Please Sign in
User Name
Password
or Register
Not a member? Gain full access to all the dental juice !
Click Here...

Juce Home Demo Pages Juce Learning Team CPD new! Full Pages Index Help & FAQ CPD Certificates Search Endodontics Welcome When to do it What to do Bleach Safety Pulpitis Pulp Capping Deciduous Pulpotomy Deciduous Pulpectomy RCT Basics Prep in a Nutshell Pre-Operative Expand Access Expand Coronal Preparation Expand Apical Preparation Expand Obturation Expand Rotary Nickel Titanium General rules Reciprocating or rotary Dentsply PathFiles Dentsply ProGlider WaveOne Gold Glider ProTaper Gold WaveOne Gold Reciproc Blue Warm Obturation Expand Ultrasonics and Endo Surgical Endo Expand Clinical Cases Expand Spotters  Expand Give module feedback

Endodontics: NiTi
Dentsply PathFiles

   This Dentsply video shows PathFiles being used to prepare a glide path prior to Rotary NiTi canal prep. PathFiles are Rotary Nickel-Titanium.

PathFile advantages include:

   • Ledging is unlikely
   • Foramen is not transported
   • Can get round steep curves



Dentsply PathFiles

A "Glide Path" needs to exist before introducing a Rotary NiTi file for canal prep, or the tip may bind and separate. PathFiles are designed to create a size 20 Glide Path

more... If a size 19 PathFile, which has a 2% taper, goes 1/2mm past working length, it creates a size 20 space at working length.  OK
. However, being Rotary NiTi themselves, they need their own Glide Path, albeit a narrow one !



Always negotiate canal up to a size 10 Hand File before using PathFiles.



National Differences

In the UK, all endo files are single-patient use by law, so problems with separation (fracture) are rare. Outside the UK, they may be used many times, so separation (due to work-hardening) is a bigger problem.

How large should the Glide Path be?
A Protaper Shaper File will eventually separate if taken many times down canals with an inadequate glide path (See references at page bottom). Multiple-use is of course not a problem in the UK as they are only used once. Outside the UK, it is recommended that the Glide Path should be size 20, to prevent separation.

Dentaljuce recommend that:
If using Hand Files only, and single-use files, the Glide Path should be prepared to a loose size 15.

more...  We have found that going up to size 20 with Hand Files can cause too much damage, especially if there is a S-shaped curve (transportation), or a steep curve (ledging or zipping), in the canal. However, in countries that re-use files many times, the dentist must weigh the risk of canal damage against the risk of file separation. Or use PathFiles !  OK


If using PathFiles, go up to size 19 (P3). They are flexible enough to go round the curves nicely, without transportation or ledging.

Sequence

Easy Canal   -  i.e. Size 15 file goes to length
Just the Size 3 (0.19) PathFile is needed.



Normal Canal

1. Establish Patency with size 8, then 10 Hand Files.

2. Create glide path with Pathfiles 1, 2, 3 (.13, .16, .19) to 0.0
more... 0.0 means Working Length, as established by an Electronic Apex locator - EAL. OK
. (But it is also OK to go to +1.0, to maintain apical patency.)



Tight Canal

1. Explore with size 8, then 10 Hand Files. (May not reach length.)

2. Step Back with PathFiles 1, 2, 3 (.13, .16, .19) at 1mm increments from the size 10 length.
 
3. Use Protaper S1 to length of P3. This will improve access.

4. Retry 08, 10 Hand Files to length.

5. Proceed with Pathfiles as per normal canal



After Pathfiles have created Glide Path:

Establish EAL length (0.0). 

Confirm glide path with P1, P2, P3.

 

References Click here


J Endod. 2004 Apr;30(4):228-30.
Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments.
Berutti E, Negro AR, Lendini M, Pasqualini D. Department of Endodontics, School of Dentistry, Turin University, Turin, Italy. 

Abstract
 

We evaluated the influence of manual preflaring and torque on the failure rate of rotary nickel-titanium ProTaper instruments Shaping 1 (S1), Shaping 2 (S2), Finishing 1 (F1), and Finishing 2 (F2). These factors were evaluated using an in vitro method by calculating the mean number of Endo-Training-Blocks shaped before file breakage under different conditions.

Group A (S1 on simulators with no preflaring) shaped 10 blocks before failure, group B (S1 on manually preflared simulators) shaped 59 blocks (p<0.01 versus group A), group C (S2 with low torque) shaped 28 blocks, group D (S2 with high torque) shaped 48 blocks (p<0.01 versus group C), group E (F1 with low torque) shaped eight blocks, group F (F1 with high torque) shaped 23 blocks (p<0.01 versus group E), group G (F2 with low torque) shaped four blocks, and group H (F2 with high torque) shaped 11 blocks (p<0.01 versus group G). 

Manual preflaring creates a glide path for the instrument tip and is a major determinant in reducing the failure rate of these rotary nickel-titanium files. All instruments worked better at high torque.


 

J Endod. 2009 Mar;35(3):408-12.
Use of nickel-titanium rotary PathFile to create the glide path: comparison with manual preflaring in simulated root canals.
Berutti E, Cantatore G, Castellucci A, Chiandussi G, Pera F, Migliaretti G, Pasqualini D. Department of Endodontics, School of Dentistry, University of Turin, Turin, Italy.
Erratum in:  J Endod. 2009 Nov;35(11):1606. 

Abstract
 

The study compared changes to canal curvature and incidence of canal aberrations after preflaring with hand K-files or with nickel-titanium rotary PathFile in S-shape Endo Training Blocks. The influence of the operator's expertise was also investigated. One hundred training blocks were colored with ink, and preinstrumentation images were acquired digitally. Preflaring was performed by an endodontist with PathFile (group 1) and hand stainless steel K-files #10-15-20 (group 2); an inexpert clinician performed preflaring with PathFile (group 3) and hand stainless steel K-files (group 4). Preinstrumentation and postinstrumentation images were superimposed to evaluate the outcomes investigated. Differences in canal curvature modification and incidence of canal aberration were analyzed with the Kruskall-Wallis plus post hoc tests and by the Monte Carlo method, respectively, (P < .05). The PathFile groups demonstrated significantly less modification of curvature (P < .001) and fewer canal aberrations (P < .001).

No expertise-related difference was found within instrument groups (P > .05), whereas the inexpert clinician produced more conservative shaping with Pathfiles than did the expert with manual preflaring (P < .01).


OK ▲



See Ratings

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

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)


Tags

2009

abstract

before

being

berutti

block

blocks

canal

canals

clinician

create

creates

curvature

curve

curves

damage

dentistry

dentsply

department

differences

eal

endo

endod

endodontics

establish

evaluated

failure

file

files

finishing

found

glide

goes

group

hand

however

images

incidence

inexpert

influence

instrument

instruments

investigated

italy

kfiles

ledging

length

manual

method

nickeltitanium

niti

normal

outside

pasqualini

patency

path

pathfile

pathfiles

performed

preflaring

preinstrumentation

prep

problem

protaper

rate

references

risk

rotary

round

school

separate

separation

shaped

shaping

simulators

size

stainless

steel

steep

times

tip

torque

training

transportation

turin

university

were

working

Disclaimer

Reviewer's Feedback Area