Reamers. The triangular cross-section even in the smaller diameters gives the Flexoreamers an increased flexibility, while the rounded tip (identical to the Flexofiles) reduces the risk of ledging or apical transportation when preparing curved canals. Available in ISO diameters from 15 to 40 and lengths 21, 25 and 31 mm 47
  • 48. Round stainless steel wire Spiral flutes, resembles cones Fragile and fractures easily. Has higher cutting efficiency than k- instruments.(+ve rake angle) Used in one direction only retraction, Not used in toruqe motion. Also used to engage and remove retained instruments, guttapercha, silver cones. H-FILES [HEDSTROM FILES] 48
  • 49. Safety hedstroem – It is hedstroem with non cutting side in order to prevent ledging in the canals. Hyflex file- It has cross section which presents an S shaped instead of helix teardrop cross section of hedstroem file. 49
  • 50. Unifiles – •They are machined from round stainless steel wire by cutting two superficial grooves to produce flutes in a double helix design. •Less subjected to fracture but less efficient. S file- • It has double helix cross section and is variation of unifile. • It differs from unifile that angles of flutes remain uniform through the instrument length and depth of flutes increases from tip to handle. H-type root canal files. Hedstrom (left), Unifile (right). B, S file. 50
  • 51. SPREADERS  Long tapered instruments with pointed tip  Used to condense the filling material laterally against the canal walls creating space for insertion of additional auxiliary cones  Finger spreaders are available in sizes 15 to 45 with color coding.  Manufactured from SS or NITI 51
  • 52. PLUGGERS  Have smooth and flat apical tips.  Used for condensation of guttapercha during obturation.  Used primarily for vertical condensation.  Pack MTA and CaOH in canal  Types: With handle or finger plugger 52
  • 54. Lentulospiral  It has long spiral working end.  Hand instruments or latch type attachment.  Used with low speed hand piece.  Sealer or cement is placed into the root canal.  Available in 21,25, 29 mm lengths 54
  • 55. 55
  • 56. CLASSIFICATION OF ENDODONTIC INSTRUMENTS (ON BASIS OF THEIR METHOD OF USE) according to Grossman 12th edition GROUPS TYPES OF INSTRUMENTS – HAND / ENGINE DRIVEN EXAMPLES I Endodontic instruments for hand use only K-type files H type file Barbed broaches Reamers spreaders pluggers 56
  • 57. TYPES TYPES OF INSTRUMENTS – HAND / ENGINE DRIVEN EXAMPLE II Non rotary endodontic instruments used with a handpiece. Engine driven instruments Ultrasonic and sonic instruments III Rotary endodontic instruments used with handpiece Low speed instruments with latch type of attachment . • Gates glidden drill • Peeso reamers • Niti Rotary instruments 57
  • 58. Rotary contrangled handpiece Specially designed handpieces providing a mechanical action to root canal cutting instrument have been available from 30 yrs. They reduce time spent in canal preparation. Main drawbacks -use should be limited in straight canals, often misdirected and cause perforations Specially designed to power new NITI instruments in canal. Speeds vary from 300 to 2000rpm.  Micromega MM 324 reduction gear handpiece  Quantec ETM,  Niti matic  Anthogyr  Electronic digital motor handpiece 58 ANTHOGYR TORQUE CONTROL HANDPIECE
  • 59. Reciprocating handpiece - Giromatic handpiece- Uses K file or K reamer with 90degrees Reciprocating arc, speed 3000cycles/min. only latch type instruments M4 safety handpieces 30 degree reciprocation Uses safety hedstroem instruments. 4:1 gear ratio Which even at full speed demonstrates minimal torquing. Chuck activated mechanism. M4 Safety Handpiece GIROMATIC HANDPIECE 59
  • 60. Endo-gripper  10:1 gear ratio  45⁰ turning motion  uses regular hand files. Canal finder system  Contra angled hand piece, speed 3000rpm.  Used in initial preparation of curved and narrow canals  Tendency to straighten the canal and widen the apical foramen on over instrumentation.  Uses A file, variation of H file 60
  • 61. Racer •Its a contraangled hand piece that uses standard file and oscillates the file in root canal. •The instrument length can be preadjusted to the estimated working length. Disadvantage- debris may be forced ahead of instrument into periapical tissues. 61
  • 62. Vertical stroke handpiece  Driven by air or electrically  vertical stroking range is from 0.3 to 0.1 mm.  Quarter turn reciprocating arc along with vertical stroke is seen when instrument starts binding in the canal. 62
  • 63. GATES-GLIDDEN DRILL:  Has a long thin shaft ending in a flame shaped head with a safe tip to guard against perforations.  Flame head cuts laterally and is used with gentle, apically directed pressure.  The long shaft is designed to break at neck, i.e. the narrowest diameter that lies adjacent to the hand piece. 63
  • 64. • GG drills come in various sizes from ISO 50 ( size 1 ) to ISO 150( size 6 ) lengths 32mm and 28mm. • Speed 750 to 1500rpm USES:  To remove lingual shoulder during access preparation for anterior teeth • To enlarge root canal orifices. • To clean and shape the cervical third of root canals in step- back preparation. 64
  • 65. FLEXOGATE: Used in enlarging apical region of canal. Noncutting pilot tip. Advantages: less likely to cause transportation It has breakage point 16mm from tip, so ease of retrival. Disadvantages: more readily # Flexogates (aka “Handy Gates”) hand-powered version of a Gates-Glidden drill used to perfect apical cavity preparation. Note the safe noncutting pilot tip. (Courtesy of Dentsply/Maillefer.) 65
  • 66. PEESO- REAMERS  They differ from GG drills in having parallel sided cutting flutes.  Available in sizes ISO 070 ( size 1 ) to sizes ISO 170( size 6 )  It cuts laterally.  As they are less well controlled than GG drills their use is restricted to post space preparation . 66
  • 67. SIZE GATES-GLIDDEN(mm) PEESO REAMERS (mm) No.1 0.5 0.7 No.2 0.7 0.9 No.3 0.9 1.1 No.4 1.1 1.3 No.5 1.3 1.5 No.6 1.5 1.7 67
  • 68. ULTRASONI CS  Sound as a energy source activates endo file resulting in 3D activation of file.  First used in endodontics by Richmann in 1957  Martin and cunningham 1st developed a device, tested it and marketed it in 1976 cavitron endo system(no longer)  Followed by Enac, piezon master 400.  Operate at frequency of 25-30kHz.  Uses K-files and canal should be enlarged atleast upto 20 size before size 15 can fully function.  Delivers irrigant/coolant Naocl, Cleaning and shaping is carried by k file. 68
  • 69. A, Cavitron Endo unit with handpiece (right) and reservoir hatch (top right). Dials (front panel) regulate vibratory settings. Foot control not shown. B, CaviEndo handpiece mounted with an Endosonic diamond file. Irrigating solution emits through a jet in the head. (Courtesy of Dentsply/Cavitron.) 69
  • 70.  Initially it was thought that main debriding action is due to CAVITATION  But later its belived that ACOUSTIC STREAMING is responsible for debridment.  Small files cause more acoustic streaming – clean canals. CAVITATION ACOUSTIC STREAMING 70
  • 71. 71  The ultrasonic files are K-Files without handles, which can be mounted using appropriate inserts on the ultrasonic handpiece.  Until a few years ago they were recommended for root canal shaping, currently they are used to passively activate the irrigating solution before canal obturation.  use of the ultrasonic files for canal shaping is not recommended due to their tendency to make ledges in the canal walls and their structural fragility.
  • 72. SONIC INSTRUMENTS • Prinicipal sonic hand piece is micro mega 1500 sonic air endo system. Others Megasonic 1400, Endostar. • Airline pressure is 0.4Mpa.Operate at frequency of 2-3kHz • Oscillating range is 1500 to 3000c/sec • Irrigant /coolant is tap water • 3 choices of files used with sonic handpiece Rispi sonic - resembles old rat file Shaper – barbed broach Trio sonic – triple helix H file All of them have safe ended non cutting tips. Primarily used for step down enlargement 72
  • 73. NICKEL TITANIUM FILES  NiTi is also known as NiTinol  In endodontics commonly used NiTi alloys have NiTi nol (60% weight of Ni, 40% Ti)  First use of NiTi in endodontics was reported in 1988, by Walia et al when a 15 No. NiTi was made from orthodontic wire and it showed superior flexibility and resistance to tortional fracture. This suggested the use of NiTi files in curved canals 73
  • 74. ADVANTAGES OF NiTi • More flexible • Better conformation to canal curvature. • Resistance to fracture. • Less wear. • Superelasticity • Corrosion resistance • Faster instrumentation • No need to pre curve 74
  • 75. ROTARY NiTi SYSTEMS • Since last many years innumerable number of RNT file system have been made available • Various rotary NiTi systems available are 1.Profile 2.Pro Taper 3.Greater Taper 4.Quantec 5.Light speed system 6.K3 system 7.Hero shaper 642 8.RACE (Reamers with alternating cutting edges) 9.Flexmaster 10.Rapid body shapers 11.Mtwo rotary niti system 12.SAF 13.Wave 14. Liberartor 15. V taper 16. Endosequence 75
  • 76. PROFILE SYSTEM  Earlier profile was sold as series of 29 instruments in .02 taper, soon became available in .04 & .06 taper  The tips of the ProFile Series 29 rotary instruments (Dentsply–Tulsa) had a constant proportion of tip diameter increments (29%).  Because of the nonstandardized diameters, obturation was performed with nonstandardized gutta-percha cones, using either lateral compaction or thermoplastic obturation of gutta-percha  Later, another ProFile series was developed and marketed in Europe. This version featured tip sizes similar to those of ISO-normed instruments 76
  • 77. 77  ProFiles as rotary instruments in nickel titanium introduced by Dr.W. Ben Johnson in 1994  Obtained by micromachining three parallel furrows on a nickel titanium wire  Cross-section -defined as a “triple U” with blades characterized by flat cutting surfaces called “radial lands”.  Design is a reduction of the central “core” of resistance of the instrument with a resulting structural fragility to torsional stress conditions & increase in flexibility.
  • 78. 78
  • 79. 79
  • 80.  ProFiles all present a working surface of 16 mm and a round non cutting tip  furthermore along the shaft there are “depth gages” that are dark grooves placed at 18, 19, 20, 22 and 24 mm from the tip.  The handle of the ProFile in nickel plated and has a small ISO standard coloured rings which are useful to identify both the diameter and the taper (one small ring for the .02 series, two small rings for the.04 series, and three small rings for the .06 series)  ProFiles are used in a crown down based on reductions of taper and/or diameter. 80
  • 81. Advantages: Safety feature is design: unwind and then windup backward prior to breaking. Stresses become evenly distributed along entire instrument in contrast to conventional instrument where stresses are more concentrated at tip of narrow end. Area of contact is less, so contact pressure is high and this gives instrument greater cutting efficiency. Due to pronounced taper of these instrument, canal is shaped quickly. 81
  • 82. ProFile Orifice Shapers 82  series of 6 instruments devised for the elimination of coronal interferences and for flaring the coronal one third of the canal  Characterized by blades and a tip that are identical to that of the ProFiles, a total length of 19 mm and an active part that is 10 mm long.  The diameter at the tip and the taper of the 6 ProFile Orifice Shapers are respectively 20-.05, 30-.06, 40-.06, 50-.07, 60-.07 and 80-.08  used at the initial phases of the ProFile instrument sequences
  • 84. PROTAPER FILES  Designed by Dr.cliff ruddle, Dr.john west, Dr.pierre machtou.  Triangular cross section and is variably tapered across its cutting length. A unique feature is each instrument has changing percentage tapers over the length of cutting blades. This design improves flexibility, cutting efficiency and the safety of these files.  No radial lands - so decreases the friction between blade of the file and the canal wall while increasing the cutting efficiency. 84
  • 85.  The Protaper system consists of three shaping and three finishing files. 2 more finishing files are now added.  3 shaping files have increasing tapers towards handle  5 finishing files have a reverse pattern  Protaper file has a changing helical angle and pitch over their cutting blades which reduces the instrument from screwing into the canal and allows better removal of debris. 85
  • 86. SX:  D0 diameter is 0.19mm and D9 is 1.1mm  After D9 the rate of taper drops off S1:  Has purple identification ring on its handle  D0 diameter is 0.17mm and D14 is 1.20mm  Used to prepare coronal part of the root S2:  Has white identification ring on its handle  D0 diameter is 0.20mm and D14 is 1.20mm  Used to prepare middle third of the canal 86 SHAPING FILES
  • 87. 87
  • 88. FINISHING FILES • Three finishing files F1,F2,F3 are used to prepare and finish the apical part of the root canal F1: • Yellow colored ring • D0 diameter and apical taper is 20 and 0.07 F2: • Red colored ring • D0 diameter and taper is 25 and 0.08 F3: • Blue colored ring on handle • D0 diameter and taper is 30 and 0.09 • Each instrument has decreasing percentage of taper from D4 to D14.This improves flexibility and decrease the potential for taper lock 88
  • 89. Advantages Progressive taper design improves flexibility and instrumentation in curved canals. Both shapers and finishers remove debris and finish preparation with smooth continous taper. Balanced pitch and helical angle of instrument prevents threading and optimize cutting action while effectively removing debris Triangular crosssection of instrument increases safety, tactile sense and cutting action. 89
  • 90. QUANTEC FILE SYSTEM  devised by John McSpadden are available in 2 series of instruments cutting(Quantec SC) and noncutting tips(Quantec LX)  Quantec SC has a facetted cutting tip without a transition angle and with a 60° tip angle. The LX Quantec instead present a blunt pointed tip at 60°, which is non cutting.  Cross section is S shaped & has a positive blade angle with two wide radial lands and relief behind the lands  This unique design minimizes its contact with the canal, thereby reducing the torque, and increases the strength of the instrument  Quantec system utilizes the “graduated taper technique” to prepare a canal  The instruments are used at 300 to 350 rpm in a high- 90
  • 92. 92  The LX Quantec consist of:  – four 17 mm long instruments with a 0.25 mm tip diameter and a taper of .06, .08, .10 and .12 which are ideal for removal of coronal interferences;  – seven instruments for canal preparation; these are 21 or 25 mm long with a 0.25 mm tip diameter and tapers of .03, .04, .05, .06, .08, .10 and .12;  – ten instruments for apical finishing, which are 21 or 25 mm long having a taper of .02 and ISO diameters from 15 to 60.
  • 93. 93  The SC Quantec consist of:  – two 17mm long instruments with a 0,25 mm tip diameter to eliminated coronal interferences  four instruments for canal preparations which are 21 or 25 mm long with a 0.25 tip diameter and a taper of .03, .04, .05, .06;  – ten instruments for apical finishing which are 21 or25 mm long having a taper of .02 and an ISO diameter from 15 to 60.
  • 94. LIGHT SPEED FILE • Developed by Dr.steve senia & Dr.william widleymin early 1990s • so called because a “LIGHT” touch is needed as “SPEED” of instrumentation is increased.  very similar to the Gates Glidden drills with a long shaft and a working part in the shape of a very short flame.  The set of instruments consists of ISO-sized rotary files from size 20 through 100, including nine half- sizes ranging from 22.5 through 65 that half size instruments have white or black rings on their handles. 94
  • 95. 95  LightSpeed instruments are made with a point of separation at 18 mm from the tip, in order to facilitate their removal incase of endocanal fracture  The LightSpeed instrument has a cross-sectional U blade design in which flat radial lands with neutral rake angles enhance planing of the canal walls and centering of the instrument within the canal. The helical blade angle and narrow shaft diameter facilitate debris removal coronally.  The length of the working part varies according to the calibre from 0.25 to 1.75mm, tip is rounded and non cutting  LightSpeed instruments available in the 21, 25 and 31 mm lengths, must be used from the smallest to the largest in a stepback sequence with a typical pecking movement
  • 96.  Recommended working speed is 750-2000rpm with preference towards 1300 to 2000 range. Advantages Better preparation of apical portion of canal to a size larger than what can be normally produced by using tapered instruments Results in rounded and centered apical preparations. 96
  • 97. 3 SYSTEM  Cutting head of K3 show three radial lands with relief behind two radial lands. Asymmetrically placed flutes make the K3 system with superior canal tracking ability, add peripheral strength to K3 system, and prevent screwing into the canal. 97
  • 98. 98
  • 99.  K3 files have positive rake angle providing them an effective cutting surface  a non working tip, a variable helical angle, a variable pitch with less blades on the coronal part to prevent the screw in effect  diameter of the core reduces in the coronal direction so as to keep the flexibility of the instrument constant all along its length.  Sequence of using the K3 is crown-down based on decreasing diameter, taper or on alternate decreasing of diameter and taper 99
  • 100. RACE FILES  Race Files (Reamers with alternating cutting edges)  characterised by a triangular cross-section, cutting blades, non working tip and alternating cutting angles that reduce the risk of screw in, canal blockage and reduces the working torque of the instruments  Electrochemical treatment of these files provides better resistance to corrosion and metal fatigue.  can be used either in the crown-down or step back 100
  • 101. 101  available in the following tapers and lengths:  – RaCe .06 taper # 20, 25 and 30 with overall length of 19 mm and blade length of 10 mm;  – RaCe .06 taper # 20, 25 and 30 with overall length of 25 mm and blade length of 16 mm;  – RaCe .04 taper # 25, 30 and 35 with overall length of 25 mm and blade length of 16 mm;  – RaCe .02 Taper from # 15 to # 60 with overall length of 25 mm and blade length of 16 mm.  also includes for flaring the coronal third of the canal, the Pre-RaCe, availabe in ISO diameters 40 with .10 and .06 taper, ISO 35 with .08 taper
  • 102. 102
  • 103. GT Files  devised by Dr. L.S. Buchanan, are instruments in NiTi with greater taper obtained by machining  Have sharpened blades which are machined in an counter-clockwise direction with a pitch and helical angle that is variable from the tip towards the handle.  the number of spirals are higher and the cutting angle wider near the apical part of the instrument, while coronally the spiral number is reduced and the angle becomes narrower.  Clinically the apical part functions like a K-File, while the coronal part functions like a reamer.  have the blade direction counter-clockwise, that is opposite to other hand instruments and therefore to be able to cut they must be rotated in a counter-clockwise direction. 103
  • 104. 104  consist of four instuments with a fixed diameter at the tip of 0,20 mm, a maximum diameter of the blades of 1.00 mm and a taper respectively of .06, .08, .10 and .12  the length of the cutting part of the GT Files reduces from 13.5mm for the .06 taper to 6.7 mm for the .12 taper.  have a non-cutting tip, depth gages that is dark markings placed along the shank at 18, 19, 20, 22 and 24 mm from the tip, that facilitates the positioning of the silicone stop and allows accurate control of the insertion depth of the instrument.  The colours of the handle (white for GT .06, yellow for GT .08, red for GT .10 and blue for GT .12) do not follow the ISO system  useful to bypass the ledges and in the presence of canals with a severe apical curvature due to the
  • 105. 105
  • 106. Rotary GT Files 106  Like the hand instruments, the Rotary GT Files present a non cutting tip, a prefixed tip diameter and a prefixed maximum flute diameter (MFD), multiple tapers and a blade length inversely proportional to the taper.  Differences include -blade direction which is clockwise in the Rotary GT and counter-clockwise in the Hand GT -Rotary GT blades are classical “radial lands” without the sharp cutting angles found in the Hand GT Files
  • 107. 107  Rotary GT Files are at present available in 4 principal series, each one of which comprises 4 instruments:  – GT 20 Series comprises 4 instruments with a 0.20 mm tip diameter and tapers of .04, .06, .08 and .10  – GT 30 Series comprises 4 instruments with a 0.30 mm tip diameter and tapers of .04. .06, .08 and .10  – GT 40 Series comprises 4 instruments with a 0.40 mm tip diameter and tapers of .04, .06, .08 and .10  – GT Accessory comprises 3 instruments with a taper of .12 and a tip diameter respectively of 0.50, 0.70 and 0.90 mm The maximum blade diameter is 1.00 mm for all GT’s 20 and 30 Series and for GT 40 Series with of .04,.06 and .08 taper, it is 1.25 mm for GT 40 Series with .10 taper and is 1.5 mm for GT
  • 108. 108
  • 109. 109  The blade length varies according to the tip diameter, to the maximum diameter and according to the taper.  The Rotary GT Files are generally used in a crown down sequence progressively reducing their taper and/or their diameter
  • 110. HERO 642  Mechanical instruments derived from the Helifiles  a triple helix cross-section with three positive rake angles; no radial cutting lands but there are cutting angles.  – a higher “ residual core” inside the blades which increases the resistance to torsional loads diminishing the risk of fracture 110
  • 111. 111  a progressive sequence of the blades to reduce the tendency to screw in  three tapers which permit the reduction of the contact surfaces between the blades and the canal walls  a tip that remains centred in the canal  Hero are used in a crown down sequence based on the reduction of the taper (6-4-2) and/or of the diameters.
  • 112. 112
  • 113. Hero Shaper 113  derived directly from the 642 Hero’s and they have the same triple helix cross-section,with positive rake angles  differs from the 642 Hero in that - the rake angle (helical angle) of the blades is variable and increases from the tip towards the handle, - the pitch (distance between two spirals) increases with the taper of the instruments, -the shorter handle allows an easier access to the posterior teeth & tip is completely inactive and self guiding  These changes in the geometry of the Hero Shaper reduce the risk of instrument screw in, increases the flexibility and optimizes the removal of the debris.
  • 114. 114  The Hero Shaper series comprises three instruments with a taper of .06 (20, 25 and 30) and three instruments with a taper of .04 (20, 25 and 30), available in lengths 21, 25 and 29 mm. Endoflare  designated for the enlargement of the coronal one third of the canal for the elimination of coronal interferences.  They have a tip diameter of 0.25 mm and .12 taper.  The Endoflare have the same tip characteristics, helical angle, pitch and cross-section as the Hero Shaper.
  • 115. 115 Hero Apical  for the enlargement of the apical one third in canals  series comprises two instruments both with tip diameter of 0.30 mm with a taper of .06 and .08 respectively  have the same characteristics regarding tip, helical angle, pitch and cross-section as the Hero Shaper
  • 116. Flexmaster  The FlexMasters available with tapers .02, .04 and .06 in lengths 21 and 25 mm  Tip diameter 0.15 to 0.7mm for 0.02 file 0.15 to 0.4mm for .04 & .06files  Flex master has a triangular cross-section with convex angles, cutting blades and a tip very similar to that of the ProTaper, however, it differs by the multiple taper, helical angle and pitch. 116
  • 118. Rapid Body Shapers, 118  instruments feature the patented nonledging Roane bullet tip and allow the practitioner to rapidly shape the body of the canal without the problems that can occur using Gates-Glidden drills.  develop a parallel-walled canal shape.  RBS series consists of four instruments: No. 1 (0.61 mm at the tip), No. 2 (0.66 mm at the tip), No. 3 (0.76 mm at the tip),
  • 119. Pow-R Nickel-Titanium Rotary Files 119  also with a nonledging Roane bullet tip, are available in both 0.02 and 0.04 tapers  to clean and shape the middle and apical regions of the canal in a conservative manner.  Available in standard ISO instrument sizes as well as in half sizes 17.5, 22.5, 27.5, 32.5, and 37.5 for more precise apical refinement. follow standard ISO color codes as well.  Both the RBS files and Pow-R instruments are used in high-torque, gear-reduction handpieces with rpm ranging from 300 to 400.
  • 120. Endosequence  Manufactured by FKG in switzerland & In US by brassler  It has precision tip which is noncutting tip that results in safety combined with efficiency.  Instruments are electropolished – remove imperfections that leads to seperation.  Variable pitch and helical angles which gives more control.  Because of reamer like design i.e, alternate Contact ponts and sharp edges it has superior cutting efficiency .  available in both.04 (size 15–80) and .06 (size 15–50) taper instruments, in lengths of 21, 25 and 31mm instruments.  speed 500-600 rpm 120
  • 121. V taper files 121  Set of 3 variable taper NiTi roary files.  Facilitates to attain deeper apical shapes with fewer instruments and conservative access.  Most cases completed with 2-3 files  Parabolic crosssection – highly efficient and flexible cutting instrument with being extremely safe and resistant to #  Neutral rake angle – very efficient in cutting  No land – reduces friction, heat buildup in file.
  • 122. LIBERATOR 122  Straight fluted file unlike the others which are helically fluted  Triangular in crosssection  Lack of radial lands so reduces friction  saftey tip keep file centered in canal  Efficient in removal of dentin  Manufacturing process eliminates transverse microcracks  Speed 1000-2000rpm
  • 123. Wave NiTi files 123  new endodontic system that uses reciprocating technology  innovative thermal treatment process to create the M-Wire NiTi material.  resulting characteristics provide overall flexibility and greater resistance to cyclic fatigue.  Available in 21, 25 & 40 tip diameters with 6%, 8%, 6% tapers respectively.  Perfect canal shapes are achieved with just 1 single file
  • 124. Mtwo NiTi rotary system 124  standard set for this system includes four instruments with variable tip sizes ranging from #10 to #25, and tapers ranging from .04 to .06 (size 10/.04 taper, size 15/.05 taper, size 20/.06 taper, size 25/.06 taper).  The colored ring on the handle identifies the size, accordingto ISO standards.  number of grooved rings on the handle identifies the instrument taper: one ring means .04 taper, two rings mean .05 taper, three rings mean .06 taper and four rings mean .07 taper.  available in 21 mm, 25 mm, and 31 mm lengths.
  • 125. 125  cross-section of Mtwo is an “italic S” with two cutting blades  RA is one of the most effective, enhancing the cutting efficiency of this instrument The tip is non- cutting.  The Mtwo NiTi rotary instruments are used at 300 rpm.  operative sequence suggested for these instruments is a crown-down technique.
  • 126. SELF ADJUSTING FILES Hollow, NiTi files with slight abrasive surface Operated by KaVo handpiece 5000 vibrations/min & 0.4mm amplitude File get compressed and adapts to canal walls & apply uniform cutting action. Continous irrigation One file is used through out the procedure. 126

Notas do Editor

  1. Pre set trays and cassettes ease d organisation, storage n delivery of endo ins… Dis is an example
  2. Power sources,types
  3. Combination of a round and tapered course diamond which allows access into the pulp chamber and preparation of the chamber walls, in one operation. Burs tip matches round bur sizes for initial penetration .Diamond shaft flares the pulp chamber.
  4. After initial penetration, the long, tapered Endo-Z bur can be used to create a funnel shape for easier access in the pulp chamber. The rounded, non-cutting, safe-ended tip prevents penetration of the pulp chamber floor or the root canal walls.
  5. These ISO-sized hand instruments feature 7mm k-type flutes. The exaggerated tapers enhance the instruments tensile strength, making even the most difficult or calcified canals easier to locate, penetrate and initially instrument
  6. Height of barb should be half the core diameter. Taper is less(0.007mm/mm)
  7. Depth of barb should be 1/3rd the diameter of tip. Taper is more than broaches(0.015mm/mm)
  8. UNIFILE unifile: •          Introduced by McSpadden as modification of H- file. •          Cross section shows double helix or ‘S’ shape. •          Flutes are less deeper than  H-file, so greater bulk so less likely to fracture. •          Cutting of dentin is more efficient in withdrawal strokes. •          S-file is modification of unifile with less fragility.
  9. NITI IN APICAL PART SS IN CORONAL PORTION
  10. Clockwise rotation.
  11. It has unique chuck that locks regular files with their handles
  12. THE MORE freely THE INSTRUMENT MOVES IN CANAL THE LONGER THE STROKES.
  13. If the drill binds , it will fracture at neck of the shaft and extrude from the tooth. The fractured segment is easily removed by grasping the broken shaft with pliers.
  14. CAVIATATION bubbles are formed from action of file, they become unstable, collapse & cause vaccum like implosion Acoustic streaming- small intense circular fluid movements around the tip (eddy current)
  15. , that facilitate the positioning of the silicone stop and allow an accurate control of the depth of instrument placement
  16. that facilitate the positioning of the silicone stop and allow an accurate control of the depth of instrument placement.
  17. ProTaper (Progressively Tapered),
  18. whereby a series of varying tapers are used to prepare a single canal.
  19. pecking movement (advancement in the apical direction followed by a light withdrawal)
  20. All the instruments of the RaCe series have a particular rubber stop divided into 8 petals, defined as Safety Memo Disk (SMD) 17 that represents the recommended method by the manufacturer to keep a controlledcheck of instrument fatigue. After using each instrument a number of petals proportional to the radius of the canal curvature (which is evaluated by placing a SMD transparent gage over the diagnostic radiograph)are removed, in this way the operator is aware of how much fatigue stress each RaCe instrument has been subjected to and therefore whether to continue to use it or discard it.
  21. Prior to using RBS, the apicalregion of the canal must be prepared with a minimum No. 35 ISO instrument to within 0.5 mm of the apex. The No. 1 RBS is then placed in a gear-reduction, slow-speedhandpiece at 275 to 300 rpm and allowed to track down the canal 2 to 3 mm. Constant and copious irrigation is necessary at all times. The RBS is removed to clean the fluting and is reinserted to track another 2 to 3 mm down the canal. This sequence is repeated until the No. 1 RBS is within 4 mm of the apex. The No. 2 RBS is then used like the No. 1, also to within 4 mm or shorter from the apex.The No. 3 RBS, followed by the No. 4 RBS, is used to within 7 mm of the apex, completing the body shaping.The No. 1 RBS will feel very aggressive, whereas the No. 2 through 4 RBS feel almost passive in comparison. Apical refinement is subsequently completed by hand instruments or via Pow-R nickel-titanium rotary instruments.
  22. The operative sequence suggested for these instruments is a crown-down technique, whereby the apex is reached by every NiTi instrument at each step. This means that this is a technique from the crown to the apex, but it first uses smaller instruments before using bigger ones, as is done in the step-back technique. The inventor defines this as a “simultaneous technique,” as the entire length of the canal is approached at the same time.