Files are the instruments most used for cleaning and shaping the root canal system. Traditionally they are manufactured from stainless steel in the form of a filament with a round cross-section and an ISO .02 Taper. They are firstly precision ground in such a way as to have a quadrangular cross-section and then twisted clock wise to achieve the definitive form. The number of spirals per mm (pitch) for stainless steel files can very slightly depend on the manufacturers but is always more (generally double) than that of the reamers; their blades are furthermore positioned perpendicular to the long axis of the instrument giving files a particularly efficient cutting action during filing(- CANTATORE, G.:Preparazionecanalare con strumentimeccanici Ni-Ti. Dental Cadmos (Dossier). 2:11, 1996. - CANTATORE, G.: Evolution des techniques d¶instrumentationcanalaire. European Dental Magazine Le Monde Dentaire. 87:11, 1998. - KRELL, K.V.: Endodontic instruments. In: Walton R.E., Torabi-nejad M. (eds.): Principles and practice in endodontics. W.B. Saunders Company, Philadelphia. p. 149, 1989.) K FILES The K-type file was first introduced in 1901 and receives the name K-type from the holder of its original patent, the Kerr Manufacturing Company.K-Files are made by twisting a steel wire with a square cross-section. In cross-section a K-File has a robust quadrangular design which increases its resistance to torsion and flexion making it particularly useful in the initial negotiation of the canal; the four pointsof contact by the blades against the canal walls improve the tactile perception of the operator, making the KFilethe ideal instrument for exploring (scouting) endodontic anatomy. The tip of the K-File is cutting and has an aggressive transition angle with the first spiral capable of causing ledging especially when using the less flexible instruments in curved canals. The K-Files produce large amounts of dentinal debris, which can block the spirals of the files making them less efficient at cutting and the push and pull action can push debris apically, causing a plug and blocking the foramen. After having dominated the market for 65 years, K-style endodontic instruments came into a series of modifications beginning in the 1980s.
Modifications of K-style files K-flex files The Kerr Manufacturing Company in 1982 introduced a new instrument design that they termed the K-Flex File(Sybron Endo/Kerr; Orange Calif.). Itrepresents the first attempt to make a ³hybrid´ instrument, able to integrate the force and versatility of a K-File with the cutting aggression of a Hedstroem file.The crosssection of the K-Flex is rhombus or diamond shaped. The spirals or flutes are produced by the same twisting procedure used to produce the cutting edge of the standard K-type files; however, this new cross-section presents significant changes in instrument flexibility and cutting characteristics. The cutting edges of the high flutes are formed by the two acute angles of the rhombus and present increased sharpness and cutting efficiency. The alternating low flutes formed by the obtuse angles of the rhombus are meant to act as an auger, providing more area for increased debris removal. The decreased contact by the instrument with the canal walls provides a space reservoir that, with proper irrigation, further reduces the danger of compacting dentinal filings in the canal. Testing five brands of K-type files for stiffness, the San Antonio group found KFlex files to be the most flexible. Moreover, not a single K-Flex fractured in torque testing, even when twisted twice the recommended level in the ADA specification.(Roth WC, et al. A study of the strength of endodontic files. JOE 1983;9:228.)
K-flexo files The K-Flexofiles(www.dentsply-maillefer.com)are files in steel obtained by twisting a wire with a triangular cross-section. The FlexoFiles tip is rounded and has a transitional angle that is blunted making this instrument safer during the shaping of curved canals and particularly suited for the balanced force technique. (POWELL, S.E., SIMON, J.H.S., MAZE, B.B.: A comparison of the effect of modifyed and nonmodified instrument tips on apical canal configuration. J. Endod. 12:293, 1986. - POWELL, S.E., WONG, P.D., SIMON, J.H.S.: A comparison of the effect of modified and nonmodified instrument tips on apical canal configuration. J. Endod. 14:224, 1988.) They have a triangular cross-section which helps them to maintain a 3 point contact with the dentinal wall, at the same it; it makes the files less bulky and more flexible than conventional K-files.Furthermore, the increased space for the removal
of debris (due to the triangular design in cross-section) explains why there is less tendency with respect to K-Files to build dentin mud andto cause dangerous apical plugging with debris.( - NEWMAN, J.C., BRANTLEY, W.A., GERSTEIN, H.: A study of the cutting efficiency of seven brands of endodontic files in linear motion. J. Endod. 9:136, 1983.) The FlexoFiles are only available in ISO diameters of 0.15 to 0.40 mm and lengths 21, 25 and 31 mm. The K-FlexoFiles Golden Mediums(www.dentsplymaillefer.com) are identical to the K-FlexoFiles exceptthat the diameters have intermediate values comparedto those of the ISO standard.The K-FlexoFiles Golden Mediums infact are onlyavailable in ISO diameters 12, 17, 22, 27, 32 and 37.
Triple-flex file Kerr has introduced a hybrid instrument they call the Triple-Flex File (Kerr; Orange,Calif.) It has more spiral flutes than a K reamer but fewer than a K file.Made from triangular stainless steel and twisted, not ground, the company claims the instrument is more aggressive and flexible than the regular K-style instruments.
SA- K-file, B- Kreamer, C- K-flex file, D- triple flex file