1. Large Taper Files

2. Engine-driven files

3. Hand-Using Large Taper Files

4. A, Lateral view. (SEM, ×50.) B, Cross section. (SEM, ×200.)

6. Large Taper File Advantages  Easier  Only one instrument sequence whatever the canal shape  An easy to remember protocol (color-coded)  Faster  Only 3 instruments needed in most cases  High cutting power

7. Large Taper File Advantages  More efficient  increased apical taper for better canal cleaning  Better debris removal due to the unique design of these instruments  Safer  Guiding tip with rounded end to minimize canal deviations  These instruments are also available in manual version to treat anatomically difficult cases or for clinicians who prefer to use hand files for tactile control reasons

8. How to prepare root canal by using Large Taper Files ?

9. D1 DX D2M2 M1M3

10. 1. Prepare a straight-line access cavity with no restrictions in the entry path into the chamber

11. 2. Establish proper access and a glide path with No. 10 and No. 15 steel files to the working length or the apical constriction exit.

12. 3. Begin shaping with the D1 using multiple, passive-pressure passes. Go no deeper than 1/3 of the estimated canal length. Irrigate and recapitulate with a No. 10 hand file, establishing patency to full working length. With D1, extend the preparation to full working length. D1 shaping Irrigation recapitulation NaClO EDTA

13. 4. “Brush” with the DX to improve the straight-line access in short teeth or to relocate canal access away from furcation in posterior teeth.

14. 5. D2 is now used to full working length. Irrigate, recapitulate D2 shaping Irrigation recapitulate NaClO EDTA

15. 6. With M1, passively extend the preparation to within 0.5 mm of the working length. Withdraw after one second! And only one second! The M1 has a tip size of 0.20 mm, and if a No. 20 hand instrument is found to be snug, the preparation is finished.

16. 7. If the M1 and the No. 20 hand file are loose, continue the preparation with the M2, which is 0.25 mm diameter at the tip. If the M2 and the No. 25 hand file are loose, continue the preparation with the M3, which is 0.30 mm diameter at the tip.

17. Frequent irrigation and file cleansing are imperative irrigation and recapitulation! 5.25%NaClO 17%EDTA irrigation

18. The data of engine-driven Large Taper files FileSpeed(rpm)Torque(N· cm) DX3003.0 D12503.0 D22501.0 M12501.6 M22502.0 M32502.0

19. How to better use Large Taper Files  Prepare a straight-line access cavity with no restrictions in the entry path into the chamber.  Fill the access cavity with Sod Hypochlorite.  Establish a smooth glide path with No. 10 and No.15 stainless steel hand files.  Use maximum magnification to observe the movement of the rotary instrument. “Seeing” rotary apical movement is safer than simply “feeling” such movement.

20. How to better use Large Taper Files  Use a torque- and speed-controlled electric motor, powering the hand-piece at 200 to 300 rpm.  Be much gentler than with hand instruments. Always treat in a moist canal. Irrigate frequently!  Slow down! Each instrument should do minimal shaping. Only two, three, or four passes may be required for the file to engage restrictive dentin and carve the shape to the proper depth.

21. How to better use Large Taper Files  Instruments break when flutes become loaded or when instruments are forced. Check the flutes frequently under magnification and clean them. Cyclic fatigue from overuse, or if the glide path is not well established, also leads to breakage.

22. How to better use Large Taper Files  Large Taper Files instruments are disposable and, like all endodontic files and reamers, are designed for single-patient use. Sometimes instruments are even changed within the same treatment (eg, in the case of a four-canal molar).  Irrigate with 17% EDTA or a viscous chelator during the ProTaper shaping.

23. How to disinfect, clean and sterilize files

24. 1. Manual Cleaning or assisted by an ultrasonic device  No visible impurities should be observed on the instruments.  Discard any instruments with large obvious defects (broken, bent, and twisted).  The disinfecting solution should be aldehyde free and without di- or triethanolamines as corrosion inhibitor.

25. 2. Rinsing  Abundant rinsing (at least 1 min)  Use quality water in accordance with local regulations.  If a disinfecting solution contains a corrosion inhibitor, it is recommended to rinse the instruments just before the autoclaving.  Dry on a single use non-weaved cloth, or with a drying machine or filtered compressed air.

26. 3. Packaging  Place the devices in a kit, support or container to avoid any contact between instruments and pack the files in “Sterilization pouches”.  Check the validity period of the pouch given by the manufacturer to determine the shelf life.  Use packaging which are resistant up to a temperature of 141°C (286°F) and in accordance with EN ISO 11607.

27. 4. Sterilization  Steam sterilization at: 134 °C / 273°F during 18 min.  Use only autoclaves that are matching the requirements of EN 13060, EN 285.  Use a validated sterilization procedure according ISO 17665  Control the efficiency (packaging integrity, no humidity, color change of sterilization indicators).

28. 5. Storage  Keep devices in sterilization packaging in a dry and clean environment  Sterility cannot be guaranteed if packaging is open, damaged or wet.  Check the packaging before using them (packaging integrity, no humidity and validity period).

29. Thank you! To order email to icdr@hotmail.com or call 94481 91202 icdr@hotmail.com