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ROTARY ENDODONTICS
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Root Canal Instrumentation
Crown down preparation
Coronal third
Middle third
Apical third
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Armamentarium
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Armamentarium
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Armamentarium
Stainless steel size 10 K-files
Used to explore canal patency
Filing or quarter turn pull motion
Do not rotate through 360 degrees
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Armamentarium
Stainless steel size 15 and 20 K files
Used to establish actual working length
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Armamentarium
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ArmamentariumProfile orifice shapers
Used to prepare the coronal onethird of the root canal
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Profile Orifice Shapers
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Armamentarium
Profile 0.06 taper rotary files
Used to prepare the middle third
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Armamentarium
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ArmamentariumProfile 0.04 taper hand NiTi files
Used to prepare the apical third ofthe root canal
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Armamentarium
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Estimated Working Length
Estimated working length is the distancefrom the reference point to theradiographic apex, as measured on a
parallel preoperative radiograph
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Estimated working length Take a pre-operative parallel radiograph
Clinically, use a XCP film holder
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Estimated working length
Length from incisal edge toradiographic apex
Only an estimate because ofradiograph distortion
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Estimate canal size
Radiographic appearance
Crown/root morphology
Standardized sizes (See table in manual)
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Estimate canal size
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Explore Canal Patency
Ensure that canal can be negotiated to
radiographic apex Select #10 K file
Precurve file if necessary
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Explore Canal Patency
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Explore Canal Patency
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Establish Actual Working length
Instrumentation should terminate at: The apical constriction
1 mm short of radiographic apex
Actual WL = Estimated WL 1 mm
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Establish actual working length
WL can be established using: Radiographs
Apex locator
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Establish Actual Working Length
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Establish Actual Working Length
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Establish Actual Working Length
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Establish Actual Working Length
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Crown Down Preparation
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Crown Down Preparation
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Crown-down preparation
Plastic incisor with transparent root
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Crown-down preparation Place SS K file into canal until the tip
is just visible at the apex
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Actual Working Length
Remove file from canal
Subtract 1 mm
This is the actual working length
In this case the WL is 20 mm
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Actual Working Length
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Preparation of Coronal Third
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Preparation of Coronal Third
The coronal third measurement is WL minus
8 mm, that is 12 mm Profile OS do not have rubber stops
however the cutting flutes measure 10 mm
The goal is to work the largest OS to 12 mm
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Preparation of coronal third
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Preparation of coronal third
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Preparation of the coronal third Rotate OS at 300 rpm
Note: Orifice shaper should be rotating at
300 rpm before it is placed in the canal
Advance the OS in 1 mm increments
When resistance is encountered retractOS while still rotating
Never force any instrument apically
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Preparation of coronal third
Blue (#60) OS extends to approx. 9 mm
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Preparation of coronal third
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Preparation of coronal third
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Preparation of coronal third
Gold (#50) OS reaches 12 mm
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Preparation of coronal third
Progress from larger to smaller orifice shaper
Each smaller OS will extend further into canal
Repeat the sequence until the largest OSextends to 12 mm
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Preparation of coronal third
Blue (#60) OS extend to WL 8 mm = 12 mm
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Preparation of Middle Third
Profile 0.06 taper series 29 rotary files
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Preparation of Middle Third
Profile 0.06 taper series 29 rotary files
The middle third measurement is WLminus 4 mm, that is 16 mm
The aim is to work the brown (#7) file to16 mm
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Preparation of Middle Third
Proceed from larger to smaller file
Each smaller file will extend further intothe canal
Repeat the sequence until the largest
file extends to 16 mm
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of middle third
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Preparation of apical third
Profile 0.04 taper nickel titanium hand files
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Preparation of apical third
Profile 0.04 taper nickel titanium hand files
The measurement is the full workinglength, that is 20 mm
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Preparation of apical third
Measure working length on #15 file Set rubber stop at that length
Lubricate the canal with Prolube
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Preparation of apical third
Advance size 15 file to working length Rotate file through 360 degrees
Irrigate copiously with NaOCl after each
file
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Preparation of the apical third
Advance size 20 file to working length Continue through sequence, seating
each file to working length
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Preparation of apical third
Progress from smaller to larger files
Each file is fully seated at working length
Small canals prepared to a minimum ofISO 35 or 40
Large canals prepared to a minimum ofISO 40 50
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Preparation of apical third
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Fil ki l i f
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File kit on completion ofinstrumentation
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Master Apical File (MAF)
The largest file that extends to workinglength
MAF film is exposed to confirm lengthand placement
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Master Apical File
For large canals minimum MAF #40 - 50 For small canals minimum MAF #35 - 40
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Master Apical File
Take a radiographwith MAF in place.This confirms:
Length
Placement
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Mission Accomplished!