Update in Modern Root Canal Instrumentation and Disinfection Techniques. Part 1
You will receive 2 credit(s) of continuing education credit upon successful completion of this course. The purchase price of this course is $98.00

This course divided in 2 parts is designed for the general practitioner to improve their knowledge and their endodontic skills. In this first part of the course, will start with a review of the basic biologic and instrumentation principles. This part will refresh the basic concepts, canal anatomy, patency, crown down concepts and working length determination.


Learning Objectives:
Upon completion of this course, the participant should be able to:
  1. Understand the biologic objectives of root canal therapy
  2. Describe root canal anatomy, root shapes and apical root anatomy
  3. Know how to use and trouble shoot apex locators
  4. Understand the importance of effective bio-mechanical cleansing
  5. Know the methods for effective bio-mechanical cleansing
  6. Describe the basic concepts of root canal instrumentation

The number of NiTi rotary systems have increased at an astounding rate over the past 10 years. This course is intended to help the practitioner understand how to use mechanical NiTi instrumentation in a safe and efficient way.
  1. Bacteria
  2. Canal anatomy
    1. The oval canal shape
    2. Strategies to reduce intracanal bacteria
    3. Apical sizes
  3. Straight line access
    1. Orifices openers
    2. Ultrasonic tips
  4. Patency
    1. Canal patency
    2. Apical patency
  5. Crown down and shaping concepts
    1. Crown down basics
    2. Crown down benefits
  6. Working length
    1. Canal apical anatomy
    2. Apex locators

  1. Kakehashi S, Stanley HR, Fitzgerald RJ. The effect of surgical exposure of dental pulps in germ-free and conventional laboratory rats. OOO 1965; 20:340-9
  2. Peters OA, Schonenberger K, Laib A. Effects of four Ni-Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J 2001; 34(3):221-30
  3. Kerekes K, Tronstad L. Morphometric observations on the root canals of human molars. J Endod 1977; 3(3):114-8
  4. Card SJ, Sigurdsson A, Orstavik D, Trope M. The effectiveness of increased apical enlargement in reducing intracanal bacteria. J Endod 2002; 28(11):779-83
  5. Usman N, Baumgartner JC, Marshall JG. Influence of instrument size on root canal debridement. J Endod 2004; 30(2):110-2
  6. Wu MK, Wesselink PR. Efficacy of three techniques in cleaning the apical portion of curved root canals. OOOO 1995; 79(4):492-6
  7. Khademi A, Yazdizadeh M, Feizianfard M. Determination of the minimum instrumentation size for penetration of irrigants to the apical third of the root canal systems. J Endod 2006; 32(5):417-20
  8. Wu MK, R’oris A, Barkis D, Wesselink PR. Prevalence and extent of long oval canals in the apical third. OOOO 2000; 89(6):739-43
  9. Alves FR, Aleida BM, Neves MA, Moreno JO, Rocas IN, Siqueira JF Jr. Disinfecting oval-shaped root canals: effectiveness of different supplementary approaches. J Endod 2011; 37(4):496-501
  10. Johnson BR, Remeikis NA. Effective shelf-life of prepared sodium hypochlorite solution. J Endod 1993; 19(1):40-3
  11. Abou-Rass M, Piccinino MV. The effectiveness of four clinical irrigation methods on the removal of root canal debris. OOO 1982; 54(3):323-8
  12. Ram Z. Effectiveness of root canal irrigation. OOO 1977; 44(2):306-12
  13. Nielsen BA, Baumgartner J. Comparison of the EndoVac system to needle irrigation of root canal. J endod 2007; 33(5):611-5
  14. Hockett JL, Dommisch JK, Johnson JD, Cohenca N. Antimicrobial efficacy of tow irrigation techniques in tapered and non tapered canal preparations: an in vitro study. J Endod 2008; 34(11):1374-7
  15. Townsend C, Maki J. An in vitro comparison of new irrigation and agitation techniques to ultrasonic agitation in removing bacteria from simulated root canal. J Endod 2009; 35(7):1040-3
  16. Ahmad <, Pitt Ford TJ, Crum LA. Ultrasonic debridement of root canals: acoustic streaming and its possible role. J Endod 1987; 13(10):490-9
  17. Sabins RA, Johnson JD, Hellstein JW. A comparison of the cleaning efficacy of short-term sonic and ultrasonic passive irrigation after hand instrumentation in molar root canals. J Endod 2003; 29(10)674-8
  18. Van Der Sluis LW, Wu MK, Wesselink PR. The evaluation of removal of calcium hydroxide paste from the artificial standardized grove in the apical root canal using different irrigation methodologies. Int Endod J 2007; 40(1):52-7
  19. Gutarts R, Nusstein J, Reader A, Beck M. In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. J Endod 2005; 31(3):166-70
  20. Burleson A, Nusstein J, Reader A, Beck M. The in vivo evaluation of hand/rotary/ultrasound instrumentation in necrotic, human mandibular molars. J Endod 2007; 33(7):782-7
  21. Alves FR, Almeida BM, Neves MA, Moreno JO, Rocas IN, Siqueira JF Jr. Disinfecting oval-shaped root canals: effectiveness of different supplementary approaches. J Endod 2011; 37(4):496-501
  22. Peters OS, Bradsley S, Fong J, Pandher G, Divito E. Disinfection of root canals with photon-initiated photoacoustic streaming. J Endod 2011; 37(7):1008-12
  23. Bystrom A, Claesson R, Sundqvist G. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol 1985; 1(5):170-5
  24. Siqueira JF JR, Lopes HP. Mechanisms of antimicrobial activity of calcium hydroxide: a critical review. Int Endod J 1999; 32(5):361-9
  25. Shuping GB, Orstavik D, Sigurdsson A, Trope M. Reduction of intracanal bacteria using nickel-titanium rotary instrumentation and various medications. J Endod 2000; 26(12):751-5
  26. Khan AA, Sun X, Hargreaves KM. Effect of calcium hydroxide on proinflammatory cytokines and neuropeptides. J Endod 2008; 34(11):1360-3
  27. Schilder H. Filling root canals in three dimensions. J Endod 2006; 32(4):281-90
  28. Buchanan LS. Management of the curved root canal. J Calif Dent Assoc 1989; 17(4):18-25
  29. Silveira LF, Martos J, Pintado LS, Teixeira RA, Cesar Neto JB. Early flaring and crown-down shaping influences the first file bind to the canal apical third. OOOO 2008; 106(2):99-101
  30. Marshall FJ. Planning endodontic treatment. Dent Clin North Am 1979; 23(4):495-518
  31. Kuttler Y. Microscopic investigation of root apexes. JADA 1955; 50:544052
  32. Sanderink GC, Huiskens R, Van der Stelt PF, Welander US, Stheeman SE. Image quality of direct digital intraoral x-ray sensors in assessing root canal length. The RadioCisioGraphy, Visualix/VIXA, Sens-A-Ray, and Flash Dent systems compared with Ektaspeed films. OOO 1994; 78(1):125-32
  33. Nguyen HQ, Kaufman AY, Komorowski RC, Friedman S. Electronic length measurement using small and large files in enlarged canals. Int Endod J 1996; 29(6):359-64
  34. Jenkins JA, Walker WA 3rd, Schindler WG, Flores CM. An in vitro evaluation of the accuracy of the root ZX in the presence of various irrigants. J Endod 2001; 27(3):209-11
  35. Garofalo RR, Ede EN, Dorn SO, Kuttler S. Effect of electronic apex locators on cardiac pacemaker function. J Endod 2002; 28(12):831-3
  36. Rosenberg DB. The paper point technique. Dent Today 2003; 22(2):80-6
  37. Stabholz A, Rotstein I, Torabinejad M. Effect of preflaring on tactile detection of the apical constriction. J Endod 1995; 21(2):92-4


  1. Gunnar Bergenholtz, Preben Horested-Bindslev, Class Reit. Textbook of Endodontology. Munksgaard International Publishers. Danmark, 29 August 2003.

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