Update in Modern Root Canal Instrumentation and Disinfection Techniques. Part 2
You will receive 2 unit(s) of continuing education credit upon successful completion of this course. The registration fee is only $82.00

This course is designed for the general practitioner to improve their knowledge and their endodontic skills. In this second part most new rotary systems and reciprocating systems will be presented and discussed with the participants. A review of file separation mechanisms will also be given along with an explanation of file removal techniques used by most endodontists.

Peter Tawil, DMD
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Learning Objectives:
Upon completion of this course, the participant should be able to:
  1. Know the difference between endodontic motors available on the market
  2. Know the different NiTi file systems available on the market
  3. Understand effective rotary nickel-titanium file utilization and prevention of iatrogenic events
  4. Know how NiTi file fractures occurs and how to prevent them
  5. Know the separated instrument removal techniques used by endodontists and their limitations
  6. Know how to assess what NiTi file systems works best in your hands

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. This lecture will update dentists with the new NiTi metal treatments, design changes and will review most new endodontic systems.

  1. Endodontic Motors
    1. The historic progression of root canal instrumentation
    2. Torque control
    3. Endodontic motors
  2. Rotary files universal rules
    1. Terminology
    2. Apical control zone
    3. NiTi versus stainless-steel
    4. Rotary instrumentation golden rules
  3. NiTi file Separation
    1. Causes for NiTi Separation
    2. Broken instrument removal technique
  4. Endodontic file systems
    1. Metal types
    2. Metallurgy timeline
    3. New metallurgy in NiTi
    4. New file systems on the market
    5. Hybrid techniques
    6. Clinical cases
  1. Gambarini G. Advantages and disadvantages of new torque-controlled endodontic motors and low-torque NiTi rotary instrumentation. Aust Endod J 2001; 27(3):99-104
  2. Bishop K, Dummer PM. A comparison of stainless steel Flexofiles and nickel-titanium NiTiFlex files during the shaping of simulated canals. Int Endod J 1997; 30(1):25-34
  3. Schafer E. Shaping ability of Hero 642 rotary nickel-titanium instruments and stainless steel hand K-Flexofiles in simulated curved root canals. OOOO 2001; 92(2):215-20
  4. Schafer E, Lohmann D. Efficiency of rotary nickel-titanium FlexMaster instruments compared with stainless steel hand K-Flexofile -- Part 2. Cleaning effectiveness and instrumentation results in severely curved root canals of extracted teeth. Int Endod J 2002; 35(6):514-21
  5. Garip Y, Gunday M. The use of computed tomography when comparing nickel-titanium and stainless steel files during preparation of simulated curved canals. Int Endod J 2001; 34(6):452-7
  6. Pettiette MT, Metzger Z, Phillips C, Trope M. Endodontic complications of root canal therapy performed by dental students with stainless-steel K-files and nickel-titanium hand files. J Endod 1999; 25(4):230-34
  7. Pettiette MT, Delano O, Trope M. Evaluation of success rate of endodontic treatment preformed by students with stainless-steel K-files and nickel-titanium hand files. J Endod 2001; 27(2):124-7
  8. Boessler C, Peters OA, Zehnder M. Impact of lubricant parameters on rotary instrument torque and force. J Endod 2007; 33(3):280-3
  9. Cheung GS. Instrument fracture: mechanisms, removal of fragments, and clinical outcomes. Endodontic Topics 2009; 16:1-26
  10. Ormiga F, da Cunha Ponciano Gomes JA, de Araujo MC, Barbosa AO. An initial investigation of the electrochemical dissolution of fragments of nickel-titanium endodontic files. J Endod 2011; 37(4):526-30
  11. Roland DD, Andelin WE, Browning DF, Hsu GH, Torabinejad M. The effect of preflaring on the rates of separation for 0.04 taper nickel titanium rotary instruments. J Endod 2002; 28(7):543-5
  12. Berutti E, Negro AR, Lendini M, Pasqualini D. Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments. J Endod 2004; 30(4):228-30
  13. Schrader C, Peters OA. Analysis of torque and force with differently tapered rotary endodontic instruments in vitro. J Endod 2005; 31(2):120-3
  14. Yared GM, Bou Dagher FE, Machtou P. Cyclic fatigue of Profile rotary instruments after simulated clinical use. Int Endod J 1999; 32(2):115-9
  15. Peters OA, Barbakow F. Dynamic torque and apical forces of ProFile.04 rotary instruments during preparation of curved canals. Int Endod J 2002; 35(4):379-89
  16. Wolcott S, Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S, Meyers J. Separation incidence of protaper rotary instruments: a large cohort clinical evaluation. J Endod 2006; 32(12):1139-41
  17. Sonntag D, Peters OA. Effect of prion decontamination protocols on nickel-titanium rotary surfaces. J Endod 2007; 33(4):442-6
  18. Shen Y, Qian W, Abtin H, Gao Y, Haapasalo M. Fatigue testing of controlled memory wire nickel-titanium rotary instruments. J Endod 2011; 37(7):997-1001
  19. Alapati SB, Brantley WA, Nusstein JM, Daehn GS, Svec TA, Powers JM, Johnston WM, Guo W. Vickers hardness investigation of work-hardening in used NiTi rotary instruments. J Endod 2006; 32(12):1191-3
  20. Metzger Z, Zary R, Cohen R, Teperovich E, Paque F. The quality of root canal preparation and root canal obturation in canals treated with rotary versus self-adjusting files: a three-dimensional micro-computed tomographic study. J Endod 2010; 36(9):1569-73
  21. Peters OA, Paque F. Root canal preparation of maxillary molars with the self-adjusting file: a micro-computed tomorgraphy study. J Endod 2011; 37(1):53-7
  22. Roane JB, Sabala CL, Duncanson MG Jr. The “balanced force” concept for instrumentation in curved canals. J Endod 1985; 11(5):203-11
  23. You SY, Bae KS, Baek SH, Kum KY, Shon WJ, Lee W. Lifespan of one nickel-titanium rotary file with reciprocating motion in curved root canals. J Endod 2010; 36(12):1991-4
  24. Varela-Patino P, Ibanez-Parraga A, Rivas-Mundina B, Cantatore G, Otero XL, Martin-Biedma B. Alternating versus continuous rotation: a comparative study of the effect on instrument life. J Endod 2010; 36(1):157-9
  25. 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(3):408-12
  1. Gunnar Bergenholtz, Preben Horested-Bindslev, Class Reit. Textbook of Endodontology. Munksgaard International Publishers. Danmark, 29 August 2003.

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