endodontic instruments basic & hand instruments

73

Upload: ddert

Post on 26-May-2015

1.829 views

Category:

Education


17 download

DESCRIPTION

Endodontic instruments basic & hand instruments http://theoptimalsmile.wix.com/dentistry

TRANSCRIPT

Page 1: Endodontic instruments basic & hand instruments
Page 2: Endodontic instruments basic & hand instruments

In considering the endodontic instruments those that are hand

operated are the most important.

However other specialised instruments such as explorers &

excavators have been designed to adapt to the root canal

treatment requirement.

Originally instrument for root canal treatment were few in

number and crude in design.

The earliest hand operative devices had long handles that were

best suited for anterior teeth.

As RCT diversified, small “finger” instruments were developed for

posterior teeth.

New designs in endodontics instruments have been introduced

and will continue to evolve.

Page 3: Endodontic instruments basic & hand instruments

MICRO

INSTRUMENTS

INTRACANAL INSTRUMENTS

GENERAL INSTRUMENTS

Classification

Page 4: Endodontic instruments basic & hand instruments

1) Front surface mouth mirror

Page 5: Endodontic instruments basic & hand instruments

2) Periodontal probe

Page 6: Endodontic instruments basic & hand instruments

3) Explorer

Page 7: Endodontic instruments basic & hand instruments

4) Cotton forceps

Page 8: Endodontic instruments basic & hand instruments

5) Endodontic explorers

DG 16

DG 16/23

Page 9: Endodontic instruments basic & hand instruments

6) Endodontic excavator

Page 10: Endodontic instruments basic & hand instruments

7) Endodontic ruler

Page 11: Endodontic instruments basic & hand instruments

8) Instrument organizer (endodontic kit)

used for arrangement of reamers and files according to the size and length.

provides holes for the files to be place vertically in a sponge which is saturated with disinfectant to maintain its sterility.

Page 12: Endodontic instruments basic & hand instruments

9) Endodontic syringe

tip of the instrument is flat to prevent penetration of the needle to the small canals;

also it has a groove in its tip to permit the irrigation which might be under pressure to flow coronally rather than forcing it to the apical foramen causing post operative pain.

Page 13: Endodontic instruments basic & hand instruments

10) Transfer sponge

Page 14: Endodontic instruments basic & hand instruments

A-Carbon steel-

contain less than 2.1% of carbon

Have high hardness than SS instruments.

Prone to corrosion, so cant be re-sterilised.

Prone to rust.

Example: barbed broch

B-Stainless steel instruments-

contain 18% chromium, 8-10% nickel, 0.12% carbon

Corrosion resistant

Stiff nature

Prone to fracture

Prone to distortion

Page 15: Endodontic instruments basic & hand instruments

C-Nickel titanium - contain 55% Ni and 45% Ti

Shape memory

Super elasticity

Low modulus of elasticity

Corrosion resisitant

Softer

Good resilience

Biocompatibility

Poor cutting efficiency

Don’t show signs of fatigue before they fracture

Poor resistance to fracture.

Page 16: Endodontic instruments basic & hand instruments

1-Broaches & Rasps:

Made from round stainless steel wire blank.

Working edges are created by cutting into the wire at an angle to its long axis.

The depth angle and number of cuts (barbs) will determine how the instrument is used

Page 17: Endodontic instruments basic & hand instruments

2- K Files & reamers:

Designed in 1904 by Kerr Manufacturing Co.

Are the most widely copied and extensively manufactured endodontic

instruments worldwide .

Previously made of Carbon Steel Presently made of Stainless Steel.

K File and Reamer are the oldest instruments used to machine dentin.

Produced by grinding graduated sizes of round Piano wire into either a

square or triangular configuration

These instruments are useful for penetrating and enlarging root

canals.

These instruments works primarily by compression and release

destruction of the dentin surrounding the canal.

Page 18: Endodontic instruments basic & hand instruments

Design & structure

Made from triangular

blanks.

More flexible.

The helix angle is small,

therefore effective only in

rotating motion

Has cutting tip

0.5-1 flute/mm.

Page 19: Endodontic instruments basic & hand instruments

Reamer: Sizes & Codes

comes in sizes 06 -

140,

all with a taper of 0.02.

design is identified by

the triangle symbol on

the handle.

Page 20: Endodontic instruments basic & hand instruments

Reamer: Recommended use

It is used by continuous

rotation when the resistance

is small or moderate

and by balanced force when

the resistance is greater.

In curved canals ledging

easily occurs with even small

reamer sizes if instruments

are not pre-curved.

Page 21: Endodontic instruments basic & hand instruments

Reamer: Safety tips

Reamers can be rotated only using

moderate pressure.

Use of force, particularly with

smaller sized instruments, may

result in distortion of the helical

structure and ultimately in fracture.

Each instrument should be checked

for symmetry by rotating it against

an even background before

introducing it into the canal.

Page 22: Endodontic instruments basic & hand instruments

K-file: Design & Structure

Made from rectangular blanks

Helix angle is greater than in a reamer, and therefore preparation by a K-file is effective both in rotary and filing motion.

The tip of the instrument is cutting

less flexible than reamers but are more effective in cutting.

1.5-2.25 flute/mm.

Page 23: Endodontic instruments basic & hand instruments

K-file: Sizes & Codes

K-files are produced in sizes 06 - 140,

all with a taper of 0.02.

K-file design is identified by the square symbol on the handle.

Page 24: Endodontic instruments basic & hand instruments

K-file: Recommended use

It prepares both in filing motion (up and

down) and when rotated.

In slightly curved canals -continuous

rotation when the resistance is small and

balanced force against greater resistance.

Compared to reamers, the use of

continuous rotation is limited because of

the screwing effect typical of K-file.

Page 25: Endodontic instruments basic & hand instruments

K-file: Safety tips

K-files can be rotated only using moderate

pressure.

Use of force, particularly with smaller sized

instruments may result in distortion of the helical

structure and ultimately in fracture.

Balanced force technique and filing instead of

continuous rotation should be used with sizes 06 -

15 to minimize fracture risk.

Each instrument should be checked for symmetry

by rotating it against an even background before

introducing it into the canal

Page 26: Endodontic instruments basic & hand instruments

Flexoreamer: Design & Structure

manufactured from a triangular steel wire that is twisted to give the typical shape of a reamer.

The helix angle is small, and therefore effective only in rotatory motion.

The tip of the instrument is non-cutting (bat-tip/inactive tip) making flexoreamer well suited for the preparation of evenly curved canals without risk of ledging.

Page 27: Endodontic instruments basic & hand instruments

Flexoreamer: Sizes & Codes

come in sizes 15 – 40.

all with a taper of 0.02.

Flexoreamers are best

distinguished from normal

reamers by the size code at the

top of the instrument: in

flexoreamers the colour of the

number is the same as the

colour of the handle.

Page 28: Endodontic instruments basic & hand instruments

Flexoreamer: Recommended use

The flexoreamer is well suited both

for straight canals and slightly

curved canals.

It prepares dentin in rotation but not

if used as a file.

The cutting efficiency and usability of

flexoreamers are excellent.

In slightly curved canals the

recommended technique sare

continuous rotation when the

resistance is small and balanced

force against greater resistance.

Page 29: Endodontic instruments basic & hand instruments

Flexoreamer: Safety tips

Flexoreamers can be rotated only using

moderate pressure.

Use of force, particularly with smaller

sized instruments, may result in

distortion of the helical structure and

ultimately in fracture.

Every instrument should be checked for

symmetry by rotating itagainst an even

background before introducing it into

the canal

Page 30: Endodontic instruments basic & hand instruments

FlexoFile: Design & Structure

Page 31: Endodontic instruments basic & hand instruments

FlexoFile: Sizes & Codes

Page 32: Endodontic instruments basic & hand instruments

FlexoFile: Recommended use

Flexofile is suited for both straight

canals and slightly curved canals.

Effective both in filing motion(up and

down) and when rotated.

In slightly curved canals the

recommended techniques are

continuous rotation when the

resistance is small and balanced force

against greater resistance.

Use of continuous rotation is limited as

compared to reamers because of the

screwing effect typical of K-files

Page 33: Endodontic instruments basic & hand instruments

FlexoFile: Safety tips

Flexofiles can be rotated (balanced

force) only using moderate pressure.

Use of force, particularly with smaller

sized instruments, may result in

distortion of the helical structure and

ultimately in fracture.

Every instrument should be checked

for symmetry by rotating it against an

even background before introducing it

into the canal

Page 34: Endodontic instruments basic & hand instruments

Hedstrom File: Design & Structure

Manufactured from round steel wire by

grinding.

The helix angle is close to right angle,

which is therefore preparation by H files

is effective only when using a filing

motion (up and down movement).

More positive rake angle.

blade with a cutting rather than a

scraping angle

Page 35: Endodontic instruments basic & hand instruments

Hedstrom File: Sizes & Codes

come in sizes 08 – 140.

all with a taper of 0.02.

H-file design is identified by the circle symbol on the handle.

Page 36: Endodontic instruments basic & hand instruments

Hedstrom File: Recommended use

can be used both in straight canals and curved canals.

Cut only in retraction.

In curved canals, files (sizes 20/25 and bigger) must be pre-curved to correspond to the shape of the curve.

H-files must always fit loosely in the canal to avoid risk for fracture.

Small sizes up to #25 can be used down into full preparation length while bigger sizes are often used 1 - 3 mm short.

Page 37: Endodontic instruments basic & hand instruments

Hedstroem File: Safety tips

Hedstrom files show a greater risk for fracture than reamers and K-files if used in a wrong way.

Hedstrom must always fit loosely in the canal and they must never be rotated.

In curved canals Hedstrom-files are pre-curved to correspond to the shape of the canal.

Before introducing them into the canal, all Hedstrom files must be inspected for possible earlier damage to the instrument and discarded immediately if an asymmetry in the cutting area is found

Page 38: Endodontic instruments basic & hand instruments

Rhomboidal or Diamond shaped

This new cross-section presents significant changes in instrument flexibility and cutting characteristics

The cutting edges of the high flutes are formed by the two acute angles of the rhombus and present increased sharpness and cutting efficiency

The alternating low flutes formed by the obtuse angles of the rhombus are meant to act as an auger, providing more area for increased debris removal

Page 39: Endodontic instruments basic & hand instruments

They are made up of SS

A hybrid instrument.

More flutes than reamer but fewer than

K-file.

Made from triangular stainless steel

blank by twisting, not ground.

More aggressive & flexible than regular

K-style instrument.

Page 40: Endodontic instruments basic & hand instruments

Made by removing the sharp

cutting edges from the tip of

instrument.

Have non cutting tip, so less

chances of ledge formation,

canal transportation when used

with balance force technique.

Triangular cross section which

provides it flexibility

Made up of NiTi and cut during

anticlockwise rotary motion.

Page 41: Endodontic instruments basic & hand instruments

Has noncutting safety side

along the length of the blade

which reduces the chances of

perforation.

The noncutting side is directed

to the side of canal where

cutting is not required.

Therefore prevents ledging of

the canals

Page 42: Endodontic instruments basic & hand instruments

It is called S because of its cross-

sectional shape.

Produced by grinding, which

makes it stiffer than H file.

The file is designed with 2 spirals

for cutting blades, forming double

helix design.

It has good cutting efficiency in

either filing or reaming action,

thus file can also be classified as

hybrid design.

Page 43: Endodontic instruments basic & hand instruments

Used for difficult and calcified canals.

Have better buckling resistance

than k files.

Available in size 8, 10, 15 of length

18, 21 and 25 mm.

Page 44: Endodontic instruments basic & hand instruments

Were described by Weine.

Comes under intermediate files provided with

half sizes between conventional instruments.

Available in sizes from 12-37 like 12, 17, 22,

27, 32, 37.

Used for narrow canals.

They are formed by cutting 1 mm from tip of

instrument.

Page 45: Endodontic instruments basic & hand instruments

In 1959, a new line of standardized instruments and filling material was introduced by ingle and levine

A formula for the diameter and taper in each size of instrument and filling material was agreed on.

A formula for a graduated increment in size from one instrument to the next was developed.

A new instrument numbering system based on instrument metric diameter was established.

Page 46: Endodontic instruments basic & hand instruments

After the introduction of standardized instruments, about the

only changes made were

the universal use of stainless rather than carbon steel

the addition of smaller (Nos. 6 and 8) and larger (Nos. 110-

150) sizes as well as color coding.

It was not until 1976 that the first approved specification for

root canal instruments was published (ADA Specification No.

28)

Page 47: Endodontic instruments basic & hand instruments

The numbering system, last revised in

2002, using numbers from 6 to 140, is

based on the diameter of the

instruments in hundredths of a

millimeter at the beginning of the tip of

the blades, a point called D0 (diameter

1 mm) , and extending up the blades

to the most coronal part of the cutting

edge at D16 (diameter 2-16 mm in

length).

Additional revisions are under way to

cover instruments constructed with

new materials, designs, and tapers

greater than 0.02 mm/m

Page 48: Endodontic instruments basic & hand instruments

Instruments with a taper greater than

the ISO (International Standards

Organization) standard of 0.02 mm/mm

have become popular: 0.04, 0.06, 0.08,

0.10, and 0.12.

This means that for every millimeter

gain in the length of the cutting blade,

the width (taper) of the instrument

increases in size by 0.04, 0.06, 0.08,

0.10, or 0.12 of a millimeter rather than

the ISO standard of 0.02 mm/mm.

These new instruments allow for

greater coronal flaring than the 0.02

instrument

Page 49: Endodontic instruments basic & hand instruments

comes in three lengths:

standard, 25 mm;

long, 31 mm; and

short, 21 mm.

Page 50: Endodontic instruments basic & hand instruments

Taper

usually is expressed as the amount the file diameter increases each millimeter along its working surface from the tip toward the file handle.

Flute

It is the groove in the working surface used to collect soft tissue and debris

Page 51: Endodontic instruments basic & hand instruments

Leading (cutting) edge

The surface with the greatest

diameter that follows the groove

(where the flute and land

intersect) as it rotates.

.

Page 52: Endodontic instruments basic & hand instruments

land (marginal width)

If a surface projects

axially from the central

axis as far as the cutting

edge between flutes

Page 53: Endodontic instruments basic & hand instruments

Relief

o To reduce frictional resistance,

some of the surface area of the

land that rotates against the canal

wall may be reduced to form the

relief.

Page 54: Endodontic instruments basic & hand instruments

Helix angle

The angle the cutting

edge forms with the

long axis of the file

Page 55: Endodontic instruments basic & hand instruments

Rake angle

angle formed by the

leading edge and the

radius of the file.

Page 56: Endodontic instruments basic & hand instruments

cutting angle/effective rake angle

is a better indication of a file’s cutting ability

determined by measuring the angle formed by the

cutting (leading) edge and the radius when the file is

sectioned perpendicular to the cutting edge

If the flutes of the file are symmetric, the rake angle

and the cutting angle are essentially the same.

Page 57: Endodontic instruments basic & hand instruments

Pitch

The 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

Page 58: Endodontic instruments basic & hand instruments

long, tapered and pointed end instrument, -compress gutta percha into the apex and periphery of the prepared canal and also towards the irregularity of canals

leaving a space for insertion of auxiliary root canal filling material cones.

Pluggers have blunt or flat ended tips.

Page 59: Endodontic instruments basic & hand instruments

M series plugger-spreaders

double-ended long-handled instruments

Handles colour coded Corresponds to standard sizing and taper of K-type files

Finger held spreaders and condensers

similar to K-type files with plastic or metal handles.

Page 60: Endodontic instruments basic & hand instruments

Instruments have been designed to take full advantage

of the increased visibility obtained with dental operating

microscopes, endoscopes, and orascopes.

Better visualization of the surgical site would have

limited value without microsurgical instruments such as

ultrasonic tips for root-end preparation and micro-

mirrors for inspecting the root end.

Page 61: Endodontic instruments basic & hand instruments
Page 62: Endodontic instruments basic & hand instruments

1- micro-mirrors

Small round

Medium oval

Page 63: Endodontic instruments basic & hand instruments

2-Retractor

Care must be taken to rest the retractors only on bone, not on the reflected soft-tissue flap or on the neurovascular bundle

Page 64: Endodontic instruments basic & hand instruments

3-Elevator

4-Curette

Jacquette

spoon

Rubinstein Mini-Molt

Page 65: Endodontic instruments basic & hand instruments

5-Scaler

6-Surgical forceps

Page 66: Endodontic instruments basic & hand instruments

1-Castroviejo needle holder

2-Castroviejo scissor

Page 67: Endodontic instruments basic & hand instruments

3- microcondenser & plugger

Page 68: Endodontic instruments basic & hand instruments

4-Messing gun type syringe

Page 69: Endodontic instruments basic & hand instruments

5-Plugger with teflon sleeve

Page 70: Endodontic instruments basic & hand instruments

6- Another delivery system designed specifically for MTA placement. Kit includes a variety of tips for use in different areas of the mouth and a single-use Teflon plunger.

Page 71: Endodontic instruments basic & hand instruments

7- Hard plastic block with notches of varying shapes and sizes MTA is

mixed on a glass slab to the consistency of wet sand and then packed

into a notch. The applicator instrument is used to transfer the

preformed plug of MTA from the block to the root end.

Page 72: Endodontic instruments basic & hand instruments

Current NiTi hand preparation procedures that use files with a

greater or variable taper are a substantial improvement over

instrumentation with 0.02 tapered stainless steel files

particularly when used in curved root canals.

These newer instruments should produce canals with a better

shape, using fewer instruments in a shorter time.

Microsurgical instruments such as ultrasonic tips for root-end

preparation and micro-mirrors for inspecting the root end

enhances better visualization and contributed to rapid

development of peri-radicular surgery.

Page 73: Endodontic instruments basic & hand instruments