The "Balanced Force" Concept for Instrumentation of

Curved Canals
El Concepto de "Fuerza Balanceada" para la
Instrumentacion de Conductos Curvos
Root curvature is a frequent occurrence in the human
dentition and when a curvature is present, endodontic

Canal curvature has always introduced complexity

into canal preparation. The "balanced force concept," developed by trial and error experimentation
over the past 12 yr, is proposed as a means of
overcoming the curvature influence. Its concepts use
force magnitudes in order to create control over
undesirable cutting associated with canal curvature.
Rotation is promoted as the means for maintaining
magnitude as a control and counterclockwise direction of rotation provides finite operator control. Diagrammatic evaluations, mathematical calculations,
bending moments, test canals, sectioned teeth, and
clinical radiographs are presented to document each
step of the concept. The concept comes to fruition
with the introduction of a new K-type file design.

La curvatura del conducto siempre representb una

complejidad en la preparacion del mismo. El concepto de "fuerza balanceada" desarrollado a traves
de experimentacibn pot ensayo y error durante los
ultimos 12 a~os, se propone como un medio de
superar la influencia de la curvatura. Sus conceptos
usan magnitudes de fuerza a fin de Iograr el control
del corte indeseable asociado con la curvatura del
conducto. Se promueve la rotacibn como medio de
mantener la magnitud como control, y la direccion
de rotaci6n en sentido contrario a las agujas del reloj
permite un definido control al operador. Se
presentan evaluaciones diagram&ticas, calculos
matematicos, momentos de torsi6n, pruebas de
conductos, dientes seccionados y radiografias clinicas para documentar cada paso del concepto, que
se ve completado con la introducci6n de un nuevo
dise~o de limas tipo K.

preparation of the associated pulp canal system becomes difficult. In fact, curvature introduces such complexity that total instrumenting concepts have been
developed to deal with the curved canal (1-5). Even with
these, it is commonplace for a canal located within a
curved root to be enlarged to a smaller final diameter
than it would be if it were located within a straight root.
Justification for such alteration is simply the fact that a
curvature introduces factors into preparation which, if not
controlled during enlargement, will cause transpor-tation,
ledge formation, and even perforation (1-4, 6, 7). The
more severe the curvature of the root, the more one
tends to reduce the intended preparation diameter in an
effort to prevent irreversible damage of the canal wall.
Reducing the preparation size under such circumstances appears to be logical for two reasons: (a)
smaller diameter preparation means less cutting of the
canal walls and consequently a lesser likelihood for
expression of undesirable cutting effects and (b) small
diameter files are more flexible and therefore less likely
to cause transportation during enlargement.
The curvature problem appears to be solved by small
preparation diameters until one examines what that
solution sacrifices in canal debridement and reliability of
the final seal. Smaller preparation diameters reduce the
amount of mechanical and chemical cleansing of the
canal space. Several studies appear to indicate less
complete removal of debris when small nonflared preparations are used (8-10) while others relate to the
flushing effect of irrigants and indicate that irrigants are
not effective in washing debris from a small diameter
canal (11-13). Finally, Allison et al. (14)indicate that
preparation size/design has an influence upon the final

seal. They found that the best seal was achieved when a
stepback preparation was used.
The goals of an endodontic treatment are to remove the

canal'ssoft tissue contents as completely as pos-sible,

eliminate as completely as physically possible any
microbial elements, and create a situation within the

203
204

Roane et al.

canal that can prevent microbes or toxic substances from

passing through the canal system to the apical supportive
structures. To routinely and dependably ac-complish
these goals each time a canal is prepared, it seems
reasonable to demand the same completeness of
preparation for each canal regardless of whether it is
straight or curved. Variations in the size of prepara-tions
should occur in response to root or canal size rather than
the degree of root curvature. If such were possible,
specifically defined standardized canal prep-arations
based on intracanal morphological needs and not root
curvature could be used. This is not presently the case
and to become capable of such preparation will require
advancement in the existing preparation technology. Our
goal of preparation based upon root size rather than
curvature was initially envisioned by Roane in 1970 and,
as a result of 12 yr of trial and error experimentation, a
preparation technique has been de-veloped which
appears to accomplish the specified goals. This article is
an attempt to describe that tech-nique termed "the
balanced force concept," to support its validity, and to
make its concepts available so that others may also
examine and test its validity.

RATIONALE
The balanced force concept was derived from the
physical law which states: for every action there is an
equal and opposite reaction. To develop the concept,
this law was used to identify and define actions and
reactions that occur during canal preparation in order
to study them and attempt to define a sequence of
events and motions that could be used to control
endodontic instruments during preparation. Successful
motions were retained and a preparation method defined which directed high magnitude forces against
small magnitude forces to develop a balance of action
to reaction, making it possible to ignore curvature during canal preparation.
To understand the balanced force concept it is necessary to study the design of preparation instruments,
develop a thorough knowledge of their characteristics,
and learn to recognize their complete capabilities as
well as their specific behavior during movement. With

this accomplished that knowledge may be used to

select an instrument which provides enough variation
in capabilities to allow the user a means of instrument
control when canal curvature is encountered.
Clinical usage and subsequent physical analysis indicate that it is best to select a triangular cross-section Ktype file. This type of preparation instrument offers
several advantages over other cross-sectional designs
and instrument types, when a balance of forces is being
sought. Most importantly, the K-type design provides
cutting edges with identical rake and clearance angles
(15) reg~dless of the direction of movement. Since these
angles remain unchanged by direction of ap-

Journal of Endodontics

proach with the cutting surface, the K-type instrument

may be used as a bidirectional cutting tool without a
loss of efficiency (16) (Fig. 1). Bidirectional cutting
means that the operator has two more cutting directions available with a K-type instrument than would be
available if a Hedstrom-type instrument were used.
Second, when a triangular configuration is selected
the cross-sectional mass of each file is reduced, the
flute depth is increased, and the magnitude of the
bending moment or "restoring force," as it will be
referred to here, is decreased.
A triangular file has a cross-sectional area or mass that is
37.5% less than that of a square file of the same
standardized size. This point is verified by calculating the
area of two #4 0 files, assuming one to be manu-factured
with a triangular and the other with a square crosssection. The area of a triangular cross-section file is
determined using the equations b -- 3 R/1.732 and A =
b/4 x 1.732. In these equations b represents the length of
one side of an equilateral triangle, R the circumradius or
one-half of the cutting diameter, i.e. 1/2 of 0.40 mm, and
A the area of the triangle. Substitute the known values
and find b = 3 (0.2)/1.732 -- 0.346 mm. With the value
thus obtained for b, the second equation may be solved
for the cross-section area: A = 0.346/4 x 1.732 = 0.0499
mm 2. For a square file, the

Vol. 11, No. 5, May 1985

equations a = d/1.414 and A -- a 2 are required. In these a

represents the length of one side of the square, d the cutting
diameter of the file or 0.40 ram, and A the area of the square.
Substitute the known values and find: a = 0.4/1.414 = 0.282
mm. By using that for a, the area equation is solved thusly: A
= (0.282)2 -- 0.0795 mm 2.

Results of the preceding calculations rounded to two

significant numbers indicate that when the cutting ra-dius
is 0.4 mm (i.e. a #40 file), a triangle has a cross-sectional
area of 0.05 mm 2 while a square has an area of 0.08
mm 2. With the recognition that curvature could be
considered as a constant acting upon both shapes and
that the amount of metal, i.e. the cross-sectional area,
varies between the two shapes, then one shape may be
compared with the other using a percentage ratio based
upon their cross-sectional areas. By using this method, it
becomes apparent that a triangular file has only 62.5% as
much cross-sectional area as a square file of equal

FiG 1. W is a line drawn tangent to the circumference of cut c at a point

of contact with one cutting edge of a triangular shaped K-type
instrument. W is used to describe the clearance angles U and V into the
flute space associated with that cutting edge. They are equal and are 60
degrees by definition. P is a tangent line drawn in a similar fashion to
intersect one edge of a square K-type instrument. It is used to define the
clearance angles Q and R which are equal and 45 degrees by definition.
The sides of the square and triangle are lettered a and b, respectively,
and the areas are shaded for comparison. It is easy to recognize that the
square has a cross-sectional area which is much larger than that of the
triangle, i.e. 37.5% greater. The rake angle for both the triangle and
square may be measured as the angle between the radial line d and the
lines b and a, respectively. Both shapes produce negative rake angles;
however, the triangle enjoys a 15-degree more favorable angle. Neither
the rake nor the clearance angle is altered for either by the direction of
movement.

cutting radius and if geometry had no affect upon

bending, the triangular file would be expected to develop
only 62.5% as large a resisting load (restoring force)
against the canal wall as a square file assuming both
were placed through the same cur-vature. Clinically
speaking, a triangular file is predicted to be more flexible
and to apply a lighter restoring force against the wall of a
curved canal during preparation. This means, that the
triangular ground instrument will be less likely to
transport a canal wall during prepara-tion. Its K-type
bidirectional design allows the operator to select any of
four potential cutting approaches, i.e. insertion,
withdrawal, clockwise, or counterclockwise rotation.
Figure 1 provides a graphic comparison be-tween the
triangular and square, i.e. cutting edge con-figuration,
rake, and clearance angles.
By recognizing that geometry has an influence upon
structural properties of materials, it is desirable to establish a relationship between the restoring force and the
cross-sectional geometry rather than only the area as

just previously considered. To do this it must be

recognized that the restoring force may be measured
through its opposing force, the angular deflection bending moment. Values have been experimentally determined for bending moments between various geometric
shapes and were recently reported by Krupp et al. (17). In
their study, the amount of force required to produce a 60degree angular deflection of a triangular size 30 Unitek
file was one-third less than that required to produce an
equal deflection of a square size 25 Unitek file. Their
graphs indicated that a bending momer)t slightly greater
than 40 g-cm deflected the size 30 triangular file 60
degrees while a bending moment slightly greater than 60
g-cm was required to deflect
the size 25 square file equally. A decrease in the restoring
force reported as bending moment occurred in spite of a
greater cutting radius, i.e. larger instrument size of the
triangular file. The square file in this case

Balanced Force Concept

205

has 83% as large a cross-sectional area as that of the

comparable triangular file yet it generates about one and
one-half times as large of a restoring force, i.e. bending
moment of 60 versus 40 g-cm. By recognizing that the
restoring force is a statically applied load which holds
the files cutting surfaces against the curvature in a
single direction and that it is the load which is responsible for a straightening of the curve during
preparation, one can predict that a square file is more
likely to uncontrollably straighten the canal, to cut excessively at its tip, and therefore is more likely to ledge a
preparation. The difference in restoring force magni-tude
coupled with our unreported clinical and experi-mental
observations lead us to conclude that a square shape
should be avoided whenever possible, but es-pecially
when using large instrument sizes.
The next step in understanding how to maintain
preparation size past a curve is learning to identify the
direction and location for expression of the restoring
force which is generated by elastic distortion within an
instrument when it is passed through a canal curvature.
Identification allows recognition of where the loads
concentrate and provides information useful in learning
how to prevent effective expression of those loads in
undesireable areas. It is important to learn to control
these forces in order to prevent them from becoming a
major influence during canal enlargement as their
expression can produce disastrous results. To accomplish control it is necessary to compare the magnitude of
loads, apply the rule that for every action there is an
equal and opposite reaction, and finally identify motions
which will direct the forces applied by the operator in
such a manner that they will mask those generated by
curvature. When such a balance is established, the
canal may be enlarged through its original axis, at least
in the apical third of the canal. In the process transportation is eliminated or at least displaced coronaUy where
it is less likely to have serious consequences. The
desired balance of forces can be generated simply by
rotating the instruments to produce canal enlargement.
This is true since rotation directs dentinal hardness
against the restoring force of the curved instrument and
simultaneously uses that hardness to create the cutting
loads. Rotation prevents expression of the cur-vaturegenerated restoring force via magnitude, at least for a
limited range of file sizes. Figure 2 illustrates the balance
of forces generated by rotation. The relative magnitudes
of the force generated from dentinal resist-ance and the
restoring force generated in the instru-ment by a
curvature are not defined; however, perform-ance tests

demonstrate the validity of the assumption that the

restoring force is of less magnitude than the forces
created from dentinal resistance (Figs. 3 and 4). The
206

Roane et al.

FIG2. The enclosing circle representsdentin as it contactsthe cutting

edges of a file. R represents the internal force applied by dentinal
hardnessas it is vectored toward the center of the instrument.S is a
restoring force applied againstthe curvature by the file attemptingto
return to its original straight condition. S remains stationary as the
instrument is rotated while R rotates with the blades. As long as R
remains greater than S, the instrumentwill not transport the canal;
however, should the file be pulledout rather than rotated this formula
fails and S applies the primary cutting load. Transportation will
frequently occur under such conditions.

The magnitude of the restoring force developed within a

file is a function of the file'smass, geometry, and
composition as well as the radius and arc of the
instrumentation curve. Its expression is inversely re-lated
to the distance from the curve to the instrument tip.
Consequently, the restoring force is a variable force and it
will increase: (a) if the metal mass increases, either as a
result of shape or instrument diameter; (b) if the radius of
the canal curvature is decreased; (c) if the arc of the
canal curvature is increased; or (d) if the distance from
the curve to the file tip is decreased. By using these
relationships, one can identify specific canal alterations
that must be achieved in order to accomplish large
preparation sizes around curvatures without undesireable results, i.e. transportation, ledges, and perforations. Initially, the radius of the curve should be
increased by creating a canal access (1, 4, 5), i.e.
opening the coronal end and straightening the curvature

magnitude of dentinal resistance is a function of dentinal

hardness and generates a force during prepa-ration
which remains relatively constant for each canal.
(Fig. 5). This effectively increases the radius and decreases the arc of the canal curvature by allowing the
instrument a straighter path to the apex. The resulting
straighter instrument generates a lesser restoring force
along its cutting edges and tip. The lighter loads pro-duce
less dentin removal and the canal is enlarged using
cutting pressures equal to that of smaller.instru-ments. As
a consequence, larger diameter instruments may be
used before transportation, ledging, or perfo-ration are
likely. To avoid apical expression, primarily ledging, the
distance from. the curve to the instrument tip may be
increased by extending the file tip beyond the apex
before introducing the next larger instrument.

Journal of Endodontics

Overextension is generally considered to be undesira-ble

and the consequences of leverage are best man-aged by
modification of the instrument tip in order to gain balance
through the removal of the terminal cutting points.
Modification of the instrument'stip is a recent inno-vation
and has produced perhaps the most dramatic change in
instrument response within the concepts of balanced
forces. It entails removal of the cutting sur-faces that
primarily express the static restoring force and therefore
the surfaces that are primarily responsible for canal
transportation. Proper removal of these cut-ting points
provides better instrument control than any previously
recognized method, including canal access preparation
(Fig. 5). The modified instrument is not presently
available on a commercial scale. A photo-graph of the
modification is presented in Fig. 6 along side that of a
normal tip to emphasize the terminal points. These points
cut in response to a restoring force produced when the
curvature deflects the file

FIG 3. This electron micrograph of a prepared canal in a mandibular

incisor reveals lingual movement of the preparation. The access in
this tooth appliedpressureto the file shaft which should havecaused
movement facially. The observationof a tapered preparation to the
lingual supports the balance of force magnitude concept. Missing
dentin to the lingual unbalanceddentinal resistanceto that side and
allowed the file to be pushed away from the F wall masking entirely
the expressionof any restoring force along the F wall.

Vol. 11, No. 5, May 1985

Balanced Force Concept

207

FiG 4. Presented are four cases that were prepared using the balanced force concept. The minimum apical preparation diameter was 0.45
mm. The second molar in A was completed using standard files and tip overextension whereas the other three cases were completed using
modified instruments.

64 TE$
#LIDDEN
2hNhL

4CCE$$

A
FtG 5. This graphic representation A and actual molar canal access B illustrate how an access preparation alters the curvature'seffect upon
enlarging instruments. B and C are the areas of dentin removal which are responsible for angular change. The change in instrument entry
angle before and after canal access is illustrated as the angle a and represents a reduction in the arc of the canal'scurvature. Space created
by the access allows the canal curvature to be expressed in the instrument as though the radius of the curve had been increased. The curve
becomes more generalized and distributes throughout the canal length, thereby decreasing the curvature-related forces and their expression.
terminal points and produces supporting triangular planes which
208
Roane et al.
distribute loads to keep them below cutting magnitude. Penetrating
capacity is maintained as the flute depths are unchanged and the
three original cutting edges are replaced by six new edges.
Journal of Endodontics

is evident that use of the balanced force concepts,

especially with modified instruments, enables one to
prepare a curved acrylic canal much larger than classical techniques, without producing apical transportation.
File tip modification and use of the balanced force

s,," A

I
//

FIG 6. Presented are two triangular K-type files. File A has a

standard tip with distinct points created when its cutting edges are
terminated with a standardized tip. File B is a prototype modified
instrument with a parabolic tip. This configuration eliminates the

FIG 7. This hypothetical canal curvature is separated into its

compo-nent parts. Point A is the axis of the curve, r is the radius,
and a defines its arc. When a theoretical file is passed around this
curve, it develops internal forces as a result of molecular
compression and expansion within its mass. Those forces, i.e.
restoring forces, are subsequently expressed at the file tip over
the/ever FT. Changing the curve by altering its arc or radius can

alter the magnitude of the restoring force, while changing the lever
length by moving tip T away from the curve helps to reduce
expression by decreasing the leverage advantage for the restoring
force. Canal access may be used to change the curvature while file

overextension can be used to increase the lever arm. File tip

modification does not affect the lever; it simply prevents expression
of the generated forces. FZ indicates the file's original straight
condition and determines the zero force line, i.e. no restoring force.

from its passive or zero force straight line position

(Fig. 7). The restoring force when present is
transmitted to the file tip through its metal shaft
which acts as a lever arm.
Altering the instrument tip removes its capability to
respond to elastic distortion in a concentrated area and
thereby mandates the expression of those forces over the
length of each cutting edge rather than at the file tip.
Thus, with the terminal points removed, internal
distortions established by the canal curvature generate a
restoring force which is proportioned over the cutting
edges and .dispersed enough to allow the relatively
larger magnitude of dentinal hardness to deny noticable
expression. Consequently, the file'sstraight profile becomes unapparent in the completed preparation. Introduction of tip modification introduces an ability .to enlarge a curved canal even along its inside wall completely to the apex. This ability does not appear to exist
within the methods tested to date using standard ground
K-type instruments. (Fig. 8). If the results seen in Fig. 8
are'comparedwith those of Weine et al. (2), it

Vol. 11, No. 5, May 1985

concept can enable one to easily enlarge a canal from

a size 20 to a size 55 file without recognizable transportation in the presence of rather significant canal
curvature.
TECHNIQUE CONSIDERATIONS
To utilize the balanced force concepts, instrumenta-tion
should be refined into placement, cutting, and removal of
each file using only rotary motions. Place-ment is
accomplished using clockwise rotation (18) and light,
inward pressure. Cutting is accomplished using
counterclockwise rotation (19) and inward pressure
adjusted to match the file'sstrength, i.e. very light for
small instruments and heavy for very large instruments.
Cleaning or debris removal is accomplished using one to
two noncutting no pressure or slight outward pull
clockwise rotations. Cleaning is normally completed only
after the desired length has been reached and
maintained with counterclockwise rotation. Axial reciprocation or filing motion is used only to produce canal
transportation, to flare the coronal area, and during the

FIG 8. Presented are two acrylic canal models which have been
enlarged from an original diameter of size 20 through a file size 55
using the balanced force concept. Sample A was prepared with
standard instruments using 0.5-mm stepbacks every other file size.
It was the best of a series and shows slight outward transportation
apically. Sample B was prepared using modified files and no
stepback. It is typical of the series as no apical transportation was
seen in the entire group. Enlargement appears to have been
accomplished along both its inner and outer wall to the foramen.

initial opening of calcified canals. Such motion voids the

balanced force formulation and its use should be limited
to extremely small diameter instruments or to that portion
of the canal which is coronal to the curvature, except
where transportation will serve to remove a preexisting
ledge or shelf. When unmodified instru-ments are used,
the working depth should be shortened by 0.25 mm with
each change to the next larger size instrument in order to
prevent accumulation of tip cuts at a single point. If
accumulated, tip cuts will create a mechanical ledge. The
stepback precaution is not nec-essary when the tips are
modified and filing action may be used more freely
without drastic loss of control.
The reason for clockwise placement and counterclockwise cutting may not be apparent at first. To
understand that concept, one has to again analyze file
design and postulate the reactions produced by variations of motion or direction. The cutting edges incline
down a K-type file shaft at approximately 45 degrees
from the vertical axis (Fig. 6). By standardized specification, the circumradius increases from the tip toward the
handle and the flutes spiral clockwise. The result is
simply that a load delivered by clockwise rotation pulls
away from the operator and moves the instrument

apically, while a load delivered by counterclockwise

rotation pushes toward the operator and moves the file
out of the canal (Fig. 9). As a consequence of this, the
operator may sense the total of all forces during counterclockwise rotation, torque plus outward movement,
while he or she senses only the torque portion of a
clockwise rotation. The unnoted inward movement in that
case places the instrument further into the canal and
excessively embeds its cutting edges into dentin. The
described movements are a consequence of vec-tored
forces created when the applied torque interacts

Balanced Force Concept

209

pow , /

MOVEMENT
FIG 9. This illustration indicates the reactions which occur along the
blade inclines of a K-type file during clockwise and counterclockwise
rotation. Dentin strikes the incline opposite the rotating force, debris
is reflected to the dentin side, while a portion of the torque is
vectored causing the instrument to move into the canal when the
torque is clockwise and out of the canal when the torque is
counterclockwise. Inward movement is labeled power and is used to
place the instru-ment into canals. Outward movement is labeled
control. It is used to incrementally disengage the cutting edges and
may be opposed by the operator pushing inwardly to produce a
finite control over the cutting force.

with the canal wall along the blade inclines. The resultant forces move the instrument into the canal when the
torque is applied clockwise and as the instrument moves
inwardly its standardized taper forces the cut-ting blades
deeper into the canal walls. In other words, at a given
point within a canal, the cutting radius increases as the
file moves inwardly. Conversely that radius decreases as
the file moves outwardly. Inward movement is a result of
clockwise instrument rotation while outward movement is
a result of counterclock-wise instrument rotation (Fig. 9).
Hence, not only does the operator sense the full load

while rotating the instrument counterclockwise but a load

of dentin too great to shear will cause the file to move
outwardly and that movement will simultaneously
decrease the depth of cutting edge penetration into the
dentin. The de-crease in penetration depth continues
210

Roane et al.

the engaged dentin and gives the operator complete

control over each cutting action. With the use of this
system, the operator may recognize the accomplish-ment
of a cut when a slight pop is felt. Continuing
counterclockwise rotation past 120 degrees, once den-tal
cutting is recognized, enlarges the canal to the files
cutting diameter as each blade will have reached the
beginning position of another by that point. Further
counterclockwise rotation helps to ensure full diameter
enlargement and removal of dentin which may have
compressed away from the first blade pass. Upon
completing each cut, the file is again positioned for
cutting by using a clockwise placement stroke of one-half
or less revolution. Each placement is followed by a
counterclockwise cutting rotation. This sequence is
repeated until the working depth has been achieved and
the canal is fully enlarged by counterclockwise rotation.
When enlargement has been accomplished, a final
clockwise cleaning rotation is used to load canal debris
into the flutes and to elevate that debris away from the
apical foramen. Cleaning helps to prevent debris
accumulation within the canal where debris will act to
upset the balance of forces and also helps prevent
excessive loss of debris into the apical tissues.
Clockwise loading of debris is a nonenlarging motion
intended only to facilitate removal.

DISCUSSION
Utilization of the concept of balanced forces enables one
to produce enlargement of canals past severe curvatures
without compromise of enlargement con-cepts or
preparation diameters. Examples of clinical cases
completed using the methodology described are
presented in Fig. 4. Without modified tips it is necessary
to extend the instrument slightly beyond the apex in order
to prevent transported walls and ledge formation. When
over extension is used, the tip must be retracted to lie
within the canal space at least one or two instru-ment
sizes before completing the desired preparation diameter
in order to ensure establishment of a constric-tion or
ledge. In those cases, the ledge created by the last one
or two instruments becomes the apical stop and serves
to prevent overextension of gutta-percha during the filling
procedure. Figure 4A presents a case completed in this

until the opera-tor's applied inward pressure exceeds the

shear strength of the total engaged dentin and a cut
results. This relationship finitely adjusts applied force
against
fashion. This process is neither com-pletely accurate nor
clinically desirable and it may be eliminated in the future
through the use of the modified instruments. Extensive
clinical trials of the modified files have demonstrated this
conclusion to be true. Several cases are presented in
Fig. 4 (B to D) which reveal the clinical value of file tip
modification.

CONCLUSIONS
The balanced force concept of instrumentation is simply
an expansion of the concept of reaming canals. It differ~
primarily in that the cutting motion is intention-

Journal of Endodontics

ally counterclockwise and may be accomplished at any

level without blockage, especially when modified instruments are used. Instrument placement is accomplished
by clockwise rotation and is capable of producing significant loads on an instrument tip without requiring the
application of inward pressure by the operator. This fact
enables small instruments, i.e. # 8 and #10, to be
crushed past calcifications and allows one to open
calcified canals rapidly. In addition, this approach to
calcified canals appears to reduce the incidence of
secondary blockage from loosened particles.
The balanced force concept is similar to reaming in the
fact that clockwise rotation of each instrument must be
limited to no more than 180 degrees in order to prevent
overinsertion of the apical portion of the instru-ment into
dentin. Such overinsertion causes the tip to cease
turning and allows the rotating force to unwind the file
coronal to that point and increases the likelihood of
instrument separation (20). Each placement load is
followed by a cutting motion, counterclockwise rotation of
120 degrees or greater. This action completely en-larges
the canal to the file diameter, frees the instru-ment, and
prepares it for placement to a deeper depth when the
next clockwise rotation is supplied. Clockwise placement
and counterclockwise cutting rotations are repeated until
the desired depth or working length is reached. On
occasion the file becomes filled with debris and will
Vol. 11, No. 5, May 1985

tained helps to explain our apparent disregard for reported counterclockwise instrument weakness (21,

hesitate to accept the next placement motion. When that

occurs, the file must be removed, cleaned, and then
reinserted before instrumentation may pro-gress. Upon
reinsertion, preparation is continued until the desired
working depth is obtained and the canal diameter has
been enlarged by counterclockwise rota-tion of at least
120 degrees. A greater angle of rotation is desired, i.e.
one or two revolutions, but cannot be safely
accomplished in all canals. This is especially true when
an extremely sharp curvature exists as such a curvature
can easily cause fatigue failure and result in instrument
separation. Canals which are evenly curved throughout
their length produce little likelihood of frac-ture while
those exhibiting sharp curvature concen-trated in a small
segment of the root require careful rotation with minimum
or limited clockwiseJcounter-clockwise movement, i.e.
120 degrees either direction. Enlargement is noticeably
slower in such situations. Sharp curvatures located
primarily in the apical one-third of a canal present the
greatest difficulty as they do not allow much alteration of
the curvature angle or radius via canal access and their
influence is expressed through a very short lever arm.
To support the balanced force concept and establish its
safety, we have accumulated data relative to instru-ment
failure during clinical use (20). In that study instru-ment
damage was related to the direction of rotation which
produced the observed faults or failure in order to
determine the risk of instrument separation and its
relationship to the direction of rotation. The data ob22). The findings of preparations produced in plastic
canal blocks using the balanced force concept will
be pre-sented in a subsequent article.