Cleaning and Shaping of

Cleaning and Shaping of

the Root Canal System
the Root Canal System
Edit by Hou Tiezhou
Edit by Hou Tiezhou
02988088507
02988088507

Objectives of Canal Preparation
Objectives of Canal Preparation
Start with the end in mind
Start with the end in mind

Objectives of root canal preparation
Objectives of root canal preparation
The root canal system must be:
The root canal system must be:

Cleaned
Cleaned
of its oranic remnants
of its oranic remnants

Shaped
Shaped
to recei!e a three
to recei!e a three
dimensional fillin of the entire root
dimensional fillin of the entire root
canal s"ace
canal s"ace

Objectives of root canal preparation
Objectives of root canal preparation
The canal is
The canal is

#leansed "rimarily by irriation

#leansed "rimarily by irriation

Sha"ed "rimarily by instrumentation

Sha"ed "rimarily by instrumentation


Cleansing of the root canal
Cleansing of the root canal
$b%ecti!es
$b%ecti!es

&emo!al of oranic debris

&emo!al of oranic debris

Elimination of bacteria
Elimination of bacteria

Irrigation
Irrigation
'n ideal irriant:
'n ideal irriant:

(s nonto)ic
(s nonto)ic

*issol!es !ital and necrotic tissue

*issol!es !ital and necrotic tissue

(s bactericidal
(s bactericidal

+ubricates the canal

+ubricates the canal

&emo!es the smear layer

&emo!es the smear layer

Sodium hypochlorite
Sodium hypochlorite

*issol!es !ital and necrotic

*issol!es !ital and necrotic
tissue
tissue

(s bactericidal
(s bactericidal

+ubricates the canal

+ubricates the canal

Sodium Hypochlorite
Sodium Hypochlorite
Cannot be considered
non-toxic!!!

Prolube
Prolube
EDTA and carbamide
peroxide in a water soluble
base

Prolube
Prolube

,acilitates "lacement of file

,acilitates "lacement of file

Entra"s debris
Entra"s debris

'ids in remo!al of the smear

'ids in remo!al of the smear
layer
layer

ED!
ED!

#helatin aent
#helatin aent

Effecti!ely remo!es smear layer

Effecti!ely remo!es smear layer

Shaping of the root canal
Shaping of the root canal

#anal sha"e - "roduced by

#anal sha"e - "roduced by
instrumentation
instrumentation

$b%ecti!e is a smooth ta"ered

$b%ecti!e is a smooth ta"ered
"re"aration
"re"aration

Shaping of the root canal
Shaping of the root canal

Instruments
Instruments
(nstruments differ accordin to:
(nstruments differ accordin to:

.etal
.etal

Ta"er
Ta"er

Ti" desin
Ti" desin

#ross sectional eometry

#ross sectional eometry

+enth of cuttin blades

+enth of cuttin blades

Sizin
Sizin

"etals
"etals
Nickel titanium
Nickel titanium
Stainless steel
Stainless steel
E)cellen fle)ibility
E)cellen fle)ibility
+ess fle)ible
+ess fle)ible
#onforms to canal
#onforms to canal
Straihtens and
Straihtens and
cur!ature
cur!ature
trans"orts canal
trans"orts canal
/lastic deformation
/lastic deformation
/ermanent
/ermanent
deformation
deformation

"etals
"etals
Stainless steel fles demonstrate permanent
deformation

"etals
"etals
Nickel titanium fles demonstrate plastic
deformation

aper
aper
*efinition
*efinition
(ncrease in diameter "er unit lenth
(ncrease in diameter "er unit lenth

#hat is aper$
#hat is aper$
0.32 mm diameter increase
D! D
0."! mm diameter
increase
D!
D

#hat is taper$
#hat is taper$

aper
aper
Ta"er of instruments in 0 of . file 1it
Ta"er of instruments in 0 of . file 1it

Stainless steel files - 0202 ta"er

Stainless steel files - 0202 ta"er

$S - !ariable ta"ers ranin from 0205 to

$S - !ariable ta"ers ranin from 0205 to
0208
0208

Series 29 rotary /rofiles - 0203 ta"er

Series 29 rotary /rofiles - 0203 ta"er

4iTi hand files - 0205 ta"er

4iTi hand files - 0205 ta"er

ip Design
ip Design

4on6cuttin ti"
4on6cuttin ti"

7ullet nose 830 deree9 ti"

7ullet nose 830 deree9 ti"

Smooth transition anle where ti"

Smooth transition anle where ti"
meets flat radial lands
meets flat radial lands

ip Design
ip Design

*esined to follow a "ilot hole

*esined to follow a "ilot hole

:uides instrument throuh canal

:uides instrument throuh canal
durin "re"aration
durin "re"aration

ip Design
ip Design

Cross%sectional geometry
Cross%sectional geometry

Three radial lands

Three radial lands

Each contains bidirectional cuttin

Each contains bidirectional cuttin
edes
edes

;ee" instrument centered in the

;ee" instrument centered in the
canal
canal

#uttin edes scra"e dentin

#uttin edes scra"e dentin

Cross sectional geometry
Cross sectional geometry

Cross sectional geometry
Cross sectional geometry
& & Not Not
Self Self- -Threading Threading
& & Gentle Planing Gentle Planing
Action Action

Cross sectional geometry
Cross sectional geometry

&adial lands se"arated by three u6

&adial lands se"arated by three u6
sha"ed flutes
sha"ed flutes

/ro!ide s"ace for accumulation of

/ro!ide s"ace for accumulation of
debris
debris

.o!es debris out of canal

.o!es debris out of canal

'ength of cutting blade
'ength of cutting blade

Traditionally <3 mm
Traditionally <3 mm

$rifice sha"ers - <0 mm

$rifice sha"ers - <0 mm

Si(ing of instruments
Si(ing of instruments
(S$ sizes
(S$ sizes

4umber refers to ti" diameter in

4umber refers to ti" diameter in
tenths of mm
tenths of mm

The ti" diameter increases by 0205

The ti" diameter increases by 0205
mm from sizes <0 to 30= then by
mm from sizes <0 to 30= then by
02<0 mm
02<0 mm

Si(ing of instruments
Si(ing of instruments

> increase in diameter from ?<0

> increase in diameter from ?<0
to ?<5 file is 50>
to ?<5 file is 50>

*ifference between ?55 and ?30

*ifference between ?55 and ?30
is only 9>
is only 9>

Si(ing of instruments
Si(ing of instruments
Series 29
Series 29

/roressi!e 29> increase in ti"

/roressi!e 29> increase in ti"
diameter
diameter

(nstruments are better s"aced

(nstruments are better s"aced

.ore instruments in smaller sizes

.ore instruments in smaller sizes
and fewer lare instruments
and fewer lare instruments

Cro)n Do)n echni*ue
Cro)n Do)n echni*ue

The coronal "ortion is "re"ared

The coronal "ortion is "re"ared
before the a"ical "ortion
before the a"ical "ortion

,ollows medical "rinci"le of

,ollows medical "rinci"le of
cleansin before "robin a wound
cleansin before "robin a wound

Cro)n Do)n echni*ue
Cro)n Do)n echni*ue

Cro)n Do)n echni*ue
Cro)n Do)n echni*ue

Eliminates constrictions in the

Eliminates constrictions in the
coronal reion
coronal reion

&educes effect of canal cur!ature

&educes effect of canal cur!ature

(m"ro!es tactile awareness durin

(m"ro!es tactile awareness durin
a"ical "re"aration
a"ical "re"aration

Cro)n Do)n echni*ue
Cro)n Do)n echni*ue

'llows more effecti!e irriation

'llows more effecti!e irriation

&emo!es ma%ority of tissue and

&emo!es ma%ority of tissue and
microbes before a"ical third is
microbes before a"ical third is
a""roached
a""roached

&educes chane in wor1in lenth

&educes chane in wor1in lenth
durin a"ical "re"aration
durin a"ical "re"aration

Cro)n Do)n echni*ue
Cro)n Do)n echni*ue

#oronal third
#oronal third
$rifice sha"ers
$rifice sha"ers

.iddle third
.iddle third
0203 ta"er rotary /rofiles
0203 ta"er rotary /rofiles

'"ical third
'"ical third
0205 ta"er hand /rofiles
0205 ta"er hand /rofiles

Clinical Procedure
Clinical Procedure

Estimate wor1in lenth

Estimate wor1in lenth

/arallel radiora"h
/arallel radiora"h

Estimated wor1in lenth is the distance

Estimated wor1in lenth is the distance
from the reference "oint to the
from the reference "oint to the
radiora"hic a"e)
radiora"hic a"e)

Parallel Radiograph
Parallel Radiograph

Clinical Procedure
Clinical Procedure

Establish straiht line access to

Establish straiht line access to
a"ical third
a"ical third

Clinical Procedure
Clinical Procedure
E)"lore canal "atency
E)"lore canal "atency

Ensure that canal is neotiable to

Ensure that canal is neotiable to
radiora"hic a"e)
radiora"hic a"e)

Small file - ?<0 ;6file

Small file - ?<0 ;6file

.ay need to "recur!e these SS files

.ay need to "recur!e these SS files

Clinical Procedure
Clinical Procedure

,iles used in a "ush@"ull or

,iles used in a "ush@"ull or
Auarter turn "ull motion
Auarter turn "ull motion

Never rotate these files

Never rotate these files
through 360 degrees
through 360 degrees

Clinical Procedure
Clinical Procedure

Clinical Procedure
Clinical Procedure

Clinical Procedure
Clinical Procedure
Estimate canal size
Estimate canal size

&adiora"hic a""earance
&adiora"hic a""earance

#rown@root mor"holoy
#rown@root mor"holoy

Standardized tables
Standardized tables

Estimation of canal si(e
Estimation of canal si(e

Estimation of canal si(e
Estimation of canal si(e
See Table in
manual

Clinical Procedure
Clinical Procedure
'ctual B+ determination
'ctual B+ determination
/re"aration should terminate at
/re"aration should terminate at

'"ical constriction
'"ical constriction

< mm short of radiora"hic a"e)

< mm short of radiora"hic a"e)

Clinical echni*ue
Clinical echni*ue
'ctual B+ determination
'ctual B+ determination

&adiora"h
&adiora"h

'"e) locator
'"e) locator

Clinical Procedure
Clinical Procedure
Actual #orkin$ %en$t&
Determination

Clinical Procedure
Clinical Procedure

Clinical Procedure
Clinical Procedure
'"e) +ocator
'"e) +ocator

Clinical Procedure
Clinical Procedure
Crown down cleaning and shaping of canals
Crown down cleaning and shaping of canals

Clinical Procedure
Clinical Procedure
This techniAue a""lies only to teeth
This techniAue a""lies only to teeth
ranin from <8 - 2C mm in lenth
ranin from <8 - 2C mm in lenth

#oronal third measurement is B+ minus 8

#oronal third measurement is B+ minus 8
mm
mm

.iddle third measurement is B+ minus 5

.iddle third measurement is B+ minus 5
mm
mm

'"ical third measurement is B+

'"ical third measurement is B+


Preparation of the coronal third
Preparation of the coronal third

#oronal third measurement is wor1in lenth minus

#oronal third measurement is wor1in lenth minus
8 mm
8 mm

/re"ared usin /rofile orifice sha"ers

/re"ared usin /rofile orifice sha"ers

Preparation of the coronal third
Preparation of the coronal third

/rofile orifice sha"ers

/rofile orifice sha"ers

(n seAuence larer to smaller

(n seAuence larer to smaller

Preparation of coronal third
Preparation of coronal third

.easure B+ minus 8 mm on larest $S

.easure B+ minus 8 mm on larest $S

+ubricate the canal with /rolube

+ubricate the canal with /rolube

Preparation of coronal third
Preparation of coronal third

&otate $S at C00 r"m

&otate $S at C00 r"m
Note: Orifice shaper should be rotating at
Note: Orifice shaper should be rotating at
300 rpm before it is placed in the canal
300 rpm before it is placed in the canal

'd!ance the $S in < mm increments

'd!ance the $S in < mm increments

Bhen resistance is encountered retract

Bhen resistance is encountered retract
$S while still rotatin
$S while still rotatin

4e!er force any instrument a"ically

4e!er force any instrument a"ically

Preparation of the coronal third
Preparation of the coronal third

This $S will not e)tend to B+ minus 8 mm

This $S will not e)tend to B+ minus 8 mm

(rriate co"iously
(rriate co"iously

Irrigation
Irrigation

Preparation of coronal third
Preparation of coronal third

.o!e to ne)t smallest $S

.o!e to ne)t smallest $S
This will extend further than previous instrument
This will extend further than previous instrument

&e"eat the ste"s described for larest $S

&e"eat the ste"s described for larest $S

.o!e to ne)t smallest $S

.o!e to ne)t smallest $S

#ontinue this seAuence until wor1in lenth

#ontinue this seAuence until wor1in lenth
minus 8 mm is reached
minus 8 mm is reached

Preparation of coronal third
Preparation of coronal third

&eturn to larest $S
&eturn to larest $S

This will now e)tend further into

This will now e)tend further into
the canal than it did "re!iously
the canal than it did "re!iously

&e"eat this seAuence until this

&e"eat this seAuence until this
8the larest9 $S reaches B+
8the larest9 $S reaches B+
minus 8 mm
minus 8 mm

Preparation of the coronal third
Preparation of the coronal third

4e!er force any instrument a"ically

4e!er force any instrument a"ically

(rriate after e!ery instrument

(rriate after e!ery instrument

0se co"ious amounts of /rolube

0se co"ious amounts of /rolube

Preparation of coronal third
Preparation of coronal third

Preparation of middle third
Preparation of middle third

.iddle third measurement is B+

.iddle third measurement is B+
minus 5 mm
minus 5 mm

/re"ared usin 0203 ta"er Series

/re"ared usin 0203 ta"er Series
29 rotary /rofiles in seAuence
29 rotary /rofiles in seAuence
larer to smaller
larer to smaller

Preparation of middle third
Preparation of middle third
'repared wit& 0.0! Series 2" NiTi rotar(
'rofles

Preparation of middle third
Preparation of middle third

.easure wor1in lenth minus 5 mm

.easure wor1in lenth minus 5 mm
on the larest 0203 ta"er series 29
on the larest 0203 ta"er series 29
rotary file
rotary file

Set reen rubber sto" at that lenth

Set reen rubber sto" at that lenth

+ubricate the canal with /rolube

+ubricate the canal with /rolube

Preparation of middle third
Preparation of middle third

&otate at C00 r"m

&otate at C00 r"m
File must be rotating at 300 rpm before it
File must be rotating at 300 rpm before it
is placed in canal
is placed in canal

'd!ance file in < mm increments

'd!ance file in < mm increments

Bhen resistance is encountered

Bhen resistance is encountered
retract file while still rotatin
retract file while still rotatin

#o"ious irriation with 4a$#l

#o"ious irriation with 4a$#l

Preparation of middle third
Preparation of middle third

Preparation of the apical third
Preparation of the apical third

/re"are to actual wor1in lenth

/re"are to actual wor1in lenth

0se 0205 ta"er 4iTi hand files in

0se 0205 ta"er 4iTi hand files in
seAuence smaller to larer
seAuence smaller to larer

Preparation of apical third
Preparation of apical third

Preparation of apical third
Preparation of apical third

.easure wor1in lenth on ?<5 file

.easure wor1in lenth on ?<5 file

Set rubber sto" at that lenth

Set rubber sto" at that lenth

+ubricate the canal with /rolube

+ubricate the canal with /rolube

Preparation of apical third
Preparation of apical third

'd!ance size <5 file to wor1in

'd!ance size <5 file to wor1in
lenth
lenth

&otate file throuh C30 derees

&otate file throuh C30 derees

(rriate co"iously with 4a$#l

(rriate co"iously with 4a$#l
after each file
after each file

Preparation of the apical third
Preparation of the apical third

'd!ance size 20 file to wor1in

'd!ance size 20 file to wor1in
lenth
lenth

#ontinue throuh seAuence=

#ontinue throuh seAuence=
seatin each file to wor1in lenth
seatin each file to wor1in lenth

Preparation of apical third
Preparation of apical third

The larest file that e)tends to wor1in

The larest file that e)tends to wor1in
lenth is the .aster '"ical file 8.',9
lenth is the .aster '"ical file 8.',9

,or lare canals - minimum .', ?50 6 50

,or lare canals - minimum .', ?50 6 50

,or small canals - minimum .', ?C5 6 50

,or small canals - minimum .', ?C5 6 50

"aster !pical +ile
"aster !pical +ile

Ta1e a radiora"h with .', in "lace2

Ta1e a radiora"h with .', in "lace2
This confirms:
This confirms:
D
+enth
+enth
D
/lacement
/lacement

"ission accomplished
"ission accomplished
Smooth ta"ered "re"aration
Smooth ta"ered "re"aration