Documente Academic
Documente Profesional
Documente Cultură
Hashim M. Hussein
M.Sc. of Conservative Dentistry
• Cleaning and shaping is one of the most important steps in the root
canal therapy for obtaining success in the root canal treatment.
• For the success of endodontic treatment one must remove all the
contents of the root canal completely because any communication from
root canal system to periodontal space acts as portal of exit which can
lead to formation of lesions endodontic origin.
• Instruments and irrigants must go deeper into the canals to remove all
the debris and contents of root canal.
• After obturation, there should be complete sealing of the pulp
chamber and the access cavity so as to prevent microleakage into the
canal system.
• Hand files are the most commonly used for endodontic instruments.
This group of instruments has been manufactured from stainless steel
instruments.
2. Filing:
• Push-pull motion of an instrument.
• Used with file.
3. Combination of Reaming and Filing:
• File is inserted with a quarter turn clockwise and
apically directed pressure (i.e. reaming) and then
is subsequently withdrawn (i.e. filing).
• Watch winding motion is less aggressive than quarter turn and pull
motion (Combination of reaming and filing) because in this motion, the
instrument tip is not forced into the apical area with each motion,
thereby reducing the frequency of instrumental errors.
Techniques:
• Determine WL and select initial apical file.
• Do circumferential filing to increase the apical
constriction 2 to 3 files sizes greater than initial
apical file.
Step back technique:
• It also known as Telescopic (Serial) canal
preparation technique. It includes keeping
the apical preparation small with a gradual
taper coronally.
• For radicular access, the original ProTaper system offers the auxiliary
shaping file SX, which is used in a brushing motion on the outstroke to
pre-flare the orifice, eliminate triangles of dentin.
• The glide path may be further enlarged with either a #15 hand file or
dedicated mechanical glide path files, such as PathFiles (DENTSPLY).
• The PTN files are used with an outward brushing motion. This method
creates lateral space and enables this file to progress a few millimeters
inward. A brushing action serves to improve contact between the file
and dentine, especially in canals that exhibit irregular cross-sections.
• Insertion of PTN X1 file through the canal.
• Irrigate and flush out gross debris, recapitulate with a #10 file.
• Once the PTN X2 file has reached the working length, it is removed.
The shape may be confirmed as finished when the apical flutes of this
file are visibly loaded with dentine.
• residual debris and move the debris into solution, then re-irrigate to
liberate this debris.
• The PTN X4 and X5 files are primarily used to prepare and finish larger-
diameter canals.
• If there is any doubt as to whether the orifice has actually been found,
place a small instrument in the opening and take a radiograph.
• Once the orifice has been located, a No. 8 K-file is
penetrated into the canal to negotiate the calcified canal.