B m p/ rotary endodontic courses by indian dental academy

CONTENTS
INTRODUCTION
PROFILE SYSTEM
PROFILE GREATER TAPER ROTARY INSTRUMENT
PROTAPER ROTARY SYSTEM
LIGHT SPEED ROTARY SYSTEM
K3 ROTARY NICKEL TITANIUM
REAL WORLD ENDO-SEQUENCE FILE
RACE (REAMER WITH ALTERNATING CUTTING EDGES)
LIBERATOR
V-TAPER ROTARY SYTEM
HERO-642
QUANTEC ROTARY SYSTEM
MITY ROTO 360°
NAVI-FLEX ROTARY SYSTEM
CONCLUSION
REFERENCES
1

RECENT ADVANCES IN
BIOMECHANICAL PREPARATION
INTRODUCTION:
The main objective of the biomechanical preparation is
removal of organic substrate and micro organisms from
root canal system.
1899 first endodontic hand piece introduced. The problem
associated with stainless steal hand instruments are
Canal preparation is inconsistent making obturation less
predictable
Many instruments and steps are needed. Hence it is a tome
consuming.
Canal transportation occurs when larger stiffer
instruments are used.
Traditional coronal enlargement instruments remove more
dentin.
In order to overcome these problems the rotary
instruments are evolved. These instruments are made up
of
2

54% Nickel
44 % Titanium
2% Cobalt
Boran added to improve the surface hardness.
The first rotary system which developed is profile system
THE PROFILE SYSTEM:
The Profile system was developed by Tulsa Dental In 1994.
Their first product was Profile 29 Series. The 29 indicates
that the rate of increase between file sizes in this series is
at a constant rate of 29%. In sometime, some part of Nickel
was substituted by 2% cobalt.
They are made up of Nickel-titanium i.e. 55% wt nickel and
45wt% titanium. These NiTi files have unique properties of
super elasticity and shape memory. Due to these
properties, the instruments adapt well in curved canals
and maintain canal shape better than stainless steel files.
Some unique features of these instruments include:
- Strength and flexibility in curved canals.
3

- Radial landed U-shaped flutes and cutting edges with 20°
negative rake angles which leave the debris coronally and
prevent the instruments from screwing into dentin.(fig b)
- Bullet shaped nose with rounded transition angle. This
design helps the file remain self-centered in the canal and
also reduces the chances of canal transportation and
procedural errors.(fig c)
- Variable taper shafts that reduces the number of
instruments( fig a)
Fig a fig b fig
c
Range of instruments:
The Profile range comprises 3 instrument types with each
type having different length. They can easily identified by
the coloured rings on shanks.
4

Profile orifice shapers:
• 5 to 8% taper.
• Available in no. 1-6 (20-80).
• Length 19mm
• Used to prepare coronary section of canal, removing
gutta-percha and sealer before inserting a root post. The
Profile 0.5 also can be used for the root canal treatment
of deciduous teeth. The handle has 3 rings.
0.06 profile taper:
Taper 6%
- Available in no. 15-40.
Length: 21mm-25mm.
5

These files used to prepare middle section of canal. The
handle has 2 coloured rings.
0.04 profile:
Taper 4%, No. 15-90.
It is available in length 25, 21 and 31mm.
The handle of 0.04 profile carries single coloured ring.
Motor and speeds:
For best performance and avoid any breakage the
instruments should used at constant speed between 150-
350rpm.
For this, independent electric motor can be used. This
motor will provide high torque and run quickly allowing
comfortable vibration free working.
6

These may also used directly on the dental chair unit with
a high gear reduction rate contra-angle hand piece.
E.g. electrically driven (40,000rpm) with a speed of 300rpm
obtained with 120:1 contra angle.
Golden Keys:
1) Light pressure: Only light pressure is needed, no
heavier than when writing with pencil. Profile
instruments, particularly the smaller size should
never forced into canal otherwise wind up may occur,
possibly to the point of breakage.
2) In and out movement:
The high frequency bending caused by high-speed
rotation especially in curved canals, leads to stresses in
the Ni- Ti alloy used. It can be best avoided by a slight
in and out movement (2-3mm) while working. It will help
in distributing the fatigue uniformly along the length of
instrument. Each instrument is used in the root canal
for a period of only 5-10 seconds.
3) Irrigation:
Through out entire sequence irrigate as frequently
and abundantly with syringe using 2.5% sodium
7

hypochlorite. For apical preparation and final
preparation NaOCl and EDTA can be used alternatively.
For very difficult canals, in an early preparatory stage
a lubricant like Glyde may be of advantage.
4) Before canal preparation started with Profile, it is
very important to insert stainless steel hand files to
the level 2mm deeper than the desired depth. The
advantage of these are two-fold:
1) It gives information regarding canal morphology and
curvature
2) Creates a patent pathway for rotary instruments.
Operational Sequence:
1) Crown-down:
Estimate the provisional working length using
diagnostic X-ray. The first objective is to pen the root
canal as far as minimum estimated working length i.e.
for e.g. if your estimated working length is 21mm,
21mm-3mm, 18mm. The stopper on the instrument is
adjusted to the 18mm. Then the instruments are used
in following sequence:
8

Profile 0.5 No. 3 (0.06/40:. It is 19mm relatively and it
is easily inserted into the canal. Without any hindrance,
from opposing teeth, with # 30.5 already rotating in
canal, insert without any excessive pressure and apply
simple in and out movement, for about 5-10 seconds.
When the progression become difficult do not increase
the pressure. 90 for next size file.
Profile 0.5 No. 2 (0.06/30): It is smaller than No. 3 0.5
so it moves more apically compared to the previous
instrument. Use it in the same way as before; withdraw
as soon as progression is difficult.
Profile 0.06/25: This Profile has a smaller diameter
than the previously used instruments and is more
flexible due to greater length of its cutting section used
in this instrument same as previous one.
Profile 0.06/20: The instrument penetrates more
apically than the preceding one .Use in same way as
before.
Profile 0.04/25: Same as the previous one.
9

2) Determination of working length: By using
conventional K-file (No.10, No. 15) with help of
radiograph.
If preferred, an apex locator is also used to complete the
crown-down procedure and determine working length.
3) Apical preparation until the exact working length.
Profile 0.04/20: Use this instrument to exact working
length.
Profile 0.04/25: Use to exact working length.
If the canal anatomy is large No. 30, No. 35 can be used
each till exact working length.
4) Final flaring: It is by using 0.06 / 20 profile with the
profile 0.06/20 inserted into the canal while it is
rotating without an apical pressure and is applied in
an in and out movement.
10

For wide canals:
1. Crown down 0.5 # (.07/50)
0.5 # 3 (.06/40)
0.6/30
0.6/25
0.4/30
0.4/25
2. Determination of working length:
Apical preparation .04/25
.04/30
Final flaring (.06/25) profile
Advantage of profile 29 series:
1. These files stay centered in canal and maintain canal
curvature.
11

2. The instrumentation time required for profile system
is less compared to stainless steel files. It reduces the
operator and patient fatigue.
3. The instrument is wider at DIG (end of cutting part).
Therefore gives necessary coronal flare to root canal
automatically.
4. The tip is bullet shaped so that there is less chance of
canal transportation and procedural errors.
5. Less debris extrusion compared to step back
technique (Hinrich et al).
6. Prepare the root canal with 3-D effect.
Disadvantage:
1. Loss of tactile sensation: There is less feed back from
rotary instruments regarding direction of curvature
and location of apical terminus.
2. Intracanal separation is most often problem while
using profile system. Breakage of NiTi instruments
can occur without any visible signs of permanent
deformation.
3. The Ni-Ti rotary profile system has low cutting
efficiency.
12

4. There is chance of corrosion of profile rotary
instruments when used along with sodium
hypochlorite. It leads to chloride corrosion which
leaves micropitting on instruments, surface leading
to crack formation and instrument failure.
13

PROFILE GREATER TAPER ROTARY INSTRUMENTS
(GT ROTARY)
Designed by Steve Buchanan. These instruments create
funnel shaped root canal more efficiently.
The instrument has variable pitched flutes that are closer
nearer the tip and further apart toward shank. It allows the
instrument to be stronger at tip where stress can be more
extensive. The larger spacing of the flutes at the shank
provides good flexibility and cutting efficiency.
14

1) GT rotary files: There are 4 files in this group
length 21mm, 25mm. These files have two
coloured rings. Each of the file has different taper
i.e. G.T. 12% (0.12)
GT 10% (0.10)
GT 8% (0.08)
GT 6% (0.06)
Rang
e of instruments
- 4% taper.
- 20-35 no.
Available in 21, 25 and 31mm. They have only one ring.
They are mainly used to prepare the terminal part of
root canal.
15

G.T. Accessory files: These are 12 taper available in
35, 50, and 70 size length 21mm and 25mm.
• Identified by the three grooves on handle.
• Used to refining the final preparation.
Operations sequence:
1) Crown down: It can be done using G.T. rotary files.
a. Profile G.T. 0.012 taper with tip size 20 take to
resistance.
b. Profile G.T. 0.10 taper with tip size 20 taken to
resistance.
c. Profile G.T. 0.08 taper with tip size 20 taken to
resistance.
d. Profile G.T. 0.06 taper tip size 20 taken to
resistance.
Before this patency of is canal checked with No. 8 stainless
steel file.
2) Determination of working length.
3) Apical preparation.
a. Profile 0.04 taper size 20.
16

b. Profile 0.04 taper size 25
c. Profile 0.04 taper size 30.
d. Profile 0.04 taper size 35
4) Final refining of root canal. This is by using G.T.
accessory files.
PROTAPER ROTARY SYSTEM:
These instruments have following design features:
1. Progressive taper: The protaper has varying tapers
within one file ranging from 3.5% to 19% this makes
it possible to shape the specific sections of root canal
with one file.
2. Modified guiding tip and varying tip diameter:
- The modified guiding tip allows one to follow the
canal better without any transporation and
procedural errors.
- The varying tip diameter helps in cutting the specific
areas of root canal without stressing the instrument
in other sections.
3. New cross-section of instrument:
17

- These instruments will have convex triangular cross-
section. This design results in a reduced contact are
between cutting blade and dentin. It increases the
cutting efficiency and decreases the torsional strain
of instrument.
4. Varying helicle angle and pitches:
5. New shorter handle: The length of the handle reduced
to 15mm to 12.54mm to allow for better access.
18

Available in two sets:
- Shaping files (3 files) i.e. SX1, S1 & S2.
- Finishing files (3 files) F1, F2 & F3.
SX or auxiliary shaping file (SX):
Identification by lack of its ring on handle. This instrument
has highest increase in taper from D0 to D9 (3.5% to 19%).
These files are mainly used for initial preflaring and
relocation of canal orifices.
S1 or shaping file 1: It has purple identification ring on its
handle.
S2 or shaping file 2: It has white identification ring on its
handle.
19

These instruments (S1 & S2) mainly useful in shaping of
coronal and middle third of canal.
Finishing file: 3 in number:
- Finishing file (F1): Tip diameter 0.20 yellow
identification ring.
- Finishing file 2 (F2): Tip diameter 0.25, red
identification ring.
- Finishing file 3 (F3): Tip diameter 0.30, blue ring.
These instruments has fixed taper from D1 and D3 i.e. F1-
7%, F2-8% and F3-9%.
These instruments mainly used in preparation of apical
third of canal at full working length.
20

Guidelines for use of pro-taper:
1. Establish straight line access.
2. Use instrument in well irrigated and lubricated canal
i.e. NaOCl 17% EDTA also can be used.
3. Establish a smooth glide path with No. 10, and no.
15 stainless steel file.
4. Clean the flutes of file frequently and inspect for any
signs of distortion.
5. Use torque controlled electric motor with handpiece
at 200-300rpm.
6. Force should never be applied to a file; only a light
brushing motion should be used.
7. Use the instruments in recommended sequence.
21

Operation sequence:
1. Establish straight line access and gliding path, using
no. 10 and no. 15 stainless steel file. Determine
estimated working length using diagnostic x-ray.
2. Flood the canal with NaOCl and begin shaping with
shaper S1 using light brushing motion .Go no. deeper
than 3-quarter of estimated length recapitulate and
irrigate.
3. Now use SX to improve straight line access and
relocate the canals, with same motion. Insert the
instrument while it is rotating. If a light resistance is
felt it is withdrawn in a brushing motion. Never force
instrument once you feel resistance. This instrument
will cut more coronal dentin create more flare and
thus allow better instrumentation in apical region.
4. Now determine exact working length using stainless
steel file (No. 10 or no. 15) with help of well angulated
radiograph or electronic apex locator.
5. Now use S1 and S2 to full working length with
brushing motion.
22

6. Now with finishing file (F1) passively extend the
preparation 0.5mm short of working length withdraw
after 1 second.
The F1 has tip diameter 0.20mm. If no. 20 hand
instruments found to be snug at the apex, preparation
is finished.
If F1 and no. 20 hand instrument is loose continue
preparation with F2. It has tip diameter 0.25mm. Again
confirm with no. 25 hand instrument, if it is snug.
Irrigate and finish the preparation.
If F2 is loose continue preparation with F3 which
0.30mm tip diameter, followed by confirmation with no.
30 hand instrument. If it is snugly fitting finish the
preparation.
Between each instrument it is very important to irrigate
copiously with NaOCl and recaputation with K-file to
maintain patency.
23
Straight line axis &
gliding path
SX-file
S2 file – full W.L. F1 file – full W.L.
Gauging of apical
-file #20) F2 file – full W.L.

OPERATION SEQUENCE
Advantage:
- High cutting efficiency.
a. Triangular cross section.
b. Balancing pitch and helicle angle.
- Fewer instruments to complete the preparation.
- Less debris in apical region.
- File stress is minimized.
Straight line axis
& gliding path
S1-file
(brushing motion)
SX-file
Determination of W.L.
And S1 to full W.L.
S2 file – full W.L.
F1 file – full W.L. Gauging of apical
Foramin (K-file #20)
F2 file – full W.L.
24

- Modified guiding tip enables file to easily follow a
prepared glide path without goughing side walls.
- Increased tactile sense due to triangular cross-
section.
Disadvantage:
- Cutting efficiency decrease with use.
- Possibility of canal transportation. Therefore
instrument is immediately removed once working
length has been reached.
- Severely curved canal difficult to use so hand
Protapers are better option.
-
25

LIGHT SPEED ROTARY SYSTEM:
It was so named because light touch is needed and as the
speed of instrumentation is increased.
This instrument is specially engineered nickel-titanium
Gates-Glidden-like reamers that allows enhanced tactile
controls and enhanced apical preparation larger than those
created with other rotary systems.
The instrument consists of set of ISO sized rotary files i.e.
from no. 20 to 140 in length 21, 25, 31mm. Light speed
instruments also have half sizes 22.5, 27.5, 32.5. These
half sizes are color coded exactly same to that of previous
size but also have white or black ring on handle them easy
in identification from full size.
Some unique design feature of light speed instrument:
- Short cutting heads and long non-cutting taper less
shafts.
- They have radial lands and U-shaped spiral grooves
between radial lands.
26

- lightly longer non-cutting pilot tip.
Guidelines:
1. These instruments should rotate at constant speed
between 1500-2000. It should not exceed 2000. This
constant speed is very important because Ni-Ti files
will not sustain repeated change in torque.
2. Straight-line access to mid-root is very important
because they glide the rotating instrument in curves
of root canal.
3. Maintain patency of canal using hand-instruments
before starting the preparation with light speed
instruments.
4. Always use progressively larger instruments in
correct sequence from smaller to larger .Never skip a
size to gain time.
5. Irrigate copiously with sodium hypochlorite and
EDTA alternatively between each instrument.
6. Once the instrument reached to W.L. do not linger at
that point and immediately withdraw while rotating.
Technique:
27

Zurich Light speed technique:
1. Initial apical rotary (IAR): First light speed
instrument which begins to cut canal wall at W.L.
2. Master apical rotary (MAR):
It is the last instrument to form the apical
preparation. This is G-12 light speed larger than IAR.
3. Final rotary (FR):
The last step back instrument which completes the
preparation.
It has 4 steps:
Access and coronal pre-flaring:
Once the orifices are located they are enlarged using Gates-
Glidden drills (No. 12).
Determination of working length and IAR:
W.L. should determined using 15 No. stainless steel
file and verified radiographically or electronically.
Now start using light-speed instruments (No. 20) to
W.L. The first few instruments are may not ream the canal
wall because canals are too large these instruments are
called non-binding instruments. Always begins with No. 20
28

never skip the size. Eventually one instrument will begin to
cut at W.L. It is called initial apical rotary (IAR).
Determine MAR:
All light speed instruments used after IAR are called
binding instruments. These instruments are used in
controlled forward and backward movement (3-4mm) it is
called pecking movement. This forward movement reams
the canal and backward motion tends to clean the head.
Now use the instrument sequentially with pecking
movement. The last instrument which used to prepare the
apical portion is depending on many factors like:
- Degree and angle of curvature.
- Presence of secondary or tertiary curves.
- Diameter of root apices.
Usually the size of MAR:
- For anterior 60-70 no.
- For posterior teeth 40-50.
Step back and recapitulation:
29

Light speed instruments are stepped back after selecting
the MAR. The step-back is 1mm from previous instrument.
Finally all canals are recapitulated with respective to their
MARS and irrigation should be done.
Manufacture recommended technique:
Here the initial apical rotary (IAR): file is identified by
gauging the apical canal diameter.
To gauge the light speed instruments must used by hand
advancing apically by advancing apically using moderate
pressure but never rotated. The initial smaller size
instrument easily goes to working length. One instrument
which is not going to full working length, it is called first
light speed size to bind (FLSB). From this instrument we
should begin rotary instrumentation.
Determining the apical preparation size: Start
instrumenting with FLSB with slow continuous movement
until it engages the canal wall. From this point give slowly
controlled forward and backward movements (pecking
movement). This pecking movement translates downward
cut of the dentin count the no. of pecks it takes FLSB to
reach the working length. Repeat the counting of pecks for
each sequentially larger instruments.
30

The instrument which takes atleast 12 pecks to reach
working length is the MAR. This is called the “12 peck’s
rule”.
Complete apical instrumentation:
After determining the MAR use next instrument 4mm
shorter than the W.L. This enables the SimpliFill G.P. Plug
to closely match the size and shape of canal preparation. If
you are obturating with standardized GP step back should
start from 4mm so that each instrument length is 1mm
shorter than previous one.
Instrument middle root:
Instrument with sequentially larger size instrument
the 4-5mm of canal with only full size instruments (skip
half size instrument). These instruments should not enter
the apical 5mm of canal. Instrument with larger size
instrument until the size which will not pass easily the
apical extent of coronal third of canal.
Recapitulate: Recapitulate to working length with
MAR of each canal.
Light speed technique taper technique:
31

It is also called hybrid technique. In this technique
canals are cleaned and shaped in a crown-down fashion by
using tapered instruments. The apical portion of canal
cleaned by using light speed instruments. The master
apical rotary files are selected using 12 pecks rule.
Advantages:
1. The light speed instruments produce
larger apical preparation, because of their tip
design. Due to this there is better removal of
necrotic material and micro-organism in apical
area, with larger canal space more disinfecting
solutions reach apical area and ensure a better
disinfection.
2. There is no or little transportation when
canal prepared with light speed instruments.
(Glossen et al JOE 1995).
Disadvantage:
Time consuming because of too many instruments
used in the system.
32

K3 ROTARY NICKEL TITANIUM FILE
SYSTEM
Designed by Dr. John McSpadden in 2002.
It has following design features:
1. Positive rake angle: The profile and most of the
other instruments has negative rake angle
which result in scraping rather than cutting
action. The slight positive rake angle as in the
case of K3 results in digging and plowing of
dentin. It will improve the cutting efficiency.
2. Variable flute angle: The flute angle is variable
i.e. taper increases from tip to handle. So more
debris removal from the canal.
3. Wide radial land: In K3 has increased mass of
metal in peripheral area near the blade. It has
good mass of metal behind the cutting blade. It
makes the K3 resistant to torsional or rotary
stress.
33

4. Access handle: The K3 files has short handle so
that it can be used easily in posterior region of
the mouth.
5. Variable core diameter or flute depth: The flute
depth is less in the tip of the instrument where the
strength is more important. It gradually increases
as it moves up. It results in more flexibility and
increased debris removal.
6. Simplified color coding: The K3 system has only
two tapers 0.04 (green) and 0.06 (orange). The
instrument handle has two colour bands on
handle. The top band signifies taper and bottom
band conforms ISO sizing.
7. Safe ended tip: It avoids ledging, perforations
zipping and other nasty surprises.
35

Range of Instruments:
Body shapers: They have enhanced taper of 0.08, 0.10 and
0.12 with tip size no. 25 and in length 17, 21 and 25mm
length. They are mainly used for coronal shaping.
Files are which are used for apical preparation 0.02 taper
files, tip size 15-40 in length 21mm, 25mm and 30mm.
0.04 taper files, 0.06 taper file} tip size 15-60, and in length
21mm, 25mm, 30mm.
Guidelines:
1. Never force an instrument apically.
2. Frequent irrigation with sodium
hypochlorite with EDTA is desirable.
3. Patency should maintained during
preparation. Patency can be maintained
using small K-file (6-15) after every
rotary file.
4. Check the flutes of K3 files for bend, or
stretch, shiny spot, if found discard
immediately. In the case where root
canals are linked the files are discarded
after single use.
36

5. Use electric torque control motor with
auto reverse to rotate the files in proper
rpm (300-350rpm). The instrument
should not use more than 5-7 seconds.
Technique:
- If the canals are severely curved,
scouting of middle third and coronal third with hand
files before advancing into rotary file is important.
- Crown down instrumentation is
desirable. It implies cleaning of coronal third is done
first then middle third and finally apical third.
- First obtain straight line access.
- Locate canal orifice and obtain canal
patency using hand files.
- Begin crown down by taking 0.12
taper K3 body shaper to resistance (3-4mm down the
canal). It should be done with EDTA gel followed by
flushing with NaOCl.
- Take next 0.10 taper K3 shaper to
resistance.
37

- Recapitulation and irrigation can be
done to clear the debris from coronal and middle
third of canal.
- Before rotary instrumentation in
apical area it is important to explore with hand
instruments (K-file 10-15). It helps to determine any
curvature calcification or patency. After achieving
this goal operator should passively introduce no. 10
or 15 K file to estimated working length.
- The working length is confirmed by
the use of a well angulated radiograph or electronic
apex locator.
- Once the true working length is
established the K3-rotary files are introduced in a
canal in a crown down fashion. It can be done by two
ways:
a. With sequence (from longer tip
size to smaller with fixed
taper).
b. With varying taper (mixing the
taper as tip size diminishes).
38

- With sequence: Here
start instrumentation with tip size 35 (0.06 taper) or
large to tip size no. 20 or 15, until full working length
is achieved. In the case where canals are narrow 0.04
taper series are also used in similar fashion.
-
- Variable taper
sequence:
0.06 K3 + 40 to resistance.
0.06 K3 + 20 to W.L.
0.04 K3 + 25 to W.L.
0.06 K3 + 25 to W.L.
Combination of K3 and light speed technique:
Hence shaping of coronal and middle third of canal done
by using K3 rotary system. The apical shaping can be done
using light speed instruments.
39

Advantages:
1. Excellent cutting ability.
2. Moves smoothly in canal and give robust sense
of tactile control.
3. Excellent fracture resistance.
4. More flexible.
5. Due to their access handle they can be use
efficiently in posterior teeth or patient with
limited mouth opening (shortening of handle by
5mm without affecting the working length of
file).
6. Less screwing in effect in K3 compared to other
brands of NiTi files (because of variable flute
pitch).
40

REAL WORLD ENDO-SEQUENCE FILE:
Developed by Brassler USA. It has following design
features.
1. It has alternate contact point design.
- Improves cutting efficiency.
- Prevents screwing into dentin.
- Enhances debris removal.
- Centres the file within the canal.
2. Electro-polished surface.
- Eliminates surface imperfections.
- Increases file sharpness.
3. Precision tip: It has a nonactive tip, fully active
precisely at 1mm (D1). The file has good self-centring
capacity in canal with less transportation.
4. No radial lands and with variable pitch and helicle
angle.
- Flexibility is maximized.
- Torque is minimized.
41

- Sharp cutting edge.
- Good controls over procedure.
DESIGN OF REAL WORLD ENDO-SEQUENCE FILE
42

The real word end sequence file available in both 0.04 and
0.06 tapers. The kit consists of following files.
Expeditor file: it is 0.04 taper, no. 27, 21mm used to
estimating the canal size.
0.06 taper file: with size extra small, small, medium, and
large.
0.04 taper file: with size extra small, small, medium, and
large.
i.e. small (no. 15-30).
Medium (25-40)
Large (35-50).
Speed: It run in portable hand piece with speed of 450-
600rpm. This portable handpiece has several advantages.
- It is light in weight and good tactile
controls.
- It has torque controls and
autoreverse feature.
- Nine-speed options are available
(200-1000rpm) thus deliver a
outstanding power).
43

Technique:
1. After access opening confirm / establish patency by
moving a no. 10 or 15 stainless steel K-file with help
of no. 15 stainless K-file creating a glide path. After
obtaining the glide path working length should
determined with help of x-ray / Apex locator.
2. Using an endo-sequence expeditor rotary file
penetrate the canal until significant resistance (i.e.
progress is no longer easy). Now remove expeditor
rotary file. Now we should choose the next size file by
information gained by.
- Preoperative radiograph.
- Resistance of # 10 hand file.
- Depth of penetration of expeditor.
If E-file is goes down half away it means canal is small.
If E-file goes more than half away it means canal is
medium.
If E-file is loose that means canal is large.
3. Now according to the size determined by expeditor
file choose appropriate size of file. Use these files in
a crown down fashion i.e. (30, 25, 20, 15 for small
44

canal). Use each file until resistance is
encountered .Usually no. 70 file with will go to full
working length with resistance.
RACE (REAMER WITH ALTERNATING CUTTING EDGES)
Design feature:
45

1. Triangular cross section.
- Sharper cutting edges with good
cutting efficiency.
- Less torque required.
2. Electrochemical polishing:
- Removes microsurface imperfections
produced during manufacture, it
reduces the fracture of instrument.
- Result in smooth cutting edge with
less stresses in the canal.
- Improved resistance to metal fatigue.
3. Alternate helix angle of instrument. The cutting edges
of instrument has alternate helix angle as it rotates
in the canal.
- Reduces the torque by 75% so there
is no screwing in effect.
- It reduces the cutting length of
instrument.
- Enhanced debris removal.
46

- Guard against binding, grabbing file
followup.
4. Softex tip:
- Ensure excellent centring in the
canal.
- Decreases risk of deviation.
47

DESIGN OF RACE (REAMER WITH ALTERNATING CUTTING
EDGES)
Range of instrument available:
48

These are available in different tapers:
0.2 taper (15-40 no.).
0.4 taper (25-35)
0.6 taper (25-40)
0.8 taper; 0.10 taper } (35-40).
These instruments have ISO sizing color coding . Available
in length 21, 25, 31 mms. These are available in two kits
i.e. 12mm handle and 15mm handle.
Speed: Cordless single micromotor can be used at a speed
(125-625rpm). These hand pieces:.
Are compact light weight, comfortable and have time
torque control with autoreverse feature.
Technique:
Five instrument technique:
Step 1: Establishing glide path using 10 no. hand K-file
(Schotlander and canal finder # 10 0.02 taper).
Step 2: Insert a 10, # 40 into canal in light in and out
painting motion, while moving circumferentially around the
canal. Then use next 0.08 taper in a same manner. These
instruments are restricted to 4/3rd
portion of canal only.
49

Step 3: Measure working length.
Step 4: For preparation of apical portion of canal, start
with 0.02 taper no. 25 gradually inserted to working
length. If this file is not going to the working length,
instrument with hand file (k-file no. 15) .When working
length has reached, continue with 0.02 (no. 25), change to
0.04 ± 25 and 0.06 ± 25 proceed to W.L.
Three instrument technique:
After some experience in wide canals we can use this
technique.
Here first 3 steps are same as above in step 4 go directly to
0.06 taper ± 25 to full working length.
Advantages:
- Less work torque (75%).
- More debris removal.
- Optimum controls.
- Reduced risk of metal fatigue.
- Improved resistance to instrument
fracture.
50

LIBERATOR
Design:
1. Straight flute design: Most of the other rotary file
systems helically fluted like appearance. They act like
a wood screw, so natural tendency to self thread. The
liberator is a straight flute design so there is 0% self
threading.
2. Lack of radial lands so less friction. Liberator rotary
files have no land area so not friction.
3. Higher rpmm reduces torque. The liberator file
rotates at high rpm 1000 to 2000. So less torque
generated and less file separation.
4. Roane softex tip that keeps file centred and
minimizes ledging and file separation.
5. Efficient dentin removal – Liberator NiTi files quickly
and more efficiently removes dentin because of their
sharp cutting blades moving at high velocity. So there
is more kinetic energy generated. (Liberator delivers
32 times more kinetic energy than conventional file
system).
52

6. Less transverse micro-cracks. The pattern of grinding
is parallel with axis of file. This compare to
conventional file where grinding pattern is
perpendicular to axis is resulting in transverse micro-
cracks in file.
The liberator files available in different tapers:
0.02, (25-70).
0.04 (30-70)
0.06 (35-80)
They available 21, 25, and 31 length.
Guidelines:
1. Complex canal systems may require.
- Reduced rotational speed.
- Use 0.2 taper files.
- Hand filing.
2. Be sure that straight line access is there for
canal orifices.
3. Operate liberator at 1000-2000 rpm.
53

4. Advance each liberator slowly (no-packing
movement).
5. Irrigate between each liberator file.
54

Straight flute design
Straight flute Helicle flute
55

Less transverse micro-cracks
Conventional file Liberator file
Technique:
For small root diameter:
Access opening and determine working length using small
flex file.
Establish gliding path using 10 no. file for select file tip
size according to root diameter. 70 no. liberator place
rotating file into the canal and apply sufficient pressure to
advance to depth 5mm short of working length.
60 no. liberator advance
4mm short of working
length.
56

55 no. liberator advance 3mm short of working length.
35 no. liberator advance 0.5mm short of working length.
25 no. liberator advance slightly beyond the foramen.
Shaping is completed irrigate dry and fill the canal.
For medium sized root diameter:
No. 70 liberator rotating file into the canal with slight
apical pressure advance to depth 2mm short of working
length.
No. 60 advance to depth 1mm short of working length.
No. 45 advance to depth 0.5mm short of working length.
57

No. 30 advance to depth slightly through apical foramen.
Shaping is completed.
File tip size for large root diameter:
80 no. liberator rotating file introduced into the canal and
55 liberator file is advanced to a depth 0.5mm short of
foramen.
35 no. Liberator file advanced to a depth slightly through
foramen. Shaping is completed.
58

V-TAPER ROTARY SYSTEM
Design feature:
1. Safe core, variable pitch and neutral rake angle.
Safe core – Reduces chances of instrument fracture,
variable pitch – Decrease screw in effect.
Neutral rake angle: eliminates gouging, and grabbing of
positive rake angle and inefficiency and heat build of
negative rake angle
2. No radial lands: Thus no dragging, friction heat build
and inefficiency which can cause fracture.
3. Non-cutting tip prevents ledging and transportation.
4. Variable taper: Natural root canal has variable taper.
So these variable taper files shape effectively
59

especially in apical third area. (Deep apical
preparation and eliminates taper lock), natural shape
of canal maintained.
5. Parabolic cross section: It is most efficient cross-
sectional design especially for deep hole reaming
action in root canal.
6. Endonol: It uses a specially formulated NiTi-alloy for
manufacturing of V-taper files. This metal has
superior mechanical features.
7. Easy color coding for identification.
8. Short handle.
Guidelines:
- Straight line access and establish
glide path (# 10 V hand file).
- Do not over prepare the working
length.
- Do not over heat NiTi files. Super
elastic and shape memory properties
may be lost.
- 1 second rule: Cut the dentin only
for 1 second.
60

- Always use a lubricant.
- Set electric motor between 250-
400rpm.
- Use light apical pressure.
- Consider 21mm length whenever
possible for better access.
- Do not over use the file. The file
should be used for 3-4 individual
canals. If file damaged discard
immediately.
- When apical third of canal has
abrupt curvature use hand files for
preparation.
It is 3 file systems:
0.10 taper tip diameter 30
61

Technique:
1. Glide path: #10 V-hand files. 10 (VO2) - # 10 (VO4) -
# 10 (VO6). Determine working length.
2. Coronal shaping: 25(V08) – 30 (V09) to the point of
resistance.
3. Apical shaping: 30 (V10) – 25 (V08) – 20 (V06) to the
point of resistance.
4. Final shaping
30 (V10) to working length for large canal.
25 (V08) to working length for medium canal.
20 (V06) to working length for small canals.
62

HERO-642
Introduced by Daryl Green – manufactured by Micromega
instrument Co, from NiTi.
Features and benefits:
1. Three cutting edges for a positive cutting in curette
effect.
2. Bigger inner core provides better resistance to
fracture.
3. Progressive fluting present, so less screwing in effect.
4. Three variable tapers which peel the canal wall on
small contact point.
5. Tip which stays centred in the canal.
6. Versatile it can be used along with sonics and hand
files.
7. Economical as it requires few instruments.
63

Speed: these files can be run in contraangle handpiece at
a speed of 300-600rpm.
Instruments: Available in 3 tapers.
2% taper # 20-45, in 21, 25, 29mm in length,
4% taper – 20-30 in 21, 25, 29mm
6% taper # 20-30 21mm, 25mm.
Technique:
For easy canals:
- Locate canal orifice and determine
working length.
- Use 0.06 taper # 30 to 2/3 of
working length by slow in and out
64

movement with circumferential
filling.
0.04 taper # 30 to 2mm short of working length.
- 0.02 # 30 taper to full working
length. Recapitulate with hand file
and irrigate.
For easy canals
Difficult canals
For canals with
Average difficulty
65

For canals with average difficulty
Same technique but the sequence begins with # 25
For difficult canals use the same procedure but sequence
begins with # 20.
66

QUANTEC ROTARY SYSTEM
Design: Features and benefits:
- Positive rake angle with active
cutting action.
- Wider radial lands which provides
blade support while providing peripheral strength
to resist torsional and rotary stress.
- The third radial land stabilizes and
keeps the instrument centered in canal and
minimizes over engagement.
67

- Radial land relief reduces the
friction on the walls.
- Safe ended tip: Safe cutting; non
cutting.
- Short handle: So easy posterior
access.
Range of instrument: These instruments are available in
different taper.
It consists of range of instruments with identical tip size #
25 17, 21, 25mm length.
0.12 taper.
0.10 taper
0.08 taper
0.06 taper
0.05 taper
0.04 taper
0.03 taper
0.02 taper } # 15-40, 17, 21, 25mm length.
68

This instrument run in high torque gear reduction slow
speed hand piece.
Technique: Crown down starting with larger taper file first
and progressing with file with lesser taper.
- Straight line access and check for
patency of canal.
- Determination of working length.
- Establishment of glide path.
- Use light pecking movement – now
start instrument with 0.12 taper instrument
advances till you meet resistance.
- Then follow the frequency
instrument till # 0.03 taper.
- Apical preparation with 0.02 taper
Quantec file from 15-40 to working length.
69

MITY ROTO 360°
Design:
- Unique 4-file design with flat edged
flutes prevents instrument from
getting caught on canal walls.
- It works in reaming motion provides
uniform canal preparation.
- Reduces preparation time.
Available in:
- 15-80 tip sizes in 21 and 25mm
length.
NAVI-FLEX ROTARY SYSTEM:
- Precision grounded flutes.
- Self-centering bullet tip.
- 18mm length for easy use in initial
flaring.
70

- ISO colour coded easy for
identification.
Range of instruments available in:
- 0.8 Taper (tip size 60, 45).
- 0.6 Taper (tip size 35, 25).
- 0.4 taper from no. 15-55.
71

Techniques:
Establishment of straight line access and patency.
Instrument in a crown down fashion.
- Navi-Flex 0.08/60 till significant
resistance.
- Naviflex 0.08/45 till significant
resistance.
- Naviflex 0.6/35
- Naviflex 0.6/25
Determine working length:
- NF 0.04 / 45 till resistance.
- 0.04 / 35 till resistance.
- 0.04/30 till resistance.
- 0.04 / 25 till resistance.
This sequence should repeated until the 0.04/25
taper reaches to full working length.
72

Irrigate and recapitulate.
CONCLUSION
Proper biomechanical cleaning and shaping of root canal system is
the basis of endodontic therapy. Since the introduction of first rotary
instrument, various new systems have been established in the
market, the benefits of which are apparent in their perfect preparation
of the root canal system. Their widespread use in regular practice is
being looked upon with skepticism because of overzealous tooth
removal and a highly mechanical approach.
Nevertheless, the combination of anatomic, biologic and
pathophysiologic knowledge of the tooth and skill of the operator
play a large role in optimizing the quality of root canal treatment.
73

REFERENCES:
 GROSSMAN 11TH EDITION
 COHEN 8TH AND 6TH EDITION
 INGLE 5TH EDITION
 STOCK 2ND EDITION
 WALTON
 WEINE 5TH EDITION
 DCNA 2004
74

B m p/ rotary endodontic courses by indian dental academy

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

En vedette

En vedette (18)

Similaire à B m p/ rotary endodontic courses by indian dental academy

Similaire à B m p/ rotary endodontic courses by indian dental academy (20)

Plus de Indian dental academy

Plus de Indian dental academy (20)

Dernier

Dernier (20)

B m p/ rotary endodontic courses by indian dental academy