Rotary Canal

Preparation

Dr. Ebtissam Al-Madi

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 Outline
• Objectives of Cleaning & Shaping
– Biological
– Clinical
– Mechanical
• Instrumentation Techniques
– Stepback technique
– Crowndown technique
– Rotary Instrumentation
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• Biological Objectives
– Removal of all tissue, bacteria and bacterial
products and substrates from the root
canal system
• Mechanical
– Shaping of the root canal system to
facilitate placement of a root canal filling
• Clinical
– Eliminate apical periodontitis and return
tooth to normal function
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 Cleaning

Endodontic
Triad
Shaping Filling

Shaping to facilitate cleaning and Filling

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 Restoration

Obturation

Cleaning & Shaping

of the canal

Access
Preparation
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Stepback

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 Stepback Technique
(1960’s)
• The most widely used preparation
technique
• Replaced Non-tapering Preparation
technique

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 Stepback Technique
• Apical Preparation:
1. Establish access (straight
line)
2. Establish working length
3. File Instrument (watch-
winding, file, ream, etc)
4. Place next larger file,
instrument, and repeat till
you reach file 3-4 sizes
larger (MAF)

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 Stepback Technique
• Step back:
1. Place next larger file to a
length 1 mm shorter of
working length, file, irrigate
and recapitulate
2. Repeat process with
successively larger files at 1
mm increments shorter than
preceding file.

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 Stepback Technique
• Variations to the classic stepback
technique
– Initially enlarge coronal aspect with GG
burs
– Complete coronal preparation with GG
burs
– Use of small GG burs in mid-root level
– Use of Hedstrom files to flare the
preparation
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 Stepback technique
• Advantages • Disadvantages
– Minimize – Significant apical
procedural errors extrusion of debris
(transportation, (post-operative
ledging, apical pain)
perforation) – Apical blockage
– Canal deviation
– Alteration of
working length

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Crown down

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 Crowndown Technique
• More recent technique
• Produce similar result to step-back

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 Crowndown technique
• Development of straight-line access
• Eliminate pulp chamber obstructions
and check patency
• GG enlargement with size 4-3-2,
irrigate
• Coronal to mid root enlargement with
instruments from large to small,
irrigate
• Establish working length, irrigate
• Introduce progressively smaller files
deeper into the canal until resistance
is encountered
• Establish apical preparation size
• Complete preparation Al-Madi, 491 Den 14
 Crowndown technique
• Variations to the classic crowndown
technique
– Crown-down pressure-less technique
– Roane technique
– Double flare technique
– Modified double flare technique
– Rotary Instrumentation

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 Crowndown technique
• Advantages • Disadvantages
– Early blockage of
– Reduce apical canal
extrusion (reduce
pain)
– Elimination coronal
interferences
– Improved irrigation to
apical part of canal
– Facilitate working
length determination
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 Instruments

Hand Rotary
Instruments Instruments

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 Hand instruments
• Been in use for over 100
years
• Still integral part of
cleaning & shaping
• Better tactile sensation
• ISO standardization
• Broaches, k-files, Flex-
R files, NiTi files, H-
files

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Hand engine driven
• Properties of NiTi Alloy
– Superelasticity
– High resistance to cyclic fatigue
• Series 29

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 Rotary Files
• Advantages • Disadvantages
– Less transportation – Cannot be used in
and ledging some cases
– Shape canal – Buildup of debris
uniformly – Cannot use beyond
– Reduced operator apical foramen
fatigue – Fracture can occur
– Improved suddenly
efficiency – Initial cost
– Loss of tactile
sensation
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 Rotary Instruments
• Lightspeed • Protaper
• Profile • Sequence
• Hero • RaCe
• Quantec • V-taper
• K3
• Flexmaster
• GT
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 Design characteristics
• Non-cutting vs cutting
tip
• Tip size
• Taper
• Cross section
• Rake angle
• Helix angle
• Pitch

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Tip shape

• Tip could be
non-cutting,
cutting

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 Tip Size

• Can be the same as ISO hand

tips sizes- color coded accordingly
• Can be half sizes (12.5, 17.5,
etc) as in Light Speed.
• Can skip sizes ( only 20,30, 40)
as in GT rotary
• Can be nonspecific sizes
(according to percentages ex.
18.5, 20..) as in ProTaper.

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 Tip Taper

Taper ranges from 0.02 to 0.12

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 Tip Taper

• Constant taper- Variable tip

– Hand files (0.02)
– Profile 0.04
• Graduating taper- constant
tip size
– GT series
– Quantec
• Varying taper- different
tip sizes
– ProTaper

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 Cross section- Radial Lands

A radial land is a surface that projects axially

from the central axis, between flutes, as far as
the cutting edge

Non-cutting tips and

radial lands keeps a file
centered in the canal.

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Cross section- Radial Lands

Smaller radial land

equals decreased
strength for blade
support

Increased radial land

increases peripheral
strength behind the
cutting blade

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 Rake Angle
The rake angle is the angle formed by the cutting
edge and a cross section taken perpendicular to the
long axis of the instrument

Rake angles affect the

cutting efficiency and
the aggressiveness of
the file

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Rake Angle

Overly Positive Rake Angle

Positive Rake Angle

Neutral Rake Angle

Negative Rake Angle

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 Helical flute angles

The helical angle is the angle that the cutting edge

makes with the long axis of the file

• As the flute angle is

increased more debris
can be carried away
from canal.
• Constant helical flute
angles allow debris to
accumulate and are more
susceptible to the effect
of “screwing in” forces.

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 Pitch
Pitch is the number of spirals or threads per
unit length.

Constant pitch and

constant helical angles
produce a “pulling” or
“sucking down into” the
canal.

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 Lightspeed
(Senia & Wildey 1990’s)
• Long, thin non-
cutting shaft
• U shape design
• Most flexible RI
• Low incidence of
transportation,
preparation errors,
and loss of working
length
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 Profile
(Ben Johnson 1994)
• Increased taper
• Began as series 29
#0.02 taper, then
#0.04 and 0.06 tapers
• Profile (maillefer-
Europe) manufactured
tips similar to ISO
• Negative rake angle

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• Coronally pre-enlarge
• Use of Orifice shapers
• Alternative use of #.04
and #.06 tapers as well
as alternate tip sizes
• Same basic technique
for similarly designed
files

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Profile
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Profile

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 K3
(McSpadden)
• Predecessors:
Quantec
• Unique cross
sectional design
with +ve rake
angle, 3 wide radial
lands, peripheral
blade relief

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 ProTaper
(Cliff Ruddle, John West, Pierre Matchou)
• Only 6 instruments
• Modified k file
with no radial lands
• Varying taper that
increase coronally
in shaping files and
opposite in
finishing files

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ProTaper
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 Hybrid technique
• Instruments can be used in a manner that
promotes their individual strengths and
avoids their weaknesses
• Hand instruments secure a patent glide
path
• Tapered rotary instruments efficiently
enlarge coronal canal areas
• Less tapered instruments allow additional
apical enlargement

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 Newer Rotary
Instruments?
• Light Speed • RaCe
• Hero 642 • V-Taper
• GT files • Endo Sequence
• Quantec
• Flexmaster

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 More information
• Pathways of the Pulp 9th e-edition
• Endodontics- Ingle 5th CD editon
• Advanced Endodontics- Rhodes
• Endodontics- Stock
• JOE
• IEJ
• Company brochures & Videos
• Internet

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 How & Where to learn?
• Read & understand the brochure-
Don't be fooled!
• Read the literature in textbooks and
journals- Be an informed consumer.
• Try on extracted teeth till you
master the technique- try before you
buy.

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