Beruflich Dokumente
Kultur Dokumente
1- Endodontic explorer
Double ended instrument with tapered tines at right or obtuse
angle.
2- Pulp tester:
3- Tooth slooth:
It is used for diagnosing various
stages of incomplete crown
fractures (cracks).
It is designed in such a way that
chewing force can be applied
selectively on one cusp at a time.
4- Transillumination
By placing a high-intensity light source on the tooth surface, a
root fracture can be observed.Access cavity is viewed with
cervical fiber optic transillumination.
I n s tru m e n ts u s e d fo r a cce s s
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B- Instruments used for root canal
preparation:-
1- Reamers 2- Files
According to the material of which R C instruments are
made, we have 3 materials:
•Carbon steel, it is not used now because of its liability to
corrosion.
•Stainless steel, it is more resistant to corrosion but it has
limited flexibility.
•Nickel-titanium, it is more flexible & is more adaptable to
canal curves (3 times as flexible as st.st. with very low
modules of elasticity)
Factors Affecting Flexibility
- Instrument cross sectional shape
- Number of flutes
- Work hardening
- Material
- Size
Work Hardening:
Work hardening is a function of size, shape and
tightness twists i.e.:
1. For the same shape and amount of twists the larger
the instrument the greater the work hardening.
2. A square shafted instrument due to it’s greater bulk
at the extremities will have greater work hardening than a
triangular instrument.
3. The tighter the twists the greater the work hardening
induced [i.e. Reamers have ½ No. of flutes of files and ½
work hardening.
Effect of material on flexibility
Advantage:
Increased flexibility is that a file may follow the canal curvature
with less deformation of the curve during enlargement.
Disadvantage:
Less control in negotiating tiny canals
Inability to pre-curve the file for introduction into canals of
posterior teeth when there is a decreased inter occlusal
opening.
Cutting efficiency may be reduced compared to stainless
steel due to the greater elasticity.
Thus to benefit from nickel-titanium, (passive
instrumentation) may have to be substituted for more
aggressive use, including engine-driven configurations.
Standardization:
This includes:
1. length
2. sizing
3. tip design
4. torsional limits
5. color coding
1. Lengths:
File & reamer lengths are available in 3 shaft
lengths 21, 25, 31 mm.
Shorter instruments offer improved operator
control and easier access to posterior teeth, to
which limited opening impairs, access.
Longer roots are served by 31 mm instruments
2. Sizing:
3. Tip design:
Tip angle of K-type files & reamers is 75O +
or – 15O
New instruments have different tip angles &
designs to minimize canal alterations.
Non cutting tips guide the file through the curve rather than cut
the outer canal wall.
4. Torsional limits:
It is the amount of rotational torque that can be applied to a
locked instrument to the point of failure (separation).
Instruments should have sufficient strength to be rotated and
worked vigorously without separation.
5. Color coding:
color coding of file handles indicates size as follows
Size D0 D 16 Handle color code
Size D0 D 16 Handle color code
and specification for shapes of tip-75°, plus or minus 15°.
The ground twisted instruments include:
K-type reamer K-type file
K-flex file Flexofile
Names Cross section Type of motion
Names Twisting and Cross
pullingsection Type of motion
reaming action
K-reamer stainless
Twistingsteel blank
and pulling reaming action
i.e. rotation &
K-reamertriangular
stainlessor square
steel blank
i.e. rotation &
triangular or square
in cross – section. passive withdrawal
in cross – section. passive withdrawal
Twisting square or
Twisting square or
K-file triangular cross section
K-file st.triangular
st. st.
blank
cross section
st. blankwith
with Passive “widdling”
2.52.5
twists
twistsper
permm.
mm.
Passive “widdling”
motion
motion
Twisting and
Twisting andpulling
pulling aa
rhomboidal
rhomboidal cross
cross section
section Rotated
Rotated (1/4(1/4
turn)turn)
and and
K-flex
K-flex filefile st. st. blank. It has
st. st. blank. It has withdraw
withdrawn n ag aiag nst
ai nst
moremore flexibility&&more
flexibility more
d iff erent portion
d ifferent portion
cutting efficiency.
cutting efficiency. o f the ca na l w a ll
o f the ca na l wa ll
(circumferential filling)
(circumferential filling)
Twisted from a st st blank of
Twisted
Flexofile triangularfromcross
a stsection
st blank of
with
1.81 flutes
triangular per section
cross mm. the with
tip is
Flexofile
1.81modified
flutes perto bemm.
non-cutting.
the tip is
modified to be non-cutting.
Those instruments are made from a st st wire that is 1st ground to
a tapered triangle, square, or rhomboid cross section, then it is
twisted to generate the instrument.
“K” Type Files and Reamer: [Ground Twisted]
- Introduction by Kerr in 1901.
- “K” type instruments are stiffer than other instruments due to
their mode of manufacturing [Twisting and Pulling] as:
• Grain structure of the wire is preserved.
• The entire bulk of metal makes up the blade with it’s
cutting edges.
A- Ground twisted instruments:
i- K-type instruments:
K-type file & reamer (Kerr manufacturing company): are the
oldest instruments used for canal preparation.
K-reamer:
ii) K-file:
iv) Flexofile:
This is a flexible instrument twisted from a st st blank of triangular
cross section with 1.81 flutes per mm. the tip is modified to be
non-cutting.
B- Machined Files
Modification of the H-file where one side of the file (the flutes) are
ground flat along its length. Cross section: rounded with one flat
side used for anti-curvature filing.
3) “S” files (S shape):
N .B .
W ith th e “S ” file : c u ttin g is m o s t
e ffic ie n t in p u ll s tro k e s , h o w e v e r
its d e s ig n a llo w s fo r c u ttin g b y
ro ta tio n a s w e ll.
T h e m a n u fa c tu re r re c o m m e n d s
re a m in g fo r a p ic a l p re p a n d filin g
fo r c o ro n a l fla rin g
4) Helifile:
manufactured similar to “H” & unifiles. It has 3 cutting blades:
In appearance it resembles a reamer.
It has greater cutting efficiency & flexibility
5) The Flex R File:
2) Gates – Glidden Drills:
Sizes:
From 1 to 6
No. 1 = file # 50
No. 2 = file # 70
No. 6 = file # 150
15 or 19 mm long
Uses:
• Achieve straight line access by reaming dentin shelf.
• Flaring of occlusal and middle canal third [not beyond the
curvature]
• Remove G.P. & drill post space.
• Used from small to large sizes (step back) or large then
smaller size (crown-down)
N.B.
• It should not be used with pressure.
• The instrument is designed to break high in the shank to
facilitate its removal upon breakage as the broken part will
protrudes outside the canal.
3) Peeso Reamers:
They are both aggressive and might rapidly over prepare the
canal or cause perforations if used incorrectly.
3. Protaper files
Protaper files are Multiple & progressively tapered, nickel titanium
,rotary files. from 2 % -19% ( different taper in the same file ).
It also serves clinically to improve flexibility, cutting efficiency &
reduce the number of recapitulations needed to achieve length,
specially in tight or more curved canals.
3) Root canal pluggers
4) Heat carriers:
5) Thermo-mechanical compactors:
[McSpadden Compactor] are engine driven with
flutes that resemble inverted “H” file.
Mechanism: Frictional heat softens G.P. in the
canal and compact G.P. by its flutes.
Disadvantages.
- possible over heating. - breakage in the canal.
6) Ultrasonic Spreaders:
Resemble regular spreaders but are mounted on an ultrasonic
unit. The vibrating spreader thermo-mechanically softens G.P.
and is used for warm lateral condensation
V. Miscellaneous Instruments
2) Endodontic locking tweezers:
Allows easy handling of materials as paper points, gutta-percha
etc. in 4 handed transfers.
3) Endodontic Rulers:
For file length measurements. They have different designs and
should be autoclavable for sterilization and infection control.
4) Irrigation syringes
5) Paper points:
Come in standardized sizes used for
drying, carrying medication or taking
cultures.
6) Length stops:
Rubber or silicon stops.
Metal stops.
Test handles
It is an adjustable handle that can be moved on the
instrument shaft and locked at a specific length.
Pastes, zinc oxide petroleum jelly rubber dam material
were used to place marks on the file.
N.B.
When placing a stop on the instrument, it is important to avoid
angulations of the stopper ,which might measure different lengths
as the file is rotated.
7) Laser Endodontics
Attempt to retroseal the apical orifice of the root canal using
an
Nd:YAG and
a carbon-dioxide laser.
8) Rubber dam
Device utilized to isolate the tooth under treatment from the oral
environment to prevent contamination and aspiration or
swallowing of instruments by the patient.
9) Magnifying Devices
11) Transfer sponge
A sponge in a glass or plastic dish soaked A special storage and measuring device is
with alcohol is ideal for organizing, cleaning, conveniently fit on the index finger.
storing files and Gates-Glidden burs during
the appointment.
Motions Description
Motions Description
1) Reaming motion
An instrument is rotated in a clockwise direction and withdrawn
passively from the canal without applying any pressure on the
canal walls.
It is used in the apical part of the canal to produce a circular cross
section that match the cross section of gutta-percha points.
2) Filing motion
4) Watch-winding
5) Balanced force
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