Cleaning and Shaping of the Root Canal System. Part II Edit by Hou Tiezhou 02988088507.
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Transcript of Cleaning and Shaping of the Root Canal System. Part II Edit by Hou Tiezhou 02988088507.
Cleaning and Shaping of the Root Canal System. Part II
Edit by Hou Tiezhou02988088507
Root Canal Instrumentation
Estimate working length Verify canal patency Estimate canal size Establish actual working length
Root Canal Instrumentation
Crown down preparation Coronal third Middle third Apical third
Armamentarium
Armamentarium
Armamentarium
Stainless steel size 10 K-files Used to explore canal patency Filing or quarter turn pull motion Do not rotate through 360 degrees
Armamentarium
Stainless steel size 15 and 20 K files Used to establish actual working length
Armamentarium
Armamentarium
Profile orifice shapers Used to prepare the coronal
one third of the root canal
Profile Orifice Shapers
Armamentarium
Profile 0.06 taper rotary files Used to prepare the middle third
Armamentarium
Armamentarium
Profile 0.04 taper hand NiTi files Used to prepare the apical third of
the root canal
Armamentarium
Estimated Working Length
Estimated working length is the distance from the reference point
to the radiographic apex, as measured on a parallel
preoperative radiograph
Estimated working length Take a pre-operative parallel radiograph Clinically, use a XCP film holder
Estimated working length
• Length from incisal edge to radiographic apex
•Only an estimate because of radiograph distortion
Estimate canal size
Radiographic appearance Crown/root morphology Standardized sizes (See table in manual)
Estimate canal size
Explore Canal Patency
Ensure that canal can be negotiated to radiographic apex
Select #10 K file Precurve file if necessary
Explore Canal Patency
Explore Canal Patency
Establish Actual Working length
Instrumentation should terminate at: The apical constriction 1 mm short of radiographic apex Actual WL = Estimated WL – 1 mm
Establish actual working length
WL can be established using: Radiographs Apex locator
Establish Actual Working Length
Establish Actual Working Length
Establish Actual Working Length
Establish Actual Working Length
Crown Down Preparation
Crown Down Preparation
Crown-down preparation
Plastic incisor with transparent root
Crown-down preparation
Place SS K file into canal until the tip is just visible at the apex
Actual Working Length
Remove file from canal Subtract 1 mm This is the actual working length In this case the WL is 20 mm
Actual Working Length
Preparation of Coronal Third
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
Preparation of coronal third
Preparation of coronal third
Preparation of the coronal third
Rotate OS at 300 rpmNote: 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
retract OS while still rotating Never force any instrument apically
Preparation of coronal third
Blue (#60) OS extends to approx. 9 mm
Preparation of coronal third
Preparation of coronal third
Preparation of coronal third
Gold (#50) OS reaches 12 mm
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 OS
extends to 12 mm
Preparation of coronal third
Blue (#60) OS extend to WL – 8 mm = 12 mm
Preparation of Middle Third
Profile 0.06 taper series 29 rotary files
Preparation of Middle Third
Profile 0.06 taper series 29 rotary files The middle third measurement is WL
minus 4 mm, that is 16 mm The aim is to work the brown (#7) file
to 16 mm
Preparation of Middle Third
Proceed from larger to smaller file Each smaller file will extend further
into the canal Repeat the sequence until the
largest file extends to 16 mm
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of apical third
Profile 0.04 taper nickel titanium hand files
Preparation of apical third
Profile 0.04 taper nickel titanium hand files The measurement is the full working
length, that is 20 mm
Preparation of apical third
Measure working length on #15 file Set rubber stop at that length Lubricate the canal with Prolube
Preparation of apical third
Advance size 15 file to working length Rotate file through 360 degrees Irrigate copiously with NaOCl after
each file
Preparation of the apical third
Advance size 20 file to working length
Continue through sequence, seating each file to working length
Preparation of apical third
Progress from smaller to larger files Each file is fully seated at working
length Small canals prepared to a minimum of
ISO 35 or 40 Large canals prepared to a minimum of
ISO 40 – 50
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
File kit on completion of instrumentation
Master Apical File (MAF)
The largest file that extends to working length
MAF film is exposed to confirm length and placement
Master Apical File
For large canals – minimum MAF #40 - 50 For small canals – minimum MAF #35 - 40
Master Apical File
Take a radiograph with MAF in place. This confirms: Length Placement
Mission Accomplished