ROOT CANAL HAND

INSTRUMENTS
 CONTENTS
1. Introduction
2. History
3. Classification
4. Basic Instrument Pack
5. Instruments For Access Cavity Preparation
6. Instruments For Canal Exploration
7. Instruments For Cleaning And Shaping Of The Root
Canal Space
A. Hand Instruments:
 Standardization
 Components of endodontic instruments
 Various Hand Insruments
i. Barbed broaches and rasps
ii. K- reamer
iii. K- file
iv. K – style modification
v. K- flex file
vi. Flex-O-file
vii. Flex-R-file
viii. Triple flex file
ix. Hedstroem file
x. Modifications of H- file
xi. Profile series 29
xii. Intermediate files
xiii. Hand flare files
xiv. Hand GT files
xv. Heliapical
xvi. Zipperer flexicut
xvii. Flexogates

[Link] files
xix. Endodontic pluggers and spreaders
8. Recent advances
9. Measuring Instruments, Gauges And Stands
10. Studies

11. Conclusion

12. References
INTRODUCTION
 The principles of root canal treatment consists of thorough
cleaning, adequate shaping and complete filling of the root
canal system.

 In order to accomplish these objectives, many different

instruments are available.

 Some of the instruments are common to all branches of

dentistry while others have been modified or are specifically
designed for endodontics.
CLASSIFICATION

 Grossman’s Classification (based on the

function)
 ISO Classification (according to method of
use)
 According to Stock
 According to Cohen
 F.J Harty’s Classification
 Grossman’s Classification

FUNCTION INSTRUMENTS

Exploring Smooth broaches and endodontic explorers

(Used to locate canal orifice and to determine the
direction and patency of root canal )
Debriding or Barbed broaches
extirpating (Used to extirpate the pulp and to remove debris
and other foreign materials )
Cleaning & Reamers and Files
Shaping (Used to shape the canal space laterally and
apically )
Obturating Pluggers, spreaders and lentulospirals
(To cement and pack guttapercha points into the
canal space )
 ISO and FDI Classification

GROUP TYPES OF EXAMPLES

INSTRUMENTS –
HAND / ENGINE
DRIVEN

Hand use only Files : K-type, H type

I Reamers:K & U-type
Broaches
Pluggers & spreaders
GROUP TYPES OF EXAMPLES
INSTRUMENTS –
HAND / ENGINE
DRIVEN

Engine driven latch Similar to group I

II type instruments also
Handle has been includes paste fillers
replaced by a latch (lentulospirals)
type adaptor for
insertion in contra
angle hand piece
2 parts - cutting
head & latch type
attachment
 Lentulospiral

Greater
Taper Ni-Ti
instruments
K - Reamer
GROUP TYPES OF EXAMPLES
INSTRUMENTS –
HAND / ENGINE
DRIVEN
III Engine driven latch Gates  Glidden
type drills or Peeso reamers
reamers
fabricated from a
single metal latch
and shaft and
operative head, all
compound of a
single piece
Gates-
Peeso reamers
Glidden drills
GROUP TYPES OF EXAMPLES
INSTRUMENTS –
HAND / ENGINE
DRIVEN
IV Root canal points Gutta percha points
Silver points
GUTTA PERCHA POINTS SILVER POINTS
 Classification (According to
Cohen)
 Group I: Manually operated instruments.
eg. Barbed broaches, K-type & H-type instruments
 Group II: Low- speed instruments with a latch type attachment.
eg. Gates-Glidden burs, Peeso reamers
 Group III: Engine-driven nickel titanium rotary instruments.
 Group IV: Engine-driven instruments that adapt themselves three
dimensionally to the shape of root canal.
eg. Self adjusting file (SAF)
 Group V: Engine-driven reciprocating instruments.
 Group VI: Ultrasonic instruments.
 BASIC INSTRUMENT PACK

 Mouth mirror
 Endodontic explorer- DG 16
 Long spoon excavator
 Locking tweezers
 Briault and Periodontal probes
 Flat plastic instrument and
amalgam plugger
 A millimeter ruler
 A surgical hemostat
 MOUTH MIRROR
(front-surface)
- good visibility
- undistorted image

Available Sizes:

Size 3 (18mm)

Size 4 (20mm)

Most commonly used-

Size 5 (22mm)

Size 6 (24mm)
 DG 16 EXPLORER

- Double ended probe

- Has 2 straight and very
sharp ends
- The 2 ends are angulated
in two differeent
directions from the long
axis of the instrument
- Helps in location of canal
orifices and for detecting
fractures.
• EXCAVATORS
- For excavation of caries
- To reach the depths of molar
preparations
Long-blade, Long Shank
Endodontic Spoon Excavator
FUNCTIONS:
• To scoop out pulp chamber contents flick
away pulp stones.
• Shape allows currettage of the pulp
chamber when conventional excavators
will not reach the floor of the pulp
chamber used to currette periapical lesions
 ENDODONTIC TWEEZERS

- For handling paper points,

gutta percha points, cotton
wool pellets and root canal
instruments.
- locking and non-locking
type.
- Locking type has a latch that
permits materials to be held
without continous finger
pressure.
 BRIAULT PROBE AND
PERIODONTAL PROBE

- for the initial assessment

of the tooth for caries and
the localised periodontal
condition.
 PLASTIC INSTRUMENT

 The blade like end is used to carry and place

temporary filling materials.

 The opposite end is used as a plugger to condense

filling materials in the pulp chambers.
 ENDODONTIC MILLIMETER
RULER
1. It is used to assess root canal length.

2. It is a 0.5mm ruler used to measure

files,gutta percha cones .

3. It has a ring attached to the back so

that it may be worn on the finger.
 INSTRUMENTS FOR ACCESS CAVITY
PREPARATION

 Instruments for initial penetration and

deroofing of pulp chambers.
 Instruments for exploration of canal orifices.
 Instruments for initial penetration
and deroofing of pulp chambers
BURS:
 Round burs
 Friction grip tapered or cylindrical burs
 Endo access burs
 LA axxess burs (sybron endo)
 Endo Z burs
 Transmetal burs
 Great whites
 Multipurpose bur
 LN bur, Muller bur
 Gates- Glidden burs/ drills
Round burs Friction grip tapered or
cylindrical burs

LA axxess bur

Endo access burs Endo Z burs

Transmetal burs

Great whites

LN bur,28mm Multipurpose bur

Muller bur,32mm
 Instruments for exploration of
canal orifices

 Endodontic explorer- DG 16
 Micro-opener/ Microdebrider (rotary powererd)
 Gates-Glidden drills
 Pathfinder files
 Orifice shapers
 Bending tool
- Flexobond
- Endobender
 MICRO OPENERS
and MICRODEBRIDERS

 A new addition to finding and

enlarging canal orifices is the
micro-opener

 With K type flutes in 0.04 and 0.06

tapers mounted like a spreader

 This can be followed by a micro

debrider in ISO 0.02 taper,
headstroem-type flutes to further
flare the canal
 Designed by Dr. L. Stephen Buchanan,
SybronEndo's Endo-Bender allows the
clinician to accurately bend endodontic
products like SS files, posts, pluggers, FLEXOBEND
and spreaders to all canal curvatures.
E
 The Endo-Bender accomplishes what N
hemostats, pliers, cotton rolls or fingers D
never could without kinking or O
destroying them. B
E
 It is autoclavable. N
 Pathfinder file: Non ISO taper file for D
penetration into apex of a curved, E
sclerotic canal. R

 Less taper than standard 10 no. file.

 PEESO REAMERS

 LA Axxess bur, GG drills produced thinnest dentin walls & thus their use in
canals should be done with caution
Duarte MA [Link].
 INSTRUMENTS FOR CLEANING AND
SHAPING OF THE ROOT CANAL SPACE

Standardization:
 Before 1958, endodontic instruments were manufactured
according to the whim of manufacturers with no definite
specifications.

 In 1958, Ingle and Levine first proposed a standardization

criteria
 Recommendations made by INGLE and LEVINE are as
follows:

1) The instruments shall be numbered from 10 to 100, the numbers

to advance by 5 units to size 60, and thereby by 10 units to size
100.

2) The instrument number shall be representative of the diameter

of the instrument tip in hundredth of a mm (1/100).
Eg. No. 20 is 0.20 mm (20/100) at the tip.
3) The working blades (flutes) shall begin at the tip designated
site D1 and shall exactly 16 mm upto shaft terminating at
designated site D2.

4) The diameter of D2 shall 0.32 mm greater than that of D1. eg:

File no.20 shall have a diameter of 0.20 mm at D1 and a
diameter of 0.52 (0.20 + 0.32) mm at D2

5) This sizing will ensure a constant increase in taper of 0.02 mm

per mm of every instrument regardless of its size.
 Modifications from Ingles original proposal are-
1. An additional diameter measurement point at D3, 3
mm of from tip of cutting end of instrument at D0 .
2. Tip angle of an instrument should be 75o  15o
3. D2 was designated as D16.
4. Greater taper (0.04,0.06 and 0.08) are available.
COLOUR CODING:
 The International Standards
Organisation (ISO)
recommended a colour
coding system
GROUP 1

 For easier recognition

 Small sized instruments (06,

08) were added and colour
coded as pink, grey
respectively.
 GROUP 2

 Consists of 6 colours chosen in

ascending order of size from
light to dark.

 These colours are repeated in

each of the three groups.
GROUP 3

 Change in D1
0610 0.02 mm
1060 0.05 mm
60160 0.10 mm
Instrument length:
 Measured from the instrument tip to the
end of the shank (l2)

 Manufactured in four lengths

Standard  25 mm
Long  28 mm and 31 mm
(useful in canines)
Short  21 mm
(used in 2nd and 3rd molars or
when patient has restricted
mouth opening)

 Although instruments are available in

various lengths, the working end of the
instrument (length of the cutting
segment-l1) remains constant i.e. 16
mm.
2002- last revised using numbers 6-140.

The begining of the tip of the blade is represented by D0(diameter 1)

D16(diameter 2) Represents the most coronal part of the cutting edge

at 16mm from the tip.

At present instruments with 0.04and 0.06 and 0.08 taper are

available (allows greater flaring).

Half sizes in 0.02 flare available are-

12.5,17.5,22.5,27.5,32.5 and 37.5(for sharpening extremely fine

canals).

1989-American National Standards institute (ANSI) Granted

approval of ADA specification no 28 for endodontic files and
reamers.
 COMPONENTS OF
ENDODONTIC INSTRUMENTS
 To make the best use of files, the clinician should know the parts of
each file and understand how variations in design affect
instrumentation.
 They are –
1. Taper
2. Flute
3. Radial land/marginal width
4. Cutting edge/leading edge/blade
5. Relief
6. Helix angle
7. Rake angle
8. Pitch
 Historically, as an ISO standard, a file was fluted and
tapered at 2% for 16mm, but now files incorporate a wide
variation of lengths and tapers of working surfaces.

 Same taper E.g.: - Profile.

 Varying taper E.g.: - Greater taper files (GT)
 Graduating taper E.g.: - Quantec
 Progressive taper E.g.: - Pro taper.
 Flute : It is the groove in the working surface used to
collect soft tissue and dentin chips removed from the canal
wall.

 The effectiveness of the flute depends on its –

depth, width, configuration and surface finish
 Radial land /marginal width land :
 Is a flat cutting surface present between two grooves/flutes.

 Advantages –
1. Reduces the tendency of the file to screw into the canal,
2. Reduces transportation of the canal,
3. Reduces the propagation of micro cracks on its circumference,
4. Supports the cutting edge, and
5. Limits the depth of cut.

 Disadvantages –
1. Clogging of the instrument
2. Dragging resulting in friction and
heat built-up
1. Inefficient cutting
 Cutting edge/leading edge/blade :
 It is an angle where flute and land
intersect.

 Function –

1. The cutting edge forms and deflects

chips from the wall of the canal and
severs or snags soft tissue.

2. Its effectiveness depends on its angle

of incidence and sharpness
Relief :
 Is the surface area of land that is
reduced to a certain extent to
reduce frictional resistance.

Helical Angle :

 The angle formed by the cutting

edge with the long axis of the file
called the helical angle.
Rake Angle :

 Is the angle formed by the leading

edge and radius of the file.

 The rake angle can be positive or

negative .

 If the rake angle is obtuse: Positive

rake angle/cutting action.
 If the rake angle is acute : Negative
rake angle /scrapping action.
 When using negative rake angle instrument is used –

 Instrument cutting is done by applying a downward

pressure which creates a wave of compression ahead of
the blade.

 It requires a lot of pressure to keep the blade in contact

with surface being cut, that is to keep it from riding up on
the compressive wave.
When a positive rake angle instrument is used

 Cutting is by separating one molecule of matter from

work piece and creating a chip that curls away from the
edge of the blade.

 Creates a very little lateral pressure.

 Thus removing the surface layer with very little effort

and pull out the debris created with each shot thus
producing very little smear layer, producing a shaving
action.
Pitch :

 Is the distance between a point on the leading

edge and the corresponding point on the
adjacent leading edge.
 INSTRUMENTS

Instruments differ according to:

 Metal
 Taper
 Tip design
 Cross sectional geometry
 Length of cutting blades
 Metals

 Modern root canal instruments are made of either

stainless steel or nickel-titanium.

 Carbon steel instruments are also available but these

are for one use only because they cannot be re-
sterilized due to corrosion.

 The stainless steel or Ni-Ti instruments are not

susceptible to pitting or crevice corrosion
M. Darabara [Link].
 Stainless steel

 When approximately 12% to 30% chromium is added to

iron, the alloy is commonly called stainless steel.
 Austenitic are the most corrosion resistant alloys.
 Composition:
 Chromium 11.5-17%
 Nickel 0-2.5%
 Carbon 0.15-1.20%
 Greater ductility and ability to undergo cold work without
fracturing.
 Greater ease for welding
 Comparative ease in forming
 NICKEL TITANIUM ALLOYS
 The first investigation of nickel titanium in endodontics
was reported in 1988 by Walia, Brantely and Gerstein.
 Superior resistance to fracture.
 Retains the shape of the curved canals.
 Superelasticity, shape recovery, resistant to cyclic fatigue.

Walia [Link].
 Less incidence of ledges and perforation
 Disadvantages:
 Cutting efficiency of nitinol is only 60% than that of a
matching stainless file
 It does not give any indications before fracture
 Metals

Nickel titanium files demonstrate plastic deformation…

Stainless steel files demonstrate permanent deformation…
Cross sectional geometry…

• Not
Self-Threading

• Gentle Planing
Action
 HAND INSTRUMENTS
BARBED BROACHES AND
RASPS:
 ANSI Specification No. 63
 ISO-FDI No. 36301
 Differs from standardization
of H-type or K-type
instruments because of the
taper and length of the
working portion of the shaft
(10 mm)
 The major difference between
broaches and rasps lies in the
depth and angle of cut in the
wire shaft (core)
 Broaches have greater depth
of cut

 the remaining core

thickness is much
reduced

 resulting in more fragile

instruments throughout
its working length

 making it more
susceptible to fracture if
used continuously
 Round wires, smooth surfaces of which are notched to
produce barbs which are bent at an angle from the long axis.
 They are thin, flexible, tapered and pointed instruments used
for removal of intact pulp tissue, paper points and cotton
dressings.
 Their barb height is half of their core diameter.
 Barbed broaches are identified by 8 pointed stars.
 once the barbs are bent along the shaft, it becomes
ineffective
 RASPS
 They are thin tapered instruments with taper of
0.015mm/[Link] were previously known as rat tail files.

 They are identified by 8 pointed polyhedron Applicators.

 They are slender, flexible, tapered and pointed instruments

used for application of sealer or medication into the root
canal.

 They are produced by shallow incisive cuts.

 BARBED BROACHES RASPS

Barb height equal to ½ the core diameter is One third tip diameter
larger Incisive cuts are shallow
(Rat tail file)
Identification – 8
pointed polyhedron

Taper 0.007 to 0.010 mm per 0.015 to 0.020 mm per

mm (less taper) mm (more taper)

Number of barbs About 40 (exceptionally 50 to 60; blunt

fine) hence weaker

Length of working end 9 to 10.5 mm, till the last relatively short
broach
 Barbed broaches are used with 360° clockwise
or counter-clockwise rotation to entangle pulp
tissue.

 Broaches used with giromatic handpiece are

called Girocleanser.
 KREAMER
Characteristic features:

 Have ½ to 1 cutting blade per mm

 Made from either triangular or square
blank
Smaller sizes -square
Larger sizes –triangular
 Triangular cross section is more
flexible
 Angle of blades to long axis is 20
degree
 Have fewer cutting blades than K-files.
 Primarily designed to be used in a
rotary reaming motion
 K-FILES
 ADA/ANSI SPECIFICATION
no. 28
Characteristic features:
 K-files have 1 ½ to 2 ½ cutting
blades per mm of their working
end
 About twice the number of
spirals on a K- reamer of
corresponding size
 Angle of the flutes to the long
axis is about 25-40 degree
 Thus, like reamers they are
primarily designed to be used
in rotary reaming motion.
 K- REAMER

K - FILE

 Oliet and Sorin evaluated the triangular cross sectional

reamers cut with greater efficiency than do the square cross
sectional reamers but the failure rate of triangular
instruments was considerably higher.

 Webber et al found that instruments with triangular cross

section were initially more efficient, but lost sharpness more
readily than square ones of the same size.
 K-FLEX FILES
•Has a rhomboidal or diamond cross
section
•Two acute and two obtuse angles
•Has only two cutting edges
•Most flexible file.
Roth et. al.
•Advantage : more flexible, sharper blades
•Disadvantage: rapid loss of cutting
efficiency
 The high flutes are formed by the
two acute angles of the rhombus
 It presents increased
sharpness and cutting
efficiency.

 The alternating low flutes formed

by the obtuse angles of the
rhombus
 provides more area for
increased debris removal.
 HEDSTROEM FILES
 ANSI No. 58
 ISO No. 3630/1

 Also known as H-type files

 Has a characteristic Christmas

tree appearance (with spiral
cutting surface winding up the
shaft)

 The angle between cutting edge

and the long axis of the
instrument is about 60-65 degree.
 Modifications of Hedstroem files
 Hyflex file
‘S’ shape cross
section.

 Unifile
(Developed by
Mc spadden)
tip flexible.
DOUBLE HELIX
 S file
Stenman et. al.

 Safety H file TRIPLE

non cutting tip HELIX
(Buchanan)
 PROTAPER
• Multiple tapering
• Fewer files required to create a desired taper
• Both hand and rotary use
• Length : 19, 21, 25mm
• Protaper SX, S1, S2, F1, F2, F3, F4, F5
• Shaping File # 1 and Shaping File # 2, termed S1 and S2, have
purple and white identification rings on their handles,
respectively.
• The S1 and S2 files have D0 diameters of 0.17 mm and 0.20
mm, respectively.
• The Auxiliary Shaping File, termed SX, has no identification
ring on its gold-colored handle
• Its overall length of 19 mm, provides excellent access when
space is restrictive.
• The SX file has a D0 diameter of 0.19 mm
 Three Finishing files named F1, F2 and
F3 have yellow,red and blue
identification rings on their handles
corresponding to D0 diameters of 0.20
mm, 0.25 mm,0.30 mm, 0.40mm,
0.50mm, 0.60mm respectively.
 Additionally, F1, F2, and F3 have fixed
tapers between D1 and D3 of .07, .08,
and .09, respectively
 Finishing files have “decreasing” tapers
from D4-D14. This design feature
serves to improve flexibility, reduce the
potential for dangerous taper-lock, and
prevent the needless over-enlargement
of the coronal two-thirds of a root canal.
 ENDODONTIC PLUGGERS AND
SPREADERS
• Smooth tapered metal instruments –
compress and compact gutta percha

• Pluggers or condensers – blunt / flat ended

• Spreaders – short, more tapered and pointed

• M series plugger- spreaders are double

ended long handled instruments

• Color coded corresponding to standard

sizing and taper of K – type files.
 MEASURING INSTRUMENTS,
GAUGES AND STANDS

 Simple metal ruler

 Endodontic stops
 Endo-M-Bloc
 Endo block
 Endo ring
ENDODONTIC STOPS
• Use
– To shorten the instrument to
the desired working length

• Materials used
– Teflon
– Silicone

ENDODONTIC
STOP DISPENSER
ENDO-M-BLOC
 ENDO BLOCK
with 42 depth guides

• An endodontic block is a sturdy block used to organise and hold

endodontic finger and rotary instruments during procedures;
allows easy and accurate measurement of the length of finger
instruments with a measuring device incorporated.
• Reduces the possibility of percutaneous injuries when handling
endodontic finger and rotary instruments.
 ENDO RING
 Endoring II
The Endoring II enables the clinician to directly
place, store, measure and clean endodontic hand
and rotary instruments within the operating field. It
reduces the risk of cross-contamination and
minimizes the passing of sharps between dentist
and staff. Using the Endoring II helps make
endodontic procedures safer and faster.

Endoring Foam - Open cell foam can be steam

autoclave processed prior to single use. For
convenience, endodontic instruments can be pre-
loaded into the foam prior to processing. Single-use
only.

Laser Etched Endoring Ruler - Autoclavable

detachable metal ruler has precise laser-etched
1/2mm markings for files up to 37mm in length.
Rapidly and accurately calibrates instruments for
right and left handed clinicians.
 CONCLUSION

• Successful endodontic treatment requires accurate

diagnosis, proper cleaning and shaping, which can be
achieved by using proper instruments.

• These days a lot of choice among instruments is

available both for hand as well as rotary use which has
made it easier for the dentist to give treatments
efficiently as well as effectively.

• Knowledge of instruments improves the quality of

treatment and makes work more easier for both
operator and patient.