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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!