The power point contains instruments used in RCT

1. ENDODONTIC INSTRUMENTS
By Muwanguzi Owen

2. INTRODUCTION
• Instruments play a very important role in the success of a root canal
treatment therefore a basic knowledge of endodontic instruments is
essential.
• General guidelines exist for root canal preparation, but due to the
complex and varied canal anatomy each case presents unique
challenge.
• A variety of instruments are thus available for this purpose.

3. CLASSIFICATION OF INSTRUMENTS
ISO-FDI (Federation Dentaire
International) grouped root canal
instruments according to their
method of use:
• Group I : Hand use only, for example,
K and H-files, reamers, broaches,
etc.
• Group II : Latch type Engine driven—
same design as group I but can be
attached to hand piece, e.g. Profiles,
Light speed.
• Group III : Drills or reamers Latch
type Engine driven, for example,
Gates-Glidden, Peeso reamers.
• Group IV : Root canal points like
Grossman’s classification
• Function Instruments
• Exploring- Smooth broaches and
endodontic explorers (To locate
canal orifices and determine
patency of root canal)
• Debriding or extirpating-Barbed
broaches (To extirpate the pulp and
other foreign materials from the
root canal)
• Cleaning and shaping- Reamers and
files (Used to shape the canal space)
• Obturating Pluggers, spreaders and
lentulospirals (To pack gutta-percha

4. PHYSICAL PROPERTIES
• Complete debridement requires instruments to contact and plane all canal walls
• No instrument can fully clean and shape all root canal spaces due to anatomical
complexities.
• Irregular canal spaces often don’t match the round shape of most instruments.
• Stainless steel instruments are relatively flexible and have poor adaptability to
curved canals.
• Nickle-Titanium instruments are more flexible, better suited for fine, curved
canals bur have no significant advantage in irregular canal spaces.
• Effective canal preparation demands skillful and careful use of instruments to
maximize debridement and minimize procedure errors.

5. HAND-OPERATED
INSTRUMENTS

6. • Alloys used in manufacturing endodontic instruments include:
1. Carbon steel
2. Stainless steel
3. Nickle-titanium

7. CARBON STEEL
• These alloys contain less than 2.1% carbon
• Advantage: harder than stainless steel instruments
• Disadvantage: prone to rust and corrosion, and so they can not be
resterilized.
• Example: Barbed broach

8. STAINLESS STEEL
• Contain 18% chromium, 8-10% nickel and 0.12 percent carbon.
• Advantage: corrosion resistant
• Disadvantages: stiff, prone to fracture, prone to distortion.
• Example: K-file, H-file, reamer

9. NICKEL TITANIUM
• Contain 55% nickel and 45% titanium
• Advantages: shape memory, super elasticity, corrosion resistant,
softer, and biocompatibility.
• Disadvantages: poor cutting efficiency, they don’t show fatigue before
they fracture.
• Example: NiTi hand files, profiles, protapers

10. STANDARDIZATION OF INSTRUMENTS BY
INGLE AND LEVINE
• Instruments are numbered from 10 to 100.
• Files are numbered from 15 – 60 with an increment of 5.
• There is an increment of 10 from 60 onwards.
• Cutting blades 16mm in length (L1)
• The diameter of the instrument at tip (D1) is determined by size in
hundredths of millimeters.
• D2 is uniformly 0.32mm greater than D1
• Length of entire file black is 25mm.

12. MODIFICATIONS IN STANDARDIZATION
• 4 modifications were made
1. Additional measurement at D3, 3mm
from tip (D1)
2. Specification for angles of the tip (75°
± 15)
3. Number 6 and 8 have been added for
increased instrumentation
4. Color coding added for quicker
identification of diameters of files

14. Broaches and Rasps
Broaches
• There are two types of broach:
smooth broach and barbed broach
• Smooth broaches are used as
pathfinder whereas barbed broach
are used to remove pulp tissue
during root canal treatment.

15. Rasp
• Similar to barbed broach
• Used to destroy pulp tissue from
canal space (extirpate pulp
tissue)

16. Reamer
• K-type instrument used to ream
the canals
• It has a triangular blank and
lesser number of flutes than a
file.
• Have same cutting efficiency as
the file

17. Files
• Instruments used in cleaning and shaping of root canals.
• Used for removing tissue and superficial dentin from the canal wall
• Commonly used files include: K-file, K-flex file, Flexo file, Flex-R file,
Hedstroem file, Safety H-file, S-file

18. K File
• Triangular, square or rhomboidal
in cross section
• K-file has 1½ to 2½ cutting blades
per mm of their working end.
• Disadvantage: less cutting
efficiency, extrusion of debris
periapically.

19. K-flex file
• It is rhombus in cross section
having two acute angles and two
obtuse angles
• The acute angles increase
sharpness and cutting efficiency
of the instrument.
• The obtuse angles provide more
space for debris removal

20. Flexo file
• Similar to K-flex file but with a triangular cross section
• This provides more flexibility and resisting fracture
• Its tip is modified to noncutting types

21. Flex-R file/Roane file
• Made by removing the sharp
cutting edges from the tip of
instrument.
• This reduces the ledge formation
and canal transportation
• It is made out of NiTi and cuts
during anticlockwise rotary
motion

22. Hedstroem file
• Has flutes
• Only cuts when the instrument is
withdrawn
• Advantage: better cutting
efficiency
• Disadvantage: lacks flexibility,
tend to fracture and is an
aggressive cutter

23. C+ file
• Used in difficult and calcified
canals
• Available in size 8, 10, and 15
• Length of 18, 21, and 25 mm.
• Made of stainless steel and has
square cross section

24. Golden medium file
• Used for narrow canals
• Available in sizes 12 to 37

26. NONROTARY ENDODONTIC
INSTRUMENTS

27. Engine Driven Instruments
1. Reciprocating hand piece:
rotates at 3000 rpm
2. Vertical stroke hand piece:
either air or electric driven

28. Sonics and Ultrasonic
Sonic hand piece
• Uses compressed air
• Sonic hand pieces uses three
types of files which include:
Hello sonic, sharper sonic, and
Rispi sonic
• Have non cutting tip and come in
sizes ranging from 15 to 40.

29. Continuation
Advantages:
• Better shaping of canal than ultrasonic ones
• Lesser chances of debris extrusion due to constant irrigation
• Produces clean canals
Disadvantages:
• Walls of canal are rough
• Chances of tranpostation are more in curved canals

30. Ultrasonic hand piece
• They are called endosonics
• Use K-file as a canal instrument

31. Uses of Endosonics
• Access enhancement: produces smoother shapes of access cavity
• Orifice location: very useful in removal of chamber calcification
• Irrigation: endosonics produce more cleaner canals
• GP placement: GP gets plasticized by friction generated from the
endosonics

32. ROTARY ENDODONTIC
INSTRUMENTS USED WITH A
HANDPIECE

33. Slow speed rotary stainless steel instruments
• These include
1. Gates-Glidden bur
2. Flexogates
3. Peeso reamers

34. Gates-Glidden bur
• Have a flame shaped cutting
point that cuts laterally
• They are used at speed of 750 to
1500 rpm in brush stroking
manner
• Weakest part of it is the junction
of the shank and the shaft of the
instrument

35. Uses of Gates-Glidden drills
• Enlarge root canal orifices
• For removal of lingual shoulder during
access preparation of anterior teeth
• During retreatment cases or post-space
preparation for removal of gutta-percha
• During instrument removal, for space
preparation

36. Flexogates
• Are modified gates-glidden
• More flexible for apical preparation
• Form smoother edges and increased removal of debris
• Have a safe non cutting guiding tip

37. Peeso Reamers
• Rotary instruments for post
space preparations
• Safe no cutting tip
• Used mainly for post space
preparation when gutta percha
has to be removed from
obturated root canal

38. NITI ROTARTY INSTRUMENTS
Advantages:
• Shape memory
• Superelasticity
• Good resiliency
• Corrosion resistant
• And softer than stainless steel
Disadvantages:
• Poor cutting efficiency
• Don’t show signs of fatigue
before fracture
• Poor resistance to fracture

39. Generations of rotary instrument
• First generation: Profiles, Quantec
• Second generation: Profile GT
• Third generation: K3, Race protaper
• Fourth generation: V-taper

40. INSTRUMENTS USED FOR
FILLING ROOT CANALS

41. Hand spreader
• Made of stainless steel
• Designed to place the accessory gutta-percha points
• Don’t have standard size and shape
• Not used routinely

42. • They are shorter in length
• Standardized and color coded to match the size of gutta-percha points
• Made from stainless steel or NiTi

43. Hand plugger
• Larger diameter than the
spreader
• Have blunt ends
• Used to compact warm gutta-
percha vertically and laterally
into the root canal
• Calcium hydroxide or MTA are
also packed into canals using it

44. Finger plugger
• Used for vertical compaction of
gutta-percha

45. Lentulo spirals
• Used for applying sealer cements to the root canal walls before
obturation
• Can be used as hand or rotary instruments

46. Apex locator
Uses
• Measuring the canal length
• Locate the apical foramen
• Enhance accuracy

47. REFERENCES
• Textbook of Endodontics, Nisha Garg – 3rd
edition
• Principles and practice of Endodontics – 3rd
edition