endodontic insruments-1

8/22/2019 endodontic insruments-1

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ENDODONTICINSTRUMENTS

(HAND INSTRUMENTS)

GUIDED BY-

DR. ARUNDEEP SINGH

Presented by-

Arvinder


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CONTENTS

History

Classification

Diagnostic instruments

Basic instruments

Isolating devices Instruments for access cavity prepration

Standardisation of endodontic instruments

Exploring instruments

Debriding instruments

Cleaning & shaping instruments Irrigation devices

Root canal filling instruments

Non ISO instruments


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HISTORY

1750- Fauchard recommended removal of pulp. 1850- wooden pegs for debriding pulp.

Early 1900- introduction of files,reamers,lentulospiral.

1915- Kerr manufacturing company obtained patent for

all instruments later known as K type instruments. 1957- Richman introduced first ultrasonic system.

1958- Ingle & Levine first proposed standardisation.

1959- filling materials.

1964- introduction of giromatic handpiece.

1988- 1st use of NiTi in endodontics instruments.


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SUCCESS OF ENDODONTICS DEPENDS UPON

ENDODONTIC TRIAD

Access cavity preparation

Biomechanical Preparation of the root

canal.(Cleaning and shaping)

ObturationFor these three steps instruments are

mandatory

Ingles endodontics 6th edition


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MATERIALS

Carbon steel- high cutting efficiency

Stainless steel- low cutting efficiency & becomesdull rapidly

Nickel titanium- Ni 54% ,Ti 44%

Co & boran- improve surface hardness


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At high temperatures,NiTi exsts as BCC

lattice,reffered to as AUSTENTIC phase (stable &

stronger)

On cooling,this phase transfers to close packed

hexagonal known as MARTENSITIC phase(weak

phase)

NiTi austenite phase

stress induced

Martensitic phase

stress relieved

Austenite phase

DISADVANTAGE- cutting efficiency is only 60%

than that of stainless steel files

This transformation results

in 2 features-1. Shape memory

2. Super elasticity


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CLASSIFICATION


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FUNCTION INSTRUMENTS

Exploring Smooth broaches and endodontic explorers

(Used to locate canal orifice and to determine the

direction and patency of root canal)

Debriding Barbed broaches

(Used to extirpate the pulp and to remove debris and

other foreign materials

Shaping Reamers and Files(Used to shape the canal space laterally and apically )

Obturating Pluggers, spreaders and lentulospirals

(To cement and pack guttapercha points into the canal

space)

Classification According to Function (Grossmans Classification)

Grossmans 12th edition


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ISO AND FDI CLASSFICATION OF ENDODONTIC

INSTRUMENTS

TYPES TYPES OF

INSTRUMENTS

HAND / ENGINE

DRIVEN

EXAMPLES

I Endodontic instruments

for hand use only

K-type files

H type file

R-Type rasps

Barbed broaches

spreaders

condenser

Ingles 5th edition


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ISO AND FDI CLASSFICATION OF ENDODONTIC

INSTRUMENTS

TYPES TYPES OF

INSTRUMENTS

HAND / ENGINE

DRIVEN

EXAMPLES

II Engine driven

instruments

Handle has been

replaced by a latchtype adaptor for

insertion in contra

angle hand piece

Similar to group I

instruments

Niti Rotary instruments

like Profile

Paste fillers

(lentulospirals)

Ingles 5th edition


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GROUP I GROUP II

K- reamer

Greater

Taper Ni-Ti

instruments

Lentulospiral

GROUP III


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TYPES TYPES OF INSTRUMENTSHAND

/ ENGINE DRIVEN

EXAMPLE

III

IV

Endodontic engine driven instruments

latch and shaft and operative head, all

made of a single piece

Endodontic points

Gates glidden

Peezo reamer

GP points

Silver points

Paper points

Ingles 5th edition


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ACCORDING TO COHEN

Group 1- manually operated instruments (barbed broaches &

K type,H type instruments)

Group 2- low speed instruments with latch type attachment

(GG burs & peesoreamers)

Group 3- engine driven Ni-Ti rotary instruments

Group 4- engine driven instruments that adapt themselves

three dimensionally to shape of root canal. (SAF,self adjusting

file)

Group 5- engine driven reciprocating instruments

Group 6- ultrasonic instruments

Cohens 10th edition


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DIAGNOSTICDEVICESFor pulp vitality

Battery operated instrument

connected to a probe.

Designed to stimulate a

response by electrical excitation

of the neural elements within

the pulp.

Does not provide any

information regarding the

vascular supply to the tooth.

Considered advantageous

when compared with the

thermal tests since the

quantitative readings areobtained. Cohens 10th edition


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Pulse oximetry.

Cohens 10th edition

Non invasiveoxygen saturation monitoring device widelyused in medical practice for recording blood oxygen

saturation levels during administration of I.V. anesthesia.

System consists of a probe containing a diode that emits light

in two wavelengthsRed660nmInfrared940nm

Probe is placed on labial surface of tooth-ideally on middle

1/3rd & a silicon photodetector diode is placed on opposingsurfaces of tooth & is connected to a microprocessor .

In the red range the oxyhaemoglobin absorbs less light thandeoxyhaemoglobin & viceversa in the infrared region.


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Mechanism of the dental pulse oximeter. (a) Light-emitting diode emitting red light at

660 nm. (b) Light-emitting diode emitting infrared light at 940 nm.

(c) Photodetector. (d ) Pulse oximeter monitor. (e) Pulse oximeter sensor. (f) Custom-

made pulse oximeter sensor holder. HbO2, oxygenated hemoglobin;

HbR,deoxygenated hemoglobin; SpO2, oxygen saturation of arterial blood


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Laser doppler flowmetry

Cohens 10th edition

1. Non invasive , electrooptical technique

2. Can measure blood flow inmicrovasculature systems.

3. Incident laser beam ofknown wavelength is directedthrough crown of tooth

4. moving red blood cellscause frequency of laser beamto be dopple shifted & somelight to be back scattered outof tooth


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Cold tests (A stream ofcold air,ethyl chloride

spray(-41C), application ofice,Carbon-di-oxide snow(dry ice-78.5C))

Heat tests(Hot air,Hot water,A hot burnisher ,Hot

gutta-percha ,Hot compound)

Cohens 10th edition


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MAGNIFICATIONDEVICES

Loupes

Operating microscopes

Cohens 10th edition

DISADVANTAGES-1. Fixed magnification power that can

not be increased or decreased.

2. No integerated light source

3. No way to digitally document

viewed images.

4. Focus is adjusted throughmovements of clinicians head.

1. Wide range of magnification.2. Coaxial illumination

3. Easy photographic

documentation

4. Focus adjustments by moving

the microscope.


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BASIC INSTRUMENTS

Front sur face mouth mirror

Locking pliers

I t has a lock that allows mater ials to be held without continuous

finger pressure; also it has a groove which faci l i tates holdinggutta percha and absorbing points. Cohen 10th edition


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Explorer DG-16 endodontic explorer

Cohen 10th edition


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the endodontic ruler

Endodontic excavator-larger than a spoon

excavator

-excavation of the contents of thepulp chamber.

-Also used in curettage of periapical

lesions in surgical endodontics .

Cohen 10th edition


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Endodontic fi le organiser

:It is used for arrangement

of reamers and files according

to the size and length.

The organizer provides holes for

the files to be place vertically.

Cohen 10th edition


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Transfer sponge:

It is sponge saturated

with disinfectant

solution. The reamers

and files can be

placed in it afterbeing used.

Cohen 10th edition


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MICROINSTRUMENTS

Micromirrors Microcondensers

Cohen 10th edition


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MATERIALS FOR ISOLATION

Rubber damprovides the best possible isolation.

In 1864 S.C.Barnum a New York city dentist

introduced the rubber dam into dentistry

1. Rubber dam sheets

2. Rubber dam clamps

3. Rubber dam holders(frame)

4. Rubber dam retainer forceps

5. Rubber dam punch

6. Rubber dam templates or stamps

7. Dental floss

8. Wedgets

Ingles 6th edition


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RUBBER DAM SHEET

It is made of latex or non-latex.

Available in 2 sizes-5*5

6*6

Available in varying thickness. Light and dark sheets are available for colour

contrast.

Has a shiny & dull side, dull side will be facing the

occlusal side.

Ingles 6th edition


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Rubber Dam Clamps

Clamps without wings Clamps with wings

Ingles 6th edition


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3. RUBBERDAMHOLDER (FRAME)

Used to maintain the

borders of the rubberdam in position.

Types:

a).Youngs holder-It isa U-shaped metal framewith small metalprojections for securingborders of the rubber

dam.

Ingles 6th edition


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b). Ash pattern - mostsuitable for children.

C). Swenska N-frames are suitablefor taking

radiographs with thedam.

Ingles 6th edition


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4. RUBBERDAMRETAINERFORCEPS

Used for placement and removalof retainer from the tooth.

Ingles 6th edition


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5. RUBBERDAMPUNCH

Used for making holes in thedam

Parts a). Rotating metal disc

bearing 5 to 6 holes of

different sizes according to

size of teeth.

b). A sharp pointed plunger.

Ingles 6th edition


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6. RUBBERDAMTEMPLATE

Both have positions ofthe teeth marked on

them and are used to

transfer them to the

rubber dam sheet forholes to be punched.

Ingles 6th edition


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8. Wedget

An elastic used to secure the dam

around the teeth farthest away from the clamp.

7. Dental floss

Tied around the retainer

before carried to the oral cavity to

prevent accidental aspiration of

clamp.

Ingles 6th edition


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ACCESSORIES

Rubber Dam napkin: This is a sheet of absorbent

material placed between the rubber dam and skin.

Lubricant: A lubricant is applied in the area of punch

holes facilitates the passing of dam septa through

proximal contacts.

Ingles 6th edition


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INSTRUMENTSFORACCESSCAVITY

PREPARATION

Hand pieces

Reciprocating

handpiece

Vertical stroke

handpiece

Ingles 6th edition


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BURS

Access

burs:#2,#4,#6

round carbide

burs

Access bur #57

fissure carbide bur

Round end

cutting tapered

diamond bur

(endo access bur)Cohen 10th edition


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safety tip tapereddiamond bur(lt)

Safety tip tapered

carbide bur(rt)

#2, #4 rounddiamond burs

Transmetalbur

Cohen 10th edition


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INSTRUMENTS USED IN CLEANING AND SHAPINGTHE PULP SPACE:

Includes:

Hand Instruments

Rotary Instruments


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1958 Ingle and Levine first proposed standardization of

endodontic instruments and suggested guidelines for the same

1) The instruments shall be numbered from 10 to 100, the numbers to

advance by 5 units to size 60, and thereby by 10 units to size 100.

2) The instrument number shall be representative of the diameter of theinstrument tip in hundredth of a mm (1/100). Eg. No. 20 is 0.20 mm

(20/100) at the tip.

Ingles 5th edition


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3) The working blades (flutes) shall begin at the tip designated site D1 and

shall exactly 16 mm upto shaft terminating at designated site D2.

4) The diameter of D2 shall 0.32 mm greater than that of D1. eg: File no.20shall have a diameter of 0.20 mm at D1 and a diameter of 0.52 (0.20 +

0.32) mm at D2

5) This sizing will ensure a constant increase in taper of 0.02 per mm ofevery instrument regardless of its size.

Ingles 5th edition


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Ingles 5th edition

MODIFICATIONS FROM INGLES ORIGINAL


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MODIFICATIONSFROM INGLESORIGINAL

PROPOSALBYISO

6) An additional diameter

measurement point at D3, 3

mm of from tip of cutting

end of instrument at D0

7) Tip angle of an instrumentshould be 75o 15o

Weine 6th edition


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COLOUR CODING:

The International Standards

Organisation (ISO)recommended a colourcoding system for easierrecognition

consists of 6 colours chosenin ascending order of sizefrom light to dark

Small sized instruments (06,

08,10) were also added andcolour coded as pink, grey.purple respectively.

GROUP 1

Ingles 5th edition


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These colours are repeated in

each of the three groups

Change in D1

0610 0.02 mm

1060 0.05 mm60160 0.10 mm

GROUP 3

GROUP 2

Ingles 5th edition


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Instrument length:

Measured from the instrument tip

to the end of the shank (l2)

Manufactured in three lengths

Standard 25 mm

Long 31 mm

(useful in canines)

Short 21 mm

the working end of theinstrument (length of the cuttingsegment, l1 ) remains constant is16 mm.


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Broaches and rasps:

Available in 2 types- smooth & barbed

Broach doesnt cut dentin but can be used for pulp extirpation

or to remove cotton or paper pts which might have lodged in

canal. Manufactured from round wire,the smooth surface of which

has been notched to form barbs bent at an angle from the

long axis.

USE- insertion through the access cavity until dentinal walls

are felt,broach slightly withdrawn ,then rotated a fewrevolutions & removed

Smooth broach is free of barbs. Used to explore the canal

patency.

Weines 6th edition


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Smallest size broach available has the width of a

size 20 instrument.

Should not used initially in narrow canals until the

canal is wide enough.

Both broach & rasps have similar design except in

taper & barb size. Barb size is larger in broach.

The broach has a taper of #.007 to #.01 taper and

the rasp has a taper of #.015 to #.02 taper.

Weines 6th edition


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REAMERS


A S


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REAMERS: a sharp edged tool for enlarging

or tapering holes. Lesser no of flutes & have

triangular blank. No of flutes are

-1 per mm while in files are

11/2-2 /mm.

Action:twisted clockwise to

turn to engage dentin & then

withdrawn-penetration, rotation

and retraction.

Remove intracanal debris with

clockwise reaming action

whereas conterclockwise turning

will force debris apically.

Ingles,6th edition


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Reaming is the only method that produces a round,

tapered preparation, and this only in perfectly

straight canals. In such a situation, reamers can be

rotated turn before retracting.

In a slightly curved canal, a reamer should berotated only -turn.

FILES


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FILES Kerr manufacturing company was the first to

produce it,hence the name K type file/reamer.

More number of flutes than reamers, no of flutes are

11/2-2 /mm.

Greater cross sectional area than reamers.

Cutting action can be effected in either a filing or

reaming motion.In a filing motion,the

instrument is placed into the

canal at the desired

length,pressure is exerted

against the canal wall,and

while this pressure is

maintained,the instrument is

withdrawn without turning.

In a reaming action,the

motion is the

same as for a reamer -

penetration,rotation,and

retraction.

Withdrawing the file cuts

away the engaged dentin.

Ingles,5th edition


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K TYPE FILES : Square cross

section.More no of flutes. Superior cutting



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K REAMERVS. FILE


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Rhombus/diamond shaped cross section

Cutting edges are formed by two acute angles

of rhombus which leads to increase sharpness& cutting efficiency.

low flutes formed by obtuse angles providemore space for debris removal & for irrigation.

The major disadvantage is its rapid loss ofcutting efficiency.

K FLEX FILES

Ingles 6th edition


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TRIPLE FLEX FILE

More recently, Kerr has introduced a hybrid

instrument called as Triple-Flex File.

It has more spiral flutes than a K reamer but fewer

than a K file.

Made from triangular stainless steel and twisted

Instrument is more aggressive and flexible than the

regular K-style instruments

Ingles 5th edition


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FLEXOFILE:

Similar to K FLEX but

have triangular cross

section. More

flexibility and ability to

resist #.

Ingles 5th edition

FLEX R FILES


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FLEX R FILES: Made by removing sharp

cutting edges from tip ofinstrument /tip angle is

reduced

Reduce ledge formation,

canal transportation. Non cutting tip enables the

instrument to traverse along

the canal rather than gouge

into it.

Have triangular cross

section.

Ingles 5th edition


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K FILEMODIFICATIONS

K-Flex

Flex-R

HEDSTROEM FILES(H-FILE)


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( )

Flutes resemble successivelysmaller triangles set one onanother.

Manufacture by cuttingspiral flutes into the shaft ofa piece of round taperedstainless steel wire.

It cuts only in one direction.,

during retraction

Cross section :single helixtear drop

Ingles 5th edition


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USES-

1. In immature teeth,where the walls are irregular &

may harbour debris.

2. useful in removing silver points or loose broken

instruments from canals(file is placed alongside the

material to be removed,then rotated,& pulled

towards the occlucal surface)

3. Widening straight canals,coronal portion of

curved canals for easier placement of smallerinstruments.

Ingles 5th edition


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DRAWBACKS-

1. It is weakened at each position during

manufacture,resulting in a place for fracture if the

flutes bind in dentin & the handle is rotated.

If it is rotated clockwise after binding in

dentin,instrument moves further apically & crack the

weakened & stressed root.

Ingles 5th edition


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H-FILE MODIFICATIONS

Unifile & Dynatrak

McSpadden was the first to modify the traditional

Hedstroem file.Marketed as the Burns Unifile and

Dynatrak

These files were designed with two continous

cutting edges, a double-helix design.

In cross-section, the blades presented an S

shape rather than the single-helix teardrop cross-

sectional shape of the true Hedstroem file

Ingles 5th edition


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At this time, Unifiles and Dynatraks are no longer being

marketed; however,the Hyflex file appears to have the

same cross-sectional configuration.

The S File alsoappears to be a variation of theUnifile in its double-helix configuration.

Buchanan has further modified the Hedstroem file, the

Safety Hedstrom, which has a noncutting side to

prevent ledging in curved canals.

Ingles 5th edition


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U FILE

A new endodontic classification of instrument, for whichthere is no ISO or ADA specification as yet, is the U-File.

Marketed as ProFiles, GT Files, LIGHTSPEED andUltra-Flex files.

The U-Files cross-sectional configuration has two

90-degree cutting edges at each of the three points ofthe blade

Adapts well to the curved canal, aggressively planingthe external convex wall while avoiding the moredangerous internal concave wall, where perforationstripping occurs.

A noncutting pilot tip ensures that the file remains in the

lumen of the canal, thus avoidingtransportation andzipping at the apex. used in both a push-pull and rotary motion

Ingles 5th edition


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Cross-sectional view of a U File

Ingles 5th edition

ProFiles are supplied in 0 04 0 05 0 06 0 07 and


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ProFiles are supplied in 0.04, 0.05, 0.06, 0.07,and

0.08 tapers and ISO tip sizes of 15 through 80.

GT ProFiles, developed by Buchanan in the U

design,are unusual in that the cutting blades

extend up the shaft only 6 to 8 mm rather than 16

mm, and the tapers start at 0.06 /mm (instead of

0.02), as well as 0.08 and 0.10, taperedinstruments.

They are made of nickel titanium and come as hand

instruments and rotary files.

GT instruments all start with a noncutting tip ISOsize 20

Ingles 5th edition


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An unusual variation of the U-shaped design is

the LIGHTSPEED instrument Made only in NiTi

Resembles a Gates-Glidden drill in that it has only

a small cutting head mounted on a long, noncutting

shaft. It is strictly a rotary instrument but comes with a

handle that may be added to the latch-type

instrument for hand use in cleaning and shaping

abrupt apical curvatures .

The instruments come in ISO sizes beginning with

No. 20 up to No. 100.

The heads are very shortonly 0.25 mm for the

size 20 and up to 1.75 mm for the size 100Ingles 5th edition


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QUANTECFILES.

The newly designed Quantec instrument,althoughcalled a file, is more like a reamer.

used in the reamers rotary motion.

Produced as both hand- and rotary-powered

instruments. First designed by McSpadden.

Quantec is produced in three different tapers0.02, 0.04, and 0.06/mmas well as safe-cuttingand noncutting tips.

The instruments are sized at the tip and numberedaccording to the ISO system15, 20, 25, etc.

Ingles 5th edition


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C+ FILES

C+ Files are ideal for initial instrumentation ofdifficult or calcified root canals.

They have a cutting tip which engages thedentine and are available in three lengths,

18mm, 21mm and 25mm and three sizes 8,10 and15

The files are stainless steel, have a squarecross section and have a blunt, non-aggressive tip to allow the instrument tosafely follow the canal to the apex.

HAND PROTAPER FILES


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HANDPROTAPERFILES

convex triangular cross-section.

Six instrument set, comprised of just three Shapingand three Finishing files.

Shaping File # 1 and Shaping File # 2, termed S1

and S2, have purple and white identification rings

on their handles, respectively. The S1 and S2 fileshave D0 diameters of 0.17 mm and 0.20 mm,

respectively.

The Auxiliary Shaping File, termed SX, has no

identification ring on its gold-colored handle and,with a shorter overall length of 19 mm, provides

excellent access when space is restrictive. The SX

file has a D0 diameter of 0.19 mm

NEW INSTRUMENTS WITH INTERMEDIATE


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NEWINSTRUMENTSWITHINTERMEDIATE

SIZES

GOLDEN MEDIUMS

1. Corresponds in size to half between standardised

ISO sizes & are numbered 12,17,22,27,32,37.

PROFILE SERIES-29

1. Hand instrument with 0.02 taper.

2. Have constant 29% increase in tip diameter.

Weines 6th edition

CUSTOMISED FILES


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CUSTOMISEDFILES

When tha canal curvature is 30 degrees orless,removal of flutes usually is not necessary

Canal curvatures> 30degrees,flute removal is

mandatory.

Weines 6th edition


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Three Finishing files named F1, F2 and F3 haveyellow, red and blue identification rings on their

handles corresponding to D0 diameters of 0.20

mm, 0.25 mm, and 0.30 mm, respectively.

Additionally, F1, F2, and F3 have fixed tapersbetween D1and D3of .07, .08, and .09, respectively

NICKEL TITANIUM


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NICKELTITANIUM

NITIFLEXK FILES MADE

OF NI-TI


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NICKEL-TITANIUM

1962 Buehler

55 NiTiNOL

55 wt % Ni

45 wt % Ti

2% substituted with Co

1988 Walia et al - endodontics


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PROPERTIES

Show shape memoryand superelasticity

Softer than stainless steel

Not heat treatable

Have a low modulus of elasticity; but greater strength Tougher and more resilient

Lower cutting efficiency


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ADVANTAGES

2-3 times more elasticflexibility

Superior resistance tofracture

DISADVANTAGES

Cutting efficiency only 60% Does not give indication of

wear before fracture

SHAPE MEMORY PROPERTY OF Ni-Ti

GREATER TAPER Ni-Ti HAND INSTRUMENTS


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GREATER TAPER Ni Ti HAND INSTRUMENTS

Made of nickel titanium

Available in variable tapers

0.04

0.06

0.08

0.10

0.12

Designed to cut coronal dentin while instrument tipfollowed passively.

GT hand instruments

Ingles 5th edition


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CANALORIFICEFLARINGINSTRUMENTS

Instruments available are:

Gates glidden drills

Peeso reamers

Ingles 5th edition


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GATES GLIDDENBURS

is one piece rotary

cutting instrument

and bur diameter rangesfrom 0.5-1.5mm

Ingles 5th edition

There are 6 sizes each bur is marked on the latch attachment


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There are 6 sizes each bur is marked on the latch attachment

portion of the instrument with an indented strip to indicate the

size .

Gatesglidden drill Instrument size in mm Equivalent K file size

#1 0.50 50

#2 0.70 70

#3 0.90 90

#4 1.10 110

#5 1.30 130

#6 1.50 150


Gates glidden drills has 3 main uses:


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1)Flaring of the coronal two thirds of the root canals.

2)For removal of guttapercha from a canal during post spacepreparation or during retreatment

3)To widen the canal for retrieval of broken instruments

.

PEEZO REAMER


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PEEZOREAMER

Similar to gates glidden but have parallel cutting sides

The sizing for the peezo reamer starts at 0.70mm for a #1 peezo reamers andincreases 0.20mm with every subsequent size

Peezo reamer Size of the tip in mm#1 0.70

#2 0.90

#3 1.10

#4 1.30#5 1.50

#6 1.70



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Peeso Reamers

Most often used in preparing

coronal portion of the root canal

for receiving a post

Safeended

TipDiameter: 0.71.7 mm

These reamers are available ina 32 mm length and a 28 mm

length for posterior teeth

Ingles 5th edition

DEVICES FOR MEASURING ROOT CANAL


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DEVICES FOR MEASURING ROOT CANAL

LENGTH

An apex locator typically hasfour parts: (1) the lip clip, (2)

the file clip, (3) the

instrument itself, and (4) a

cord connecting the other

three parts.

A display indicates the

advancement of the file

toward the apex

Root ZX apex locator with lip clip and

file holder.

Apex locators available in 4 generations-Resistance based;Impedance

type;Frequency based) Cohens 10th edition

IRRIGATION DEVICES


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Classification

JOE - June 2009

Di bl i f ti l


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Disposable syringes for conventional

irrigation

Types of irrigating needles


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Commercially available 30-G needles (A-C) Open-ended needles: (A) flat , (B) beveled

, and (C) notched. (D-F) Closed-ended needles: (D) side vented, (E) double side vented ,

and (F) multivented

JOE2010


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ENDOACTIVATOR

Sonically activated

instrument. A plastic file is

sonically activated while inthe canal. This sonic

activity causes acoustic

streaming of the irrigant

throughout the canal

enhancing the cleaning ofthe canal.

Cohens 10th edition


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Strong, flexible, medical-

grade polymer

composition

Color-coded by size foridentification

Convenient depth gauge

rings at 18, 19 and 20

mm

HOWTOUSE-


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Prepare canal to produce a fully tapered shape

Fill pulp chamber with NaOCl, EDTA, or other final

rinse solution Select the Activator tip that manually fits loosely within

2 mm of working length.

Attach the Activator tip over the handpiece.

Place the attached Activator tip into the prepared root

canal Depress the ON/OFF switch to activate.

Depress the 3-speed switch to select medium speed orlow speed

Use a pumping action to move the handpiece/Activatorin short 2-3 mm vertical strokes

Agitate the intracanal solution for 30-60 seconds

Repeat the above steps for each intracanal irrigantused

ENDOVAC


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ENDOVAC

1.Combined irrigation/evacuation system2.a macrocannula or microcannula is connected via tubing

to a syringe of irrigant and the high-speed suction of a

dental unit

Cohens 10th edition


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macrocannula

The plasticmacrocannula

has a size 55 openend with a .02 taper

attached to a

titaniumhandle for gross,

initial flushing of thecoronal part of the

root canal.

microcannula

The size 32 stainlesssteel microcannula

has 4 sets of 3 laser-cut, laterally

positioned, offset holesadjacent to its closed

end

attached to

a titanium finger-piecefor irrigation of theapical part of the

canal by positioning itat the working length

Cohens 10th edition


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During irrigation, the delivery/evacuation tip deliversirrigant to the pulp chamber and siphons off the

excess irrigant to prevent overflow.

The cannula in the canal simultaneously exerts

negative pressure that pulls irrigant from its freshsupply in the chamber, down the canal to the tip of

the cannula, into the cannula, and out through the

suction hose.

Thus,a constant flow of fresh irrigant is beingdelivered by negative pressure to working length


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Advantages- 1. avoid air entrapment

2. safely deliver irrigants to workinglength without

causing their undue extrusion into the periapex

SAFETY IRRIGATOR

(disposable)


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(disposable)

1. Irrigation/evacuation system

that apically delivers theirrigant

2. Have a thin needle

containing a lateral opening

& evacuates the solution

through a large needle at the

root canal orifice

3. Have a large coronalevacuation tube, enabling the

user to safely irrigate and

evacuate simultaneously with no

worry of clogging. Cohens 10th edition

HealOzone equipment


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HealOzone equipment

1. Ozone is a naturallyoccuring compound

consisting of 3

oxygen atoms.

2. Antimicrobial agent

against

bacteria,viruses,fungi.

Mechanism of action

1. Destruction of cell walls & cytoplasmic membranes of bacteria & fungi.

Attacksglycoproteins& glycolipids

Increasedmembrane

permeability

Immediatefunctionalcessation

Cohens 10th edition


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The HealOzone device comprisesAn air filter

A vacuum pump

An ozone generator

A handpiece fitted with a sealing silicone cup

and a flexible hose.

IJCDS AUGUST, 2011 Int. Journal of Clinical

Dental Science

ULTRASONICIRRIGATIONDEVICE


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1. ultrasonically activated files have potential to

prepare & debride root canals mechanically. 2. files oscillate at frequencies of 25-30kHz

3. operate in transverse vibration

4. 2 types -

Ultrasonic

irrigation

Passive

ultrasonic

irrigation

Cohens 10th edition

PUI-

1 relies on transmission of acoustic energy from an


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1. relies on transmission of acoustic energy from an

oscillating file to an irrigant.

Small file is introduced in canal as far asapical region

Root canal filled with an irrigant solution &ultrasonically oscillating file activates the

irrigant

Irrigant penetrate easily into apical part ofroot canal

Cohens 10th edition

INSTRUMENTS FOR FILLING ROOT CANALS:


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SPREADERS

used to compact gutta percha in root canalobturation.


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Finger spreader

Hand spreader

Pl ggers ha e diameter larger than


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Pluggers have diameter larger than

spreaders & have blunt end.

Hand pluggers


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NiTi finger spreader and plugger.

LENTULOSPIRAL: use for placement of the sealer,


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cement & Ca(OH)2 dressings.

SOTOKAWAS CLASSIFICATIONOF INSTRUMENT


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DAMAGE

Ingles 5th edition

INSTRUMENTS FOR RETRIEVING


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MASSERANN KIT - INTRODUCED BY MASSERANN

Trepan bur

Extractors

Masserann kit

BROKEN INSTRUMENTS AND POSTS

REFERENCES


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REFERENCES

Ingles 5th edition Ingles 6th edition

Cohens pathways of pulp 6th edition

Cohens pathways of pulp 9th edition

Cohens pathways of pulp 10th edition Weines endodontic therapy 6th edition


Christos B. Evaluation of irrigant flow in the root

canal using different needle types by an unsteadycomputational fluid dynamics model.JOE,2010

Li-sha Gu. Contemporary irrigant agitationtechniques and devices.JOE 2009;35(6)


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Documents

endodontic insruments-1