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ENDODONTIC
INSTRUMENTS

   INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education
   www.indiandentalacademy.com




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CONTENTS
•   INTRODUCTION
•   HISTORY
•   CLASSIFICATION OF ENDODONTIC INSTRUMENTS
•   EXAMINING INSTRUMENTS
•   EXPLORING INSTRUMENTS
•   DEBRIDING INSTRUMENTS
•   CLEANING AND SHAPING INSTRUMENTS
•   STANDARDISATION OF ENDODONTIC INSTRUMENT
•   ISO GROUP I INSTRUMENTS
•   ISO GROUP II INSTRUMENTS
•   ISO GROUP III INSTRUMENTS
•   ISO GROUP IV INSTRUMENTS
•   NON-ISO INSTRUMENTS
•   NEW CONCEPT IN INSTRUMENT DESIGN
•   CONCLUSION
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INTRODUCTION:

     “worksman is known by his tool”
 As the endodontic therapy becomes a more routine part
 of general dental practice the clinician is bombarded with
 number of newer products designed to make treatment
 more precise and easier to perform.
 Newer instruments overcome the deficiency seen in
 earlier instruments.
 Thus a thorough knowledge in evolution of instruments is
 mandatory for operator.


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HISTORY:

• 2200 years old Nabatean warrior skull _ oldest root canal
    filling
•   1750 – Fauchard recommended removal of pulp
•   1850 _ wooden pegs for debriding pulp
•    Early 1900 – Introduction of files ,reamers ,pathfinder ,
    lentulospiral
•   1915_kerr manufacturing company obtained patent for
    all instruments later known as k_type instruments
•   1957 _Richman introduced first ultrasonic system
•   1958_introduction of racer file handle
•   1958 – Ingle & Levine 1st proposed standardization.
•   1959 – New line of standardized instruments & filling
    materials. www.indiandentalacademy.com
•   1962 – Working committee on standardization .
•   1964 _ Introduction of giromatic handpiece.
•   1975 _ 1st report on potential application of NiTi alloys
•   1976 – 1st approved specification for root canal
    instruments.
•   1976 to 1984_ Martin and Cunningham provided
    instruments that were set for vibration at 25 to 40KHz
•   1984 _introduction of canalfinder system
•   1988 _ 1st use of NiTi in endodontic instruments
•    1989 – ANSI approval of “ADA specification number 28
    for endodontic files & reamers.”
•   1989_Wildey and Senic introduced canal master



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CLASSIFICATION OF ENDODONTIC
INSRUMENTS


BASED ON FUNCTION
     A)EXPLORING _to locate canal orifice and to assist
     in obtaining patency of root canal
     B) DEBRIDING _to extirpate pulp and remove debris
     C) CLEANING AND SHAPING _ clean and shape
     root canals laterally and apically
     D) OBTURATING _To pack filling material into root
     canal
MODE OF USE
     A) HAND
     B) ROTARY
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ISO GROUPING
      A) GROUP I _hand use only
      B) GROUP II _engine driven latch type
      C) GROUP III_ engine driven latch type drills or
reamers
      D) GROUP IV_ root canal points




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EXAMINING INSTRUMENTS
• Instruments used in examination are
      1)front surface mouth mirror _ overcomes the
  problem of associated with double image

      2)periodontalprobe

      3)explorer

      4)cotton forceps



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EXPLORING INSTRUMENTS
ENDODONTIC EXPLORERS:

•   Long, narrow working ends.
•   Angle away from shank – easy access.
•   Locate canal openings.
•   Explore pulp chambers.




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PATHFINDER:

• To negotiate highly calcified and constricted root canals.

• Available in pre sterilized single-unit packages, in 19, 21
  and 25 mm lengths and two sizes, K1 and K2.


• The carbon steel shaft – greater sharpness and strength
  for penetrating calcified root canals.




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DEBRIDING INSTRUMENTS
ENDODONTIC EXCAVATOR

• Longer offset – better reach

• Excise pulp tissue from pulp chamber




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BARBED BROACH, RASP AND
APPLICATORS:
    • Made from soft iron wire.
• Differ from other H-type and K-type _ taper and working
     portion length. (ANSI sp. No :63)
•    The length of working portion of shaft _ 10mm.
•    Taper – 0.007mm/mm (Broach).
             0.015mm/mm (rasp).
•    Difference between broach and rasp
                _ depth and angle of cut.
•    Barb height – half of core diameter (Broach).
•    Barb height – one third of core diameter (rasp).




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• Barbed broach – Thin, flexible, tapered and pointed
                      removal of intact pulp tissue, paper
                                     points and cotton
                 dressings.
                     Identification symbol – 8 pointed star




• Rasps – rough walled canal preparation.
           Previously rattail file
           Identification symbol – 8 pointed polyhedron
•   Applicators – slender, tapering, flexible, pointed
                  C.S. – circle
                 Incisive cuts – shallow, slight elevation

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MICRO OPENERS
•   Exploring of explorers + Instrumentation of K-files.
•   7mm K-type flutes.
•   10 and 15 size with 0.04/0.06mm/mm taper

MICRO DEBRIDERS
    •Instrumenting or retreating – hard to reach canals.
           •H-type configuration – 20 and 30 size.
                                    0.02mm/mm taper with
                                    16mm cutting flutes.




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ISO GROUP I INSTRUMENTS
MANUFACTURE:
First made from carbon steel
Now made universally of Ni-Ti and stainless steels.
Produced by two techniques.
1st technique Grinding graduated sizes of round “piano”
   wire into various shapes and second grinding for taper.
   Then, twisted in counter clockwise direction for
   programmed number of times.
2nd technique Grind spirals into tapered wire rather than
   twisting. Ni-Ti instruments are produced by this
   technique.

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STANDARDIZATION
STANDARIZATION OF ENDODONTIC INSTRUMENTS
        The recommendations for standardization of
   endodontic instruments
   A) Instruments numbered from 10 to 100, based on
   diameter of the instruments in hundreds of a millimeter at
   the beginning of the tip of the blades
   B)The instruments from size 10 to size 60 advance by 5
   units then by 10 units to size 140.
   C) The working blade (flutes) shall begin at tip,
   designated site D0 (diameter 1) and extend up to the
   most coronal part of the cutting edge at D16 (diameter
   2). The flutes extend 16mm up the shaft.



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E) The instruments enlarge by 0.02 mm/mm from D0 to D16
D) The tip angle of an instrument should be 75 ±15°




Color coding of instruments _ easier identification of
instruments


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TERMINOLOGIES IN INSTRUMENT
 DESIGN:

RAKE ANGLE:
     “The angle between the cutting edge and a
 perpendicular to the surface being cut”


HELICAL ANGLE:
     “The angle the cutting edge makes with the long
     axis of the instrument”



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CLEANING AND SHAPING
INSTRUMENTS
K FILES

• Instruments with tighter spirals.
• 1.97 to 0.88 cutting flutes per mm of operating
    head.
•   Produced mainly from square blank.
•   Cutting action – either filing (rasping) or reaming
    (drilling) motion.
•   Filing – rake of flutes rasp the walls as the
    instrument is withdrawn without turning.
•   Reaming – penetration, rotation and retraction

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• More work hardened – stiffer than reamers.
• Identification symbol – square




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K REAMERS


•   Instruments with lesser number of flutes.
•   0.80 to 0.28 cutting flutes per mm of operating head.
•   Produced mainly from triangular blanks.
•   Cutting action penetration, rotation and retraction.
•   Identification symbol – equilateral triangle




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K-STYLE MODIFICATION
K-FLEX:
• Forerunner of hybrid instruments.
• Hybrid – strength and versatility of
          K-type + aggressive cutting of H-type.
•   Cross-section – rhombus or diamond.
•   Cutting edge – Two acute angles.
•   Alternating low flutes – obtuse angle – increase debri
    removal.
•   Space reservoir – reduced compacting           dentinal
    filing.
•   Increase flexible.
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HEDSTROEM FILES


• Cutting spiraling flutes into shaft of round, tapered
    stainless steel wire.
•   Very positive rake of flute design.
•   Impossible to ream or drill.
•   Cut in one direction – retraction.
• Cross-section – single helix teardrop


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H-STYLE MODIFICATION:
•   Mcspadden – Unifile
•   ‘S’ file – variation of unifile
•    Double helix design.
•   Cross-section – ‘S’ shaped.
•   Helical angle – less than 90 degrees
•   Unifile , ‘S’ file _ flutes less deep than H files
•   Differs _ angle of flutes – constant
               depth of flute _ increases from tip to handle
•   ‘A’ file _ hand and rotary
               steep flutes and 40 degree helical angle
              non cutting tip
•   Safety Hedstroem files – non cutting side – prevent
    ledging.

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TIP MODIFICATION :

          • Tip design led to improved cutting efficiency.
              (NWU group)
          •   Triangular pyramidal tips outperformed
              conical tips. (NWU group)
          •   University of Oklahoma – redesigning tips
              eliminating their cutting ability.
          •   Powell et al – “grinding to remove the
              transition angle” from tip to first blade.
          •   Modified tip _ less transportation and more
              inner curvature preparation. (Sabala et al
              1988)
          •   Flex-R-files, control safe files, Anti-Ledging
              file and safety Hedstrom file.
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FLEXOFILES:

•   Flexible file_ triangular cross section stainless steel blank
•   Non cutting tip(1.81 flutes per mm)
•   Golden medium _similar in design




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FLEX_R FILES

•   Used in BALANCED FORCE TECHNIQUE
•   Triangular blank machined
•   Advantage _
              increased stiffness and strength _ smaller files
              increased flexibility _ larger files
•   cut efficiently _ anti clockwise rotary motion
•   safe ended tip




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HELIAPICAL:

•   Resembles conventional files _ apical 4 to 5mm
•   Remainder blank shank
•   Smaller size _ fracture if continuous rotation




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ZIPPERER FLEXICUT

• Triangular blank_ SCS spacecraft steel
• High vaccum fired chrome nickel steel _ uniform
    structure
•   Advantage _ flexibility and non aggressive tip




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FLEXOGATES:

• Stainless steel instrument – similar to
                             canal master
•   One spiral fluting – expanded head
•   Non cutting tip
•   Smooth flexible shank _ circular in C.S
•   Shank _ deliberately weak at handle end




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INTERMEDIATE FILES

• Produced _ trimming 1mm from tip of file and rounding
    off sharp edges on a diamond file
•   Files changed from
         10 to 12
          15 to 17
          20 to 22
          25 to 27
•   Advantage _ smooth progress through files
•   Disadvantage _ disposable , edges difficult to smooth
    may cause ledging
•    Overcomed _ “GOLDEN MEDIUM” intermediate


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OBTURATING INSTRUMENTS
ENDODONTIC CONDENSERS AND
SPREADERS:
• Smooth tapered metal instruments – compress and
    compact gutta-percha
•   Pluggers or condensers – blunt or flat-ended tips



    Spreaders – more tapered and pointed tips



    Long handled – chrome plated or stainless steel

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• M series plugger-spreaders – double-ended
      long-handled instruments
  Handles colour coded
  Corresponds to standard           sizing and
  taper of K-type files



• Finger held spreaders and condensers –
  similar to K-type files with plastic or metal
  handles.




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ENDODONTIC PLIERS AND
FORCEPS:

• Handling and placement of silver point and gutta-percha
    cones.
•   Pliers – tapered groove in beak for grasping silver cone.
•   Forceps – grooved or serrated beaks for holding gp
    cones.
•               Have latch mechanism for locking in closed
    position.




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RECENTADVANCES
SENSEUS FLEXOFILE
•   Unique silicone handle.
•    Stainless steel triangular core file and safe ended tip.
•    Large, ergonomic handle provides comfort and excellent
    tactile feedback.
•   X-ray visible calibration ring (25mm and 31mm) to
    improve accuracy and diagnosis.




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NEW C-PILOT FILE:

•   Probing calcified canals.
•   Creating smooth passage for rotary NiTi preparation.
•   Extra sturdy – unique thermo process.
•   Thin but strong for obliterated canals.
•   ISO 6%, 8%, 10%, 12.5%, 15%.
•   Length – 19, 21, 25mm.




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ENDO HANDLE:

• Colour coded handles with locking chamber

• Micro files used with file holder




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NiTi spreaders
• NiTi finger spreaders
• Used in curved canals for good obturation




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FLEX MASTER

•   K-type cutting blades with Blunt tip.
•   Cross-section – convex.
•   Sufficient space between blades – removal of dentinal
    debris.
•   Highest cutting efficiency – efficient preparation.
•   50% faster.




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CC+ SERIES

•   Includes H-file, R-reamer, K- file, flexicut file, C-pilot file.
•   Additional longitudinal ridge – increased grip.
•   Anti slip effect.
•   Easier, less tiring.
•   X-ray visible calibration rings
       Continuous depth control during preparation.
       Faster stopper positioning.
•   Increased accuracy.




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ISO GROUPS II AND III

    Engine – driven instrument use – 3 types of contra angle
     handpiece.
   • A full rotary handpiece – Latch or friction grip.
   • Reciprocating/Quarterturn handpiece.
   • Special handpiece – vertical stroke with reciprocating
     quarterturn.
ISO GROUP II –
 Instruments with shaft and operating head as separate pieces

 ISO GROUP III –
  Instruments with shaft and operating head as one piece.
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ROTARY CONTRA ANGLE
HANDPIECE
• Instrumentation – Straight line drilling or side
    cutting.
•   With round or tapered burs – coronal access
    to canal orifice.
•   With special reamers – Funnel out orifices.
•   With Nickel titanium reamer type instruments
    – Clean and shape canals,
•   Misdirected or forced behind limits –
    Perforations.



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• Solution – Use of slower handpiece.
             Ex: 1) Medidenta/ Micro Mega MM 324
                      reduction gear Handpiece.
                 2) Aseptico Electric Motor handpiece.
                 3) The Quantec ETM.
                  4) The Moycol union broach sprint
                      EDM.
•   Speeds – 300 rpm for NiTi profiles.
            2000 rpm for Light Speed instruments.
•   Newer electric handpieces – Both speed and torque
                                     control.
•   New rotary handpiece – Morita tri Autozx.
•   Tri Auto ZX – Battery – powered slow-speed (280 rpm)
    handpiece with a built in apex locator.
•   NiTiMatic _ 16:1 gear reduction handpiece
                300 rpm

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RECIPROCATING HANDPIECE:

• Giromatic handpiece – Accepts latch type
    instruments.
•    Canal insruments available for use with
    GIROMATIC
               giro pointer _ 16mm long orifice opener
               giro broach or cleanser
               giro file,a hedstroem configuration
               giro reamer
               heli girofile_3 cutting blades in c.s
•   Quarter-turn motion – 3,000 times per minute.


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• M4 safety handpiece – 30 degree reciprocating
                            motion.
                       Regular hand files by their
                          handles.
• Endo-Gripper – 10:1 gear ratio, 45 degree turning
                     motion.
• Endo Cursor _ press button chuck
               Take hand instruments




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VERTICAL STROKE HANDPIECE:

•   Air or electrically driven – Vertical stroke, 0.3 to 1mm.
•   On binding – Quarter turn reciprocating motion.
•   Canal finder system – A file, variation of H file.
                                Reciprocal rotation with filing
                                motion.
                           Penetration of severely curved
                        and constricted canals without

                          perforation or ledging.



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• Canal leader – speed reducing handpiece with 4:1 step
                       down
•   Vertical movement of 0.4 to 0.8mmwith 30 degree contra
    rotational movement
•   3 instruments available_ K file with safe ended tip,H file
    and universal file
•   Racer handpiece – vertical oscillation




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RANDOM HANDPIECE

• Excalibur _ lateral vibrational movement
         20000 to 25000 r.p.m.
               Use modified K files




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ENDO IT PROFESSIONAL

• Individually programmed torque limit and speed for each
    instrument.
•   Fast reaction auto stop – reverse.
•   Warning signal at 75% torque limit.
•   Warning signal – motor in reverse rotation.




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ISO GROUP II
Instruments with shaft and operating head as separate
   pieces:
Ex:
• B-2 reamer – cylindrical working head
              2 cutting edges – spiral
             c.s – rectrangle
             working head and shaft – similar to
                                               K-type.
             Used with contraangle or straight handpiece

• Lentulospiral – power-operated, spiral.
                Used with contraangle or
                 straight handpiece
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• Quarter-turn reamer – power-operated,
                      tapered and pointed
                      used with giromatic or racer
                          handpiece
                      enlarge/widen root canal
                      similar to blank of K-type.

McSpadden compactor – specially designed
                            Apically directed spirals.
                       frictional heat softens
                     guttapercha
•Other group II – K-reamer, H file, R-type rasp,
             barbed broach
                     Used with giromatic or racer handpiece
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EZ FILL
• It has patented bi_directional spiral produces a coronal
    and apical cement flow simultaneously
•   When the opposite flows of cement meet they are forced
    to laterally
•   Used in slow up and down and circular motion for 5
    seconds
•   Used in contra angle in forward direction




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ISO GROUP III
Shaft and operating head as 1 piece.
• G-type reamer – GG drill
                  stainless steel or NiTi
                 Short, flame-shaped head with
                    side cutting blades
                 Short, non-cutting guide at tip
                 Long-thin neck connects
                   working head and shaft.
                    Number 1 to 6
                  Used with gear reduction, slow speed,
                    high torque handpiece
                  Speed – 750 to 1000 RPM

• B-1 reamer – similar to G-type.
             Twice long working head.
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• O-type reamer – long, tapered head
                3 spiralling blades – plane angle
   short     neck.



• P-type reamer – Paeso drill
                Long, narrow, tapering head
                Side cutting, spiral blades
      Tip – cutting /non-cutting.
      Thick neck
       Number 1 to 6



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• A-type and D-type – similar design.

• A-type – long, tapered, pyramid shaped
          4 side cutting blade
          c.s – square
          short, narrow neck.

• D-type – shorter pyramidal point
          Short narrow neck.



• Ko, T-, M- reamers- orifice enlargers
                     straight/contra angle handpiece
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• Ko reamer – longer than tapered and pointed fissure but
   with out cross-cut.
           8 side cutting blades with spiraling
         Short neck.

• T reamer – 12-16 straight side cutting blades
              Short head length.

• M reamer – round head
             6-8 cutting blades
             Neck-long and flexible.

• Root facer – power operated rotary
               Crownless tooth.
               Thin wheel shaped end cutting with center
   cylindrical truncated cone with
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               Smooth surface entering
BURS:
• Burs with extended shank –
    preparation in pulp space with low
    speed handpiece.
•   Surgical length – 26mm.
•   Extra long shank – 34mm
                        Ex: Brasseler, shank 25
                        Good visibility and control
•   Friction grip tapered fissure burs (557 or 701) –
    correct outline form.
•   Round burs – normal and extra long
                 Size 2, 4, 6
                 Deroofing
•   Longer and smaller round burs – fine calcified
    canals.
•   Safe ended diamond / tungsten carbide bur / endo2
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    bur – taper, smooth access cavity.
ULTRASONIC INSTRUMENTS:
• System in which sound as an energy source activates an
    endodontic file resulting in a three dimensional activation
    of the file.
•   File – Vibrates in a sinus wave like fashion.
•   Antinodes _ maximal displacement (tip).
•   Nodes        – no displacement.
•   Fracture – at the nodes.
•   Debriding action – Cavitation and acoustic streaming.
•   Cavitation – positive pressure followed by a negative
                    pressure in the fluid.
                 Cavity formed in the negative phase
                   implodes with great force during next
                   positive pressure phase.
•   Acoustic streaming – small, intense, circular, fluid
                                movement.
                           occurs closer to the tip.
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• Various ultrasonics used
        Cavitron endodontic system.
        Enac unit.
        Piezon master 400.
•   20 to 25 KHZ – used.
•   Piezoelectrical design – Decreased heat
                           Increased energy
•   Magnetostrictive – Increased heat
                      decreased energy.

• Endosonic ultrasonic synergistic system –
    instrumentation + irrigation.




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• Cavi-Endo ultrasonic unit – 1st
• Use either inert sterile or chemically active irrigant.
• Modifications of K-type or R-type.
• Endosonic diamond file – cutting of dentin by abrasion.
                             Coronal enlargement.
• Ultrasonic tips – used in detection of canal orifices.
  removal of posts, fractured      instruments, coating canals
  with        sealer




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SONIC INSTRUMENTS:

•   Sonic systems – vibration in audible frequency range
•   Frequency – 2 to 3 KHZ.
•   Micro Mega 1500 sonic Air endo system – Airline
    pressure of 0.4 MPA.
•   Sonic file – large elliptical motion at the tip.
•   Loaded – longitudinal motion, up and down.
•   Oscillatory range – 1500-3000 cycles per second.
•   Three sonic files used – Rispisonic, shaper sonic, Trio
    sonic.



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• Rispisonic – old rat tail file
                       (8 cutting blades)
                coronal third
•   Shaper sonic – husky barbed broach.
                       (16 cutting blades).
                apical one third
•   Triosonic – tripled helix H file.
•   Sizes – 15 to 40.
•   Length – 17 to 29mm.
•   Rougher canal surface.

• Endosonic 3000- sonic handpiece similar to
                              sonic air driven
    scalers.

• Irrigation – filtered water.
• Dis advantange –perforations,
    transportation.
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ISO GROUP IV:

• Not strictly endodontic instrument but have been
  considered part of armamentarium under developing
  international standards.

ABSORBENT POINTS:
• Slender cones made of paper or other absorbent
  material.
• Uses – drying the canal
       Conveying medicaments
       Obtaining canal cultures
• Available in standardized sizes

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ROOT CANAL FILLING POINTS

• Smaller, slender cones of solid material.
• Used for canal obturation.
  Ex: silver points, gutta-percha points.
• Available in standardized sizes and taper




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NON-ISO INSTRUMENTS
•   Advent of NiTi _ newer instrument system
•   Instruments with greater taper
•   Tapers _ 4% ,6% ,8% ,10% ,12%
•   Better shaping
•   Faster treatment
•   TERMINOLOGIES:
•   RADIAL LAND – “The surface that projects axially from
    the central axis between the flutes”
•   PITCH – “Number of flutes per unit length”

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ProFile

• Design – U grooves and radial lands
• Lands – prevent uncontrolled cutting
            Prevents premature fractures, perforation and
               transportation
            Strength of the instrument
•    Standard taper – 0.04mm/mm
                   0.06, 0.08mm/mm taper available
•    Used in control, slow speed, high torque rotary
    handpiece
•   Rotational speed – 275 to 325 RPM
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• Available – ISO sizing
             series 29 standards
  4% taper – small canals and apical regions
  6% taper – mid root portions
• Orifice shapers – 0.06, 0.07mm/mm taper
                   shaping coronal portion of canal
                   length – 19mm, cutting length 9mm
                   30, 40, 50 sizes




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GT PROFILES


          •   Made of Ni-Ti.
          •   Both hand and rotary.
          •   Instruments – size 20.
          •    Tapers – 0.06, 0.08, 0.10, 0.12mm/mm
          •   Cutting blades – 6-8 mm of shaft.
          •   Standard set – 4 instruments, size 20, taper
              0.06, 0.08, 0.10, 0.12mm/mm.
          •   Design – radial landed, clockwise cut U
              blade flutes with non-cutting tip
          •   Maximum flute diameter – 1mm
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•   6% taper – moderate to severely curved canals in small roots
•   8% taper – straight to moderately curved canals in small roots
•   10% taper – straight to moderately curved canals in large roots
•   Accessory GT files
    3 instruments – 0.12mm/mm taper
                  maximum flute diameter of 1.5mm
                  35, 50, 70 size
         unusually large root canals to apical diameter greater than
    0.3mm




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LIGHTSPEED


•   NiTi instrument.
•   Resemble a GG drill.
•   Rotary instrument.
•   Sizes – 20 to 140
•   Half sizes – upto. 60
•   Head size – 0.25mm for size 20
               1.75mm for size 100.
•   Used in slow speed handpiece
•   Rotational speed – 1,000 to 2,000 RPM


• Used in pecking motion
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• Laser etched length control rings – eliminate need for
    silicone stops
•   Advantage – finish apical third preparation to a larger
    size.
•   Disadvantage – excessive number of instruments –
    strain




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QUANTEC FILES
• Design – similar to ProFile
            Double helical flute design with
               extensive peripheral mass
•   Lands       – wider
                 Enhanced strength
•   Both – hand and rotary– powered instruments.
•   Quantec series – 10 NiTi files
                    0.02 to 0.06 taper
•   Both safe cutting and non-cutting tips.




                 www.indiandentalacademy.com
• Quantec flare series – 0.08, 0.10, 0.12mm/mm taper
                         25 size
                         shape coronal third of canal
•   Built in graduated taper technique
•   Used in high torque, gear reduction, slow speed
    handpiece


• Speed – 300 to 350 RPM




              www.indiandentalacademy.com
Hero 642

• Design – tri helical Hedstroem with sharp flutes
    Increased distance between flutes – reduced risk of
    binding
•   Large central core
•   Size – 20 to 45
•   Taper – all sizes – 0.02mm/mm
           Size 20, 25, 30 – 0.04, 0.06mm/mm
•   Crown down technique
•   Speed _ 500 to 600 rpm



              www.indiandentalacademy.com
PROTAPER:

• Multiple tapering – fewer files required to create a
    tapered shape.
•   Used – curved canals, restricted canals
•   Both rotary and hand instruments
•   Increased efficiency, effectiveness.
•   Length – 19, 21, 25mm.
•   Protaper SX, S1, S2, F1, F2, F3,



              www.indiandentalacademy.com
Shaping files
SX shaper – canals of teeth with shorter roots
            expand the coronal aspect of preparation
            increased rate of taper
            Do – 0.19mm, D9 – 1.1mm,D14_ 1.2mm
            rate of taper drops from D9 to D14
S1 shaper – D0 – 0.17mm,D14 _ 1.2mm
            prepare coronal third of canals
S2 shaper – D0 – 0.20mm ,D14 _ 1.1mm
           prepare middle third along with coronal region
              of apical third




             www.indiandentalacademy.com
Finishing files
To plane away variation in canal diameter in apical one
   third
F1 – size 20, taper 0.07mm/mm (D0 to D3)
F2 – size 25, taper 0.08mm/mm (D0 to D3)
F3 – size 30, taper 0.09mm/mm (D0 to D3)




Speed – 200 to 300 RPM




Used in torque and speed control electric motor handpiece
             www.indiandentalacademy.com
K3 ROTARY INSTRUMENTS:

•   Triple fluted, asymmetric Endo file system.
•   Taper – 0.02, 0.04, 0.06mm/mm.
•   3 modified land area.
•   1 blade – radial land.
•   2 blade – relieved land area.
•   Increased peripheral strength – resist torsional stress.
•   Positive rake angle – active cutting action.
•   Radial land relief – Reduces friction.
•    Design – cut efficiently, safely and quickly with
    unparalleled debri removal.

              www.indiandentalacademy.com
RaCe ROTARY INSTRUMENTS:

•   Triangular cross-section.
•   2 sets of cutting edge
•   Alternating helical design
•   Spade shaped safety tip
•   No radial land.
•   Taper – 0.02, 0.04, 0.06mm/mm.
•   Design – increased flexibility, reduced torque – reduces
    fracture.
•   Speed _ 500 rpm

              www.indiandentalacademy.com
CANAL MASTER SYSTEM:

•   Both hand and engine driven instruments.
•   Instrument similar to GG drill.
•   Hand instrument – apical preparation.
•   Engine driven – coronal preparation of root canals.
•   Non-cutting pilot tip
          Hand instrument – 0.75mm.

         Engine driven – 2.0mm.




              www.indiandentalacademy.com
• Major features:
    a) Replace usual cutting tip with non-cutting pilot.
    b) Cutting head – 1-2mm.
    c) Shaft diameter constant and reduced.
•   Follow original canal curvature and reduce
    transportation.
•   Hand instrument – colour coded handles
                     Sizes – 20 to 80
                     60 degrees reciprocal rotation.
•   Rotary instrument – colour coded latch type attachments
                       Sizes – 50, 60, 70, 80, 90, 100.




              www.indiandentalacademy.com
RAPID BODY SHAPERS AND POW – R ROTARY
 FILES

Rapid body shapers – 4 NiTi rotary engine reamers
                   pattern bullet tip
                   shape body of the canal
RBS NO: 1 – 0.61mm at the tip
RBS NO: 2 – 0.66mm at the tip
RBS NO:3 – 0.76mm at the tip
RBS NO:4 – 0.86mm at the tip
Speed – 275 to 300 RPM

Used in gear reduction, slow speed handpiece

            www.indiandentalacademy.com
POW – R rotary files – NiTi with non ledging bullet tip
                     0.02, 0.04 taper
                     clean and shape middle and apical
                           third
                     ISO size and half sizes available
                     pecking motion




             www.indiandentalacademy.com
RECENTADVANCES
V – taper system
• Variable decreasing rate of taper starting from tip
  towards shaft
• Ex: V10
          0 to 4mm – 10% taper
          4 to 8mm – 5% taper
          8 to 12mm – 2% taper
Self core parabolic cross-section –
  efficient, safe and flexible



             www.indiandentalacademy.com
M2 SYSTEM:
• NiTi rotary system
• Flutes _ minimum contact
         maximum space for debri removable
  Radiographically visible calibration _ increased accuracy
                                        no stops required




            www.indiandentalacademy.com
LIBERATOR
•   Taper _ 2%,4%,6%
•   Sizes _ 15 to 40
•   Speed _ 1000 to 2000 rpm
•   Straight flute design cannot selfthread
•   Lack of radial lands reduces friction
•   Safety tip keeps the file centered




              www.indiandentalacademy.com
NEW CONCEPT IN INSTRUMENT
DESIGN:
• New instruments based on constant percent change
• Percent change – difference between D0 diameters
    divided by D0 diameter of smaller file and multiplied by
    100
•   Series 29 – percent changes is 29.17%
•   Fewer instruments than current system
•   More instruments at the beginning and fewer at the end
•   Ex: profile series 29, golden medium instruments
•   Golden medium instruments series – reduce large
    percentage change between smaller sized files
•   GM – provide half sizes
         disadvantage – machining tolerance 0.02mm

              www.indiandentalacademy.com
CONCLUSION

• Successful endodontic treatment requires accurate
    diagnosis , proper access opening, cleaning and shaping
    which can be achieved by using proper instruments.
•   Knowledge of instruments improves the quality of
    treatment and makes work more easier for both operator
    and patient.




              www.indiandentalacademy.com
www.indiandentalacademy.com

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Endodontic instruments /certified fixed orthodontic courses by Indian dental academy

  • 1. ENDODONTIC INSTRUMENTS INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. CONTENTS • INTRODUCTION • HISTORY • CLASSIFICATION OF ENDODONTIC INSTRUMENTS • EXAMINING INSTRUMENTS • EXPLORING INSTRUMENTS • DEBRIDING INSTRUMENTS • CLEANING AND SHAPING INSTRUMENTS • STANDARDISATION OF ENDODONTIC INSTRUMENT • ISO GROUP I INSTRUMENTS • ISO GROUP II INSTRUMENTS • ISO GROUP III INSTRUMENTS • ISO GROUP IV INSTRUMENTS • NON-ISO INSTRUMENTS • NEW CONCEPT IN INSTRUMENT DESIGN • CONCLUSION www.indiandentalacademy.com
  • 3. INTRODUCTION: “worksman is known by his tool” As the endodontic therapy becomes a more routine part of general dental practice the clinician is bombarded with number of newer products designed to make treatment more precise and easier to perform. Newer instruments overcome the deficiency seen in earlier instruments. Thus a thorough knowledge in evolution of instruments is mandatory for operator. www.indiandentalacademy.com
  • 4. HISTORY: • 2200 years old Nabatean warrior skull _ oldest root canal filling • 1750 – Fauchard recommended removal of pulp • 1850 _ wooden pegs for debriding pulp • Early 1900 – Introduction of files ,reamers ,pathfinder , lentulospiral • 1915_kerr manufacturing company obtained patent for all instruments later known as k_type instruments • 1957 _Richman introduced first ultrasonic system • 1958_introduction of racer file handle • 1958 – Ingle & Levine 1st proposed standardization. • 1959 – New line of standardized instruments & filling materials. www.indiandentalacademy.com
  • 5. 1962 – Working committee on standardization . • 1964 _ Introduction of giromatic handpiece. • 1975 _ 1st report on potential application of NiTi alloys • 1976 – 1st approved specification for root canal instruments. • 1976 to 1984_ Martin and Cunningham provided instruments that were set for vibration at 25 to 40KHz • 1984 _introduction of canalfinder system • 1988 _ 1st use of NiTi in endodontic instruments • 1989 – ANSI approval of “ADA specification number 28 for endodontic files & reamers.” • 1989_Wildey and Senic introduced canal master www.indiandentalacademy.com
  • 6. CLASSIFICATION OF ENDODONTIC INSRUMENTS BASED ON FUNCTION A)EXPLORING _to locate canal orifice and to assist in obtaining patency of root canal B) DEBRIDING _to extirpate pulp and remove debris C) CLEANING AND SHAPING _ clean and shape root canals laterally and apically D) OBTURATING _To pack filling material into root canal MODE OF USE A) HAND B) ROTARY www.indiandentalacademy.com
  • 7. ISO GROUPING A) GROUP I _hand use only B) GROUP II _engine driven latch type C) GROUP III_ engine driven latch type drills or reamers D) GROUP IV_ root canal points www.indiandentalacademy.com
  • 8. EXAMINING INSTRUMENTS • Instruments used in examination are 1)front surface mouth mirror _ overcomes the problem of associated with double image 2)periodontalprobe 3)explorer 4)cotton forceps www.indiandentalacademy.com
  • 9. EXPLORING INSTRUMENTS ENDODONTIC EXPLORERS: • Long, narrow working ends. • Angle away from shank – easy access. • Locate canal openings. • Explore pulp chambers. www.indiandentalacademy.com
  • 10. PATHFINDER: • To negotiate highly calcified and constricted root canals. • Available in pre sterilized single-unit packages, in 19, 21 and 25 mm lengths and two sizes, K1 and K2. • The carbon steel shaft – greater sharpness and strength for penetrating calcified root canals. www.indiandentalacademy.com
  • 11. DEBRIDING INSTRUMENTS ENDODONTIC EXCAVATOR • Longer offset – better reach • Excise pulp tissue from pulp chamber www.indiandentalacademy.com
  • 12. BARBED BROACH, RASP AND APPLICATORS: • Made from soft iron wire. • Differ from other H-type and K-type _ taper and working portion length. (ANSI sp. No :63) • The length of working portion of shaft _ 10mm. • Taper – 0.007mm/mm (Broach). 0.015mm/mm (rasp). • Difference between broach and rasp _ depth and angle of cut. • Barb height – half of core diameter (Broach). • Barb height – one third of core diameter (rasp). www.indiandentalacademy.com
  • 13. • Barbed broach – Thin, flexible, tapered and pointed removal of intact pulp tissue, paper points and cotton dressings. Identification symbol – 8 pointed star • Rasps – rough walled canal preparation. Previously rattail file Identification symbol – 8 pointed polyhedron • Applicators – slender, tapering, flexible, pointed C.S. – circle Incisive cuts – shallow, slight elevation www.indiandentalacademy.com
  • 14. MICRO OPENERS • Exploring of explorers + Instrumentation of K-files. • 7mm K-type flutes. • 10 and 15 size with 0.04/0.06mm/mm taper MICRO DEBRIDERS •Instrumenting or retreating – hard to reach canals. •H-type configuration – 20 and 30 size. 0.02mm/mm taper with 16mm cutting flutes. www.indiandentalacademy.com
  • 15. ISO GROUP I INSTRUMENTS MANUFACTURE: First made from carbon steel Now made universally of Ni-Ti and stainless steels. Produced by two techniques. 1st technique Grinding graduated sizes of round “piano” wire into various shapes and second grinding for taper. Then, twisted in counter clockwise direction for programmed number of times. 2nd technique Grind spirals into tapered wire rather than twisting. Ni-Ti instruments are produced by this technique. www.indiandentalacademy.com
  • 16. STANDARDIZATION STANDARIZATION OF ENDODONTIC INSTRUMENTS The recommendations for standardization of endodontic instruments A) Instruments numbered from 10 to 100, based on diameter of the instruments in hundreds of a millimeter at the beginning of the tip of the blades B)The instruments from size 10 to size 60 advance by 5 units then by 10 units to size 140. C) The working blade (flutes) shall begin at tip, designated site D0 (diameter 1) and extend up to the most coronal part of the cutting edge at D16 (diameter 2). The flutes extend 16mm up the shaft. www.indiandentalacademy.com
  • 17. E) The instruments enlarge by 0.02 mm/mm from D0 to D16 D) The tip angle of an instrument should be 75 ±15° Color coding of instruments _ easier identification of instruments www.indiandentalacademy.com
  • 18. TERMINOLOGIES IN INSTRUMENT DESIGN: RAKE ANGLE: “The angle between the cutting edge and a perpendicular to the surface being cut” HELICAL ANGLE: “The angle the cutting edge makes with the long axis of the instrument” www.indiandentalacademy.com
  • 19. CLEANING AND SHAPING INSTRUMENTS K FILES • Instruments with tighter spirals. • 1.97 to 0.88 cutting flutes per mm of operating head. • Produced mainly from square blank. • Cutting action – either filing (rasping) or reaming (drilling) motion. • Filing – rake of flutes rasp the walls as the instrument is withdrawn without turning. • Reaming – penetration, rotation and retraction www.indiandentalacademy.com
  • 20. • More work hardened – stiffer than reamers. • Identification symbol – square www.indiandentalacademy.com
  • 21. K REAMERS • Instruments with lesser number of flutes. • 0.80 to 0.28 cutting flutes per mm of operating head. • Produced mainly from triangular blanks. • Cutting action penetration, rotation and retraction. • Identification symbol – equilateral triangle www.indiandentalacademy.com
  • 22. K-STYLE MODIFICATION K-FLEX: • Forerunner of hybrid instruments. • Hybrid – strength and versatility of K-type + aggressive cutting of H-type. • Cross-section – rhombus or diamond. • Cutting edge – Two acute angles. • Alternating low flutes – obtuse angle – increase debri removal. • Space reservoir – reduced compacting dentinal filing. • Increase flexible. www.indiandentalacademy.com
  • 23. HEDSTROEM FILES • Cutting spiraling flutes into shaft of round, tapered stainless steel wire. • Very positive rake of flute design. • Impossible to ream or drill. • Cut in one direction – retraction. • Cross-section – single helix teardrop www.indiandentalacademy.com
  • 24. H-STYLE MODIFICATION: • Mcspadden – Unifile • ‘S’ file – variation of unifile • Double helix design. • Cross-section – ‘S’ shaped. • Helical angle – less than 90 degrees • Unifile , ‘S’ file _ flutes less deep than H files • Differs _ angle of flutes – constant depth of flute _ increases from tip to handle • ‘A’ file _ hand and rotary steep flutes and 40 degree helical angle non cutting tip • Safety Hedstroem files – non cutting side – prevent ledging. www.indiandentalacademy.com
  • 25. TIP MODIFICATION : • Tip design led to improved cutting efficiency. (NWU group) • Triangular pyramidal tips outperformed conical tips. (NWU group) • University of Oklahoma – redesigning tips eliminating their cutting ability. • Powell et al – “grinding to remove the transition angle” from tip to first blade. • Modified tip _ less transportation and more inner curvature preparation. (Sabala et al 1988) • Flex-R-files, control safe files, Anti-Ledging file and safety Hedstrom file. www.indiandentalacademy.com
  • 26. FLEXOFILES: • Flexible file_ triangular cross section stainless steel blank • Non cutting tip(1.81 flutes per mm) • Golden medium _similar in design www.indiandentalacademy.com
  • 27. FLEX_R FILES • Used in BALANCED FORCE TECHNIQUE • Triangular blank machined • Advantage _ increased stiffness and strength _ smaller files increased flexibility _ larger files • cut efficiently _ anti clockwise rotary motion • safe ended tip www.indiandentalacademy.com
  • 28. HELIAPICAL: • Resembles conventional files _ apical 4 to 5mm • Remainder blank shank • Smaller size _ fracture if continuous rotation www.indiandentalacademy.com
  • 29. ZIPPERER FLEXICUT • Triangular blank_ SCS spacecraft steel • High vaccum fired chrome nickel steel _ uniform structure • Advantage _ flexibility and non aggressive tip www.indiandentalacademy.com
  • 30. FLEXOGATES: • Stainless steel instrument – similar to canal master • One spiral fluting – expanded head • Non cutting tip • Smooth flexible shank _ circular in C.S • Shank _ deliberately weak at handle end www.indiandentalacademy.com
  • 31. INTERMEDIATE FILES • Produced _ trimming 1mm from tip of file and rounding off sharp edges on a diamond file • Files changed from 10 to 12 15 to 17 20 to 22 25 to 27 • Advantage _ smooth progress through files • Disadvantage _ disposable , edges difficult to smooth may cause ledging • Overcomed _ “GOLDEN MEDIUM” intermediate www.indiandentalacademy.com
  • 32. OBTURATING INSTRUMENTS ENDODONTIC CONDENSERS AND SPREADERS: • Smooth tapered metal instruments – compress and compact gutta-percha • Pluggers or condensers – blunt or flat-ended tips Spreaders – more tapered and pointed tips Long handled – chrome plated or stainless steel www.indiandentalacademy.com
  • 33. • M series plugger-spreaders – double-ended long-handled instruments Handles colour coded Corresponds to standard sizing and taper of K-type files • Finger held spreaders and condensers – similar to K-type files with plastic or metal handles. www.indiandentalacademy.com
  • 34. ENDODONTIC PLIERS AND FORCEPS: • Handling and placement of silver point and gutta-percha cones. • Pliers – tapered groove in beak for grasping silver cone. • Forceps – grooved or serrated beaks for holding gp cones. • Have latch mechanism for locking in closed position. www.indiandentalacademy.com
  • 35. RECENTADVANCES SENSEUS FLEXOFILE • Unique silicone handle. • Stainless steel triangular core file and safe ended tip. • Large, ergonomic handle provides comfort and excellent tactile feedback. • X-ray visible calibration ring (25mm and 31mm) to improve accuracy and diagnosis. www.indiandentalacademy.com
  • 36. NEW C-PILOT FILE: • Probing calcified canals. • Creating smooth passage for rotary NiTi preparation. • Extra sturdy – unique thermo process. • Thin but strong for obliterated canals. • ISO 6%, 8%, 10%, 12.5%, 15%. • Length – 19, 21, 25mm. www.indiandentalacademy.com
  • 37. ENDO HANDLE: • Colour coded handles with locking chamber • Micro files used with file holder www.indiandentalacademy.com
  • 38. NiTi spreaders • NiTi finger spreaders • Used in curved canals for good obturation www.indiandentalacademy.com
  • 39. FLEX MASTER • K-type cutting blades with Blunt tip. • Cross-section – convex. • Sufficient space between blades – removal of dentinal debris. • Highest cutting efficiency – efficient preparation. • 50% faster. www.indiandentalacademy.com
  • 40. CC+ SERIES • Includes H-file, R-reamer, K- file, flexicut file, C-pilot file. • Additional longitudinal ridge – increased grip. • Anti slip effect. • Easier, less tiring. • X-ray visible calibration rings Continuous depth control during preparation. Faster stopper positioning. • Increased accuracy. www.indiandentalacademy.com
  • 41. ISO GROUPS II AND III Engine – driven instrument use – 3 types of contra angle handpiece. • A full rotary handpiece – Latch or friction grip. • Reciprocating/Quarterturn handpiece. • Special handpiece – vertical stroke with reciprocating quarterturn. ISO GROUP II – Instruments with shaft and operating head as separate pieces ISO GROUP III – Instruments with shaft and operating head as one piece. www.indiandentalacademy.com
  • 42. ROTARY CONTRA ANGLE HANDPIECE • Instrumentation – Straight line drilling or side cutting. • With round or tapered burs – coronal access to canal orifice. • With special reamers – Funnel out orifices. • With Nickel titanium reamer type instruments – Clean and shape canals, • Misdirected or forced behind limits – Perforations. www.indiandentalacademy.com
  • 43. • Solution – Use of slower handpiece. Ex: 1) Medidenta/ Micro Mega MM 324 reduction gear Handpiece. 2) Aseptico Electric Motor handpiece. 3) The Quantec ETM. 4) The Moycol union broach sprint EDM. • Speeds – 300 rpm for NiTi profiles. 2000 rpm for Light Speed instruments. • Newer electric handpieces – Both speed and torque control. • New rotary handpiece – Morita tri Autozx. • Tri Auto ZX – Battery – powered slow-speed (280 rpm) handpiece with a built in apex locator. • NiTiMatic _ 16:1 gear reduction handpiece 300 rpm www.indiandentalacademy.com
  • 44. RECIPROCATING HANDPIECE: • Giromatic handpiece – Accepts latch type instruments. • Canal insruments available for use with GIROMATIC giro pointer _ 16mm long orifice opener giro broach or cleanser giro file,a hedstroem configuration giro reamer heli girofile_3 cutting blades in c.s • Quarter-turn motion – 3,000 times per minute. www.indiandentalacademy.com
  • 45. • M4 safety handpiece – 30 degree reciprocating motion. Regular hand files by their handles. • Endo-Gripper – 10:1 gear ratio, 45 degree turning motion. • Endo Cursor _ press button chuck Take hand instruments www.indiandentalacademy.com
  • 46. VERTICAL STROKE HANDPIECE: • Air or electrically driven – Vertical stroke, 0.3 to 1mm. • On binding – Quarter turn reciprocating motion. • Canal finder system – A file, variation of H file. Reciprocal rotation with filing motion. Penetration of severely curved and constricted canals without perforation or ledging. www.indiandentalacademy.com
  • 47. • Canal leader – speed reducing handpiece with 4:1 step down • Vertical movement of 0.4 to 0.8mmwith 30 degree contra rotational movement • 3 instruments available_ K file with safe ended tip,H file and universal file • Racer handpiece – vertical oscillation www.indiandentalacademy.com
  • 48. RANDOM HANDPIECE • Excalibur _ lateral vibrational movement 20000 to 25000 r.p.m. Use modified K files www.indiandentalacademy.com
  • 49. ENDO IT PROFESSIONAL • Individually programmed torque limit and speed for each instrument. • Fast reaction auto stop – reverse. • Warning signal at 75% torque limit. • Warning signal – motor in reverse rotation. www.indiandentalacademy.com
  • 50. ISO GROUP II Instruments with shaft and operating head as separate pieces: Ex: • B-2 reamer – cylindrical working head 2 cutting edges – spiral c.s – rectrangle working head and shaft – similar to K-type. Used with contraangle or straight handpiece • Lentulospiral – power-operated, spiral. Used with contraangle or straight handpiece www.indiandentalacademy.com
  • 51. • Quarter-turn reamer – power-operated, tapered and pointed used with giromatic or racer handpiece enlarge/widen root canal similar to blank of K-type. McSpadden compactor – specially designed Apically directed spirals. frictional heat softens guttapercha •Other group II – K-reamer, H file, R-type rasp, barbed broach Used with giromatic or racer handpiece www.indiandentalacademy.com
  • 52. EZ FILL • It has patented bi_directional spiral produces a coronal and apical cement flow simultaneously • When the opposite flows of cement meet they are forced to laterally • Used in slow up and down and circular motion for 5 seconds • Used in contra angle in forward direction www.indiandentalacademy.com
  • 53. ISO GROUP III Shaft and operating head as 1 piece. • G-type reamer – GG drill stainless steel or NiTi Short, flame-shaped head with side cutting blades Short, non-cutting guide at tip Long-thin neck connects working head and shaft. Number 1 to 6 Used with gear reduction, slow speed, high torque handpiece Speed – 750 to 1000 RPM • B-1 reamer – similar to G-type. Twice long working head. www.indiandentalacademy.com
  • 54. • O-type reamer – long, tapered head 3 spiralling blades – plane angle short neck. • P-type reamer – Paeso drill Long, narrow, tapering head Side cutting, spiral blades Tip – cutting /non-cutting. Thick neck Number 1 to 6 www.indiandentalacademy.com
  • 55. • A-type and D-type – similar design. • A-type – long, tapered, pyramid shaped 4 side cutting blade c.s – square short, narrow neck. • D-type – shorter pyramidal point Short narrow neck. • Ko, T-, M- reamers- orifice enlargers straight/contra angle handpiece www.indiandentalacademy.com
  • 56. • Ko reamer – longer than tapered and pointed fissure but with out cross-cut. 8 side cutting blades with spiraling Short neck. • T reamer – 12-16 straight side cutting blades Short head length. • M reamer – round head 6-8 cutting blades Neck-long and flexible. • Root facer – power operated rotary Crownless tooth. Thin wheel shaped end cutting with center cylindrical truncated cone with www.indiandentalacademy.com the canal. Smooth surface entering
  • 57. BURS: • Burs with extended shank – preparation in pulp space with low speed handpiece. • Surgical length – 26mm. • Extra long shank – 34mm Ex: Brasseler, shank 25 Good visibility and control • Friction grip tapered fissure burs (557 or 701) – correct outline form. • Round burs – normal and extra long Size 2, 4, 6 Deroofing • Longer and smaller round burs – fine calcified canals. • Safe ended diamond / tungsten carbide bur / endo2 www.indiandentalacademy.com bur – taper, smooth access cavity.
  • 58. ULTRASONIC INSTRUMENTS: • System in which sound as an energy source activates an endodontic file resulting in a three dimensional activation of the file. • File – Vibrates in a sinus wave like fashion. • Antinodes _ maximal displacement (tip). • Nodes – no displacement. • Fracture – at the nodes. • Debriding action – Cavitation and acoustic streaming. • Cavitation – positive pressure followed by a negative pressure in the fluid. Cavity formed in the negative phase implodes with great force during next positive pressure phase. • Acoustic streaming – small, intense, circular, fluid movement. occurs closer to the tip. www.indiandentalacademy.com
  • 59. • Various ultrasonics used Cavitron endodontic system. Enac unit. Piezon master 400. • 20 to 25 KHZ – used. • Piezoelectrical design – Decreased heat Increased energy • Magnetostrictive – Increased heat decreased energy. • Endosonic ultrasonic synergistic system – instrumentation + irrigation. www.indiandentalacademy.com
  • 60. • Cavi-Endo ultrasonic unit – 1st • Use either inert sterile or chemically active irrigant. • Modifications of K-type or R-type. • Endosonic diamond file – cutting of dentin by abrasion. Coronal enlargement. • Ultrasonic tips – used in detection of canal orifices. removal of posts, fractured instruments, coating canals with sealer www.indiandentalacademy.com
  • 61. SONIC INSTRUMENTS: • Sonic systems – vibration in audible frequency range • Frequency – 2 to 3 KHZ. • Micro Mega 1500 sonic Air endo system – Airline pressure of 0.4 MPA. • Sonic file – large elliptical motion at the tip. • Loaded – longitudinal motion, up and down. • Oscillatory range – 1500-3000 cycles per second. • Three sonic files used – Rispisonic, shaper sonic, Trio sonic. www.indiandentalacademy.com
  • 62. • Rispisonic – old rat tail file (8 cutting blades) coronal third • Shaper sonic – husky barbed broach. (16 cutting blades). apical one third • Triosonic – tripled helix H file. • Sizes – 15 to 40. • Length – 17 to 29mm. • Rougher canal surface. • Endosonic 3000- sonic handpiece similar to sonic air driven scalers. • Irrigation – filtered water. • Dis advantange –perforations, transportation. www.indiandentalacademy.com
  • 63. ISO GROUP IV: • Not strictly endodontic instrument but have been considered part of armamentarium under developing international standards. ABSORBENT POINTS: • Slender cones made of paper or other absorbent material. • Uses – drying the canal Conveying medicaments Obtaining canal cultures • Available in standardized sizes www.indiandentalacademy.com
  • 64. ROOT CANAL FILLING POINTS • Smaller, slender cones of solid material. • Used for canal obturation. Ex: silver points, gutta-percha points. • Available in standardized sizes and taper www.indiandentalacademy.com
  • 65. NON-ISO INSTRUMENTS • Advent of NiTi _ newer instrument system • Instruments with greater taper • Tapers _ 4% ,6% ,8% ,10% ,12% • Better shaping • Faster treatment • TERMINOLOGIES: • RADIAL LAND – “The surface that projects axially from the central axis between the flutes” • PITCH – “Number of flutes per unit length” www.indiandentalacademy.com
  • 66. ProFile • Design – U grooves and radial lands • Lands – prevent uncontrolled cutting Prevents premature fractures, perforation and transportation Strength of the instrument • Standard taper – 0.04mm/mm 0.06, 0.08mm/mm taper available • Used in control, slow speed, high torque rotary handpiece • Rotational speed – 275 to 325 RPM www.indiandentalacademy.com
  • 67. • Available – ISO sizing series 29 standards 4% taper – small canals and apical regions 6% taper – mid root portions • Orifice shapers – 0.06, 0.07mm/mm taper shaping coronal portion of canal length – 19mm, cutting length 9mm 30, 40, 50 sizes www.indiandentalacademy.com
  • 68. GT PROFILES • Made of Ni-Ti. • Both hand and rotary. • Instruments – size 20. • Tapers – 0.06, 0.08, 0.10, 0.12mm/mm • Cutting blades – 6-8 mm of shaft. • Standard set – 4 instruments, size 20, taper 0.06, 0.08, 0.10, 0.12mm/mm. • Design – radial landed, clockwise cut U blade flutes with non-cutting tip • Maximum flute diameter – 1mm www.indiandentalacademy.com
  • 69. 6% taper – moderate to severely curved canals in small roots • 8% taper – straight to moderately curved canals in small roots • 10% taper – straight to moderately curved canals in large roots • Accessory GT files 3 instruments – 0.12mm/mm taper maximum flute diameter of 1.5mm 35, 50, 70 size unusually large root canals to apical diameter greater than 0.3mm www.indiandentalacademy.com
  • 70. LIGHTSPEED • NiTi instrument. • Resemble a GG drill. • Rotary instrument. • Sizes – 20 to 140 • Half sizes – upto. 60 • Head size – 0.25mm for size 20 1.75mm for size 100. • Used in slow speed handpiece • Rotational speed – 1,000 to 2,000 RPM • Used in pecking motion www.indiandentalacademy.com
  • 71. • Laser etched length control rings – eliminate need for silicone stops • Advantage – finish apical third preparation to a larger size. • Disadvantage – excessive number of instruments – strain www.indiandentalacademy.com
  • 72. QUANTEC FILES • Design – similar to ProFile Double helical flute design with extensive peripheral mass • Lands – wider Enhanced strength • Both – hand and rotary– powered instruments. • Quantec series – 10 NiTi files 0.02 to 0.06 taper • Both safe cutting and non-cutting tips. www.indiandentalacademy.com
  • 73. • Quantec flare series – 0.08, 0.10, 0.12mm/mm taper 25 size shape coronal third of canal • Built in graduated taper technique • Used in high torque, gear reduction, slow speed handpiece • Speed – 300 to 350 RPM www.indiandentalacademy.com
  • 74. Hero 642 • Design – tri helical Hedstroem with sharp flutes Increased distance between flutes – reduced risk of binding • Large central core • Size – 20 to 45 • Taper – all sizes – 0.02mm/mm Size 20, 25, 30 – 0.04, 0.06mm/mm • Crown down technique • Speed _ 500 to 600 rpm www.indiandentalacademy.com
  • 75. PROTAPER: • Multiple tapering – fewer files required to create a tapered shape. • Used – curved canals, restricted canals • Both rotary and hand instruments • Increased efficiency, effectiveness. • Length – 19, 21, 25mm. • Protaper SX, S1, S2, F1, F2, F3, www.indiandentalacademy.com
  • 76. Shaping files SX shaper – canals of teeth with shorter roots expand the coronal aspect of preparation increased rate of taper Do – 0.19mm, D9 – 1.1mm,D14_ 1.2mm rate of taper drops from D9 to D14 S1 shaper – D0 – 0.17mm,D14 _ 1.2mm prepare coronal third of canals S2 shaper – D0 – 0.20mm ,D14 _ 1.1mm prepare middle third along with coronal region of apical third www.indiandentalacademy.com
  • 77. Finishing files To plane away variation in canal diameter in apical one third F1 – size 20, taper 0.07mm/mm (D0 to D3) F2 – size 25, taper 0.08mm/mm (D0 to D3) F3 – size 30, taper 0.09mm/mm (D0 to D3) Speed – 200 to 300 RPM Used in torque and speed control electric motor handpiece www.indiandentalacademy.com
  • 78. K3 ROTARY INSTRUMENTS: • Triple fluted, asymmetric Endo file system. • Taper – 0.02, 0.04, 0.06mm/mm. • 3 modified land area. • 1 blade – radial land. • 2 blade – relieved land area. • Increased peripheral strength – resist torsional stress. • Positive rake angle – active cutting action. • Radial land relief – Reduces friction. • Design – cut efficiently, safely and quickly with unparalleled debri removal. www.indiandentalacademy.com
  • 79. RaCe ROTARY INSTRUMENTS: • Triangular cross-section. • 2 sets of cutting edge • Alternating helical design • Spade shaped safety tip • No radial land. • Taper – 0.02, 0.04, 0.06mm/mm. • Design – increased flexibility, reduced torque – reduces fracture. • Speed _ 500 rpm www.indiandentalacademy.com
  • 80. CANAL MASTER SYSTEM: • Both hand and engine driven instruments. • Instrument similar to GG drill. • Hand instrument – apical preparation. • Engine driven – coronal preparation of root canals. • Non-cutting pilot tip Hand instrument – 0.75mm. Engine driven – 2.0mm. www.indiandentalacademy.com
  • 81. • Major features: a) Replace usual cutting tip with non-cutting pilot. b) Cutting head – 1-2mm. c) Shaft diameter constant and reduced. • Follow original canal curvature and reduce transportation. • Hand instrument – colour coded handles Sizes – 20 to 80 60 degrees reciprocal rotation. • Rotary instrument – colour coded latch type attachments Sizes – 50, 60, 70, 80, 90, 100. www.indiandentalacademy.com
  • 82. RAPID BODY SHAPERS AND POW – R ROTARY FILES Rapid body shapers – 4 NiTi rotary engine reamers pattern bullet tip shape body of the canal RBS NO: 1 – 0.61mm at the tip RBS NO: 2 – 0.66mm at the tip RBS NO:3 – 0.76mm at the tip RBS NO:4 – 0.86mm at the tip Speed – 275 to 300 RPM Used in gear reduction, slow speed handpiece www.indiandentalacademy.com
  • 83. POW – R rotary files – NiTi with non ledging bullet tip 0.02, 0.04 taper clean and shape middle and apical third ISO size and half sizes available pecking motion www.indiandentalacademy.com
  • 84. RECENTADVANCES V – taper system • Variable decreasing rate of taper starting from tip towards shaft • Ex: V10 0 to 4mm – 10% taper 4 to 8mm – 5% taper 8 to 12mm – 2% taper Self core parabolic cross-section – efficient, safe and flexible www.indiandentalacademy.com
  • 85. M2 SYSTEM: • NiTi rotary system • Flutes _ minimum contact maximum space for debri removable Radiographically visible calibration _ increased accuracy no stops required www.indiandentalacademy.com
  • 86. LIBERATOR • Taper _ 2%,4%,6% • Sizes _ 15 to 40 • Speed _ 1000 to 2000 rpm • Straight flute design cannot selfthread • Lack of radial lands reduces friction • Safety tip keeps the file centered www.indiandentalacademy.com
  • 87. NEW CONCEPT IN INSTRUMENT DESIGN: • New instruments based on constant percent change • Percent change – difference between D0 diameters divided by D0 diameter of smaller file and multiplied by 100 • Series 29 – percent changes is 29.17% • Fewer instruments than current system • More instruments at the beginning and fewer at the end • Ex: profile series 29, golden medium instruments • Golden medium instruments series – reduce large percentage change between smaller sized files • GM – provide half sizes disadvantage – machining tolerance 0.02mm www.indiandentalacademy.com
  • 88. CONCLUSION • Successful endodontic treatment requires accurate diagnosis , proper access opening, cleaning and shaping which can be achieved by using proper instruments. • Knowledge of instruments improves the quality of treatment and makes work more easier for both operator and patient. www.indiandentalacademy.com