This document discusses the components and design of various endodontic instruments. It describes the parts of rotary instruments like the flute, radial land, relief, helix angle, rake angle, and pitch. It then reviews the designs of different instrument types like K-files, reamers, Hedstrom files, and Gates-Glidden drills. The document also discusses modifications to traditional designs as well as newer nickel-titanium rotary systems like ProFile, LightSpeed, ProTaper, Hero, and K3. Overall, the document provides an overview of the evolution of endodontic instrument design and the key features of different instrument types.
Understanding the basic metallurgy, commonly used instruments and newly available rotary systems in the market enable us to better disinfect the root canal.
There are 3 types of file systems
- Flex R FIle
- Safety H Files
- Rotary File System
The invention of Flex R File was back then when Powell noticed that the straight stainless steel tips of the files could only increase the tendency of the transport or ledge and eventually to perforate curved canals at the outer wall which is a convex curvature of the canal. It was then when Powell pointed out that the reduction of tip angle could help the file to focus on the original canal and could cut the edges or the sides evenly. This modification of the tip brought in the Flex R File.
introduction, history of rotary instruments in endodontics, classification, properties of NiTi, generations and design features, rotary file systems available
Understanding the basic metallurgy, commonly used instruments and newly available rotary systems in the market enable us to better disinfect the root canal.
There are 3 types of file systems
- Flex R FIle
- Safety H Files
- Rotary File System
The invention of Flex R File was back then when Powell noticed that the straight stainless steel tips of the files could only increase the tendency of the transport or ledge and eventually to perforate curved canals at the outer wall which is a convex curvature of the canal. It was then when Powell pointed out that the reduction of tip angle could help the file to focus on the original canal and could cut the edges or the sides evenly. This modification of the tip brought in the Flex R File.
introduction, history of rotary instruments in endodontics, classification, properties of NiTi, generations and design features, rotary file systems available
A quick and concise recap of Endodontic Instruments.
This presentation resolves the basic doubts within terminologies and provides visual conceptualization of the same.
Protaper means progressively taper.
•NiTi
Protaper means progressively taper.
•NiTi
Increased flexibility
• Each instrument produces its own 'crown down effect' as larger tapers make way for smaller tapers.
• Protaper files engage a smaller area of dentine reducing torsional loads and file fatigue
This presentation describes about evolution of nitinol (NiTi), its properties, manufacturing, metallurgy and various rotary systems in the field of endodontics.
Endodontic sealers a summary and a quick review Rami Al-Saedi
a slideshow presentation lectured and presented in Al-Sadr Specialized dental center in the continuing dental learning weekly lectures.
Rusafa medical institute- Baghdad- Iraq
lecturer: Dr. Rami Ahmed Jumaah (BDS)
Supervisor: Dr. Iman J. Ahmed (BDS: MSc)
A concise and brief presentation on cleaning and shaping of root canals. Colorful and well pictured. Ideal for UG students and PG students to get a good understanding of BMP techniques.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
A quick and concise recap of Endodontic Instruments.
This presentation resolves the basic doubts within terminologies and provides visual conceptualization of the same.
Protaper means progressively taper.
•NiTi
Protaper means progressively taper.
•NiTi
Increased flexibility
• Each instrument produces its own 'crown down effect' as larger tapers make way for smaller tapers.
• Protaper files engage a smaller area of dentine reducing torsional loads and file fatigue
This presentation describes about evolution of nitinol (NiTi), its properties, manufacturing, metallurgy and various rotary systems in the field of endodontics.
Endodontic sealers a summary and a quick review Rami Al-Saedi
a slideshow presentation lectured and presented in Al-Sadr Specialized dental center in the continuing dental learning weekly lectures.
Rusafa medical institute- Baghdad- Iraq
lecturer: Dr. Rami Ahmed Jumaah (BDS)
Supervisor: Dr. Iman J. Ahmed (BDS: MSc)
A concise and brief presentation on cleaning and shaping of root canals. Colorful and well pictured. Ideal for UG students and PG students to get a good understanding of BMP techniques.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
CLEANING AND SHAPING USING ROTARY ENDODONTIC INSTRUMENTS /certified fixed or...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Rotary cutting instruments in conservative dentistrySaraSultana10
A detailed explanation of rotary cutting instruments used in operative dentistry. This is based on the Textbook of preclinical conservative dentistry by Nisha Garg and Amit Garg
Similar to nitiendo-2-140902012325-phpapp02.pdf (20)
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. Nickel Titanium Instruments in
Endodontics: Part 2
Dr. Ashok Ayer
Department of Conservative Dentistry &
Endodontics
College of Dental Surgery
BPKIHS, Dharan
4. Components of Endodontic Instruments
Flute:
Groove in the working surface used to collect
soft tissue and dentine chips removed from
the canal wall.
The effectiveness of the flute depends on its
depth, width, configuration, and surface finish.
Its effectiveness depends on its angle of
incidence and sharpness.
5.
6. Radial land/ marginal width:
Is a flat cutting surface present between two grooves/
flutes.
The land touches the canal walls at the periphery of the
file and reduces the tendency of the file to screw into
the canal,
Reduces transportation of the canal.
Reduces the propagation of microcracks on its
circumference,
Supports the cutting edge, and
Limits the depth of cut.
7. Disadvantages:
Clogging of the instruments,
Friction and heat build-up,
Inefficient cutting.
Rotary Profile niTi file, #5 (denTSPLY Tulsa dental,
Tulsa, OK). note the instrument’s wide marginal land (arrows)
8. Relief:
Surface area of land that is reduced to a
certain extent to reduce frictional resistance.
Helix angle:
The angle the cutting edge forms with the
long axis of the file.
Augers debris collected in the flute from the
canal.
This angle is important for determining
which file technique to use.
9. Components of the Quantec niTi rotary instrument
(Sybronendo, Orange, CA)
10. Rake angle
Is the angle formed by the leading edge and the
radius of the file.
If the angle formed by the leading edge and the
surface to be cut (its tangent) is obtuse, the rake
angle is said to be positive or cutting.
If the angle formed by the leading edge and the
surface to be cut is acute, the rake angle is said to be
negative or scraping
11. Positive and negative rake angles.
Positive angle results in cutting action
Negative angle results in scraping action.
12. However, the rake angle may not be the same
as the cutting angle.
The cutting angle, or the effective rake angle,
is a better indication of a file’s cutting ability
and is 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.
13. The pitch of the file is the distance between a
point on the leading edge and the
corresponding point on the adjacent leading
edge.
Most files have a variable pitch, one that
changes along the working surface.
Because the diameter increases from the file
tip toward the handle, the flute becomes
proportionately deeper, resulting in a core
taper that is different from the external taper.
15. Instrument Designs
1. The difference between the file’s minimum and maximum
diameters can be reduced so that the torque required for
rotating the larger diameter does not exceed the plastic
limit of the smaller diameter.
2. The space between the tip and the maximum diameter
can be reduced so that the required torque does not
exceed the ultimate strength of any part of the file.
Cohen and Hargreaves. Pathways of
pulp,10th edition
16. 3. A zero taper or nearly parallel and fluted working
portion of the file can be provided for curved canals
so that the apical portion of the canal can be
enlarged without undue file stress and compression
of debris.
4.The continuity of the blade engagement can be
interrupted.
5.The number of flute spirals can be eliminated or
reduced to the smallest number necessary to prevent
excessive torque, which results from the
accumulation of debris.
6. Means can be provided to complete the file function
before the flutes fill with debris.
17. 7.Any land width can be minimized to reduce
abrasion on the canal surface.
8.The file can be given an asymmetric cross-
section to help maintain the central axis of
the canal.
9.The number of flutes with similar helix angles
can be reduced. When helix angles are
dissimilar, screwing-in forces are reduced;
when flutes have no helix angles, screwing-
in forces are eliminated.
18. 10. Positive cutting angles can be
incorporated to enhance the efficiency of
canal enlargement.
11. Blades can be made appendages or
projections from the file shaft rather than
ground into the shaft.
12. Channels can be cut along the long
axis of the file to facilitate its removal if it
breaks.
19. K-file
K-files were manufactured by twisting square or
triangular metal blanks along their long axis,
producing partly horizontal cutting blades.
The tip is cutting and pyramidal
Helical angle: 45˚
Noncutting tips, also called Batt tips, are created
by grinding and smoothing the apical end of the
instrument
20. NiTi K-files are extremely flexible and
are especially useful for apical
enlargement in severe apical curves.
They can be precurved, but only with
strong overbending; this subjects the file
to excess strain and should be done
carefully.
Because of their flexibility, the smaller
NiTi files (sizes up to #25) are of limited
use.
21.
22. Cross-sectional analysis of a K-file
reveals why this design allows careful
application of clockwise and counter
clockwise.
Rotational and translational working
strokes.
23. Modification of K- files:
K flex file:
Rhomboidal/ diamond cross- section
Increased flexibility and cutting
efficiency
24. K- flex O file:
Twisting a triangular cross section blank
Non- cutting tip
Increased flexibility but less cutting
efficiency
25. K- flex R file/ Roane file
Machined from triangular cross section
blank
Modified safe-end tip. (reduction in
cutting tip angle).
Balanced force technique, cuts during
anticlockwise rotary motion
26. Triple flex file:
Triangular stainless steel wire is twisted
Has more flutes than reamer but less than
K- file.
27. C + files:
Better buckling resistance than K – file
Sizes: 008, 010, 015
Length: 18, 21, 25 mm
Used for initial penetration and cut
better, especially in calcified canals.
28. Reamers
Triangular or square blank
Triangular blanks are more flexible, have a larger
groove, more susceptible for fracture.
Square blanks are stable and rigid and have
smaller groove.
Helical angle 20˚
Reaming: penetration, rotation (¼- ½) and
retraction.
Retraction brings about the cutting action.
29. Less flutes compared to K-file:
Files: tighter flutes: 1.93- 0.88 mm
Reamers: looser flutes: 0.80- 0.28 mm
Example;
No. 30 file: 22 flutes per 16 mm of blade
No. 30 reamer: 15 flutes per 16 mm of
blade.
30. Hedström Files
Hedström files are milled from round stainless steel
blanks.
Cutting action: Retraction
They are very efficient for translational strokes, but
rotational working movements are strongly discouraged
because of the possibility of fracture.
Helical angle: 60˚
Better cutting action than K-file (more positive rake
angle).
31.
32. Hedström files up to size #25 can be
efficiently used to relocate canal orifices and,
with adequate filing strokes, to remove
overhangs.
Similarly, wide oval canals can be
instrumented with Hedström files as well as
with rotary instruments.
33. Modifications:
Unifile/ Dyanatrak:
Designed with two spirals for cutting blades
Cross section: ‘S’ shaped double helix
High incidence of separation.
Others: Hyflex file, S- file, Triple helix
34. A- file:
Variant of H- file
More flexible
Flutes/ cutting edges are at acute angle to the
long axis of the file.
When used in curved canals,
Flutes on the inner edge collapse and hence no dentine
is removed,
On the outer edge it opens, filling the dentine on the
outer curvature (simulates anticurvature filling)
35. U - file
Heath 1988
Cross- section: Six corners, two 90˚ cutting edges
at each of the three points of the blade.
Radial land
Adapt well to curved canals
Non cutting tip
E.g. Profile, GT files, Light speed, Ultra-flex files
36. Gates-Glidden Drills
GG instruments are manufactured in a set and
numbered 1 to 6 (with corresponding diameters of
0.5 to 1.5 mm)
GG drills are side-cutting instruments with safety
tips; they can be used to cut dentin as they are
withdrawn from the canal
GG instruments should be used only in the
straight portions of the canal, and they should be
used serially and passively
NiTi: FlexoGates
40. A clinician who is unfamiliar with the tip design of a
particular instrument is apt to do either of the
following:
Transport the canal (if the tip is capable of
enlarging the canal and remains too long in one
position)
Encounter excessive torsion and break the file (if a
noncutting tip is forced into a canal with a smaller
diameter than the tip).
Transportation of the original axis of the canal can
occur by remaining too long in a curved canal with
a tip that has efficient cutting ability.
41. As long as the file is engaged 360 degrees,
canal transportation is unlikely to occur.
Only with overuse does the file begin to cut on
one side, resulting in transportation.
Most instrumentation errors occur when the file
tip is loose in the canal, which gives it a
propensity to transport the canal.
If the canal is smaller than the file, the prudent
use of a cutting tip is more efficient.
If the canal is larger than the tip, using a less-
effective cutting tip can help prevent
transportation.
Cohen and Hargreaves. Pathways of
pulp,10th edition
42. Instrument System Cross-Section Tip Design Taper Other features
Profile Non cutting Fixed taper 20 degree helix angle
& constant pitch
Triple U shape with radial lands.
Neutral rake angle planes dentin walls.
LightSpeed Non cutting Specific instrument Thin, flexible noncutting
sequence produces shaft & short cutting
a tapered shape. Head.
ProTaper Non cutting Variable taper along Pitch & helix angle
balanced to prevent
taper lock.
Convex triangular shape,
sharp cutting edges, no radial lands.
HERO Non cuttingFixed taper; 2,4,6 % Variable pitch. Files have
a short cutting portion
(12- 16 mm).
Triangular shape with positive rake angle for cutting efficiency.
No radial lands.
Grossman’s Endodontic Practice. 12th Edition
43. K3 Non cutting Fixed taper Variable pitch & core
2, 4,6 % diameter.
Positive rake angle for cutting efficiency
Three radial lands, relief for reduced friction
FlexMaster Non cutting Fixed taper Individual helical angles
2, 4, 6% for each instrument to
Intro file has 11% reduce screw-in effect.
Convex triangular shape with
sharp cutting edges & no radial lands
RaCe Non cutting Fixed taper Alternating cutting edges
2,4,6,8,10% along the length due to
alternating twisting
& untwisting
Mtwo Non cutting Fixed taper Variable pitch, Steep
4, 5, 6, 7 % helical angle to reduce
screw-in effect.
S- shape design with two cutting edges, no radial lands.
Minimum core width to improve flexibility
Grossman’s Endodontic Practice. 12th Edition
44. Nickel-Titanium Rotary Instruments
The specific design characteristics vary,
such as tip sizing, taper, cross section,
helix angle, and pitch.
New designs continually are produced, but
the extent to which clinical outcomes (if
any) will depend on design characteristics
is difficult to forecast.
45. LightSpeed and LightSpeed LSX Instruments
Developed by Steve Senia and William Wildey
in the early 1990s and now also known as LS1.
Long, thin non-cutting shaft and short anterior
cutting part (0.25- 1.75mm)
A full set consists of 25 LightSpeed LS1
instruments in sizes #20 to #100, including half
sizes (e.g., 22.5, 27.5); LSX does not have half
sizes, and a set includes sizes #20 to #80.
46. The recommended working speed for LS1
instruments is 1500 to 2000 rpm and for
LSX, 2500 rpm.
Both variants should be used with minimal
torque, owing to the thin shaft.
Cross sections of LightSpeed LS1 cutting
parts show three round excavations, the U-
shape design common to many earlier NiTi
instruments,
Whereas the LSX is shaped like a flat
chisel in cross section.
47. design features of a LightSpeed instrument. A, Lateral view
(scanning electron micrograph [SeM], ×50). B, Cross section (SeM,
×200). C, Lateral view. D, design specifications.
48. Considerably more flexible than any
other instrument on the market.
Cyclic fatigue is lower than with all other
instruments, allowing the use of higher
rpm speeds.
All Light-Speed instruments feature a
noncutting tip.
49. Because of their design, LightSpeed LS1
and LSX require specific instrumentation
sequences to produce canal shapes
amenable to root canal filling.
The current recommendation calls for an
apical 4-mm zone to be prepared to a
cylindrical, nontapered shape.
This section may then be filled with the
proprietary SimpliFill system
50. A low incidence of canal transportation and
preparation errors.
Loss of working length was also minimal in
most of these studies
Bergmans L et al.
Int Endod J 35:820, 2002
51. Marending M, et al Compared the apical fit in
two dimensions of the first K-file versus the first
Lightspeed LSX instrument binding at working
length after an initial crown-down preparation.
The apical large canal diameter was assessed
more accurately by the LSX instruments
Instruments with a flat widened tip were found to
determine apical cross-sectional diameter
better than round, tapered instruments.
Marending M, et al. International
Endodontic Journal, 45, 169–176, 2012.
52. ProFile
[DENTSPLY Tulsa Dental] was introduced by Ben
Johnson in 1994.
Have increased tapers compared with
conventional hand instruments
The ProFile system was first introduced as the
“Series 29” hand instruments in .02 taper, but it
soon became available in .04 and .06 taper.
The tips of the ProFile Series 29 rotary
instruments had a constant proportion of
diameter increments (29%).
53. Design features of a ProFile
instrument. A, Lateral view
(scanning electron micrograph
[SeM], ×50). B, Cross section
(SeM, ×200). C, Lateral view.
D, design specifications.
54. Cross sections of a ProFile instrument show a
U-shape design with radial lands and a parallel
central core.
Lateral views show a 20-degree helix angle, a
constant pitch, and bulletshaped noncutting
tips.
Together with a neutral or slightly negative rake
angle, this configuration facilitates a reaming
action on dentin rather than cutting.
Also, debris is transported coronally and is
effectively removed from the root canals.
55. ProFile instruments shaped canals without
major preparation errors in a number of in
vitro investigations.
A slight improvement in canal shape was
noted when size .04 and .06 tapered
instruments were used in an alternating
fashion.
Bryant ST et al. Int Endod J 31:275, 1998.
Int Endod J 32:155, 1999.
56. Comparative assessments in vitro
suggested that ProFile prepared mesial
canals in mandibular molars with less
transportation than K3 and RaCe.
Loss of working length did not exceed 0.5
mm and was not affected by the use of
.06 tapered instruments.
Bryant ST et al. Int Endod J 32:155,
1999.
Al-Sudani D et al. J Endod 32:1198,
2006.
57. Newer ProFile family of instruments is the
Vortex (DENTSPLY Tulsa Dental).
The major change lies in the non-landed cross
section, whereas tip sizes and tapers are similar
to existing ProFiles.
Manufactured using M-Wire, Profile Vortex also
have varying helical angle to counteract the
tendency of non-landed files to thread into the
root canal.
58. GT and GTX Files
Steve Buchanan in 1994.
This instrument also incorporates the U-file design and
was marketed as ProFile GT.
The system was first produced as a set of four hand-
operated files and later as engine-driven files.
Four tapers (.06, .08, .10, and .12).
The maximum diameter of the working part was 1 mm.
This decreased the length of the cutting flutes and
increased the taper.
59. The instruments had a variable pitch and an
increasing number of flutes in progression to the tip;
the apical instrument diameter is 0.2 mm.
Instrument tips were noncutting and rounded, these
design principles are mostly still present in the
current incarnation, the GTX instrument.
The main differences are the NiTi alloy type used
(M-Wire, manufactured by SportsWire, Langley,
OK) and a different approach to instrument usage,
emphasizing the use of the #20 .06 rotary.
60. Design features of a GT-file. A, Lateral view (scanning electron micrograph
[SeM], ×50). B, Cross section (SeM, ×200). C, Lateral view. D, design
specifications
61. The GTX set currently includes tip sizes 20, 30,
and 40 in tapers ranging from .04 to .08.
The recommended rotational speed for GT and
GTX files is 300 rpm, and the instrument should
be used with minimal apical force to avoid
fracture of the tip.
62. Studies on GT files found that the prepared
shape stayed centered and was achieved
with few procedural errors.
A shaping assessment using μCT showed
that GT files machined statistically similar
canal wall areas compared with ProFile and
LightSpeed preparations.
These walls were homogeneously machined
and smooth.
Hata G et al. J Endod 28:316, 2002
Peters OA et al. Int Endod J 34:221, 2001.
Park H: Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 91:715, 2001.
63. HERO 642, Hero Shaper
First-generation had neutral or slightly negative
rake angles.
Second-generation systems were designed with
positive rake angles, which gave them greater
cutting efficiency.
HERO instruments (MicroMega, Besançon,
France); the original system known as HERO 642
has now been replaced by HERO Shaper, with very
little difference in the instrument design.
64. Cross sections of HERO instruments show
geometries similar to those of an H-file without radial
lands.
Tapers of .02, .04, and .06 are available in sizes
ranging from #20 to #45.
The instruments are relatively flexible (the acronym
HERO stands for high elasticity in rotation) but
maintain an even distribution of force into the cutting
areas.
HERO instruments have a progressive flute pitch
and a noncutting passive tip.
65. Design features of a HeRO instrument. A, Lateral view (scanning electron
micrograph [SeM], ×50). B, Cross section (SeM, ×200). C, Lateral view. D,
design specifications
66. Research with HERO files indicates a shaping
potential similar to that of the FlexMaster and
the ProFile.
HERO Shapers were found to have a better
centering ability compared to RaCe
instruments in resin blocks.
Hülsmann M et al. Int Endod J
36:358, 2003. Garala M et al. Int Endod J 36:636, 2003.
Aydin C et al. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 105:e92, 2008.
67. ProTaper Universal
The instruments were designed by Cliff
Ruddle, John West, and Pierre Machtou.
Originally comprised just six instruments:
three shaping files and three finishing files.
This set is now complemented by two larger
finishing files and a set designed for
retreatment procedures.
68. In cross section, ProTaper shows a modified K-type
file with sharp cutting edges and no radial lands.
This creates a stable core and sufficient flexibility for
the smaller files.
The cross section of finishing files F3, F4, and F5 is
slightly relieved for increased flexibility.
A unique design element is varying tapers along the
instruments’ long axes.
The three shaping files have tapers that increase
coronally, and the reverse pattern is seen in the five
finishing files.
70. Design features of a ProTaper instrument. A, Lateral view (scanning electron
micrograph [SeM], ×50). B, Cross section (SeM, ×200). C, Lateral view. D,
design specifications.
71. Tip diameter (mm)
Sx 0.19 At D9 = 1.1 mm
S1 0.185 At D14 =1.2 mm
S2 0.20 At D14 = 1.1 mm
Tip Diameter (mm) Taper (mm)
(D₀- D₃)
F1 0.2 0 7%
F2 0.25 8%
F3 0.30 9%
F4 0.40 5%
F5 0.50 4%
72. Cross section of Finishing files
Triangular cross section of Shaping files
73. The finishing files have rounded noncutting
tips.
The convex triangular cross section of
ProTaper instruments reduces the contact
areas between the file and the dentin.
The first is the preparation of a glide path,
either manually or with special rotary
instruments.
74. Optimal helical angle with variable pitch on
the cutting flutes, designed to maximise
efficiency and again prevent the file
screwing into the canal.
The tip design is a modified non-cutting tip
which acts as a guide in the root canal but
does not cut.
75. A more lateral “brushing” working stroke. Such
a stroke allows the clinician to direct larger files
coronally away from danger zones and
counteract any “threading-in” effect.
In a study using plastic blocks, the ProTaper
created acceptable shapes more quickly than
GT rotary, ProFile, and Quantec instruments
but also created somewhat more aberrations.
Yun HH et al. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 95:228, 2003.
76. A study using μCT showed that the ProTaper
created consistent shapes in constricted
canals, without obvious preparation errors,
although wide canals may be insufficiently
prepared with this system.
It has been recommended that ProTaper be
combined with less tapered, more flexible
rotaries to reduce apical transportation.
Peters OA et al. Int Endod J 36:86, 2003. Javaheri HH et al. J Endod 33:284, 2007
77. Protaper Next
The convergence of a variable tapered design on
a given file (ProTaper Universal), innovative M-
Wire technology, and a unique offset mass of
rotation.
Off-centred, rectangular cross section giving the
files a unique, snake-like swaggering movement.
This improved action creates an enlarged space
for debris removal, optimises the canal tracking
and reduces binding.
78. X1, X2, X3, X4, and X5
Corresponding to sizes:
17/04, 25/06, 30/07, 40/06, and 50/06, respectively.
Recommended speed is 300RPM with
a torque from 4-5.2Ncm.
79. M-Wire technology: Improves the
resistance to cyclic fatigue by almost
400% when comparing files of the same
tip diameter, taper and cross-section.
Offset mass of rotation: Asymmetrical
rotary motion and, at any given cross-
section, the file only contacts the wall at 2
points.
80. Clinically, this provides 3 significant
advantages:
Reduced engagement due to the swaggering effect
which limits undesirable taper lock.
Affords more cross-sectional space for enhanced
cutting, loading, and augering debris.
Allows any PTN file to cut a bigger envelope of
motion compared to a similarly-sized file with a
symmetrical mass and axis of rotation.
This means a smaller-sized and more flexible PTN
file can cut the same-size preparation as a larger
and stiffer file with a centered mass and axis of
rotation.
81. K3
Dr. McSpadden; the Quantec 2000 files were followed
by the Quantec SC, the Quantec LX, and the current K3
system (all by SybronEndo).
The overall design of the K3 is similar to that of the
ProFile and the HERO in that it includes instruments
with .02, .04, and .06 tapers.
The most obvious difference between the Quantec and
K3 models is the K3’s unique crosssectional design: a
slightly positive rake angle for greater cutting efficiency,
wide radial lands, and a peripheral blade relief for
reduced friction.
82. Design features of a K3 instrument. A, Lateral view (scanning electron
micrograph [SeM], ×50). B, Cross section (SeM, ×200). C, Lateral view. D,
design specifications.
83. Unlike the Quantec, a two flute file, the K3
features a third radial land to help prevent
threading-in.
In the lateral aspect, the K3 has a variable pitch
and variable core diameter, which provide apical
strength.
This complicated design is relatively difficult to
manufacture, resulting in some metal flash
A round safety tip, but the file is about 4 mm
shorter than other files
84. Tested in vitro, K3’s shaping ability seems to be similar to
that of the ProTaper and superior to that achieved with hand
instruments.
Bergmans L et al. Int Endod J 36:288, 2003.
Schäfer E et al. Int Endod J 36:199, 2003.
85. FlexMaster
.02, .04, and .06 tapers.
The cross sections have a triangular
shape, with sharp cutting edges and no
radial lands.
This makes for a relatively solid instrument
core and excellent cutting ability.
The overall manufacturing quality is high,
with minimal metal flash and rollover.
86. Design features of a FlexMaster instrument. A, Lateral view (scanning
electron micrograph [SeM], ×50). B, Cross section (SeM, ×200). C,
Lateral view. D, design specifications.
87. Have rounded, passive tips; the tip
diameters are 0.15 to 0.7 mm for size
.02 instruments and 0.15 to 0.4 mm for
size .04 and .06 files.
In addition to the standard set, the Intro
file, which has a 0.11 taper and a 9-mm
cutting part, is available
88. Several studies indicate that the
FlexMaster allows centered preparations in
both constricted and wider canals and that
it performed on par with other systems.
Hübscher W et al. Int Endod J 36:740, 2003.
Hülsmann M et al. Int Endod J 36:358, 2003.
Weiger R et al. Int Endod J 36:483, 2003
89. RaCe, Bio Race
The name, which stands for reamer with
alternating cutting edges, describes just one
design feature of this instrument
Light microscopic imaging of the file shows flutes
and reverse flutes alternating with straight areas;
this design is aimed at reducing the tendency to
thread the file into the root canal.
Cross sections are triangular or square for #.02
instruments with size #15 and #20 tips.
The lengths of cutting parts vary from 9 to 16 mm
90. Design features of an RaCe instrument. A, Lateral view (scanning electron
micrograph [SeM], ×50). B, Cross section (SeM, ×200).C, Lateral view. D,
design specifications.
91. The surface quality of RaCe instruments
has been modified by electropolishing.
Two largest files (size #35, #.08 taper
and size #40, #.10 taper) are also
available in stainless steel.
The tips are round and noncutting
92. EndoSequence
The Sequence rotary instrument is
produced by FKG in Switzerland and
marketed in the United States by Brasseler.
This is another instrument that adheres to
the conventional length of the cutting flutes,
16 mm, and to larger tapers, .04 and .06, to
be used in a crown-down approach
93. Design features of a Sequence instrument. A, Lateral view (scanning electron
micrograph [SeM], ×50). B, Cross section (SeM, ×200). C, Lateral view. D,
design specifications.
94. A unique longitudinal design called alternating
wall contact points (ACP) reduce torque
requirements and keep the file centered in the
canal
An electrochemical treatment after
manufacturing, similar to RaCe files, that results
in a smooth, polished surface.
This is believed to promote better fatigue
resistance, hence a rotational speed of 600 rpm
is recommended for EndoSequence.
Koch KA et al. Dent Clin North Am 48:159,2004.
95. Twisted File
In 2008, SybronEndo presented the first fluted
NiTi file.
Manufactured by plastic deformation, a process
similar to the twisting process that is used to
produce stainless steel K-files.
According to the manufacturer, a thermal
process allows twisting during a phase
transformation into the so called R-phase of
nickel-titanium.
The instrument is currently available with size
#25 tip sizes only, in taper .04 up to .12.
96. Design features of a Twisted File (TF) instrument. A, Lateral
view (scanning electron micrograph [SeM], ×50). B, Cross
section (SeM, ×200). C, Lateral view. D, design
specifications.
97. Twisted Files size #25 .06 taper were more
flexible than ProFiles of the same size.
The manufacturer recommends a conventional
crown-down technique after securing a glide
path with a size #15 K-file.
Specifically, for a “large” canal, tapers .10 to
.06 should be used, and in a “small” canal,
tapers .08 to .04 are recommended.
Gambarini G et al. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 105:798, 2008
98. Path Files
Mechanical glide path and Preflaring.
Available in 3 ISO sizes (013, 016 and 019) and
3 lengths (21, 25 and 31mm).
Flexible and resistant to cyclic fatigue, they offer
many advantages compared to manual solutions
99. NiTi – Square Section – 2% Taper
High strength against cyclic fatigue
Flexibility
Tip design (transition angle reduction)
Reduced risk of ledges and canal transportation
PathFile™ K-File
100. Helio P. Lopes et al.
(Buckling Resistance of Pathfinding
Endodontic Instruments):
The results indicated that the buckling
resistance decreased in the following order:
C+ file > C-Pilot file > PathFile
Considering that buckling resistance may
influence the performance of instruments
during the negotiation of constricted canals,
the C+ files showed significantly better
results than the other instruments tested.
Helio P. Lopes et al . J Endod 2012;38:402–404
101. Self-adjusting file
The instrument is made as a
hollow, thin NiTi lattice
cylinder that is compressed
when inserted into the root
canal and adapts to the
canal’s cross-section.
It is attached to a vibrating
handpiece.
Continuous irrigation is
applied through a special hub
on the side of its shank.
102. The SAF instrument adapted
into a root canal that was
initially prepared with #20 K-file.
Right: A #20 K-file in the canal.
Left: The SAF file in its relaxed
form.
Center: The SAF file inserted
into the same narrow canal.
It will apply delicate pressure on
the canal wall, attempting to
resume its original shape.
103. The abrasive surface
and details of the lattice
of the SAF instrument.
The extreme elasticity is
the total of the elasticity
of each of the delicate
NiTi segments.
104. The VATEA continuous irrigation unit used with the SAF instrument.
The unit has two containers and provides a continuous flow (low
pressure, 5 ml/min) of either irrigant (i.e., sodium hypo-chlorite and
edTA) through double silicon tubes that are connected to the hubs on
the front of the device.
It is controlled by finger-operated switches located on the handpiece.
105. A micro–computed tomography (microCT) analysis of the operation
of the SAF instrument in a flat canal with extremely oval cross-
section.
Right: Buccolingual and mesiodistal views of the root canal
reconstructed from microCT.
Left: Cross-sections at 4 and 6 mm from the apex.
Red: before, blue: after treatment.
106. ENDO-EZE reciprocating files
The endo-eze file system (Ultradent, South Jordan,
UT) is a recently introduced addition for Giromatic
handpieces.
The set has four instruments that are designed to
clean the middle third of the canal.
The sizes and tapers are 0.10 #0.025 taper, 0.13
#0.35 taper, 0.13 #0.45 taper and 0.13 #0.06 taper.
The use of stainless steel hand instruments is
suggested for the apical third of the canal
107.
108.
109. The WaveOne single-file reciprocating system
Single-use, Single-file system to shape the
root canal completely from start to finish.
M-Wire technology.
Improving strength and resistance to cyclic fatigue
by up to nearly four times in comparison with
other rotary NiTi files.
At present, there are three files in the
WaveOne single-file reciprocating system
available in lengths of 21, 25 and 31 mm
110.
111. The WaveOne Small file is used in fine
canals. The tip size is ISO 21 with a
continuous taper of 6 %.
The WaveOne Primary file is used in the
majority of anals. The tip size is ISO 25 with
an apical taper of 8 % that reduces towards
the coronal end.
The WaveOne Large file is used in large
canals. The tip size is ISO 40 with an apical
taper of 8 % that reduces towards the coronal
end
112. The instruments are designed to work with a reverse cutting
action.
All instruments have a modified convex triangular cross-
section at the tip end, and a convex triangular cross-section at
the coronal end . This design improves instrument flexibility
overall
WaveOne apical cross-section,
modified convex triangular
WaveOne coronal cross-section, convex
triangular.
114. The specially designed NiTi files work in a similar but
reverse “balanced force” action using a pre-
programmed motor to move the files in a back and
forth “reciprocal motion”
The counter-clockwise (CCW) movement is greater
than the clock-wise (CW) movement. CCW movement
advances the instrument, engaging and cutting the
dentine.
CW movement disengages the instrument from the
dentine before it can (taper) lock into the canal.
Three reciprocating cycles complete one complete
reverse rotation and the instrument gradually
advances into the canal with little apical pressure
required.
116. Endo Express and Safe Sider
Reciprocating Motion.
SafeSiders have 16 flutes compared to 24
flutes for files.
Less flutes leads less engagement with the
walls of the canal which means less
resistance, binding and virtually no instrument
separation.
117. Flat-side of the SafeSider:
Act as chisels in the clockwise and counter
clock-wise motion allow to remove debris
easily.
SafeSiders are safely used at least 3
times more than NiTi instruments before
they are discarded.
118. Revo-S Sequence
The asymmetrical cutting profile of the
Revo-S facilitates penetration by a snake-
like movement, and offers, a root canal
shaping which is adapted to the biological
and ergonomic imperatives.
It is composed of only two instruments for
apical penetration (SC1 and SC2), and a
recapitulating and cleaning instrument (SU)
119. Revo-S instruments for apical progression (SC1 & SC2), &
cleaning (SU).
The working lengths are adapted for a crown-down
preparation.
The asymmetry alternates with the symmetry, in order to
optimize the canal penetration (SC1), the strength (SC2), &
the cleaning (SU)
120. Apical finishing instruments with an asymmetrical cross
section allowing the final shaping of the apical third.
The selection of preparation diameter adapted to most
clinical cases, and
Cleaning without pushing debris beyond the apical
foramen
121. Mtwo
VDW, Munich, Germany
The standard set for this system includes
four instruments with variable tip sizes
ranging from #10 to #25, and tapers ranging
from .04 to .06 (size 10/.04 taper, size
15/.05 taper, size 20/.06 taper, size 25/.06
taper
122. After this basic sequence, that gives the canal a
#25/.06 shape, the system is conceived to permit
three different approaches to root canal
preparation.
The first sequence allows clinicians to achieve
enlarged apical diameters using the size 30 (.05)
taper, 35 (.04) taper or 40 (.04) taper;
The second leads to a .07 taper that can facilitate
vertical condensation of gutta-percha, maintaining
a size #25 apical preparation;
The third implies the use of the Mtwo apical files
123.
124. SEM image of Mtwo instrument cross-section, showing the two blade
cutting surfaces resulting in an “Italic S” design.
.
125. The Helical angle (HA) of Mtwo instruments
is variable and specific for the different files
HA is more open (greater) for the bigger
sizes (less flutes for instrument length), and
it decreases for the smaller sizes (more
flutes).
This determines a greater cutting efficiency
for the bigger sizes and a greater
mechanical resistance together with a
tendency to advance in the canal for the
smaller ones.
126. The HA is variable in the same instruments,
it increases from the tip to the handle as
does the spiral pitch,
While it is constant for the smaller files,
especially for the #10 .04, the first rotary
instrument that is introduced in the root
canal.
The variable HA reduces the tendency of
the instrument to be sucked down into the
canal
127. The MtwoR instruments are specifically
designed for the retreatment of obturation
materials.
The retreatment files are Mtwo R 15/.05 and
Mtwo R 25/.05, presenting an active tip that
allows clinicians to easily penetrate obturation
material.
128. Conclusion:
An explosion in knowledge and technology has created
an exciting time in the specialty of endodontics.
New instruments and materials seem to appear faster
than clinicians can learn about the preceding versions.
This has created an educational challenge for
practitioners, universities, and manufacturers, requiring
a greater degree of cooperation among these groups
than ever before.
Clinicians should only use those instruments and
materials that have been shown safe and effective by
independent studies.
Cohen and Hargreaves. Pathways of pulp,10th edition
129. Most systems include files with tapers greater than the #.02
stipulated by the ISO norm.
The Light-Speed LS1 and LSX are different from all other
systems;
The ProTaper, RaCe, and Twisted File have some unique
features; and most other systems have increased tapers.
Minor differences exist in tip designs, cross sections, and
manufacturing processes, but the clinical effects of these
modifications currently are unknown.
Even in vitro, tests have only begun to identify the effect of
specific designs on shaping capabilities, and differences in
clinical outcomes in regard to these design variations
appear to be minimal.
Cohen and Hargreaves. Pathways of pulp,10th edition
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