ENDODONTIC

INSTRUMENTS

Aaron Sarwal
MDS 2nd Prof
Batch 2017
INDEX
 Introduction
 Classification of Endodontic Instruments
 Standardization of Endodontic Instruments
 Make of Endodontic Instruments
 Terms used with Endodontic Instruments
 Hand Instruments
 Rotary Devices
 Clinical Considerations
 References
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.

 A variety of instruments are thus available for this purpose.

 CLASSIFICATION OF
ENDODONTIC INSTRUMENTS

According to Grossman
EXPLORING
DEBRIDING CLEANING AND OBTURATING
INSTRUMENTS:
INSTRUMENTS: SHAPING INSTRUMENTS:
INSTRUMENTS:
to locate the canal
to extirpate the pulp to cement and pack
orifice and
and remove any to clean and shape gutta-percha
determine patency of
foreign debris. E.g. the root canal into the root. E.g.
the root canal. E.g.
barbed broach. laterally and apically spreaders, pluggers
endodontic
e.g. reamers and files. and lentulospirals.
explorers, smooth
broaches
(pathfinders).
CLASSIFICATION OF CLEANING
AND SHAPING INSTRUMENTS

According to ISO – FDI (Based on use)

Group I: Hand Use only eg. K-Files, H-Files
Group II: Engine driven latch type eg. Gates Glidden Drills,
Peso reamers
Group III: Engine driven Ni-Ti Rotary Instruments eg. Profile,
Protaper
Group IV: Engine driven 3-D Adjusting Instuments eg Self
Adjusting File System
Group V: Engine driven reciprocating Instruments eg.
WaveOne
Group VI: Sonic and UltraSonic Instruments
 CLINICAL CLASSIFICATION
1. INSTRUMENTS USED FOR DIAGNOSIS
1. Endodontic Explorers

2. Tooth Slooth

3. Dental Transilluminator

4. Pulp Vitality Tester

 CLINICAL CLASSIFICATION
2. INSTRUMENTS USED FOR ACCESS OPENING
1. Diamond Rose Head Burs

2. Tapered Fissure

3. Carbide Burs

4. Safe End Long Burs

5. Endo Z Bur
 CLINICAL CLASSIFICATION
3. INSTRUMENTS USED FOR CANAL PREPARATION:
a) INSTRUMENTS USED TO REMOVE PULP TISSUE:

i. Barbed Broaches

i. Endodontic Excavators

a) INSTRUMENTS USED FOR ROOT CANAL PREPARATION

i. Reamers

ii. Files
 CLINICAL CLASSIFICATION
4) INSTRUMENTS USED FOR ROOT CANAL OBTURATION:
i. Lentulo spirals

ii. Spreaders

iii. Pluggers

iv. Condensors

v. Heat carriers

vi. Thermomechanical
compactors
 STANDARDIZATION OF
ENDODONTIC INSTRUMENTS
 Before 1958, endodontic
instruments were manufactured
without benefit of any
established criteria.

 The numbering (1 to 6) was

entirely arbitrary. An
instrument of one company
rarely coincided with a
comparable instrument of
another company.
 STANDARDIZATION OF ENDODONTIC
INSTRUMENTS
Ingle’s Original Recommendation
 Cutting blades 16 mm in length

 2 % Taper.

 The diameter of the instrument

at tip (D1) is determined by size
in hundredths of millimetres.

 Diameter 2 (D2) is uniformly

0.32 mm greater than D1.

 Length- 21, 25, 31 mm.

 STANDARDIZATION OF ENDODONTIC
INSTRUMENTS
Modification of Ingle’s Original Recommendation
 Two modifications were made in Ingle’s original proposed
recommendation:
1. Additional measurement at D3, 3 mm from tip/ D1

2. Specification for shapes of the tip: 75 degrees, ± 15

degrees.
 STANDARDIZATION OF
ENDODONTIC INSTRUMENTS
ISO-COLOR CODING
With the exception of Pink, Gray and Purple, all the
colors are repeated every six instruments
#06 PINK ONLY AVAILABLE IN #06
#08 GRAY ONLY AVAILBLE IN #08
#10 PURPLE ONLY AVAILBLE IN #10
#15 #45 #90
#20 #50 #100
#25 #55 #110
#30 #60 #120
#35 #70 #130
#40 #80 #140
 STANDARDIZATION OF
ENDODONTIC INSTRUMENTS
GEOMETRIC SHAPE CODING
MAKE OF ENDODONTIC INSTRUMENTS
METALLURGY
Alloys Used for Manufacturing
Endodontic Instruments

• These alloys contain less-than 2.1 percent

CARBON STEEL of carbon.

• These are corrosion resistant instruments.

STAINLESS STEEL • They contain 18 percent chromium, 8-10
percent nickel and 0.12 percent carbon.

• These instruments contain 55 percent

NICKLE - TITANIUM nickel and 45 percent titanium.
METALLURGY OF ENDODONTIC
INSTRUMENTS
CARBON STEEL

ADVANTAGES
• Higher hardness than stainless steel
instruments.

DISADVANTAGES
• Prone to corrosion, so cannot be
autoclaved.
• Prone to rust.
e.g. Barbed Broach
METALLURGY OF ENDODONTIC
INSTRUMENTS
STAINLESS STEEL

ADVANTAGES
• Corrosion resistance

DISADVANTAGES
• Stiff in nature
• Prone to fracture
• Prone to distortion
Example: K-file,
METALLURGY OF ENDODONTIC
INSTRUMENTS
NICKLE-TITANIUM
ADVANTAGES
• Shape memory
• Super elasticity
• Low modulus of elasticity
• Corrosion resistant
• Softer than steel
• Good resiliency
• Biocompatibility

DISADVANTAGES
• Poor cutting efficiency.
• NiTi files do not show signs of fatigue before they
fracture.
• Poor resistance to fracture as compared to stainless steel. HyFlex CM NiTi Files
MAKE OF ENDODONTIC INSTRUMENTS
MANUFACTURING AND DESIGN
 MANUFACTURING OF
ENDODONTIC INSTRUMENTS
•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:

MACHINING GRINDING AND TWISTING

• The instrument is directly • Raw wire is ground into tapered

machined on the lathe for
example H-file and NiTi
instruments are machined.
geometric blanks, i.e. square,
triangular or rhomboid.
• Blanks are twisted
counterclockwise to produce
cutting edges.
 DESIGN OF ENDODONTIC
INSTRUMENTS
COMPONENTS OF A FILE:

•TAPER
•CORE
•FLUTE
•CUTTING EDGE
•LAND
•HELIX ANGLE
•PITCH
•RAKE ANGLE
•CUTTING ANGLE
•TIP DESIGN
 DESIGN OF ENDODONTIC
INSTRUMENTS
TAPER
 It is expressed as the amount of file diameter increases each millimetre
along its working surface from the tip towards the file handle.
INSTRUMENT DESIGN : TAPER
INSTRUMENT TAPER

PROFILE 2%, 4%, 6%

HERO 642 2%, 4%, 6%

K3 2%, 4%, 6%

FLEXMASTER 2%, 4%, 6%, INTRO FILE-11%

RACE 2%, 4%, 6%, 8%,10%

QUANTEC SC 2%,3%, 4%, 5%,6%, 8%,10%,12%

M-TWO 4%,5%,6%,7%

GT FILE 4%, 6%, 8%, 10%, 12%

LIGHTSPEED NO TAPER

PROTAPER VARIABLE TAPER

 DESIGN OF ENDODONTIC
INSTRUMENTS
CORE
 It is the cylindrical centre part of the file having its circumference outlined
and bordered by the depth of the flutes.
 DESIGN OF ENDODONTIC
INSTRUMENTS
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.
 DESIGN OF ENDODONTIC
INSTRUMENTS
CUTTING EDGE
 The surface with the greatest diameter that follows the groove (where the
flute and land intersect) as it rotates, forms the leading (cutting) edge, or
the blade of the file.
 DESIGN OF ENDODONTIC
INSTRUMENTS
LAND/MARGINAL WIDTH
 The surface that projects axially from the central axis as far as the cutting
edge between the flutes
FUNCTIONS

• Prevents ‘‘screwing in’’ of

the file
• Supports the cutting edge
• Limits the depth of cut
• Reduces the propagation
of micro-cracks on its
circumference.
• Maintains the file in the
centre of root canal.
 DESIGN OF ENDODONTIC
INSTRUMENTS
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.
 DESIGN OF ENDODONTIC
INSTRUMENTS
PITCH
 The pitch of the file is the distance between a point on the leading edge
and the corresponding point on the adjacent leading edge.
OR
 It may be the distance between corresponding points within which the
pattern is not repeated.
 DESIGN OF ENDODONTIC
INSTRUMENTS
RAKE ANGLE
 The angle formed by the leading edge and the radius of the file when the
file is sectioned perpendicular to its long axis.
 DESIGN OF ENDODONTIC
INSTRUMENTS
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.
 DESIGN OF ENDODONTIC
INSTRUMENTS
TIP DESIGN
 It can affect file control, efficiency, and outcome in the
shaping of root canal systems.
 The tip of the original K-file resembled a pyramid.
 Instrument tips have been described as cutting, non-cutting,
and partially cutting, although no clear distinction exists
among the three types
 DESIGN OF ENDODONTIC
INSTRUMENTS
TIP DESIGN
 Powell et al pointed out that when this tip “angle” is reduced,
the file stays centred within the original canal and cuts all
sides (circumference) more evenly.
 This modified-tip file has been marketed as the Flex-R-file.
TERMS USED WITH ENDODONTIC
INSTRUMENTS
 TERMS USED WITH
ENDODONTIC INSTRUMENTS
ELASTIC LIMIT
 It is the maximum stress that can be
applied to a metal without producing
permanent deformation.
 Application of external forces causes
internal stresses that cause
deformation.
 If the stresses are not too much, the
metal will return to its original
dimensions on removal of the stress.
 TERMS USED WITH
ENDODONTIC INSTRUMENTS
STRESS
 The force acting across a unit area in a solid material.
 Stress is a quotient of force divided by area.
 TERMS USED WITH
ENDODONTIC INSTRUMENTS
STRAIN
 The amount of deformation a metal undergoes.
 It is the change in length divided by original length.
 Strain has no units.
 TERMS USED WITH
ENDODONTIC INSTRUMENTS
ELASTIC DEFORMATION
 Reversible deformation that does not exceed the elastic limit.
 TERMS USED WITH
ENDODONTIC INSTRUMENTS
SHAPE MEMORY
 It is the property of an alloy to return to its original shape
when heated.
HAND-OPERATED INSTRUMENTS
BARBED BROACHES, RASPS, K-FILES, K-REAMERS, H-FILES
 BARBED BROACHES
 Specification : (ADA no. 63, ISO no. 3630/1)

 Barbed broaches are short-handled

instruments used primarily for vital pulp
extirpation.

 They are also used to loosen debris in

necrotic canals or to remove paper points
or cotton pellets.

 These instruments are 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 some significant
differences in taper and barb size.

 The broach has lesser taper of .007 to .010/mm

and the rasp has more taper of .015 to .020/mm.

 Barb height is much greater in the broach than in

the rasp.

BROACH

RASP
 SMOOTH BROACH

 There is also a smooth broach,

sometimes used as a pathfinder.

 The newly released Pathfinder CS

(SybronEndo/Kerr; Orange, Calif.),
made of carbon steel, is less likely to
collapse when forced down in a fine
canal.
 K-STYLE FILES AND REAMERS
 In 1904 Kerr Manufacturing Company
designed the, K-style files and reamers. (ADA
NO 28 / ISO standard no. 3630-1)

 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.
 K-REAMER K- FILE

BLANKS OF K-STYLE REAMERS

AND FILES
 K-REAMER K- FILE

CROSS SECTION OF K-STYLE

REAMERS AND FILES
 MODIFIED K-INSTRUMENTS
K-FLEX FILE
 The Kerr Manufacturing
Company in 1982 introduced a
new instrument design that they
termed the K-Flex File.

 The cross-section of the K-Flex is

rhombus or diamond shaped.
This new cross-section presents
significant changes in instrument
flexibility and cutting
characteristics.
 MODIFIED K-INSTRUMENTS
FLEX-R FILE (MILLED K-FILE)

 They are made by removing the

sharp cutting edges from the
tip of the instrument .and the tip is
rounded.

 The flutes are sharper and has less

negative rake angle than
a traditional twisted K-file.
 MODIFIED K-INSTRUMENTS
C-FILE (MALLIFER)
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 for greater strength
•Eases penetration of calcified canals
•Available in 21 mm & 25 mm
 H-STYLE INSTRUMENTS
 Specification : ADA 58.
ISO no. 3630-1.

 H-type files are made by

cutting/grinding the spiraling
flutes into the shaft of a piece of
round, tapered, stainless steel wire.

 H-files cuts in only one direction—

retraction/ pull motion.
 H-FILES
 Single helix, tear drop shaped cross-section.

 Deep grinding of the surface of H-file

reduces central mass of metal and thereby
weakened the structure. hence it should not
to be used in a rotational manner.
 MODIFIED H-STYLE FILES
 McSpadden was the first to modify the
traditional Hedstroem 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 Hedstroem file.
 S-FILE
 The “S” File (J-S Dental) also appears to be a variant of the
Unifile in its double-helix configuration.

 This instrument can be used with any hand motion (filing or

reaming) thus this file can also be classified as hybrid design .
 MICRO-DEBRIDERS
 These are H-Files characterized by short
staff bent at and angle of 200 deg, with
a long plastic handle.

 Available in sizes 20 and 30, taper 0.02

 The flutes clear away paste, pulpal

residues, gutta-percha, and
calcification.

 These instruments also allow additional

shaping of the canal.
 SAFETY H-FILES
 H-Files with a non-cutting edge to prevent ledging and stripping
in curved canals.
ROTARY INSTRUMENTS
LOW-SPEED LATCH-TYPE AND ENGINE-DRIVEN INSTRUMENTS
 MOTORS FOR ROTARY
INSTRUMENTS
Work on the principle of continuous rotation within the root canal at a fixed slow
speed
 LOW-SPEED ROTARY
INSTRUMENTS
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 hardened carbon 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.

 These instruments come in sizes 1 to 6

 LOW-SPEED ROTARY
INSTRUMENTS
PEESO- REAMER

• It has long sharp flutes with a safe tip

connected to a thick shaft.

• It is most often used in preparing the

coronal part of the root canal for a
post and core.
GG DRILL SIZES V/S PEESO REAMER SIZES
 NICKEL-TITANIUM ROTARY
ENDODONTIC INSTRUMENTS
 The greatest innovation in endodontic
instrumentation in recent times is probably the
introduction of nickel titanium rotary instruments .

 Nickel-titanium alloy (Nitinol) was discovered by

Buehler and Wang at the US Naval Ordnance
Laboratory in the early 1960s.

 The name Nitinol was derived from the elements

that make up the alloy, nickel and titanium, and
“nol” for the Naval Ordnance Laboratory.
SUPER-ELASTICITY OF NICKEL-
TITANIUM ALLOY
 Super-elasticity and shape memory of NiTi alloy is
because of phase transformation in their crystal
structure.

 The alloy exists in two crystallographic forms i.e. parent

Austenitic phase which is stronger and stable than the
daughter Martensitic phase.

 On release of stress, the structure reverts back to

Austenite.
Austenite  Martensite  Austenite
 DESIGN OF NICKEL-TITANIUM
ALLOY
•NiTi flex-files are manufactured
from nickel-titanium wire that is
ground to give the typical profile
of a K-file.

•The tip of the instrument is non-

cutting ('batt-tip') which makes
the NiTiflex-file well suited for the
preparation of curved canals
without the risk of ledge
formation.

•NiTiflex-files come in sizes 15 - 60,

all with a taper of 0.02.
 NICKEL-TITANIUM ROTARY
ENDODONTIC INSTRUMENTS
 NICKEL-TITANIUM ROTARY
ENDODONTIC INSTRUMENTS
 NICKEL-TITANIUM ROTARY
ENDODONTIC INSTRUMENTS
 NICKEL-TITANIUM ROTARY
ENDODONTIC INSTRUMENTS
CLINICAL CONSIDERATIONS
DO’S
Assess canal anatomy thoroughly
Achieve straight line access prior to
instrumentation
Follow crown-down sequence
Use glide path for patency of canal
Use files for 5 to 10 seconds only
Adequate irrigation and lubrication
Wipe flutes after each use
Examine files before, during and after
use
DON’TS
Instrument blindly
Staying in canals for long
Use of same files repeatedly
Forceful instrumentation
Rotation for too long
Dry instrumentation
Use of unclean files
Use files without inspection
CONCLUSION
 From a biological perspective,
root canal treatment is
directed toward the
elimination of micro-organisms
from the root 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.
REFERENCES
 Ingle’s Endodontics: 5th & 6th Edition
 Torabinejad & Walton’s Endodontics Principle &
Practice: 4th Edition
 Grossman’s Endodontic Practice: 11th and 13th
Edition
 Cohen’s Pathways Of Pulp:9th Edition
 Franklin Weine’s Endodontic Therapy:6th Edition