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ProTaper System

The Pro Taper System ( Dentsply Maillefer Ballaigues, Switzerland ) represents a new generation of NiTi instruments currently a aila!le" The system was de eloped !y a group of endodontists ( Prof " Pierre Machtou ,Dr" #lifford $uddle, and Prof "%one &est") in corporation with Dentsply Maillefer" #ompared to other systems, these files demonstrate completely new file features it has !een designed !y 'ran(ois )e!y and *il!ert $ota" +,-. The distinguishing feature of the ProTaper System is the progressively variable tapers of each instrument that de elop a /progressi e preparation0 in !oth ertical and horizontal directions" 1nder use, the file !lades engage a smaller area of dentin, thus reducing torsional load that leads to instrument fatigue and file separation" /Taper loc20 is reportedly reduced, e3tending a newly found freedom from concern a!out !rea2age" This instrument system, consisting of three /shaping0 and three /finishing0 files4 But ery recently there was addition of 5 more )ccessory finishing files to this original ProTaper system, along with , retreatment files" 6t is !eing mar2eted as ProTaper Universal. )ccording to the de elopers, ProTaper nic2el7titanium rotary files su!stantially simplify root canal preparation, particularly in cur ed and restricted canals" 8and ProTaper 2it is also a aila!le" 9riginal ProTaper file design along with ProTaper Universal +:;. additional finishing files will !e ela!orated in this draft" 'or $etreatment files design refer in $otary NiTi in retreatment"

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File Design Features : ProTaper instruments ha e a con e3 triangular cross7 section which reduces the contact area !etween the file and dentin" fig

But '7,, '7;, = '7> has a reduced cross7 sections with a 17 shape to facilitate a higher degree of fle3i!ility" 'ig

6mpro ed cutting efficiency has !een safely incorporated through !alancing the pitch and helical angles for !etter remo al of de!ris out of the root canal and pre ent the instrument from screwing into canal"

Modified guiding tip and the aria!le tip diameters allow the files specific cutting action in defined areas of the canal with out stressing the instrument in other sections"

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ProTaper Configurations:

@) Three shaping files ---------------------- S X, S1 & S2 2) Three + T o finishing files ------------------ ! 1, ! 2, !" + )ccessory finishing files
!#&!$ )ll files are a aila!le in 5@ mm ,5> mm and ,@mm lengths" Shaping !iles. The Shaping 'iles are la!eled S-X, S- 1, an% S-2& The S-X Shaper is an au3iliary instrument used in canals of teeth with shorter roots or to e3tend and e3pand the coronal aspects of the preparation, similar to the use of *ates7*lidden drills or orifice openers" The )u3iliary Shaping instrument (S3) has no identification ring on its gold7 colored handle and a shorter o erall length of @< mm" The S3 has a D? diameter of ?"@<mm and a D@; diameter approaching @"5? mm" The shaping instruments ha e increasingly larger percentage tapers o er the length of their cutting !lades allowing each instrument to engage, cut and prepare a specific area of the coronal aspect of canal relocates canal orifices resulting in straight line access" S3 has a much Auic2er rate of taper !etween D@ and D< as compared with the other ProTaper Shaping files"

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The S-1 and S-2 files start at tip sizes of ?"@: mm and ?"5? mm, respecti ely, and each file gains in taper up to @"5 mm" But unli2e the consistent increase of taper per millimeter in the 6S9 instruments, the ProTaper Shapers ha e increasingly larger tapers each millimeter over the 14 mm length of their cutting !lades" This is what ma2es the instruments uniAue"

Shaping !ile S-1 is designed to prepare the coronal one7third of the canal, whereas Shaping !ile S-2 enlarges and prepares the middle third in addition to the critical coronal region of the apical third"

!inishing !iles& The three finishing !-1, !-2, !-" B 2 )ccessory finishing files !-#, !-$ ha e !een designed to plane away the ariations in canal diameter in the apical one7third"

!-1, !-2, !-" ha e tip diameters (D?) of 6S9 sizes 5?, 5>, and ,?, respecti ely" Their tapers differ as well" Between D ? and D,, they taper at rates of ?"?:, ?"?C, and ?"?< mmDmm, respecti ely" 'rom D; to D@;, each instrument shows a decreased taper that impro es its fle3i!ility"

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!-#, and!-$ )ccessory files are added under the name ProTaper Universal these files has ha e tip diameters (D?) of 6S9 sizes ;? and >? tapers differ !etween D ? and D,, they taper at rates of ?"?- and ?"?>mmDmm respecti ely" 'ote:- $edaction in taper form of these !-# and !-$ "

ProTaper (enefits& @" 5" The progressi e (multiple) taper design impro es fle3i!ility and /car ing0 The !alanced pitch and helical angles of the instrument optimize cutting efficiency, an important asset in cur ed and restricti e canals" action while effecti ely augering de!ris coronally, as well as pre enting the instrument from screwing into the canal" ," ;" Both the /shapers0 and the /finishers0 remo e the de!ris and soft tissue The triangular cross7section of the instruments increases safety, cutting from the canal and finish the preparation with a smooth continuous taper" action, and tactile sense while reducing the lateral contact area !etween the file and the dentin" The modified guiding instrument tip can easily follow a prepared glide path without gouging side walls"

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)anal Preparation& ProTaper System: *+i%elines for Use @" Esta!lish a smooth glide path with No" @? and No" @> stainless steel hand files" 5" 1se ma3imum magnification to o!ser e the mo ement of the rotary instrument" /Seeing0 rotary apical mo ement is safer than simply /feeling0 such mo ement" ," 1se a torAue7 and speed7controlled electric motor, powering the handpiece at 2,, to ",, rpm" ;" Be much gentler than with hand instruments" )lways treat in a moist canal" 6rrigate freAuentlyF >" Slo %o n- Each instrument should do minimal shaping" 9nly two, three, or four passes may !e reAuired for the file to engage restricti e dentin and car e the shape to the proper depth" -" 6nstruments !rea2 when flutes !ecome loaded or when instruments are forced" #hec2 the flutes freAuently under magnification and clean them" #yclic fatigue from o eruse, or if the glide path is not well esta!lished, also leads to !rea2age" :" ProTaper instruments are disposa!le and, li2e all endodontic files and reamers, are designed for single7 patient use" Sometimes instruments are e en changed within the same treatment (eg, in the case of a four7canal molar)" C" 6rrigate with @:G EDT) or a iscous #helator during the ProTaper shaping" ProTaper System: .ire/tions for Use @" 5" Esta!lish proper access and a glide path with No" @? and No" @> stainless steel files to the wor2ing length or the apical constriction e3it" 'lood the canal and cham!er with sodium hypochlorite and !egin shaping with the Shaper S-1 using multiple, passi e7pressure passes" *o no deeper than three7 Auarters of the estimated canal length" 6rrigate and recapitulate with a No"@? hand file, esta!lishing patency to full wor2ing length" Now, with S-1, e3tend the preparation to full wor2ing length" )gain irrigate and recapitulate"

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/Brush0 with the Shaper S-X to impro e the straight7line access in short teeth or to relocate canal access away from furcation in posterior teeth" Shaping file S-2 is now used to full wor2ing length" 6rrigate, recapitulate, and re7 irrigate" #onfirm and maintain wor2ing length with a hand file" ($emem!er, as cur es are straightened, canals are shortened") &ith !inisher !-1, passi ely e3tend the preparation to within ?"> mm of the wor2ing length" &ithdraw after one secondF )nd only one secondF The !-1 has a tip size of ?"5? mm, and if a No" 5? hand instrument is found to !e snug, the preparation is finished" &ith the instrument in place, radiographically erify the e3act length !efore final irrigation"

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6f the !-1 and the No" 5? hand file are loose, continue the preparation with the !inisher !-2, which is ?"5> mm diameter at the tip" #onfirm with a No" 5> hand instrument and, if snug, confirm the length radiographically and irrigate"

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6f the !-2 instrument and the No" 5> hand file are loose, continue the preparation to Hust short of the wor2ing length with the !inisher !-" file, which has a ?",? mm tip diameter, and follow with the confirming No" ,? instrument" 6f the No" ,? is found to !e snug, the preparation is finished" 'reAuent irrigation and file cleansing are imperati eI irrigation an% re/apit+lation&

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1se !-# and !-$ for finishing wider apical areas" ) study using micro 7 #T showed that the ProTaper created consistent shapes in

constricted canals without o! ious preparation errors, although wide canals may !e insufficiently prepared with this system" 9")"Peters et al, concluded in an in Jitro study that, ProTaper instruments may !e more effecti e in shaping narrow canals than wider, immature canals" +,:." To attend this a!o e pro!lem pro!a!ly two more finishing files !# & !-$ are added to the original instrumentation"

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6n a comparison of ProTaper and K, instruments (Sy!ron Endo, *lendora, #)), Bergmans et al +,C. found few differences, with the e3ception of some transportation !y the ProTaper into the furcation region" %7L Blum,et al +,<. in a study !y using Endographe ha e found that the ProTaper shaping files are !est used with lateral forces to decrease the coronal screwing effect" The ProTaper finishing files should !e used with slow penetration and !e introduced only into canals that ha e a confirmed smooth and reproduci!le glide path"

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