CLEANING AND

SHAPING OF ROOT
CANALS
MOHAMMED AMER, HUSSAIN OWAID, LARA HAMID
SUPERVISED BY DR FADI ALHASHIMY
INTRO

• Cleaning and shaping are separate and distinct concepts but are
performed concurrently.
• The cleaning and shaping procedures are designed maintain an
apical matrix for compacting the obturating material regardless of
the obturation technique.
• Cleaning and shaping is one of the most important step to achieve
successful endodontic treatment
SCHILDER’S DESCRIBED MECHANICAL AND
BIOLOGICAL OBJECTIVES FOR SUCCESSFUL RCT
• Mechanical Objectives
 The root canal preparation should develop a
continuously tapering cone.
 Preparation In multiple planes, which
introduces the concept of ‘flow’
 Decreasing cross-sectional diameters at every
point apically and increasing at each point as
the access cavity is approached
 Do not transport the foramen
 Keep the foramen as small as practical in all
cases
 A CONTINUOUSLY TAPERING CONE
Why to do ?
How to achieve ?
 CONCEPT OF ‘FLOW’
• The root canals within curved roots are Similarly curved
 CROSS-SECTIONAL DIAMETERS
DECREASES APICALLY AND INCREASES
CORONALLY
 NOT TO TRANSPORT THE FORAMEN

• How to avoid ?
 KEEP THE FORAMEN AS SMALL AS
POSSIBLE
• How to achieve ?
• The goal is to clean but not to enlarge the foramen. If the diameter of a foramen is increased
from 0.2mm to 0.4mm, the area of the foramen has increased by +four times! Not only does
this increase the risk of tearing, it also increases the potential for microleakage.
APICAL GAUGING
SCHIDLER’S BIOLOGICAL OBJECTIVES
Confine instrumentation to the root canal
Beware of forcing necrotic material and microbes
beyond the foramen “will cause flareup”
Remove all tissue debris from the root canal system
(naocl)
Complete cleaning and shaping of single canals in one
visit
Create sufficient space during canal enlargement for
intracanal medication (calcium hydroxide) and for
potential exudates reception
CLEANING

• It’s the removal of potentially pathogenic contents from the root canal
system including necrotic pulp tissue, dentine debris and microbes.

• Success of RCT in a tooth with a vital pulp is higher than that of a necrotic
The reason is
- The persistent irritation of necrotic tissue remnants
- The inability to remove the microorganisms and their by-products.
CLEANING
•The factors affecting the cleaning process are
- tooth anatomy and morphology
- the instruments and irrigants available for treatment.

•The goal of cleaning not total elimination of the

irritants but it is to reduce the irritants. Because
Instruments must contact and plane the canal walls to
debride the canal. Morphologic factors such as lateral
and accessory canals, canal curvatures, canal wall
irregularities, fins, cul-de-sacs, and ishmuses make total
debridement virtually impossible.
CLEANING

•Obtaining glassy smooth walls is a

preferred indicator of debridement. The
properly prepared canals should feel
smooth in all dimensions when the tip of a
small file is pushed against the canal walls.
This indicates that files have had contact
and planed all accessible canal walls
thereby maximizing debridement.
SHAPING

• The establishment of a specifically shaped

cavity which maintain the original shape and
taper of the canal and allow three-
dimensional progressive access into the
apical part to permit the final obturation
instruments and materials to fit easily.
ROOT CANAL SHAPING
 Before starting the endodontic treatment,
proper diagnosis and evaluation of the tooth
has to be perform to ensure that the tooth
has favourable treatment prognosis.

 During preparation of the access cavity, a

straight line access from the coronal to the
apical regions of the canal must be obtained.
This can be performed by removing the
overlying dentine to ensure flaring and
smooth internal walls of the cavity with
straight line access to the root.
CORONAL ACCESS
• Access cavities should be cut so
the pulpal roof, including all
overlying dentin, is removed
• The axial walls are extended
laterally such that the orifice(s) is
just within this outline form
• The internal walls are flared and
smoothed to provide straightline
access into the orifice
CORONAL ACCESS

• After proper access cavity design

if the pulp is vital and bleeding,
the chamber is filled brimful with
a viscous chelator.
• In the instance where the pulp is
necrotic, the chamber is irrigated
and completely filled with a
5.25% solution of warm NaOCl
CANALS NEGOTIATION
The smaller stainless steel
files are measured and
precurved to conform to the
anticipated full length and
curvature of the root canal.
Stainless steel 0.02 tapered
10 and 15 hand files are then
utilized to explore the
coronal two-thirds of the root
canal system.
ORIFICE ENLARGEMENT
• After negotiating the coronal
two-thirds, the canal is flushed
with NaOCl and, depending on
the operator and available
space, may be pre-enlarged
using hand instruments, gates
glidden drills utilized like
brushes, or rotary NiTi shaping
files coronal two-thirds of a canal has been
pre-enlarged then there is improved
access to the apical one-third.
APICAL NEGOTIATION
 With the coronal two-thirds
optimally prepared and filled
with irrigant, the apical one-
third is then scouted and
reconnaissance information
gathered.
 Small hand files are used to
negotiate the rest of the canal,
confirm a smooth glide path to
the terminus, and establish
patency
GLIDE PATH
 Ensure glide path of the canal
and apical patency before
starting canal preparation. This
can be performed by passing a
small size K-file (usually a
size #8 or #10) beyond the
apex. The glide path file can
help to ensure complete
opening of the canal and
facilitate working length
estimation
WORKING LENGTH
• Electronic apex locators can provide valuable,
accurate and reliable information as to working
length.
• It should be understood that apex locators do not
replace films but are used intelligently and in
conjunction with radiographs.
• When a predictable and smooth glide path is
established to the RT and working length is
confirmed, then the apical one-third of the canal
can be finished in a variety of ways
INSTRUMENTATION CROWN DOWN
TECHNIQUE
INSTRUMENTATION CROWN DOWN(STEP-
DOWN) TECHNIQUE (VIDEO)
INSTRUMENTATION STEP BACK TECHNIQUE
(VIDEO)
IRRIGATION
 Irrigating solutions are expected to kill
microorganisms and disrupt the biofilm,
endotoxin, dissolve pulp‐tissue remnants, remove
hard‐tissue debris and the smear layer, provide
lubrication for instruments, and be biocompatible
WHAT ARE PROPERTIES OF AN IDEAL
IRRIGANT SOLUTION?
• It must have broadspectrum antimicrobial properties.
• It must aid in the debridement of the canal system.
• It should have the ability to dissolve necrotic tissue or debris.
• It should have low toxicity level.
• It should be a good lubricant.
• It should have low surface tension so that it can easily flow into
inaccessible areas.
• It should be able to effectively sterilize the root canal.
• It should be able to prevent formation of smear layer during
instrumentation or dissolve the latter once it is formed.
• It should inactivate endotoxin.