Endodontic Instruments

Endodontic instruments
Dr. musa mohammedtom musa

B.d.s, Mfdrcsi, MSc clinical restorative
dentistry, implant Diploma BAIRD
Academy
LEARNING OBJECTIVES
Define a basic set of instruments
Describe the general physical properties of
endodontic instruments
Describe the design (longitudinal, cross-
sectional, and tip configuration) of the more
common canal preparation instruments and
their mode of use .
LEARNING OBJECTIVES
Explain the basis for sizing and taper
(standardization) of hand-operated instruments.
Describe proper use of instruments to prevent
breakage within the canal.
Recognize visible changes in instruments that
will predispose to breakage.
LEARNING OBJECTIVES
7. Describe techniques used for sterilization
and disinfection of instruments.
8. Select appropriate sterilization methods for
each instrument type.
9. Identify procedures and chemicals that might
cause deterioration of files and how to recognize
that deterioration.
LEARNING OBJECTIVES
10. Describe and differentiate between
conventional files and files of alternative designs. 11.
Define the differences between stainless steel and
nickel titanium intracanal instruments.
12. Describe the action and use of rotary
instruments for both cleaning and shaping canals.
As root canal treatment diversified, smaller
“finger” instruments were developed for
posterior teeth.
In addition to being more adaptable, these
provided improved tactile sense for the
operator.
New designs in endodontic instruments have
been introduced and will continue to evolve.
INSTRUMENTS FOR DIFFERENT PROCEDURES
Examination
A kit for examination and diagnosis includes
(1) a front surface mouth mirror.
(2) a periodontal probe;
(3) an explorer, such as the double-ended No.
5 explorer;
(4) the Glick No. 1 instrument; and
(5) cotton forceps
Emergency
Basic instrumentation for most emergency
procedures includes (1) an examination kit,
(2) an anesthetic armamentarium,
(3) a canal preparation (cleaning and shaping)
system,
(4) occasionally an incision for drainage kit.
Emergency
Incision and drainage instruments include
(1) scalpel handle and blade.
(2) periosteal elevator.
(3) rubber dam drain.
(4) needle holder.
(5) irrigating syringe with an 18-gauge needle, sterile
saline, and suction tip.
Cleaning and Shaping
Instruments used for access and cleaning and shaping
include
(1) syringe with a 27-gauge needle.
(2) locking cotton pliers. (3) rotary instruments (Gates-
Glidden drills),
(4) a plastic instrument (Glick No. 1) for temporary
placement.
(5) broaches and files. (6) a lentulo spiral drill, and
(7) a millimeter ruler.
Nomenclature for Instruments
The nomenclature follows the recommendations of the
International Organization for Standardization (ISO).
1. Hand-operated include K-type reamers and files,
broaches, and Hedstrom-type files.
2. Engine-driven are hand types that have a latch that
inserts into a slow-speed hand piece. These include
rotary (Gates-Glidden and Peeso) engine-driven
Nomenclature for Instruments
3. Ultrasonic and sonic are diverse in design. Some
resemble barbed broaches, some resemble files, and
others are diamond-coated wires. All insert into a
dedicated vibratory handpiece that energizes the
instrument.
4. Nickel-titanium is a cross-over design and has
been adapted both for hand instruments and rotary
PHYSICAL CHARACTERISTICS
Despite continual improvements in design and
physical properties, there are still no instruments
that totally clean and shape all root canal spaces.
stainless steel instruments are relatively inflexible,.
Nickel-titanium instruments are more flexible and
adapt more readily to fine, curved canals.
Instrument Fabrication
A hand-operated reamer or file begins as a
round wire that is modified to form a tapered
instrument with cutting edges.
The instrument is used with a twisting (reaming)
or pulling (filing) motion in an attempt to
produce clean, smooth, symmetrical canal walls.
Hand-Operated Instruments
Several cross-sectional shapes of files are
commercially available . Two techniques for
manufacturing these instruments have been
developed.
Machined
One technique involves machining (grinding) the
instrument directly on a lathe; an example is the
Hedstromtype file . All nickel-titanium
instruments are machined. Some manufacturers
produce K-type files using the machined (lathe-
grinding) process.
Ground-Twisted
Another technique consists of first grinding,
then twisting. Raw wire is ground into tapered
geometric blanks: square, triangular, and
rhomboid . The blanks are then twisted
counterclockwise to produce helical cutting
edges. These are K-type files and reamers.
Clinical Use
the difference between files and reamers is their
intended use. Files are manipulated with or push
-pull planing, motion.. Reamers are twisted and
withdrawn; therefore cutting takes place during
rotation.
Physical Properties
Flexibility, sharpness, and corrosion resistance are
properties related to metal and design. Traditional
metals have included stainless or carbon steel.
Compared to stainless steel, many carbon steel
instruments have been shown to cut somewhat
more efficiently;. However, carbon steel is little used
because it is more susceptible to corrosion.
Physical Properties
Nickeltitanium alloy have more a modulus of
elasticity than stainless steel,. An advantage of this
increased flexibility is that a file follows the canal
curvature with less deformation (transportation)
during enlargement. A disadvantage of the
increased flexibility is the inability to precurve the
file and cutting efficiency of nickel-titanium files may
be reduced with clinical usage.
Standardization
Lengths
Files and reamers are available in three shaft
lengths: 21, 25, and 31 mm.. The 25- and 31mm
instruments are used for longer roots. The 25-mm
instruments are the most commonly used
instruments during root canal preparation.
Standardization
Sizing
Dimensions of K-type files and reamers are
designated according to the diameters of the
instrument at specified positions along its length
Sizing Dimensions of K-type files and reamers are
designated according to the diameters of the
instrument at specified positions along its length
Standardization
Sizing
The diameter at the tip of the point is known as D0.
The spiral cutting edge of the instrument must be at
least 16 mm long, and the diameter at this point is
D16. The file diameter increases at a rate of 0.02
mm per running millimeter of length.
Standardization
Sizing
Another “standard” introduced by one of the
nickeltitanium rotary series (Profile)is a 29%
constant increase in tip diameters between sizes
Standardization
Sizing
The nickel-titanium rotary instruments have other
variable tapers of 0.04 and 0.06. For every
millimeter of length, the diameter increases by 0.04
or 0.06 mm. These greater tapers make these more
aggressive in creating marked flaring preparation.
Standardization
Tip Design
Originally, the tip angle of K-type files and reamers was
approximately 75 degrees plus or minus 15 degrees. This
design was intended to provide cutting efficiency without
an excessively sharp transition angle.
Newer designs have different tip angles and designs in an
attempt to minimize canal alterations.
Standardization
Torsional Limits
Torsional limit is the amount of rotational torque
that can be applied to a “locked” instrument to the
point of breakage (separation).
Smaller instruments (less than size 20) can
withstand more rotations without breaking than
larger (greater than size 40) instruments.
Standardization
Torsional Limits
Torsional limit is the amount of rotational torque
that can be applied to a “locked” instrument to the
point of breakage (separation).
Smaller instruments (less than size 20) can
withstand more rotations without breaking than
larger (greater than size 40) instruments.
Standardization
Color Coding
Color coding of file handles designates size. Color
coding of the newer nontraditional instruments
varies according to the manufacturer.
Avoidance of Instrument Separation

Separation of hand files in the canal is prevented by regularly
inspecting the instrument for defects such as
(1) unwinding of the flutes (twisting clockwise and opening of
the flutes)
(2) roll-up of the flutes (excessive continued clockwise twisting
after unwinding),
(3) tip distortion (the tip has been bent excessively), and
(4) corrosion.

Endodontic Instruments

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Endodontic Instruments

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Endodontic instruments

Dr. musa mohammedtom musa

Avoidance of Instrument Separation

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