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Rotary Instruments {1}

Alaa AlQudah

Majd Sharadqah
28 – 11 – 2016
 Rotary instrumentation
Slides aren’t included

 Rotary instrumentation is considered a great advanced to dentistry , it

makes endodontic much much easier .
 Although rotary instrumentation is make the life easier , it is not mean
the manual instrumentation is not important.

 There are many rotary systems ( may reach 12 systems) , so we can't be familiar
with all of them .

 In this lecture we will talk about 3 systems , that are used in dental schools .

 The goal of endodontic treatment: is cleaning the canals from bacteria , debris
& infected dentin why?:

1. Because the pulp is irreversibly inflamed (which mean can't get back )and cause
the severe pain to the pt and awake him at night so we have to remove the pulp.

2.if they remain, they can go through the apical foramen and cause periapical lesion
( apical peridontitis or apical abscess ,….. )

 So it is not enough to remove the pulp only , you must remove a layer of dentin
all around the canal , to make sure that you clean the pulp from all source of bacteria
& its byproduct .

Note :
As you know , the canal is not straight at all , it has areas of concavity so
the irrigant solution cant reach these areas ( cleaning & shaping produce a
straight access to canal so the irrigant solution can reach it easily ).

 We cant instrument all parts of canal ,but instrumentation can :

1-facilitate the irrigation which can reach these area and dissolve infected dentin .
2- facilitate the action of intracanal medicament ( Ca(OH)2 ) which has
bactericidal effect and can dissolve infected dentin .
3-shaping the canal to→ facilitate the canal to receive the filling .

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  Shaping of canal :
As you know the GP is 3D filling , so we must shape the canal with continuous
taper ( which smallest diameter apically & largest coronally )

 Hand Instruments :
Such as K-file , remear , H-file , finger spreader
K-file : related to Kerr manufacturing company .

 File vs Remear :

Remear is less twist , more flexible , but less effective in canal preparation .so it is
rarely used now a day .

K-file vs Reamer H-file

 H-file :
1- have cone shape .
2- used to remove gatta percha during retreatment ,,if the gatta pearcha are not
well condensed / the chance of break is more than K-file , so you should be careful.

 Finger spreader :
Used for lateral condensation

 Barbed broach :
Used to pulpal extirpation
 K-files : Barbed broach

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1- length : it has 3 lengths ; 21mm , 25mm ,31mm ,
For molars we prefer use 21mm file in order not to
interfere with occlusion & coz the most molar canals
have 21mm length or less. Note :
31mm files usually used for canine. You should be careful
with color coding for
2- taper : it has constant taper 2% manual & rotatary
The tip diameter of the file = its size divided by 100 instrument.
Ex : file 20, its diameter (D0) = 20/100 = .2mm
( if we suppose that the length is 21mm)
Its diameter at 20mm (D1) = .2 + .02 = .22mm
Its diameter at 19 mm ( D2 ) = .2 + .02*2 = 0.24mm
D10 = .2 + .02*10 = 0.4
D16 = .2 + .02*16 = .52

for hand files , the standard technique is step back technique , that
mean when I increase the size of file by 5 , I must go a step backward ,
ideally we reduce .5mm (from length) with increasing each size , but if
the file is not go easily ( especially in posterior teeth ) , we allowed to
reduce 1mm.

The main disadvantages of this technique :

1-the time consuming ,
2- procedural accident ( because it is made of stainless steel , with
limited flexibility , so any excessive pressure , may cause ledge ,
perforation , etc ).
3-it may push the debris beyond the apical foramen.

Rotary instrumentation
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  We use crown down technique, we start with highest taper
instrument ( when we insert the file in canal , the contact points just in
coronal portion , so it will cut coronally :

1-enlarging the coronal part first

2- Improve the penetration of irrigant solution because you enlarge coronaly
3- Remove the infective debris which found mostly in coronal portion
4- Reduce the effective curvature ( so the canal become straighter make the
work easier & reduce procedural accident ).

 Nickel-titanium orifice shaper have replaced Gates-Glidden drills now a

day , and used sequentially from the largest to the smallest sizes.

 nickel-titanium characteristics :
1- Super elasticity
2- Shape memory
3- Resistance to cyclic fatigue
(that result from repetitive bending or motion
Or rotation )
4- It reduce the incidence of procedural problem
5- There is a limited use of NT files ( maximum for
5 canals )
Stainless steel file Vs NT file
*Stainless steel file is stiffer so,
if the file doesn’t go to the
lenght , you must replace it by
smaller size , in order not cause
ledge when it return to initial
shape due to excessive force .
*stainless steel has a sign for
fatigue , like glossy point ,
whereas nickel-titanium
doesn’t have a warning sign.

 Today we will talk about the most common rotary system ;

1- Profile ( the oldest one , introduced in 1994)
2- Protaper
3- Protaper next ( introduced in 2013 , as a modification of potaper)

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  Profile system :
1- The files have triple U-shape cross section with radial land
2- It has ISO file tip (standard size tip) as k-file , #10,#20 ,#25 , ….. , #40 ,
some reach to file size 90
3- It has .04 or .06 taper .( it may has .02 taper , but rarely used)
4- It fit on special low speed hand piece.

Flat Radial land:

- it keep the file centered in
natural root canal while enlarging
it , prventing the instrument for
being stuck the canal while it is
being rotated

- but it reduce the efficiency of

cutting .

 Each profile file has a certain

number of ring on its base , which
indicate its taper :
1 ring , mean .02 taper
2 rings , mean .04 taper
3 rings , mean .06 taper

 As we said befor , it has ISO tip

,so size 30 file (blue color file ) ,
has .3mm tip diameter
D0 = .3mm
If taper .04 , then D1= .34mm
D2 = .38mm
If the taper .06 , then D1 = .36mm
D2 = .42mm

 It also has color code:

White : size 15
Yellow: 20
 In the DTC , we put a mark on the shank of
Red : 25
rotary file after each use , using sharp
Blue :30
instument , in order to count who many
times it was used . |Page5

After 5 uses of the file , you must get rid it.

 Green :35
Black : 40

 Protaper system :

-Protaper file is like modified profile file , with sharp cutting edges & no
radial land .

-So it is more effective in

cutting.
-but you should be careful
during use it , in order
not to stuck in canal.

- it has variable taper for same file ( not like profile )

(( it may start by .04 taper , then it become .07 , then .11))
-it is consist of 6 size files , 3 shaping files ( for coronal preparation ) &
3 finishing files ( for apical preparation )

 The first one is SX (

orifice shaper ) ,its length
is 2 mm shorter than other
(19 mm length). Coz it
designed to cut coronally
only.

 The other files , either

21mm or 25mm
Always start your RCT to locate the
canal with k files first then the rotary
instrument ,,,
‫؛‬: Deroo balkm :P

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 SX file :
1 - the tip diameter is .19mm ( a little bite smaller than file 20 )
( it has small tip , so you can insert it easily in the canal )
2 - But its taper is larger , it start by .035 mm , at D9 the taper become
.19mm ( 19% instead of 2%)
( it designed to cut coronally only , without any apical preparation )

S1 file :
1-its length is either 21 or 25mm
2- its tip diameter is .19mm
3-its taper is much larger than SX ( ex, at D4 the taper is 12% )
4-it used to prepare the coronal third . ( while S2 for middle third)
5-you have to insert k files first which equal or bigger then S1
You cant use file 10 then s1 immediately because you have to make sure
that the canal large enough so not dig the canal so I have to make sure
that I put k files with right diminution which in this case file 20 suitable

 The main difference
between shaping &
finishing file is :
Notes :
1- In the market , you can find Hand Protaper
files, they have the same features & concept of
Rotary protaper file , but they considered
safer for beginner .

The shaping file has 2- the canal must be wet , befor inserting the
greater taper coronally , rotary file .
while finishing file has
greater taper apically. 3- the rotary files cant be used with the
standered slow speed hand piece , because
they will break ( there is special hand piece
with 200 – 350 rps )
 F1 file :
1-its tip diameter is 0.2mm ( so it has yellow code as #20 k-file )
2-taper at D1= 7% , when you go coronally , it decreased to 5%
3-it can inter to full working length , to prepare the canal apically .

 It is not necessary to use all finishing files , we can stop at F1 or F2

according to situation .

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 We cant use rotary files in severly curved canals , because it become fatigue
& broken easily.

Important notes :
 Before you insert any rotary file , you must always negotiate the canal
using hand instrument ( K-file) , regardless the system used .
 ) ‫( بنسميهم فايالت االستطالع‬
 In order to know the patent of canal .
 if the canal was blocked , we couldn’t use rotary instrument.

 So before inserting any rotary instrument , you must negotiate the canal
by (equal or larger size K-file )
 Before inserting the SX file (.19mm tip diameter ) , you must insert
size 20 K-file .
 To make sure the canal is large enough , so the rotary file will not dig
the canal, it will enlarge the already existing canal.

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