RECENT ADVANCES IN ENDODONTIC INSTRUMENTS

Introduction
Endodontic treatment is based on the principles of Debridement,
Sterilization and obturation of the root canal system.
Careful cavity preparation, can preparation and canal obturation are
the keystones to successful root canal therapy which are dependent
on complete removal of
!ulp tissues
!ulp remnants
"acteria
"acterial components from pulp space.
#he factors which defect these are
#ype of instrument used
$aterial
#echni%ues
&perators skill
'istory(
"efore )*+,, endodontic instruments were manufactured without
benefit of any established criteria. #here was little uniformity in
%uality control of manufacturer.
Earlier for the manufacturer of root canal instruments, the primary
forms was mainly on - materials
). Carbon Steel.
-. Stainless steel.
Carbon Steel instrument was usually produced by .rindin.
.raduated sizes of round piano wire into s%uare or trian.ular
confi.uration. It was a very hard material.
Stainless steel instrument was resilient and ductile than carbon steel.
#hese wires are .round alon. its lon. a/is into a 0 sided 1s%uare
cross section2 or 3 sided 1#rian.ular cross section2 tapered shaft that
is twisted into each blade of a similar sized instrument determines
whether that instrument is a reamer havin. less flutes or a file havin.
more flutes. #he cuttin. efficiency of these material is more as
compared to other materials. "ut it also has limitations like distorts
faster, 4ractures, problems with precurvin. in hi.hly curved canals.
Due to these drawbacks or limitations #itanium was introduced.
#itanium is a fle/ible material with favourable properties for an ideal
instrument desi.n.
#itanium alon. with 5ickel forms a still better material than others.
#itanium with 4luminium is also introduced which I would be
discussin. later in recent advances.
Classification of Instruments
I. 6ll to 7rossman
a2 E/plorin. instruments
i. e. to locate the canal orifice and determine its patency.
Endodontic e/plorers
Smooth broaches
b2 Debridin. instruments
i. e. intirpate the pulp and remove any forei.n debris.
"arbed broaches
c2 Shapin. instruments
i. e. the shape the root canal laterally and apically.
8eamers
4iles
d2 &bturatin. instruments
i. e. to cement and park .uttapercha into the root canal
Spreaders
!lu..ers
9entuth spirals
6:#&$6#ED 8&&# C6569 !8E!686#I&5 DE;ICES
If used in collaboration with hand instruments most of the devices
can same as useful ad<ustments in root canal preparation. Dan.er
zones, apical preparation and narrow curved canals are difficult to be
treated by en.ine driven root canal instruments.
6dvanta.es
It is easy to use.
Saves time.
Ideal preparation of 8C
8eduction in fati.ue 1overall strain becomes less and fati.ue is
led2.
8eduction is treatment time which depends on the tooth to be
treated to be treated and e/pertise of clinicians.
9imitations(
#hey can be used only after manual early phase of treatment
carried out.
#hese can be used only after the completion of preparation of
canals usin. IS& size no. )+.
#here is lack of tactile sensation.
#hey can be .enerally classified as
)2 8eciprocal
-2 8otary
32 :ltrasonic
02 Sonics.
IS& 7roups II and III(
En.ine driven instruments can be used in 3 types of contran.led
handpieces(
4ull rotary 1latch = friction .rip2
8eciprocal %uarter turn.
Special handpiece that imparts a vertical stroke but with an
added reciprocatin. %uarter turn that cuts in when the
instruments is stressed.
6u to Stock(
#hey can be classified au to the type of movement imported to
the cuttin. instrument.
8otary
8eciprocal
;ertical
8andom.
I. 8&#68>
Instrumentation with a full rotary handpiece is by strai.ht line
drillin. or side cuttin..
:ses(
)2 #o develop coronal access to canal orifice do not bend.
-2 #o wider as much as -=3
r d
or canals.
32 #o prepare post channels for final restorations.
6s these instruments do not bend they should be used in slow
speed handpieces.
E/ample(
$edidenta .ear reduction handpiece
Sensomatic handpiece.
?here, the tor%ue is controlled and speed is reduced to as much as
)@ 8$!.
#he most popular en.ine driven instruments are(
7ates 7lidden
8eso reamers
5itimac
&rifice opener
Canal master :
$cSpadden En.ine file
7ates 7lidden Drills(
$ade of hardened carbon steel.
It has a lon., thin shaft endin. in a flame shaped head with a
safe tip to .uard a.ainst perforations
:ses(
4or initial openin. of canal orifice.
4or deepest penetration in both strai.ht and curved
canals.
#o remove the lin.ual shoulder in anterior teeth.
#he flame shaped head cuts laterally and is used with .entle,
apically directed pressure.
#hey are infle/ible therefore the instrument was desi.ned to
have a weak spot in the part of the shaft closest to the
handpiece, so that if the instrument separates the separated part
can be easily removed.
#hey come in sizes )A which are IS& standard.
77D @. +, @. B, @. *, ). )@C ). 3@, ). +@
Diain mm ) - 3 0 + A
!eeso 8eamers(
$ade of hardened carbon steel.
#hese have lon. sharp flutes.
#hese are also flame shaped.
Sharper cuttin. ed.e, cuts laterally.
$ore efficient.
:ses(
)2 :sed in preparin. coronal part of root canal for post and core.
-2 #o remove .uttapercha.
Sizes )A
Diameters in mm @. B, @. *, ). )@, ). 3@, ). +@, ). B@
) - 3 0 + A
Disadvanta.e(
#hese instruments corrode easily.
Infle/ible.
$cSpadden En.ine 4ile(
Desi.ned to be used in rotary instrument.
5i#i$6C a new .ear reduction handpiece 15# company
:S62 is used which runs at 3@@rpm.
6lso Sensomatic 'andpiece can be used.
- different types of 5i#i files have been desi.ned.
Sensory files 5i#i/l files
8edesi.ned 'type instrument :type confi.uration made
from 5i#i.
5ow called 5#power
files.
6re the finishin. files.
6dvanta.es
4le/ible
8esistance to fracture
#hese files are manufactured with a affective tip that facilitates
ne.otiatin. around curvatures and led.es.
&rifice &pener(
$artin has developed an orifice opener used to flare and
prepare the cervical and middle portions of the canal.
:sed in slow speed latch type handpiece.
Comes in sizes -+B@.
#his $ series of openers are more fle/ible than 77D.
Canal $aster System
Introduced by ?idley and Senia.
6s discussed before in hand instruments these are Dstyle
modifications with a en.ine driven system.
#hese are same with a latch type to be used in en.ine.
II. 8ECI!8&C69
#his uses a special handpiece which contrarotates the
instrument, throu.h *@E 3@@@ times = min 1%uarterturn
motion2.
#hese were introduced in ),** by 8ollins.
#hese may be classified dependin. on the direction of
movement that they import.

8otary ;ertical 1!ushpull2
7iromatic
Derr $0
Endo cursor
Canal finder system
Intra endo 39DS;
Endolift
7iromatic(
Introduced in )*A0
6 variety of canal instruments can be used with the 7iromatic.
7iro pointer 1orifice opener )Amm2
7iro broach
7iro file 1'file confi.uration2
7iro reamer
'eli.irofile 13 cuttin. blades in CS2
6u to ?eine(
7iromatic produced wider apical deviations 1zip2 in canals with sharp
apical curvature.
9ater instruments like F#riocutG were desi.ned for 7iromatic.
Kerr M4
It is so named because it utilizes 0() .ear reduction handpiece.
It imparts a reciprocal watchwindin. 3@E motion to the endo
instrument.
:sed at )+@@ rpm.
Safely 'files are used with this handpiece.
Disadvanta.es
)2 Causes fre%uent breaka.e of instrument.
-2 Creates hour.lass preparation, led.es zips, and strip
perforations.
Canal 4inder System
It was developed in 4rance.
It is a specialized handpiece with a vertical movement of @. 3 to
)mm H a free rotation a movement 1)=0 turn2
If there is no resistance in the canal the instrument
moves upto )mm.
In cases of minimal resistance it moves @. 3mm.
In severe resistance it stops.
Increasin. the vertical pressure will stop the
vertical movement.
#he free rotational movement allows the tip of the instrument
to more away from an obstruction in the root canal wall.
6 file = Dfiles either made of stainless steel = 5i#i can be
used.
#he cuttin. instruments are specially desi.ned as they have 0@E
helical an.le more pronounced cuttin. and better debridement
as discussed earlier.
#he clinical research associates described it as Fsimple, easy,
predictable, automated instrument that compares favourably to,
or e/ceeds hand instrumentation and especially well suited for
narrow or hi.hly curved canals.
Disadvanta.es( Causes zippin. = transportation.
:ses (
Shapin. the canal.
8etreatment of root canals containin. .uttapercha.
Canal 9eader(
Is a modified speed reducin. handpiece
'as a vertical movement and of @. 0 @. ,mm and contra
rotational movement which is restricted to 3@E.
#hree cuttin. instruments are available(
Dfile with safe ended tip for narrow C.
$ore a..ressive 'file.
6 universal file which is fle/ible 'file with safe
ended tip.
Intra Endo 39DS;(
It is a easier type handpiece.
Is a lookalike of the canal finder system.
6part from up and down movement, it can import full turn
movement when a/ial pressure is applied.
#he vertical movement is in ran.e of @. 0mm.
It can make use of conventional reamer and 'file.
Endo 9ift 1Derr2(
Is also a lookalike of canal finder system.
E/calibur
!roduces a random lateral vibratory motion.
It vibrates only laterally and is derived of vertical movement.
#he amplitude of movement is ). + -mm.
Dfiles are used at -@, @@@ -+@@@ rpm.
#his device may be classified as a subsonic instrument
1oscillates at )@@@-@@@ fre%uency=sec2.
Disadvanta.es(
Due to its effective cuttin. ability it may remove e/cessive
dentin.
#ends to strai.hten the canals or causes strip perforations.
III. :9#86S&5ICS
Is based on a system in which sound as ener.y source activates
a file. #his results in a 3D activation of the file.
It imports sinusoidal vibrations of hi.h intensity to root canal
instrumentation in the ran.e which is above that of audible
perception.
#he main debridin. action was thou.ht to be by cavitation.
&ri.inally introduced to endodontics by 8ichman in )*+B, it was
further developed by 'oward, $artin and ?alter Cunnin.ham in
)*BA.
Intereslin.ly, ultrasonics was intended by them to be used as a root
canal sterilizin. device.
#here are - methods of .eneratin. ultrasoncis oscillations in the file
shank.
$a.netostrictive !eizoelectric
8e%uires water coolin. i. e.
if 5a&Cl is used as an
irri.ant, the water must be
led away from the stack via
additional tubin.. #his
makes the handpiece both
clumsy and e/pensive
$ore powerful.
Does not re%uire water
coolin..
Disadvanta.es( 6pical widenin.
led.es in curved canals.
E.. ( E56C, 5eosonic $iniendo
13@, @@@ 3+@@@ D'z2
!roduces tapered canal e.(
Cavi Endo 1-+, @@@ 'ertz2
- types of files are used(
)2 "oth use Dfile
-2 Diamond impre.nated file for the strai.ht part of the canal.
6dvanta.esC
)2 Cleanin. of root canal due to aroustic streamin. 1turbulence
alon. the shank of the file when immersed in a fluid2.
-2 Causes less e/trusion of root canal debris into periape/.
)@)+ number files should be used as they are most fle/ible and
therefore causes less led.es.
:ses(
a2 6s a root canal shapin. device.
b2 6s a debridin. device by cavitation process i. e. a process
by which bubbles formed from action of file become
unstable, collapse and cause a vacuum like IimplosionJ.
c2 #o remove posts or fracture instruments.
d2 #o coat the canal wall with sealer.
I;. S&5ICS
#he principal sonic endodontic handpiece available today is the
$icro me.a )+@@ 1$$)+@@2.
Sonic 6ir Endo System.
#hese use compressed air at a pressure of @. 0$!a.
#hey impart vibration in the fre%uency of )+@@3@@@ 'z.
6 vibrational wave form is imported to the file shank.
3 choices of files that can be used with sonic handpieces are(
8ispi sonic
Shaper sonic
#rio sonic
6ll these instruments have a safe ended noncuttin. tip of ). +
-. @mm in len.th.
#he IS& size ran.e from )+0@.
Rispi Shaper Trio
Dev by Dr.
8etano Spina in
Italy
by Dr. 9. $.
9aurichesse in
4rance.
also known as
heliosonic or
triosonic.
8esembles rat
tail file

8esembles
hirsky barbed
broach.
8esembles a
reamer or tipple
helire 'file
:sed in coronal
-=3
r d
of root
canal
:sed in apical
third 1)=3
r d
2
for coatin.
sealers and
placin.
Ca1&'2
-
paste.
, cuttin. blades

)A cuttin.
blades
!roduces
undulatin. =
rippled canal
wall
most effective
in widenin.
than canals
1than
respisonic2
least effective
$icrome.a 8etroprep (
#ips are desi.ned for periapical sur.eries, these are available in
3 standardized members 1K3+, K0+, K++2 and in 3 len.ths 1-mm,
3mm2 but these can only by used where there is an e/istin. hole
in the tooth in which it insert.
?hen lateral movement is stopped in the canal a vertical
movement of appro/ )@@ml is evident. #he movement of the
file shank creates a form of acoustic microstreamin. with -
areas of turbulence one around the midshankC other cut the
tip.
Ultrasonics Sonics
!ermits use of either an inert,
sterile or chemically active
irri.ant selected by clinician
15a&Cl2.
Irri.ation in limited to filtered
'-& as delivered throu.h the
dental unit coolin. system.
&scillations are transverse It is elliptical
It re%uires a settin. up or special
connection as it involves only a
handpiece.
Circumferential filin. Circumferential filin.
4re%uency -@, @@@-+@@@=sec )+@@A+@@ cycles=min.
96SE8S
#he use of lasers is still to be approved by the :S food and
dru. administration. 5onetheless the method appears
promisin..
?achman was the first be su..est lasers.
9evy made use of 5d(>67 laser mounted with fibreoptic to
clean and shape the canal.
?avelen.ths of ). @Am was used.
#he laser beam is carried throu.h a silica fibre accompanied by
a coolin. system that delivers a spray of air and water.
9eavy compared the laser preparation. :sin. SE$ evaluation
he concluded that preparation with a laser beam is opossible
with an improvement in the cleanliness of canal walls when
compared to conventional techni%ues.
$CLI$ Series 1$ity files2 1IEM, -@@@2
6re a series of 5i#i rotary instruments available in + different
tapers and 0 desi.ns.
#apers @. @3, @. @0, @. @0+, @. + and @. @++ all with identical tip
size -+.
'ave flattened radial land a noncuttin. tips.
0 different blade desi.n.
a2 : type
b2 ' with pro.ressive radial with dissimilar helical 9Js to
permit widenin. at the ape/ and preferential side cuttin..
c2 @. @- tapers with e%ual radial lands utmost their len.ths.
Instruments for sealin. the root canal.
62 'and and 4in.er 'eld Instruments
1i2
Several varieties of specialized endodontic pliers and forceps
are available for placement of silver point and 7! Cones.
#he pliers .enerally have a tapered .roove alon. the beak for
firmly .raspin. the rid.ed silver cone, whereas the forceps may
have either .rooved or serrated beaks for holdin. 7. !. cones.
Endodontic forceps differ from common colle.e or cotton
forceps in that they have a latch mechanism for lackin. the
instrument in the closed position. #his mechanism allows easier
transfer of and instrument and material from assistant to
operator durin. treatment.
1ii2 Endodontic condenses 1plu..ers2 and spreaders
6re smooth metal instruments used to compress and compact
the 7. ! material either laterally or vertically within the
prepared root canal space accordin. to either the lateral or
vertical condensation of 7. !. fillin. techni%ues.
Spreaders
'ave more tapered and pointed
tips for lateral packin. of the
material
Pluers
'ave slunt or flat ended tips for
compression
6ccordin. to the IS&=6D6 in )**@, these instruments are modeled as
5o. )+0+ for spreaders
5o. )+)0@ for plu..ers
#his new attempt to brin. order out of chaos would abondon the old
confusin. numberin. systems 1))@, D)), D))#, 6"CD, L4, 44, 4,
$, 4$ etc2.
9on. handled spreaders = plu..ers are formed of chromeplated
or stainless steel with operative head at various 9s to the shaft.
$series plu..er, spreader are doubleended lon.handled
instruments that correspond to the standard sizin. and taper of
Dtype files and reamers.
#he handles are color coded.
6 specification for spreaders and plu..er is currently
developed by the 65SI standard.
+ di.it no. the first - di.its represent the diameter of the
instruments at the tip.
remainin. 3 di.its desi.nate the taper in hundredths of mm.