Endodontic Instruments

DR. POOJA JOSHI

Department of Conservative Dentistry,
Endodontics and Aesthetic Dentistry
Index
Introduction
Classification of endodontic instruments
Standardization of endodontic instruments
Manufacturing of endodontic instruments
Design of endodontic instruments
Properties of endodontic instruments
Instruments used for diagnosis, access
opening, cleaning & Shaping and root filling
Generations of NI-TI rotary files
Sonic & Ultrasonic instruments
Instruments used for other
endodontic procedures, Endodontic
Surgery & Microsurgery,
Magnification
Lasers in Endodontics
Introduction
Instruments play a very important 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.
Over the years, the hand instruments have been successful in

achieving the biological healing of periapical tissues.

In recent past, automated and mechanized instruments are

being tried to improve upon the speed and efficiency of the

treatment.
 Classification of Endodontic
Instruments
Harty’s
classification
Instrume
nts used
for
access
cavity
preparati
on Rubber
Basic dam Bur
instruments s
Instrum
ents Hand
Power assisted
used for instrumen
instruments
ts
root
canal
preparat
ion

Electronic Instruments for

measuring retrieving broken
devices instruments
 Equipmen
Instrum t used for
ents sterilizati
used for on of
filling endodonti
root c
canal instrumen
ts

Equipm
ent Equipm
used for ent for
storing improvi
instrum ng
ents visibility
 Grossman’s
classification

Shaping
Exploring instrument
instrument s

Obturati
Debriding ng
instrument instrume
s nts
 ISO - FDI
classification

Group II: Group III:

Group I: Engine Engine
Hand driven driven Ni-Ti
Use only latch Rotary
type Instruments
 Group IV:
Engine
driven 3-D
Adjusting
Instrumen
ts
Group V:
Engine
driven
reciproca
ting
Instrume
nts
Group VI:
Sonic and
UltraSoni
c
Instrume
nts
 Standardization of
Endodontic
instruments

Ingle and LeVine’s

Standardization
(for endodontic hand instrument)
Ingle and Levine using an electronic micro-comparator
found variation in the diameter and taper for same size of
instrument.
They suggested the following guidelines for instruments
for having uniformity in instrument diameter and taper.
Instruments shall be
numbered from 10 to
100; the numbers to
advance by 5 units to
size 60 and then by 10
units to size 100. This
has been revised to
Each
includenumber
numbersshall
frombe 6
representative
to 140. of the
diameter of the
instrument in hundredths
of a millimeter at the tip;
e.g., No. 10 is 10/100 or
0.1 mm at the tip, No. 25
is 25/100 or 0.25 mm at
The working blade
(flutes) shall begin at
the tip, designated site
D0, and shall extend
exactly 16 mm up the
shaft, terminating at
designated site D2. The diameter of D2 shall be
Diameter of
0.20 mm at D0
32/100 or 0.32 mm greater
than that of D0; e.g., a No. 20
k-file shall have a diameter of
0.20 mm at D0 and a
Diameter of diameter of 0.20 plus 0.32 or
0.52 mm at D2
0.52 mm at D2.
This sizing ensures a constant
increase in taper of 0.02
The tip angle of an instrument
should be 75 ± 15°.

Instrument sizes should

increase by 0.05 mm at
D0, between number 10
and 60, e.g., number 10,
15, and 20, and they
should increase by 0.1
In addition,
instrument handles
have been color
coded for easier
recognition. Pink,
gray, purple, white,
yellow, red, blue,
green, black, white..
 Manufacturing
A hand operated 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:
• The instrument is directly machined
Machini on the lathe for example H-file and
ng NiTi instruments are machined.

• Raw wire is ground into tapered

Grinding geometric blanks, i.e. square,
triangular or rhomboid.
and • Blanks are twisted
twisting counterclockwise to produce
cutting edges.
Manufacturing of Endodontic
Instruments

Earlier instruments were made of

carbon steel and stainless steel.
Advantage: good cutting efficiency
Disadvantage: lack flexibility

Ni-Ti alloy were introduced in

dentistry by Naval Ordinance
Laboratory known as nitinol.
 Alloys Used for Manufacturing
Endodontic Instruments

Advantages
• Higher hardness
Carbo than stainless
n steel steel instruments.
• Contain
less-than Disadvantages
2.1 • Prone to corrosion,
percent
of carbon. so cannot be
autoclaved.
• Prone to rust. Barbed Broach
 ADVANTAGES
Stainle • Corrosion resistance
ss
steel
• Contain DISADVANTAGES
18%chrom
ium8-10 % • Stiff in nature
nickel • Prone to fracture
0.12 % • Prone to distortion
carbon.
K-file
 Nickle-
ADVANTAGES
Titaniu • Shape memory
m • Super elasticity
• Introduced
• Low modulus of elasticity
in dentistry • Corrosion resistant
by Naval • Softer than steel
Ordinance
• Good resiliency
Laboratory,
• Biocompatibility
earlier
known as Disadvantages
“NITINOL”
• Poor cutting efficiency.
• Contain 55
• NiTi files do not show signs
percent of fatigue before they
nickel and fracture. HyFlex CM NiTi Files
45 percent • Poor resistance to fracture
titanium. as compared to stainless
steel.
 Comparison of NI-TI &
Stainless steel instruments
 Design of endodontic
instruments
TAPER

Taper is the amount of instrument diameter increase each

millimeter along its working surface from tip to the handle .

The traditional ISO instruments were standardized to have

#.02 taper or 2% taper

Greater tapered instruments have been developed with 4,

6, 8, and even 10% taper.

Tapered instruments help in preparing canals of wider

diameter without overenlarging the canal at working length.
FLUTE
It is a groove present on the working area of
file to collect soft tissue and dentin chips
removed from canal wall

Effectiveness of flute depends upon depth,

width, configuration, and surface finish
BLADE (CUTTING EDGE )

It is the working area of file .

It is the surface with the greatest diameter
which follows the flute as it rotates.
The cutting edge has 2 surfaces
The rake face (surface of the cutting edge on
the leading side)
The clearance face (surface of the blade on the
trailing side)
LAND (Radial land/marginal width):

It is the area between the flutes which

projects axially from central axis, between
flutes as far as the cutting edge
This feature is incorporated to reduce canal
transportation and supports the cutting edge
It acts as a blade support, that is, amount of
material supporting the blades
‰ RELIEF

Surface area of land which is reduced to a

certain extent to reduce frictional resistance.

It aids in protecting the instrument from over

engagement and seperation
HELIX ANGLE
It is the angle formed by cutting edge with the
long axis of the file.
File with constant helical angle results in
inefficient removal of debris and is susceptible
to “screwing in” forces
This angle is important for determining which
file technique to use
Variable helix angle causes better removal of
debris and reduces the chances of screwing
into the wall
RAKE ANGLE
•If the instrument is sectioned
perpendicular to the long axis, the
angle formed by cutting edge and the
radius of the instrument is called rake
angle.
•It can be positive, neutral, or negative
TIP DESIGN

 Original stainless steel root canal instruments

usually possess a sharp, cutting tip.
 However, rotary instruments currently are
manufactured with modified noncutting tips as these
noncutting tips cause less canal transportation and
remove debris better than traditional instruments
having conventional cutting tips.
Instruments used in root
canal treatment

Diagnostic
Instruments
Traditional instruments used in
conventional operatory are modified for
endodontic use

Magnifying loops and microscopes are

used to enhance the visibility and
enhance the diagnostic skills
INSTRUMENTS FOR ACCESS
CAVITY OR CORONAL
PREPARATION
Bur Conventional burs are used
s initially for access cavity
preparation
Long shank burs and extra
long shank burs are used in
endodontics during
preparation of deep pulp
chamber and even preparation
of coronal
These burspulp
can spaces.
also be used to
remove the gutta-percha from
the coronal aspect of the root
canal.
Endo
acces It is a
s bur combination of
round and
cone – shaped
coarse
diamond
allows access
into the pulp
chamber

prepares the
chamber walls.
Endo
–Z It is a long,
bur tapered bur for
easy access in
pulp chamber
after initial
It ahs non
preparation.
cutting safe
tip, prevents
its penetration
in the pulp
chamber.
Cutting
surface length
is 9.0 mm and
total length is
21 mm
 Gates –
glidden drill
This has a long, thin shaft ending
in a flame-shaped head with a
non-cutting safe tip to guard
against perforation.

It is made of stainless steel.

The flame shaped head cuts

laterally and is used with a
gentle, apically directed
pressure. It has a modified safe
tip i.e. non-cutting tip.
Used to expand the canal orifice
for easier instrumentation and
obturation.
May be used to expand the
coronal portion of the root canals

Available in two sizes. Short (28

mm) and regular (32 mm)

These instruments come in sizes

1 to 6.
Judicious use of the instrument is
necessary because it is liable to
fracture.
 Peeso
reamers
It is stiff instrument and does not
follow root canal even if there is
a slight curvature

It is made of stainless steel.

Main use – to prepare the root

canal for post and core
preparation because of its
effective lateral cutting.
Recommended speed is 400 –
800 rpm
These are not end cutting
instruments.

There is a nipple at the

end of the instruments,
which prevents cutting at
the tip
The nipple engages the
wall of a curved canal, the
drill just spins and does
not cut apically.
 Difference between GG drills
and peeso reamers.
GG drills Peeso
reamers
Cutting Smaller Larger
head
Shaft
Diameter of headsThinner
are differentThicker
for the same
number instrument
 CLASSIFICATION OF ELECTRONIC APEX
LOCATERS

 First generation resistance-based electronic apex locator :Endodontic

Meter and Endodontic Meter S II.

 Second generation impedance-based apex locator

 Third generation multiple-frequency apex locator:Endex apex locator

 Fourth generation multiple-frequency ratio-based apex locator:Propex

IQ (Dentsply Sirona; and Elements Diagnostic EAL (SybronEndo).

 Fifth-generation EALs (dual-frequency ratio type):e Rayapex, Propex II ,

Propex Pixi , I -ROOT, Joypex 5

 Sixth-generation EALs (adaptive apex locators) Adaptive apex locator,

Raypex 6
A newer advance is the
integration of the apex locator
with the battery-powered
endodontic slow-speed
handpiece :(Tri Auto ZX II by J.
Morita)
 EXPLORING
Smoot
INSTRUMENTS
h
broach
es
Used to explore the patency of root canal.

Tapered instruments made of soft steel

Conventional taper is 0.007-0.01 mm with
variable length
 DG 16 and
JW17
microexplore
r

Named after scientist David Green

Used to explore the root canals

However, diameter at the tip was large

enough to penetrate narrow canals

It may push the collagen more apically.

Modified forms of DG16 explorers are

D used like DG 16/17 and DG 16/23.
G1
6
 JW17 microexplorer is narrower than DG16
and easily penetrates the canals

It slides through the collagen collected at

the opening of the canals

Another explorer KC33 much heavier and

sturdier is also available for exploring the
JW1 canal
7
Pathfin
der files
The smaller number files
(No.6 and 8) are used to
negotiate the patency of root
In canals
canals, that as
known arepathfinders
calcified or
with obstruction, stiffer files
such as C+ file or C-Pilot file
are recommended
 EXTERPATING
INSTRUMENTS

Barbed It is tapered instrument made of

soft steel.
broaches
and rasps The shaft is notched by a shredder
to produce sharp barbs outward
from the shaft

Used to primarily for the

extirpation of pulp.
Also used for the removal of
necrotic debris, absorbent points,
cotton, and other foreign materials
from the root canal.
 Available in 3 sizes depending upon the
configuration of barbs.
‘XX’ –
‘X’ – ‘XXX’ –
mediu
coarse fine
m

Recently, seven types of color coded broaches have

been introduced
Black – Green – Red – extra
Blue – fine
coarse medium fine (XF)

Yellow – Purple –
White –
double quadri
triple extra
extra fine extra fine
fine (XXXF)
(XXF) (XXXXF)
 It is The
carefully The soft
inserted broch is tissue The
through slightly and canal is
the withdra debris debrided
access wn, then of bulk
cavity, rotated
get contents
till a few engage before
approxi revolutio d on further
mate ns and barbs preparat
canal removed and is ion,
length is . remov
reached.
ed.
It should never be inserted with force.

Once the dentin wall is felt, the broach

should not be pushed further.

Used in canals which are at least 20-25

number sizes.

The size of the broach is important.

• Too wide – push the pulpal tissue apically and bind in
canal and subsequently break
• Too narrow – not able to engage the pulpal tissue
properly.
Barbed broaches and rasps, although
similar in design, have significant
difference in taper and barb size.
Rasp has taper of 0.015-0.020
mm/mm.

Barb height is much larger in than in

rasp.
Broac
The barb of broach comes out of h
instrument core, so barb is much
weaker than rasp.

Ras
Disadvantages p

• Barbs are the weak links;

may break within the canal.
• Do not help in preparation of
root canal.
RASP/RAT TAIL FILES

‰ It has ADA specification No. 63

‰ Rasp has similar design to barbed broach
except in taper and barb size.
Barb size is larger in broach than rasp
‰ It is used to extirpate pulp tissue from
canal space
 SHAPING INSTRUMENTS
• Identified by a ‘triangle’ symbol on the
Reamer handle.
s • Manufactured by twisting stainless steel wire
into triangular blanks to produce cutting
edges.
• Because each angle of blank is approximately
600, a sharp knife edge is available to shave
the canal walls.
How to
use Clockwise
Reaming
turning will
involves
remove
placement
dentin chips
of
and debris
instrument
It is used from the
towards
with pushing canal wall.
apex until
and rotating However,
some
motion. counter
binding is
clockwise
felt and then
turning may
revolving
force the
the handle
debris
clockwise.
apically
 o o
n m
of th
re e
Flexorea a Hn
or
mer mas
er nm
, oal
us nre
u ca
m
allut
er
y ti
us nb
e gy
d tih
inp.a
c vi
ur n
v g
e di
d ff
ca er
n e
nt
 • Identified by a ‘square’ symbol on the handle.
• Triangular blanks of reamer are replaced with
square blank in files.
• Blanks are twisted more to give greater number of
cutting edges.
Files • Square blank has an angle of 900
• Cutting efficiency is less than reamer.
• Files have one and half to two and a half flutes per
mm and so having more cutting edges.
 How
to use The file is used with pulling
motion. The
Filing The withdrawal
involves instrument of
placement is removed instrument
of by by
instrument scrapping dragging
in root against the flutes
canal until side wall on dentin
some with little walls
binding is or no effectively
felt revolution. prepares
Hedstrom files
Identified by the ‘circle’ symbol on the
handle.
This files were manufactured with the
idea of having superior cutting
efficiency.
This files have flutes that resemble
successively smaller triangles set on
one another.
They are manufactured by using sharp rotating
cutter that gouges triangular segments out of a
round shaft.

This produces sharp cutting edges at the base of

each cone, which cut the tooth structure on
pulling only.

Cross-section of H-file shows coma-shaped (tear-

drop) appearance with one cutting edge.
•Instrumentation of immature
•Gouging in the root canal
teeth with wide canals, which
may harbor considerable debris. may lead to fracture if
•To remove GP points or loose bind in dentin. (only pull
broken instruments from canals. stroke is allowed;
•To widen coronal portion of
curved canals. rotation lead to fracture.
•For widening the orifices of any •If screwed apically with
canals for easy manipulation force, the susceptibility
during preparation and
obturation
of root fracture increases

Indication Contraind
s ications
 OBTURATING
INSTRUMENTS
•Spreaders and pluggers are
used to compact the gutta
percha into root canal during
obturation.
•In 1990, ISO/ADA Endodontic
Standardization Committee
recommended the size of 15–
45 for spreaders and 15–140
 Lentul
o
Paste fillers spirals
Lentulo spirals are used for applying sealer to the root
canal walls before obturation

Available in lengths of 17, 21 and 25 mm with size 15 – 40.

The metal handle is color coded. Both hand and rotary

versions are available

It has left-handed screw threading so that sealer flows

down to the tip when rotated in low speed.
 Hand
spread
Spreaders ers
It is made from stainless steel
designed to facilitate the placement
of accessory gutta-percha points
around the master cone during
lateral compaction technique.
Hand spreader does not have
standardized size and shape
It is not used routinely because
excessive pressure may cause
fracture of root.
 Finger
spread
These areers
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
and may cause wedging and root fracture
if forced during compaction. They also
 Hand
plugge
Pluggers rs
Hand plugger has diameter larger
than spreader and have blunt end
It is used to compact the warm gutta-
percha vertically and laterally into
the
It is root
also canal
used to carry small
segments of gutta-percha into the
canal during sectional filling
technique
Calcium hydroxide or MTA like
materials may also be packed into
the canals using hand plugger
 Finger
plugge
rs
They are used for vertical compaction of
gutta-percha. They apply controlled
pressure while compaction and have
more tactile sensitivity than hand
plugger.
 Heat
carriers
and
pluggers
It is designed exclusively for the
warm vertical gutta – percha
technique.
These are machined from a
stainless steel and are angled
inward for easy insertion.
Available in anterior and posterior
configurations to allow for easy
access.
 ROTARY
INSTRUMENTS
First use of NiTi in endodontics
was reported in 1988 by Walia
et al. when a 15 No. NiTi file
was made from orthodontic wire
and it showed superior
flexibility and resistance to
torsional fracture. This
suggested the use of NiTi files
in curved canals.
Generations of NiTi rotary files

Profile Quantec File

HERO 642 GT rotary
System System
files
Protaper Protaper K3 files Hero
universal gold system shapers
System System
K3XF files Hyflex CM
Twisted files
Wave one recip
roc
Self
adjusting
file
REVO – S Protaper One shape
Next
Endomotor
Rotary endodontics
employs electrically –
powered instruments to
perform the root canal
treatment rather than
traditional stainless – steel
manual files
Traditional micromotors
cannot be used with rotary
NiTi endodontic shaping
instruments, as these
instruments need to be
used with the following:
•Ultralow speeds
CLASSIFICATION OF ENDOMOTORS

TORQUE-CONTROLLED
HANDPIECES

These handpieces have to be either

connected to an electric motor or an air-
powered motor.

The torque settings are preset by the

manufacturer and cannot be altered.
ELECTRIC TORQUE-CONTROLLED
MOTORS

 They have the handpiece and motor integrated

into one single device.
 Several popular torque and speed settings are
preset in the library memory. Alternately, the
operator can also program his/her preferred
torque and speed settings.
 auto stop function
 auto reverse function
 There are two types of these motors:
 (a) Corded electric controlled motors
 (b) Cordless electric controlled motors
COMBINED ROTARY AND
RECIPROCAL MOTORS

 Adaptive motors: These are the

newer generation of combined
rotary and reciprocal motors
wherein the rotary files are used in
rotary mode but would change to
reciprocal mode once the file
exceeds a certain stress inside the
canal. The instrument once again
goes back to rotary motion once the
intracanal stress is reduced.
Electronic apex locator

An electronic instrument used to

determine the distance to the apical
foramen

The screen also allows the operator to

visualize the file movement during
instrumentation
 CLASSIFICATION OF ELECTRONIC APEX
LOCATERS

 First generation resistance-based electronic apex locator :Endodontic

Meter and Endodontic Meter S II.

 Second generation impedance-based apex locator

 Third generation multiple-frequency apex locator:Endex apex locator

 Fourth generation multiple-frequency ratio-based apex locator:Propex

IQ (Dentsply Sirona; and Elements Diagnostic EAL (SybronEndo).

 Fifth-generation EALs (dual-frequency ratio type):e Rayapex, Propex II ,

Propex Pixi , I -ROOT, Joypex 5

 Sixth-generation EALs (adaptive apex locators) Adaptive apex locator,

Raypex 6

Grossman’s Endodontic Practice-14th

Essentials of Endodontics- Vimal Sikri
 SONIC AND ULTRASONIC
INSTRUMENTS
• Concept of using ultrasonics
in endodontics was
suggested by Richman in
1957.
• The pioneer research on
endosonics was done by
Cunningham and Martin in
early 1980.
• Endosonics is a device
which imparts sinusoidal
Nisha Garg, Textbook of Endodontics-3
rd

vibration of high intensity to

 Sonic
handpiece
Sonic instruments rely on a passage
of pressurized air through the
instrument handpiece for use
operating at 3–6 kHz.

It has an adjustable ring to give

oscillating range of 1,500–3,000
cycles

There are two options for irrigating the root

canal while using sonic handpieces. Either
the waterline of the dental units can be
attached to the sonic handpiece or the
water can be cut off and the dental
assistant can introduce sodium hypochlorite
from a syringe
Sonic handpiece uses the following types of
files:
• Helio sonic (Trio sonic)
• Shaper sonic
• Rispi sonic

All these instruments have safe ended noncutting tip 1.5–2 mm

in length. The sizes for these instruments range from 15 to 40

Instrument oscillates outside the canal which is converted into

vibrational up and down movement in root canal. Sonic
instruments are used in step down technique

When sonic file is operated without any constraint, it sets up

circular motion characterized by true vertical or longitudinal
movement.
•Better shaping of canal as •Walls of prepared
compared to ultrasonic canals are rough
preparation
•Due to constant irrigation, •Chances of
lesser chances of debris transportation
extrusion beyond the apex
•Produces clean canals free are more in
of smear layer and debris curved canals.
Advantag Disadvant
es ages
Ultrasonic
handpiece
Ultrasonic endodontics is based
on a system in which sound [as an
energy source (20–42 kHz)]
causes three dimensional
activation of a file in the
surrounding medium.
•Ultrasound energy can be produced by magnetostriction; it
converts electromagnetic energy into mechanical energy or
piezoelectricity.

Ingle’s Endodontics-7th edition

Ultrasonic systems involve a power
source to which an endodontic file (K
file) is attached with a holder and an
adapter. Before a size 15 can be freely
used with ultrasonics, canal must be
enlarged with
Irrigants are hand from
emitted instruments
cords ontothe
a
size
power Nos. 30–40and
source file travel down the file
into the canal to be energized by the
vibrations.

Ultrasonic
handpiece
with attached
K-File
 • Clean canals free of
smear layer and debris
Advanta • Enhanced action of
ges NaOCl because of
increased temperature
and ultrasonic energy.

• Causes transportation
Disadva of root canal if used
ntage carelessly.
 Uses of Endosonics
• Use of round or tapered
Access ultrasonically activated
enhancem diamond coated tips has
shown to produce smoother
ent: shapes of access cavity.
• Ultrasonic instruments are

Orifice very useful for removal of

chamber calcifications,
troughing for canals in
location • isthmus and locating the
Endosonics results in
canal orifices.
activation of the irrigating

Irrigati solution in the canal by

cavitation and acoustic

on
streaming. This combined
with oscillation of the
instrument results in cleaner
canals
 • Moreno first
Sealer Gutta- the
suggested MTA
technique of
placemen percha
plasticizing placemen
t obturation
gutta-percha t
in the canal
with • Low powered
• Sealer is
endosonics. ultrasonics
placed using
Gutta-percha can be used
an ultrasonic
gets to vibrate the
file which runs
plasticized material into
without fluid
due to friction position with
coolant.
being no voids.
generated.
Final vertical
compaction is
done with
hand or finger
pluggers.
 Ultrasonic
help in
removalEndodontic
of retreatment
post by
activating
Intraradicula
tip of Gutta –
Silver point
r post
ultrasonic percha
Endosonics
instrument removal
removal removal
alone or
against Krell
with
metal post. introduced a
solvent
The conservative
helps in approach for
ultrasound
removing removal of
energy
gutta- silver point.
transfers to
percha
the post
from canals
and breaks
down the
luting
cement
resulting in
loosening
of the post
 Instruments used in other
endodontic procedures
Other than root
canal treatment
there are other
endodontic
procedures like root-
end resection, rood-
end preparation,
root-end filling,
perforation repair,
intentional
replantation, etc.,
Ingle’s Endodontics-7th edition where verity of
Examination
instruments

Dental mirror

Periodontal probe Tip of micro-explorer used to –

Endodontic explorer
• Search for leak in root-end filling
• Distinguish canal or craze line from microfracture line
Micro explorer
 Bar • 15c blade is used for
d incision.
Par • There is a long handle
Incision
ker
blades and a mini-blade
especially useful for
Bla
Microbl
des No. 15c molar surgery.
ade • The blade is small
: enough to manage
No. 15 No. 12 the interproximal
papilla and large
enough to make a
No. 11 vertical releasing
incision in one stroke
15C blade
microblade in use
s
 Elevation
instruments

Traditional Microsurgic
periosteal al elevators
elevator
 Molt
curette
no. 2-4
• Even though several types of
elevators are available, the
Molts curette no. 2–4 is
suitable for both elevation and
curetting with minimum
trauma.
• One has to gently use the
elevator against the bone
taking care not to tear the
flap. It is necessary to reflect
the flap along with the
periosteum to minimize
 These are sharp curettes,
used to spoon out the
Curettage lesion
instruments

Sybronendo Mini jacquette

Curettes

Mini
Endodontic
Tissue retraction
instruments

Carr Carr
#1 #2
KP-1, -2, and -3 45° retractor 90° retractor
retractors serrated serrated edge
edge for for anterior
posterior applications
applications
 Osteotomy
instruments

Impact air 45o

handpiece
Lindemann Micromirrors microexplore
burs rs
Instruments for
preparing root
end

Microsurgical
ultrasonic
Retro fill
instruments
Carriers

Retro fill
Pluggers
 Irrigational
instruments

Stropko Microsucti
irrigator on
Hemostasis
instruments

Kocher artery Kelly

forcep haemostatic
forcep
 Suturing
instruments

Scissors Tissue forcep Needle holder

 Surgical
operating
microscope

Surgical Magnifying
operating loupes
microscope
 Benefits of
magnificati
on
Improved posture with less head, neck, back and
shoulder fatigue

Visual acuity at a greater focal distance with

decreased eye strain

Increased accuracy and effectiveness of

assessment and treatment
 LASERS IN ENDODONTICS
 Laser is an acronym for “Light Amplification by
Stimulated Emission of Radiation”.
 This technology was first used for dental
application in 1960 but its use has rapidly
increased in the last few decades.
 TYPES OF LASERS
 Carbon Dioxide Lasers
 Neodymium:Yttrium Aluminum-Garnet Lasers
 Argon Lasers

Nisha Garg, Textbook of

endodontics-3rd edition
 APPLICATIONS OF LASERS IN
ENDODONTICS
 Laser Doppler Flowmetry
 Diagnodent
 Thermal Testing
 Pulp Capping and Pulpotomy
 Root canal treatment
 Modification of root canal walls
 Sterilization of root canals
 Photoactivated disinfection (PAD)
 Root canal shaping and obturation
 Treatment of incomplete fracture
 Apicoectomy
 Treatment of dental hypersensitivity
 Teeth whitening
REFERENCES

 COHEN PATHWAYS OF PULP 12TH EDITION

 INGLES ENDODONTICS

 GROSSMANS ENDODONTIC PRACTICE 14TH EDITION

 TEXTBOOK OF ENDODONTICS NISHA GARG AMIT GARG


 ESSENTIALS OF ENDODONTICS VIMAL K SIKRI

 ENDODONTIC THERAPY FRANKLIN S WEINE

THANK YOU