The HyFlex CM Rotary NiTi File technique For best results, a new file should be used for each

procedure. The number of times the instruments can be re-used

depends on the treatment and procedure. Instruments must be inspected before and after use. Hyflex CM files may respond to pressure, torque, and resistance with a lengthening of the spirals, which allows the file to avoid binding to the walls and therefore increases fracture resistance. During autoclaving, the instruments can regain their shape (Figures 3A-3D). However, care must be taken if the instruments start to rewind in the opposite direction during use because the files will not regain their shape and should be discarded. If after autoclaving, a file has multiple spirals that appear lengthened, or the file appears to not be functional, the file should be discarded. The following are general recommendations for the instrumentation process: Sterilize files prior to use. See sterilization instructions below Use of a slow-speed handpiece is required. Operate the handpiece at 500 rpm. Recommended torque setting is up to 2.5 Ncm (25 mNm) Irrigate/lubricate the canal frequently when using the files Clean file flutes after each insertion into the root canal Recapitulate between each step with the patency file An advantage of HyFlex CM files is that they can be used with multiple techniques (crown-down, step-back) or with the single-length technique proposed by the manufacturer (Figure 4). Figures 5 and 6 show the handle characteristics, ISO color sequence, taper, flute design, and cross sections of the rotary instrument. Sterilization instructions Remove files from the packaging prior to sterilization. Note that due to the unique features of the alloy, the files may be slightly bent as a result of the packaging process. This can be gently corrected by hand. Place the devices in a file block, support, or container to avoid any contact between instruments. If the disinfecting solution contains a corrosion inhibitor, it is recommended to rinse the instruments just before autoclaving. Put the file kit in a sterilizable wrap or container. Steam sterilization at 134C/273F for 6 minutes; for prion inactivation, 18 minutes is recommended. Keep devices in the sterilization packaging stored in a dry, clean environment. Step-by-step single-length technique instructions Figures 7-9 show the disposition of the instruments from left to right and a method of placing them together with the K-files in a sponge during clinical use.

Coronal patency After gaining straight-line coronal access, assess working length (WL) with an electronic apex locator and create an apical glide path to a K file 02/20 hand file size (Figure 10).

After use Immediately after use, soak all instruments in a detergent and disinfecting solution combined with a proteolytic enzyme, if possible If debris is left on the file, use a soft toothbrush for cleaning Note the Sterilization Instructions