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Clinical Hints: Compiled by Dr. Gavan O'Connell

This document discusses the advantages of nickel-titanium (NiTi) rotary endodontic file systems. 1. The main advantages of NiTi rotary systems are that they provide predictable results, save time, reduce operator fatigue, extrude debris away from the apex reducing post-op pain, and are less likely to transport canals compared to hand instrumentation. 2. NiTi rotary files must be used in conjunction with hand files which serve functions like determining canal anatomy and creating/confirming a smooth glide path. 3. The document then discusses factors like tapers, separations, cross-sections, and provides details on using the ProTaper NiTi rotary system in

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0% found this document useful (0 votes)
132 views20 pages

Clinical Hints: Compiled by Dr. Gavan O'Connell

This document discusses the advantages of nickel-titanium (NiTi) rotary endodontic file systems. 1. The main advantages of NiTi rotary systems are that they provide predictable results, save time, reduce operator fatigue, extrude debris away from the apex reducing post-op pain, and are less likely to transport canals compared to hand instrumentation. 2. NiTi rotary files must be used in conjunction with hand files which serve functions like determining canal anatomy and creating/confirming a smooth glide path. 3. The document then discusses factors like tapers, separations, cross-sections, and provides details on using the ProTaper NiTi rotary system in

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Firu Lgs
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© © All Rights Reserved
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You are on page 1/ 20

CLINICAL

HINTS

Compiled by Dr. Gavan O’Connell


M.D.Sc (Melb) L.D.S. (Vic)
with thanks to Dr Cliff Ruddle D.D.S.
Contents
Advantages of NiTi Rotary Systems 3

ProTaper Universal Technique Guide 8

Preparation Sequence

1. Scout Coronal 2/3rds 9

2. Pre-enlargement of Coronal 2/3rds 10

3. Scout Apical 1/3rd 12

4. Finish Apical 1/3rd 12

Finishing the preparation with ProTaper Universal


for hand use 15

Obturation 16

Retreatment 17

Ordering Information 18


Advantages of
NiTi Rotary Systems
In the last decade, after generations of little change, various technological advances
(e.g. microscopes, ultrasonics, new obturation concepts and materials) have
revolutionised the discipline of endodontics. It is the rotary Nickel Titanium (NiTi)
instruments, however, that have had the greatest impact. Particularly advantageous
was the advent of instruments of increased taper with their crown down preparation
creating predefined shapes.

The 5 main advantages of the NiTi rotary systems are:


1. Predictable results every time even when dealing with curved
canals.
2. Time Saving: with practice a standard molar can be
totally cleaned and shaped in far less time than hand
instrumentation.
3. Less Fatigue for the operator compared to hand
instrumentation.
4. Less post-op pain owing to debris being extruded from the
canal during the crown-down technique instead of being
pushed through the apex during step-back.
5. Less Transportation of canals

There are 4 aspects of NiTi rotary files that need to be discussed in order to obtain a
clearer understanding of their correct and safe use.

1. The use of Hand Files


There is a misconception that hand files are unnecessary when using NiTi rotary
files. This could not be further from the truth. In fact, the role of hand files has been
redefined since the introduction of NiTi rotary files. Hand files are complementary to
NiTi rotary files, and serve the following functions:
• To determine straight line access
• To give information regarding the root canal system anatomy
• To 'scout' the canal to either create or confirm a 'glide path'
• To act as 'patency finders'
• To determine working length
• To finish the preparation when there is an 'irregular glide path'


Advantages of
NiTi Rotary Systems
2. Tapers
Most dentists are now aware of the concept
of tapers. For nearly 50 years 'conventional'
hand files have had a constant taper of 2% i.e.
measuring from the tip for every millimetre we move
coronally, the diameter of the instrument increases
by 0.02mm. Since the introduction of NiTi rotary
instruments we have seen a whole range of tapers
up to 12%. However, regardless of the percentage figure 1
taper of the file, the taper was always constant for
each individual file (see figure 1).
That rule has also changed recently with the advent
of the ProTaper NiTi rotary filing system. The files
have variable tapers within each individual file (see
figure 2).
ProTapers were the brainchild of four endodontists
who were looking to design a safer file which
would give increased torque strength and increased
resistance to metal fatigue.
Adequate taper is so important to ensure better
penetration of irrigants in order to obtain better
cleaning of the root canal system. It also provides better figure 2
hydraulics for better Gutta Percha compaction.

3. Separations
The benefits of using rotary NiTi files are well documented. Therefore, why isn’t
everybody using them? Price is not the reason; although more expensive per individual
file compared to hand files, rotary NiTi files are more cost effective owing to their
efficiency. It is the fear factor of separated instruments that is still preventing some
practitioners from taking the next step into NiTi rotary files.
There are only 2 ways NiTi rotary files will separate:
1. Excessive Torque: Torque is a resistance to rotation; basically you have exceeded
the strength of the instrument.
2. Metal Fatigue: When a NiTi rotary file is rotated around a curve it goes from
maximum stretch to maximum compression. Sooner or later it will experience
metal (or cyclic) fatigue. Metal fatigue is accumulative.


Advantages of
NiTi Rotary Systems
Please refer to the following chart for factors affecting both Torque Failures and Metal
Fatigue failures. As an example, with ALL OTHER FACTORS BEING THE SAME, if you
increase the pressure on the file you increase the likelihood of Torque Failure.

Torque Failures Metal Fatigue Failures


Pressure Ò Curvature Ò
Curvature Ò Radius Ú
Surface Area Ò Diameter of instrument Ò
R.P.M. Ú Taper Ò
Lubrication Ú No. of forward/reverse cycles Ò
Referring to this chart, it now makes sense that in the straight portion of a canal we
need high torque strength (large tapers/diameters). However, around the curve we
need flexibility and increased resistance to metal fatigue. Therefore, we choose a
small taper instrument. It can now be seen that if you have a constant taper in a
file then that file cannot have high torque strength and at the same time have high
resistance to metal fatigue.
The uniqueness of a variable tapered instrument e.g. ProTaper S1 is that it gives
apical flexibility (small apical taper and minimum metal fatigue), but at the same time
increased torque strength because of its larger coronal tapers.
In recent times with the introduction of the latest generation of torque
controlled motors (see figure 3), an increase in the safe use of NiTi
files has occurred. These motors are programmed so that the optimal
torque for each file can be selected.
Rotary files should be used passively within the canal, and
their use continued as long as they move easily in an
apical direction. Never force NiTi rotary files. Nickel
Titanium is so flexible that if forced it will buckle and
figure 3 – X-Smart Unit
eventually succumb to metal fatigue.
There are typically 3 factors affecting a rotary file from passively moving in an apical
direction:
1. Canal size/Instrument size
2. Debris – INTRACANAL and INTRABLADE. Ensure that the canal is free of debris
by using copious irrigation and frequent recapitulation. Ensure that flutes are free
of debris.


Advantages of
NiTi Rotary Systems
3. Root Canal Anatomy e.g. mid-root curvature
(may appear calcified on the radiograph) or
abrupt apical curve. We are aiming to obtain
a smooth, reproducible glide path so that
the tip of our rotary instrument can passively,
accurately and safely follow the canal.

4. Cross-Section of Cutting Blades


Rotary NiTi files can either be classified as ACTIVE
(in one example semi-active) or PASSIVE (see figure figure 4 – ProFile
4). Basically an active file will rotate and cut in a canal without pressure; a passive
file needs apical pressure to cut.
When using a rotary NiTi file it is essential to know
the cross-sectional design of that file in order to
know how it can and should be used. For instance
figure 4 shows the ProFile in cross-section which is
an example of a passive cutting blade. The radial
lands 'plane' the walls of the canal, and although
repeated return is not recommended, if you do you
are less likely to get transportation of the canal.
Figure 5 shows the ProTaper (SX, S1, S2, F1, F2)
in cross-section, which is an example of an active
cutting blade. No radial lands, and the slightly figure 5 – ProTaper
convex triangular shape reduces the contact area
between the blade of the file and dentine. This feature serves to enhance cutting
efficiency, reduces torsional friction and improves safety. However, this type of
cutting blade needs to be used in a technique
where repeated return is prohibited to prevent
transportation of the canal.
To follow is an explanation of the files in the ProTaper
system and a detailed step-by-step technique on
their safe use. Figure 6 serves to emphasize the
typical anatomy found in a mandibular molar.
One needs to appreciate the position, size and
morphology of the pulp chamber. Often the floor
of the pulp chamber is constricted creating internal
triangles of dentine. Additionally, one should be
alert to root curvatures, external root concavities
and root canal system anatomy.
figure 6

Advantages of
NiTi Rotary Systems
The NiTi ProTaper system is comprised of just three shaping and five finishing
instruments. The instruments have handles that are 13mm long to facilitate access
and are available in 21, 25 or 31mm lengths. The
ProTaper files have non-cutting guiding tips to help
auger soft tissue out of the canal. The ProTaper
instruments are only used in canals that have a
confirmed 'smooth, reproducible glide path' (more
on this shortly).

The SX file (figure 7) has a gold coloured handle


without any identification rings. It has an overall
length of just 19mm. This shorter length allows it
to be introduced into more restrictive areas where
figure 7
access is a problem. SX may be used to optimally
shape canals in shorter roots, relocate canals away from external root concavities
and produce more shape, as desired, in the coronal one-third of canals in longer
roots. SX has 9 increasingly larger tapers ranging from 3.5% to 19%.

The SX diameters between D6–D9 may be equated


to the Gates Glidden drills 1–4. Strategically, the
SX file is used with a lateral brushing motion to
cut dentine, between D6–D9, on the outstroke.
Importantly, the apical extent of SX should NOT
engage dentine; rather passively follow a canal
that has a confirmed smooth, reproducible glide
path. The S1 (figure 8) has a purple identification
ring and exhibits 12 increasingly larger tapers
over the length of its cutting blades. The S2 has
a white identification ring and exhibits 13 tapers figure 8
over the length of its cutting blades. The S1 is designed to prepare the coronal one-
third whereas the S2 is designed to enlarge and prepare the middle one-third of the
canal. In general, each instrument engages, cuts
and performs its own crown-down preparation.

The first three finishing files, termed F1, F2 and F3


(figure 9) have yellow, red and blue identification
rings on their handles corresponding to tip
diameters of 0.20, 0.25 and 0.30mm respectively.
The F1, F2 and F3 have fixed tapers of 7%, 8%
and 9% in their apical extents, respectively, and
decreasing percentage tapers in the coronal two-
thirds of their cutting blades.
figure 9

Advantages of
NiTi Rotary Systems
Decreasing percentage tapers over a portion of a file’s larger cutting blades improves
flexibility and decreases the potential for dangerous 'taper lock' and/or strip
perforations.
The final two finishing files, termed F4 and F5
(figure 10) have two identification rings each. The
F4 has black rings corresponding to a tip diameter
of 0.40mm. The F5 has yellow rings corresponding figure 10
to a tip diameter of 0.50mm. The F4 and F5 have
a fixed taper of 6% and 5% in their apical extents, respectively, and decreasing
percentage tapers in the coronal two-thirds of their cutting blades.
F4 and F5 are primarily for cases where the apex is larger or for those clinicians who
philosophically subscribe to making anatomically smaller-sized canals larger. The
torque settings for F4 and F5 are the same as for F3.

ProTaper Technique Guide


The following technique guide is designed to make the use of ProTaper straightforward,
user-friendly and safe. The intention is not to be a textbook on endodontic principles.
It is assumed that all the necessary infection control procedures have been adhered
to and rubber dam has been used etc. The principles of access cavity design will
not be discussed and it will also be assumed that this most important aspect of root
canal procedure has been performed adequately. It is also given that all canals have
been found, and hence the use of ultrasonic instruments like ProUltra will also not
be discussed.
Shaping of the root canal means gaining adequate taper, without over-enlargement
of the coronal portion of the canal, without ledging, without canal transportation
and without zipping (figure 11) of the foramen. Correct shaping (= adequate taper)
gives:
• Better cleaning of root canal system
• Better penetration of irrigants
• Better hydraulics for G.P. compaction
Our cleaning and shaping objectives, therefore, should be:
• To have a continuous tapering preparation
• Maintain the original canal anatomy
• Maintain the original position of the foramen
• Keep the foramen as small as practical
figure 11


Preparation Sequence

The preparation sequence that will be described involves


the following steps:
• Scout the coronal 2/3rds of the canal
• Pre-enlargement of the coronal 2/3rds
• Scout the apical 1/3rd of the canal
• Finish the apical 1/3rd preparation

1. Scout Coronal 2/3rds


For the purposes of this exercise, 'scout' means using #10 and #15 handfiles. These
scouting files give you an idea of:
• cross-sectional diameter of the canal
• canal anatomy
• access: where is the handle? Is it standing up tall? Do I have radicular and coronal
access? The handles of small handfiles are frequently off axis in furcated teeth due
to internal triangles of dentine (see page 6).
Following complete straightline access, a #10
handfile may be used to scout a portion of the
overall length of the canal (figure 12). The #10
handfile will create more space than its numerical
name would suggest as it is 0.10mm at D0 and
tapers to 0.42mm at D16. Small #10 and 15
handfiles are used to either create sufficient space
or to confirm available space prior to using more
efficient NiTi rotary files.
We will use 2/3rds as our step 1 scouting
distance, but this will vary from case to case.
Wiggle in (can use small ‘watch winding’ motion)
figure 12
#10 handfile until it meets resistance (until it is
snug), and then pull back. Note the length that the #10 reached. Feed it in again,
snug, pull back etc. Do this about 6 times. Remember at this stage you are not trying
to get to working length.
The #15 handfile is 50% larger at D0 than the #10. It is 0.47mm at D16, and serves
to expand and refine the glide path. Before safely introducing a ProTaper into a canal,
sufficient space must exist to accommodate and guide its modified guiding tip.


Preparation Sequence
Wiggle in #15 handfile until snug and then pull
back (figure 13). Again do this about 6 times. It
should reach the same length as the #10 handfile.
If experiencing any problems (especially in vital
cases) use a lubricant such as Glyde. Irrigate,
recapitulate with #10 handfile (push/pull) and
re-irrigate.

You have completed Step 1:


Scout Coronal 2/3rds of the canal

2. Pre-enlargement of
Coronal 2/3rds figure 13

ProTaper instruments are not end cutting, but


are rather designed to safely follow a smooth
reproducible glide path. S1 has a D0 diameter
of 0.17mm and its modified guiding tip easily
follows the part of the canal that was previously
scouted with #10 (0.10mm) and #15 (0.15mm)
handfiles.
The S1 is used with virtually no apical pressure.
When any rotary instrument ceases to progressively
and passively advance deeper into a canal,
figure 14
it should be removed and its blades cleaned.
Importantly, the S1 expands, refines and smooths the glide path. I like to think of the
S1 as our 'workhorse'.
• Set the motor at the correct torque for S1 (figures 15 & 16). Advance
the S1 to the same length as the #15 handfile reached (figure 14). DO NOT
GO ANY DEEPER. If you have reached the required depth, DO NOT RE-ENTER
canal with S1. Remember these files have active cutting blades and repeated
return is unnecessary and fraught
with danger. If you did not reach the
required depth, then take the S1 out
of the canal, clean the flutes and
reintroduce in to the canal, but
deeper this time.
DO NOT GO BACK TO
THE SAME LENGTH.

figure 15 figure 16

10
Preparation Sequence
Shaping files can be used with a 'brushing' motion.
• Once required depth obtained then irrigate,
recapitulate with #10 handfile (push/pull) and
re-irrigate.
Furcated teeth have internal triangles of dentine
(figure 17) which should be removed during the
initial stages of treatment to facilitate shaping
procedures. Uprighting the handle of the smaller
sized hand files often requires refining and
figure 17
expanding the access preparation in conjunction
with removing the mesial triangle of dentine from
the cervical third of the canal.
With just a single instrument, the ProTaper SX file
may be used to rapidly, effectively and safely
remove restrictive triangles of dentine (figure 18).
• Set the motor for the correct setting for SX
• The SX is carried in to the canal and passively
allowed to advance until its apical movement
slows.
figure 18
• The SX file is then lifted coronally about 1mm
and its middle one-third blades between D6 and
D9 (remember from page 7, these diameters
equate to Gates-Glidden 1–4 drills) may be
used. These middle one-third blades are used
in a lateral brushing motion to cut dentine on
the outstroke. Cut away from the furcation.
Once lateral space has been created, then SX
will invariably advance passively deeper into
the canal.
The cycle of passive advancement followed by figure 19
brush-cutting dentine on the outstroke is repeated
to create lateral space so the rapidly tapering blades can progressively shape deeper
into the canal. Importantly, the apical extent of SX is NOT designed to cut dentine,
but passively follow the glide path. The reason for the cutting blades on the apical
portion of SX is to help auger soft tissue out of the canal. The use of SX is continued
until about 2/3rds of the overall length of its cutting blades are below the orifice
(figure 19). DON’T FORGET: Irrigate, recapitulate with #10 handfile (push/pull) and
re-irrigate.
You have completed Step 2: Pre-enlargement of Coronal 2/3rds.

11
Preparation Sequence
3. Scout Apical 1/3rd
• With excellent radicular access, a pre-measured
and pre-curved #10 handfile is used to scout
and negotiate the rest of the length of the canal
(figure 20).
• The #10 handfile is moved gently to the
terminus, then minutely through the foramen
to establish patency. Repeat the 6 pullback
movements done previously.
figure 20
• Irrigate
• The #15 handfile follows the path of the #10,
improves the glide path and dictates the next
clinical move. When it is difficult to pass small
handfiles to length, then viscous chelators
(e.g. Glyde) should be used to encourage the
mechanical objectives.
• Determine working length with an electronic apex
locator (e.g. PROPEX) and confirm radiographically
(with #15 handfile) (figure 21). figure 21
• Repeat the 6 pullback movements (as done
previously) to length with the #15 handfile
(figure 22). Irrigate, recapitulate (#10 handfile
push/pull), re-irrigate.
We are now ready to finish the apical 1/3rd
preparation. However, we first must determine if
we can use rotary files to do this or whether we
finish with handfiles. We do this by verifying if we
have a smooth, reproducible glide path.
figure 22
You have completed Step 3:
Scout Apical 1/3rd of the canal.

4. Finish Apical 1/3rd


A smooth, reproducible glide path is important. A
#15 handfile may be used to verify whether the
apical one-third of a pre-enlarged canal has either
a smooth or irregular glide path (figure 23).
figure 23
12
Preparation Sequence
A smooth, reproducible Glide path is verified if a brand new #15 handfile can be
gently pushed over a few millimetres, and can passively slide to length.
If you encounter obstructions when trying to move the #15 handfile passively (as
outlined below) then you do not have a smooth, reproducible glide path. You,
therefore, cannot expect a rotary file to be used in an area where a handfile could
not go freely.

This is a critical technique:


1. Move the #15 file 1mm short of the working length and gently push back to
working length. Do this WITHOUT any twisting.
2. Move the #15 file 2mm short of working length and repeat the above.
3. Move the #15 file 3mm short of working length and repeat the above.
4. Move the #15 file 4mm short of working length and repeat the above.
5. Move the #15 file 5mm short of working length and repeat the above.

Did you obtain a smooth, reproducible glide path?

NO  then finish the apical one-third by hand filing.


See p.15 for details on finishing with ‘ProTaper Universal for hand use’.

YES  then it is safe to finish the apical one-third with ProTaper.

Let’s assume that we have a smooth, reproducible glide path and, therefore, will
complete the preparation with ProTaper.
• We commence with the S1 file (and NOT ProTaper finishing files).
• Check correct torque setting on motor.
• Remember all ProTaper shaping files can be used with a 'brushing' motion.
S1 will now be taken to full working length
(figure 24). When the S1 will not achieve length,
passively remove the instrument, clean its cutting
blades and irrigate, recapitulate and re-irrigate.
Appreciate that depending on the degree of
apical curvature, it may require one, two or three
passes to safely move the S1 to length. Once you
have reached working length with the S1, do
NOT go back into the canal with this instrument.
figure 24

13
Preparation Sequence
4. Finish Apical 1/3rd (continued)
• Set the motor at the correct torque for S2
The ProTaper S2 (figure 25) with the white
identification ring on its handle is designed to
perform its own crown-down work.
It carries another wave of shaping deeper into the
canal and will typically move easily to the desired
working length on the first pass. Do NOT go back
figure 25
in to the canal with this instrument once working
length has been achieved. Irrigate, recapitulate and re-irrigate.
The first ProTaper finishing file selected is the
F1 (#20/.07) with the yellow identification ring
(figure 26).
• Set the motor at the correct torque for F1
The F1 is designed to smoothly blend the deep,
apical 1/3rd shape into the middle 1/3rd of the
canal. Before using the F1 it is wise to reconfirm
working length, as a more direct path to the
figure 26
terminus has been created. The finishing files are
used passively with short penetrating strokes until length is achieved. When the F1
achieves working length, then it is withdrawn as
the shape is cut. Do NOT go back in to the canal
with this instrument. Irrigate, recapitulate and re-
irrigate.
• Following the use of the F1 (#20/.07) to length,
the foramen is gauged using a #20 handfile
(figure 27). If the #20 handfile is snug at length,
gently tap the handle of the file. If it remains in
position, the canal is fully shaped and ready
to obturate. A #20/.07 F1 ProTaper to length figure 27
is consistent with our cleaning and shaping
objectives in that it has kept the foramen size as small as practical. If using lateral
condensation, use the F1 GP for ProTaper. If using a ProTaper Obturator, use size
F1.
• If the #20 handfile is loose at length, then gauge the size of the foramen with a
#25 handfile. If the #25 handfile is snug at length, then the canal is fully shaped
and ready to pack.

14
Preparation Sequence
The following procedures are only necessary if the
#25 handfile as previously described was short of
length. The next ProTaper finishing file selected is
the F2 (#25/.08) with the red identification ring
(figure 28).
• Set the motor at the correct torque for F2
The F2 is used passively and when length is
achieved, it is withdrawn. Following the use of the
F2 to length, the foramen is gauged using a #25 figure 28
handfile. If the #25 is snug at length and tapping
the handle does not move the file beyond the foramen, the canal is fully shaped and
ready to obturate. If the #25 is loose at length, then gauge with the #30 handfile. If
the #30 handfile is snug at length, then the canal is fully shaped and ready to pack.
If the #30 handfile is short of length, then proceed to F3.
• Set the motor at the correct torque for F3
F3 (#30/.09) has the blue identification ring
(figure 29). The F3 is used passively and, in more
curved canals, just short of length as the previous
rotary files have created a more direct path to the
terminus. Following the use of the F3, the foramen
is gauged using a #30 handfile. If the #30 is
snug at length (do ‘tapping test’), the canal is fully
shaped and ready to obturate. figure 29
If the #30 handfile is loose at length, then proceed
to F4 and F5 as necessary to easily complete these more open and straightforward
cases. Also in short canals or large straight canals, after initial negotiation ('scouting')
use the SX in a circumferential mode. It is not necessary to use the S1 or S2 in
these cases. Instead, after confirming working length, proceed to gauge the foramen
diameter. Then use the appropriate ProTaper Finishing file to prepare the apical
terminus.

Finishing the preparation with ProTaper Universal for


hand use
ProTaper Universal for hand use, with silicone handles, has the same design as its
rotary equivalent. The deep shape produced ensures superior root canal preparations
than those obtained using conventional stainless steel files (figure 30).
The sequence is identical to that used when using rotary ProTaper
Universal files.
15
As mentioned previously, sometimes it is not
possible to obtain a glide path in the apical
third of the preparation (e.g. complex root
canal anatomies). In these cases hand filing
is recommended over rotary to complete the
preparation. ProTaper for hand use gives superior
control, predictability and quality than currently
available stainless steel files. ProTaper Universal
for hand use can be used either in a modified
balance force technique or in a reaming (back figure 30
and forth) motion.

Obturation
Now that we are more frequently finishing our
apical preparations with larger tapers we need
to review how we obturate these canals more
efficiently. We need to be more aware of tip sizes
and apical tapers of the finishing files we are
using.
Let us first look at Lateral Condensation having
prepared a canal with ProTaper NiTi rotary files.
If, for instance, our last ProTaper to length was the figure 31
F1 (remember it has an ISO tip size of 20 and 7%
apical taper) then don’t waste your time trying
conventional 2% GP cones as your master points.
Instead use a GP point for ProTaper F1 which will
give a snug fit to length. Minimal accessory GP
points will now be needed. In fact, single cone
obturation may be sufficient (figure 31).
The use of warm obturation techniques has
become popular in recent years. Materials such
as Thermafil result in ideal 3-D fills, thanks to the
excellent shapes produced by NiTi rotary files like
ProTaper Universal. Continuing the tradition of
Thermafil, the colour-coded ProTaper obturators
correspond to the matching ProTaper Universal
finishing files (figure 32).

figure 32

16
Retreatment
Retreatment of endodontically filled teeth is now a relatively common occurrence.
However, the techniques to carry out this procedure are limited, and often time-
consuming.
The ProTaper Universal range now includes a series
of RETREATMENT files. As they are ProTapers, they
are Nickel Titanium rotary files with variable tapers.
There are three ProTaper Universal Retreatment
files, all with silver handles for identification as
Retreatment files within the ProTaper Universal
endodontic treatment system. The Retreatment files
are designated D1 (one white ring), D2 (two white figure 33
rings) and D3 (three white rings) (figure 33).
In general, D1 is for the coronal third, D2 for the middle third and D3 for the apical
third. These files have short 11mm handles for improved visibility and access. When
removing Gutta Percha (and carrier-based Gutta Percha) the speed of the torque-
controlled motor needs to be increased to 500-700 r.p.m. There is no need for using
solvents when removing Gutta Percha with this technique.
The D1 is only 16mm in length and it has a cutting tip as it is only used in the straight
portion of the canal. The initial apical taper is 9% and it has a #30 tip size. D1 has
the same torque setting as the F3.
The D2 is 18mm in length, has a size #25 non-cutting tip with an initial apical taper
of 8%. D2 has the same torque setting as the F2.
The D3 is 22mm in length and also has a non-cutting tip which is size #20. D3 has
an initial apical taper of 7% and uses the same torque setting as the F1.

17
18
PACK PACK
CODE NUMBER DESCRIPTION SIZE
CODE NUMBER DESCRIPTION SIZE

ROTARY FILES A041123110200 ProTaper Uni F2 31mm 6


A040922190100 ProTaper Uni SX-F3 Ass 21mm 6 A041123110300 ProTaper Uni F3 31mm 6
A040922590100 ProTaper Uni SX-F3 Ass 25mm 6 A041123110400 ProTaper Uni F4 31mm 6
A040923190100 ProTaper Uni SX-F3 Ass 31mm 6 A041123110500 ProTaper Uni F5 31mm 6
A041021910100 ProTaper Uni SX 19mm 6 A141021600100 ProTaper Uni Retreatment D1 6
A041022110100 ProTaper Uni S1 21mm 6 A141021800100 ProTaper Uni Retreatment D2 6
A041022110200 ProTaper Uni S2 21mm 6 A141022200100 ProTaper Uni Retreatment D3 6
A041022510100 ProTaper Uni S1 25mm 6 A141220090000 ProTaper Uni Retreatment Asst. 6
A041022510200 ProTaper Uni S2 25mm 6 HAND FILES
A041023110100 ProTaper Uni S1 31mm 6 A041802190100 ProTaper Uni FHU Asst. 21mm 6
A041023110200 ProTaper Uni S2 31mm 6 A041802590100 ProTaper Uni FHU Asst. 25mm 6
A041122110100 ProTaper Uni F1 21mm 6 A041803190100 ProTaper Uni FHU Asst. 31mm 6
Ordering Information

A041122110200 ProTaper Uni F2 21mm 6 A041601910100 ProTaper Uni FHU SX 19mm 6


A041122110300 ProTaper Uni F3 21mm 6 A041602110100 ProTaper Uni FHU S1 21mm 6
A041122110400 ProTaper Uni F4 21mm 6 A041602110200 ProTaper Uni FHU S2 21mm 6
A041122110500 ProTaper Uni F5 21mm 6 A041602510100 ProTaper Uni FHU S1 25mm 6
A041122510100 ProTaper Uni F1 25mm 6 A041602510200 ProTaper Uni FHU S2 25mm 6
A041122510200 ProTaper Uni F2 25mm 6 A041603110100 ProTaper Uni FHU S1 31mm 6
A041122510300 ProTaper Uni F3 25mm 6 A041603110200 ProTaper Uni FHU S2 31mm 6
A041122510400 ProTaper Uni F4 25mm 6 A041702110100 ProTaper Uni FHU F1 21mm 6
A041122510500 ProTaper Uni F5 25mm 6 A041702110200 ProTaper Uni FHU F2 21mm 6
A041123110100 ProTaper Uni F1 31mm 6 A041702110300 ProTaper Uni FHU F3 21mm 6
PACK PACK
CODE NUMBER DESCRIPTION SIZE
CODE NUMBER DESCRIPTION SIZE

HAND FILES (continued) GP POINTS


A041702110400 ProTaper Uni FHU F4 21mm 6 A022X00010100 GP Points ProTaper Uni F1 60
A041702110500 ProTaper Uni FHU F5 21mm 6 A022X00010200 GP Points ProTaper Uni F2 60
A041702510100 ProTaper Uni FHU F1 25mm 6 A022X00010300 GP Points ProTaper Uni F3 60
A041702510200 ProTaper Uni FHU F2 25mm 6 A022X00090100 GP Points ProTaper Uni F1-F3 60
A041702510300 ProTaper Uni FHU F3 25mm 6 A022X00090200 GP Points ProTaper Uni F4-F5 60
A041702510400 ProTaper Uni FHU F4 25mm 6 OBTURATORS
A041702510500 ProTaper Uni FHU F5 25mm 6 A141100010100 ProTaper Obturator F1 6
A041703110100 ProTaper Uni FHU F1 31mm 6 A141100010200 ProTaper Obturator F2 6
A041703110200 ProTaper Uni FHU F2 31mm 6 A141100010300 ProTaper Obturator F3 6
A041703110300 ProTaper Uni FHU F3 31mm 6 A141100010400 ProTaper Obturator F4 6
A041703110400 ProTaper Uni FHU F4 31mm 6 A141100010500 ProTaper Obturator F5 6
Ordering Information

A041703110500 ProTaper Uni FHU F5 31mm 6 A141100011100 ProTaper Obturator F1 20


SEQUENCERS A141100011200 ProTaper Obturator F2 20
A041300000300 ProTaper Sequencer Treatment 1 A141100011300 ProTaper Obturator F3 20
A041300000400 ProTaper Sequencer Retreatment 1 A141100011400 ProTaper Obturator F4 20
PAPER POINTS A141100011500 ProTaper Obturator F5 20
A022W00010100 Paper Points ProTaper Uni F1 180 STARTER KITS
A022W00010200 Paper Points ProTaper Uni F2 180 A041522190100 ProTaper Starter Kit T 21mm 6
A022W00010300 Paper Points ProTaper Uni F3 180 A041522590100 ProTaper Starter Kit T 25mm 6
A022W00090100 Paper Points ProTaper Uni F1-3 180 A041523190100 ProTaper Starter Kit T 31mm 6

19
A022W00090200 Paper Points ProTaper Uni F4-5 180 A141500090000 ProTaper Uni Retreat Starter Kit 6
CLINICAL
HINTS

DENTSPLY (Australia) Pty Ltd ABN 15 004 290 322 DENTSPLY New Zealand
11–21 Gilby Road Mt Waverley VIC 3149 16 Morgan Street, Newmarket, Auckland,1023
Tel: 1300 55 29 29 • Fax: 1300 55 31 31 Tel: 0800 DENTSPLY (33 68 77)
[email protected] • www.dentsply.com.au Fax: 0800 DENTFAX (33 68 32)
Email: [email protected]
Website: www.dentsply.co.nz

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