BIOMECHANICAL

PREPARATION
USING ROTARY NITI
Presenter: Dr. Dhivya P
 Content
■ Introduction ■ Specific NITI
■ Instrument designs instrumentation
■ Key terminologies techniques
■ Recommended speed
■ History of
and preparation
Instrumentation
approach for different
kinematics
systems.
■ Shaping and cleaning
■ Conclusion
■ Overview of different
■ References
existing NITI rotary
systems
Introduction

Biomechanical techniques for preparing root canals have

evolved from manual methods to rotary techniques employing
nickel-titanium instruments.

Using NiTi rotary instruments for root canal instrumentation has

enabled us to create consistently tapered preparations more
predictably and efficiently, while minimizing procedural
mishaps, especially in curved canals.
 ZIP APICAL PERFORATION

STRIP
ELBOW
PERFORATION

LEDGE

Iatrogenic damage caused

by root canal preparation
Over the last few years, many changes have been
observed, including:

 innovations in instrument design,

 surface and thermal treatments for NiTi alloys, and

 the incorporation and hybridization of new movement

strategies to drive instrumentation systems.
Knowing the morphological and mechanical
characteristics of endodontic instruments, as well
as their proper mode of use, provides greater
security and versatility to the operator.
 Basic principles for canal
preparation:

PLANNING FOR • Each root canal has to be addressed

ROOT CANAL individually.
PREPARATION
• Root canal preparation should be
planned thoroughly before starting
treatment.

• Careful evaluation of radiographs is

mandatory.
The nature of canal curvatures in terms of radius and angle is of importance
for proper selection of instrument (size, taper, flexibility, risk of
fracture).

The nature of a curve is three-dimensional, with only two planes of the

curve visible in the radiograph.

In certain cases, three-dimensional imaging using cone-beam computed

tomography (CBCT) may be helpful to identify anatomical intricacies and
intraoperative complications.
 Is an appropriate
technique important?

Since canal anatomies vary,

techniques to effectively clean
and enlarge the canal may
include modifications and may
include different types of
NITI INSTRUMENT
DESIGN
 Taper

Flute

Components of file Cutting edge

Land

Core
 Taper
Represented by a percentage that
indicates the amount of change in
the diameter (in hundredths of a
millimetre) for every millimetre
away from the tip.
 The outer diameter of endodontic files
increases gradually over their length
from the tip to the shank.

In certain designs, the taper can be

variable rather than fixed.

As the taper is correlated with the

Taper diameter, the file’s rigidity can be
highly affected by taper;

The higher the taper the less

flexible is the file.

 But with file designs increased the

depth of clearing flutes -
reducing the bulk of metal in the
central axis of the file - minimizing
iable Versus Constant Tapered Systems
The potential problem when utilizing some
constant tapered file systems.

Over-engagement
(leading to excessive torque on a file)

 Manufacturers introduced variable

tapered file systems utilizing larger tapers
(.12, .10, .08, .06)

Utilizing variable tapers can reduce over-

engagement (when used in a crown-down
sequence),

X consequence of removing excessive

Rotary Instrumentation: Achieving Its Full Potential cervical root dentin because of their large
https://www.dentistrytoday.com/endodontics/1 tapers.
0227-niti-rotary-instrumentation-achieving-its-
full-potential
 Effectiv
eness
Taper
DEPTH
WIDTH
Flute CONFIGURATIO
N
SURFACE
Components of file ANGLE OF INCIDENCE
Cutting edge FINISH
SHARPNESS

Land

Core
 LAND
Lands are the surfaces of files that
extend as far axially from the center
as the cutting edges that define the
files circumference.

– Reduces screw-in forces

– Support cutting edge
– Reduce transportation
– Limit the depth of cut
– Reduces the tendency of
manufacture faulty
The force of abrasion is a direct result of the surface area of a
land that rotates against the wall of the canal.

Can Prevent the blades from

Wide lands engaging an adequate depth.

Very useful in small diameter

files by adding rigidity, enabling
Excessive abrasion forces the file to negotiate curvature.

Increase in the torque

requirement for rotation. When the LAND is too WIDE, files
can be effectively used for removal
of Gutta Percha

“ Because the land occupies most of the working space and

keeps the leading edge from engaging in to the canal
Full radial land – ProFile, GT.
Recessed land – Quantec.
Modified radial land – K3.
No radial land – ProTaper, Race,
Endowave, Hero 642.
 Rake angle
• Rake angles are also important and affect the cutting efficiency of the instrument.
• The rake angle is the angle formed by the cutting edge and a
cross section taken perpendicular to the long axis of the
instrument.
• The cutting angle, on the other hand, is the angle formed by the cutting edge and
a radius when the file is sectioned perpendicular to the cutting edge.
• Positive rake angles will cut more efficiently than neutral rake angles, which scrap
the inside of the canal.
• Most conventional endodontic files utilize a negative or “substantially neutral”
rake angle.
• An overly positive rake angle will result in digging and gouging of the dentin. This
can lead to separation.
Current Therapy in
Endodontics
Helical angle:

The helical angle is the angle that the cutting edge makes
with the long axis of the file.

As a rotary files works in a canal, the dentinal debris

needs to be removed quickly and effectively.

Files with a CONSTANT helical flute angle allow debris to

accumulate, particularly in the coronal part of the file.
Files that maintain the
same helical angle along
the entire working length
will be more susceptible to
the effect of
“screwing in” forces.

By VARYING the flute

Helical angle, debris will
be removed in a more
efficient and the file will be
les likely to screw into the
canal.
 Pitch
Pitch is the number of spirals or
thread per unit length.
Screws historically have had a
constant pitch.
The result of a constant pitch
and constant helical angles is a
“pulling down” or “sucking down
into” the canal.
This is particularly significant in
rotary instrumentation when
using files with a constant taper. Current Therapy in
Endodontics
Priyanka Jain MSC, MDS,
In the second generation,
the manufacturers, -

Progressive pitch
length.

 the instruments have

given the better
efficiency for canal
shaping.
Depth of the fluting:

It is the half of the

maximum distance between
external and internal
instrument diameter.
Fluting volume
The pitch and the depth of flutes determines the
volume

 Fluting volume is important

 As the flutes accumulate a substrate cut

off from the root canal walls during the
preparation.

 The fluting volume at a certain level may

be completely filled with debris

 Hence reducing the cutting efficiency

 Progressive instrumentation will lead to

increase in torsional stress
Cross-section

Rotary files with radial land areas are further subdivided

depending on the shape of the grooves

 U-shaped or L-shaped,
 Resulting in a U-type or H-type file.
Rotary systems review Soni MR et al
Journal of Dental & Oro-facial Research Jul-Dec 2014
• Convex triangle- ProTaper, Wave One, Triple U-Profile,
• Equilateral triangle- Race, S-type-M-two, Reciproc, and
• Rectangular– ProTaper Next
• Inner core and Cross-section Area: More the core and CSA,
more is the Torsional Resistance but less is the Cyclic fatigue
resistance.
• Cross-sectional design: Instrument separation occurs in the
decreasing order with the following cross sections.
– Square > rectangular > triangular and slender
rectangular triangle
• S-shaped, H-file fracture more compared to triangular cross section.

• Different cross sections along the length of an instrument improve the

fracture resistance; for example: One shape and WaveOne

• Asymmetric cross sections of ProTaper Next and Revo-S also

reduce screwing in and breakage

• Protaper universal files (F2, F3, F4, F5) are made more flexible by
incorporating an additional groove in the middle of side of convex
triangular cross section
DESIGN CONSIDERATIONS

What are the most important relations of the

components of file design and canal anatomies
that enable us to improve out techniques?
 Consideration of design effectiven

– Cutting ability
The capabilities of files – Stress concentration
made of the same – Operational torque
– Flexibility
material are entirely
– Screw-in forces
dependent on design
– Ability to maintain
and can be a central axis
success/failure. – Tip mechanics
What determines the
file’s Cutting Ability?

The cutting ability of a file is

primarily the result of its
cross-section design when
the taper and technique are
the same.
 Cutting abilities of file can
also often change along
the working surface due
■ ratio of the depth of flute
and file diameter,
■ width of lands
■ and helix angle.

Mastering Endodontic
Instrumentation, McSpadden

The depth of cut is greater with RaCe and Pro Taper than with the
ProFile/ Profile GT files ( more positive rake angles). However these
 Versluis et al. (2012) reported flexural stiffness and
induced internal stress were mainly governed by the bulk
of the Centre core of the instrument.

The magnitude of the ‘screw-in’ effect and reaction torque on

the canal wall seemed to follow the same trend and was
related to the flexural rigidity of the cross-section
configuration of the instrument.

The trend applies to the varying pitch as well ‘screw-in’

forces decreased with decreasing pitch (increasing threads).
Ha et al. Screw-in effect of nickel–titanium file ©
2014 International Endodontic Journal.
Square cross-section showing the highest value, - to greater number of
contacts that were equally spaced in cross-section

Triangular configuration of the same centre-core diameter, the triangular

design exhibited lower forces than rectangular.

The slender-rectangular design, with the same cross-sectional area as the

triangular design but a smaller centre-core diameter, produced a lower
‘screw-in’ force and reaction torque
Ha et al. Screw-in effect of nickel–titanium file © 2014 International
 NiTi instruments show better
canal-centering ability than
stainless steel instruments

Canal Instrument with U-shaped cross

section with radial land areas,
centering negative rake angle that cuts equally

ability over 360°C with a planing action and

is considered to be self-centering.

As dentin is a resilient material,

instrument's positive rake angle makes
it work like a shaver on the dentin
• The variable taper design of ProTaper dampens the screw-in
effect. - better centering ability

• Instruments with less cross-sectional area & taper will show

better canal-centering ability.

• Instruments with noncutting tips show better canal-

centering ability.
Instrument
Tip design
 • Tip is an element of the working part of
instrument that performs the guiding
function.
• The tip might have a sharp or rounded

Tip design / (bullet like) configuration, depending on

whether it appears: active (cutting tip), or
Transitional passive (non-cutting tip).

angle • Most of the current file systems have

passive tips which does not have cutting
edges and does not possess cutting
properties.
• This reduces the risk of instrument
deviation from the canal axis, and as a
result the risk of transportation or ledge
formation
Roane et al defined
as the “transition
angle” (TA).

The TA is formed by
an instrument axis
and is tangent to the
last spiral of the
same instrument.

A more open angle

will result, along with
minor instrument
penetration capacity.
• Booster tip is a lead tip, that is
incorporated in XPendoShaper.
• The lead section enters canal ensuring
fit into the pre-established glide path.
• There are no cutting flutes on this
section (¼ mm)
• The next ¼ mm has 6 cutting flutes,
which shapes canal.

The repeated use of the shaper prepares the canal to a taper size
consistent with the intracanal dentinal anatomy and hardness.
The Following are some of the consideration and
ramifications of designs that are the important in
formulating techniques in approaching difficult cases:

• A files with a more efficient cutting design requires less torque,

pressure or time to accomplish root canal enlargement.

• In a straight canal, the ability of a files to withstand torsion is related

to the square of its diameter.

• In a curved canal, the ability of a file to resist fatigue has an inverse

relationship with the square of its diameter.
• The torque required to rotate a files varies directly with the surface
area of the file’s engagement in the canal.

• Fatigue of a file increases with the number of rotations of the file in

a curvature.

• Fatigue of a file increases with the degree of curvature of the canal.

• To improve the efficiency, the smaller the surface area of a file

engaged in the canal, with greater rotation speed.
• The more spirals a flute has per unit length around the shaft of a
ground file, the less resistance to torsion deformation there is, but
the more flexible it is.

• The fewer spirals a flute has per unit length around the shaft of a
ground file, the more it resists torsion deformation, but the more rigid it
is.

• The sharper the cutting blade of a file, the fewer spirals per unit length
the file should have.
• The greater the number of flutes with the similar helix angles, the
greater tendency a file has to screw into the canal and become bound.

• Maximum engagement of a file occurs when it progresses into the canal at

a rate that is equal to its feed rate, the rate the file progresses into the
canal without the application of positive or negative pressure.

• Less canal transportation occurs with a file having greater flexibility,

an asymmetrical cross – section design, and/or a land.
Key terminologies

• Torque

• Cyclic fatigue

• Torsional fatigue

• Rotary motion

• Reciprocating motion

• Apical gauging
TORQUE

Torque requirements vary with the file diameter

 If the torque and pressure required for rotating the larger diameter portion

of a file exceeds the torque required to break the smaller diameter portion,

the file is particularly vulnerable when engaging the larger diameter since

the stress on the smaller diameter cannot be detected.

IMPORTANCE OF SPEED

Speed varies within Manufactures.

Although greater the speed, the more is the cutting

efficiency, higher speeds have more disadvantages such as:

• Loss of tactile sensation

• Breakage of the instrument due to the flute distorsion.
• Change in anatomical curvature of canal
• Loss of control
CYCLIC FATIGUE

 As an instrument is held in a static position and continues to rotate,

one half of the instrument shaft on the outside of the curve is in
tension, whereas the half of the shaft on the inside of the curve
is in compression.

 This repeated tension-compression cycle, caused by rotation within

curved canals, increases cyclic fatigue of the instrument over time
and may be an important factor in instrument fracture
WHAT IS TORSION?
Torsion is the axial force of being twisted when one part of a file
rotates at a different rate than another part.
So any distortion of a file that results from twisting – unwinding, is
caused by the stress of torsion.

Cause of torsion stress:

• The force of cutting

• The force of screwing-in
• The force of abrasion of the non-cutting surface
• The force of distortion –from rotating in curvatures
• The force debris exert on the walls
Root canal Instruments

Current Therapy in Endodontics

Priyanka Jain MSC, MDS, BDS
GENERATION OF NITI FILES

First Generation
 The first rotary 0.02 taper NiTi instrument was designed by Dr. John McSpadden and
came to market in 1992.
 In 1994, Dr. Johnson introduced a line of files which became known as the ProFile
0.04 tapered series. Following soon after were the ProFile 0.06 tapers and the
“Orifice Shapers.”
 Dr. Johnson broke the paradigm of ISO 0.02 tapered files by making these more
highly tapered files, and together with Dr. McSpadden, the two are generally
regarded as the fathers of NiTi rotary files.
 LightSpeed developed by Dr. Steve Senia and Dr. William Wildey, the Quantec
developed by Dr. John McSpadden, and the Greater Taper files developed by Dr.
Steve Buchanan.
SECOND GENERATION

 All first-generation NiTi rotary files had passive cutting radial lands, fixed tapers over the
length of their working parts, and required a considerable number of files to achieve
preparation objectives.
 By the end of the 1990s, the next generation of NiTi rotary files came to market.
 The critical distinctions of this generation of instruments are that they have actively
cutting edges without radial lands and fewer instruments are required to fully prepare a
canal.
 The angle between the cutting blade and the longitudinal axis of the instrument is lower than
in first-generation files, which greatly reduces the tendency for a screwing effect during use.
 This generation of NiTi files includes the ProTaper (Dentsply Tulsa) rotary files which, unlike all
other passive or active NiTi cutting instruments, have multiple tapers of increasing and
decreasing size on a single file.
The first-generation rotary systems had neutral or slightly negative
rake angles. Several second generation systems were designed with
positive rake angles, which gave them greater cutting efficiency [e.g.
K3 system (SybronEndo, Orange, CA) invented by Dr. McSpadden)

Third-generation files Improvements in NiTi metallurgy.

Heat treatment (thermal processing) is one of the most fundamental

approaches toward adjusting the transition temperatures of NiTi alloys
and affecting the fatigue resistance of NiTi endodontic files.
Fourth Generation

The procedures utilizes reciprocation, which may be defined as any

repetitive up-and-down or back-and-forth motion.

Blanc, a French dentist, first introduced this technology in the late

1950s.

As compared to full rotation, a reciprocating file that utilizes an equal

bidirectional movement requires more inward pressure to progress,
will not cut as efficiently as a same-size rotary file, and is more limited
in augering debris out of the canal.

This generation of instruments and related technology has largely

fulfilled the long hoped-for single-file technique.
Fifth Generation

The fifth generation of shaping files has been designed such that the center of mass
and/or the center of rotation are offset.

In rotation, files that have an offset design produce a mechanical wave of motion that
travels along the active length of the file.

Like the progressively percentage tapered design of any given ProTaper file, this offset
design serves to further minimize the engagement between the file and dentin..

Commercial examples of file brands that offer variations of this technology are Revo-S
(Medidenta), One Shape, and the PTN file system. Today, the safest, most efficient, and
simplest file systems utilize the most proven design features from the past, coupled
with the most recent technological advancements currently available.
Current Therapy in
Endodontics
Priyanka Jain MSC, MDS, BDS
Endodontic Motor

They can be grouped as

■ first-generation motor without torque control, fully electronically
controlled
■ second-generation motor with sensitive torque limiter,
■ third-generation simple torque-controlled motor, and
■ fourth-generation motor with built-in apex locator and torque
control
A rotary endodontic system incorporates three key elements into
its operation:

■ Torque-sensing, which monitors how much twisting force the file

is encountering;
■ Auto reversing, which reverses the rotation of the file if the file
exceeds the torque limit; and
■ Constant file rotational speed,

Which many file manufacturers recommend. All these features help

to reduce the chance of files breaking in the canal.
 HISTORY OF
INSTRUMENTATIO
N KINEMATICS
 Timeline of movements used in mechanical root canal
preparation

Nickel–titanium instruments in endodontics: A

concise review of the state of the art
CONTINUOUS ROTARY MOTION

Rotation It is continuous clockwise rotation of file - 3600.

Rotary files undergo plastic deformation when their

endurance limit is exceeded.

Endurance limit is the level of stress or strain at which a file

can be subjected to a virtual infinite cycles without failure.
Continuou • One important instrument behavior on
s Rotary its constructive features is the 'self-
feeding effect'.
Motion • During root canal preparation, all
fluted instruments (if the fluting has
the same direction as the rotation
motion) are drawn into the canal due
to the rotation, even in the absence of
vertical feed (vertical pressure from
the operator).
– It is the 'screwing-in effect‘ - the
instrument progresses inward in the
canal under the axial feed from the
operator.
Rotary instrumentation has the following advantages over
hand instrumentation:

 Enhanced ability to collect and remove debris from the canal

system
 Continuous clockwise rotation will convey debris only in a coronal
direction from the canal ramifications and apical foramen
 Mechanical rotation provides a more constant 3600 engagement of
the file tip in the canal that forces it to follow the canal and results
in better control for maintaining the central axis of the canal,
– reducing the incidence of ledging or perforation
 The most obvious benefit for continuous rotation is the reduction in
the time required for instrumenting the canal.
 Produces greater taper in canal preparation.
Disadvantages include:

 Structural fatigued instrument can lead to fracture.

- Fracture of nickel-titanium rotary instruments continues to be
of concern (Best, et al., 2004) and appears to be a manifestation
of continuous rotation.

 In continuous rotary motion, and it may result in over

instrumentation beyond the apical constriction, which is
sometimes a cause of canal transportation.
 Rotational reciprocating motion

 Reciprocation was first introduced in 1964 with the Giromatic

system (MicroMega),

 The Giromatic system, Endo-Gripper, Intra-Endo 3 LD and Dynatrak

(Dentsply) operate with equal angles of 90° clockwise (CW)
and clockwise (CCW) motion.

– Over time, the Giromatic system lost popularity because it

produced greater procedural errors than hand filing (Weine et al.
1976).
Rotational reciprocating motion

More recently, reciprocating motion regained popularity with the

introduction of NiTi alloys and endodontic torque control motors.

In 1985, a balanced-force technique for curved canals was

described by Roane et al. (1985) and included unequal CW and
CCW motions with hand files.
Yared (2008) – land mark study - introduced the concept of single-file
reciprocation, which was based on a balanced-force technique.

Thus a new reciprocating instrument – developed – single file

preparation.

Based on these developments, manufacturers introduced single-file

reciprocating systems including:

WaveOne (Dentsply Tulsa Dental Specialities) and Reciproc (VDW,

Munich, Germany).
Reciprocation It is defined as repeated
CW/CCW movements of the file.
There are many variation of
Reciprocation motion:
• Complete: Reciprocating angles are
same in both CW and CCW
directions ( OSCILLATORY)
• Partial: Asymmetrical oscillations
( rotational effect )
• Hybrid reciprocation: Combined
movements. – ie. It can be fixed of
flexible
• In reciprocation, the clock wise rotation changes to
Counter clock wise before the file is subjected to
endurance limit, hence reducing the risk of separation.
– The reasons include, in reciprocation, fatigue of file occurs at
multiple sites, whereas in rotary, a single site undergoes
repeated fatigue.
– A higher number of reciprocating cycles are required to complete
one full rotation, which extends the cyclic fatigue resistance.
■ The major difference in the reciprocating instruments
– It has CCW cutting direction, so the instruments
could cut if the CCW movement was greater than the
CW movement.
■ However, except for these reciprocating instruments, all
of the instruments are designed for cutting in the CW
direction.

■ If a clinician tries to use these reciprocating

instruments with CW rotating motors or tries to use
CW cutting instruments with the reciprocating
motors (CCW motion is greater than CW motion),
 Cyclic Fatigue
 The reciprocating movement induces less cyclic
fatigue and promoted an extended life Of the
instrument in comparison with conventional
rotation.
COMPARISON  Comparing cyclic fatigue resistance Of instrument
BETWEEN used with continuous rotation and the new motion
ROTARY AND (TF Adaptive rotating reciprocation).
RECIPROCATING
FILES  The results showed a significant increase Of
cyclic fatigue resistance Of instruments
used with the TFA motion.
 This can be explained by the alternating Of
engaging/disengaging movements.
 Debris
Extrusion
• The results demonstrated that the full sequence
rotary instrumentation systems were
COMPARISON associated with less debris extrusion compared
BETWEEN with the reciprocating single file systems, one
ROTARY AND Of which, Reciproc, produced significantly more
RECIPROCATI debris compared with all the Other systems.
NG FILES • This can be explained by the absence Of
physiological back pressure provided by
periapical tissues that may influence
debris extrusion.
 Bacterial Reduction
The rotary systems, ProTaper Maintenance Of
Universal and Mtwo, have been Root Canal
shown to provide adequate
geometry and substantial Anatomy
bacterial reduction in the root
COMPARISON canal.
Berutti et al. Compared
canal shaping efficacy
BETWEEN  A recent study compared between reciprocating files
ROTARY AND both motions. and rotary files.
RECIPROCATI  The conclusion - was that
NG FILES reciprocating systems The studies concluded that
resulted in similar the original canal contour in
bacterial reductions to curved canals was better
those obtained with rotary maintained when the
systems or with the manual reciprocating file system
instrumentation technique. was used compared with
rotary instruments.
 Some systems due to its characteristics of
their instruments – rotate
eccentrically/asymmetrically.

Rotary ( the axis of rotation is off centered)

eccentric The first available systems enabling

asymmetrical motion were:
movement • Revo-S (MicroMega),
s • ProTaper Next (Dentsply),
• OneShape (MicroMega) and
• TRUShape 3D Conforming Files
(Densply).
 Vertical vibration / Transaxial
■motion
In 2010, the Self-Adjusting File system (SAF) (Re-Dent-Nova)
was introduced.
■ It is operated by vibrating a slightly abrasive lattice using an
in-and-out motion to remove dentine and provide continuous
irrigation during preparation (Metzger et al. 2010).
 Rotary motion plus rotational reciprocating
motion
(adaptive motion)
■ Some systems have been designed to combine rotary and reciprocating
movements, taking advantage of each one.

■ Ultradent, Sybron Endo, Easy and J Morita have presented proposals of engines or
instrument systems capable of working in the root canal with both kinematics.

The Genius system (Ultradent, South Jordan, UT, USA), introduced in 2016, was
developed for use in clockwise rotary and reciprocating (90° clockwise, 30°
counterclockwise) motion.
■ Canal preparation is first performed with reciprocating motion, which allows safer
negotiation of the canal; then, symmetric rotary action is used to finish the
preparation, guaranteeing greater efficiency in dentin removal from the canal and
less extrusion of debris.
Optimum • Optimum torque reverse (OTR) motion
is a torque-sensitive reciprocal motion
Torque in which the motor rotates in
alternating 90° counterclockwise and
reverse 180° clockwise rotation when the

Motion torque exceeds a predetermined

value.
(OTR)
• OTR motion reduced both torque and
screw-in force during the crown-down
preparation phase of the crown-down
technique and during the apical
preparation phase of the single-length
technique.
Optimum • This movement was also developed by J
Morita company (J Morita MFG. CORP Kyoto,

Glide Path Japan) and may be used to reach the glide

path and the foramina patency.

(OGP) • Rotary instruments with small size (#10,

#15 and #20) may be used with gentle
movements of symmetric and asymmetric
alternated rotation, simulating the partial
enlargement and exploration.
• In OGP movement, the instrument used to
glide path performs a symmetric oscillatory
movement, followed by a clockwise rotation
of 180o.
Mechanical glide path
instruments
■ The combined use of stainless steel hand instruments and NiTi rotary
instruments is recommended when establishing a glide path for curved
and/or narrow canals
■ While hand instruments provide tactile feedback on root canal anatomy,
the superior flexibility and mechanical strength of NiTi instruments aim to
reduce the occurrence of iatrogenic errors during root canal exploration.
■ The instruments have a quadrangular cross-section, which increases their
torsional strength.
 Removal Of Filling Material during Retreatment

Recent studies compared the efficacy Of reciprocating and

rotary techniques for removing filling material during
retreatment.
 Remaining endodontic filling material was observed on the
canal walls Of all the specimens regardless Of the
technique used;

 The reciprocating technique was the most rapid method for

removing Gutta Percha and sealer.

 More apically extruded material in reciprocating system

compared with retreatment rotary
SHAPING AND
CLEANING
 Rotary shaping guidelines
■ First – good diagnostics are important for successful rotary canal
preparation, including the exposure and analysis for adequate
radiographs.
– Clinicians – need to determine – the overall anatomy, the
existence, the extent, and the position of canal curvatures.
– Radiographs and findings, help to determine merging points
and canal dimensions.
– Based on these findings- 2 general rules – first to ascertain a
glide path, which may be defined as patent canal section that
allows the tip of the instrument to rotate freely and to act guide.
■ After preparation of an optimized access cavity
with high speed burs, the canals are negotiated
with 10-15 k files.

■ Coronal flaring facilitates direct access into the

middle and sometimes even into the apical
canal third to facilitated proper irrigation.
■ Canals are prepared with using hand files up to
no. 20 using watch winding or balanced force
motion.

– This procedure is important as it secures an

open glide path allowing a subsequent
rotary instrument to predictably reach
working length.
■ Second- to have a direct straight line of access deep into the
middle third root canal, which will reduce cyclic fatigue and
allow the instrument to shape canals with little or no canal
transportation.
■ This can be more readily accomplished in a crown-down method
than in a step-back patterns: this sequence also helps to reduce
friction and consequently , torque.
Current Therapy in Endodontics
Priyanka Jain MSC, MDS, BDS
 SPECIFIC NITI
INSTRUMENTATION
TECHNIQUES
  Crown Down
Specific NiTi  Single Length
Instrumentation  LightSpeed technique
Techniques  Techniques with the self-Adjusting file
 Hybrid Techniques
 CROWN DOWN
APPROACH
Working lengths are determined after
any coronal pre enlargement.

Open glide path is secured with K files

– up to #15 or #20.

The canal preparations begins with 6%

taper instruments in descending tip
diameter.

In narrower canals 6% taper is

followed after 4% tapered instruments.

Apical preparation is performed either

multiple shaping waves / step back
manner.

Recapitulation with small hand file is

Coronal  The extension of an access
Preflaring cavity into the coronal most
portion of the root canal.
 Coronal pre-flaring is done if a
canal is constricted,
mineralized, difficult to access.
 This canal modification should be
preceded by a scouting step.
 Tools for pre flaring are : GG and
dedicated NiTi instruments.
– GG – are used in step back
and step down sequences
– Niti files – crown down
sequences.
■ Specific orifice shaping rotaries.
Instruments for
Coronal Flaring Most
 of the NiTi systems recommended for
HyFlex CM 1 – size 25, .08
use in a crown-down approach.
(Coltene, Cuyahoga Falls, OH,
It also promotes early access of
USA),
irrigants and allows rotary
 BioRaCe BR0 – size 25,
instruments to prepare the apical
 ProFile Orifice Shapers No. 2
portion- less wall contact and friction
– size 30, .06 (Dentsply Tulsa
Coronal flaring instruments should be
Dental Specialties, Tulsa, OK,
cutting-efficient and preferably act
USA), and
laterally.
 ProTaper Sx – size 19, variable
taper (Dentsply Maillefer,
Cutting efficiency of endodontic instruments Peters et al
Ballaigues, Switzerland).
 Single
Length
The approach for ProTaper and
PTN instruments differs from
other NiTi rotary instruments
(except MTwo, WaveOne and Reciproc)

No traditional crown-down
procedure is performed.

This step is essential for ProTaper

shaping instruments, because
they are mostly side cutters
and have fine, fragile tips.
 LightSpeed LSX (Spade Blade)

They manufactured not by

milling but by stamping. The
files are used for apical
preparation
2005 - Modifications and
developments of
LightSpeed instruments,
called LSX. (the “X” be
added for “extra safe.” )
The blade design provides
better tactile feedback than
Unique Feature Reduces Irretrievable
the original. Instrument Separation
Inside Dentistry September 2009
The spade blade has several advantages:
 There are no flutes to fill with
debris.
 The spade blade has no helical
angle (spiral thread)
 The blade design provides space
for cut debris and for bypassing in
the unlikely event of instrument
separation.

The LSX was designed with a short blade -

a “safe failure” mode, which means that if it
is overstressed, there is an excellent chance
Evolution of nickel–titanium nstruments: from past to future
MARKUS HAAPASALO & YA SHEN Endodontic Topics 2013, 29, 3–
Hybrid
Techniques
The principle involves the
use of a variety of
instruments: for example,
GG drills and K-files for
establishing straight-line
access;
ProTaper instruments for
body shaping and apical
preenlargement; NiTi
K-files or LightSpeed
instruments for apical
The ideal preparation form for the hybrid
concept takes its pattern from the definition
by Schilder and its slightly modified.

“ A three dimensional continuously

tapered cone in multiple planes with
sufficient apical enlargement preserving
foramen position and size.”

For best cutting efficiency, the general instrumentation approach

preferably should be performed by crown down; however a
combination with step back and apical widening is often needed.
 OVERVIEW OF
DIFFERENT EXISTING
NITI ROTARY
SYSTEMS
Nickel–titanium instruments in Endodontics: a concise review of the state of the art Gavini G, Santos M, Caldeira
CL, Machado MEL, Freire LG, Iglecias EF et al. Braz. Oral Res. 2018
Nickel–titanium instruments in Endodontics: a concise review of the state of the art Gavini G, Santos M, Caldeira
CL, Machado MEL, Freire LG, Iglecias EF et al. Braz. Oral Res. 2018
Nickel–titanium instruments in Endodontics: a concise review
of the state of the art
Gavini G, Santos M, Caldeira CL, Machado MEL, Freire LG,
Nickel–titanium instruments in Endodontics: a concise review
of the state of the art
Gavini G, Santos M, Caldeira CL, Machado MEL, Freire LG,
Iglecias EF et al.
Nickel–titanium instruments in Endodontics: a concise review
of the state of the art
Gavini G, Santos M, Caldeira CL, Machado MEL, Freire LG,
 MTwo

• Mtwo files are characterized by two sharp cutting edges and a relatively small core diameter
• The smaller the core diameter the greater the space between the cutting edges and the
canal wall.
• This file design together with the increasing pitch length from the tip the shaft of these files
may enhance the debris removal capacity of the Mtwo file.
• Mtwo instruments resulted in better centred canals.
• Mtwo comprised only six instruments

Mtwo – shaping and cleaning. Part 2 Schafer et al. 2006 International Endodontic Journal
 Pro
Taper
.
This progressively
tapered design
serves to
significantly
improve flexibility, Convex, triangular cross-section which enhances
cutting efficiency
and safety.
the cutting action while decreasing the rotational
friction

A changing helical angle and pitch over their

cutting blades which reduces -screwing into the
canal.
THE PROTAPER TECHNIQUE:
SHAPING THE FUTURE OF ENDODONTICS
by Clifford J. Ruddle, © ADVANCED ENDODONTIC
 Pro Taper
 The ProTaper files
each have a
noncutting,
modified guiding
tip.

 The ProTaper system

is comprised of just
three Shaping and
three Finishing
files

THE PROTAPER TECHNIQUE:

SHAPING THE FUTURE OF ENDODONTICS
by Clifford J. Ruddle, © ADVANCED ENDODONTIC
P
R
O
T
A
P
E
R
G
O
L
D
 The ProTaper
NEXT System

 Uses innovative
M-Wire
technology, and
 a unique offset
mass of rotation

(as developed by Dr.

Michael J. Scianamblo
and the Dentsply
International team).
 Offset mass of rotation: PTN files produce a unique asymmetrical
rotary motion and, at any given cross-section, the file only contacts
the wall at 2 points.

This provides 3 significant advantages:

■ Reduced engagement due to the

swaggering effect, limiting undesirable
taper lock
■ More cross-sectional space for enhanced
cutting
■ Allows to cut a bigger envelope of motion

This means a smaller-sized and more flexible PTN file can cut the
same-size preparation as a larger and stiffer file with a centered mass
and axis of rotation.
 Instruments with different cross-sections
along the active part.
• Has modified convex triangular from
tip to D8 (the eighth millimeter), with
three cutting edges oriented
counterclockwise,
• Triangular convex from D9 to D16.
• The taper is constant in the first three
mm and decreases thereafter.
• The variability of tip diameters -
prepare a wide range of apical
diameters and root canal anatomies
• The reduced taper ensures a more

Wave One conservative preparation with greater

dentin preservation at D16 (cervical
region of the preparation).
The WaveOne Gold file exhibits
a unique alternating off-
centered parallelogram shaped
cross-section design with two 85°
cutting edges
• This design limits the engagement
between the file and the dentine to
only one or two contact points at
any given cross section.

– This reduces taper-lock and the

screw-effect, improves safety,
increases cutting efficiency, and
provides more chip space to auger
The newly designed files are also manufactured with an ogival
(pointed arch shape), roundly tapered and semi-active guiding
tip to ensure that progress along canals is safe with a secured
and confirmed reproducible glide path.
 Clinical safety guidelines during
NiTi instrumentation
Generally, following suggestions should be considered to avoid iatrogenic errors:

• Avoid subjecting NiTi rotary instruments to excessive stress.

• Use instruments that are less prone to fracture.
• Follow an instrument use protocol.
• Assess root canal curvatures radiographically and instrument them carefully
• Ensure that the endodontic access preparation is adequate.
• Make a glide path with small size files (sizes 10-20).
This allows preservation of pathway to the working length and
reduces the formation of transportations and ledges.
• Use crown down approach.
• Recapitulate using a small file to establish and maintain patency to
reduce transportation and respecting the original canal shapes.
• No instrument should be introduced into the root canal space until an
appropriate irrigant is introduced into the pulp chamber.
• Do not stop the preparation in between. Overzealous use of NiTi
rotary files (especially beyond apical foramen) could cause cracks in
apical roots.
 • Endodontic motors have undergone a
revolution regarding torque control and
adjustable kinematics in different directions;
• Adaptive motion is a novel modified
reciprocating motion that aims to combine the
advantages of rotary and reciprocating
Summary of Niti motions;
instrumentation
• The literature suggests that adaptive motion
has advantages over simple rotary motion in
terms of removal of filling material and cyclic
fatigue;
• The actual speed and angles of reciprocation
may differ from the manufacturers’ declared
values;
• Changing the stress point on the
 The instrumentation speed, force, kinematics and torque
values are several factors that affect instrument failure;

• The actual torque deviated from the pre-set torque and

could be higher than the torque reported at the fracture of
several NiTi rotary instruments;

• Decreased axial stress on the file and enhanced debris

removal appear to be advantages of instruments with
asymmetrical motion;

• Conflicting results amongst the studies on reciprocating

motion may be related to the use of different instruments.
 References
■ Mastering Endodontic Instrumentation - John T. McSpadden, 2007
■ C O H E N ’ S P A T H W A Y S of the PULP – 11th edition
■ Current Therapy in Endodontics, Priyanka Jain Ames, Iowa : John Wiley &
Sons, Inc., 2017.
■ Design features of rotary root canal instruments, Rzhanov/Belgaera ENDO (LONG ENGL) 2012.
■ Rotary Endodontics or Reciprocating Endodontics: Which is New and Which is True? Sahu et
al. JOURNAL OF HEALTH SCIENCE AND RESEARCH, December 2016.
■ THE PROTAPER TECHNIQUE: SHAPING THE FUTURE OF ENDODONTICS by Clifford J. Ruddle, ©
ADVANCED ENDODONTIC 2015
■ Effect of Cervical Preflaring on Apical File Size Determination Tennert et al. JOE — Volume 36, Number
10, October 2010
■ Ha et al. Screw-in effect of nickel–titanium file © 2014 International Endodontic Journal.
■ Twisted Files and Adaptive Motion Technology: A Winning Combination for Safe and
Predictable Root Canal Shaping May 4, 2016
by Gary Glassman, DDS, FRCD(C); Gianluca Gambarini, MD, DDS; Sergio Rosler, DDS, MSc
References
■ THE PROTAPER ADVANTAGE: SHAPING THE FUTURE OF ENDODONTICS* by
Clifford J. Ruddle,D.D.S.
■ Modern Endodontic NiTi Systems: Morphological and Technical
Characteristics Part I: “New Generation” NiTi Systems Nicola M. Grande, E
N D O D O N T I C T H E R A P Y VOL. 5 NO. 1 January 2005
■ The hybrid Concept of NITI rotary instrument, Helmut Walsh et al.
Dent clinc of North America 2004
■ Nickel–titanium instruments in endodontics: a concise review of the state of
the art Giulio GAVINI et al. Braz. Oral Res. 2018;32(suppl):e67
■ Mechanical root canal preparation with NiTi rotary instruments:
Rationale, performance and safety. Status Report for the American
Journal of Dentistry LARS BERGMANS et al. American journal of dentistry ·
November 2001 Source: PubMed CITATIONS 220
■ Reciprocating instruments in Endodontics: a review of the
literature PJ van der VyverI; C Jonker S. Afr. dent.
j. vol.69 n.9 Johannesburg Oct. 2014
THANK YOU !