2MECHANICAL GLIDE PATH & PREFLARING NEW ROTARY NiTi INSTRUMENTS FORMECHANICAL GLIDE PATH & PREFLARING
3PREFLARING & GLIDE PATH– DEFINITION Preflaring is the preliminary root canal enlargement needed to reduce the risk of taper lock of the tip of the first rotary instrument used to shape the canal.Glide Path is obtained during preflaring and corresponds to the smooth canal preparation that rotary instruments can follow without the risk of blockage or bending.Until now, this stage is conventionally performed with hand SST instruments, such as K-Files 008, 010 or 015.
4PREFLARING & GLIDE PATH– IMPORTANCE Study conclusionsBy creating a canal (a Glide Path) at least as large as the diameter of the NiTi rotary instrument that will be used successively (and which has a greater taper), drastically reduces the torsional stress and, therefore, the risk of file separation.
5PREFLARING & GLIDE PATH– IMPORTANCE Glide Path is an essential step:- to fully understand and appreciate the anatomy of the canal to be treated (i.e. mentally develop a three dimensional image of the canal system to shape)- to reduce the risk of rotary instrument breakage
6MANUAL PREFLARING – PROBLEMS The initial preflaring and glide path are normally carried out with stainless steel hand files.Because of the relative stiffness of these instruments, it can be difficult to avoid the risk of:canal transportation→ may lead, in severe cases, to root canal perforation
7MANUAL PREFLARING – PROBLEMS Because of the relative stiffness of these instruments, it can be difficult to avoid the risk of:ledges→ the tip could block in the canal and, if not withdrawn but pushed apically, could eventually breakapical zip→ may lead to obturation difficulties
8PREFLARING & GLIDE PATH – NEW SOLUTION PathFile™, a new rotary Nickel-Titanium solution for Mechanical Glide Path and PreflaringA new range available in 3 ISO sizes (013, 016 and 019) and 3 lengths (21, 25 and 31mm).Flexible and resistant to cyclic fatigue, they offer many advantages compared to manual solutions.
9PATHFILE™ – STANDARD SEQUENCE Scout and negotiation with a standard K-File #010 until it can move smoothly along the canalWith same file, working length determination in combination with an Apex locatorPathFile™ #013 to working lengthPathFile™ #016 to working lengthPathFile™ #019 to working lengthCanal shaping with any NiTi rotary system
10PATHFILE™ – OTHER SEQUENCES LARGE AND EASY CANALSIf it is possible to reach the full working length with a K-File #020, the Glide Path is not necessary and no PathFile™ will therefore have to be used.
11PATHFILE™ – OTHER SEQUENCES “INTERMEDIATE” CANALSIf the user feels, during the initial scouting with the K-File 010, that the canal is rather wide, the recommendation is to use either PathFile™ 016 and 019 or even only PathFile™ 019.
12PATHFILE™ – OTHER SEQUENCES THIN, CUVED, CALCIFIED CANALSIn these cases the standard sequence is recommended, i.e. PathFile™ 013, 016 and 019
13PATHFILE™ – DIRECTIONS FOR USE Rotation speed ≈ 300 rpmInstruments should be used with a delicate in/out movement until they reach the full length. Strong axial forces should therefore be avoided.Time needed to reach working length normally does not exceed 3-5 seconds/fileThe rotating motion will carry debris in a coronal direction
14FEATURES AND BENEFITS Development in collaboration with Prof Berutti, Prof Cantatore and Dr Castelluccisupport of 3 internationally renowned Opinion Leaders as well as of the Dentsply Maillefer OPL networkquality evidence thanks to their expertise
15PATHFILE™ – FEATURES & BENEFITS NiTi – Square Section – 2% Taperhigh strength against cyclic fatigueflexibilityTip diameters ( )gradual increase that facilitates the progression of the files without the need for strong axial pressure
16PATHFILE™ – FEATURES & BENEFITS Tip design (transition angle reduction)Reduced risk of ledges and canal transportationPathFile™K-File
17PATHFILE™ – STUDY CONCLUSION The study carried out by Prof Berutti, Prof Cantatore and Dr Castellucci clearly shows that, when compared to manual instruments, PathFile™:1. better maintains the original canal anatomy→ less canal transportation and canal aberrations2. is more forgiving procedural errors such as incorrect working length→ no apical transport when WL is too long→ no ledges when WL is too short
18PATHFILE™ – STUDY CONCLUSION The study carried out by Prof Berutti, Prof Cantatore and Dr Castellucci clearly shows that, when compared to manual instruments, PathFile™:3. reduces the instrumentation time needed4. allows General Dental Practitioners to obtain similar results to those achieved by endodontists