||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
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 . 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.
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.
• If using PathFiles, go up to size 19 (P3). They are flexible enough to go round the curves nicely, without transportation or ledging.
- i.e. Size 15 file goes to length
Just the Size 3 (0.19) PathFile is needed.
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
. (But it is also OK to go to +1.0, to maintain apical patency.)
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.
08, 10 Hand Files to length.
with Pathfiles as per normal canal
After Pathfiles have created Glide Path:
Confirm glide path
with P1, P2, P3.
References Click here