endodontics

1. Endodontic Instruments: Basic &
Hand instruments using in endo work

2. INTRODUCTION
• In considering the endodontic instruments those that are hand operated
are the most important.
• However other specialised instruments such as explorers & excavators
have been designed to adapt to the root canal treatment requirement.
• Originally instrument for root canal treatment were few in number and
crude in design.
• The earliest hand operative devices had long handles that were best
suited for anterior teeth.
• As RCT diversified, small “finger” instruments were developed for posterior
teeth.
• New designs in endodontics instruments have been introduced and will
continue to evolve.

3. GENERAL
INSTRUMENT
S
INTRACANAL
INSTRUMENT
S
MICRO
INSTRUMENT
S
Classification

4.  GENERAL INSTRUMENTS
• 1) Front surface
mouth mirror

5. • 2) Periodontal
probe

6. • 3)
Explorer

7. • 4) Cotton
forceps

8. • 5) Endodontic
explorers
DG 16
DG 16/23

9. • 6) Endodontic
excavator

10. • 7) Endodontic ruler

11. 8) Instrument organizer
(endodontic kit)
• used for arrangement of
reamers and files according
to the size and length.
• provides holes for the files to
be place vertically in a
sponge which is saturated
with disinfectant to maintain
its sterility.

12. 9) Endodontic syringe
• tip of the instrument is flat to prevent
penetration of the needle to the small canals;
• also it has a groove in its tip to permit the
irrigation which might be under pressure to flow
coronally rather than forcing it to the apical
foramen causing post operative pain.

13. 10) Transfer sponge

14. ALLOY USED FOR MANUFACTURING:
A-Carbon steel-
contain less than 2.1%
of carbon
• Have high hardness
than SS instruments.
• Prone to corrosion, so
cant be re-sterilised.
• Prone to rust.
• Example: barbed broch
B-Stainless steel
instruments-
contain 18%
chromium, 8-10%
nickel, 0.12%
carbon
• Corrosion resistant
• Stiff nature

15. C-Nickel titanium - contain 55% Ni and 45% Ti
• Shape memory
• Super elasticity
• Low modulus of elasticity
• Corrosion resisitant
• Softer
• Good resilience
• Biocompatibility
• Poor cutting efficiency
• Don’t show signs of fatigue before they fracture
• Poor resistance to fracture.

16.  INTRACANAL INSTRUMENTS
1-Broaches & Rasps:
• Made from round stainless steel wire blank.
• Working edges are created by cutting into the wire at an angle to
its long axis.
• The depth angle and number of cuts (barbs) will determine how
the instrument is used

17. 2- K Files & reamers:
• Designed in 1904 by Kerr Manufacturing Co.
• Are the most widely copied and extensively manufactured endodontic
instruments worldwide .
• Previously made of Carbon Steel Presently made of Stainless Steel.
• K File and Reamer are the oldest instruments used to machine dentin.
• Produced by grinding graduated sizes of round Piano wire into either a
square or triangular configuration
• These instruments are useful for penetrating and enlarging root canals.
• These instruments works primarily by compression and release
destruction of the dentin surrounding the canal.

18. REAMERS:
Design & structure
• Made from triangular
blanks.
• More flexible.
• The helix angle is small,
therefore effective only in
rotating motion
• Has cutting tip
• 0.5-1 flute/mm.

19. Reamer: Sizes & Codes
• comes in sizes 06 - 140,
• all with a taper of 0.02.
• design is identified by
the triangle symbol on
the handle.

20. Reamer: Recommended use
• It is used by continuous rotation
when the resistance is small or
moderate
• and by balanced force when the
resistance is greater.
• In curved canals ledging easily
occurs with even small reamer
sizes if instruments are not pre-
curved.

21. Reamer: Safety tips
• Reamers can be rotated only using
moderate pressure.
• Use of force, particularly with
smaller sized instruments, may
result in distortion of the helical
structure and ultimately in fracture.
• Each instrument should be
checked for symmetry by rotating it
against an even background
before introducing it into the canal.

22. K-FILE
K-file: Design & Structure
• Made from rectangular blanks
• Helix angle is greater than in a
reamer, and therefore preparation
by a K-file is effective both in
rotary and filing motion.
• The tip of the instrument is cutting
• less flexible than reamers but are
more effective in cutting.
• 1.5-2.25 flute/mm.

23. K-file: Sizes & Codes
• K-files are produced in
sizes 06 - 140,
• all with a taper of 0.02.
• K-file design is
identified by the
square symbol on the
handle.

24. K-file: Recommended use
• It prepares both in filing motion (up and down)
and when rotated.
• In slightly curved canals -continuous rotation
when the resistance is small and balanced
force against greater resistance.
• Compared to reamers, the use of continuous
rotation is limited because of the screwing
effect typical of K-file.

25. K-file: Safety tips
• K-files can be rotated only using moderate pressure.
• Use of force, particularly with smaller sized
instruments may result in distortion of the helical
structure and ultimately in fracture.
• Balanced force technique and filing instead of
continuous rotation should be used with sizes 06 -
15 to minimize fracture risk.
• Each instrument should be checked for symmetry by
rotating it against an even background before
introducing it into the canal

26. FLEXOREAMER
Flexoreamer: Design & Structure
• manufactured from a triangular
steel wire that is twisted to give
the typical shape of a reamer.
• The helix angle is small, and
therefore effective only in rotatory
motion.
• The tip of the instrument is non-
cutting (bat-tip/inactive tip) making
flexoreamer well suited for the
preparation of evenly curved
canals without risk of ledging.

27. Flexoreamer: Sizes & Codes
• come in sizes 15 – 40.
• all with a taper of 0.02.
• Flexoreamers are best
distinguished from normal reamers
by the size code at the top of the
instrument: in flexoreamers the
colour of the number is the same
as the colour of the handle.

28. Flexoreamer: Recommended use
• The flexoreamer is well suited both for
straight canals and slightly curved canals.
• It prepares dentin in rotation but not if
used as a file.
• The cutting efficiency and usability of
flexoreamers are excellent.
• In slightly curved canals the
recommended technique sare continuous
rotation when the resistance is small and
balanced force against greater resistance.

29. Flexoreamer: Safety tips
• Flexoreamers can be
rotated only using
moderate pressure.
• Use of force, particularly
with smaller sized
instruments, may result in

30. FLEXOFILE
FlexoFile: Design &
Structure

31. FlexoFile: Sizes &
Codes

32. FlexoFile: Recommended use
• Flexofile is suited for both straight canals
and slightly curved canals.
• Effective both in filing motion(up and
down) and when rotated.
• In slightly curved canals the
recommended techniques are continuous
rotation when the resistance is small and
balanced force against greater
resistance.
• Use of continuous rotation is limited as
compared to reamers because of the
screwing effect typical of K-files

33. FlexoFile: Safety tips
• Flexofiles can be rotated (balanced
force) only using moderate pressure.
• Use of force, particularly with smaller
sized instruments, may result in
distortion of the helical structure and
ultimately in fracture.
• Every instrument should be checked for
symmetry by rotating it against an even
background before introducing it into
the canal

34. HEDSTROM FILE
Hedstrom File: Design & Structure
• Manufactured from round steel wire by
grinding.
• The helix angle is close to right angle,
which is therefore preparation by H files is
effective only when using a filing motion
(up and down movement).
• More positive rake angle.
• blade with a cutting rather than a scraping
angle

35. Hedstrom File: Sizes &
Codes
• come in sizes 08 – 140.
• all with a taper of 0.02.
• H-file design is identified
by the circle symbol on
the handle.

36. Hedstrom File: Recommended use
• can be used both in straight canals
and curved canals.
• Cut only in retraction.
• In curved canals, files (sizes 20/25
and bigger) must be pre-curved to
correspond to the shape of the
curve.
• H-files must always fit loosely in
the canal to avoid risk for fracture.
• Small sizes up to #25 can be used
down into full preparation length
while bigger sizes are often used 1
- 3 mm short.

37. Hedstroem File: Safety tips
• Hedstrom files show a greater risk for
fracture than reamers and K-files if
used in a wrong way.
• Hedstrom must always fit loosely in
the canal and they must never be
rotated.
• In curved canals Hedstrom-files are
pre-curved to correspond to the
shape of the canal.
• Before introducing them into the
canal, all Hedstrom files must be
inspected for possible earlier damage
to the instrument and discarded
immediately if an asymmetry in the
cutting area is found

38. K FLEX FILE:
• Rhomboidal or Diamond
shaped
• This new cross-section presents
significant changes in instrument
flexibility and cutting
characteristics
• The cutting edges of the high
flutes are formed by the two
acute angles of the rhombus
and present increased
sharpness and cutting efficiency
• The alternating low flutes formed
by the obtuse angles of the
rhombus are meant to act as an
auger, providing more area for
increased debris removal

39. TRIPLE FLEX FILE
• They are made up of SS
• A hybrid instrument.
• More flutes than reamer but fewer
than K-file.
• Made from triangular stainless
steel blank by twisting, not ground.
• More aggressive & flexible than
regular K-style instrument.

40. FLEX-R-FILES/ROANE FILES
• Made by removing the sharp
cutting edges from the tip of
instrument.
• Have non cutting tip, so less
chances of ledge formation, canal
transportation when used with
balance force technique.
• Triangular cross section which
provides it flexibility
• Made up of NiTi and cut during
anticlockwise rotary motion.

41. SAFETY HEDSTROM FILE
• Has noncutting safety side
along the length of the blade
which reduces the chances
of perforation.
• The noncutting side is
directed to the side of canal
where cutting is not required.
• Therefore prevents ledging
of the canals

42. S-FILE
• It is called S because of its cross-
sectional shape.
• Produced by grinding, which makes
it stiffer than H file.
• The file is designed with 2 spirals for
cutting blades, forming double helix
design.
• It has good cutting efficiency in
either filing or reaming action, thus
file can also be classified as hybrid
design.

43. C+ FILES
• Used for difficult and calcified canals.
• Have better buckling resistance
than k files.
• Available in size 8, 10, 15 of length
18, 21 and 25 mm.

44. GOLDEN MEDIUM FILES
• Were described by Weine.
• Comes under intermediate files provided with
half sizes between conventional instruments.
• Available in sizes from 12-37 like 12, 17, 22, 27,
32, 37.
• Used for narrow canals.
• They are formed by cutting 1 mm from tip of
instrument.

45. ENDODONTIC INSTRUMENT STANDARDIZATION
In 1959, a new line of standardized instruments and
filling material was introduced by ingle and levine
• A formula for the diameter and taper in each size of
instrument and filling material was agreed on.
• A formula for a graduated increment in size from
one instrument to the next was developed.
• A new instrument numbering system based on
instrument metric diameter was established.

46. After the introduction of standardized instruments, about the
only changes made were
• the universal use of stainless rather than carbon steel
• the addition of smaller (Nos. 6 and 8) and larger (Nos. 110-
150) sizes as well as color coding.
It was not until 1976 that the first approved specification for root
canal instruments was published (ADA Specification No. 28)

47. • The numbering system, last revised in
2002, using numbers from 6 to 140, is
based on the diameter of the instruments in
hundredths of a millimeter at the beginning
of the tip of the blades, a point called D0
(diameter 1 mm) , and extending up the
blades to the most coronal part of the
cutting edge at D16 (diameter 2-16 mm in
length).
• Additional revisions are under way to cover
instruments constructed with new
materials, designs, and tapers greater than
0.02 mm/m

48. • Instruments with a taper greater than the
ISO (International Standards Organization)
standard of 0.02 mm/mm have become
popular: 0.04, 0.06, 0.08, 0.10, and 0.12.
• This means that for every millimeter gain
in the length of the cutting blade, the width
(taper) of the instrument increases in size
by 0.04, 0.06, 0.08, 0.10, or 0.12 of a
millimeter rather than the ISO standard of
0.02 mm/mm.
• These new instruments allow for greater
coronal flaring than the 0.02 instrument

49. comes in three
lengths:
• standard, 25
mm;
• long, 31 mm;
and

50. PARTS OF FILE:
Taper
• usually is expressed
as the amount the file
diameter increases
each millimeter along
its working surface
from the tip toward the
file handle.
Flute
•

51. Leading (cutting)
edge
• The surface with the
greatest diameter
that follows the
groove (where the
flute and land
intersect) as it

52. land (marginal
width)
• If a surface
projects axially
from the central
axis as far as
the cutting

53. Relief
o To reduce frictional resistance, some of
the surface area of the land that rotates
against the canal wall may be reduced
to form the relief.

54. Helix angle
• The angle the
cutting edge
forms with the
long axis of
the file

55. Rake angle
• angle formed
by the leading
edge and the
radius of the
file.

56. cutting angle/effective rake angle
• is a better indication of a file’s cutting ability
• determined by measuring the angle formed by the
cutting (leading) edge and the radius when the file
is sectioned perpendicular to the cutting edge
• If the flutes of the file are symmetric, the rake
angle and the cutting angle are essentially the
same.

57. Pitch
• The distance between a point on the
leading edge and the corresponding
point on the adjacent leading edge,
or it may be the distance between
corresponding points within which
the pattern is not repeated

58. 3) SPREADER & PLUGGER
• long, tapered and
pointed end
instrument, -
compress gutta
percha into the apex
and periphery of the
prepared canal and
also towards the
irregularity of canals

59. 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.

60. MICRO-INSTRUMENTS
• Instruments have been designed to take full advantage
of the increased visibility obtained with dental operating
microscopes, endoscopes, and orascopes.
• Better visualization of the surgical site would have
limited value without microsurgical instruments such as
ultrasonic tips for root-end preparation and micro-
mirrors for inspecting the root end.

61. Divided into 2 groups
Surgical instruments Root end filling & suturing

62. SURGICAL INSTRUMENTS
1- micro-
mirrors
• Small
round
• Medium
oval

63. 2-Retractor
• Care must be
taken to rest
the retractors
only on bone,
not on the
reflected
soft-tissue
flap or on the
neurovascula

64. 3-Elevator
4-Curette
• Jacquette
• spoon
Rubinstein Mini-Molt

65. 5-Scaler
6-Surgical
forceps

66. ROOT END FILLING & SUTURING
1-Castroviejo
needle holder
2-Castroviejo
scissor

67. 3- microcondenser
& plugger

68. 4-Messing gun
type syringe

69. 5-Plugger with
teflon sleeve

70. 6- Another delivery system designed
specifically for MTA placement. Kit includes
a variety of tips for use in different areas of
the mouth and a single-use Teflon plunger.

71. 7- Hard plastic block with notches of varying shapes and sizes MTA is mixed
on a glass slab to the consistency of wet sand and then packed into a notch.
The applicator instrument is used to transfer the preformed plug of MTA
from the block to the root end.

72. CONCLUSION
• Current NiTi hand preparation procedures that use files with a greater or
variable taper are a substantial improvement over instrumentation with
0.02 tapered stainless steel files particularly when used in curved root
canals.
• These newer instruments should produce canals with a better shape,
using fewer instruments in a shorter time.
• Microsurgical instruments such as ultrasonic tips for root-end preparation
and micro-mirrors for inspecting the root end enhances better visualization
and contributed to rapid development of peri-radicular surgery.

73. Thank you