Endodontics: Video.
Profile NiTi demo on block. 2m 41s
This clip shows a canal being prepared to a continuous taper from coronal to apical, using a combination of Gates Glidden Drills, waves of Profile 06 taper rotary NiTi files, and K-flex hand files
This clip does not have sound
Canal Exploration
Start with exploration of the canal using hand files size 10 to 25. Do not push them further than they want to go - they are being used to get a feel for the natural diameter of the canal at various lengths, and to establish that there is a glide path for the Rotary NiTi to follow.
Flare Coronal 2/3rds with Gates Glidden Drills
GG4 - The orifice is countersunk with a size 4. Insert it about 3 mm. (This step is not recommended for narrow roots.)
GG3 - Continue coronal preparation with a size 3, about 1/3rd down the canal.
GG2 - Take the size 2 no further than the start of the apical curve (usually 2/3rds down canal).
GG2 - Smooth the outline into a cone shape using the side of the GG2 as a file.
Preflare the apical third with hand files (15 & 20). Establish canal patency, and length with Electronic Apex Locator. Take a working length radiograph.
Rotary NiTi
Note - Rotary preparation stops 1mm (or 2mm) short of W.L. The final 1 or 2 mm is prepared with hand files. All rotary stops are set to this "short" length.
Start first wave of crown-down apical preparation using Profile 06 taper rotary files. Do not take the file further than it wants to go with gentle pressure.
06 Profile size 35
06 Profile size 30
06 Profile size 25
06 Profile size 20
Confirm canal patency with small hand file.
Start second wave of rotary NiTi files.
06 Profile size 35
06 Profile size 30
06 Profile size 25
Gauge the foramen width, and prepare the apical 1mm with hand files.
Size 15 - loose
Size 20 - slight binding
Size 25 - quite tight
Size 30 - very tight. Round canals tighten up quickly, oval canals take longer.
Fully prepared Apical diameter is thus 30 (This is the "Master File" size).
Finish apical prep by step-back.
Step back from Size 35 (in this case) to 50. Each file should gently insert to a progressively shorter length, establishing and confirming that there is a smooth and gradual taper.
Confirm Canal Patency with seeker.
Preparation Complete.
Explore canal, size 10, 15 Explore canal, size 10, 15, 20 Explore canal, size 10, 15, 20, 25 Countersink orifice: GG4 Prepare coronal 1/3rd lightly with GG3 Take GG2 no fu
rther than coronal aspect of curve Gently smooth the prepared walls using GG2 as a file Explore apical 1/3rd (size 15 hand file). Establish patency and glide path. First wave of 06 Profile:
size 35 First wave of 06 Profile:
size 35, 30 First wave of 06 Profile:
size 35, 30, 25 First wave of 06 Profile:
size 35, 30, 25, 20 Confirm canal patency - 15 hand file Second wave of 06 Profile:
size 35 Second wave of 06 Profile:
size 35, 30 Second wave of 06 Profile:
size 35, 30, 25 Gauge foramen width, establish Master Apical File (MAF) size MAF size = 30 in this case Step back, confirm taper. Confirm canal patency, procedure complete.
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