My presentation is about Materials used for dressing , cleaning , irrigating the canals. Also include , irrigation techniques and instruments . Enjoy !!

1. Dr. Hamza
Department of Operative Dentistry
Armed Forces Institute of Dentistry
NUMS, Rawalpindi.

2. The root canal system must be:
• Cleaned of its organic remnants
• Shaped to receive a three dimensional
filling of the entire root canal space

3. PRIMARY OBJECTIVES:
• Remove infected soft and hard tissue
• Give disinfecting irrigants access to the
apical canal space
• Create space for the delivery of
medicaments and subsequent obturation
• Retain the integrity of radicular structures
CLINICAL OBJECTIVES

4. MECHANICAL OBJECTIVES:
• Cleaned and shaped canal must be
continuous tapering-funnel shaped
• Cross sectional diameter of canal narrower
every point apically
• Maintain original anatomy, consider curvatures
and root concavities.
• Maintain the position of the foramen.
• Keep the foramen as small as practical

5. BIOLOGICAL OBJECTIVES:
• No forcing of necrotic debris beyond the
apical foramen
• Removal of all tissues and debris from the
root canal space
• Creation of sufficient space for placement
of intra canal medicament and irrigation

6. CLEANING AND SHAPING:
TECHNICAL ISSUES

7. HAND AND ENGINE DRIVEN
INSTRUMENTS

8. MODE OF MANUFACTURE:
• Cutting sharp coronally angulated barbs into metal wires
USES:
• To remove pulp from root canals
• In cases of mild inflammation severing pulp completely at the
constriction
BROACHES

9. MODE OF MANUFACTURE:
• By twisting triangular or square stainless steel blanks producing
partly horizontal cutting blades
• Non-cutting tips are formed by grinding and smoothening the apical
end of instruments-Batt Tips
FEATURES:
CROSS SECTION:
• Triangular or square
CUTTING EFFICIENCY:
• Triangular cross sectioned files have greater flexibility and cutting
ability
• 1 ½ to 2 ½ cutting blades per mm of working end
FILES: K-FILES

10. MODE OF MANUFACTURE:
• Milled from round stainless steel blanks to produce spiral flutes
• Efficient in translational strokes
• Rotational working strokes-possibility of fracture
FEATURES:
CUTTING EFFICIENCY:
• Positive rake angle- Good cutting efficiency
USE:
• Should be used in staight canals as they are not very flexible and
are aggressive cutters
• Wide oval canals can be well instrumented with H-Files
HEDSTROM FILES(H-FILES)

11. LENGTH:
• 21mm
• 25mm
• 31mm
LENGTH OFTHE WORKING PART:
• 16mm
ISO STANDARDIZATION OF FILES

12. DIAMETER:
• Numeric name of the file is derived from the
diameter at Do(e.g No.25-0.25mm at tip )
• Do-Cross sectional diameter at the first rake angle
of any file
• D1,D2-Points 1mm and 2mm coronal to Do
• D16-Largest diameter of an ISO-normed file

13. STANDARD TAPER:
• 0.02mm increase in diameter per millimeter
of length
e.g size#10 instrument has a diameter of
0.42mm
at D16

14. TIP SIZE:
• Increases by 0.05mm for file sizes #10 to
#60
• Increases by 0.1mm for file sizes #60 to
#140

15. COLOUR CODING OF FILES

16. FEATURES:
• Long thin shaft with parallel walls
• Short cutting head-Flame shaped
• Side-cutting instruments with safety tips
MODE OF USE:
• Safely used at 750-1500 rpm-in electric gear reduction
handpieces
• Used to cut dentine as withdrawn from the canals-On
Outstroke
• Cutting action can be directed away from root concavities
• Only used in straight portions of canals
GATES GLIDDEN DRILLS

17. SIZE:
Rings on the shank indicates size
ISO STANDARDIZATION
1 50 0.5mm
2 70 0.7mm
3 90 0.9mm
4 110 0.11mm
5 130 0.13mm
6 150 0.15mm
LENGTHS AVAILABLE:
28mm
32mm

18. • Select a GG instrument with a diameter to allow
introduction into orifice and progress for 1mm
• Then smaller instruments and progress until the
coronal third
ADVANTAGES:
• Efficiently opens orifices
• It simplifies subsequent cleaning and shaping
procedures
• Helps establish a smooth glide path
STEP DOWNTECHNIQUE

19. • Small GG instrument is introduced into the canal
and dentine removed on outstroke
• The process is repeated with the next larger
instrument
STEP BACK TECHNIQUE

20. USES:
• For coronal flaring during root canal preparation.
• During re treatment cases
• Post space preparation
 Its use at high r.p.m , incorrect angle of insertion, with
excessive pressure and aggressive drilling may result in
• Strip perforations
• Instrument separation

21. • Introduced since early 1990s
• Instruments are manufactured mostly by grinding but some
are produced by laser etching or plastic deformation under
heating
• Precision at surface quality is not very high
• Improvement in surface quality by electropolishing and
coating it with titanium nitride can be made
• Two properties of importance are (i) Superelasticity
• (ii) Resistance to cyclic fatigue
• These properties allow continuously rotating instruments in
curved root canals
• They have reduced clinical problems like
ledging,transportation,perforation
NICKEL-TITANIUM ROTARY
INSTRUMENTS

22. Three design groups
GROUP 1: Light speed
GROUP I1: Rotary instruments with 0.04 and 0.06 tapers e.g
ProFile
GROUP 111: Rotary instruments with specific design changes
e.g ProTaper

23. Developed by Dr. Steve Senia and Dr. William Wildely in early
1990s
DESIGN:
• It has a long, thin, non-tapered, non-cutting shaft and a short
anterior cutting part
LS 1 INSTRUMENTS:
NUMBER OF INSTRUMENTS:
• 25
TIP SIZES:
• #20 - #100
• Half sizes(e.g 22.5,27.5)
LIGHTSPEED AND LIGHTSPEED LSX
INSTRUMENTS

24. R . P .M:
• 1500-2000
CROSS SECTION:
• U-shaped design with 3 rounded excavations

25. LSX INSTRUMENTS
CROSS SECTION:
• Flat Chisel shaped

26. • Both LS 1 and LSX are highly flexible
• Have low cyclic fatigue- allowing use of higher rpm
• Require specific instrumentation sequences to produce canal
shapes for filling
• Apical 4mm zone to be prepared to a cylindrical non-tapered
shape later filled with SimpliFill system
• Low incidence of canal transportation and preparation errors

27. • Profile system(DENTSPLY Tulsa dental)- Introduced by Dr.
Ben Johnson in 1994
SERIES 29
• They have a constant 29% increase in tip diameter
• Constant increase offers a smooth progressive enlargement
of the canal
ProFile

28. ProFile 0.02, 0.04 and 0.06 ISO Instrument:
• Safe-ended non-cutting tips
• Increasing D0 diameters, and 16 mm of cutting blades
• The Profile 0.02 taper series is designed for extremely
curved canals
• The ProFile 0.04 series was initially designed for subsequent
carrier based obturation techniques
• 0.06 taper instruments provide a fuller shape over the length
of the canal

29. ORIFICE SHAPERS: 0.05, 0.06, 0.07, and 0.08
TAPERS:
• Extend 19mm below the head of the handpiece
• 10 mm of cutting blades
• Tips are safe-ended, have increasing D0 diameters
• Used to prepare the coronal two-thirds of the root canal
system

31. CROSS SECTION:
• 3 radial lands separated by U-shaped grooves,radial lands
keep it centered
• Parallel central core-increases flexibility
FEATURES

32. • 200 helix angle
• -ve rake angle
• Constant pitch
• Bullet shaped non cutting tips
• r.p.m-150-300-preferably electrical motors
• It shapes canals without major preparation errors
• Improvement in canal shape with use of 0.04-0.06
instruments

33. • GT- Greater Taper
• Introduced by Dr. Steve in 1994
• Initially - Set of 4 hand operated instruments
• Later – Engine driven files
FEATURES OF GT FILES:
TAPER:
0.06 0.10
0.08 0.12
GT & GTX FILES

34. TIP SIZE:
• 20(0.2mm)
TIP DESIGN:
• Non-cutting,rounded
MAXIMUM DIAMETER OF WORKING PART:
• 1mm
• It decreases the length of cutting flutes
• Increases the taper
VARIABLE PITCH:
• Increase in number of flutes in progression to the tip
R.P.M: 300

35. CROSS SECTION:
• U shaped with 3 radial lands

36. • Current version of the GT files
• Formed by M-wire of the Ni-Ti alloy
TIP SIZES:
• 20,30,40
TAPERS:
• 0.04-0.10
GTX FILES

37. • Blades feature unique helical angles and variable
radial lands that reduce contact against the canal
wall for faster cutting.
• Wider flutes make fewer continuous rotations
around the instrument from the tip to the end of the
cutting zone.
• Sophisticated, open blade design reduces the
chance of threading.
• Cutting efficiency is increased by the deeper chip
space created by the wider flutes.

38. • To pre enlarge coronal portion of a canal
• To prepare apical one-third of large root canals
• 3 Ni-Ti instruments are included
TAPER:
0.12
Do:
• 0.35mm
• 0.50mm
• 0.70mm or 0.90mm
MAXIMUM FILE DIAMETER:
• 1.5mm
ACCESSORY GT

39. • 2nd generation rotary instruments- Positive rake angle
• Original HERO 642 now replaced by HERO Shaper
• Relatively flexible instruments
• HERO-High Elasticity in Rotation
• Cross section similar to H-file without radial lands
• Its shaping potential is similar to FlexMaster and ProFile
• Have better centering ability during preparation than RaCe
instruments
HERO 642, HERO SHAPER

41. It has a unique design of varying taper along the
instrument’s long axis
No. OF INSTRUMENTS:
3-Shaping files(SX,S1,S2)
3-Finishing files complemented by 2 larger finishing
files(F1,F2,F3,F4,F5)
PRO TAPER UNIVERSAL

42. CROSS SECTION:
• Has a modified K-Type file
• Sharp cutting edges
• No radial lands
R . P . M:
• 150-350

43. COLOUR CODING OF FILES:
• By rings on handle
• SX: No ring on the golden handle
• S1:Purple
• S2:White
• F1:Yellow
• F2:Red
• F3:Blue

44. TIP DIAMETER:
• SX: 0.19mm
• S1:0.185mm
• S2:0.20mm
• F1:0.2mm
• F2:0.25mm
• F3:0.30mm
• F4:0.4mm
• F5:0.5mm

45. TIP DESIGN:
• S Files: Partially cutting
• F Files: Non-cutting,rounded
LENGTH OF WORKING PART:
• 14mm
TAPER:
• Varying taper
• S Files: It increases coronally
• F Files: Between Do-D3-constant taper
F1(7%),F2(8%),F3(9%)
D4-D14 –decrease in taper

46. SX:
• To shape canals in short roots
• To relocate canals from external root concavities
S1:
• To prepare coronal 1/3rd of canal
S2:
• To prepare and enlarge middle 1/3rd of the canal
FINISHING FILES:
• To optimally finish the apical 1/3rd and progressively expand the
shape in middle 1/3rd
USES

47. USAGE CHARACTERISTICS:
• Preparation of glide path
-either manually or special rotary instruments
-prevents breakage
-allows assessment of canal size
• Lateral brushing strokes
-counteracts threading-in effect

48. ADVANTAGES:
• Progressively tapered design – Improved flexibility
• Convex triangular cross section- decreased contact area
between blade and dentine and serves to enhance cutting
action
• Balancing helix angle and pitch-increase cutting efficiency
and prevents threading into canals
• Short handles as compared to standard file-better access to
posterior region
• Studies show that they produce desirable shape more quickly
than GT and ProFile
• Create consistent shape in contricted canals

49. Introduced by Dr. Mc Spadden
FEATURES:
CROSS SECTION:
• Wide radial lands
• Positive rake angle for greater cutting efficiency
• Peripheral blade relief to reduce friction
TIP DESIGN:
• Round safety tip
LENGTH:
• File is 4mm shorter than other files
CUTTING ABILITY:
• Similar to ProTaper and superior to hand instruments
K3

51. FEATURES:
TAPER:
• 0.02
• 0.04
• 0.06
TIP DESIGN:
• Rounded ,passive
TIP DIAMETERS:
• 0.15mm-0.7mm for 0.02 instruments
• 0.15-0.4mm for 0.04 and 0.06 instruments
FLEXMASTER

52. CROSS SECTION:
• Triangular with sharp cutting edges and no radial lands
INTROFILE:
• In addition to the standard set
• Taper of 0.11
• Cutting blade – 9mm
PREPARATIONS:
• Centered preparations in constricted and wide canals
• Superior shaping ability than K-Files

54. • Stands for reamer with alternating cutting edges
DESIGN OF FILES:
• Light microscopic evaluation shows- flutes and reverse flutes
alternating with straight areas
• This design reduces the threading of file into the canals
FEATURES:
CROSS SECTION:
• Triangular or square for 0.02 instument with size #15 and #20 tips
TIP DESIGN:
• Rounded, non-cutting
LENGTH OF CUTTING PART:
• 9-16mm
COLOUR CODED HANDLES OF INSTRUMENTS
RaCe, BIO RaCe

55. • Their surface quality is improved by electropolishing
• Two largest files size#35,0.08 taper, #40 0.10 taper are also
available in stainless steel
BIO RaCe:
To allow preparations two larger sizes with emphasis on 0.02 taper

56. • Alternating wall contact points (ACP) reduce torque
requirements and keep file centered in canal
• To be used in crown down technique
FEATURES:
LENGTH OF CUTTING BLADE:
• 16mm
TAPER:
• 0.04,0.06
• Electropolishing of instruments is done to improve surface
quality
ENDO SEQUENCE

58. • Manufactured by plastic deformation
• The thermal process allows twisting during a phase
transformation into the so called R- phase of nickel titanium
• Production process results in superior physical properties
TIP SIZE:
• 25
TAPER:
• 0.04-0.12
TWISTED FILE

59. • Superior resistance to angular deflections
• Superelasticity
• Shape Recovery
• Elastic deformation of upto 7%
• These properties are due to phase transitions in NiTi alloys
 Ni-Ti exists reversibly in two conformations, martensite(low temp)
and austenite(high temp)
depending on ambient temperature and external tension
 Heating above212 F
• Martensite-to-Austenite-shape memory forces instrument back to
preexisting form
 On linear deformation
• Austenite-to-Martensite
PHYSICAL AND CHEMICAL
PROPERTIES OF NICKEL
TITANIUM

60. • Surface imperfections like – milling marks, metal flash
• They provide access to corrosive substancese.g NaOCL
leading to micropitting and then fracture
• Electropolishing used to improve surface irregularities

61. Two specific modes
• TORSIONAL FRACTURE
• When tip of the instrument binds in the canal and saft is still
rotating
• FLEXURAL FRACTURE
• When repeated cyclic loadind leads to metal fatigue
FRACTURE MECHANISMS

62. THANKYOU