Textbook of Endodontics

Fig. 12.2: Modification from Ingle’s standardization

• Tip angle of an instrument should be 75o ± 15o.

• Greater taper instruments (0.04, 0.06, 0.08—) have also been
made available.

Color coding of endodontic instruments (Fig. 12.3) Fig. 12.3: Color coding of endodontic instruments
Color code Instrument number
Pink 06
Gray 08
Purple 10
White 15 Fig. 12.4: Barbed broach
Yellow 20
Red 25
Blue 30 • Broach does not cut the dentin but can effectively be used
Green 35 to remove cotton or paper points which might have lodged
Black 40 in the canal
White 45 • Broach should not be forced apically into the canal, as its
Yellow 50 barbs get compressed by the canal wall. While removing
Red 55 this embedded instrument, barbs get embedded into dentin
Blue 60
and broach may break on applying pressure.
Green 70
Black 80 Uses of Broach
• Instruments available in length 21, 25, 28 and 30 mm are • Extirpation of pulp tissues
used for root canal therapy, and those of 40 mm size are • Removal of cotton or paper points lodged in the canal.
used in preparing root canals for the endodontic implants. • Loosen the necrotic debris from canal.

Broaches and Rasps Rasps

Broaches • They have ADA specification No. 63.
Broaches are of two types: • Rasps have similar design to barbed broach except in taper
a. Smooth broaches: These are free of barbs. Previously they and barb size. Barb size is larger in broach then rasp
were used as pathfinder, but at present flexible files are used (Fig. 12.5).
for this. • They are used to extirpate pulp tissue.
b. Barbed broach (Fig. 12.4)
Broach Rasp
• They are one of the oldest intracanal instruments with
• Barb extends to half of its Barbs extend to one
specifications by ANSI No. 63 and ISO No. 3630-1. core diameter, making third of the core, so it
• They have ADA specification No.6 it a weaker instrument. is not as weak as barbed
• Broaches are short handled instruments meant for single broach
use only. • Less taper • More taper (0.015-
• They are made from round steel wires. The smooth surface (0.007-0.010 taper/mm) 0.020 taper/mm)
of wire is notched to from barbs bent at an angle from • Barbs are very fine and longer • Barbs are blunt,
the long axis shorter and shallower
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 Endodontic Instruments
Fig. 12.5: Diagrammatic picture of a broach and rasp

Fig. 12.6: Pulp extirpation using broach

B
Figs 12.7A and B: Reamers
Technique of pulp extirpation (Healey, 1984)
Penetrate the barbed broach along the canal wall
towards the apex
↓
As it reaches to the apical constriction, move it
into the center of mass of pulp tissue
↓
Rotate the broach several times in a watch winding manner to entrap
the pulp which is then withdrawn from the canal (Fig. 12.6)

Reamers (Fig. 12.7)

1. Reamers are K-type instruments (manufactured by Kerr
company), which are used to ream the canals. They cut by
inserting into the canal, twisting clockwise one quarter to
half turn and then withdrawing, i.e. penetration, rotation
and retraction.
2. Reamers have triangular blank and lesser number of flutes
than files (Fig. 12.8). Numbers of flutes in reamer are ½-
1/mm, while in files the flutes are 1½-2½/mm (Fig. 12.9).
3. Though reamer has fewer numbers of flutes than file, cutting
efficiency is same as that of files because more space between
flutes causes better removal of debris.
4. Reamer tends to remain self centered in the canal resulting Fig. 12.8: Triangular blank and lesser
in less chances of canal transportation. number of flutes in reamer
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 Textbook of Endodontics

Fig. 12.9: Reamer has lesser number of flutes than file Fig. 12.10: Filing/Rasping action

Files
Files are the instruments used during cleaning and shaping of
the root canals for machining of the dentin. Since Kerr
manufacturing company was first to produce them, the files
Fig. 12.11: K-file
were also called K-files.
Files are predominantly used with filing or rasping action
in which there is little or no rotation in the root canals. It is
placed in root canal and pressure is exerted against the canal
wall and instrument is withdrawn while maintaining the pressure
(Fig. 12.10).

Difference between files and reamers

Files Reamers
1. Cross-section Square Triangular
2. Area of cross-section More less
3. Flutes more less
(1½-2/mm) (½-1/mm)
4. Flexibility Less More (because of
less work hardening)
5. Cutting motion Rasping Rotation and
penetration, retraction.
(Push and pull)
6. Preparation shape Usually avoid Round
7. Transport of debris Poor Better
because of because of space
tighter flutes present in flutes

Commonly used files

1. K-file
2. K-flex file
3. Flexo-file
4. Flex-R file
5. Hedstrom file
6. Safety H-file
7. S-file

K-files (Fig. 12.11)

• They are triangular, square or rhomboidal in cross-section,
manufactured from stainless steel wire, which is grounded
144 into desired shape (Fig. 12.12). Fig. 12.12: Square or triangular cross-section of a K-file
• K-files have 1½ to 2½ cutting blades per mm of their

Endodontic Instruments
working end
• Tighter twisting of the file spirals increases the number of
flutes in files (more than reamer).
• Triangular cross-sectioned files show superior cutting and
increased flexibility than the file or reamers with square blank
(Fig. 12.13).

Disadvantage of K-files Fig. 12.13: Triangular cross-sectioned file shows better flexibility
and cutting efficiency than square cross-sectioned file are reamer
1. Less cutting efficiency
2. Extrusion of debris periapically.

K-flex Files (Fig. 12.14)

• They were introduced by Kerr manufacturing company
in 1982. It was realized that square blank of file results
in total decrease in the instrument flexibility. To maintain Fig. 12.14: K-flex file
shape and flexibility of these files, K-flex files were
introduced.
• K-flex files are rhombus in cross section having two acute
angles and two obtuse angles (Fig. 12.15).
• Two acute angles increase sharpness and cutting efficiency
of the instrument.
• Two obtuse angles provide more space for debris removal.
Also the decrease in contact of instrument with canal walls
provide more space for irrigation.
• They are used in filing and rasping motion.

Flexo Files (Fig. 12.16)

• These are similar to the K-Flex files except that they have
triangular cross section. This feature provides them more
flexibility and thus ability to resist fracture.
• The tip of file is modified to non-cutting type.
Fig. 12.15: Rhombus cross-section of K-flex file
• They are made up to NiTi.
• Flexo files have more flexibility but less of cutting efficiency.

Triple Flex Files

• They are made up of stainless steel and are triangular in
cross section.
• They have more flutes than reamers but lesser than k-files.
Fig. 12.16: Flexo-file

Flex-R-files/Roane Files
• Flex-R-files are made by removing the sharp cutting edges
from the tip of instrument (Figs 12.17A and B). The
noncutting tip enables the instrument to traverse along the
canal rather than gouge into it.
• This design reduces the ledge for mation, canal
transportation and other procedural accidents when used
with balanced force technique.
• Another feature of flex-R file is presence of triangular cross-
section which provides it flexibility to be used in curved
canals.
• They are made up of NiTi and cut during anticlock wise
rotary motion. Figs 12.17A and B: Flex-R-file

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 Hedstrom Files (H-files) (Figs 12.18A and B) Disadvantages of H-files
Textbook of Endodontics

• Hedstrom files have flutes which resemble successively 1. Lack flexibility

triangles set one on another (Fig. 12.19). 2. Tend to fracture
• They are made by cutting the spiral grooves into round, 3. Aggressive cutter
tapered steel wire in the same manner as wood screws are
made. This results in formation of a sharp edge which cuts Safety Hedstrom File
on removing strokes only (Fig. 12.20). • This file has non-cutting safety side along the length of
• Hedstrom files cut only when instrument is withdrawn the blade which reduces the chances of perforations. The
because its edges face the handle of the instrument. non-cutting side is directed to the side of canal where cutting
• When used in torquing motion, their edges can engage in is not required. The non-cutting side of safety file prevents
the dentin of root canal wall and causing H - files to fracture. lodging of the canals (Fig. 12.21).
• Rake angle and distance between the flutes are two main
features which determine working of the file. S-file
• H-files have positive rake angle, i.e. its cutting edge is turned • It is called ‘S’ file because of its cross-sectional shape.
in the same direction in which the force is applied which • S-File is produced by grinding, which makes it stiffer than
makes it dig into the dentin making it more aggressive in Hedstrom file. This file is designed with two spirals for
cutting. cutting blades, forming double helix design (Fig. 12.22).
• Hedstrom files should be used to machine straight canals
because they are strong and aggressive cutters. Since they
lack the flexibility and are fragile in nature, the H-files tend
to fracture when used in torquing action.

Advantages of H-files
1. Better cutting efficiency
2. Push debris coronally

Figs 12.18A and B: Hedstrom file Fig. 12.20: Screw entering a piece of wood

Fig. 12.19: Diagrammatic view of Hedstrom file Fig. 12.21: Safety Hedstrom file
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 Endodontic Instruments
Fig. 12.22: S-file Fig. 12.23: Gates-Glidden drills

• S-file has good cutting efficiency in either filling or reaming

action, thus this file can also be classified as a hybrid design.

C+Files
• C+ files are used for difficult and calcified canals. They have Fig. 12.24: Flame shaped head mounted
better buckling resistance than K-files. on long thin shaft in Gates-Glidden drill
• They are available in size 8, 10 and 15 of length 18, 21 and
25 mm.

Golden Medium Files

1. These files were described by Weine. They come under
intermediate files provided with half sizes between
conventional instruments.
2. They are available in sizes from 12-37 like 12, 17, 22, 27,
32 and 37.
3. They are used for narrow canals.
4. They are formed by cutting 1 mm from the tip of instrument.
In this way No. 10 file can be converted to no. 12, and 15
to No. 17 and so on.

ENGINE DRIVEN INSTRUMENTS

Gates-Glidden Burs (Fig. 12.23)
• Traditional engine driven instruments include Gates-
Glidden drills which have flame-shaped cutting point
mounted on long thin shaft attached to a latch type shank Fig. 12.25: Due to safety design, if cutting tip of instrument jams against
(Fig. 12.24). canal wall, the fracture occurs at junction of shaft and shank and not
at tip
• Gates-Gliddens are available in a set from 1 to 6 with the
diameters from 0.5 to 1.5 mm.
• Due to their design Gates-Glidden drills are side cutting
instruments with safety tips (Fig. 12.25).
• They should be used at the speed of 750-1500 rpm. In at the junction of shank and the shaft but not at the tip
brushing strokes. of the instrument. This makes the easy removal of fractured
• Safety design of Gates-Gliddens is that its weakest part lies drill from the canal.
at the junction of shank and shaft of the instrument. If • They can be used both in crown down as well as step back
its cutting tip jams against the canal wall, fracture occurs fashion (Fig. 12.26).
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