Endodontic Instruments and Their Uses

Endodontic Instruments and Their
Uses
Introduction:
A. Aims::
1. to acquaint the student with the endodontic armamentarium
2. to relate the forms of the instruments to their functions and limitations
B. Instrument classification: present discussion is limited to hand-operated types:
1. E
2. E
3. E,C, and S
4. F
C. Instrument types:
1. manufacture
2. purposes
3. methods of use
D. Instrument Standardization:
1. basis
2. color identification
3. practical effects
E. What happens when you don't do right:
THE NO-NO's
Objectives:
A. Debriding and cleaning of the root canal.
B. Removal of all infected and affected dentin.
C. Smoothing of the canal walls.
D. Selective preparation of curved canal walls.
E. Tapering of the canal to receive a filling.
Note: Tapering and shaping of the canal is begun in conjunction with the debridement
and cleaning of the canal. It is completed at the time of fitting the master filling point, at
which time additional coronal widening (funnelling) may be required.
Armamentarium:
A. Barbed broaches
B. K-type files
C. Reamers
D. Mm. ruler
E. Rubber stops
F. Irrigating set-up
General Rules of Instrument Usage:
A. Obtain straight line access, insofar as it is possible.
B. Use instruments in sequence, NEVER skip sizes.
C. NEVER force an endodontic instrument.
D. NEVER traumatize periapical tissue; this will retard healing
andcausepain.Measurement control stops must be utilized at all times. Accurate
reference points are a necessity.
E. Minimize forcing of debris through the apical foramen by employing gentle
instrumentation and proper measurement control.
F. Always work in a wet canal (flooded with irrigating solution). RC-Prep (a chelating
agent) may be used by the more experienced clinician.
G. Clean instruments frequently during their use.
H. Never use an instrument that is dull or that shows signs of rust or wear (untwisting,
burnished areas, etc.) discard used instruments frequently, especially in small sizes.
I. The canal must be kept clear of debris during all phases of instrumentation.Irrigate
continually
Endodontic instruments are traditionally divided into four categories:

1. Exploring
2. Extirpating
3. Enlarging (cleaning and shaping), and
4. Filling
Exploring
Natural anatomy dictates the ususal places for canals, but pulp stones, dystrophic
calcifications and restorations can alter the actual configuration encountered. The
endodontic explorer is used to locate orifices, and as a tool to remove calcification.
Using the endodontic explorer. Pulp stone occuping much of the pulp
chamber.
from Pathways of The Pulp p.151
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Extirpating
The barbed broach is an extirpating, NOT an enlarging, instrument. The barbed broach
is formed from a tapered round shaft by lifting up portions of metal of the shaft almost at
a right angle to the shaft. These elevated barbs will engage the pulp tissue and remove
it from the canal. In its use, the largest size broach which will fit freely - loosely - in the
canal is selected.
A broach must not engage the canal walls as it is advanced, or the pressure on the
barbs will flatten them against the shaft; as the instrument is withdrawn, the barbs will
then embed themselves in the walls, making it difficult or impossible to remove the
broach. Because the barbs are "nicked" out of the shaft this is an extremely fragile
instrument, and will break easily if misused. It must fit loosely.
The barbed broach must always be fitted loosely in the canal. The barbs of a tightly fitted
broach will engage the dentinal walls on the withdrawal stroke, greatly increasing the
likelihood of instrument fracture.
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Enlarging
The K-type file is manufactured by twisting or grinding a square or triangular tapered
shaft so that the cutting edges are almost perpendicular to the long access of the
instrument. It is the instrument most commonly used for cleaning and shaping.
The K-file works on the "pull" stroke - that is, by scraping the canal walls as it is
withdrawn from the canal. It is advanced to the full working length rotated 1/4 to 1/2 turn
clockwise, and withdrawn while being pressed against one of the walls. The process is
repeated against each of the walls in turn until the canal is sufficiently enlarged to
proceed to the next size instrument. Do not proceed too quickly - it is preferable to
utilize an instrument to the maximum extent possible before proceeding to the next
instrument in the series. The file must be cleaned repeatedly during use; never use an
instrument packed with filings or debris.
The root canal reamer is manufactured by twisting a tapered square or triangular shaft,
but the fewer twists result in an instrument with the cutting edges more nearly parallel to
its long axis. By rotating the reamer 1/4 to 1/2 turn clockwise, the cutting edges scrape
the canal walls as it is advanced to the working length. The reamer must be in contact
with the walls of the canal in order to be effective, but it must not bind or it may break.
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Measurement Control Technique
Instruments should always be used with a rubber stop as a measurement control. The
instrument tip pierces the center of the stop at right angles; it is then slid along the shaft
to the correct working length. If the stop is not placed squarely at a right angle to the
shaft of the instrument, a measurement error will result.
A. Measurement Technique B. Proper placement of

measurement stops.
Root Canal Cleaning and Shaping Instruments

Senseus™ FlexoFile® Endodontic Instrument
The Senseus FlexoFile instrument’s unique, silicone

handle is as intelligently designed as its flexible file.
The large, ergonomic handle provides comfort and
excellent tactile feedback. It has x-ray-visible
calibration rings (25 & 31mm) that help improve
accuracy and diagnostics, and a stainless steel
trangular-core file and safe-ended Batt® Tip.
SureFlex Nickel-Titanium
®
Files
The Maillefer SureFlex nickel-titanium hand files
®
combine the amazing flexibility of nickel-titanium

with the cutting ability of stainless steel. Flexibility
isn't the only reason to try out these extraordinary
instruments. Maillefer SureFlex files offer cutting
®
effiency that exceeds other nickel-titanium files.

SureFlex files have a variable core geometry with a
®
constant coefficient of flexibility throughout the

entire range of sizes. In other words, the SureFlex ®
files are designed to be stiff in smaller sizes,

enabling dentists to reach the apices.. while being
flexible in larger sizes to more easily move through
severely curved canals.
FlexoFiles ®
Outstanding flexibility, cutting efficiency and unique

non-slip handles make this the flexible file of choice
for curved and narrow canals.
All of the Maillefer stainless steel FlexoFiles feature
®
our remarkable non-cutting tip. This safe-ended

design offers a less aggressive tip and is available
on instruments in traditional ISO sizes ranging #6
through #140. (21mm & 25mm) The FlexoFiles are ®
also available in half-sizes for easier transitions

between instruments, plus you can now get these
great instruments in 31mm lengths.
Micro-Openers and Micro-Debriders

Maillefer Micro-Openers combine the canal finding
capabilites of an explorer with the instrumentation
capabilities of a K-file. They are ISO-sized hand
instruments with 7mm k-type flutes. The Micro-
Openers are available in sizes 10 and 15 with .04
and .06 tapers. The exagerated taper enhance the
instruments' tensile strength. This makes it easier
to locate, penetrate and initially instrument even
the most difficult or calcified canals.
The Micro-Debriders are outstand for
instrumentting and retreating hard-to-reach and
hard-to-visualize canals. These instruments have a
hedstrom cutting configuration with a standard .02
taper in sizes 20 and 30 with 16mm cutting flutes.
More Hand Instruments
Hand Instrumentation
K-File
The Maillefer K-Files and K-Reamers have set
the standard by offering superior cutting
efficiency and precision handling. Both the K-
Files and K-Reamers are available in 21mm,
25mm and 31mm lengths. K-Files start at ISO
size 6 and go up to size 140. The K-Reamers are
available in sizes 8 through 140.
Unifile™
This patented double headstrom design offer
efficient cutting ability on insertion and
withdrawl. The Unifile is available in 21 and
25mm lengths.
Barbed Broach
Our Barbed Broaches now have color coded

plastic handles which offer a secure grip for
bulk removal of pulpal tissue. These 21mm
stainless steel instruments come in sizes
from XXXX-Fine to Coarse.
Glyde File Prep root canal

®
conditioner
Glyde root canal gel enhances the dentists
ability to perform a root canal. Used as a
lubricant and chelating agent during canal
cleaning and shaping, Glyde File Prep lifts
debris coronally while it cleans and
lubricates. It works by effervescing when it
reacts with sodium hypochlorite. The
bubbling effect lifts dentinal mud and non-
vital tissue for easy removal. The EDTA
(ethylenediaminetetraacetic acid) in Glyde
File Prep effectively removes bacteria and
leaves dentinal tubules and lateral canals
ready for obturation.

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Endodontic Instruments and Their

Endodontic instruments are traditionally divided into four categories:

A. Measurement Technique B. Proper placement of

Root Canal Cleaning and Shaping Instruments

The Senseus FlexoFile instrument’s unique, silicone

combine the amazing flexibility of nickel-titanium

effiency that exceeds other nickel-titanium files.

constant coefficient of flexibility throughout the

files are designed to be stiff in smaller sizes,

Outstanding flexibility, cutting efficiency and unique

our remarkable non-cutting tip. This safe-ended

also available in half-sizes for easier transitions

Micro-Openers and Micro-Debriders

Our Barbed Broaches now have color coded

Glyde File Prep root canal

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