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Short Communication

Peregrination of endodontic tools-past to present

Ashwini Tumkur Shivakumar, Sowmya Halasabalu Kalgeri
Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital, Mysore, Karnataka, India

The clinical practice of yesterday’s endodontics becomes the heresy of today, and today’s endodontic
practice becomes the heresy of tomorrow. The history of endodontics begins in the 17th century. Since
then, there have been numerous advances and developments, and research has proceeded continuously Access this article online
without pause. The manufacture of the first instruments for endodontic use dates back to 1875. These early Website: www.jicdro.org
instruments were made by hand from thin steel wires, and they performed the function of modern barbed DOI: 10.4103/2231-0754.176265
broaches. In 1955, Ingle was the first to express the need for standardization of canal instruments. In 1965, Quick Response Code:
the American Association of Endodontists adopted the terminology and nomenclature of the proposed
standardized system. For many years, the standard cutting instruments have been the reamer, the K-type
file, and the Hedstroem file. Recent changes in both metallurgy and endodontic concepts have led to the
introduction of a wide range of new instruments. An effort has been made here to present the journey of
endodontic instruments from the past to the present.

Key words: Files, reamer, recent endodontic instruments, rotary endodontics

This article is the result of an effort to delineate in brief Files are commonly made from metal. They are usually of
the journey of endodontic instruments from the past to carbon, SS, or nickel titanium (NiTi) alloy. Files may be made
the present. Endodontic therapy or root canal therapy is a from metal blanks that are twisted or machined to produce
sequence of treatments for the infected pulp of a tooth that various sizes and tapers. Typical file lengths are 21 mm, 25 mm,
results in the elimination of infection and the protection of and 31 mm. An International Organization for Standardization
the decontaminated tooth from future microbial invasion.[1] (ISO) sizing system is used to describe the tip size of
Root canals and their associated pulp chambers are the endodontic files. Files are usually color-coded in an ISO color
physical hollows within a tooth that are naturally inhabited by system to aid the dentist. Typically, steel files have 2% tapers,
nerve tissue, blood vessels, and other cellular entities, which but in recent years, NiTi files with up to 12% tapers have been
together constitute the dental pulp.[2] Endodontic therapy popularized. Endodontic instruments are usually available as
involves the removal of these structures; the subsequent both hand and rotary instruments[4] [Figure 1].
shaping, cleaning, and decontamination of the hollows with
Even though the stainless steel (SS) instruments are corrosion-
small files and irrigating solutions; and the obturation (filling)
resistant and stiff in nature, they are considerably prone to
of the decontaminated canals with an inert filling such as
gutta-percha. facture and distortion. Hence the breakthrough in clinical
endodontics involved the progression from utilizing a long
Endodontic files and reamers are the instruments used by
dentists when performing root canal treatment. These tools This is an open access article distributed under the terms of the
are particularly used to clean and shape the root canal, with Creative Commons Attribution-NonCommercial-ShareAlike 3.0
the concept being to perform complete chemomechanical License, which allows others to remix, tweak, and build upon the
debridement of the root canal to the length of the apical work non-commercially, as long as the author is credited and the
new creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com
Address for correspondence:
Dr. Ashwini Tumkur Shivakumar, Department of Conservative
Dentistry and Endodontics, JSS Dental College and Hospital,
Mysore, Karnataka, India. Cite this article as: Shivakumar AT, Kalgeri SH. Peregrination of endodontic
E-mail: drashts2000@yahoo.co.in tools-past to present. J Int Clin Dent Res Organ 2016;8:89-92.

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Shivakumar and Kalgeri: Peregrination of endodontic tools

series of SS hand files and several rotary Gates Glidden drills and this generation of instruments in general, have passive
to the integration of NiTi files for shaping canals. Regardless cutting radial lands, which helped a file to stay centered in
of the methods, the mechanical objectives were brilliantly the canal curvatures during work and fixed tapers of 4% and
outlined by Dr. Herbert Schilder almost 40 years ago.[5] 6% over the length of their active blades.[8] In addition, this
generation of files have negative rake angles, which makes the
In 1988, Walia proposed nitinol, which is an exotic metal: It
file passive; these instruments perform a scraping or burnishing
does not conform to the normal rules of metallurgy and is also
rather than a real cutting action, remove dentin slower, and
known as controlled memory wire, or shape-memory alloy. The
have less of a tendency for canal straightening.
NiTi alloys used in root canal treatment contain approximately
56% (wt.) nickel and 44% (wt.) titanium. NiTi instruments are This generation’s systems require numerous files for
two to three times more flexible than SS.[6] A game-changing completing preparation of the root canal, which was the
feature of files manufactured using NiTi was that curved canals major disadvantage[9] [Table 1 and Figure 2].
could be mechanically prepared through continuous rotary
motion. By the mid-1990s, the first commercially available SECOND GENERATION
NiTi rotary files were launched on the market.[7]
The second generation of NiTi rotary files appeared on
This write-up is a discussion of the history of endodontic dental markets in 2001.[6] The feature that distinguished this
instruments, a mechanical classification of each generation generation of instruments from the first generation is that they
of file systems. Rather than identify the cross sections, files have active cutting edges and thus require fewer instruments
will be characterized on the basis of having either a passive to prepare a root canal. In general, active instruments cut
or an active cutting action. more effectively and more aggressively, and have a tendency
to straighten the canal curvature[5,9] [Table 2 and Figure 3].
In order to appreciate the evolution of mechanical NiTi
instruments, it is useful to know that first-generation NiTi files, Improvements in NiTi metallurgy became the hallmark of what
may be considered the third generation of mechanical shaping

Figure 1: basic SS endodontic instruments Figure 2: first-generation instruments

Table 1: First generation [Figure 2]

Features Sybron endo Micro-mega Tulsa dental VDW Munich Germany
Cross section Double-helical Triple helix geometry Triple-U-shaped Triangular
Radial lands 2 recessed radial lands present Absent 3 radial lands present 3 cutting blades
Tip type Quantec LX (non-cutting) Tip; Quantec SC Inactive Nonactive Nonactive
(Cutting) Tip
Rake angle Positive Positive Neutral Positive
Helical angle Variable Constant Variable (grows from tip —
to shaft)
Speed range 300-350 rpm 500-600 rpm 300-500 rpm 300 rpm

Table 2: Second generation [Figure 3]

Features Dentsply mailefer Sybron endo VDW FKG dentaire
Cross section Convex triangular Asymmetric cross section Italic S-shaped Triangular
Radial lands Absent 3 radial lands present Absent Absent
Tip type Modified guiding tip Safe cutting tip Safe-ended tip design Cutting tip
Rake angle Positive Positive Positive Negative
Helical angle Variable Variable Variable Variable
Speed range 150-350 rpm 300-350 rpm 300 rpm 300-600 rpm

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Shivakumar and Kalgeri: Peregrination of endodontic tools

files. In 2007, some manufacturers began to focus on using may be defined as any repetitive up-and-down or back-and-
heating and cooling methods for the purpose of reducing cyclic forth motion. Innovation in reciprocation technology led
fatigue, and improving safety with rotary NiTi instruments in to a fourth generation of instruments for shaping canals.
canals that are more curved. The intended phase transition point This generation of instruments and its related technology
between martensite and austenite was identified as producing have again fuelled the hope for a single-file technique. The
a more clinically optimal metal than NiTi, i.e., M-wire and reciprocating movement allows a file to progress more readily,
R-phase technology. This third generation of NiTi instruments cut efficiently, and remove debris from the canal effectively[11]
significantly reduced cyclic fatigue and consequently, less [Table 4 and Figure 5].
breakage of files occurred[10] [Table 3 and Figure 4].
The latest generation of shaping files have been designed in
This technology was first introduced in the late 1950s by a such a way that the center of mass or the center of rotation,
French dentist Dr. Blanc. An advancement in canal preparation or both are offset. When in rotation, files that have an offset
procedures was achieved with reciprocation, a process that design produce a mechanical wave of motion that travels

Figure 3: second-generation instruments

Figure 4: third-generation instruments

Table 3: Third generation [Figure 4]

Features Coltene whaledent Sybron endo Edge file Sybron endo Dentsply Tulsa Dental
Cross section Double-fluted Hedstroem design Triangular Parabolic cross section Asymmetrical U file design
(annealed heat-treated)
Radial lands Absent Absent — Present —
Tip type Nonactive Noncutting pilot tip Noncutting Safe-ended Noncutting
Rake angle Positive Positive — Positive —
Helical angle Variable, accelerated flute design Variable — Variable Variable
Speed range 500 rpm 500 rpm 300 rpm 300-350 rpm 300 rpm

Table 4: Fourth generation [Figure 5]

Features VDW GmbH Dentsply Tulsa Dental ReDent Miltex
Cross section S-shaped Modified convex triangular NiTi lattice Triangular
Radial lands No Present — —
Tip type Noncutting tip Noncutting pilot tip Nonactive (asymmetrical) Non cutting, straight flute
Rake angle Absent Neutral N/A —
Helical angle Constant Variable N/A —
Speed range 10 cycles of reciprocation/s 350 rpm 3000-5000 1000-2000 rpm

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Shivakumar and Kalgeri: Peregrination of endodontic tools

Table 5: Fifth generation [Figure 6]

Features Micro-mega Dentsply Tulsa Dental Micro-mega
Cross section Asymmetrical Off-centered rectangular Variable asymmetrical
Radial lands Absent Absent Absent
Tip type Inactive tip Rounded safe tip Inactive tip
Rake angle — Positive —
Helical angle Constant Variable Variable
Speed range 250-400 rpm 300 rpm 350-450 rpm

Figure 6: fifth-generation instruments

1. Hargreaves KM, Cohen S. Cohen’s Pathways of the Pulp. 10th ed.
USA: Mosby; 2010. p. 21.
Figure 5: fourth-generation instruments 2. Nancy A. Ten Cate’s Oral Histology: Development, Structure, and
Function. 8th ed. USA: Mosby; 2012. p. 168.
3. Shanon P, Justin JB. The Principles of Endodontics. 2nd ed. ???:
along the active length of the file. In addition, it enhances OUP Oxford; 2013. p. 58.
the removal of debris from a canal and improves flexibility 4. Nisha G, Amit G. Textbook of Endodontics. 2nd ed. India: Japeey
Publishers; 2013. p. 140-1.
along the active portion of the file. This generation’s files
5. Ruddle CJ, Machtou P, West JD. The shaping movement: Fifth-
have been recently introduced, adapting the advantages generation technology. Dent Today 2013;32:94, 96-9.
from both the second and the third generations[12] [Table 5 6. Walia H, Brantley WA, Gerstein H. An initial investigation of the
bending and torsional properties of nitinol root canal files. J Endod
and Figure 6].
7. Thompson SA. An overview of nickel-titanium alloys used in
CONCLUSION dentistry. Int Endod J 2000;33:297-310.
8. Bryant ST, Dummer PM, Pitoni C, Bourba M, Moghal S. Shaping
Each generation of system offered further development ability of .04 and .06 taper ProFile rotary nickel-titanium
toward a better system, with its own advantages and instruments in simulated root canals. Int Endod J 1999;32: 155-64.
disadvantages. It is up to a clinician to decide which system 9. Walsch H. The hybrid concept of nickel-titanium rotary
instrumentation. Dent Clin North Am 2004;48:183-202.
to use based on the type of the case. 10. Shen Y, Zhou HM, Zheng YF, Peng B, Haapasalo M. Current
challenges and concepts of the thermomechanical treatment of
Financial support and sponsorship nickel-titanium instruments. J Endod 2013;39:163-72.
Nil. 11. Yared G. Canal preparation using only one NiTi rotary instrument:
Preliminary observations. Int Endod J 2008;41:339-44.
12. Hashem AA, Ghoneim AG, Lutfy RA, Foda MY, Omar GA.
Conflicts of interest Geometric analysis of root canals prepared by four rotary NiTi
There are no conflicts of interest. shaping systems. J Endod 2012;38:996-1000.

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