ENDODONTICS Lec 6

Classification of
Endodontic Instruments
1
Term

.Classification of dental instruments ‫هنتكلم دلوقتي عن‬

:‫ أهمها‬Endodontic instruments ‫ لـ‬Several classification ‫فيه‬

1 ISO FDI grouped root canal instruments according to their method of use
method ‫ ع حســب طريقــة االســتخدام‬Endodontic instruments ‫ وهنــا هنقســم الـــ‬iso classification :‫أوال‬
:‫ إلــى‬of use

Group I Hand use only e.g. K and H-files, reamers, broaches,......

.k files ‫ زي‬Contra ‫ من غير‬manual ‫الجروب األول؛ ودي األدوات اللي بنستخدمها‬

Latch type Engine driven: Same design as group I but can be attached
Group II
to handpiece. Ex: Rotary Nickel titanium files.

.attached to contra ‫ بمعني بنستخدمها عن طريق‬latch type ‫الجروب التاني؛ ودي‬

Drills or reamers latch type engine driven e.g. Gates-Glidden, Peeso

Group III reamers.

Group IV Root canal points like gutta-percha, silver point, paper point.

‫ زي الـــ‬root canal System ‫ اللــي بنســتخدمها ونعــوض بيهــا الـــ‬restoration ‫الجــروب الرابــع؛ ودي عبــارة عــن الـــ‬
.Paper point ‫ و‬Gatta percha

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2 Grossman classification (according to function)

:‫ إلى‬function ‫ ع حسب الوظيفة‬Endodontic instruments ‫ وهنا بنقسم‬Grossman classification :‫ثانيا‬

Exploring To locate orifice of the root canal e.g. smooth broach, endodontic
instruments explorer.
localization ‫؛ ودي عبــارة عــن أي أداة هتعملــي‬exploring instruments :‫أوال‬
orifice of root canal ‫تحــدد مــكان‬
.Dg60 ‫ أشهرها‬.. Endodontic explorer or probe ‫زي‬

Extirpating Barbed broach.

instruments
.pulp tissue ‫ لـ‬remove ‫؛ ودي عبارة عن أي أداة هتعمل‬extirpating instruments :‫ثانيا‬

Shaping Files / reamers.

instruments
‫؛ ودي عبــارة عــن أدوات تســتخدم عشــان تعملــي‬shaping instruments :‫ثالثــا‬
. ‫ تشــكل قنــوات العصــب‬canals ‫ لـــ‬shaping

Obturating Spreader, plugger.

instruments
.obturation ‫؛ ودي أدوات نستخدمها عشان أعمل‬obturating instruments :‫رابعا‬

3 According to their sequence of usage during Performing root canal procedure

:‫ إلى‬sequence of using ‫ ع حسب ترتيب االستخدام‬Endodontic instruments ‫ هنقسم الـ‬:‫ثالثا‬

1 Diagnostic instruments 4 Obturating instruments

3 Enlarging instruments
2 Extirpating instruments 5 Miscellaneous

‫ هنسـتخدمها هي‬instruments ‫ من‬Category ‫ اذن اول‬diagnosis ‫ بنبـدأ نعمـل‬Endodontic treatment ‫أوال فيـه‬
.diagnostic instruments
.Extirpating instruments ‫ باستخدام‬pulp tissue ‫ لـ‬remove ‫ ونعمل‬Access preparation ‫ثم بتفتح السنة ونعمل‬
.Enlarging instruments ‫ باستخدام‬root canal ‫ لـ‬Shaping ‫ واعمل‬Cavity ‫ثم أبدأ أوسع الـ‬
.obturating instruments ‫ ونقفل باستخدام‬restorative material ‫وبعدين هنحط‬
‫ زي‬miscellaneous instruments ‫أي انسـترومنت هنسـتخدمها ومـش متصنفة تبـع األربعة اللي فـوق هنسـميها‬
.Endodontic ruler, Apex locator, rubber dam ‫الـ‬

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:‫ بالتفصيل‬sequence of using ‫ ع حسب‬classification of endodontic instruments ‫هنبدأ ندرس الـ‬

.Basic instruments, visual aids ,Vitality test and radiograph ‫ودي بتشمل‬

[1] Basic examination instruments (mirror, explorer and tweezer)

.mirror , explorer, tweezer ‫ زي‬Basic instruments ‫ ]الـ‬
1 Mirror: Retraction and Reflection during working inside oral cavity ‫بتستخدم يف‬
2 Tweezer: handling of Gatta percha,paper point and cotton ‫يستخدم يف‬
3 Explorer:
L ‫ بيكــون‬side ‫ فيــه ناحيتيــن‬double ended instruments ‫ وده بيكــون‬،Dg 60 ‫أشــهره‬
Straight ‫ التانــي بيكــون‬shape ،side
• L shape end:
unremoved part of pulp chamber during access ‫ لـــ‬detection ‫بيســاعدني أعمــل‬
‫ مشــلتهوش أقــدر أحــدده وأتأكــد‬pulp chamber ‫ بمعنــي لــو يف جــزء مــن‬preparation
.‫ وال أل‬complete deroofing of pulp chamber ‫إذا عملــت‬
• Straight part:
I- Diagnostic ‫ بمعنــي نحــدد‬orifice of root canal ‫ لـــ‬for exploring or localization ‫وده بنســتخدمه‬
.orifice ‫مكان الـــ‬
instruments
[2] Visual aids i.e. magnifying elements

Magnification & ‫ وده بتدينــا‬magnifying loops ‫ زي‬Visual aids ‫ ]تانــي حاجــة الـــ‬
.illumination during root canal treatment

[3] Vitality testing:

1 Neural tests: Thermal pulp tester, Electrical pulp tester.

2 Vascular tests:
vitality of tooth during diagnosis ‫ يســتخدمها عشــان احــدد‬certain tools ‫ ]عبــارة عــن‬
:‫ممكــن أســتعمل‬
• Neural tests: hot & cold application ‫ عن طريق‬thermal test ‫ودي عبارة عن‬
• Electrical pulp testing:
‫ أو‬low electrical current ‫ لــو بيدينــي‬،tooth vital or not ‫بســتعمله عشــان أحــدد هــل‬
non vital ‫ إذن الســنة‬No response ‫ أمــا لــو كان‬،tooth is vital ‫ إذن الـــ‬tentling sensation
• Vascular tests: more accurate to detect vitality of tooth ‫وده بيكون‬

[4] Radiographs:

1 Intra oral / Extra oral.

2 Conventional / dgital.

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◊ Surgical operating microscope Magnification aids the practitioner in locating anatomical

structures, detecting of cracks or fractures, removing obstructions, and managing treatment
complications effectively.
◊ Function of surgical microscope?? ‫إيه وظيفته‬
better Magnification & illumination ‫ هيديني‬1
mises canal ‫ زي لو يف‬Anatomical structures ‫ ل‬localization ‫ هيساعدني اعمل‬2
Cracks ‫ ل‬detection ‫ هيساعدني اعمل‬3
pulp stone ‫ زي‬Removal of obstructions within pulp chamber ‫ واعمل‬4
separated ‫ زي لو عندي‬Removal of obstructions within root canals ‫ هيسـاعدني اعمل‬5
instruments, post
Complete management of treatment complications during root ‫ هيسـاعدني اعمل‬6
‫ اللـي ممكـن يحصـل وانـت بتعمـل‬perforation ‫ ل‬repair ‫ زي اعمـل‬canal treatment
access cavity preparation

Remove of vital pulp tissue as one piece ‫وظيفتها ايه ؟؟ بتعمل‬

II- Barbed (nerve) broaches and Rasps:
Extirpating
instruments ] These instruments used primarily for vital pulp extirpation. They are also used to
loosen debris in necrotic canals or to remove paper points or cotton pellets that
have accidentally become lodged in the root canal.
] Broaches are manufactured from round wire, the smooth surface of which has
been notched to form barbs bent at an angle from the long axis.
‫ ]شكله عامل ازاي؟؟‬
slight ‫ واعمــل‬inside roots ‫ بقــدر ادخلــه‬notched ‫ بتكــون‬instruments ‫عبــارة عــن‬
‫ هيحصلهــا‬central Barbs projection ‫ وبيكــون فيــه زي اشــواك جانبيــة‬rotation
pulp tissue as one piece ‫ لـــ‬engagement

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‫ ]وظيفتها ؟؟؟‬
1 Facilitate Removal of vital pulp tissue from root canal as one piece.
2 Used mainly in large root canal ex: palatal root canal of upper 6 , distal canal
of lower single rooted teeth.
Extirpating
‫ مــش هينفــع نســتخدمها ألن ممكــن يحصلهــا‬Narrow root canal ‫امــا يف الحــاالت‬
instruments ‫ وهنستخدم‬roots of multi rooted tooth, mesio buccal root of upper 6 ‫ زي‬fracture
.small K files ‫وقتهــا‬
• K files used to remove pulp tissue from narrow canals.

.. ‫ وهنقسمها لـ‬Shaping of root canal ‫تستخدم يف‬

[1] Hand driven enlarging instruments

a- Basic enlarging instruments:

for enlarging and cutting dentin from lateral wall ‫ هنســتخدمها يف‬files ‫عبــارة عــن‬
of the canal
1 K-file:
‫ بطريقــة‬twisting ‫ بتعملــه‬Square cross section ‫ ليهــا‬metal blank ‫عبــارة عــن‬− 
working side of file ‫ وده‬flades ‫ او بنســميها‬to produce horizontal cut blades ‫معينــة‬
III- Enlarging
flades , shaft , plastic handle ‫يعني بتتكون من‬− 
instruments working length ‫ وده هيساعدني احدد‬rubber stopper ‫ويف جزء بنسميه‬− 
: ‫بستخدمه يف ايه ؟؟؟ اقدر استعمله بـ‬− 
• Reaming motion ‫وهنا بعمل‬: rotation of files inside root canal against reticular dentin.
• Filing motion ‫وهنــا بعمــل‬: cutting of dentin of root canal by pushing & pulling
against lateral walls of canal.
2 K-reamer:
.k files ‫ عدد االلتواءات بيكون أقل مقارنة ب‬flades ‫ بس عدد‬k files ‫شبه‬− 
3 H-file (Hedstrom file).

b- Hybrid (modified) enlarging instruments

[2] Engine driven instruments

.attached to hand piece ‫ هتكون‬instruments ‫عبارة عن‬− 

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Files:
◊ Files are instruments that enlarge root canals with apico-coronal insertion and
withdrawal motions.
K-files:
◊ They are manufactured by twisting square metal blanks along their long axis,
producing partly horizontal cutting blades.

K-file K-reamer
Flutes per length unit Flutes per length unit
No. of flutes
(1.5 - 2.5 / mm) (0.5 - 1 / mm)
Cross-section Square Triangle

Flexibility Less flexible More flexible

Motion Filling/reaming motion reaming motion

Enlarging
instruments
:‫إيه الفرق بين‬
K files k reamer
.k files ‫ بتكون عددها اكبر يف‬:flutes ‫عدد‬n  
‫ وبالتالــي‬metal than k reamer ‫ وبالتالــي عنــده‬Square ‫ بيكــون‬:K fileso 
.‫ اقــل مرونــة‬less flexible ‫هيكــون‬

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H-Type Instruments (Hedstrom files):

◊ The cross-section is coma shaped (tear drop) with one cutting edge.
◊ This file is constructed from round stainless-steel wire by machine grinding
forming a series of intersecting cones.
filing motion ‫ اقدر استعمله بس يف‬،succisive cones ‫ عبارة عن‬H files
◊ Contra indicated to be used in reaming motion.

Instrument Design

a- Tip Design:
• In root canal preparation, an instrument tip has two main functions:
1 Guide the file through the canal.
2 Aid the file in penetrating deeper into the canal.
the starting point of any ‫ ألنهــا‬cutting or not ‫ ودي مهمــة جــدا ســواء كانــت‬tip design− 
Enlarging instruments
instruments ‫ وهتســاعدني يحصــل‬،orifice of root canal ‫ أنــه يدخــل‬files ‫ هتوجــه‬:‫هتســاعدني يف‬− 
.penetration
b- Taper:
• The taper usually is expressed as the amount the file diameter increases each
millimeter along its working surface from the tip toward the handle.
c- Alloys:
• There are currently two principally different types of alloys used for endodontic
instruments, stainless steel and nickel titanium.
flexible ‫ وال‬rigid ‫ هيكون‬file ‫ودي بتحدد الـ‬− 
‫ ؟؟؟؟‬flexible instruments ‫طب ليه بتحتاج‬− 
‫ عشــان‬curved ‫ بمعنــي بتكــون‬degree of Curvature ‫ بتكــون فيهــا‬canals ‫ ©معظــم الـــ‬
‫ زي‬flexible instruments ‫ الزم يكــون‬canals ‫ ده واخــد شــكل‬curvature ‫اقــدر امشــي مــن‬
.Nickel titanium instruments
‫ عندهــا‬cutting efficiency ‫ و‬rigid ‫ فــدي بتكــون‬stainless steel instruments ‫ ©أمــا الـــ‬
. ‫أعلــي‬
nickel titanium instruments ‫ بتكون اعلي عند‬Flexibility .. ‫أخيرا‬− 
stain less steel instruments ‫ اعلي عند‬.Cutting efficiency ‫أما‬− 
Nickel titanium instruments ‫ لـ‬Grinding ‫وكمان بنستعمل‬− 
stainless steel instruments ‫ لـ‬twisting ‫أما‬− 

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Manufacturing

• K-file fabricated by twisting.

• Hedstrom file fabricated by grinding.
Enlarging
− Grinding is usually necessary for nickel- titanium instruments because of their
instruments superelasticity, they cannot be twisted.

‫ ؟؟‬obturating instruments ‫ايه هي‬− 

a- Spreader:
lateral condensation ‫ يستخدمها يف‬pointed instruments with sharp tip ‫ •ودي بتكون‬
or compaction of gutta percha
b- Pluggers:
IV- Vertical condensation or ‫ يســتخدمها يف‬flat end instruments ‫ •ودي بتكــون‬
Obturating compaction of soften gutta percha inside root canal
Instruments c- Lentulo spiral:
Application of sealer inside root canal ‫ •وده بنستخدمه لـ‬

‫ اللــي فــوق فــدي‬categories ‫ مــش متصنفــة تبــع األربــع‬instruments ‫أي‬− 

:‫ زي‬miscellaneous instruments ‫بنســميها‬
a- Endo meter: length of files ‫بقيس بيه‬
b- Apex locator: length ‫ يحدد بيه الـ‬electrical device ‫عبارة عن‬
V-
Miscellaneous
Instruments