Introduction

In an endodontic treatment, the root canal system is

our road map to success. In the past, we have been
thinking only vertically. Many students were taught
that the first concern in root canal preparation was
working length. Now, we understand that the critical
issue is three-dimensionality.
oot canals e!ist as multiple inter-relationships. oot
canal systems are not cylinders but ribbons, sheets and
banners. "ccentrically and abnormality are normal.
#lmost $% years ago, &childer introduced the concept
cleaning and shaping.

'hese ( concepts are inseparable. 'he secret to successful

clinical endodontics is proper shaping.
)
Cleaning:
efers to the removal of all contents of the root canal
system before and during shaping.

&ubstrates, microflora, bacterial products, foods, caries etc.

Shaping
efers to a specific cavity form with particular design
ob*ectives. 'he shape permits vertical pluggers to fit
freely within the root canal system and to general
hydraulics re+uired to transform and capture a
ma!imum cushion of gutta-percha and sealer into all
foramina.
'he purpose of this seminar is to provide the rationale and
techni+ues for proper cleaning and shaping of the root canal
system, which will enable the clinician to obturate the system.
#s with many aspects of dental profession, such as a
denture being no better than the initial impression, or
an inlay being no better than the tooth preparation, it
(
follows that canal obturation will be no better than the
cleaning and shaping of the entire system.
,enerally speaking, the ( main ob*ectives in canal cleaning
and shaping are-
Biologic Mechanical
.iologically, the
goal of intracanal
procedures is to remove all
pulp tissue remnants and
micro-organism and their
substrates along with
infected dentin.
Mechanically $-/
shaping of the canal is the
ob*ective which must be
accomplished to achieve
biologic cleaning.
BIOLOGIC OBJECTIVES
). 0onfine all instrumentation within the root canal space to
maintain its spatial integrity.
epeated instrumentation e!tending beyond the
constriction is unwarranted. It causes peri-radicular
inflammation and often destroys the normal biologic
constriction of the root ape!.
$
(. #void pushing contaminated debris past the confines of the
apical constriction.
Many instances of post treatment pain and swelling can
be attributed to necrotic tissue and micro-organism and
their to!ins being inoculated into the peri-radicular
tissues as a result of indescriminate cleaning
procedures. 'his induces a rapid immunologic
response.
$. emove all the potential irritants from the entire canal
system.
'his avoids recurrent peri-radicular inflammatory and
creates a condition that permits prompt, uneventful
healing.
1. "stablish the e!act 2.3 and completely clean and shape the
canal system during the first treatment visit.
4. 0reate sufficient width in the coronal half of the canal system
to allow for copious flushing and debridement.
1
MECHANICAL OBJECTIVES
). /evelop a continuously tapering conical form in the root
canal preparation.
'he final preparation of this system should be an e!act
replica of the original canal configuration in shape,
taper, and flow only larger. 5nly too often, canals are
simply bored out with the clinician failing to
consider the spatial relationship of the canal to the
overall root anatomy.
(. 6repare a sound apical dentine matri! at the /0 *unction.
'his provides the resistance form to the intraradicular
cavity preparation. 'his also prevents the over-
e!tension of instruments and controls the apical
movement of gutta-percha sealer during obturation.
4
$. 6repare the canal to taper apically, with the narrowest cross-
sectional diameter at the apical termination 7apical dentin
matri!8.
'he apical third of the canal preparation must provide
a tapering 9 parallel, spatial configuration in order to
ensure a firm seating of the gutta-percha and sealer.
'he three-dimensional shape of the preparation,
especially of the apical )9$
rd
, must provide a retentive
cavity to enhance condensation procedures.
1. 0onfine cleaning and shaping procedures to the canal system,
thereby maintaining the spatial integrity of the apical
foramen.
#dherence to this principle prevents violation of the
peri-radicular tissues. 'his principle is evident when
foramina are transported 7moved8 during e!cessive
apical instructions.
:
"!ternal transportations takes (
forms and may occur when
instrumentation is carried
beyond the apical matri!.
Internal transportation occurs
when the foramen becomes
clogged with dentin mud 9
denticles
ipping of the
apical end of
the foramen
resulting in a
tendrop 9
hourglass shape
/irect
perforation
begins with a
ledge or apical
blockage
"!ternal transmission is caused
by failing to precurve files, or
being too heavy handed
4. emove all residue of cleaning and shaping procedures that
could prevent patency of the apical foramen i.e. dentin
shavings and tissue debris.
ecapitulation is essential to all cleaning procedures
ignoring this important step will often lead to ledges,
loss of canal length, dev of false canals etc.
;
reparator! procedure"
1) MAF-Master apical file
Is the largest file that binds slightly at correct 23 after
straight line assess. It is determined by passively
placing the successively larger files at the 0.2.3. until
correct si<e is reached which binds at the tip.
2) Pre curving of instruments
# precurved file is a valuable tool for feeling canal
passages and for moving around calcification, ledges
and around curved foramina.
It is used also in an attempt to alleviate the diverse
effects of canal curvature.
'he primary difficulty is limited areas coronal to the
curvature.
May be done with a cotton wool roll, commercial
devices.
=
Method" o# Cleaning and Shaping
0leaning and shaping are dynamically delicate
motions, flowing, rhythmic, and energetic. In order to
use files and reamers efficiently, the movements
re+uire distinction. 'here are : distinctive motions of
files and reamers.
A) Follow:
>sually performed with files.
#re used initially during cleaning and shaping or any
time an obstruction blocks the foramen.
Irrigating, precurving different kinds of curves,
curving al the way to the tip of the instrument, and
multiple curves in multiple directions of the instrument
are all part of follow.
3) Follow-withdraw
?iles are used.
@
'his motion is used once the foramen has been reched
and the ne!t step is to create the path from access
cavity to foramen.
'he motion is follow, then withdraw or follow and
pull or follow and remove. It is simply an in A or A
out, passive motion that makes no attempt to shape the
canal.
4) art
efers to the e!tension of a reamer, to or near the
radiographic terminus.
'he reamer should gently and randomly touch the
dentinal walls and cart away debris.
!) arve
Is for shaping.
eamers are used.
)%
'he key is not to press the instrument apically but
simply and to touch the dentin with a precurves reamer
and shape on withdrawal randomly.
") #mooth
Is accomplished with files.
In the past, most endo procedures were performed with
a smoothing or circumferential filing motion.
If the previous four motions are followed smoothing is
rarely re+uired.
$) Patenc%
Is achieved with files9 reamers.
It means that the portal of e!it has been cleared of any
debris in the path.
))
Motion o# in"tru$entation % en&elope" o# $otion:
A) Filing:
Indicates a push-pull action with the instrument. 'he
inward passage of the file is powered by the hand and
the rigidity of the file. # canal wall can be damaged
very +uickly by this motion 7use of passive insertion
and pulling withdrawal from canal8.
'his is an effective techni+ue with B-file since they do
not engage during the insertion action and cut
efficiently during the withdrawal motion.
'i"ad&antage":
2ith B-file that it can easily cut three middle of a
curvature and cause strip perforation.
&) 'eaming
Indicates clockwise 9 right-hand rotation of an
instrument. 'he instrument must be restrained from
)(
insertion to generate a cutting effect. Instrument C is
increased when this motion is employed.
) (urn-and-pull
Is a combination of reaming and filling, the file is
inserted with a D turn clockwise and inwardly directed
hand pressure 7i.e. reaming8 positioned into the canal
by this action, the file is subse+uently withdrawn 7i.e.
filling8.
'he rotation during placement sets the cutting edges of
the file into dentin and the non-rotating withdrawal breaks
local the dentin that has been engaged.
'i"ad&antage":
Bourglass canal shapes were observed by 2eine.
According to #childer
0lockwise rotation of a half-revolution followed by
withdrawal. 'he file is not inserted towards the ape!,
)$
rather, he gradually allows the preparation to progress
out of the canal.
D turn to right followed by straight pull out
)) *atch-winding
Is the back-and-forth oscilation of a file 7$%-:%E8 right
and 7$%-:%E8 left as the instrument is pushed into the
canal.
It is an e!panded use of the insertion techni+ue
described by Ingle as Faiven.
'his back-and-forth movement causes the files and
reamers to plane the walls efficiently.
In a way, this is a predecessor to the balanced force
techni+ue, as the $%-:%E of clockwise rotation pushes
the file tip and working edges into the canal and the
$%-:%E of counter clockwise motion partially cuts away
the engaged dentin.
)1
+) *atch-winding and pull
2hen used with B-files, watch winding cannot cut
dentin with the backstroke. It can only wiggle and
wedge the edges tightly into the wall.
2ith each clockwise turn, the instrument moves
apically until it meets resistance and must be freed with a
pull stroke.
F) &alanced force techni,ue
'his calls for oscillation of the preparation instruments
right and left with different arcs in either direction.
'o insert an instrument, it is rotated to the right
7clockwise8 a +uarter turn. 'his pulls the instrument
into the canal and positions the cutting edges into the
walls.
Ne!t, it is rotated left 7counterclockwise8 at least )9$
rd
of the revolution to unthread the instrument and drive
it from the canal.
)4
Ad&antage":
&imultaneous apical and counter-clockwise rotation of
file strikes a balance between the tooth structure and
instrument elastic memory. 'his balance locates the
instrument very near the canal a!is, even in severely
curved canals, so this techni+ue avoids transportation.
It works effectively without pre-curving.
):
Techni(ue" #or preparing root canal":
Apical coronal techni(ue Coronal)apical techni(ue
In which the 23 is established
and the full length of the canal is
then prepared.
In which the coronal portion of
the canal is prepared before
determining the 23
e.g.
- &tandardi<ed.
- &tep-back.
- oane 7balanced force8
Advantages:
#llows early
debridement of the coronal
part of canal which may
contain bulk of organic
debris.
"nables better and
deeper penetration of irrigant
early in the preparation.
'ends to shorten the
effective 23 and determining
the 23 after such
enlargement will reduce the
problem of its alteration
during preparation.
#llows better control
over apical instrumentation.
e.g. -
- &tep-down.
- /ouble-flare.
);
- 0rown-down pressureless.
- 0anal-master
Apical coronal
1) #tandardi-ed preparation:
- /one in narrow canals with circular cross-sections.
23 determined.

&mallest instrument ad*usted to 23.

&e+uentially enlarged entire canal.

5bturation with silver cone.

'i"ad&antage":
- isk of e!trusion of debris.
- #lteration of 23.
- Fertical root C is overinstrumentation is carried out.
2) #tep .ac/ preparation:
23 determined.

Instrument that fills to correct 23 is chosen.

"nlarge $ NoGs larger at the ape!.

)=

educe the 23 length by )mm and continue to enlarge canal 9

flaring.

ecapitulate, irrigate for patency.

0oronal preparation done using ,,/.

'i"ad&antage":
- "!trusion of debris.
- #pical blockage.
- #lteration of 2.3.
- 'endency for canal deviations.
3) 'oane (echni,ue 0&alanced Force)
'hree of its main features are-
- 0anals are prepared to predesigned dimensions of which $
are recogni<ed and are 14, :% and =% according to the si<e of
apical preparation.
- 'hese dimensions refer to the si<e of the file used at the third
step back.
)@
- "ach step-back from the master apical file at the 6/3 is
%.4mm shorter than the previous one. 'his is termed as the
apical control <one.
- ?le! files are used.
- 23 determined to the radiographic ape! with the largest file
placed without force. 'his helps in determining the selection
of predesigned preparation 714, :%, =%8.
Coronal apical techni(ue
1) #tep down techni,ue:
- Is a modification of the step-back techni+ue.
6repare the coronal portion to ):-)= mm 9beginning of the curve
with anti-curvature filling.

,,/Gs are used to refine the coronal part.

/etermine 23.

>sing step-back, complete the apical preparation.

'i"ad&antage":
- 3edge formation.
- #pical blockage.
(%
- 6erforation.
'hrough this techni+ue overcomes most of the disadvantages
of the step-back techni+ue.
()
2) )ou.le Flared (echni,ue:
/etermine 2.3.

6repare till )1 mm 9 coronal to the curve.

Irrigate and clean.

,o )mm deeper, maintaining instrumentation coronal to the

curve and file.

#gain )mm deeper.

0ontinue till 23 is achieved.

6repare using step-back

Indication":
- ?or straight canals or
- ?or straight portions of curved canals.
Contra indication":
- In calcified canals.
- In young permanent teeth with open apices.
3) rown-down pressureless techni,ue:
- ?or curved canals without causing deviations. otary action
is used to cut dentine with the apical part of files.
((
/etermine 23 and prepare till C $4 till ):mm 7widen the canal
with smaller files first8

educe si<e H go down and enlarge till ape!.

0hange to C1% H repeat.

4) anal master techni,ue:
- Its aim is to aid the maintenance of curves using a rotary
instrument designed so that only the apical )-(mm is engaged
in dentine removal.
Ad&antage":
- #voids the need for recapitulation.
- 'he apical %.;4mm of the hand instrument is safe-ended to
facilitate maintenance of canal curvature.
/etermine 23

6repare to the beginning of the curve

>se canal master in step-back fashion.

($
H!*rid)techni(ue
- 0onsists of reaming the apical third and filing the coronal
two-thirds.
- 'he coronal preparation is obturated using gutta-percha.
C+,VAT+,E)THE ENGINE O- COMLICATIONS
- #s an instrument is curved, elastic forces develop internally.
'hese forces attempt to return the instrument to its original
shape and are responsible for straightening of the final canal
shape and location.
- 'hese internal elastic forces 7i.e. restoring forces8 act on the
canal wall during preparation and influence the amount of
dentin removed. 'hey are particularly influential at the
*unction of the instrument tip and its cutting edges. 'his
region is the most efficient cutting surface along an
instrument, and when activated by the restoring forces, it
removes more tissue. 'his phenomenon is responsible for
apical transportation and its conse+uences.
(1
./ re)cur&ing o# in"tru$ent"0
1/ Anti)cur&ature #iling
- Is the controlled and directed preparation into the
bulky9safety <ones and away from the thinner portions or
danger <ones of the root structure, where perforation or
stripping of the canal walls can occur.
1eed:
- It is a method of applying instrument pressure so that shaping
will occur away from the inside of the root curvature in the
coronal and middle )9$
rd
of a canal.
- 2as described by #bou-ose, ?rank and ,lick. 'hey
emphasi<ed that during shaping procedures, files should be
pulled from canals as pressure is applied to the outside canal
wall. 'his dimensionally applied pressure, prevents
dangerous midcurvature straightening in curved canals.
(4
Ad&antage":
- It maintains the integrity of canal walls at their thin portion
and reduces the possibility of root perforation 9 stripping.
- Maintains digital control over the instrument and the
preparation of the curved canal is used.
'op of the handle is pulled
into the curvature while the
shank is pulled away 7anti-
curvature8
2/ ,adicular acce""
- 2as first promoted by &childer.
- 'his creates space in the more coronal regions of the canal
which enhances placing and manipulating subse+uent files as
it increases the depth and effectiveness of irrigation.
- May be accompanied by rotary instrument 9 circumferential
filing.
(:
3/ ,e&er"i*le -laring % re)#laring
- Is the presently preferred development of flaring whereby the
coronal portion of the preparation is flared before the
completion of the apical portion.
- In the standard flaring techni+ue, the apical portion of the
tooth is completed before any filling is performed.
- In the reverse flaring and aspects of preparations are carried
out.
- Minimal filling at the tip enlargement of the coronal part
ape! is completed apical flaring.
Ad&antage":
- Irrigants are allowed to get down the canal earlier and farther
to produce cleaning.
- In curved canals, more effective preparation of the apical
area is provided when the file has fewer obstructions in the
coronal part.
(;
- ?iles, pluggers, filling material can penetrate to the ape!
more easily three a larger orifice.
In"tru$ent" u"ed #or ,e&er"e -laring
- %.1 taper instruments 7Ni-'i8.
- MeIIM
#vailable in 4 instruments A (4.%.(4 at /o 7%.%$, %.%1,
%.%14, %.%4, %.%44 9mm A tapers8.
>sed in gear reduction handpieces at $1% rpm.
Made from Ni-'i in B-style.
/esigned by Mac&padden.
itano ?iles.
Band instrument with B-configuration with several
tapers.
Made in lengths shorter than ()mm.
(=
reparation u"ing Auto$ated 'e&ice"
'i"ad&antage":
- 3oss of tactile sense and lack of control of where and how
much dentine is removed from the root canal wall.
Cla""i#ication:
2) 'otar%
- >sed in slow running standard handpiece e.g., ,,/, 6eeso,
0anal master A used only in the structure part.
- 3atest deviation is the new ):-) gear reduction handpiece
Ni'i matic at $%%rpm.
- Ni-'i files are used.
- >sed for preparation of severely curved canals.
- ?iles are manufactured with an off-centre tip that facilitates
negotiating around curvatures and ledges.
(@
22) 'eciprocal ,uarter turn:
- 'his uses a special handpiece that contrarotates the
instrument three @%E.
- ".g. ,iromatic 7)@:18.
- "ndocursor.
- "ndolift A has a vertical component in addition to the
rotation.
'i"ad&antage" o# Auto$ated
- Band instrument re+uires the same amount of time as
automated.
- ?lare preparation with hand instrument tends to remove
debris from within the canal system than automated.
- #utomated is difficult to use in the most post regions of the
oral cavity.
- 'here is greater propensity for the automated system to
produce <ipped canals, ledges etc.
$%
- # controlled power-assisted system designed to eliminate the
original problems encountered by ,iromatic appeared in
)@=).
- /ynatrak
- >ses stainless steel instruments with increased fle!ibility
consist flute depth and curved canals and rounded tip to
minimi<e and control ledges, <ips, etc.
222) 3ertical
- 0anal finder.
- Bas a vertical movement of $-) mm and free rotational
movement.
- Instrument used is canal master 7B-file with a safe ended
tip8.
- 0anal 3ender.
- Fertical movement of %.1-%.= mm
$)
$ instrument J-file with a safe ended tip.
B-file.
>niversal file 7fle!ible B-file with a safe-ended tip8.
23) 'andom
- ".g. "!calibur.
- J-files.
- (%,%%%-(4,%%%rpm.
3) #onics
- "ndostar 4
- "ndosonic #ir $%%%
Ad&antage":
- educes fatigue and stress during preparation.
32) 4ltrasonics
Magneto"tricti&e ei4oelectric
- e+uires B
(
5 cooling - Most common
- No B
(
5 cooling
- May produce apical widening
and ledges in curved canals.
Ad&antage":
$(
- 0leaning effect is by acoustic streaming.
BIOMECHANICAL ,EA,ATION
Content"
Introduction
Mechanical K .iological 5b*ectives
Methods of 0leaning K &haping
Methods of Instrumentation
'echni+ues for 6reparing oot canal
Band #utomated
#pical coronal 0oronal #pical
0leaning K &haping in curved canals
$$