Instruments
Classification of instruments:
1- Diagnostic instruments
2- Access cavity instruments
3- Isolation instruments
4- Working length instruments
5- Intra-radicular instruments
Diagnostic instruments:
Visual aids:
- Mirror, probe, tweezers.
- Illumination
- Magnification (loupes, S.O.M surgical operating microscope).
Radiographs:
- 2D images: plain R.G. and digital R.G. (the digital R.G. can be direct or indirect)
- 3D images: Cone beam computed tomographic scans CBCT scan
Vitality testing:
to detect whether the pulp is necrotic and infected or not, If necrotic and infected no
need to use anesthesia and controlling infection is needed.
Access cavity instruments:
Round bur
Safe-end stone
Endo-Z bur
Martin access bur (combination between round bur & tapered round stone)
Diamond round bur for ceramic and porcelain restorations
Transmetal bur for metallic restoration
Munce discovery bur for calcified canals (low-speed bur, with long shank and
round small cutting end.
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The isolation can be:
- Evacuation (by suction)
- Absorption (by cotton rolls)
- Barrier technique (Rubber dam) only isolation method used in endo Tx.
Rubber dam components:
1- Rubber dam sheets
2- frame
3- Clamps
4- Clamp holder
5- Puncher
Advantages of the rubber dam: VIP
- The patients are protected from the ingestion or aspiration of small instruments, dental
fragments, irrigating solutions.
- The opportunity to operate in a clean surgical field.
- Retraction and protection of the soft tissues from the cutting action of the bur.
- Better visibility.
- Reduction of delays.
Working length instruments:
- Radiographs and files
- Electronic apex locator:
It depends on the difference in electrical resistance of tissue.
Advantages:
Locates the minor diameter of the foramen
Minimize radiation exposure
Shorten preparation time
Affordable, accurate, painless & safe
Notes:
The anatomical apex is located at the CDJ, 0.5-1 mm from the radiographic apex
The anatomical apex = maximum apical constriction = minor diameter
The radiographic apex = minimum apical constriction = major diameter
Radiographs are both diagnostic and working length instruments.
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Intra-radicular instruments:
• According to use:
1. Exploring
2. Extirpating
3. Enlarging
4. Obturating
Exploring instruments:
They are instruments that are designed to explore and search for canal’s orifices in the pulp
chamber’s floor after de-roofing.
1. Endodontic explorer
2. Smooth broach
3. Micro-opener: (hand-held K-file tip)
4. Micro-debrider: (hand-held H-file tip)
Extirpating instruments:
- Extirpation is the removal of vital pulp tissue as a whole; in one piece.
- Debridement is the removal of necrotic or inflamed pulp.
- Best instrument to extirpate is the Barbed broach.
- Endodontic cutting files can also be used in extirpation and removal of pulp tissue
from within the canal.
T/F: Barbed broach is the only instrument to extirpate (×××)
Obturating instruments:
1- Spreaders: for lateral impaction of filling material.
2- Pluggers: for vertical (apical) impaction of filling material.
3- Lentulo spiral: used to spread the sealer in the canal’s walls.
• According to energy supply:
1. Hand driven instruments
2. Engine driven instruments
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• According to American dental association:
1. Group I: Hand use only
2. Group II: Engine driven instruments
3. Group III: Sonic and Ultra sonic devices
4. Group IV: Root canal points (Gutta percha points and paper points).
• According to material of construction:
1. Carbon steel: very high cutting efficiency but very low corrosion resistance.
2. Stainless steel: medium cutting efficiency with higher corrosive resistance but it’s very
stiff.
3. Nickel titanium:
a. Super elastic property (highest flexibility) and has shape memory
b. Exotic metal doesn’t apply to the laws of metallurgy.
c. Least cutting efficiency.
4. Diamond: abrasives diamond.
According to manufacturing technique:
1. Milling = machine grinding
2. Twisting
3. Stamping
P.O.C K-file H-file
Cross section Square Coma-shaped (tear-drop)
Manufacture Pulling and twisting Machine grinding
method
Cutting Less than H-file More than K-file and K-reamers
efficiency
More difficult to break Broken easily due to the presence of
weak joints
Place of Universal (apical & middle & coronal In coronal and middle thirds
cutting 1/3)
Cutting - Reaming motion Filing motion = push & pull motion =
motion - Filing motion (but not in apical rasping motion
1/3) **
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Reaming motion: insertion into the canal, rotation cutting dentine then retraction to remove
debris
K-reamers are the same as K-files except that the cross section is triangular
No. of flutes (blades) in K-reamers < in K-files
Distance between the flutes in K-reamers > in K-files
Cutting efficiency of K-reamers > K- files as the clearance space is larger in K-
reamers
Cutting efficiency of K-reamers < H-files
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