Ultrasonics endodontic tips

ULTRASONIC
ENDODONTIC INSERTS
DR. P.
SAHITHI
2

CONTENTS
 Introduction
 History
 Classification
 Application
 Commercially available inserts
 Conclusion
3

INTRODUCTION
 Ultrasound is sound energy with a frequency above the range of
human hearing, which is 20 kHz. The range of frequencies
employed in the ultrasonic units is between 25 and 40 kHz
Stock CJR
 There are two basic methods of producing ultrasound.
 Magnetostriction
 Piezoelectric principle
4

magnetostrictive piezoelectric
frequency 25-30 khz 25-50 khz
Strok pattern elliptical linear
Energy conversion Metal rod or stack of metal
sheets
Crystals activated by
ceramic handpiece
Power dispersion All surfaces active Only active on lateral sides
5

Piezoelectric units are preferred over magnetostrictive units as
they offer more cycles per second, (40 versus 24 k). The tips of
these units work in a linear, back-and-forth, “piston-like” motion,
which is ideal for endodontics.
Lea et al
The major parts of piezoelectric units are
•Piezoceramic material
•Seismic mass
They are connected to a sensor and an electrode to produce a
voltage difference
6

Piezoelectric crystal
changes shape and vibrates
when a potential difference
is applied. At a high
frequency the vibrations
from crystals produce
ultrasound waves
7

HISTORY
 The concept of using ultrasound in endodontics was first
introduced by Richman in 1957.
 In 1976, Martin published his first paper on increasing the efficacy
of bactericidal root canal irrigation associated with ultrasonic
technique.
 Bertrand et al, 1976 was the first to use a modified ultrasonic tip
for a retropreparation during an apicoectomy.
 Martin et al. in 1984, demonstrated the ability of ultrasonically
activated K-type files to cut dentin, this application found
common use in the preparation of root canals before filling and
obturation
8

.
The term endosonics was coined by Martin and Cunningham in 1985
and was defined as the ultrasonic and synergistic system of root canal
instrumentation and disinfection.
After the introduction of the first ultrasonic tips by Gary Carr, the
focus shifted to the use and possible consequences of ultrasonic root-
end preparations during apicoectomy.
The introduction of the piezoelectric device and numerous drawings
of ultrasonic tips after 1990 has allowed clinicians to remove dentin or
other dental materials in a very controlled and precise manner, using
tips that are often approximately the same size as a root canal or
smaller.
9

Most frequent applications of Ultrasonics in endodontics:
1. Access refinement, finding calcified canals, and removal of
attached pulp Stones
2. Removal of intracanal obstructions (separated instruments, root
canal posts, silver points, and fractured metallic posts)
3. Increased action of irrigating solutions
4. Ultrasonic condensation of gutta-percha
5. Placement of mineral trioxide aggregate (MTA)
6. Surgical endodontics: Root-end cavity preparation and refinement
and placement of root-end obturation material
7. Root canal preparation
Gianluca Plotino,2007 10

CLASSIFICATION OF TIPS BASED ON USE
SURGICAL TIPS
NON SURGICAL TIPS
Vibratory tip
Access refinement tip
Bulk removal tip
troughing tips
MIAN IQBAL, DCNA 2004
11

CLASSIFICATON based on design:
Enrico cassai, 2016 12

•The active tip makes an extremely effective tool when used for
removal of fiber post and obstacles in pulp chamber and in all the
circumstances in which there is a good view and a low risk of creating
iatrogenic injury.
•The smooth tip is useful in the cases in which cutting action is not
necessary on the tip but is exerted by the body of the instrument.
• This is useful in pulp stone and intracanal obstructions (such as post)
removal.
13

•The diamond coating of an ultrasonic tip makes it much more
effective and abrasive.
•Surface coatings on ultrasonic tips are intended to increase
efficiency and durability; diamond-coated tips have been shown to
require less time than stainless-steel tips or zirconium nitride tips to
cut similar preparations.
14

•Among the uncoated diamond tips we can find those with a
smooth surface and milled surface.
•The tips with milled surface have a higher lateral cutting ability
and longer lasting even compared to the coated diamond tips.
15

•The Nickel-Titanium ultrasonic tips are much more fragile than
stainless-steel, are used to work at a low intensity within the canal.
• They should be activated when in contact with the canal walls
otherwise they tend to fracture.
16

TYPE OF
ATTACHMENT
•Piezo units use 2 different thread patterns
•S-threaded tips work in satelec scalars and compatible units
like NSK, SybronEndo, J Morita, Obtura Spartan
•E-threaded tips works with EMS piezo scalars and units that
accept the thread pattern like Mectron, W&H, Bonart
17

SURGICAL ENDODONTICS:
Conventional root-end cavity preparation using rotary burs in a
microhandpiece is faced with several problems , such as:
a cavity preparation not being parallel to the canal,
difficult access to the root end,
risk of lingual perforation of the root
inability to prepare to a sufficient depth,
requires a longer cutting bevel, thus exposing more dentinal tubules
and isthmus tissue.
KIM S, JOE 2006
19

The development of ultrasonic and sonic retrotips has revolutionized
rootend therapy.Its clinical advantages are:
enhanced access to root ends in a limited working space.
This leads to a smaller osteotomy for surgical access because of the
advantage of using various angulations and the small size of the
retrotips
MEHLHAFF, JOE 1997
deeper and more conservative cavities that follow the original path of
the root canal more closely
GUTMAN JL, IEJ 1994
A better-centered root-end preparation also lessens the risk of lateral
perforation
LIN CP, JOE 1998
20

the geometry of the retrotip design does not require a beveled root-end
resection for surgical access
MEHLHAFF, JOE 1997
 thus decreasing the number of exposed dentinal tubules and
minimizing apical leakage
GILHANEY, JOE 2004
They also enable the removal of isthmus tissue present between two
canals within the same root
LLOYD J, IEJ 1997
It is a timesaving technique that seems to have a lower failure rate
VON ARX, IEJ 1998
produces less smear layer in a retro-end cavity compared to a slow-
speed handpiece
GUTMAN JL, IEJ 1994
The refinement of cavity margins that were obtained with the ultrasonic
tips may positively affect the delivery of materials into the cavities and
enhance their seal
SAUNDERS WP, IEJ 1994 21

It is recommended that the ultrasonic unit be set at medium power
The cavities be prepared to a depth of 2.5-3 mm.This depth allows for
a minimum thickness of material that can still provide an effective
apical seal.
MATTISON, JOE 1985
The cavity walls should be parallel and follow the anatomic outline of
the pulpal space
CARR G , 1997
root-end cavities should be initiated with a diamond-coated retrotip,
using its better cutting ability to prepare the main cavity. This aids in
the removal of root canal obturation materials and should be followed
by a smooth retrotip to smooth and clean cavity walls
ZUOLO ML , 1999
23

A condenser tip ultrasonically activated can be utilized for
placement of retrograde filling materials, as the ultrasonic vibration
improves the flow, settling and compaction of these materials to
rootend dentinal walls and the delivery of materials into the cavity
thus enhancing their seal
LAWLEY GR, JOE 2004
Ultrasonic tips can also be used to polish root end material and
apical surfaces. Utilizing specific ultrasonic tips for refinement of
the external radicular surface may be beneficial in the elimination
of extraradicular bacteria.
SIQUEIRA JF, 2002
24

A better quality surface was produced by the prototype
diamond-coated retrotips, in less time than the SS retrotips,
which in turn caused fewer cracks than previously reported.
 DC retrotips removed more dentine than SS retrotips and
should therefore be used with care to avoid overpreparation or
perforation.
International Endodontic Journal,
2001
25

treatment 1: root-end resection (RR) and root-end cavity preparation
(RP) with KIS ultrasonic retrotip;
treatment 2: RR and RP with Satelec S12/90 (no diamond coating)
ultrasonic retrotip;
treatment 3: RR and RP with a diamond-coated retrotip attached to a
sonic device (Sonics);
treatment 4: RR and RP with Satelec S12/90D (diamond coated)
ultrasonic retrotip.
The parameters evaluated were shape quality, presence of cracks, and
marginal chipping. The results showed no statistically significant
differences among anatomic groups, treatments, or tooth sizes (p >
0.05). As sonics removed more dental structure than the others did, its
use on small teeth is inadvisable.
JOURNAL OF ENDODONTICS,
2002
26

Sang-Won Kwak et
al
RDE, 2014
Ultrasonic tips with microprojections would be an option to
substitute for the conventional ultrasonic tips with a diamond
coating with the same clinical efficiency.
27

The purpose of this in vitro study was to evaluate the cutting
efficiency of 4 orthograde ultrasonic tips and describe a nonstatic
cutting model. The 4 ultrasonic tips tested were the Buc-1
(Obtura Spartan, Fenton, MO), Tufi #1 (San Diego Swiss
Machining Inc, San Diego, CA), ET-18D (J. Morita USA, Inc,
Irvine, CA), and P-5 (PlasticEndo, Buffalo Grove, IL)
The Buc-1 ultrasonic tip had a significantly greater
cutting efficiency than the other 3 tips at each of the 3 power
settings (P .05).
JOURNAL OF ENCODONTICS,2008
28

ACCESS REFINEMENT, FINDING
CALCIFIED CANALS, AND REMOVAL
OF ATTACHED PULP STONES
 One of the important advantages of ultrasonic tips is that they do
not rotate, thus enhancing safety and control, while maintaining a
high cutting efficiency. This is especially important when the risk
of perforation is high.
 Ultrasonics works well when breaking through the calcification
that covers the canal orifice.
 Eg: CPR 2D, BUC 2
 A troughing tip is a good choice for this task
 Eg: BUC1, 29

•Bigger tips with a limited diamond coated extension should be
used during the initial phase of removing interferences, as they
offer maximum cutting efficiency and enhance control while
working in the pulp chamber
The diamond-coated pear tip, creates a smooth,
clean flat troughing groove that facilitates canal
location.
The diamond-coated ball tip provides fine
cutting control when preparing a troughing
groove and is less aggressive than the pear tip, yet
it has the same clinical indications.
30

The subsequent phase of finding canal orifices should be carried out
with thinner and longer tips that facilitate working in deeper areas
while maintaining clear vision
Ultrasonic cutting seems to be significantly influenced by the power
setting
Paz E,JOE 2005
 as larger fragments of dentin are removed at higher power, and by
the ultrasonic unit type used .
Waplington,2000
Therefore, care should be exercised while searching for canal
orifices, as aggressive cutting may cause an undesired modification
of the anatomy of the pulp chamber.
31

The orifice of the second
mesiobuccal canal (MB2)
in an upper first molar was
located(a) and enlarged
(b). Dentine spur at the
orifice was effectively
eliminated with the use of
a diamond-coated
ultrasonic tip, thus
permitting easy location of
the orifice of the canal.
Plotino et al,JOE 2007
32

REMOVAL OF INTRACANAL
OBSTRUCTIONS
 Ultrasonic energy has proven effective as an adjunct in the removal of
silver points, fractured instruments, and cemented posts because the
ultrasonic tips or endosonic files can be used deep in the root canal
system
Souyave LC,1985
 Furthermore, the use of an ultrasonic endodontic device is not restricted
by the position of the fragment in the root canal or the tooth involved
 US has provided clinicians with a useful adjunct to facilitate post
removal with minimal loss of tooth structure and root damage
Parreira FR,JOE 1994
33

SILVER POINTS AND FRACTURED METALLIC POSTS
The traditional clinical procedure to remove root canal posts or
silver points fractured at the orifice consists of exposing the
coronal part of the obstacle by cutting an estimated 2.0-mm trough
around the obstacle with a fine diamond bur.
Further Trough around the silver point with an ultrasonic spreader
tip and carefully eliminate dentin while following the long axis,
taking care not to cut the silver point
A fine spreader tip
34

An extra-fine spreader tip used for
removal of a separated instrument in the
middle or apical third of the canal.
Ultrasonic vibration is applied for periods of a few seconds
followed by drying with compressed air. This should lead to
dislodgement of the fragment of the post
Eg: VT, CPR 1,Osada Enac ST9
SMITH BJ, JOE 2001
The space created around the silver point will usually loosen the
silver point, which can then be removed with a Steiglitz forceps or
hemostat.
35

 At all times, the use of intraoral radiographs is recommended to
confirm the position and the remaining length of the obstruction, as
well as the thickness of canal walls
FELDMAN , 1974
Application of Ultrasonics to metal posts, even with adequate
water-spray cooling, can lead to rapid in-creases in temperature of
the root surface, causing damage to the periodontal ligament. Hence ,
should not be used continuously for longer duration.
SMITH, JOE 2001
The time required for removal of a post or silver point is influenced
by the nature of the obstruction, its diameter, and location.
Semiprecious metals take more time than precious metals. Large-
diameter posts are more time consuming compared with narrow ones
NEHME WB,JOE 2001
36

Different bur kits have been proposed to remove fiber posts. The
disruption of the composite structure through the action of ultrasonic
vibration is the most effective technique in fiber post removal.
A fiber-reinforced composite post with a significantly lower modulus
of elasticity than stainless steel or titanium, conducts vibration less
efficiently
HAUMAN, IEJ 2007
 It was suggested that the absence of a water spray seems to increase
the action of US when applied to posts cemented with resin cements,
possibly because of the increase in heat
GARRIDO, JOE 2004
A spreader tip designed for multiple uses like
removal of cements
37

Results of this study indicated that 16 min ultrasonic
vibration is an effective method for removing Paraposts
from human premolar teeth.
1996
38

Fiber post removal speed was best obtained with
removal kits and fiber post removal effectiveness was
best achieved with ultrasonics and diamonds.
It is possible that improved performance might be
obtained if fiber posts are removed with kits followed
by subsequent ultrasonic instrumentation.
2005
39

They have concluded that:
1)Use of ultrasonics is effective for post removal and
reduces the force required
2)Simultaneous use of 2 ultrasonic units is more effective
than one unit
JOURNAL OF ORAL SCIENCE,
2005
40

An ultrasonic technique using CPR tips combined with the
creation of a “staging platform” using Gates Glidden instruments
and the use of the dental operating microscope was consistently
successful at removing fractured rotary nickel-titanium
instruments from narrow, curved root canals when some part of
the fractured instrument segment was located in the straight
portion of the canal.
When the fractured instrument segment was located entirely
around the curve, care must be taken because the success rate is
significantly decreased and major canal damage may ensue.
2003
41

RESTORATIVE THERAPY
ultrasonic tips have been designed to accomplish restorative ,
preventive procedures while conserving the sound tooth
structure
Tips designed for tooth preparation
42

JOURNAL OF PROSTHETIC DENTISTRY,
2008Results. The average pulpal temperature increases were 4.3°C for the
high-speed preparation and 3.8°C for the ultrasonic
preparation, which were statistically similar (P=.052). However,
significant differences were found (P<.001) for
the time expended (3.3 minutes for the high-speed bur and 13.77
minutes for the ultrasound device).
Conclusions. The intrapulpal temperatures produced during cavity
preparation by ultrasonic tips versus high-speed
bur preparation were similar. However, the use of the ultrasonic device
required 4 times longer for the completion of a
cavity preparation 43

INCREASED ACTION OF IRRIGATING SOLUTIONS
The only effective way to clean webs and fins is through movement
of the irrigation solution, as they cannot be mechanically cleaned.
BAUMGARTNER, JOE 1992
Ultrasonics creates:
• Cavitation: it is minimal and is
restricted to the tip
•Acoustic streaming effect: which is
significant and has been shown to
produce sufficient shear forces to
dislodge debris in instrumented
canals.
AHMED M, JOE 1988
44

A higher velocity and volume of irrigant flow is created in the canal
during ultrasonic irrigation
LEE SJ, IEJ 2004
US can also improve disinfection of root canals, probably because
organic tissues enters the streaming field that is generated are
disrupted.
WALMSLEY, IEJ 1987
When sonic or ultrasonic files are used in small, curved canals, they
may bind, thus restricting their vibratory motion and cleaning
efficiency
WILLIAMS, JOE 1989
To prevent a dampening effect, sonic or ultrasonic files should not
contact the canal walls; therefore, the use of smooth files is
recommended
SABINS, JOE 2003 45

Braz Dent Sci, 2018
Essentially, CFU reduction was significantly greater in the
PUI, EndoActivator and PIPS groups than in the manual–
dynamic agitation and conventional syringe irrigation
groups (p <0.001), with no significant differences among
the former three groups.
47

Gianluca PLOTINO et al,2018
No statistically significant differences were found between
5% sodium hypochlorite and 17% EDTA activation and
among the ultrasonic inserts used. When the time of
activation rises, the dentin debris removal increases in all
groups. Both sonic and ultrasonic activation demonstrate a
good capacity for dentin debris removal. The Eddy sonic
system removedmore debris from lateral extensions than the
other systems tested.
48

ULTRASONIC CONDENSATION OF GUTTA-PERCHA
Ultrasonically activated spreaders have been used to
thermoplasticize gutta-percha in a warm lateral condensation
technique.
Ultrasonic spreaders that vibrate linearly and produce heat,
thus thermoplasticizing the gutta-percha, achieved a more
homogeneous mass with a decrease in number and size of voids
and produced a more complete three-dimensional obturation of
the root canal system
DEITCH et al, JOE 2002
49

A number of obturation protocols have been described for
ultrasonic condensation of gutta-percha:
(a)ultrasonic softening of the master cone followed by cold
lateral condensation
MORENO, JOE 1977
(b) one or two times of ultrasonic activation after completion
of cold lateral condensation
AMDITIS C, 1992
(c) ultrasonic activation after placement of each second
accessory cone
DEITCH, JOE 2002
(d) ultrasonic activation after placement of each accessory cone,
which is more accepted
BAILEY, IEJ 2004
50

The ultrasonic spreader must be in the mass of gutta-percha for
about 10 seconds to achieve thermoplasticization.
Leaving it in the canal for more than 10 seconds can produce a
rise in temperature that is damaging to the root surface
BAILEY, IEJ 2004
It has been demonstrated that placement of sealers with an
ultrasonically energized file promoted a better covering of canal
walls with better filled accessory canals (evaluated by
radiography) than placement of sealers with hand instruments
STAMOS JE, JOE 1995
51

Taking surface and cross-sectional analysis together only
power setting 5 and activation times of 10 and 15 s
consistently produced ultrasonically thermocompacted root
canal fillings with fewer voids than cold lateral condensation
without sealer.
International Endodontic Journal,
2004
52

Results indicate that warm lateral condensation using a
ultrasonically energized spreader results in denser gutta-
percha fills by weight than cold lateral condensation.
2002
53

PLACEMENT OF MINERAL TRIOXIDE AGGREGATE
(MTA)
Witherspoon and Ham,2001 described the use of US to aid in the
placement of MTA.
 It was demonstrated that, with the adjunct of US, a significantly
better seal with MTA was achieved.
Placement of MTA with ultrasonic vibration and an endodontic
condenser improved the flow, settling, and compaction of MTA.
Furthermore, the ultrasonically condensed MTA appeared denser
radiographically, with fewer voids
LAWLEY JR, JOE 2004
54

The recommended placement method consists of
•selecting a condenser tip,
•then picking up and placing the MTA with the ultrasonic tip,
•followed by activating the tip and slowly moving the MTA
material down using a 1- to 2-mm vertical packing motion.
Direct ultrasonic energy will vibrate and generate a wavelike
motion, which facilitates moving and adapting the cement to the
canal walls
55

The use of ultrasonics with MTA improved the
compaction and flow of MTA, but excessive
ultrasonication adversely affected MTA properties. A
time of 2 seconds of ultrasonication per increment
presented the best compromise between microhardness
values, dye penetration depths, and lack of radiographic
voids.
BioMed Research International,
2014
56

Hand condensation resulted in better adaptation to the tube
walls and less voids than the ultrasonic method.There was no
significant difference in the results for any of the four lengths of
MTA placed by the hand method (p > 0.9). At this time hand
condensation should be considered the preferred method
for placement of MTA.
2003
57

ROOT CANAL PREPARATION
Ultrasonics failed to demonstrate superiority as a primary
instrumentation technique, as no improved debridement was
accomplished compared with hand instrumentation
SMITH RB, IEJ 1998
The relative inefficiency of ultrasonic debridement has been
attributed to file constraint within the unflared root canal space
WALMSLEY, IEJ 1989
A modification of the technique in which ultrasound is activated for
a few minutes after hand preparation has instead resulted in greater
canal and isthmus cleanliness compared with hand preparation alone
METZLER, IEJ 1989
Despite the multitude of studies conducted on ultrasonic root canal
preparation with ultrasonically activated files, the current consensus
is that this is not a viable clinical technique.
58

COMMERCIALLY
AVAILABLE INSERTS
59

Introduced by Dr. Buchanan
BUC-1 and BUC-1A: used for gross dentin removal, cutting a groove
in the mesial access wall to drop in to MB2 canals, and for unroofing
pulp chambers.
BUC-2 and BUC-2A: has disk-like tip, used to plane attached pulp
stones from the pulp chamber floor, horizontally smooth the pulp
chamber floor.
BUC-3 and BUC-3A: are extremely active instruments with sharp
tips. They are used for chasing canals halfway up a root or for digging
around a post or carrier-based obturator to remove it. The water port is
placed near the cutting surface of the tip. Should be used only at
lowest power level.
BUC
Tips
60

KiS
TIPS
They are designed for use in endodontic
microsurgery and offer increased cutting efficiency
due to their diamond coating-Syngcuk Kim,1999
 The dentin surface is left smooth, yet
microscopically rough, which results in better
adaptation of filling materials,fewer microfractures
and less leakage.
The longer shafts and increased angles give the
clinician improved access and the strategically
placed irrigation port affords more precise control
of irrigation. 61

KiS-1D : Angled 80° at the working end, this instrument is a general
purpose tip for use on anterior and posterior areas
KiS-2D: Similar to the KiS-1D, this instrument is for larger diameter
roots – 0.7 mm diameter (unlike others with 0.5mm)
KiS-3D: double-angled 75° instrument is for use on the buccal root of
the mandibular right and mesial buccal of the maxillary left molar
KiS-4D: double-angled 110° instrument is for use on the lingual root
of the mandibular left and distal buccal of the maxillary right molar
KiS-5D: A mirror image of the KiS-3D, for use on the buccal roots of
the mandibular left and mesial buccal of the maxillary right molar.
KiS-6D: mirror image of the KiS-4D, for use on lingual roots of the
mandibular right molar and distal buccal of the maxillary left molar
62

designed by Gary Carr,1990
CT-1 Initiating Tip – a straight-
line tip with 90° angle used to
initiate the preparation.
CT-2 Main Right Tip – an
angled tip for use on upper right
and lower left to complete the
preparation.
CT-3 Main Left Tip – an
angled tip for use on upper left
and lower right to complete
preparation.
CT TIPS
63

PROULTRA
TIPS
Designed by Clifford. J
Is of two types: proultra endo(1-8) and pro ultra surgical (1-6)
Pro ultra endo tips:(6-8 are titanium tips)
• Disassembling restoratives
• Removing pulp stones
• Locating calcified, aberrant or missed canals
• Troughing fins and isthmuses for orifices
• Eliminating pulp chamber cores:
- amalgams
- composites
- cements
• Eliminating posts
• Removing obturation materials
• Removing broken instruments
• Vibrating ProRoot (MTA) into root defects
tips
1-2
2-3
2-3
2-3
1-2
1-2
3-8
3-8
4-8
64

SURG 1 Universal instrument with a single 80° angle intended
for more narrow: canals of anterior teeth
• SURG 2 Universal instrument with a single 80° angle for
wider canals:of anterior teeth
• SURG 3 This instrument has a double 75°angle: used for
preparing the roots of mandibular left (dial III) and the buccal roots
of maxillary right posterior teeth (dial I)
• SURG 4 This instrument has a double 110°angle: for preparing
the more lingual roots of mandibular left (dial III) and maxillary
right posterior teeth (dial I)
• SURG 5 This instrument has a double 75°angle: used for
preparing the roots of mandibular right (dial IV) and the buccal
roots of maxillary left posterior teeth (dial II)
• SURG 6 This instrument has a double 110°angle:for preparing
the more lingual roots of the mandibular right (dial IV) and
maxillary left posterior teeth (dial II).
65

CPR
TIPS
CPR-1: is used for vibrating posts and cores and as an aid in
crown and bridge removal.
CPR-2D: has a contra-angled head and durable shape that
provides enhanced energy for removal of core materials. It is also
excellent for chasing calcified canals, uncovering hidden orifices,
trephining around obstructions within the pulp chamber, and
eliminating materials extending below the orifice
66

CPR-3D,CPR-4D,CPR-5D: Allows excellent vision and access
while troughing around posts, chasing calcified canals, eliminating
obstructions, and removing broken instruments. The three lengths
provide greater control by allowing the clinician to select an
instrument according to safe access and depth of procedure.
CPR-6, CPR-7 and CPR-8.These instruments are made of titanium
alloy, which results in a smoother cutting action with less chatter,
thereby increasing tactile sense. They are generally used in the mid
and apical portion of the root with illumination and magnification.
These instruments are end cutting only and are commonly used to
ditch around broken files, aiding in their removal.Use at low power
level.
67

UT-1 Initiating Tip – a
straight-line tip with 90°
angle used to initiate the
preparation.
UT-2 Universal Right Tip
– an angled tip for use on
upper right and lower left to
complete the preparation.
UT-3 Universal Left Tip –
an angled tip for use on
upper left and lower right to
complete the preparation.
UT
TIPS
68

BK-3 surgical tips have three bends
for easy access to any preparation,
including MB2 canals.
 They provide excellent visibility
and can finish an entire prep with one
tip. Water is delivered down the three
bends directly to the surgical site.
BK-3s are for use with any
application and at low power levels.
BK3-R : Upper right, lower left.
BK3-L :Upper left, lower right.
BK-3
TIPS
69

SJ-1 Initiating Tip – a straight-line
tip with 90° angle used to initiate the
preparation.
SJ-2 Slim Jim Right Tip – an angled
tip for use on upper right and lower
left to complete the preparation.
SJ-3 Slim Jim Left Tip – an angled
tip for use on upper left and lower
right to complete the preparation.
SJ
TIPS
70

Spreader Tips are designed for
troughing within the canal.
 Spreader Tips can trough around
posts or break open a calcification
and can also be used to help
retrieve separated files that are
stuck in the apical third of the
canal.
 Used at a very low power level.
SP-1 Small Spreader Tip
SP-2 Medium Spreader Tip
SP-2 Diamond coated
SP-3 Ultra-Fine Spreader Tip
SPREADER
TIPS
71

CONCLUSION
Ultrasonics offers many applications and advantages in clinical
endodontics. Improved visualization combined with a more
conservative approach when selectively removing tooth
structure, offers opportunities that are not possible with
conventional treatment, leading to improved techniques and use
of materials, that has enriched the way endodontics is being
practiced.
72

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