Balanced Force

May the force be with you

History
Balanced Force Concept was introduced by Roane in 1985 after 12 years of trial and error experimentation. It is proposed as a mean of overcoming the curvature influence. (1)

What is Balanced Force?

An instrumentation technique that utilized rotational movements of modified KK-type file.

A. KK-file B. Modified KK-file (parabolic tip)

3 steps of BF technique
1. PlacementPlacement-clockwise 2. CuttingCutting-counterclockwise 3. CleaningCleaning-clockwise

Roane also proposed the access opening being flared by using Gates Glidden to alter the curvature of canal.

Rationale Behind Balanced Force

Why triangular (cross(crosssection) file?
K-type file can be used as a bidirectional cutting tool without a loss of efficiency. CrossCross -sectional mass is reduced= more flexible Flute depth is increased=more efficient cutting

Why Rotation?
According to Roane, the balanced force concept is based on Newtons Third Law for every action there is an equal and opposite reaction.

Why Rotation?
Circle -> dentin as it contacts the cutting edges of a file. R -> the internal force applied by dentinal hardness as it is vectored toward the center of the instrument. S -> restoring force applied against the curvature by the file attempting to return to its original straight condition.

Roane stated 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.

Why counterclockwise rotation?

Clockwise-file threads Clockwiseinto dentin and pulls away from the operator Counterclockwise-file Counterclockwisepushes toward the operator and allows more control.

Clockwise or Counterclockwise?
In Roanes other study Clockwise or Counterclockwise he stated that in clinical setting, counterclockwise rotation result in significantly less file separation, distortion or damage leading to discard. (1:10)

Clockwise

Counterclockwise

Clockwise

Counterclockwise

Any Question???

Roane stated 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, reaction, making it possible to ignore curvature during canal preparation.

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When is the last time you see a perfectly circular canal? Most canals are ribbon shaped or irregular.

Thenwhy does balanced force work?

Would it be the

modified file?

Powell et al. Study

Part I Hand preparation (reaming &filing vs. balanced force) with the modified tip was significantly better than nonmodified. Part II Commercially modified (R(R-type) file provided the closest to ideal instrumentation regardless of technique used!!!

Kyomen et al. Study

Kyomen et al. Study

Compressive forces required to bend files.

Clinically applied apical forces of instrumentation

Why do the modified files work better? According to Kyomen study, operators tend to apply heavier force than needed for the file to compress and conform to the canal, therefore a dull file will less likely gauge into the dentin and ride on the curve better.

Sohere are the reasons we know why balanced force work.

1. modified tip allows the file to follow canal anatomy more easily without engaging and cutting the dentin(#7,9) 2. triangular crosscross-section of the file allows greater flexibility (5.13) 3. Coronal 2/3 of the canal is flared. This access preparation reduces the arc of the curvature of the canal. 4. instead of what Roane proposed, this technique places flexible files in compression, so they preferentially bend in the direction of least possible resistance(canal path).

Conclusion
The balanced force technique works clinically (especially curved canals), but its success may be due to file design and reasons other than originally proposed.

The End

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