Basic Instruments in Endodontics
It is now widely accepted that success in root canal treatment
depends upon the thorough cleaning & shaping of the root canal system
& the placement of a three- dimensional root canal filling of gutta-percha
& inert sealer. To fulfill these objectives, many different instruments each
with a specific purpose, must be available. Some of these instruments
have been used for many years, whilst others are newer & highly
technical.
Endodontic Explorer:-
The straight end of the explorer is designed to aid in location of
root canal orifices, its tip is sharp & able to negotiate a small opening, the
instrument has sufficient rigidity to explore with controlled force. The L-
shaped end aids in detection unremoved portions of the pulp chamber
root.
Plastic Instrument:-
The blade like end of this instrument is used to carry & place the
temporary filling materials. The opposite end is used as a plugger to
condense filling materials in the pulp chamber.
Endodontic excavator:-
The shape of this instrument allows curettage of the pulp chamber
when conventional excavator will not reach the floor of the chamber (had
long shank). It’s also part of the surgery kit and is used to curette
periapical lesion.
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Basic Instruments in Endodontics
Endodontic locking plier:-
It has a latch that permits materials to be held without continuous
finger pressure. The grooved tips facilitate holding absorbent points and
gutta-percha cones, which tend to loosen in ungrooved tips.
Endodontic ruler:-
The 0.5 mm ruler is a convenient instrument with which to
measure files, gutta-percha cones, and also we have a measuring blocks
and special millimeter thumb rulers.
Endodontic syringe:-
It’s used to carry the irrigants into the root canal. The needle tip is
flat to prevent penetration into smaller canal diameter and grooved to
allow irrigants that may be under pressure to flow coronolly rather than
be forced through the apical foramen. When drying canals, most of the
irrigant may be aspirated from the canal by pulling back on the plunger.
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Basic Instruments in Endodontics
Instrument organizer:-
A means of organizing endodontic files according to size and
length is a necessity. The organizer provides holes for the files, which are
held vertically in a sponge allowing them to be grasped easily. The
sponge is saturated with disinfectant solutions that maintain instrument
sterility.
Transfer sponge:-
A banker’s sponge is a convenient aid to
hold files during root canal preparation. As an
assistant or the dentist adjusts the elastic stops
on each file. The instruments are placed in the
sponge according to size. Each file is then easily
grasped, used and replaced in the sponge. The
sponge, which is saturated with disinfectant
solution, also is useful to debride the
instrument. If, during canal preparation, debris
and dentin shaving accumulate on the file, they
are easily removed by inserting the file into the
sponge a few minutes.
Instrument stop:-
After the canal length is determined, it’s necessary to mark that
length on the file. This is accomplished by placing an elastic stop on the
instrument shaft.
Silicone stops are
available commercially,
or instrument stops can
be made easily by
cutting a rubber band
into 2 mm squares,
which are then centered
on the instrument shaft.
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Basic Instruments in Endodontics
When placing the stop on the instrument, it’s important to avoid
angulation which may measure different lengths as the file is rotated. The
test handle is an adjustable handle that can be moved on the instrument
shaft and locked at a specific length. The assembly consists of a file shaft
placed in a handle and nut. Once the correct length is set, the bulky
handle provides a mechanical stop that prevents the instrument from
extending beyond the measured length. For this reason, the test handle is
useful to prevent unintentional instrumentation through the apical
foramen.
Burs:-
Several types of bur will be required to accomplish good access
preparation.
1. Round bur: - round burs, normal and extra-long, size 2, 4,
and 6, are used to lift the roof off the pulp chamber and
eliminate over-hanging dentin. The longer and smaller sizes
can be used to find calcified canals.
2. Safe-ended burs:- A safe-ended diamond or tungsten-
carbide bur, the Endo-Z bur, both with a non-cutting tip, is
used to taper & smooth the access cavity preparation. The
non-cutting tip prevents gouging on the floor of the pulp
chamber, where important landmarks could be lost in
pinpointing the location of root canals.
Hand Spreader:-
Manufactured from stainless steel, land spreaders are designed to
facilitate the placement of accessory gutta-percha points around a well-
fitting master gutta-percha point during the lateral condensation method.
Their diameter & shape are not standardized making it difficult to match
spreaders with accessory gutta-percha points.
Finger spreaders:-
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Basic Instruments in Endodontics
These instruments are color-coded to match either standardized or
accessory gutta-percha points. Their short length affords a high degree of
tactile sense & allows them to rotate freely around their axis, thus freeing
the instrument for easy removal.
The depth of spreader penetration is important for the quality of the
find apical seal; spreaders should be capable of reaching to within 1-2
mm of the apical stop alongside its master gutta-percha point.
Endodontic Pluggers:-
Endodontic pluggers consist of long-handled instruments which are
of larger diameter than spreaders & have a blunt end; they are used to
pack thermally softened gutta-percha into the root canal. The different-
diameter pluggers have reference lines on the tips to allow the assessment
of plugger depth. It’s very
important to realize when the
plugger is engaging a
cushion of softened gutta-
percha, rather than the
resistance of the canal wall.
These pluggers may also be
used to pack calcium
hydroxide into root canals.
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Basic Instruments in Endodontics