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Basic Endodontic Instruments

Prepared by

Dr . Krishna Kumar

Instrument s for access cavity preparation

Hand pieces
Hand pieces

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Instrument s for access cavity preparation

Burs

13-12-2016 Instrument s for access cavity preparation • Burs Instrument s for access cavity preparation 2
13-12-2016 Instrument s for access cavity preparation • Burs Instrument s for access cavity preparation 2

Instrument s for access cavity preparation

13-12-2016 Instrument s for access cavity preparation • Burs Instrument s for access cavity preparation 2
13-12-2016 Instrument s for access cavity preparation • Burs Instrument s for access cavity preparation 2

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Instrument s for access cavity preparation

13-12-2016 Instrument s for access cavity preparation Instrument s for access cavity preparation Name Burs Function
13-12-2016 Instrument s for access cavity preparation Instrument s for access cavity preparation Name Burs Function
13-12-2016 Instrument s for access cavity preparation Instrument s for access cavity preparation Name Burs Function

Instrument s for access cavity

preparation

Name

Burs

Function several types of burs will be used to accomplish good access preparation Fissure burs are used in the initial stage of access preparation to establish the correct outline form ,Round burs are used to lift the roof of the pulp chamber and eliminate

overhanging dentine ,Tapered Non end-cutting bur is used to 'lift lid' of pulp chamber and refine cavity.

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Instrument s for access cavity preparation

Front surface mirror

s for access cavity preparation • Front surface mirror Instrument s for access cavity preparation Name

Instrument s for access cavity

preparation

Name Front surface mirror Function is best suited for visibility deep within the pulp chamber.

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Instrument s for access cavity preparation

root canal explorer

s for access cavity preparation • root canal explorer Instrument s for access cavity preparation Name
s for access cavity preparation • root canal explorer Instrument s for access cavity preparation Name
s for access cavity preparation • root canal explorer Instrument s for access cavity preparation Name

Instrument s for access cavity

preparation

Name

probe/root canal explorer Function Used to probe and detect canal openings within the pulp chamber

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Extirpation Instrument

endodontic spoon excavator

Extirpation Instrument • endodontic spoon excavator Instrument s for access cavity preparation Name Endo
Extirpation Instrument • endodontic spoon excavator Instrument s for access cavity preparation Name Endo

Instrument s for access cavity

preparation

Name

Endo excavator Function

"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.

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Extirpation Instrument

Barbed broach

13-12-2016 Extirpation Instrument • Barbed broach Extirpation Instrument • Barbed broach 7

Extirpation Instrument

Barbed broach

13-12-2016 Extirpation Instrument • Barbed broach Extirpation Instrument • Barbed broach 7

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Extirpation Instrument

Barbed broach

13-12-2016 Extirpation Instrument • Barbed broach Extirpation Instrument Name Barbed broaches Functions • Used to

Extirpation Instrument

Name Barbed broaches Functions

• Used to remove the intact pulp

• ‘Barbs’ on the broach snag the pulp to facilitate removal .Retrieve a paper point or cotton pellet trapped in the canal . Loosen debris in necrotic canal

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Extirpation Instrument

The braded broach comes in different sizes, and the selection of suitable size is very important, it should fit loosely inside the canal, when braded broach size is larger than the canal size, the hooks of B.B engaged in the dentinal wall of the canal and stick there "Jammed broach" and with drawing it becomes difficult and might fracture inside the canal, if the dentist faced by Jammed broach, the broach should be removed vertically without twisting. The B.B must

only be used in the straight part of the canal, and

insertion of the broach (not exceed 2\3) of the canal length of the ideal way to use it is

ISO standardization

and insertion of the broach (not exceed 2\3) of the canal length of the ideal way

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ISO standardization

Before a standardized configuration was adopted, endodontic instrument varied greatly from one manufacturer to another. The configuration adopted is that set by the International Organization for Standardization (ISO), All ISO hand instruments, along with paper points, silver points and standardized gutta-percha points, conform to this system. ISO standardized files have a cutting length of 16 mm, have a specified diameter at the tip (termed D1) and increase in diameter by 0.02 mm for each millimeter along the file, so that at the end of the cutting part (16 mm along the file) the diameter (termed D2) is 0.32 mm greater than at D1. This is called an .02 taper. Files may vary in length, any extra length is provided by a ‘blank’ portion. The nominal size of the instrument is based on the diameter of its tip (the diameter at D1) expressed in hundredths of a millimeter. Thus an ISO size 50 file will have a tip diameter of 0.50 mm.

ISO standardization also uses a color for each size, as shown below:

Color

Nominal Size

Pink

06

Grey

08

Purple

10

White

15 45 90

Yellow

20 50 100

Red

25 55 110

Blue

30 60 120

Green

35 70 130

Black

40 80 140

The amount of increase in diameter from one inst. to the next is 0.05 mm in inst. from size 10 60, and 0.1 mm in inst. from size 60 140.

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Instruments for root canal preparation

K- reamer

13-12-2016 Instruments for root canal preparation • K- reamer Instruments for root canal preparation • K-
13-12-2016 Instruments for root canal preparation • K- reamer Instruments for root canal preparation • K-

Instruments for root canal preparation

13-12-2016 Instruments for root canal preparation • K- reamer Instruments for root canal preparation • K-
• K- reamer
• K- reamer

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Instruments for root canal preparation

K-reamer

instruments can be manufactured by twisting a square or triangular blank by machine .

reamer used in shaping the canal

Action o'clock wise quarter turn twist .

.

Instruments for root canal preparation

the canal Action o'clock wise quarter – turn twist . . Instruments for root canal preparation
• K- file
K- file

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Instruments for root canal preparation

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

Action o'clock wise half turn twist .

.

Instruments for root canal preparation

K-Flex files are produced from a blank that is rhomboid in cross- section; this forms both cutting and non-cutting edges. The files are more flexible than an equivalent-sized K-file .

Action o'clock wise half turn twist .

.

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Instruments for root canal preparation

Flexofile

have a triangular cross-section and are manufactured from flexible stainless steel. Flexofiles are more efficient at cutting and removing dentine than an equivalent K-file, because the blade has a sharper angle and there is more room for debris. The tip of the file is non-cutting. This is an advantage when preparing curved canals,

as

the file is guided along the canal curvature, avoiding excessive

cutting into the outer curve of the root canal or transportation. Any flexible, triangular cross-sectioned file, such as a Flexofile, can be used with the balanced force action

Action

o'clock wise half turn twist .

.

Instruments for root canal preparation

Hedstom file

force action Action o'clock wise half – turn twist . . Instruments for root canal preparation
force action Action o'clock wise half – turn twist . . Instruments for root canal preparation

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Instruments for root canal preparation

Hedstom file

Instruments for root canal preparation • Hedstom file Instruments for root canal preparation Hedstom file are

Instruments for root canal preparation

Hedstom file

are machined from a tapered cylindrical block. In cross- section they have the appearance of a series of intersecting

cones. Hedstroem files are highly efficient at removing

dentine on the outstroke when used in a filing motion, but have poor fracture resistance in rotation

Action withdrawal stroke .

.

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NiTi (Nickel titanium) rotary instruments

13-12-2016 NiTi (Nickel titanium) rotary instruments NiTi (Nickel titanium) rotary instruments These files are used to
13-12-2016 NiTi (Nickel titanium) rotary instruments NiTi (Nickel titanium) rotary instruments These files are used to

NiTi (Nickel titanium) rotary instruments

These files are used to flare the coronal aspect of the root

canal. Although they are manufactured from nickel-titanium

the files are relatively inflexible, as the cross-sectional diameter is larger than that of a standard file (ISO). The use of these instruments is therefore best restricted to the relatively straight parts of the root canal to avoid strip perforation. It is recommended that they are used in a hand piece driven by an electric motor at 150-300 rpm

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Gates-Glidden drills

13-12-2016 Gates-Glidden drills Gates-Glidden drills 17
13-12-2016 Gates-Glidden drills Gates-Glidden drills 17

Gates-Glidden drills

13-12-2016 Gates-Glidden drills Gates-Glidden drills 17
13-12-2016 Gates-Glidden drills Gates-Glidden drills 17

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Gates-Glidden drills

Small flame-shaped cutting instrument used in the conventional hand piece Different sizes coded by rings or colored bands on shank Are slightly flexible and will follow the canal shape but can perforate the canal if used too deeply

functions :

Preparing the coronal two thirds of molars canals.

Removing gutta-percha from the canal during post space preparation or during retreatment.

Widen the canal when an instrument has fractured within it.

Peeso Reamer

or during retreatment. • Widen the canal when an instrument has fractured within it. Peeso Reamer

نتحهننلن

or during retreatment. • Widen the canal when an instrument has fractured within it. Peeso Reamer
or during retreatment. • Widen the canal when an instrument has fractured within it. Peeso Reamer

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Peeso reamers drills

Small flame-shaped cutting instrument used in the conventional hand piece Different sizes coded by rings or colored bands on shank, Peeso reamers are not flexible or adaptable, if not used with care can perforate canal

functions :

Removing gutta-percha from the canal during post space preparation or during retreatment.

Instruments for root canal preparation

Disposable irrigating syringe and

disposable needle

or during retreatment. Instruments for root canal preparation • Disposable irrigating syringe and disposable needle 19

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Instruments for root canal preparation

Name

Disposable irrigating syringe and disposable needle

Function, features and precaution

• Used with an irrigant to clean and disinfect the canal during endodontic treatment • A blunt needle with side exiting delivery will reduce the risk of the needle binding

within the canal

Instruments for root canal preparation

Absorbent paper points

reduce the risk of the needle binding within the canal Instruments for root canal preparation Absorbent

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Instruments for root canal preparation

Name Absorbent paper points

Functions

• To absorb any moisture in the canal (i.e. blood, pus and saliva)

• To carry medicaments into the canal

Instruments for root canal Filling

Gutta - percha

blood, pus and saliva) • To carry medicaments into the canal Instruments for root canal Filling
blood, pus and saliva) • To carry medicaments into the canal Instruments for root canal Filling

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Instruments for root canal Filling

Name

Gutta percha points

Function and features

• Non-soluble, non-irritant points that are condensed into the pulp chamber during obturation

• Standardized type: follows same ISO classification as endodontic files

• Non-standardized: have a greater taper than the standard ISO type

Instruments for root canal Filling

Hand spreader

-standardized: have a greater taper than the standard ISO type Instruments for root canal Filling •

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Instruments for root canal Filling

Finger spreader

13-12-2016 Instruments for root canal Filling • Finger spreader Instruments for root canal Filling • spreader

Instruments for root canal Filling

spreader

13-12-2016 Instruments for root canal Filling • Finger spreader Instruments for root canal Filling • spreader
13-12-2016 Instruments for root canal Filling • Finger spreader Instruments for root canal Filling • spreader

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Instruments for root canal Filling

Name Finger spreader Function, features and precaution • Finger instrument with a smooth, pointed, tapered working end

• Used to condense gutta percha laterally

into the canal during obturation

Instruments for root canal Filling

Hand Plugger

condense gutta percha laterally into the canal during obturation Instruments for root canal Filling • Hand

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Instruments for root canal Filling

Finger Plugger

13-12-2016 Instruments for root canal Filling • Finger Plugger Instruments for root canal Filling • Plugger

Instruments for root canal Filling

13-12-2016 Instruments for root canal Filling • Finger Plugger Instruments for root canal Filling • Plugger

Plugger

13-12-2016 Instruments for root canal Filling • Finger Plugger Instruments for root canal Filling • Plugger

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Instruments for root canal Filling

Name Endodontic plugger Function Working end is flat to facilitate plugging or condensing the gutta percha vertically after the excess has been removed by melting off with a heated instrument

Instruments for root canal Filling

Lentulo spiral Drill

excess has been removed by melting off with a heated instrument Instruments for root canal Filling

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Instruments for root canal Filling

Name

Lentulo spiral filler/rotary paste filler Function and features • 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

the endodontic ruler

canal • Fits into the conventional hand piece • Use with caution as it can be

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the endodontic ruler

13-12-2016 the endodontic ruler the endodontic ruler Function • Special endodontic rulers are available for measuring

the endodontic ruler

Function

• Special endodontic rulers are available for measuring the length of finger instruments

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Endodontic block or Transfer sponge

13-12-2016 Endodontic block or Transfer sponge Endodontic block or Transfer sponge Functions • An endodontic block

Endodontic block or Transfer sponge

Functions

• An endodontic block is a sturdy block used to organize and hold endodontic finger and rotary instruments during procedures;

• Reduces the possibility of percutaneous injuries when handling endodontic finger and rotary instruments

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Endo locking tweezers

13-12-2016 Endo locking tweezers Endo locking tweezers Endo – locking pliers or (endo locking tweezers ):

Endo locking tweezers

Endo locking pliers or (endo locking tweezers):

it has lock "latch" that permits materials to be held without continuous finger pressure, it has a groove at the tip, the grooved tip facilitate holding absorbent points and gutta percha cones.

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Electronic Apex Locators

13-12-2016 Electronic Apex Locators 61 Electronic Apex Locators Name Apex locator Functions • An electronic instrument
13-12-2016 Electronic Apex Locators 61 Electronic Apex Locators Name Apex locator Functions • An electronic instrument

61

Electronic Apex Locators

Name Apex locator

Functions

• An electronic instrument used to determine the distance to the apical foramen

• The screen allows the operator to visualize the file movement during instrumentation

62

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Electric pulp tester

13-12-2016 Electric pulp tester Electric pulp tester Electric pulp tester 63 Function and directions for use

Electric pulp tester

Electric pulp tester

63

Function and directions for use

• Used to test the vitality of a tooth using electric stimulus

• Electric stimulus is increased in small increments until the patient can feel the stimulus

• Toothpaste or prophy paste is used to conduct the

current from the pulp tester to the tooth

64

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Loupes

13-12-2016 Loupes operating microscope 33

operating microscope

13-12-2016 Loupes operating microscope 33

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Loupes&

operating microscope

Illumination and magnification are vital for the location of root canals. The endodontist would use a surgical microscope while a general dental practitioner might have loupes and a headlight that give excellent magnification and illumination .

1 NygaardÖstby B.

Chelation in root canal therapy. OdontolTidskr 1957;65:3-11.

2 Loel DA.

Use of acid cleanser in endodontic therapy. J Am Dent Assoc 1975;90:148-151.

3 . Von Der Fehr FR, NygaardÖstby B.

Effect of EDTAC and sulfuric acid on root canal dentine. Oral Surg Oral Med Oral Pathol 1963;16:199-

205.

4. Mello I, Kammerer BA, Yoshimoto D. Influence of Final Rinse Technique on Ability of Ethylenediaminetetraacetic acid of removing smear layer. J Endod 2010;36:512-514.

5 . Calt S, Serper A.

Time-dependent effects of EDTA on dentin structures. J Endod 2002;28:1719.

6 . Kuah HG, Lui JN, Tseng PS, Chen NN.

The Effect of EDTA with and without Ultrasonics on Removal of the Smear Layer. J Endod 2009;35:393-

396.

7. Hu¨lsmann M, Heckendorff M, Lennon A. Chelating agents in root canal treatment: mode of action and indications for their use. Int Endod J 2003;36:810830.

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8 W. Jacob and R. Herschler,

“Biological actions of dimethyl sulfoxide,” Annals of the New York Academy of Sciences 1975; 243; 1508.

9 .J. C. de la Torre,

Biological actions and medical applications of dimethyl sulfoxide,” Annals of the New York Academy of Sciences 1983;411:1403.

10 .T. Vani, M. Rajani, S. Sarkar and C. J. Shishoo,

Antioxidant properties of the ayurvedic formulation triphala and its constituents,” International Journal of Pharmacognosy 1997;35:313317.

11. M. Rasool and E. P. Sabina,

Antiinflammatory efect of the Indian ayurvedic herbal formulation Triphala on adjuvantinduced arthritis in mice,” Phytotherapy Research, 2007;21:889894.

12 .B. Zhao.

Antioxidant efects of green tea polyphenols,” Chinese Science Bulletin 2003;48:315319

13.

Wang MY, Su C. Cancer preventive effect of Morindacitrifolia (Noni). Ann NY AcadSci 2001;952:161-168.

14

. Li RW, Myers SP, Leach DN, Lin GD, Leach G.

A cross-cultural study: Antiinflammatory activity of Australian and Chinese plants. J Ethnopharmacol

2003;85:25-32

Thank you