Instruments 2

Components of files:
1- Handle
2- Shaft
3- Working part

Standardization of root canal instruments:

1- Working blade length  16 mm
2- D0: It is the diameter at a point where the instrument blades begin at the tip of the
instrument and is measured in millimeters.
D16: is a point at which the working blades terminated, and which is 16 mm from point
D 0.
3- Taper= 0.02 mm/mm = 2%
- Taper = D 16-D 0/ Length between D 0 and D 16 = 0.32 mm/16.0 mm = 0.02
mm/mm.
- So, the taper of any given instrument is increased by 0.02 mm in diameter per each
mm of length.
- D1-D0 = D2-D1 = D16-D15 = 0.02 mm
- Total taper= 0.02 × 16 = 0.32 mm
- ∴ D16 > D0 by 0.32 mm (D16-D0= 0.32)
4- No. of instrument= D0 × 100 (no. of instrument is according to D0)
5- Transition between files

Size 6, 8, 10  0.02 mm increase = 20 µm

Size 10 to 60  0.05 mm increase = 50 µm

Size 60 to 140  0.1 mm increase = 100 µm

6- Tip angle = 75º ± 15 = 60-90, pointed

Standardized dimensions of root canal files and reamers were established by the ISO:
1. Tip.
2. Length of the blade.
3. Taper.
4. Size.
5. Number. (Of the same instrument)
6. Gradual increase in size.
7. Color Coding. (Of different instruments)

Standardized Diameter in hundredths of mm

Color
number D-0 D-16

6 Orange 0.06 0.38

8 Silver 0.08 0.40
10 Purple 0.10 0.42
15 White 0.15 0.47
20 Yellow 0.20 0.52
25 Red 0.25 0.57
30 Blue 0.30 0.62
35 Green 0.35 0.67
40 Black 0.40 0.72
45 White 0.45 0.77
50 Yellow 0.50 0.82
55 Red 0.55 0.87
60 Blue 0.60 0.92
70 Green 0.70 1.02
80 Black 0.80 1.12
White 0.90 1.22
Yellow 1.00 1.32
110 Red 1.10 1.42
120 Blue 1.20 1.52
130 Green 1.30 1.62
140 black 1.40 1.72
 • Handle style:
1. Style (D) long handled:
i) They can be used only on maxillary anterior teeth.
ii) It is not frequently used nowadays.
2. Style (B) short handled:
i) Are made on metal or plastic handles
ii) Handle configurations vary from a manufacturer to the other.
3. The measurement controls handle or test handle:
It is fitted with a chuck that allows the operator to adjust length of blade projecting from the
handle.

Length of the blade

• Files and reamers are made in a variety of lengths.
• The working part of the blade remains fixed (16 mm. in length) while the length of the instrument
from D-16 to the beginning of the handle varies.
• The 31mm; length instrument is required for some maxillary canines and the shorter instruments
are useful in molar areas where access is a problem.
• The most commonly used lengths are 21mm., 25 mm., 28 mm, and 31mm. instruments, when
one considers the average length of teeth.

• Instruments stops:
The importance of instrumentation to a known canal length has been stressed and there are
several ways of marking instruments. They can be marked very simply by:
1. Using marking paste (a mixture of petroleum jelly and zinc oxide), which can be wiped
off easily. So, this method is not used today.
2. Either silicone or small rubber discs can be used as a stops some are teardrop in shape,
with the point providing a reference guide for the reinsertion of the instrument the same way
each time, especially in teeth with curved canals.
3. A metal stop, which has the advantage that the stop fit the shaft accurately and firmly.
4. Test handle system consists of a handle marked in millimeters, which accepts special
reamers and files of various sizes. The handle can be tightened so that the working part is clamped
at a predetermined length.

Hybrid instruments advantages:

1- Increase flexibility
2- Increase cutting efficiency
3- Increase strength
4- Decrease procedural errors

Modifications
Cross section Modification is k-file (square shaped c.s.):
- Diamond / rhomboid  k-flex file
- Triangle  flex-O file, Flex-R file
k-file □ c.s.  most rigid
flex-O/R file △ c.s.  more flexible
k-flex file ◇ c.s.  most flexible, the acute angle between 2 high flutes of
the diamond shape leads to increased sharpness and cutting efficiency.
Modifications in H-file (coma-shaped c.s.):
- S-shaped/ double helix  S-file, Uni-file
- Triple helix  triocut/ helio-file  highest cutting efficiency
U-shaped c.s.  Canal mater U file  increased friction (used in apical
preparation)
Tip design From spear-shaped  pilot shaped non-cutting tip
A-file, unifile, safety-H file, canal master system, flex-R file
Advantages:
- No ledge formation
- No zipping
- No canal transportation
- No perforation
 Helical angle Helical angle is the angle between the cutting edge of the blade and the
long axis of the file.
Decrease in H.A.  increases cutting efficiency
Modification: decrease from 70º to 40º
From H-file  A-file and S-file
Taper 2%  4%  6%, and may reach to 12%
modification To increase strength and cutting efficiency
Modification a) Length: Modified from 16 mm to 2-3 mm
in cutting As in Glidden gates, flexogates, canal master instrument, light speed
blade b) Non-cutting side of the blade: as in safety-H file (to prevent
ledging in curved canals)
Material Stainless steel files are stiff
Nickel-Titanium file super elastic
Carbon steel  increased sharpness but also increased tarnish and
corrosion
Manufacturing By twisting: as K-file or
By milling: as flex-R file
Numbering Intermediate sizes (Golden medium sizes) as 12.5, 17.5, 22.5, 27.5, 32.5
system and so on

Notes:
- The acute angle formed by the 2 high flutes of the diamond (rhomboid) shape in Kflex
file increased sharpness and cutting efficiency. While the obtuse angle formed by the low flutes
producing more area for increased debris removal.

- The main advantage of A-file is its use in curved canal because:

1) The steep blades on the inner wall collapse and thus loose much of their cutting efficiency.
2) The blades on the external wall open up and more aggressively attack the dentin surface.
3) A non-cutting tip on the instrument also ensures that the tip will follow the canal lumen and
will not catch in the convex outer wall, starting a ledge or worth a perforation
 - The increase in taper has the following advantages:
a) Allows the smaller files to function under reduced stress.
b) Improves the tactile sensation at working length.
c) Allows the file tip to act as a guide and prevent instrument binding at the tip.
d) Allows greater coronal flaring
e) The steeper angle of root canal instrument allows ample irrigation due to deep penetration of
irrigating syringe into the canal.
Finally, the greater taper of the instrument making the area of contact with the canal walls small,
and therefore the contact pressure is high, and this gives the instrument greater cutting
effectiveness.

- Modifications in S-file:
1- S-shaped cross section
2- Decrease in helical angle
3- Pilot shaped tip

- Modification in safety-H file:

1- Noncutting pilot shaped tip
2- Noncutting part of the blade
It’s used to cut in dangerous zone (small dentin thickness)
If safety-H is not available,  use anti-curvature filling technique

- To use the file in:

Reaming  decrease the H.A.
Filing  increase the H.A.

- Modifications in A-file:
1- Decrease in helical angle
2- Pilot shaped tip
Engine driven instruments:
Full rotary hand piece instruments:
Since most of these instruments do not bend, they should primarily be used in perfectly straight
canals to avoid perforation of the canal.
• Disadvantages of rotary instruments: (VIP)
1. Loss of tactile sense
2. Ledge formation in curved canals
3. Perforation in curved canals
4. Instrument separation rate higher than hand driven instruments.

A- Gates- Glidden drill:

Gates Glidden (G.G.) drills are used for both initial opening of the canal orifices and deeper
penetration in both straight and curved canals.
They come in sizes 1 to 6 (50-70-90-110-130-150 #k sizes).

B- Pesso reamer:
1- It is the most often used instruments in preparing the coronal portion of the root canal.
2- It is also used in preparing post channel preparation.
3- Safe ended Pesso reamer should be used to prevent lateral perforation. A: Gates-Glidden
drill.B: Pesso reamer

C- Orifice opener:
• It is more flexible than the G.G. but it is recommended to be used only in the straight portion
of the canal.
• Orifice opener instruments come in sizes 25-70. They are used to create a funnel shaped opening
into the root canal and to widen the coronal one third of the canal. So, canal opening is more
easily located each time during the instrumentation phase.

Funnel shaped orifice is even more important during the filling phase to prevent the fine tip of
gutta percha cone to hit the pulpal floor, bent and fold back upon itself and the final root canal
filling would then be short.

Nermeen Mostafa