SafetyĮndodontic files are tiny, and can easily disappear down patients’ throats. Three-dimensional imaging has revealed that what everyone thought were thorough canal preps when seen with two-dimensional imaging, were actually not so thorough. The genesis of these innovations is said to stem from advancements in imaging. Newer designs include variations in taper or pitch, said to enhance safety, flexibility and cutting efficiency the ability to compress or expand within the canal to better hug morphology and reach difficult spots safety tips to prevent iatrogenic mishaps and innovations in flute design to enhance canal wall contact while efficiently moving debris coronally. And many are being created to do this with a single file. Endodontic Files Innovationsįile design improvements are aimed at supporting the concept of three-dimensional endodontics - the ability to address all aspects of canal anatomy. They implement ultrasonic insert/tips, which come in many sizes and configurations to address various intraoral locations and adapt to dental anatomy. Ultrasonic units have been enjoying increasing popularity for RCT applications in recent years. Both systems are effective at shaping canals, and the choice of which to use is a personal one. These include rotary and reciprocating handpieces. Rotary versions of hand files are also available for use with engine-driven handpieces. Of these, the K file is probably the most ubiquitous, followed by the H file.
These include an assortment of color-coded reamers, broaches, and a head-spinning array of files. But they often start with hand files of varying sizes. Most clinicians likely use a combination of instruments. The material is strong, yet flexible enough to handle canal curvatures without breaking. While high-quality stainless steel files have been developed to offer more flexibility, many endodontists will point to the advent of nickel-titanium files as being a major milestone in dentistry. Many innovations have centered on creating endodontic files that resist breaking inside canals. Often, hand files are first used to create patency to the radiographic terminus in the apical one-third of a canal, establishing working length, though opinions vary on this. Various types of hand and rotary files, and ultrasonic inserts/tips are available to create a glide path, removing calcifications, negotiating twists and turns, and mechanically cleaning canals, leaving smooth walls. But because the field of operation for such a procedure is tiny, the instruments used to accomplish this type of therapy must also be quite small.
In our last post, we discussed the process of shaping and cleaning canals during root canal treatment (RCT).
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