Recent Advances in Endodotics

Advances in Endodontics

Ø  Advances in diagnostic phase

Ø  Advance in preparatory phase

Ø  Advances in obturation phase.

Historical review can be broadly classified as

Ø  The empirical era [1687-1805]

Ø  The vitalistic era [1806-1878]

Ø  The focal infection era [1909-1937]

Ø  The scientific era [1937 onwards]

ADVANCES IN DIAGNOSTIC PROCEDURES

The current routine methods rely on the stimulation of A delta nerve fibers and give no direct indication of the blood flow within the pulp.

The various newer techniques which are under investigation and clinical trial are

Ø  Laser Doppler Flowmetry

Ø  Pulseoximetry

Ø  Dual Wavelength Spectrophotometry

Ø  Computerized Infrared Thermo graphic Imaging

Ø  Radiovisiography and other advanced digital imaging techniques for improved visibility

Ni Ti Instruments in endodontics - General Consensus

General Consensus

•          NiTi files perform better than stainless steel files in rotation.

•          NiTi - less transportation and centered preparation.

•          Maintains original canal shape -improves prognosis.

•          Reaming motion - less dentin extrusion.

Ni Ti Instruments in endodontics - Benefits Of Variable Taper

•          Benefits Of Variable Taper

    Root Canal Taper

•           Effective Shaping & Cleaning

•           Ample Irrigation

•           Dense 3-D Compaction of Gutta-Percha

•          Benefits of Innovative Design

•          Cutting Effectiveness

•          Preservation of Natural Canal Path

•          Safety

RaCe
(Reamers with Alternating Cutting Edge)  

Design Details   

Ÿ  Safety Memory Disc (SMD)

Ÿ  Sharp and Alternating Cutting Edges

Ÿ  Safety Tip

Ÿ  Benefits of RaCe

Ÿ  J Eliminates the Screwing-on/ Blocking and                       leads to a Weak Working Torque.

Ÿ  J Optimum Cutting Efficiency

Ÿ  J Efficient Evacuation of Dentin Chips and                         Debris

Ÿ  J System is available in 2, 4, 6, 8 & 10% taper

Ÿ  J Safety Tip ensures guidance & centering in the Canal.

Ÿ  J Reduction in the number of Instruments -provides Comfort and saves Time

Ÿ  J Maintenance of Max Dentin Thickness-increases chances of Long Term Success

J Most Instrument Ruptures are Avoided - thanks to SMD

Ni Ti Instruments PROTAPER SYSTEM

Protaper

3 shaping files  :-

                Sx auxillary shaping files

                S1

                S2

3 finnishing files :-

                F1

                F2

                F3

SX - Shaper X

•          No Identification Ring on its Au-colored Handle

•          D₀                 --Diameter is 0.19 mm

•          D₁₄--Diameter is 1.20 mm

•          D₀---D₉----- Faster Rate of Taper

•          Modified Guiding Tip

S1

•          Purple identification ring

•          D₀--Diameter  is  0.17mm

•          Coronal 1/3_rd of canal.

S2

•          White identification ring

•          D_o--Diameter is 0.20mm

•          Middle 1/3_rd of canal

Finishing Files - F1, F2, F3

•          Yellow, Red ,Blue Identification rings for F1, F2 & F3 resp.

•          F1 D₀--D₃-- 7% Taper

•          F2 D_o--D₃-- 8% Taper

•          F3 D_o--D₃-- 9% Taper

Profile System - A new Niti Instruments

Profile System

Radial- Landed Flute & U-File Design

a  Shaping Coronal Portion of Canal

a  Manipulate in Difficult Access Area

a  60 degree Bullet-Nosed Tip

a  Cutting Angle 90 degree

a  Planes the Wall without Gouging & Self Threading

a  Even Stress Distribution

Benefits :-

J Improves Flexibility & Cutting  ,efficiency in Tighter or more Curved Canal.

J Fewer Files needed.

J Reduces Torsional Load , File Fatigue                 and Potential Separation.

J Reduces Contact Area between File and Dentine.

Niti Continued

Ni Ti Instruments in endodontics

Ni Ti Instruments in Endodontics

Advantages :-

•          Reduced instrumentation time.

•           Simplified RC preparation.

Disadvantages  of stainless steel files :-

•          Increased canal blockage &         Instrument breakage

•           Insufficient canal debridement

Stainless Steel Files: Shortcomings

L Increased Time of  Canal Preparation

L Made Obturation Less Predictable

L Canal Transportation due to Design

L Excessive Dentine Removal

Nickel Titanium Rotary Instruments

Genesis

•           Nickel Titanium Naval                    Ordinance Lab. (NITINOL)

•           Property - ‘Superelasticity’                          (1960)

Tapered Preparation                     

•          Improved cleaning ability

•          Enhanced apical control of instruments

•          Less dependable on exact length determination

•          More dependable apical resistance

•          Greater confidence of cone fit

•          0.02 Taper

•           0.06 Taper