Endodontic instruments Endodontic Al Azhar University Gaza Faculty of Oral and Dental Medicine Lama El Banna

1. ENDODONTIC INSTRUMENTS
Dr.Mohammed Walid Abu-Hassira

2. CLASSIFICATION OF ENDODONTIC
INSTRUMENTS:
1) Diagnostic instruments:
a) Standard diagnostic instruments.
(mirror,probe,tweezer,excavation)
b) Diagnostic radiograph:
1. Plain radiograph (RVG-Digora)
2. Computed tomography(C.T.) and magnetic
resonance image (MRI)
3. Xero-radiography
4. CBCT

3. C) DIAGNOSTIC ADJUNCTS:
 Dental pulp testing is a useful and essential diagnostic
aid in endodontics. Pulp sensibility tests include thermal
and electric tests, which extrapolate pulp health from
sensory response. Whilst pulp sensibility tests are the
most commonly used in clinical practice, they are not
without limitations and shortcomings. Pulp vitality tests
attempt to examine the presence of pulp blood flow, as
this is viewed as a better measure of true health than
sensibility. Laser Doppler flowmetry and pulse oximetry
are examples of vitality tests.

4. 1. Electric pulp tester
(Delivers a small electrical stimulus to the pulp)

5. 2. Thermal pulp tester:
Necrotic pulp will not respond to cold or hot
1. Cold test
Ice, dry ice, or ethyl chloride used to determine the
response of a tooth to cold
2. Heat test
Piece of gutta-percha or instrument handle heated
and applied to the facial surface of the tooth
3. Laser Doppler flowmetry.
4. Pulp oximetry

6. d) Visual aids:
1. Trans-illumination
2. Dental operating microscope (32x)
3. Endoscope and orascope
e) Supplementary instruments:
(Tooth sloth,methylene blue cracked

7. 2) Instruments for access cavity preparation:
a. Round bur, trans-metal bur
b. Tapered diamond stones, endo access bur
c. Pulpal bur (7mm non-movable stopper
d. Orifice openers ( increase taper instruments)
trans-metal bur

9. 3) Exploring instruments :
a) Endodontic probe:
• Detect location and entrance of orifices
• Has longer working part
b) Micro-opener: (k, 0.02) and micro-debrider (H,
0.04)
c) Ulta-sonic tips

11. 4) Extirpating instruments:
Method: insertion into the canal quarter rotation
pull instrument
Forceful removal may cause fracture of the barbs
inside the canal

12. Pulp extirpation: total removal of the vital inflamed pulp tissue.
Debridement: removal of necrotic pulp

13. ISO STANDARDIZATION
1) Length:
Length of the working part (blade) is constant 16 mm,
while the length of shank and the blade together is
either 21,25,31.
2) Diameter:
Diameter of the cross section at D16 is larger than at
D0 by 0.32 mm

14. 3) Taper:
- It is the rate of change of diameter in relation to
change in length.
- The file diameter increases at standard rate of 0.02
mm diameter/ mm length
- Difference in diameter (D16-D0) = 0.32
- Length of working part 16m
- =0.02mm diameter/mm length

16. 4) Tip angle
The angle formed between the instrument tip and the
long axis of the instrument shaft is 75 15 (+, _
)

17. 5) Numbering system
Number of each indicates the diameter at D0 in
hundredth of mm ,
[No. of instruments/ 100 e.g. instrument # 30
30/100=0.3mm]

18. 6) Gradual incremental increase in size
• Sizes 6,8,10 incremental increase by 0.02mm
(20 microns)
• Sizes 10,60 incremental increase by 0.05mm
(50 microns)
• Sizes 60,140 incremental increase by 0.1mm (100
microns)

19. 7)Color coding
white yellow red blue green black
15,45,90 20,50,100 25,55,110 30,60,120 35,70,130 40,80,140
Sizes #6 pink , Sizes #8 grey, Sizes #10 purple

20. ROOT CANAL ENLARGING INSTRUMENTS.
1) HAND ENLARGING INSTRUMENTS

21. Reamer
K-File
H-File

22. Modified instrument.
The preparation of curved canals requires.
1. Flexible instrument
2. Increased cutting efficiency
3. Increased debris loading
4. Decrease procedural mishaps.

23. 2) Engine driven instrument:
* Vibratory
- Sonic
- Ultrasonic
* Rotary

24. LOW SPEED ROTARY INSTRUMENT
Gates glidden drills ( GG)

25. *Design: long, thin shaft of diameters 0.5- 1.5 mm
and incremental increase of 0.2mm each successive
instrument
* Length: 32mm and 28mm
* Size: 1-6: The number of rings on the shank
identifies the size

26. * Mode of action of GG
1- GG drills are side cutting instruments with safety
tips, used to cut dentin as they are withdrawn from
the canal
2- They are used in straight portion of the canal
3- Two procedural sequences have been proposed:
I. Step down sequence: start with large drills then use the
smaller ones
II. Step back technique: to smaller ones

27. Thank You