Endodontic Instruments

Dr Shahid Elyas
 Grossman Classification

Exploring Debriding Cleaning And Obturating

Instruments Instruments Shaping Instruments Instruments

• To locate the • To extirpate • To clean and • To cement and

canal orifice the pulp and shape the root pack gutta-
and determine remove any canal laterally percha into
patency of the foreign debris. and apically the root. E.g.
root canal. E.g. E.g. barbed e.g. reamers spreaders,
endodontic broach and files. pluggers and
explorers, lentulospirals
smooth
broaches
(pathfinders)
 According to ISO – FDI (Based on use)
Group
Hand Use only eg. K-Files, H-Files
1
Group
Engine driven latch type eg. Gates Glidden Drills, Peso reamers
2
Group
Engine driven Ni-Ti Rotary Instruments eg. Profile, Protaper
3
Group
Engine driven 3-D Adjusting Instuments eg Self Adjusting File System
4
Group
Engine driven reciprocating Instruments eg. WaveOne
5
Group
Sonic and Ultrasonic Instruments eg. Cavi Endo Evac,
6
 Clinical Classification
1. Instruments Used for Diagnosis
1) Endodontic Explorer

2) Tooth Slooth

3) Dental Transilluminator

4) Pulp Vitality Tester

 Clinical Classification cont..
2. Instruments Used for Access Opening
1) Daimond Rose Head Bur

2) Tapered Fissured Bur

3) Carbide Bur

4) Safe End Long Bur

5) Endo Z Bur
 Clinical Classification cont..
3. Instrument Used for Canal Preparation
§ To Remove Pulp Tissue
1) Barbed Broaches

2) Endodontic Excavators
§ Root Canal Preparation
1) K Reamer

2) K File

3) H-File
 Clinical Classification cont..
4. Instruments for Canal Obturation
1) Lentolu spiral

2) Spreader

3) Pluggers

4) Condensor

5) Heat carrier

6) Thermomechanical Compactors
 Hand Operated Instruments
§ Barbed Broaches
§ Short-handled instruments used primarily for vital pulp
extirpation
§ Used to loosen debris in necrotic canals or to remove paper
points or cotton pellets
§ Made by notching a round, tapered wire with a blade to form
sharp, projecting barbs that cut or snag tissue
 Hand Operated Instruments cont...
§ RASPS
§ Broaches and RASPS show some significant differences in taper and barb size
§ RASPS has more taper of .015 to .020/mm than broaches (.007 to .010/mm)
§ Barb height is much greater in the broach than in the RASP

RASPS

Broach
 Hand Operated Instruments cont…
§ Smooth Broach
§ Smooth broach, sometimes used as a pathfinder
§ The newly released Pathfinder CS (SybronEndo/Kerr; Orange, Calif.), made of
carbon steel, is less likely to collapse when forced down in a fine canal
 Hand Operated Instruments cont…
§ K Files & Reamers
§ In 1904 Kerr Manufacturing Company designed K-
style files and Reamers
§ Files are instruments that enlarge canals with
reciprocal insertion and withdrawal motions.
§ K-Files blade angle - Suited for cutting dentin in filing
motion (Fig A)
§ Reamers cut and enlarge canals with rotational
motions
§ K-Reamers have a rake angle - Most efficient in rotary
motion, hence reaming is preferred (Fig B)
Blanks of K-Reamer & K-File

K - Reamer K - File
Cross Section of K-Reamer & K-File

K - Reamer K - File
 Modified K-Instrument
§ K-Flex File
§ The Kerr Manufacturing Company in 1982
introduced a new instrument design that they
termed the K-Flex File
§ The cross-section of the K-Flex is rhombus or
diamond shaped. This new cross-section
presents significant changes in instrument
flexibility and cutting characteristics
 Modified K-Instrument cont..
§ Flex-R File
§ Made by removing the sharp cutting
edges from the tip of the instrument and
the tip is rounded
§ Flutes are sharper and has less negative
rake angle than a traditional twisted K-
file
 Modified K-Instrument cont…
§ C-File
§ Made of specially treated stainless steel for stiffness and strength
§ Easier access to challenging, calcified canals
§ Heat-tempered steel for stiff performance
§ Twisted file design for greater strength
§ Eases penetration of calcified canals
§ Available in 21 mm & 25 mm
 H-Style Instrument
§ H-type files are made by
cutting/grinding the spiralling flutes
into the shaft of a piece of round,
tapered, stainless steel wire
§ H-files cuts in only one direction -
retraction/ pull motion.
H-File
§ Single helix, tear drop shaped cross-section
§ Deep grinding of surface of H-file reduces
central mass of metal and thereby weakened
the structure
§ Should not be used in rotational manner
 Modified H-Style File
§ McSpadden was the first to modify the
traditional Hedstroem file
§ Marketed as the Unifile and Dynatrak, these
files were designed with two spirals for cutting
blades, 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
 Modified H-Style File cont…
§ S-File
§ The “S” File (J-S Dental) appears to be a variant of the Unifile in its double-
helix configuration
§ Can be used with any hand motion (filing or reaming) thus this file can also be
classified as hybrid design
 Modified H-Style File cont…
§ Micro-Debriders
§ H-Files characterized by short staff
bent at and angle of 200° with a long
plastic handle
§ Available in sizes 20 and 30, taper 0.02
§ Flutes clear away paste, pulpal
residues, gutta-percha, and
calcification
§ These instruments also allow
additional shaping of the canal
 Modified H-Style File cont…
§ Safety H-File
§ H-Files with a non-cutting edge to
prevent ledging and stripping in curved
canals
A. H-Style instrument resembling a wood
screw
B. Modified Hedstroem file with non-
cutting tip
C. “Safety” Hedstroem with flattened
non-cutting side to prevent stripping
K - File H - Reamer H - Files
• Push & Pull • Reaming motion • Retraction motion
• Square or ractangular blank • Triangular blank • Tear drop blank
• More flutes/mm • Less flutes/mm • Aggressive cutting
• Tighter flutes • Loosly packed flutes • Variants
• Acute angle (60) • S file,
• 90 angle
• More cutting • Less cutting
• Less flexible • More flexible
• Less fracture chance • Fracture chance high
• Variants
• K flex file, Flex-O, R, C file
 Rotary Instruments
§ Low speed Rotary Instrument
1) Gates-Glidden Drill
I. Long, thin shaft ending in a flame-shaped
head with a non-cutting safe tip to guard
against perforation
II. Made of hardened carbon steel
III. Flame shaped head cuts laterally and is used
with a gentle, apically directed pressure
IV. Has a modified safe tip i.e. non-cutting tip
V. Come in sizes 1 to 6
 Rotary Instruments
§ Low speed Rotary Instrument
2) Peeso-Reamer
I. Long sharp flutes with a safe tip
connected to a thick shaft
II. Often used in preparing the coronal
part of the root canal for a post and
core
III. Available in 28mm & 32mm length
Gates-Glidden Drill vs Peeso-Reamer
 Standardization of Instrument
§ Geomatric Shape Coding
 Instruments
• SS Hand Files = 0.2 taper
• K – Files (Kerr) = Twisted square, watch winding method
• Negoiate and shape canal
• Blade angle is suited for dentine cutting
• Have greater No. cutting flutes or spirals than reamers
• K – Reamers = Twisted squre or triangular blank, clockwise quarter turn twist
• H – Files (Handstrom) = Spiral cone, only cut in retraction
• More aggressive than K files
• NiTi Rotary Instruments = 0.4 or 0.6 taper
 File Dimension
• File length
• Short 19-21mm, Standard 25mm and Long 28-31mm
• Tapering can be 2%, 4% or 6%
• Dimension increased by 2, 4 or 6% at every 1 mm from tip towards
handle.
• D1 = Diameter at tip
• Size 15 file ---- 0.15 mm
• D2 or D16 = Diameter 16mm from tip where cuting flutes end
• Size 15 K - file ---- 0.15mm + 0.2(16) = 0.47mm
 Design of Instrument
§ Component of a File
§ Taper
§ Core
§ Flute
§ Cutting Edge
§ Land
§ Hekix Angle
§ Pitch
§ Rake Angle
§ Cutting Angle
§ Tip Design
 Design of Instrument
§ TAPER
§ Expressed as the amount of file diameter increases each millimetre along its
working surface from the tip towards the file handle
 Design of Instrument cont…
§ CORE
§ Cylindrical central part of file having its circumference outlined and bordered
by the depth of the flutes
 Design of Instrument cont…
§ FLUTE
§ Groove in the working surface used to collect soft tissue and dentin chips
removed from the walls of the canal
§ Effectiveness of flute depends on its depth, width, configuration, and surface
finish
 Design of Instrument cont…
§ CUTTING EDGE
§ Surface with the greatest diameter that follows the groove (where the flute
and land intersect) as it rotates, forms the leading (cutting) edge, or the blade
of the file
 Design of Instrument cont…
§ LAND/MARGINAL WIDTH
§ Surface that projects axially from the
central axis as far as the cutting edge
between the flutes
§ Prevents ‘‘screwing in’’ of the file
§ Supports the cutting edge
§ Limits the depth of cut
§ Reduces the propagation of micro-cracks on
its circumference
§ Maintains the file in the centre of root
canal.
 Design of Instrument cont…
§ HELIX ANGLE
§ Angle formed by the cutting edge with the long axis of
the file
§ Helps in removing debris collected in the flute from the
canal
 Design of Instrument cont…
§ PITCH
§ Distance between a point on the leading
edge and the corresponding point on the
adjacent leading edge.
Or
§ It may be the distance between
corresponding points within which the
pattern is not repeated
 Design of Instrument cont…
§ RAKE ANGLE
§ Angle formed by the leading edge
and the radius of the file when the
file is sectioned perpendicular to its
long axis
 Design of Instrument cont…
§ CUTTING ANGLE OR EFFECTIVE RAKE ANGLE
§ Angle obtained by measuring the angle formed by the cutting (leading) edge
and the radius when the file is sectioned perpendicular to its cutting edge
§ A better indication of cutting ability of a file
 Design of Instrument cont…
§ TIP DESIGN
§ It can affect file control, efficiency, and outcome in shaping of root canal
systems
§ The tip of the original K-file resembled a pyramid
§ Instrument tips have been described as cutting, non-cutting, and partially
cutting, although no clear distinction exists among the three types
 Design of Instrument cont…
§ TIP DESIGN
§ Powell et al pointed out that when this tip “angle” is reduced, the file stays
centred within the original canal and cuts all sides (circumference) more
evenly
§ This modified-tip file has been marketed as the Flex-R-file
Alloy used for Endo Instruments
Carbon Steel
Advantages
• Higher hardness than stainless steel
instruments
Disadvantages
• Prone to corrosion, so cannot be autoclaved.
• Prone to rust
Barbed Broach
Stainless Steel
Advantages
• Corrosion resistance

Disadvantages
• Stiff in nature
• Prone to fracture
• Prone to distortion
K-File
Nickle-Titanium
Advantages
• Shape memory
• Super elasticity
• Low modulus of elasticity
• Corrosion resistant
• Softer than steel
• Good resiliency
• Biocompatibility

Disadvantages
• Poor cutting efficiency
• NiTi files do not show signs of fatigue before they fracture
• Poor resistance to fracture as compared to stainless steel Hyflex CM NiTi Files
 Clinical Considerations
Do’s Don’t

• Assess canal anatomy thoroughly • Instrument blindly

• Achieve straight line access prior to • Staying in canals for long
instrumentation • Use of same files repeatedly
• Follow crown-down sequence • Forceful instrumentation
• Use glide path for patency of canal • Rotation for too long
• Use files for 5 to 10 seconds only • Dry instrumentation
• Adequate irrigation and lubrication • Use of unclean files
• Wipe flutes after each use • Use files without inspection
• Examine files before, during and
after use