ENDODONTIC

INSTRUMENTS
PRESENTED BY
DR. OSHIN BAGHEL
 CONTENTS
• INTRODUCTION
• CLASSIFICATION OF ENDODONTIC INSTRUMENTS
• STANDARDIZATION OF ENDODONTIC INSTRUMENTS
• MAKING OF ENDODONTIC INSTRUMENTS
• TERMS USED WITH ENDODONTIC INSTRUMENTS
• HAND INSTRUMENTS
• CONCLUSION
• REFERENCE
 INTRODUCTION
• Instruments play a major role in the success of a root canal treatment
therefore a basic knowledge of endodontic instruments is essential.
• General guidelines exist for root canal preparation, but due to the
complex and varied canal anatomy each case presents unique
challenges.
• A variety of instruments are thus available for this purpose.
CLASSIFICATION OF
INSTRUMENTS
 CLASSIFICATION OF
CLEANING AND SHAPING
INSTRUMENTS
 CLINICAL INSTRUMENTS
CLASSIFICATION
• INSTRUMENTS USED FOR DIAGNOSIS
• INSTRUMENTS USED FOR ACCESS OPENING
• INSTRUMENTS USED FOR CANAL PREPARATION
• INSTRUMENTS USED FOR ROOT CANAL OBTURATION
 INSTRUMENTS USED FOR
DIAGNOSIS
• ENDODONTIC EXPLORER
• PERIODONTAL PROBE
• MIRROR
SPECIALISED DEVICES
• TOOTH SLOOTH
• DENTAL TRANSILLUMINATOR
• PULP VITALITY TESTER
 Cotton forceps
Endodontic explorers
Long, narrow working ends. Angle away from shank – easy
access. These instruments are very stiff and should not be
inserted into canals. . This double ended instrument with long
tapered tines is designed to facilitates the location of canal
orifice.
PULP VITALITY TEST
RECENT AVAILABLE PULP
VITALITY TESTS
 RECENT ADVANCES IN
RADIOGRAPHY
• TUNED APERTURE COMPUTED TOMOGRAPHY
• MAGNETIC RESONANCE IMAGING
• ULTRASOUND
• OPTICAL COHERENCE TOMOGRAPHY
• CONE BEAM COMPUTED TOMOGRAPHY
• MICROCOMPUTED TOMOGRAPHY
• SPIRAL COMPUTED TOMOGRAPHY
TUNED APERTURE COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING ULTRASOUND

MICROCOMPUTED TOMOGRAPHY

OPTICAL COHERENCE TOMOGRAPHY SPIRAL COMPUTED TOMOGRAPHY

CONE BEAM COMPUTED
TOMOGRAPHY
 INSTRUMENTS USED FOR
ACCESS OPENING
• DIAMOND ROSE HEAD BURS

• TAPERED FISSURE

• CARBIDE BURS

• SAFE END LONG BURS

• ENDO Z BUR
 INSTRUMENTS USED FOR CANAL
PREPARATION
a) INSTRUMENTS USED TO REMOVE PULP TISSUE
i. Barbed broaches
ii. Endodontic excavators

b) INSTRUMENTS USED FOR ROOT CANAL PREPARATION

iii. Reamers
iv. Files
 INSTRUMENTS USED FOR ROOT
CANAL OBTURATION
• Lentulospirals

• Spreaders

• Pluggers

• Condensors

• Heat carriers

• Thermomechanical compactors
 EXTIRPATING INSTRUMENTS

• BARBED BROACHES
• Short handled ,used primarily for vital pulp
extirpation
• Loosens debris in necrotic canals.
• To remove paper points or cotton pellets
• Must only be used in the straight part of the
canal
• Manufactured by notching a round, tapered wire
with a blade to form sharp, projecting barbs that
cut or snag tissue.
 RASPS
• Broaches and rasps show significant
differences in taper and barb size
• The broach has lesser taper than rasps
• Barb height is much greater in the broach
than in the rasp
 SMOOTH BROACHES
• There is also smooth broaches
sometimes used as a pathfinder
• The Pathfinder CS ,made up of
carbon steel , is less likely to
collapse when forced down in a
fine canal
 ENDO EXCAVATOR

Endo excavator: "larger than

conventional excavator" its
shape allows curettage of
the pulp chamber when
conventional one will not
reach the floor of the
chamber, and used as
surgical aid to excavate
periapical lesion.
 INSTRUMENTS USED FOR ROOT
CANAL PREPARATION
• Kerr manufacturing company was the first to
produce files in the early 1990s, hence the name
K-type file and K-type reamer.
• At first, root canal instruments were
manufactured from
Carbon steel- contain less than 2.1% of
carbon . However chlorine and steam sterilization
caused significant corrosion. They are used only in
initial penetration of narrow canals.
• High hardness than stainless steel instruments
• Prone to corrosion, so cannot be autoclaved
• prone to rust
• The use of Stainless steel
instruments (contain 18%
chromium, 8-10% nickel, 0.12%
carbon) improved the quality of the
instruments as they where Corrosion
resistant and Stiff in nature, but
unfortunately they were prone to
fracture and distortion.
• They are precurved to the desired
form to facilitate insertion in curved
canals and used in anti curvature
filling technique.
• Recently. Nickel titanium – (contain 55% Ni and
45% Ti) was used to aid maintaining canal shape.
• They are Super elastic, Corrosion resistant, Softer
than steel, good resilience, biocompatible and have
the Shape memory property.
• However , they don’t show signs of fatigue before
they fracture , Poor cutting efficiency and Poor
resistance to fracture
 MANUFACTURING OF HAND
INSTRUMENTS
• A hand instrument reamer or file begins as a round wire which is
modified to form a tapered instrument with cutting edges.
• These are manufactured by two techniques:
[Link] first grinding graduated sizes of round “piano” wire into
various shapes and then twisting counterclockwise to produce
cutting edges.
2. By grinding spirals into tapered wire rather than twisting, e.g.
H-file and NiTi instruments are machined
 STANDARDISATION OF
INSTRUMENTS
• In [Link] established a logical nomenclature for the standardization of
root canal instruments, so all manufacturers could conform to
length ,width, and taper in specific standards.
• The international standard organization (ISO) further developed the
system.
Landmarks of standard instruments
• Length of the instrument
• Numbering of the instruments
• Incremental increase in size
• Color coding
• Instrument taper
• Tip angle
 LENGTH OF THE INSTRUMENT
• The first standard in length is the full
extent of the shaft up to the handle
and this comes in 3 lengths :25
mm(most common), 21 mm(used for
posteriors aS it affords better
operator control), or 31 mm
(commonly used for long roots as
canines.
• Second standard in length is the
length of instrument blade(is to be 16
mm starting from D1 till D16 )
• The rest of the blade has no flutes
 MODIFICATION FOR INGLE’S
STANDARDIZATION
• An additional diameter point D3 , 3mm from the tip of the cutting
end of instrument at D0 (earlier it was D1) and D2 was
designated D16.
• Tip angle should 75+_ 15 degrees.
• Greater taper were made available.(0.04, 0.06, 0.08 , 0.10 ,0.12)
 NUMBERING AND COLOR
CODING
• The instruments are available in
sizes 6 to 140 .Each number
represent diameter of instrument
in 100th of millimeter at the tip.
• For example, instrument No. 25
has a diameter at D0 =25/100 =
0.25 mm.
• Color coding
• Instrument handles should be
color coded for their easier
recognition ( white, yellow, red,
blue, green, black) and repeated
up to instrument no 140.
• In addition, no 6 is Pink, no 8 is
gray, and no10 is purple
 INCREMENTAL INCREASE IN SIZE
• In small files up to size 60 ,there is
Increment each 5/100 or 0.05 mm
increment at D. In large files60 up
to140 ,there is Increment each 10/100
or 0.1mm increment at D. While from
size 6 up to10 , the increment is 2/100
or 0.02mm.
 INSTRUMENT TAPER
• The file diameter increases at a
standard rate 0.02mm/mm Starting
at D0 ,this means that the difference
in diameter between D0 and D16
regardless the instrument size is
always 32mm
( 0.02 X 16= 0.32 ).
• E.g. instrument no 15 with 0.02
taper, would have 0.17mm diameter
after 1mm from tip and 0.47mm at
D16
• Greater taper instruments (0.04,
0.06, 0.08, 0.10, 0.12) have also
been made available.
 TIP ANGLE
• Tip angle of an instrument should be 75° ± 15°
 DESIGN OF ENDODONTIC
INSTRUMENTS
• TAPER
• CORE
• FLUTE
• CUTTING EDGE
• LAND
• HELIX ANGLE
• PITCH
• RAKE ANGLE
• CUTTING ANGLE
• TIP DESIGN
 CORE
• IT IS CYLINDRICAL CENTRE PART OF FILE HAVING ITS CIRCUMFERENCE
OUTLINED AND BORDERED BY THE DEPTH OF FLUTES
 FLUTE
• IT IS THE GROOVE IN THE WORKING SURFACE USED TO COLLECT SOFT
TISSUE AND DENTIN CHIPS REMOVED FROM THE WALLS OF THE CANAL
• THE EFFECTIVENESS OF THE FLUTE DEPENDS ON ITS DEPTH, WIDTH,
CONFIGURATION, AND SURFACE FINISH.
 CUTTING EDGE
• THE SURFACE WITH THE GREATEST DIAMETER THAT FOLLOWS THR
GROOVE( WHERE THE FLUTE AND LAND INTERSECT) AS IT ROTATES,
FORMS THE LEADING (CUTTING EDGE) , OR THE BLADE OF THE FILE.
 LAND/ MARGINAL WIDTH
• THE SURFACE THAT PROJECTS AXIALLY FROM THE CENTRAL AXIS AS FAR
AS THE CUTTING EDGE BETWEEN THE FLUTES
 HELIX ANGLE
• THE ANGLE FORMED BY THE CUTTING EDGE WITH THE LONG AXIS OF THE
FILE
• HELPS IN REMOVING DEBRIS COLLECTED IN THE FLUTE FROM THE CANAL
 PITCH
• THE PITCH OF FILE IS THE DISTANCE BETWEEN A PONT ON THE LEADING
EDGE AND CORRESPONDING POINT ON THE ADJACENT LEADING EDGE
• OR
• IT MAY BE THE DISTANCE BETWEEN CORRESPONDING POINTS WITHIN
WHICH THE PATTERN IS NOT REPEATED
 RAKE ANGLE
• THE ANGLE FORMED BY THE LEADING EDGE AND RADIUS OF THE FILE
WHEN THE FILE IS SECTIONED PERPENDICULAR TO ITS LONG AXIS.
 CUTTING ANGLE
• THE CUTTING ANGLE OR EFFECTIVE RAKE ANGLE IS A BETTER INDICATION
OF THE CUTTING ABILITY OF A FILE AND IS OBTAINED BY MEASURING THE
ANGLE FORMED BY THE CUTTING (LEADING) EDGE AND THE RADIUS
WHEN THE FILE IS SECTIONED PERPENDICULAR TO ITS CUTTING EDGE
 TIP DESIGN
• The pyramidal distal end of the active part of a
file. A pyramidal tip provides excellent cutting
efficiency but may be too aggressive . Tips have
been described as cutting, noncutting, or
semicutting, but no clear distinction exists
between the three. In 1985, in a seminal article
on the balanced‐force technique, Roane et al.
proposed a modification of the tip for the
purpose of eliminating the transition angle
between it and the first blade , thereby avoiding
canal ledging and transportation. A comparison
of three different hand techniques and one
mechanized technique demonstrated that canal
preparation with a modified tip was significantly
better than that using a traditional (unmodified)
tip .
PART 2
 K FILES AND REAMERS
• IN 1904 Kerr Manufacturing Company
designed the, K style files and reamers .
• Files are instruments that enlarge canals
with reciprocal insertion and withdrawal
motions. K files blade angle makes them
best suited for cutting dentin in the filing
motion
• Reamers cut and enlarge canals with
rotational motions .K reamers have a rake
angle which makes them most efficient in
rotary motion, hence reaming is preferred .
 REAMERS
• Reamer is K-type instrument
(manufactured by Kerr company), which is
used to ream the canals. It cuts by
inserting into the canal, twisting clockwise
one quarter to half turn and then
withdrawing, i.e.
Penetration Rotation Retraction.
• Cutting action of reamer
• instruments can be manufactured by
twisting a square or triangular blank by
machine .
• Reamer has triangular blank
and lesser number of flutes
than file.
• Number of flutes in reamer are 1/2
to 1/mm, while in file,the flutes are
1 1/2 to 2 1/2/mm
• Though reamer has fewer numbers
of flutes than file, more space
between flutes causes better
removal of debris
 K FILE
• Instruments can be manufactured by twisting a
square or triangular blank by machine the blank is
twisted into a tighter series of spiral than reamer
also K- file are more flexible than reamer .
• K -Files with a triangular cross-section tend to
have superior cutting characteristics and are more
flexible, and hence less likely to transport the
canal during preparation. .
• Mode of Action –filing ( push and pull) AND
reaming
 HEDSTORM FILE (H- FILE)
• Hedstrom file has flutes which resemble
successively triangles set one on another
• Manufactured by grinding a conical steel
wire.
• Cut in one direction – retraction (Cutting
while pulling)
• Cross-section – single helix teardrop
• Very aggressive
• Hedstrom File: Recommended use

• can be used both in straight canals and curved canals.

• H-files must always fit loosely in the canal to avoid risk for
fracture.
• Small sizes up to #25 can be used down into full preparation
length while bigger sizes are often used mm short.
• Useful for removal of Gutta-percha in re-treatment cases
• To remove /retrieve broken instruments
MODIFIED INSTRUMENT
DESIGN
 FLEXOREAMER
• The helix angle is small, and therefore
effective only in rotatory motion.
• The tip of the instrument is non-cutting
(bat-tip/inactive tip) making
flexoreamer well suited for the
preparation of evenly curved canals
without risk of ledging.
• Flexoreamer are best distinguished
from normal reamers by the size code
at the top of the instrument. In
flexoreamers the colour of the number
is the same as the colour of the handle.
 SAFESIDER REAMER

• Non-circular, non-interrupted flat-

sided reamers designed to reduce
endodontic stress
• Advance faster with less resistance to
the apex.
• Reduced binding with increased
flexibility.
• Unique design prevents clogging by
providing space for dentinal debris to
escape.
The results of this study conclude that SafeSiders stainless steel 40/0.02 instruments
exhibit a greater cutting efficiency on dentin than K-Files and K-Reamers of the same size
and taper.
 K- FLEX
• Hybrid – strength and versatility of K- type +
aggressive cutting of H-type.
• K-flex file is rhombus in cross section having
two acute angles and two obtuse angles .
The two acute angles increase sharpness
and cutting efficiency. While the two obtuse
angles provide more space for debris
removal.
• Also the decrease in contact of instrument
with canal walls provide more space for
irrigation.
• It is used with filing and rasping motion.
• Increase flexibility.
• Flexo File
• It is similar to the K-flex file except that it has
triangular cross section. This feature provides more
flexibility and thus ability to resist fracture.
• The tip is noncutting type.
• Flexo files has more flexibility but lesser cutting
efficiency.
• Triple Flex File
• It is made up of stainless steel and are triangular in
cross section.
• It has more flutes then reamer but lesser than K-
file.
• Triangular cross-section provides better flexibility
and cutting efficiency
 FLEX-R-FILE/ROANE FILE
• • Flex-R file is made by removing the sharp
cutting edges from the tip of instrument .The
noncutting tip enables the instrument to
traverse along the canal rather than gouge
into it.
• This design reduces procedural accidents
• Triangular cross section which provides it
flexibility to be used in curved canals.
• It is made up of NiTi
 C- FILE
• These are made of specially treated stainless steel for stiffness and
strength. The result is easier access to challenging calcified canals
• Heat tempered steel for stiff performance
• twisted file design
• Eases penetration
• Available in 21mm and 25mm
 C+ FILE
• Steel C+ File delivers superior strength for accessing
difficult or calcified canals. Due to its unique taper, the
Steel C+ File features an even higher degree of ultra-
stiffness to negotiate your most challenging canals.
• Up to 300% gain in resistance to buckling
• Unique taper for ultra-stiff design
• Calibration rings for easy depth determination
• Pyramid-shaped tip for easy penetration
• Highly polished for debris removal and smooth
insertion into the canal
• Square section for resistance to distortion and
increased safety
• What is the difference between a C pilot file
(GUNZ) and a C+ file (Dentsply)?? They are both
treated stainless which makes them more rigid
than regular stainless steel but the C+ file has a
cutting tip and is designed to cut through calcified
canals and the C pilot file does not cut with its tip.
 ENDO HANDLE
• Finds the smallest canal orifice with pin-point
accuracy
• Unobstructed view of the pulp chamber
• Attaches to any endodontic hand instrument
• Access any tooth in patients with limited
opening
• Ergonomic pen-grasp-grip for better control
and leverage
• Simple filing action open up the orifice and
creates a smooth path to the apex.
 PEDO FILES

• PRIME PEDO STAINLESS STEEL K-FILES 2% 18MM

• Waldent Pedo-Flex Files For Kids #16mm
 MODIFIED H- STYLE FILES
• McSpadden was the first to modify
the traditional Hedstorm File
• Marketed as the Unifile and Dynatrak,
these files were designed with two
spirals for cutting blades, a double
helix design.
• In cross section, the blades presented
an ‘S shape” rather than the single
helix teardrop cross sectional shape
of the true Hedstorm file.
 SAFETY HEDSTORM FILE
• S File
• This file has noncutting safety side along the
length of the blade which reduces the chances of
perforations.
• Non cutting edge prevent ledging and stripping in
curved canals.
• Can be used with any hand motion(filling or
reaming) thus file can be also be classified as
hybrid design.
• It is called ‘S’ file because of its cross-sectional
shape.
 D FINDERS
• These files have a D-Shaped Cross Section, thereby
increasing their strength & resilience
• Unprecedented blade strength
• Smooth Insertion
• Efficient canal preparation
• D-Finders resist but penetrate easily in the canal as
compared to K-Files
• Increased resilience, improves the penetration force,
making the files effective for a root canal narrowed
by calcification
• Cutting flutes are shaped in to prevent cutting in
(screwing effect)
 HAND PROTAPER
• It was introduced by D Cliff
Ruddle, Dr. Johan West, Ben
John and Dr. Pierre.
• Protaper means progressively
taper
• NiTi
• No identification ring on its gold or orange colored handle
• Shorter length of 19mm
• Do diameter is 0.19mm
• D14 diameter is 1.20mm
• There is increase in taper up to D9 and then taper drops off up to D14
which increases its flexibility.
• Purple identification ring on its handle
• D0 diameyer is 0.17 mm and D14 is 1.20 mm
• Used to prepare coronal part of the root.
• Abstract
• Objective: The aim of the present study was to evaluate the remaining dentin thickness
(RDT) after instrumentation with different endodontic file systems through CBCT.
• Materials and Methods: In the present study, 40 extracted, untreated human mandibular
Premolars, with curvature less than 20° were divided into four groups (n=10, each group).
Biomechanical preparation was done according to the group where, Group 1 included SS
Hand K files, Group 2 included Hand ProTaper files, Group 3 included ProFile rotary files, and
Group 4 included ProTaper Gold rotary files. CBCT images of Pre and Post instrumented
canals were taken, and RDT was measured at 3 mm, 5 mm, and 7 mm from the
radiographic root apex.
• Results: Results of the present study showed that Group 2 removed the maximum amount
of root dentin compared to other groups, Group 3 and 4 instrumentation techniques
removed almost equal amounts of dentin while Group 1 removed the least amount of root
dentin.
• Conclusion: It can be concluded that engine driven Ni-Ti instruments better maintain the
anatomy of the root canal during instrumentation with lesser removal of root dentin as
compared to hand instruments.
 INSTRUMENTS USED FOR
ROOT CANAL FILLING
• Spreaders and pluggers
• Are the instruments used to compact the gutta-percha
into root canal during obturation
• A- Hand Spreaders
• • They are made from stainless steel and are
designed to facilitate the placement of accessory
gutta-percha points around the master cone during
lateral compaction technique
• • These spreaders do not have standardized size and
shape.
• • They are not used routinely because excessive
pressure on the root may cause fracture of root.
 B- FINGER SPREADERS

• • They are shorter in length which

allows them to afford a great degree
of tactile sense and allow them to
rotate freely around their axis.
• • They are standardized and color
coded to match the size of gutta-
percha points.
• • They can be manufactured from
stainless steel or nickel titanium
• Stainless steel spreaders may pose difficulty in penetration in
curved canals, may cause wedging and root fracture if forced
during compaction. They also produce great stresses while
compaction.
• • NiTi spreaders are recently introduced spreaders which can
penetrate the curved canals and produce less stresses during
compaction. They may bend under pressure during compaction
 PLUGGERS
• A- Hand Pluggers
• • They consist of diameter larger than spreader and
have blunt end .
• They are used to compact the warm gutta-percha
vertically and laterally into the root canal.
• They may also be used to carry small segments of
guttapercha into the canal during sectional filling
technique.
• Calcium hydroxide or MTA like materials may also
be packed into the canals using pluggers.
 B- FINGER PLUGGERS

• They are used for vertical compaction of gutta-

percha. They apply controlled pressure while
compaction, and have more tactile sensitivity
than hand plugger.
• They should be cleaned prior to their insertion
into the canal; otherwise the set sealer from
previous insertion may roughen their surface and
may pull the cone outside the canal rather than
packing it.
• Also one should discard the instrument when it
has become bent or screwed to avoid instrument
separation while compaction.
 LENTULO SPIRAL
• They are used for applying sealer to the root
canal walls before obturation. • They can be
used as hand or rotary instruments.
• Small flexible instrument used to place
materials into the canal Fits into the
conventional hand piece.
• Use with caution as it can be easily broken
MISCELLANEOUS
INSTRUMENTS
ENDODONTIC RULER
INSTRUMENT ORGANIZER
( ENDODONTIC KIT)
ENDODONTIC BLOCK OR
TRANSFER SPONGE
 QUESTIONS
• Temperature for heat and cold test?
-Heated Gttapercha -65.5 degrees and Cold test- -72 degrees
• Site for pulp testing?
Incisal third for anteriors and middle third on the buccal surface of
posteriors , as the nerve density is more in these areas.
• Importance of gnarled enamel
Gnarled enamel leads to hypocalcified tooth structure which affects the
pulp vitality testing.
 CONCLUSION
• From a biological perspective root canal treatment is
directed toward the elimination of micro organisms from the
canal system and the prevention of reinfection.
• Technological advances in the form of rotary NiTi
instruments have led to dramatic improvements in the
ability to shape root canals with potentially fewer procedural
complications.
 REFERENCE
• GROSSMAN’S ENDODONTIC PRACTICE: 11TH AND 13TH EDITION
• INGLE’S ENDODONTICS 6TH EDITION
• DENTAL INSTRUMENTS 6TH EDITION , A POCKET GUIDE
• Endodontic principles and practice , By Mahmoud Torabinejad, Richard E.
Walton.
THANKYOU