Restor Dent Endod.  2015 Feb;40(1):85-90. 10.5395/rde.2015.40.1.85.

Canal preparation with nickel-titanium or stainless steel instruments without the risk of instrument fracture: preliminary observations

• Yared G

• KMID: 2316929
• DOI: http://doi.org/10.5395/rde.2015.40.1.85

Abstract

This report introduces a novel technique that allows a safe and predictable canal negotiation, creation of a glide path and canal preparation with reciprocating nickel-titanium or stainless steel engine-driven instruments in canals where the use of rotary and the newly developed reciprocating instruments is contraindicated. In this novel technique, the instruments are used in reciprocating motion with very small angles. Hand files are not used regardless of the complexity of the canal anatomy. It also allows achieving predictable results in canal negotiation and glide path creation in challenging canals without the risk of instrument fracture.

Keyword

Canal negotiation; Endurance limit; Glide path; Reciprocation

MeSH Terms

Hand
Negotiating
Stainless Steel*
Stainless Steel

Figure

• 

  Figure 1 Pre-curved instruments. (a) Mtwo 10.04 file; (b) R25 file.

• 

  Figure 2 Root canal treatment on tooth No. 27. (a) Cone fit radiograph with pre-curved R25 in distobuccal canal. Canal negotiation, glide path creation, and canal preparation in distobuccal canal was accomplished with pre-curved Mtwo 10.04 and R25 instruments used in reciprocating motion (Forward, 6 degrees; Reverse, 1 degree). The palatal canal was enlarged with an R50 instrument at the working length; (b) Obturation radiograph.

• 

  Figure 3 Root canal treatment on tooth No. 37. (a) Cone fit radiograph. The use of reciprocating motion at small angles (Forward, 6 degrees; Reverse, 1 degree) allowed the successful canal negotiation, glide path creation, and canal preparation of the mesial canal with only one straight R25 instrument despite the presence of a severe apical curvature; (b) Obturation radiograph.

• 

  Figure 4 Root canal treatment on tooth No. 26 with a complex mesiobuccal (MB) root canal system. (a) Pre-operative radiograph. Canal negotiation and canal preparation of MB2 canal were done with pre-curved engine driven K-reamer instruments with sizes 10 to 25 and 2% taper (VDW Dentsply, Munich, Germany) used in reciprocating motion; (b) Obturation radiograph.

• 

  Figure 5 Retreatment of tooth No. 36. (a) Pre-operative radiograph. The use of an R25 instrument in reciprocation at small angles (Forward, 6 degrees; Reverse, 1 degree) allowed unblocking the apical millimetres in both mesial and distal canals. Previous several attempts to unblock those canals with hand files were unsuccessful; (b) Radiograph with R25 instruments short of the desired working length; (c) Obturation radiograph after unblocking both canals.

Reference

1. Alapati SB, Brantley WA, Svec TA, Powers JM, Mitchell JC. Scanning electron microscope observations of new and used nickel-titanium rotary files. J Endod. 2003; 29:667–669.

2. American Association of Endodontists. Endodontics: Colleagues for excellence newsletter. Rotary instrumentation: an endodontic perspective. 2008. Winter. 1–8. updated 2014 Nov 2. Available from: http://www.aae.org/colleagues.

3. Buchanan LS. Managing severe canal curvatures and apical impediments: an endodontic case study. Dent Today. 2005; 24:124–131.

4. Berutti E, Cantatore G, Castellucci A, Chiandussi G, Pera F, Migliaretti G, Pasqualini D. Use of nickel-titanium rotary PathFile to create the glide path: comparison with manual preflaring in simulated root canals. J Endod. 2009; 35:408–412.

5. De-Deus G, Arruda TE, Souza EM, Neves A, Magalhães K, Thuanne E, Fidel RA. The ability of the Reciproc R25 instrument to reach the full root canal working length without a glide path. Int Endod J. 2013; 46:993–998.

6. Inan U, Gonulo N. Deformation and fracture of Mtwo rotary nickel-titanium instruments after clinical use. J Endod. 2009; 35:1396–1399.

7. Kinsey B, Mounce R. Safe and efficient use of the M4 safety handpiece in endodontics. Roots. 2008; 4(2):36–40.

8. Pruett JP, Clement DJ, Carnes DL Jr. Cyclic fatigue testing of nickel-titanium endodontic instruments. J Endod. 1997; 23:77–85.

9. Best S, Watson P, Pillar R, Kulkarni GG, Yared G. Torsional fatigue and endurance limit of a size 30.06 ProFile rotary instrument. Int Endod J. 2004; 37:370–373.

10. Saber Sel D, Abu El Sadat SM. Effect of altering the reciprocation range on the fatigue life and the shaping ability of WaveOne nickel-titanium instruments. J Endod. 2013; 39:685–688.

11. Madani ZS, Haddadi A, Haghanifar S, Bijani A. Cone-beam computed tomography for evaluation of apical transportation in root canals prepared by two rotary systems. Iran Endod J. 2014; 9:109–112.

12. Wu MK, R'oris A, Barkis D, Wesselink PR. Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89:739–743.

13. Suresh S. Fatigue of materials. 2nd ed. Cambridge: Cambridge University Press;1998. p. 59.

14. Gambarini G, Plotino G, Sannino G, Grande NM, Giansiracusa A, Piasecki L, da Silva Neto UX, Al-Sudani D, Testarelli L. Cyclic fatigue of instruments for endodontic glide path. Odontology. 2013. 11. 07. [Epub ahead of print].

15. Yared G. Continuing education: Canal preparation with only one file used in reciprocation. updated 2014 Jul 29. Available from: http://endodonticcourses.com/literature.

16. Jafarzadeh H, Abbott PV. Ledge formation: review of a great challenge in endodontics. J Endod. 2007; 33:1155–1162.