Upload
rimy-singh
View
255
Download
2
Embed Size (px)
Citation preview
8/22/2019 endodontic insruments-1
1/114
ENDODONTICINSTRUMENTS
(HAND INSTRUMENTS)
GUIDED BY-
DR. ARUNDEEP SINGH
Presented by-
Arvinder
8/22/2019 endodontic insruments-1
2/114
CONTENTS
History
Classification
Diagnostic instruments
Basic instruments
Isolating devices Instruments for access cavity prepration
Standardisation of endodontic instruments
Exploring instruments
Debriding instruments
Cleaning & shaping instruments Irrigation devices
Root canal filling instruments
Non ISO instruments
8/22/2019 endodontic insruments-1
3/114
HISTORY
1750- Fauchard recommended removal of pulp. 1850- wooden pegs for debriding pulp.
Early 1900- introduction of files,reamers,lentulospiral.
1915- Kerr manufacturing company obtained patent for
all instruments later known as K type instruments. 1957- Richman introduced first ultrasonic system.
1958- Ingle & Levine first proposed standardisation.
1959- filling materials.
1964- introduction of giromatic handpiece.
1988- 1st use of NiTi in endodontics instruments.
8/22/2019 endodontic insruments-1
4/114
SUCCESS OF ENDODONTICS DEPENDS UPON
ENDODONTIC TRIAD
Access cavity preparation
Biomechanical Preparation of the root
canal.(Cleaning and shaping)
ObturationFor these three steps instruments are
mandatory
Ingles endodontics 6th edition
8/22/2019 endodontic insruments-1
5/114
MATERIALS
Carbon steel- high cutting efficiency
Stainless steel- low cutting efficiency & becomesdull rapidly
Nickel titanium- Ni 54% ,Ti 44%
Co & boran- improve surface hardness
8/22/2019 endodontic insruments-1
6/114
At high temperatures,NiTi exsts as BCC
lattice,reffered to as AUSTENTIC phase (stable &
stronger)
On cooling,this phase transfers to close packed
hexagonal known as MARTENSITIC phase(weak
phase)
NiTi austenite phase
stress induced
Martensitic phase
stress relieved
Austenite phase
DISADVANTAGE- cutting efficiency is only 60%
than that of stainless steel files
This transformation results
in 2 features-1. Shape memory
2. Super elasticity
8/22/2019 endodontic insruments-1
7/114
CLASSIFICATION
8/22/2019 endodontic insruments-1
8/114
FUNCTION INSTRUMENTS
Exploring Smooth broaches and endodontic explorers
(Used to locate canal orifice and to determine the
direction and patency of root canal)
Debriding Barbed broaches
(Used to extirpate the pulp and to remove debris and
other foreign materials
Shaping Reamers and Files(Used to shape the canal space laterally and apically )
Obturating Pluggers, spreaders and lentulospirals
(To cement and pack guttapercha points into the canal
space)
Classification According to Function (Grossmans Classification)
Grossmans 12th edition
8/22/2019 endodontic insruments-1
9/114
ISO AND FDI CLASSFICATION OF ENDODONTIC
INSTRUMENTS
TYPES TYPES OF
INSTRUMENTS
HAND / ENGINE
DRIVEN
EXAMPLES
I Endodontic instruments
for hand use only
K-type files
H type file
R-Type rasps
Barbed broaches
spreaders
condenser
Ingles 5th edition
8/22/2019 endodontic insruments-1
10/114
8/22/2019 endodontic insruments-1
11/114
ISO AND FDI CLASSFICATION OF ENDODONTIC
INSTRUMENTS
TYPES TYPES OF
INSTRUMENTS
HAND / ENGINE
DRIVEN
EXAMPLES
II Engine driven
instruments
Handle has been
replaced by a latchtype adaptor for
insertion in contra
angle hand piece
Similar to group I
instruments
Niti Rotary instruments
like Profile
Paste fillers
(lentulospirals)
Ingles 5th edition
8/22/2019 endodontic insruments-1
12/114
GROUP I GROUP II
K- reamer
Greater
Taper Ni-Ti
instruments
Lentulospiral
GROUP III
8/22/2019 endodontic insruments-1
13/114
TYPES TYPES OF INSTRUMENTSHAND
/ ENGINE DRIVEN
EXAMPLE
III
IV
Endodontic engine driven instruments
latch and shaft and operative head, all
made of a single piece
Endodontic points
Gates glidden
Peezo reamer
GP points
Silver points
Paper points
Ingles 5th edition
8/22/2019 endodontic insruments-1
14/114
ACCORDING TO COHEN
Group 1- manually operated instruments (barbed broaches &
K type,H type instruments)
Group 2- low speed instruments with latch type attachment
(GG burs & peesoreamers)
Group 3- engine driven Ni-Ti rotary instruments
Group 4- engine driven instruments that adapt themselves
three dimensionally to shape of root canal. (SAF,self adjusting
file)
Group 5- engine driven reciprocating instruments
Group 6- ultrasonic instruments
Cohens 10th edition
8/22/2019 endodontic insruments-1
15/114
DIAGNOSTICDEVICESFor pulp vitality
Battery operated instrument
connected to a probe.
Designed to stimulate a
response by electrical excitation
of the neural elements within
the pulp.
Does not provide any
information regarding the
vascular supply to the tooth.
Considered advantageous
when compared with the
thermal tests since the
quantitative readings areobtained. Cohens 10th edition
8/22/2019 endodontic insruments-1
16/114
Pulse oximetry.
Cohens 10th edition
Non invasiveoxygen saturation monitoring device widelyused in medical practice for recording blood oxygen
saturation levels during administration of I.V. anesthesia.
System consists of a probe containing a diode that emits light
in two wavelengthsRed660nmInfrared940nm
Probe is placed on labial surface of tooth-ideally on middle
1/3rd & a silicon photodetector diode is placed on opposingsurfaces of tooth & is connected to a microprocessor .
In the red range the oxyhaemoglobin absorbs less light thandeoxyhaemoglobin & viceversa in the infrared region.
8/22/2019 endodontic insruments-1
17/114
Mechanism of the dental pulse oximeter. (a) Light-emitting diode emitting red light at
660 nm. (b) Light-emitting diode emitting infrared light at 940 nm.
(c) Photodetector. (d ) Pulse oximeter monitor. (e) Pulse oximeter sensor. (f) Custom-
made pulse oximeter sensor holder. HbO2, oxygenated hemoglobin;
HbR,deoxygenated hemoglobin; SpO2, oxygen saturation of arterial blood
8/22/2019 endodontic insruments-1
18/114
Laser doppler flowmetry
Cohens 10th edition
1. Non invasive , electrooptical technique
2. Can measure blood flow inmicrovasculature systems.
3. Incident laser beam ofknown wavelength is directedthrough crown of tooth
4. moving red blood cellscause frequency of laser beamto be dopple shifted & somelight to be back scattered outof tooth
8/22/2019 endodontic insruments-1
19/114
Cold tests (A stream ofcold air,ethyl chloride
spray(-41C), application ofice,Carbon-di-oxide snow(dry ice-78.5C))
Heat tests(Hot air,Hot water,A hot burnisher ,Hot
gutta-percha ,Hot compound)
Cohens 10th edition
8/22/2019 endodontic insruments-1
20/114
MAGNIFICATIONDEVICES
Loupes
Operating microscopes
Cohens 10th edition
DISADVANTAGES-1. Fixed magnification power that can
not be increased or decreased.
2. No integerated light source
3. No way to digitally document
viewed images.
4. Focus is adjusted throughmovements of clinicians head.
1. Wide range of magnification.2. Coaxial illumination
3. Easy photographic
documentation
4. Focus adjustments by moving
the microscope.
8/22/2019 endodontic insruments-1
21/114
BASIC INSTRUMENTS
Front sur face mouth mirror
Locking pliers
I t has a lock that allows mater ials to be held without continuous
finger pressure; also it has a groove which faci l i tates holdinggutta percha and absorbing points. Cohen 10th edition
8/22/2019 endodontic insruments-1
22/114
Explorer DG-16 endodontic explorer
Cohen 10th edition
8/22/2019 endodontic insruments-1
23/114
the endodontic ruler
Endodontic excavator-larger than a spoon
excavator
-excavation of the contents of thepulp chamber.
-Also used in curettage of periapical
lesions in surgical endodontics .
Cohen 10th edition
8/22/2019 endodontic insruments-1
24/114
Endodontic fi le organiser
:It is used for arrangement
of reamers and files according
to the size and length.
The organizer provides holes for
the files to be place vertically.
Cohen 10th edition
8/22/2019 endodontic insruments-1
25/114
Transfer sponge:
It is sponge saturated
with disinfectant
solution. The reamers
and files can be
placed in it afterbeing used.
Cohen 10th edition
8/22/2019 endodontic insruments-1
26/114
MICROINSTRUMENTS
Micromirrors Microcondensers
Cohen 10th edition
8/22/2019 endodontic insruments-1
27/114
8/22/2019 endodontic insruments-1
28/114
MATERIALS FOR ISOLATION
Rubber damprovides the best possible isolation.
In 1864 S.C.Barnum a New York city dentist
introduced the rubber dam into dentistry
1. Rubber dam sheets
2. Rubber dam clamps
3. Rubber dam holders(frame)
4. Rubber dam retainer forceps
5. Rubber dam punch
6. Rubber dam templates or stamps
7. Dental floss
8. Wedgets
Ingles 6th edition
8/22/2019 endodontic insruments-1
29/114
RUBBER DAM SHEET
It is made of latex or non-latex.
Available in 2 sizes-5*5
6*6
Available in varying thickness. Light and dark sheets are available for colour
contrast.
Has a shiny & dull side, dull side will be facing the
occlusal side.
Ingles 6th edition
8/22/2019 endodontic insruments-1
30/114
Rubber Dam Clamps
Clamps without wings Clamps with wings
Ingles 6th edition
8/22/2019 endodontic insruments-1
31/114
3. RUBBERDAMHOLDER (FRAME)
Used to maintain the
borders of the rubberdam in position.
Types:
a).Youngs holder-It isa U-shaped metal framewith small metalprojections for securingborders of the rubber
dam.
Ingles 6th edition
8/22/2019 endodontic insruments-1
32/114
b). Ash pattern - mostsuitable for children.
C). Swenska N-frames are suitablefor taking
radiographs with thedam.
Ingles 6th edition
8/22/2019 endodontic insruments-1
33/114
4. RUBBERDAMRETAINERFORCEPS
Used for placement and removalof retainer from the tooth.
Ingles 6th edition
8/22/2019 endodontic insruments-1
34/114
5. RUBBERDAMPUNCH
Used for making holes in thedam
Parts a). Rotating metal disc
bearing 5 to 6 holes of
different sizes according to
size of teeth.
b). A sharp pointed plunger.
Ingles 6th edition
8/22/2019 endodontic insruments-1
35/114
6. RUBBERDAMTEMPLATE
Both have positions ofthe teeth marked on
them and are used to
transfer them to the
rubber dam sheet forholes to be punched.
Ingles 6th edition
8/22/2019 endodontic insruments-1
36/114
8. Wedget
An elastic used to secure the dam
around the teeth farthest away from the clamp.
7. Dental floss
Tied around the retainer
before carried to the oral cavity to
prevent accidental aspiration of
clamp.
Ingles 6th edition
8/22/2019 endodontic insruments-1
37/114
ACCESSORIES
Rubber Dam napkin: This is a sheet of absorbent
material placed between the rubber dam and skin.
Lubricant: A lubricant is applied in the area of punch
holes facilitates the passing of dam septa through
proximal contacts.
Ingles 6th edition
8/22/2019 endodontic insruments-1
38/114
INSTRUMENTSFORACCESSCAVITY
PREPARATION
Hand pieces
Reciprocating
handpiece
Vertical stroke
handpiece
Ingles 6th edition
8/22/2019 endodontic insruments-1
39/114
BURS
Access
burs:#2,#4,#6
round carbide
burs
Access bur #57
fissure carbide bur
Round end
cutting tapered
diamond bur
(endo access bur)Cohen 10th edition
8/22/2019 endodontic insruments-1
40/114
safety tip tapereddiamond bur(lt)
Safety tip tapered
carbide bur(rt)
#2, #4 rounddiamond burs
Transmetalbur
Cohen 10th edition
8/22/2019 endodontic insruments-1
41/114
INSTRUMENTS USED IN CLEANING AND SHAPINGTHE PULP SPACE:
Includes:
Hand Instruments
Rotary Instruments
8/22/2019 endodontic insruments-1
42/114
1958 Ingle and Levine first proposed standardization of
endodontic instruments and suggested guidelines for the same
1) The instruments shall be numbered from 10 to 100, the numbers to
advance by 5 units to size 60, and thereby by 10 units to size 100.
2) The instrument number shall be representative of the diameter of theinstrument tip in hundredth of a mm (1/100). Eg. No. 20 is 0.20 mm
(20/100) at the tip.
Ingles 5th edition
8/22/2019 endodontic insruments-1
43/114
3) The working blades (flutes) shall begin at the tip designated site D1 and
shall exactly 16 mm upto shaft terminating at designated site D2.
4) The diameter of D2 shall 0.32 mm greater than that of D1. eg: File no.20shall have a diameter of 0.20 mm at D1 and a diameter of 0.52 (0.20 +
0.32) mm at D2
5) This sizing will ensure a constant increase in taper of 0.02 per mm ofevery instrument regardless of its size.
Ingles 5th edition
8/22/2019 endodontic insruments-1
44/114
Ingles 5th edition
MODIFICATIONS FROM INGLES ORIGINAL
8/22/2019 endodontic insruments-1
45/114
MODIFICATIONSFROM INGLESORIGINAL
PROPOSALBYISO
6) An additional diameter
measurement point at D3, 3
mm of from tip of cutting
end of instrument at D0
7) Tip angle of an instrumentshould be 75o 15o
Weine 6th edition
8/22/2019 endodontic insruments-1
46/114
COLOUR CODING:
The International Standards
Organisation (ISO)recommended a colourcoding system for easierrecognition
consists of 6 colours chosenin ascending order of sizefrom light to dark
Small sized instruments (06,
08,10) were also added andcolour coded as pink, grey.purple respectively.
GROUP 1
Ingles 5th edition
8/22/2019 endodontic insruments-1
47/114
These colours are repeated in
each of the three groups
Change in D1
0610 0.02 mm
1060 0.05 mm60160 0.10 mm
GROUP 3
GROUP 2
Ingles 5th edition
8/22/2019 endodontic insruments-1
48/114
Instrument length:
Measured from the instrument tip
to the end of the shank (l2)
Manufactured in three lengths
Standard 25 mm
Long 31 mm
(useful in canines)
Short 21 mm
the working end of theinstrument (length of the cuttingsegment, l1 ) remains constant is16 mm.
8/22/2019 endodontic insruments-1
49/114
Broaches and rasps:
Available in 2 types- smooth & barbed
Broach doesnt cut dentin but can be used for pulp extirpation
or to remove cotton or paper pts which might have lodged in
canal. Manufactured from round wire,the smooth surface of which
has been notched to form barbs bent at an angle from the
long axis.
USE- insertion through the access cavity until dentinal walls
are felt,broach slightly withdrawn ,then rotated a fewrevolutions & removed
Smooth broach is free of barbs. Used to explore the canal
patency.
Weines 6th edition
8/22/2019 endodontic insruments-1
50/114
8/22/2019 endodontic insruments-1
51/114
Smallest size broach available has the width of a
size 20 instrument.
Should not used initially in narrow canals until the
canal is wide enough.
Both broach & rasps have similar design except in
taper & barb size. Barb size is larger in broach.
The broach has a taper of #.007 to #.01 taper and
the rasp has a taper of #.015 to #.02 taper.
Weines 6th edition
8/22/2019 endodontic insruments-1
52/114
REAMERS
Grossmans 12th edition
A S
8/22/2019 endodontic insruments-1
53/114
REAMERS: a sharp edged tool for enlarging
or tapering holes. Lesser no of flutes & have
triangular blank. No of flutes are
-1 per mm while in files are
11/2-2 /mm.
Action:twisted clockwise to
turn to engage dentin & then
withdrawn-penetration, rotation
and retraction.
Remove intracanal debris with
clockwise reaming action
whereas conterclockwise turning
will force debris apically.
Ingles,6th edition
8/22/2019 endodontic insruments-1
54/114
8/22/2019 endodontic insruments-1
55/114
Reaming is the only method that produces a round,
tapered preparation, and this only in perfectly
straight canals. In such a situation, reamers can be
rotated turn before retracting.
In a slightly curved canal, a reamer should berotated only -turn.
FILES
8/22/2019 endodontic insruments-1
56/114
FILES Kerr manufacturing company was the first to
produce it,hence the name K type file/reamer.
More number of flutes than reamers, no of flutes are
11/2-2 /mm.
Greater cross sectional area than reamers.
Cutting action can be effected in either a filing or
reaming motion.In a filing motion,the
instrument is placed into the
canal at the desired
length,pressure is exerted
against the canal wall,and
while this pressure is
maintained,the instrument is
withdrawn without turning.
In a reaming action,the
motion is the
same as for a reamer -
penetration,rotation,and
retraction.
Withdrawing the file cuts
away the engaged dentin.
Ingles,5th edition
8/22/2019 endodontic insruments-1
57/114
K TYPE FILES : Square cross
section.More no of flutes. Superior cutting
Grossmans 12th edition
8/22/2019 endodontic insruments-1
58/114
K REAMERVS. FILE
8/22/2019 endodontic insruments-1
59/114
Rhombus/diamond shaped cross section
Cutting edges are formed by two acute angles
of rhombus which leads to increase sharpness& cutting efficiency.
low flutes formed by obtuse angles providemore space for debris removal & for irrigation.
The major disadvantage is its rapid loss ofcutting efficiency.
K FLEX FILES
Ingles 6th edition
8/22/2019 endodontic insruments-1
60/114
TRIPLE FLEX FILE
More recently, Kerr has introduced a hybrid
instrument called as Triple-Flex File.
It has more spiral flutes than a K reamer but fewer
than a K file.
Made from triangular stainless steel and twisted
Instrument is more aggressive and flexible than the
regular K-style instruments
Ingles 5th edition
8/22/2019 endodontic insruments-1
61/114
FLEXOFILE:
Similar to K FLEX but
have triangular cross
section. More
flexibility and ability to
resist #.
Ingles 5th edition
FLEX R FILES
8/22/2019 endodontic insruments-1
62/114
FLEX R FILES: Made by removing sharp
cutting edges from tip ofinstrument /tip angle is
reduced
Reduce ledge formation,
canal transportation. Non cutting tip enables the
instrument to traverse along
the canal rather than gouge
into it.
Have triangular cross
section.
Ingles 5th edition
8/22/2019 endodontic insruments-1
63/114
K FILEMODIFICATIONS
K-Flex
Flex-R
HEDSTROEM FILES(H-FILE)
8/22/2019 endodontic insruments-1
64/114
( )
Flutes resemble successivelysmaller triangles set one onanother.
Manufacture by cuttingspiral flutes into the shaft ofa piece of round taperedstainless steel wire.
It cuts only in one direction.,
during retraction
Cross section :single helixtear drop
Ingles 5th edition
8/22/2019 endodontic insruments-1
65/114
USES-
1. In immature teeth,where the walls are irregular &
may harbour debris.
2. useful in removing silver points or loose broken
instruments from canals(file is placed alongside the
material to be removed,then rotated,& pulled
towards the occlucal surface)
3. Widening straight canals,coronal portion of
curved canals for easier placement of smallerinstruments.
Ingles 5th edition
8/22/2019 endodontic insruments-1
66/114
DRAWBACKS-
1. It is weakened at each position during
manufacture,resulting in a place for fracture if the
flutes bind in dentin & the handle is rotated.
If it is rotated clockwise after binding in
dentin,instrument moves further apically & crack the
weakened & stressed root.
Ingles 5th edition
8/22/2019 endodontic insruments-1
67/114
H-FILE MODIFICATIONS
Unifile & Dynatrak
McSpadden was the first to modify the traditional
Hedstroem file.Marketed as the Burns Unifile and
Dynatrak
These files were designed with two continous
cutting edges, a double-helix design.
In cross-section, the blades presented an S
shape rather than the single-helix teardrop cross-
sectional shape of the true Hedstroem file
Ingles 5th edition
8/22/2019 endodontic insruments-1
68/114
At this time, Unifiles and Dynatraks are no longer being
marketed; however,the Hyflex file appears to have the
same cross-sectional configuration.
The S File alsoappears to be a variation of theUnifile in its double-helix configuration.
Buchanan has further modified the Hedstroem file, the
Safety Hedstrom, which has a noncutting side to
prevent ledging in curved canals.
Ingles 5th edition
8/22/2019 endodontic insruments-1
69/114
U FILE
A new endodontic classification of instrument, for whichthere is no ISO or ADA specification as yet, is the U-File.
Marketed as ProFiles, GT Files, LIGHTSPEED andUltra-Flex files.
The U-Files cross-sectional configuration has two
90-degree cutting edges at each of the three points ofthe blade
Adapts well to the curved canal, aggressively planingthe external convex wall while avoiding the moredangerous internal concave wall, where perforationstripping occurs.
A noncutting pilot tip ensures that the file remains in the
lumen of the canal, thus avoidingtransportation andzipping at the apex. used in both a push-pull and rotary motion
Ingles 5th edition
8/22/2019 endodontic insruments-1
70/114
Cross-sectional view of a U File
Ingles 5th edition
ProFiles are supplied in 0 04 0 05 0 06 0 07 and
8/22/2019 endodontic insruments-1
71/114
ProFiles are supplied in 0.04, 0.05, 0.06, 0.07,and
0.08 tapers and ISO tip sizes of 15 through 80.
GT ProFiles, developed by Buchanan in the U
design,are unusual in that the cutting blades
extend up the shaft only 6 to 8 mm rather than 16
mm, and the tapers start at 0.06 /mm (instead of
0.02), as well as 0.08 and 0.10, taperedinstruments.
They are made of nickel titanium and come as hand
instruments and rotary files.
GT instruments all start with a noncutting tip ISOsize 20
Ingles 5th edition
8/22/2019 endodontic insruments-1
72/114
An unusual variation of the U-shaped design is
the LIGHTSPEED instrument Made only in NiTi
Resembles a Gates-Glidden drill in that it has only
a small cutting head mounted on a long, noncutting
shaft. It is strictly a rotary instrument but comes with a
handle that may be added to the latch-type
instrument for hand use in cleaning and shaping
abrupt apical curvatures .
The instruments come in ISO sizes beginning with
No. 20 up to No. 100.
The heads are very shortonly 0.25 mm for the
size 20 and up to 1.75 mm for the size 100Ingles 5th edition
8/22/2019 endodontic insruments-1
73/114
QUANTECFILES.
The newly designed Quantec instrument,althoughcalled a file, is more like a reamer.
used in the reamers rotary motion.
Produced as both hand- and rotary-powered
instruments. First designed by McSpadden.
Quantec is produced in three different tapers0.02, 0.04, and 0.06/mmas well as safe-cuttingand noncutting tips.
The instruments are sized at the tip and numberedaccording to the ISO system15, 20, 25, etc.
Ingles 5th edition
8/22/2019 endodontic insruments-1
74/114
C+ FILES
C+ Files are ideal for initial instrumentation ofdifficult or calcified root canals.
They have a cutting tip which engages thedentine and are available in three lengths,
18mm, 21mm and 25mm and three sizes 8,10 and15
The files are stainless steel, have a squarecross section and have a blunt, non-aggressive tip to allow the instrument tosafely follow the canal to the apex.
HAND PROTAPER FILES
8/22/2019 endodontic insruments-1
75/114
HANDPROTAPERFILES
convex triangular cross-section.
Six instrument set, comprised of just three Shapingand three Finishing files.
Shaping File # 1 and Shaping File # 2, termed S1
and S2, have purple and white identification rings
on their handles, respectively. The S1 and S2 fileshave D0 diameters of 0.17 mm and 0.20 mm,
respectively.
The Auxiliary Shaping File, termed SX, has no
identification ring on its gold-colored handle and,with a shorter overall length of 19 mm, provides
excellent access when space is restrictive. The SX
file has a D0 diameter of 0.19 mm
NEW INSTRUMENTS WITH INTERMEDIATE
8/22/2019 endodontic insruments-1
76/114
NEWINSTRUMENTSWITHINTERMEDIATE
SIZES
GOLDEN MEDIUMS
1. Corresponds in size to half between standardised
ISO sizes & are numbered 12,17,22,27,32,37.
PROFILE SERIES-29
1. Hand instrument with 0.02 taper.
2. Have constant 29% increase in tip diameter.
Weines 6th edition
CUSTOMISED FILES
8/22/2019 endodontic insruments-1
77/114
CUSTOMISEDFILES
When tha canal curvature is 30 degrees orless,removal of flutes usually is not necessary
Canal curvatures> 30degrees,flute removal is
mandatory.
Weines 6th edition
8/22/2019 endodontic insruments-1
78/114
Three Finishing files named F1, F2 and F3 haveyellow, red and blue identification rings on their
handles corresponding to D0 diameters of 0.20
mm, 0.25 mm, and 0.30 mm, respectively.
Additionally, F1, F2, and F3 have fixed tapersbetween D1and D3of .07, .08, and .09, respectively
NICKEL TITANIUM
8/22/2019 endodontic insruments-1
79/114
NICKELTITANIUM
NITIFLEXK FILES MADE
OF NI-TI
8/22/2019 endodontic insruments-1
80/114
NICKEL-TITANIUM
1962 Buehler
55 NiTiNOL
55 wt % Ni
45 wt % Ti
2% substituted with Co
1988 Walia et al - endodontics
8/22/2019 endodontic insruments-1
81/114
PROPERTIES
Show shape memoryand superelasticity
Softer than stainless steel
Not heat treatable
Have a low modulus of elasticity; but greater strength Tougher and more resilient
Lower cutting efficiency
8/22/2019 endodontic insruments-1
82/114
ADVANTAGES
2-3 times more elasticflexibility
Superior resistance tofracture
DISADVANTAGES
Cutting efficiency only 60% Does not give indication of
wear before fracture
SHAPE MEMORY PROPERTY OF Ni-Ti
GREATER TAPER Ni-Ti HAND INSTRUMENTS
8/22/2019 endodontic insruments-1
83/114
GREATER TAPER Ni Ti HAND INSTRUMENTS
Made of nickel titanium
Available in variable tapers
0.04
0.06
0.08
0.10
0.12
Designed to cut coronal dentin while instrument tipfollowed passively.
GT hand instruments
Ingles 5th edition
8/22/2019 endodontic insruments-1
84/114
CANALORIFICEFLARINGINSTRUMENTS
Instruments available are:
Gates glidden drills
Peeso reamers
Ingles 5th edition
8/22/2019 endodontic insruments-1
85/114
GATES GLIDDENBURS
is one piece rotary
cutting instrument
and bur diameter rangesfrom 0.5-1.5mm
Ingles 5th edition
There are 6 sizes each bur is marked on the latch attachment
8/22/2019 endodontic insruments-1
86/114
There are 6 sizes each bur is marked on the latch attachment
portion of the instrument with an indented strip to indicate the
size .
Gatesglidden drill Instrument size in mm Equivalent K file size
#1 0.50 50
#2 0.70 70
#3 0.90 90
#4 1.10 110
#5 1.30 130
#6 1.50 150
Grossmans 12th edition
Gates glidden drills has 3 main uses:
8/22/2019 endodontic insruments-1
87/114
1)Flaring of the coronal two thirds of the root canals.
2)For removal of guttapercha from a canal during post spacepreparation or during retreatment
3)To widen the canal for retrieval of broken instruments
.
PEEZO REAMER
8/22/2019 endodontic insruments-1
88/114
PEEZOREAMER
Similar to gates glidden but have parallel cutting sides
The sizing for the peezo reamer starts at 0.70mm for a #1 peezo reamers andincreases 0.20mm with every subsequent size
Peezo reamer Size of the tip in mm#1 0.70
#2 0.90
#3 1.10
#4 1.30#5 1.50
#6 1.70
Grossmans 12th edition
8/22/2019 endodontic insruments-1
89/114
Peeso Reamers
Most often used in preparing
coronal portion of the root canal
for receiving a post
Safeended
TipDiameter: 0.71.7 mm
These reamers are available ina 32 mm length and a 28 mm
length for posterior teeth
Ingles 5th edition
DEVICES FOR MEASURING ROOT CANAL
8/22/2019 endodontic insruments-1
90/114
DEVICES FOR MEASURING ROOT CANAL
LENGTH
An apex locator typically hasfour parts: (1) the lip clip, (2)
the file clip, (3) the
instrument itself, and (4) a
cord connecting the other
three parts.
A display indicates the
advancement of the file
toward the apex
Root ZX apex locator with lip clip and
file holder.
Apex locators available in 4 generations-Resistance based;Impedance
type;Frequency based) Cohens 10th edition
IRRIGATION DEVICES
8/22/2019 endodontic insruments-1
91/114
Classification
JOE - June 2009
Di bl i f ti l
8/22/2019 endodontic insruments-1
92/114
Disposable syringes for conventional
irrigation
Types of irrigating needles
8/22/2019 endodontic insruments-1
93/114
Commercially available 30-G needles (A-C) Open-ended needles: (A) flat , (B) beveled
, and (C) notched. (D-F) Closed-ended needles: (D) side vented, (E) double side vented ,
and (F) multivented
JOE2010
8/22/2019 endodontic insruments-1
94/114
ENDOACTIVATOR
Sonically activated
instrument. A plastic file is
sonically activated while inthe canal. This sonic
activity causes acoustic
streaming of the irrigant
throughout the canal
enhancing the cleaning ofthe canal.
Cohens 10th edition
8/22/2019 endodontic insruments-1
95/114
Strong, flexible, medical-
grade polymer
composition
Color-coded by size foridentification
Convenient depth gauge
rings at 18, 19 and 20
mm
HOWTOUSE-
8/22/2019 endodontic insruments-1
96/114
Prepare canal to produce a fully tapered shape
Fill pulp chamber with NaOCl, EDTA, or other final
rinse solution Select the Activator tip that manually fits loosely within
2 mm of working length.
Attach the Activator tip over the handpiece.
Place the attached Activator tip into the prepared root
canal Depress the ON/OFF switch to activate.
Depress the 3-speed switch to select medium speed orlow speed
Use a pumping action to move the handpiece/Activatorin short 2-3 mm vertical strokes
Agitate the intracanal solution for 30-60 seconds
Repeat the above steps for each intracanal irrigantused
ENDOVAC
8/22/2019 endodontic insruments-1
97/114
ENDOVAC
1.Combined irrigation/evacuation system2.a macrocannula or microcannula is connected via tubing
to a syringe of irrigant and the high-speed suction of a
dental unit
Cohens 10th edition
8/22/2019 endodontic insruments-1
98/114
macrocannula
The plasticmacrocannula
has a size 55 openend with a .02 taper
attached to a
titaniumhandle for gross,
initial flushing of thecoronal part of the
root canal.
microcannula
The size 32 stainlesssteel microcannula
has 4 sets of 3 laser-cut, laterally
positioned, offset holesadjacent to its closed
end
attached to
a titanium finger-piecefor irrigation of theapical part of the
canal by positioning itat the working length
Cohens 10th edition
8/22/2019 endodontic insruments-1
99/114
During irrigation, the delivery/evacuation tip deliversirrigant to the pulp chamber and siphons off the
excess irrigant to prevent overflow.
The cannula in the canal simultaneously exerts
negative pressure that pulls irrigant from its freshsupply in the chamber, down the canal to the tip of
the cannula, into the cannula, and out through the
suction hose.
Thus,a constant flow of fresh irrigant is beingdelivered by negative pressure to working length
8/22/2019 endodontic insruments-1
100/114
Advantages- 1. avoid air entrapment
2. safely deliver irrigants to workinglength without
causing their undue extrusion into the periapex
SAFETY IRRIGATOR
(disposable)
8/22/2019 endodontic insruments-1
101/114
(disposable)
1. Irrigation/evacuation system
that apically delivers theirrigant
2. Have a thin needle
containing a lateral opening
& evacuates the solution
through a large needle at the
root canal orifice
3. Have a large coronalevacuation tube, enabling the
user to safely irrigate and
evacuate simultaneously with no
worry of clogging. Cohens 10th edition
HealOzone equipment
8/22/2019 endodontic insruments-1
102/114
HealOzone equipment
1. Ozone is a naturallyoccuring compound
consisting of 3
oxygen atoms.
2. Antimicrobial agent
against
bacteria,viruses,fungi.
Mechanism of action
1. Destruction of cell walls & cytoplasmic membranes of bacteria & fungi.
Attacksglycoproteins& glycolipids
Increasedmembrane
permeability
Immediatefunctionalcessation
Cohens 10th edition
8/22/2019 endodontic insruments-1
103/114
The HealOzone device comprisesAn air filter
A vacuum pump
An ozone generator
A handpiece fitted with a sealing silicone cup
and a flexible hose.
IJCDS AUGUST, 2011 Int. Journal of Clinical
Dental Science
ULTRASONICIRRIGATIONDEVICE
8/22/2019 endodontic insruments-1
104/114
1. ultrasonically activated files have potential to
prepare & debride root canals mechanically. 2. files oscillate at frequencies of 25-30kHz
3. operate in transverse vibration
4. 2 types -
Ultrasonic
irrigation
Passive
ultrasonic
irrigation
Cohens 10th edition
PUI-
1 relies on transmission of acoustic energy from an
8/22/2019 endodontic insruments-1
105/114
1. relies on transmission of acoustic energy from an
oscillating file to an irrigant.
Small file is introduced in canal as far asapical region
Root canal filled with an irrigant solution &ultrasonically oscillating file activates the
irrigant
Irrigant penetrate easily into apical part ofroot canal
Cohens 10th edition
INSTRUMENTS FOR FILLING ROOT CANALS:
8/22/2019 endodontic insruments-1
106/114
SPREADERS
used to compact gutta percha in root canalobturation.
8/22/2019 endodontic insruments-1
107/114
Finger spreader
Hand spreader
Pl ggers ha e diameter larger than
8/22/2019 endodontic insruments-1
108/114
Pluggers have diameter larger than
spreaders & have blunt end.
Hand pluggers
8/22/2019 endodontic insruments-1
109/114
NiTi finger spreader and plugger.
LENTULOSPIRAL: use for placement of the sealer,
8/22/2019 endodontic insruments-1
110/114
cement & Ca(OH)2 dressings.
SOTOKAWAS CLASSIFICATIONOF INSTRUMENT
8/22/2019 endodontic insruments-1
111/114
DAMAGE
Ingles 5th edition
INSTRUMENTS FOR RETRIEVING
8/22/2019 endodontic insruments-1
112/114
MASSERANN KIT - INTRODUCED BY MASSERANN
Trepan bur
Extractors
Masserann kit
BROKEN INSTRUMENTS AND POSTS
REFERENCES
8/22/2019 endodontic insruments-1
113/114
REFERENCES
Ingles 5th edition Ingles 6th edition
Cohens pathways of pulp 6th edition
Cohens pathways of pulp 9th edition
Cohens pathways of pulp 10th edition Weines endodontic therapy 6th edition
Grossmans 12th edition
Christos B. Evaluation of irrigant flow in the root
canal using different needle types by an unsteadycomputational fluid dynamics model.JOE,2010
Li-sha Gu. Contemporary irrigant agitationtechniques and devices.JOE 2009;35(6)
8/22/2019 endodontic insruments-1
114/114