Endodontic instruments

Materials


Carbon steel Stainless steel Nickel titanium Titanium

ISO standardization (Ingle and Levine)

1.

Numbered from 10 to 100. Advance by 5 units to size 60, then by 10 units to size 100. Representative of the diameter of the instrument in 100ths of a millimeter at the tip. Flutes shall begin at the tip, (D1) and shall extend exactly 16 mm up the shaft, terminating at D2. The diameter of D2 shall be 32/100 or 0.32 mm greater than that of D1.

2.

3.

MODIFICATIONS: D3 D16

Classification

Grossman


Exploring instruments Instruments for debridement Shaping instruments Obturating instruments

ISO Grouping


Group I: hand use only Group II: engine-driven latch type Group III: engine-driven latch type Group IV: root canal points

Cohen


Hand instruments: those specific to endodontics Instruments for pulp space preparation Devices for root canal length measurements Instruments for root canal obturation Devices for removal of root canal obstructions

ADA
        

Type Type Type Type Type Type Type Type Type

I : Reamers II : Files III : Hedstroem files IV : Rasps V : Broaches VI : Probes VII : Applicators VIII : Condensers IX : Spreaders

Harty


For access cavity preparation

  

Basic instruments Burs Rubber dam

For root canal preparation

 

Hand instruments Power assisted root canal instruments

Electronic canal measuring system Measuring instruments, gauge and stands. Instruments for retrieval of broken instruments and pastes.

Instruments for root canal filling

Hand instruments specific to endodontics

DG 16 EXPLORER ENDODONTIC SPOON

LOCKING PLIERS

Burs for access cavity

File Design

Rake Angle


Negative rake angle

Positive rake angle

Cont..
Negative angle Positive angle

 in rotary instruments

Core

The core is the cylindrical center part of the file having its circumference outlined and bordered by the depth of the flutes.

Core taper

Flute depth also influences core diameter in the same series of files.

Tip design
  

Active Partially active Passive

Taper


ISO 02

ISO 06

Torque


Torque force producing rotation.



Instrument mass Surface area of contact Radius of curvature

Instrument Failure


Torsional failure

Flexural fatigue

When torque limit of the instrument is exceeded

Arises from minute surface defects and occurs after cyclic fatigue

ISO Group I

1904

Broaches
  

Barbed broaches Rasps Smooth broaches Pathfinder CS

K reamer vs. file

K file modifications

K-Flex

Flex-R

Cont..
Golden Mediums

Flexofile

Flexicut

H-files: ADA Specification No. 58

H-file Modifications
     

Burns Unifile Dynatrak S-file Safety Hedstroem NT Sensor file (MAC file) A-file

Unifile

A-File

Noncutting tip

H-File

A-File

Safety Hedstroem

Safe sided

Apical Preparation Hand Instruments

    

Apical Reamers (Otani) Canal Master (Wildey and Senia) Canal Master U Flexogates Heliapical

Canal Master and Canal Master U



Wildey and Senia

  

1-2mm cutting head 0.75 mm non-cutting head Blank shaft

Flexogates


Hand modification of GG drills

Heliapical
 

Apical 4-5mm length Blank shaft

U-files Heath (1988)

   

Canal Master U Ultra-Flex NITIMAC Lightspeed, ProFiles, GT files

Instruments for obturation



Spreaders

Pluggers

Hand pluggers

Lentulospirals

Sotokawas Classification of Instrument Damage

ISO Group II and III

1912

Handpieces


Classification Ingle
   

Full rotary latch/friction grip Reciprocating/Quarter turn Special vertical and reciprocating Sonic and Ultrasonic

Stock


Rotary Reciprocal Vertical Random

Advantages


Disadvantages


Easy to use Saves time

Transportation, ledging and perforations Hand instrumentation necessary Apical packing of debris

 

Reduction in fatigue


Reduction in treatment time

Rotary Contra-angle Handpieces

 

Straight line drilling Uses



To develop coronal access Prepare post space channels Widen the coronal two thirds of canal With ss instruments used in straight canals only

Reciprocating Handpieces


Giromatic quarter turn (90)

 

Latch-type only 3000 turns/min

Cont


M4 Safety Handpiece (30)



Latch and regular hand files 1500 rpm

Endo-Gripper (45)
 

Regular hand files 10:1 reduction

Vertical Stroke Handpiece



Canal Finder Levy



 

0.3-1 mm stroke Used with A-file Additional quarter turn reciprocal motion

Cont


Canal Leader
 

0.4-0.8mm 30

 

Racer Intra-Endo 3LDSY Endolift

Random Movement


Excalibur
  

Random lateral motion only 1.5-2mm lateral motion 20,000-30,000 rpm

Engine driven instruments



Gates Glidden drills safe tip

  

Orifice opening Deeper penetration into straight canals Removal of lingual shoulder

Peeso reamers
 

Post space preparation Use safe-tipped to prevent lateral perforation

Availability Nos. 1 to 6

Martins Orifice Opener



More flexible 25-70

McSpadden Engine files



NiTi instruments:  Sensor files redesigned H  NiTiXL Finishing file U style  NT Power file

Gear Reduction Handpieces

Green Band

Spin burs at speeds lower than the motor speed  Ratios ranging from 8:1(1/8th motor speed) to 27:1 (1/27th motor speed)

   

Quantec ETM MicroMega 324 Aseptico New:

   

TriAuto ZX TCM ENDO Endo-Pro Electric Protorq

Sonic Handpieces 2-3 kHz

SONIC AIR

OSCILLATIONS

Sonic instruments
RispiSonic ShaperSonic TrioSonic

Ultrasonic Handpieces 20-30 kHz

PIEZOELECTRIC
MAGNETOSTRICTIVE

N = NODES A = ANTINODES

Acoustic Microstreaming

Cavitation

Ultrasonic tips

NiTi Rotary Systems

Nickel-Titanium
  

1962 Buehler Naval Ordnance Laboratory 55 NiTiNOL

   

55 wt % Ni 45 wt % Ti 2% Ni substituted with Co Equiatomic alloy

1988 Walia et al - endodontics

Properties


  

  

Show shape memory and superelasticity Softer than stainless steel Not heat treatable Have a low modulus of elasticity; but greater strength Tougher and more resilient VHN is 300-350 (SS-530) Lower cutting efficiency

Deformation
Stress

AUSTENITE

MARTENSITE

Superelasticity and Shape Memory

Manufacturing

NORMAL FINISH

ELECTROPOLISHING

ProFile Family


 

Profile 04 and 06 Orifice Shapers GT files



strength and flexibility radial-landed Ushaped flutes that lift debris coronally noncutting tips

ProFile Series 29 - 1992

Machtou and Schilder Constant percentage change

Percentage = Change

(B) D0 (A) D0 (A) D0

100 = 50% 100 = 33% 100 = 10%

100

10-15 = (0.15-0.10)/ 0.10 15-20 = (0.20-0.15)/ 0.15 50-55 = (0.55-0.50)/ 0.50

Standardized instruments
15

% Increase in diameter at D0

10

Instrument sizes

percentage change = 29% 0.129-1.000 mm

ProFile 04 and 06 - 1994

Sizes 15-40

Orifice Shapers


 

10mm cutting blades D0 20-60 Taper 05-08

Greater Taper files



  

1996, Stephen Buchanan D0=0.20mm MFD=1.0 mm Variable pitch and lengths Tapers:06, 08, 10, 12

GT Accessory files
   

3 instruments Taper=12 MFD=1.5 mm D0= 0.30, 0.50, 0.70 Coronal shaping

Protaper Progressive Taper



Pierre Machtou, Clifford Ruddle and John West 2001

Shaping files..


SX
 

D0=0.19mm Taper=3.5-19% D0=0.17mm Taper=2-11% D0=0.20mm Taper=4-11.5%

S1
 

S2
 

Finishing files


F1
 

D0=0.20mm D0-D3=7% D0=0.25mm D0-D3=8% D0=0.30 D0-D3=9%

F2
 

F3
 

Lightspeed
 

Wildey and Senia 1992 Sizes

 

20-140 5 half-sizes: 22.5,27.5, 32.5, 57.5, 65 0.16-0.51 mm diameter

Thin shafts- 0 taper



Speed 1500 rpm

Cont..


Cutting heads variable

 

Length= 0.25mm 2.25mm Tip angles= 21, 33, 75 Non-cutting

Quantec
  

McSpadden Reduced radial lands 2 fluted

Types

Safe Cutting SC


(60)

Non-Cutting LX

cont
   

D0=0.25mm Taper= 02, 03,04, 05, 06, 08, 10,12% Variable helical angle 340 rpm

HERO 642
 

High Elasticity in Rotation Tapers: 06, 04 and 02%



 

Trihelical Hedstroem design Large central core 20 to 45

K3


McSpadden 2002


02 taper 1545 04, 06 taper 15-60 Safe-ended

Positive rake angle

Vs.

Variable core diameter

Variable helical flute angle

Stronger cutting blade

Relief = less friction

Third radial land no relief Axxess handle = 4mm shorter

Newer Systems

Liberator


Straight-flute design cannot self-thread Lack of radial lands reduces friction High RPM 15002000

Roane safety tip

Manufacturing eliminates transverse microcracks

 

02, 04, 06 tapers 15-70 sizes Coronal shapers

  

Modified GG Taper= 08 D0=118,94,70

RaCE


Reamer with alternating Cutting Edges



prevent the threading an extremely low operating torque

Sharp cutting edges Safety MemoDisc for controlling NiTi fatigue;

Electro-chemical treatment: better resistance to torsion and metal fatigue

S-Apex
    

Apical preparation after using Race Inverted taper Non-threading Predetermined breaking point 15-30 sizes

Weakest part at 16mm

Endosequence


Brave and Koch

Triangular cross-section No radial lands

Alternating Contact Points (ACP) Electropolished surface Precision tip

Files


 

Taper 04 and 06 4 files each Small



Expeditor file
  

O4 taper 27 size 21mm

15-30


Medium


25-40 35-50

Large


Coronal channeling and gauging

M Two
  

Taper 04-07 10-40 sizes 4 instruments

Almost straight flutes 2 flutes