rotaper instrument was made to provide flexibility and efficiency to achieve consistently successful cleaning and shaping results.

With Protaper instrument, root canal preparation are relatively easier and faster. Follow this guideline to use Protaper instrument. Guidelines:

Establish straight line access Carefully flare the orifice(s) with gates glidden drills Use instruments in a well irrigated and lubricated canal Create a smooth glide path with small hand files Clean flutes frequently and inspect for signs of distortion Use SX to create more shape, as desired, in the coronal two-thirds Use instruments with recommended motion.

Manual ProTaper Handle Motion:

Lightly engage dentin by gently rotating the handle clockwise until the file is just snug Disengage the file by rotating the handle counterclockwise 45-90 degrees Cut dentin by rotating the handle clockwise while simultaneously withdrawing the file Repeat handle motions until desired length is achieved Depending on the anatomy, Potaper files can be used as described above or by reciprocating the handle in a back and forth motion.

The ProTaper Technique:

1.

Fill the pulp chamber with either Protaper Glyde or Sodium Hypochlorite (NaOCl) for all initial negotiation procedures. Explore the coronal two-thirds of the canal with stainless steel No. 10 and 15 hand files, using a reciprocating back and forth motion. Work these instruments passively and progressively until they are loose.

2.

Start the Protaper sequence with S1 (purple). The apical extent of S1 will passively follow the portion of the canal secured with hand files. S1 is designed to cut dentin, in a crown down manner, with its bigger, stronger and more active blades. Irrigate, recapitulate with the 10K File to break up debris and then re-irrigate.

3.

In more difficult canals, one, two or three recapitulations with S1 may be necessary to pre-enlarge the coronal two-thirds of the canal. Frequently clean the blades, then continue using this file until it reaches the depth of the 15 hand file. Irrigate, recapitulate and then re-irrigate.

4.

Once the pre-enlargement procedure is finished, use a precurved No. 10K File in the presence of NaOCl or Glyde to negotiate the rest of the canal and to establish patency. Determine working length with No. 15K File.

5.

When a smooth glide path to the terminus is verified, sequentially carry first S1 then S2 to the full working length. Remember to irrigate, recapitulate and re-irrigate after each Protaper instrument.

6.

With the canal flooded with irrigant, work the F1 to length in one or more passes. If the F1 ceases to advance deeper into the canal, remove the file, clear its blades, then continue with its use until it reaches length. Irrigate, recapitulate and re-irrigate.

7.

Following the use of F1 to length, gauge the foramen with a 20 hand file. If the 20 hand file is snug at length, the canal is shaped and ready to fill. If the 20 hand file is loose at length, proceed to the F2 and, when necessary, the F3, gauging after each Finisher with the 25 and 30 hand files, respectively.

Endodontics Protaper NiTi demo on block - video

This video shows a very brief overview, demonstrating how the Protaper system uses variable taper files to cut different parts of the canal. This ensures that only part of a file is under stress at any one time, reducing the chance of separation (fracture).

S1 (Purple). Maximum taper is coronal. Used to create coronal flare.

S2 (White). Maximum taper is in middle of file. Used to access to the apical region. F1 (Yellow). Maximum taper is at tip. Use to prepare apical region to size 20. F2 (Red). Maximum taper is at tip. Use to prepare apical region to size 25

Protaper consists of Shaper files (S1, S2) which do the bulk of the dentine removal coronally, and Finisher files which do the apical preparation (F1,F2,F3). Their shapes are subtly different: The shapers are a bit like the Eiffel Tower, and the Finishers are a bit like the Gherkin

NiTi files are however often used in conjunction with other techniques.

The sequence we would often use incorporating Protaper is:

Prepare coronal with Gates Glidden Drills sizes 4, 3, 2. Take the flare about 1/3rd way down canal. Brush on the "safe side" with GG2 to improve straight line access, and relocate

canal away from danger areas like furcations. The Protaper S1 can also be used for relocating the coronal part of a canal, using a brushing action. Determine Working Length (EAL + radiograph) Ensure there is a size 15 glide path to length. Pre-flare middle and apical with Hand ProTaper short of working length, then finish with hand files as follows: Set S1 & S2 to 1mm short of TWL. Introduce S1 into canal to TWL-1mm. If resistance felt, gently brush laterally away from furcations. Repeat with S2. Re-measure the Working Length with an apex locator. It may have shortened by 0.5 to 1mm Set S1 & S2 to the (new) working length. Insert S1 to (new) WL. Insert S2 to (new) WL. Re-confirm Glide Path with size 15 & 20 SS Hand Files Re-measure the Working Length with an apex locator. Insert F1 to 1mm short of WL. Remove immediately. (Size 20 tip, 7% taper) Insert F2 to 2mm short of WL. Remove immediately. (Size 25 tip, 8% taper) Insert F3 to 3mm short of WL. Remove immediately. (Size 30 tip, 9% taper) You have now created a flare (7%+ taper) which will allow (2% taper) hand instruments to reach the apical region without binding on the sides of the canal. This allows apical gauging to proceed without worrying the file is binding on the canal walls. Gauge the apical diameter Prepare the definitive Apical Flare Having gauged the apical diameter, prepare two or three sizes above with 2% SS hand files.(prepare to TWL). THE MAF (MASTER APICAL FILE) SIZE HAS NOW BEEN SET Flare the apical region by stepping back 1mm a time with successively larger files. (May be 1/2mm step back) Your step-back apical prep will "blend" quite quickly with the NiTi pre-flare. Use circumferential filing to smooth the canals walls. THE CANAL PREP IS NOW COMPLETE We do not recommend using engine-driven Rotary NiTi files for apical finishing. They are so sharp and efficient at cutting it is very easy to accidentally over-prepare the apical region if the canal is curved.

ProTaper System
Online Catalogue | Protocols | ProTaper System

Pierre Machtou The ProTaper system is the alternative to all other file systems in which each file has a fixed taper. Each ProTaper file has a variable changing taper over the length of its cutting blades. Specifically, the ProTaper shaping files have small-sized tips, which act as guides to follow the path of the canal previously secured with hand files. Progressively tapered shaping files work away from their apical extents and, importantly, selectively cut dentin toward their larger, stronger and more active blades. In fact, this variably tapered concept and method of use resulted from the Schilder technique, in which precurved reamers were sequentially selected, rotated in an envelope of motion and cut dentin on the withdrawal stroke to create a predictably tapered shape. ProTaper shaping files have a cross-section similar to that of reamers and, as such, are allowed to passively "float" into the canal and "follow" the glide path. To optimize safety and efficiency, shaping files are used like a brush to laterally and selectively cut dentin on the outstroke. A brushing action creates lateral space, which will facilitate moving the shaping file's larger and more active blades safely and progressively deeper into the canal. It is remarkable to note that, in this method of use, the files are essentially loose during the majority of their work within a canal. In the ProTaper concept, more than the instrument design, the motion with which the file is used, creates the shape. ProTaper Universal is a global endodontic concept involving all steps of the root canal treatment from access to obturation and retreatment. Specific instruments have been designed to simplify and make each procedure easier. The new line is compounded of an Endo access kit, ProFinders (scouting files), ProTaper paper points, Protaper Gutta Percha points, ProTaper obturators and a retreatment kit. The safety of the ProTaper rotary files has been improved with the elimination of the transition angle between the tip and the first cutting flute, and a modified cross-section for F3 making this file much more flexible. The new kit features two additional finishing files, F4 with a 0.40 tip diameter and F5 with a 0.50 tip diameter to address larger canals and for clinicians who believe in larger apical sizes. The ProTaper files are available for hand use and in 31 mm length.

Protocol 1- Cut an access cavity using the Endo access kit ( Dentsply-Maillefer) 2- Refine the canal orifices with the X-Gates at 700rpm to get a straight line access Place the X-gates along the natural axis of the orifice without working the instrument. Then, starting rotation, use a circular motion without pressure to create a funnel at this level. This should be followed by a brushing outstroke motion away from the furcation until the head of the X-Gates gets passively inside the canal orifice. 3- Fill the pulp chamber with a lubricant

A- Scout the coronal two-thirds 1-Select an ISO ? 10 K file precurved, and scout the canal to light resistance. Then, use a watch-windingpull motion to create space at this level. 2-Repeat the same procedure with the ? 15 K file and the ?20 K file. 3-Transfer the length of the ?15 K file to S1.

B- Shape the coronal two-thirds ( 300rpm ) with NaOCl irrigation At this stage, the apical three or four millimeters of S1 should be loose inside the root canal.

1-Start working S1 with a firm brushing outstroke action away from the furcation.to progressively reach the level of the 15 K file. Use a slow motion with a 4mm amplitude. Visually check the location of the debris on the flutes. No debris should be observed on the apical aspect of S1 2-As described for S1, work S2 slightly shorter than S1.

C- Scout the apical one-third 1-A?10K file, precurved, is used with a lubricant to negociate the apical third of the root canal and reach the apical limit. 2-Determine the working length with an apex locator or an X-ray. Smooth the path of the canal using an upand-down motion with a short amplitude (2mm) until the file is loose. 3- Do the same with the ?15K file to get a long (4 to 5mm) and reproducible glide path.

D- Shape the apical one-third 1- Switch to NaOCl and work S1 with the same brushing action to the working length, but stop brushing I mm shorter and let the file passively reach the apical limit. 2-By hand, drop the rotary S2 to resistance in order to assess the distance of work to be done with that file. After an adequate work by S1, S2 should never have more than 2mm of work to accomplish. 3-Then use the engine-driven S2 as described for S1. Due to the brushing outstroke motion, the operator should feel that the previous resistance met in step 2, has been completely relieved 4- Disconnect the handpiece from S2 and confirm precisely the working length with an apex locator connected on S2

E- Finish and blend the apical one-third with the coronal two -thirds 1- By hand, drop the rotary F1 to resistance in order to assess the distance of work to be done with that file. After an adequate work by S1 and S2, F1 should never have more than 2mm of work to accomplish. Then, the engine-driven F1 is passively allowed to progress apically, in one or more passes, to reach the canal terminus. F1 must be used in a non -brushing manner with no vertical pressure. The author preference for this stage is to use a manual F1 with an apex locator connected on it, to precisely achieve the apical shape. For manual ProTapers, the recommended motion is : half a turn clockwise- three quarter turns anticlockwise while withdrawing the file 2- Following F1, a ? 0.2/20 K file is dropped inside the canal to gauge the apical diameter. If the file is snug at the working length, the apical size is 20 . In this case, F2 and F3 must systematically be used in a stepback fashion to increase the deep shape. F2 is placed mm shorter than F1 and F3 one mm shorter than F2. The finishing files F2 and F3 should never have more than 2mm of work to do. 3- If the 0.2/20 K file moves beyond the foramen, gauge again with the ? 0.2/25 K file. If the file is snug at the working length, the apical size is 25. Use F2, shy from the working length, as described for F1. Then use F3 one millimeter shorter than F2. 4- The same gauging procedure with ISO K files is repeated for larger apical sizes. NB : Between each active file, the root canal system is irrigated with 2ml of NaOCl, apical patency is confirmed and the canal re-irrigated.