Charting Practice	Clinical cases	Clinical Governance	Consent & Ethics
Cross Infection	Diagnosis	Direct Restorations	Endodontics
General Pathology	History Pages	Indirect Restorations	Lab Simulations
Lab Techniques	Medical Emergencies	MCQs and SBAs	Miscellany
Occlusion	Oral Medicine	Paeds & Ortho	Practice Management
Professional Standards	Prosthodontics	Radiography	Record Keeping

See list of demo CPD Pages

Here are a few tasters from the dentaljuce catalogue - why not join us and get your CPD verified, as well as full access to all the juce!

GO Charting Practice: Welcome

GO Clinical Cases: Welcome

GO Virtual Patient: Keyser Soze

GO Clinical Case: Xena Xavier

GO Clinical Governance and Audit: Welcome

GO Clinical Audit: Self Assessment Quiz (Core Knowledge)

GO Cross-infection Control: Hand Washing

GO Diagnosis: Pathology and Radiology of Dentine Caries

GO Dental Radiography and Radiological Protection: Welcome

GO Dental Radiography QA: Processing Errors - Light Contamination

GO Dental Radiography: MCQ. Optimisation

GO Direct Restorations: Welcome

GO Direct Restorations: Lower Anteriors Build-up - Simulation

GO Direct Restorations: Composite: MOB with Supermat Matrix

GO Direct Restorations: Wedges

GO Medical Emergencies: Asthma

GO Medical Emergencies: MCQ #3

GO Endodontics: Welcome

GO Endodontics: Protaper NiTi demo on block - video

GO Endodontics: Dynamic Access Cavity Preparation

GO Endodontics: Pulp Capping

GO Miscellany: Bones of the facial skeleton - 3D

GO Miscellany: Minimal Intervention Game

GO Indirect Restorations: Crown Preps and Resistance Form

GO Indirect Restorations: Metal-Ceramic (PFM) Crown Prep.

GO Indirect Restorations: 3/4 Gold Crown Prep.

GO MCQs: Welcome

GO MCQs: Handling Materials: ParaPost

GO Occlusion: Welcome

GO Occlusion: Static Occlusion, Dynamic Occlusion and Guidance

GO Free Personal Development Plan (PDP): Welcome

GO Prosthodontics: Welcome

GO Prosthodontics: Alginate Impressions. What is Alginate?

GO Prosthodontics: Self Assessment Quiz

Aims & Objectives  This page aims to show you how to use Protaper Nickel Titanium files to prepare a root canal.   There is a video of the entire procedure being performed on a transparent block.   Alternative sequences combining NiTi and Stainless Steel instrumentation are listed.

Endodontics
Protaper NiTi demo on block - video

 
This video shows a very brief overview, demonstrating how the Protaper system uses variable taper files to cut different parts of the canal.

This ensures that only part of a file is under stress at any one time, reducing the chance of separation (fracture).

• S1 (Purple). Maximum taper is coronal. Used to create coronal flare.
• S2 (White). Maximum taper is in middle of file. Used to access to the apical region.
• F1 (Yellow). Maximum taper is at tip. Use to prepare apical region to size 20.
• F2 (Red). Maximum taper is at tip. Use to prepare apical region to size 25

Protaper consists of Shaper files (S1, S2) which do the bulk of the dentine removal coronally, and Finisher files which do the apical preparation (F1,F2,F3).  Their shapes are subtly different: The shapers are a bit like the Eiffel Tower, and the Finishers are a bit like the Gherkin

Video: Protaper NiTi demo on block
 
This clip does not have sound. 

This video shows a simplified sequence, to demonstrate the basics of Protaper.

NiTi files are however often used in conjunction with other techniques.

The sequence we would often use incorporating Protaper is:

Prepare coronal with Gates Glidden Drills sizes 4, 3, 2. Take the flare about 1/3rd way down canal.
    Brush on the "safe side" with GG2 to improve straight line access, and relocate canal away from danger areas like furcations.
    The Protaper S1 can also be used for relocating the coronal part of a canal, using a brushing action.

Determine Working Length (EAL + radiograph)
    Ensure there is a size 15 glide path to length.

Pre-flare middle and apical with Hand ProTaper short of working length, then finish with hand files as follows:

    Set S1 & S2 to 1mm short of TWL. 
    Introduce S1 into canal to TWL-1mm. If resistance felt, gently brush laterally away from furcations. 
    Repeat with S2. 
    Re-measure the Working Length with an apex locator. It may have shortened by 0.5 to 1mm 
    Set S1 & S2 to the (new) working length. 
    Insert S1 to (new) WL. 
    Insert S2 to (new) WL. 
    Re-confirm Glide Path with size 15 & 20 SS Hand Files 
    Re-measure the Working Length with an apex locator. 
    Insert F1 to 1mm short of WL. Remove immediately. (Size 20 tip, 7% taper) 
    Insert F2 to 2mm short of WL. Remove immediately. (Size 25 tip, 8% taper) 
    Insert F3 to 3mm short of WL. Remove immediately. (Size 30 tip, 9% taper) 

You have now created a flare (7%+ taper) which will allow (2% taper) hand instruments to reach the apical region without binding on the sides of the canal. This allows apical gauging to proceed without worrying the file is binding on the canal walls.

Gauge the apical diameter

Prepare the definitive Apical Flare  

    Having gauged the apical diameter, prepare two or three sizes above with 2% SS hand files.(prepare to TWL). 
    THE MAF (MASTER APICAL FILE) SIZE HAS NOW BEEN SET 
    Flare the apical region by stepping back 1mm a time with successively larger files. (May be 1/2mm step back)  
    Your step-back apical prep will "blend" quite quickly with the NiTi pre-flare. 
    Use circumferential filing to smooth the canals walls. 

    THE CANAL PREP IS NOW COMPLETE

We do not recommend using engine-driven Rotary NiTi files for apical finishing. They are so sharp and efficient at cutting it is very easy to accidentally over-prepare the apical region if the canal is curved.

Educational aims of this juce

 This page aims to show you how to use Protaper Nickel Titanium files to prepare a root canal.
  There is a video of the entire procedure being performed on a transparent block.
  Alternative sequences combining NiTi and Stainless Steel instrumentation are listed.

This page contains verifiable CE / CPD

---

How much does dentaljuce membership cost? 12 months subscription to the whole site costs just £79 GBP International payment in your own currency with PayPal 100+ hours of verifiable CPD / CE. No extra payments.
	Pay by card or cheque
Member comments: Really good, very user friendly and practical. (JW) It has to be the best value CPD around, and probably the most useful. Many thanks.(WK) Very impressed - keep being interrupted by patients turning up! (PW) I couldn't manage now without Dentaljuce. (AH - BDS Student) Well good, detail excellent, very clear to use (JM) Very good material. Brilliant for CPD. (PC) Excellent step by step guides and photos (SR) Taking ORE soon - this site is soooooo useful (AK) Excellent layout, great photos (PM) I cannot believe how brilliant this site is. I have passed Part 1 of the MJDF exam, and it will help so much for my Part 2. The animations, videos and content in general is just brilliant. Thank you. (DI) This is the Catherine Deneuve of online dentisty. (MF) I have to say dentaljuce gets better each time I look. (PP) This website is so great, I have been telling so many people. Fantastic. (DY) Thought provoking, and good reminder of what we should know. (FC) Concise and reflective Excellent content clearly explained Wow. I actually understand occlusion now, thank you so much. I saw those BDJ articles years ago when newly qualified and I didn't understand any of it. It is all so much more understandable now, thank you. (TD) Brilliant videos, thank you. (WS)