5 Instruments for second level and 3.pdf

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3. I- According to Purpose
II- ………………. ISO Grouping
III- ………………. Location of use

4. (I) Purpose
I- Diagnostic
II- Tooth Isolation
III- Extirpating
IV- Enlarging
IV- Obturating
V- Miscellaneous

5. Diagnostic
Instruments
Visual Aids
Transillumination
Vitality Testing
Radiographic
Examination

6. Visual Aids
Transillumination
Fiberoptic Light

7. Vitality Testing
Electrical
Thermal

8. Radiographic
Examination

9. Tooth Isolation

10. Group I : Hand use only


driven latch type-Engine Group II:


Group III: Root canal points
gutta-percha, silver, paper.
(II) ISO Grouping

11. Endodontic Tray instruments: -)(A
* Burs
* Locking pliers
* Endodontic explorer
* Spoon excavator * Plastic instrument
* Endodontic ruler
* Endodontic syringe
* Mosquito hemostat
(B)- Intracanal instruments
- Extirpation
- Enlarging
- Obturtating instruments
(III) Location

12. Endodontic Tray instruments

13. Burs
Straight or tapered fissure burs and long
shank round burs (no.2, 4, 6 and 8)

14. Locking pliers
For handling of the
absorbent paper points
and filling materials
Endodontic explorer
The straight end: locate
canal orifices.
The L-shaped: detecting
un-removed portions of
the pulp chamber.

15. Endodontic Ruler
Endodontic
Syringes
Mosquito Hemostat

16. Spoon Excavator:
Extra-length, double-ended
Used for removal of caries,
coronal pulp tissue and cotton
pellets in the pulp chamber.
Plastic Instrument:
Carry and place temporary filling material.
Condense filling material in the pulp chamber.

17. Extirpating Instruments:
*Barbed (nerve) broach * Reamers * Files.

Enlarging Instruments:
# Hand driven instruments
- Basic instrument
- Hybrid (modified) instruments
# Engine driven instruments.

Obturation Instruments:
* Spreaders *Pluggers *Lentulo spiral filler
Intracanal Instruments

18. Barbed Broaches

- Made from tapered
soft steel shafts

-The small sharp
barbs made by
notching the shaft

19. (1) Hand-driven instruments
 Basic instruments
 Hybrid (modified)

(2) Engine-driven instruments

20. (1) Hand Driven
Basic
Instruments:

K-type Reamer
K-type File
H-type File

21. Reamers
Manufactured by the grinding sections of a round
metal stock into a triangular shaped blade.
The machined blade is then twisted to produce
the flutes
Have ½ to 1 flute per millimeter.

22. Files:
Types of files :
(1) (K) type files, Kerr manufacturing
company
(2) (H) Hedstrom file .
 Files act by
* Rasping action for scraping of dentin.
* Reaming action.

23. (1) K-type file:
-The blade is ground into a square tapered blank
- The square stock stronger instrument, less
flexible & less sharp.
- 1 ½ to 2 ¼ flutes per millimeter.

24. (2) Hedstrom files:
-The flutes are ground into successively larger cones
or triangles from the tip to the handle.
- Remove dentin more efficiently.
- It cuts only on the
withdrawal stroke and
should never be used in
a reaming movement.

25. Basic Instruments
K-type Reamer
K-type File
H-type File

27. Standardization of
Basic RC. Instruments

28. 1- D 0: Tip
2- D16: Termination
3- Blade Length: is 16 mm.
4- D16: is 0.32 mm > D 0

29. D 16---D 0 0.32 mm
------------------------------------------------ = ------------ = 0.02 mm
Length between D 0 and D 16 16.0 mm

Taper :
Number : Diameter at D0 × 100 .
Tip : Pointed (acute angle ) 75 ± 15 degree

30. Numbering
diameter D 0 in mm x 100 e.g.: if the diameter at D 0 is
0.30 mm the number given to the instrument is 30.
progressive increase in size from one
instrument to the next is to be :
- 0.02 mm. for sizes 6, 8, and 10,
- 0.05 mm. from size 10 to size 60,
- 0.1 mm. thereafter from size 60 to size 140

31. Standardized Dimensions of Root Canal
Files and Reamers Established By The ISO
1.Taper.
2.Tip angle.
3.Length of the blade.
4.Size.
5.Number.
6.Grad. Incr. in size.
7.Color Coding.

32. Diameter in hundredths
of mm
D-0 D-16
Color Standardized number
0.38
0.40
0.42
0.47
0.52
0.57
0.62
0.67
0.72
0.77
0.82
0.87
0.92
1.02
1.12
1.22
1.32
1.42
1.52
1.62
1.72
0.06
0.08
0.10
0.15
0.20
0.25
0.30
0.35
0.40
0.45
0.50
0.55
0.60
0.70
0.80
0.90
1.00
1.10
1.20
1.30
1.40
Orange
Silver
Purple
White
Yellow
Red
Blue
Green
Black
White
Yellow
Red
Blue
Green
Black
White
Yellow
Red
Blue
Green
black
6
8
10
15
20
25
30
35
40
45
50
55
60
70
80
90
100
110
120
130
140
Color
coding of
different
sizes

33. Handle style
The handles are divided into:
1. long handled:
2. short handled:
Made of metal or plastic handles .
3. Measurement control handles (test handle):
- It is fitted with a chuck that allows for adjustment of the
length projecting from the handle.

34. Length of the instrument


Variety of lengths.
- 21 mm, 25 mm, 28 mm, 31 mm

35. Instruments stops:

(1) Using marking paste (a mixture
of petroleum jelly and zinc oxide).
(2) Silicone or small rubber discs.
(3) A metal stop.
(4)Test handle system

36. Lentulo spiral filler:
- These instruments are
normally made from fine
wire, which is twisted to
form a tapered spiral.
Obturation Instruments

37. Pluggers Spreaders
Obturation Instruments

39. Two major areas of development of new files
1- Increase the file flexibility by changing
the file Metals.

2- Increase the file flexibility and cutting
efficiency by changing the file Design.
Modifications Of Intracanal
Instruments

40. 1- Change in file Metals:
**Nickel-Titanium alloy (NiTi)
 Advantages:
 Disadvantages:
Distal

41. 2- Modifications of file Design
(Hybrid Instruments)
Included:
1. Manufacturing.
2. Cross Section.
3. Tip design.
4. Cutting blade. (Length & Side)
5. Depth and angel of blades.
6. Shaft Design
7. Taper.
8. Numbering .
9. Flexibility.

42. 1- Modification in Manufacturing

•Twisting (K- file)

•Milling (Flex-R- file)

43. 3- Modification in Tip Design
Uni-file Safety –H file H-file = Flex-R file
A-File

44. 4.a- Length of cutting blade

4- Modification in cutting blade
Canal Master Flexogates LightSpeed

45. 4.b- Non cutting side of the blade
4- Modification in cutting blade
conventional non cutting side
H-file H-file

46. 5- Modification in depth /angle of blade
H-file A-file
40°
70°

47. Smooth Flexible Non cutting shaft
6- Modification in Shaft Design
Canal Master LightSpeed

48. Angle Taper 6%
ISO Standard :
Angle Taper 2%
Angle Taper from
5 to 8%
7- Modification in Taper
Angle Taper 4%

49. 8- Modification in numbering system

50. 9- Modification in Flexibility
This involves
1.modification in the Material,
2.modification in Cross section, and
3.modification in shaft design

52. Used in Four types of contra–angle hand
pieces:
1- A full rotary hand piece , either latch or
friction grip types.
2- A reciprocating / quarter turn hand piece.
3- A vertical strokes hand piece with an added
reciprocating quarter turn.
4- Sonic and Ultrasonic hand pieces.

53. I) Rotary Contra- angle hand pieces:
 Special drills or reamers may be used to:
Funnel out orifices
widen coronal two thirds or
Prepare post space
 used with Gates-Glidden drills,
Peeso reamer,
Canal Master,
Orifice opener,
Rotary H, U and K-types instrument.

54. 1- Gates - Glidden drill:

55. 3- Peeso Reamer:
1- preparing the coronal portion
2- preparing post space.
3- Safe ended type
should be used to
prevent lateral
perforation.

57. • Create a funnel shaped opening
which is helpful during instrumentation
and obturation phases.
Orifice opener: -2

58. 4- Rotary

59. 1- As Giromatic handpiece which
accept only
latch type instruments.
2- It makes a quarter turn motion
about 3000 rpm
II ) Reciprocating handpiece:

60. III ) Vertical stroke handpiece:
1- It is driven either by air or electrically.
2- A vertical stroke ranging from 0.3- 1 mm.
3- The hand piece has a quarter turn
reciprocating motion along with
the vertical stroke.

61. IV-) Ultrasonic and Sonic handpieces:

 Instruments used in the handpieces that
move near (Sonic) or faster (Ultrasonic)
than the speed of sound range.

 It use standard K-type file design or
special broach-like instruments.

62. Ultrasonic Handpiece
Ultrasonic oscillation is generated by :
Magnetostrictive or Piezoelectricity.
Files: Modified K-file & Diamond Impregnated files

63. Action:
Advantage:
- the canal is debrided better
- bacteria are killed more readily
- less postoperative pain
Indication:

64. Micro-streaming effect with Sonic Oscillation
A: RispiSonic,
B: ShaperSonic,
C: TrioSonic

65. Sonics and Ultrasonics
Sonic Ultrasonic
Less than 20 KHz From 20-50 KHz
Air-powered Electrical power
Irrigant (water) Irrigant (NaOcl)
Rispi & shaper K-flex & D-file
MM 3000 Cavi-Endo

66. Engine-Driven Instruments
Disadvantages:
Loss of tactile sense

Ledge formation / perforation

Instrument separation

67.  Root canals prepared with laser irradiation were
cleaner than that prepared with hand instruments
and the smear layer was removed.




 The main limitation of the laser is the fiber which
carried the laser beam in one parallel direction so,

The main effect of the laser is kept concentrated at the
apical foramen resulting in damaging effect on the
periapical tissues.

While the lateral walls of the canal are affected only by
reflected and scattered part of irradiation with minimal
indirect effect.
Laser canal preparation
Adv.
Dis