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Endodontic Topics 2005, 10, 168–175 Copyright r Blackwell Munksgaard

All rights reserved ENDODONTIC TOPICS 2005

ProSystem GT: design, technique,
and advantages

This article details the design features of the GT System of Instruments and outlines the technique for their safe,
effective use. Specifically, crown-down shaping is discussed, as well as the importance of measuring the apical
diameter after initial shape has been completed. Finally the article addresses appropriate file selection for specific
forms of anatomy, and suggests key elements that are important to consider when selecting an endodontic
treatment system.

Background allowing precise and consistent tapers to be achieved
every time, regardless of the clinician’s skill or
GT instruments represent a system-based approach experience level (1).
to shaping, filling, and restoring endodontically GT Files have passive rounded tip geometry that
involved teeth (Fig. 1). GT instruments offer simple dramatically reduces the chances of apical ledging
shaping solutions for the widest range of tooth and (Fig. 5). Files with aggressive or semi-aggressive tip
canal anatomy, from the smallest most tortuous designs can easily cause dangerous laceration of apical
canals to those with apical diameters just short of anatomy during preparation procedures, significantly
open apex classification (Fig. 2A and B). GT instru- decreasing the chances of successful filling. Because of
ments have rounded tips and cutting flutes with this GT instruments tip geometry, erroneously shaping
radial-lands that more accurately maintain original root canals short of full length will not cause a ledge to
canal paths than shaping files having sharp tips and be formed so it is very easy to recover from this mistake.
flute edges (Fig. 3A and B). The GT System of The stop is reset to the correct position after discovery
instruments and materials have been updated, of the length determination error, and the final GT
improved, and added to virtually every year since their instruments is simply advanced to the terminus of
introduction. the canal.
The cutting flutes of GT instruments are landed,
adding further safety in apical regions of canals.
Instrument design
Because of this flute design, landed flutes are much
GT instruments are the only taper-centric shaping less likely to transport canal paths toward the outside of
instruments available, meaning that they vary primari- an apical canal curvature allowing these instruments to
ly by their tapers, rather than by their tip diameters be taken beyond the apical terminus, either by accident
(Fig. 4). or by intention, without ripping of the apical foramen.
GT instruments have limited maximum flute dia- Conversely, making the same length determination
meters (MFDs), allowing a wide range of tapered error when using non-landed shaping instruments may
instruments to be safely taken to full length in root require apical surgery to achieve success after the
canals, rather than stepping increasingly larger instru- foramen is ripped to an elliptical shape, destroying the
ments further back from the canal terminus. Because of apical resistance form. Landed flute edges also add
their cutting flutes being limited to safe diameters, GT safety in the shaping of coronal regions of molar root
instruments can be used to full length in canals, canals, as they minimize the transportation of the


relative to the long axis of the file. GT Rotary File. 20–0. 0.12. equals the taper of the region where more dentine needs to be removed. are different along their length. 35–0. the 20 Series. GT Obturator. GT Paper. 0. and 0. First. The 0. preparation into the inside of canal curvatures in the 0.10 mm/mm in each file set but Initial shaping vary by their designated tip diameters. 1.04 and a full more fragile diameters. GT instruments have the and 70–0.04 mm/mm to the end 169 . GT hand file line. Basic technique 0. 0. GT Gutta Percha. shapes as GT Rotary instruments of the same size tightening the flute angles in the tip regions provides designation. and 0. This will include a 20–0. and 40 Series GT Files have the same range of tapers. 0. (Fig.04.35. 0.70. 30.12. more open angles in the set (0. The GT System including (left to right) GT Hand File.06. the 0. times two.12 Accessory Series. sizes 20–0.08. GT instruments have variable-pitch flutes. Soon to be released will be the complete strength and decreases torsional stresses in those smaller.06.10. file.12 mm/mm taper. namely that has a taper greater than 0.50. 0. clockwise flute paths but cut the same preparation This provides several functional advantages.04) of the 30 and 40 series. 0. (Fig. 7) GT Hand instruments have more open flute angles at the shank end of the triangular cross-sectional blade geometry and counter- instruments and the tighter angles at their tip regions.06. furcally fluted parts of these roots.12 Accessory GT Files vary by their tip diameters and The clinical objective of initial shaping is to cut a shape have a constant rate of taper within the file set.90 mm – all with a large thin. The color bands on the shanks (or handle color GT instruments are available in four basic categories in the case of GT Obturators) indicate the tip diameters of sizing. ProSystem GT Fig. 20–0. and GT Post.08. the 30 Series. meaning GT instruments are also available in hand form in that the flute angles. (Figs 4 and 6A–C) The 20. the 40 Series.10. Second.08. stronger shank portion of the file eliminate the tendency The GT instruments and product identification of the file to thread into the canal during use as well as scheme is simple. 8) The number of black bands allowing for more cutting ability in the stronger shank on the shank-ends.12. 0. 50–0. and in the ISO convention.

p. regardless of the root Stainless steel K-files can gauge accurately in straight 170 . usually within 4–6 s after cutting commences. it is time for apical gauging in preparation for creating the ideal final shape. In small roots (as well as in medium and large roots with small and/or curved canals) it will require more than just the 20–0. Before shaping it is essential that the canal be negotiated to length up to a size #15 K-file so that a glide path has been established and to insure the pulp has been removed from the primary canal (broaching may be done if necessary).10 GT instruments will cut to full length in one or more cutting cycles.m. Stalling is caused by one of two situations. As soon as one of the GT instruments in the 20 Series has reached terminal length in the canal. it is common that a single 20–0.) into the canal until the cutting flutes contact the canal walls. (A) Mandibular molar with small dilacerated canals shaped with GT Files. Line angle extensions in access cavities must be taken to working cusps and incisal edges to assure rotary files have straight-line access into all canals. select a GT instruments smaller in taper size and continue shaping. holding a light. requiring only for that canal preparation. Apical gauging is defined as the measurement of the terminal diameter of a canal (2). the best of the root canal so that the terminal diameter of the instruments to use for gauging procedures are nickel canal can be accurately gauged or measured.02 mm/mm taper along their lengths. If the flute spaces are full of debris.10 GT instrument. Initial shaping always begins a 0. Fig.04 mm/mm taper in the root canal preparation.L. Stalling is when the file is still spinning but is no longer advancing further apically. 2. simply cleaning the file with alcohol gauze will allow it to cut further into the canal. each cutting deeper. To date. a necessity titanium K-files as they are very flexible and have a prior to choosing the final GT instruments appropriate 0. (B) Maxillary central Apical gauging incisor with large canal shaped with a 90-0. GT instruments are used by placing the spinning instrument (usually at 300 r. Either the flute spaces are full of debris or the file is too stiff to flex around a curve that it has encountered in the canal. with the 20–0. Most important is that it is immediately removed after the file stalls.12 Accessory GT File (courtesy Dr Jack Sturm). In these cases it will be necessary to use progressively smaller- tapered 20 Series GT instruments.10 GT instruments to cut initial shape to full length. steady apically directed pressure on it as it walks into the canal. In medium or large roots. If the file stalls and is not full of debris. Stephen Buchanan size or the morphology of the root canal being prepared. until the root canal terminus is reached during this first phase of shaping.

171 . Note the lack of apical transportation of the GT preparations and the significant transportation of the ProTaper shapes. Note how the tapers vary but the tip and maximum flute diameters are constant through the series of files. Fig. by passing a stainless steel #15 K-file through the foramen to confirm patency. canals but will give inaccurate results in curved canals because of their relative inflexibility. Then starting with a #20 NiTi K- Fig. 3. Gauging is accomplished after initial shaping proce- dures have allowed at least a 20–0. 20 Series GT Files. Tip geometry of GT Rotary File with radiused tip and landed flutes. 4. ProSystem GT Fig. in the presence of aqueous ethylenediaminetetraacetic acid solution.04 GT instruments to cut to length and usually begins. (A and B) mCT reconstructions of mesial canals of mandibular molars with white indicating original canal paths and transparent red showing final shapes with landed-flute GT Files on left and non-landed-flute ProTaper Files on right. 5.

(B) 40 Series GT Files. file. progressively larger instruments are taken to length decisions to be made. sively larger instruments step back from that position. (C) 0.12 Accessory GT Files. the apical geometry of root canals can be read that the instruments be taken straight in and straight indirectly by the clinician allowing informed shaping out. 6. Stephen Buchanan Fig. Shaping techniques done with- in the canal to see which sizes will pass through the out apical gauging are inconsistent at best and may terminus. and how progres.L. otherwise terminal enlargement and destruction 172 . (A) 30 Series GT Files. it is critical Thus. Because of the sharp flute edges of K-files. which size binds at length. result in over-instrumentation or overfilling.

06 (white handle). Classification of root sizes. GT Rotary File identification code and file geometry.10 (red handle). from left to right.08 (yellow handle). ProSystem GT Fig. 9. however. 20- 0. of apical resistance form will result. 7. Hopefully non- fluted gauging instruments will be available some time in the future. 50-0. The clinician must. 20- 0.12 (green handle). 70-0. Half size gauging Fig. GT Hand Files. make a decision about their apical shaping objectives. so they (myself included in previously untreated cases) will choose a final GT instruments with a tip diameter equal to or one ISO size greater than the tip size of the gauging file that bound at length. 173 .12 (brown handle). Some dentists want to retain the original foraminal diameter of the canal. Fig. 20- 0. 8. Final shaping Apical gauging allows an informed decision to be made about the final terminal diameter of the preparation appropriate for any given root canal morphology.12 (yellow handle). 35-0.

35.08 being the favored size if it is safe. Stephen Buchanan Fig. Roots can be divided into small. are finished at the next solutions that address the full range of root canal GT instruments size.06. medium. etc. 0.06 mm/mm taper. in which case one of the 0.04 mm/ mm taper (Fig. i.12 mm/mm tapers with 0.10 Rotary GT File. MB2 canals being a good example of both criteria. In those Other clinicians prefer to cut dentine the whole situations. so they would choose a final GT File ProRoot MTA and do not require traditional apical having a tip diameter at least one ISO size greater than resistance form. Next the ideal taper for a given canal must be chosen. or 0. the GT instruments system provides shaping results.12 Accessory GT instruments would be the selected instrument.. Thus.e.40 mm. #30 file bound at length a 40 Series GT File would be ideal. 10). excepting the open apex case. anatomy. if it gauges at a mely consistent shapes. Canals with moderate to severe curvature or small roots that are extremely thin are shaped to a 0. 174 . canals having open apices are best filled with length of the canal.08 mm/ mm tapers with 0.10 or 0. and the canal size and curvature used as the second considera- tion. if a make a safe and effective taper selection. and large classes (Fig. 0. Maxillary cuspid with preparation that was cut is a large root with an apical diameter larger than with a single 20-0. Medium and large roots are shaped to 0. I would have to say that I am of this mind in retreatment cases. Although GT instruments cut extre- the gauging file that binds at length. it is still required that clinicians #20 K-file size a 30 Series GT File would be selected. This is done with the root size in mind first.10 being chosen unless it Fig. Canals with severe cervical curvatures or multi- planar bends may only be safely shaped to a 0.04. 9).L.. such as a #25. Appropriate GT File selection for different root sizes. Small roots are shaped to 0. 10. 11.

Comparison of shaping for completing shape in these cases is to go to smaller outcome between variably-tapered nickel titanium GT shape GT Rotary instruments and/or GT Hand Rotary Files and traditional stainless steel instruments in instruments. The smoothly curved canal will more important than the specific tools or techniques allow trouble-free shaping to length while the re-bent that are used. its hard to cut to length with a 20. Beware of claims to the contrary. However. he or she may add a little pressure on the 1. Brown D. and attention to detail is far canals simultaneously. Chapter 7: Cleaning and Shaping Root Canal handpiece when the file stalls at the apical dilacerations Systems. experience. If the clinician is only thinking in two dimensions and does not Further reading consider the possibility of a hidden curve in one of the canals. it is the patient’s best interest that must reverse direction to join the other canal as it approaches be considered. the consistency of shaping outcomes and the ease The set-up for breakage in these cases occurs of use take precedence. I would suggest that clinicians who avoided. Finally. determination errors? Are the shaping instruments Most confluent canals have a relatively straight available in hand file as well as handpiece-driven exit. that. 11). After the buccal or lingual root surface. Buchanan S. so safety is the prime objective.e. 175 . at the end of the day. some of them curve sharply in a buccal versions? Can the file set address a wide range of apical or lingual direction as they join and exit. Obviously. the when the clinician is doing initial shaping in both clinician’s skill. the technique and Burns. 5th edn. This is common when there little or no transportation of the canal path when are two canals in the same root that are apically shaping curved canals? Are the files forgiving of length confluent. IEJ 2001: 34: 1–8. When this is canal diameters? Are they available in a wide range of the case. Buchanan S.04 GT instrument there may be a hidden curvature in together? Do the tip and flute designs cut safely with the buccal-lingual plane. one canal will have a smooth continuous tapers? Can they cut a preparation in a simple canal with curvature and the other will curve initially toward the a single file? (Fig. Pathways of the Pulp. ProSystem GT Hidden curves Conclusion Doing the initial shaping procedure before choosing With the plethora of nickel titanium shaping files the final taper shape appropriate for that canal is helpful available today. the hands of novice dentists. it can be intimidating for dentists to as information about the presence of hidden curvatures choose which set of instruments are right for their can be gained and a mistakenly large taper choice endodontic needs. canal will resist apical shaping progress. i. center of the root and then will break sharply in the Remember. If the root canal being shaped appears are in that decision mode consider the following relatively straight on the pre-operative radiograph but questions: Do the files make the same preparation the crown down shaping procedure is more difficult shape every time? Are the files a part of a system of than expected. 1991. Louis: Cohen and experience a breakage. 2. St. Gluskin A. Mosby-Yearbook. instruments and materials that are designed to work 0.