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MECHANICAL GLIDE PATH & PREFLARING
NEW ROTARY NiTi INSTRUMENTS FOR MECHANICAL GLIDE PATH & PREFLARING
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PREFLARING & 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.
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PREFLARING & GLIDE PATH– IMPORTANCE
Study conclusions By 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.
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PREFLARING & 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
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MANUAL 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
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MANUAL 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of these instruments, it can be difficult to avoid the risk of: ledges → the tip could block in the canal and, if not withdrawn but pushed apically, could eventually break apical zip → may lead to obturation difficulties
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PREFLARING & GLIDE PATH – NEW SOLUTION
PathFile™, a new rotary Nickel-Titanium solution for Mechanical Glide Path and Preflaring A 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.
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PATHFILE™ – STANDARD SEQUENCE
Scout and negotiation with a standard K-File #010 until it can move smoothly along the canal With same file, working length determination in combination with an Apex locator PathFile™ #013 to working length PathFile™ #016 to working length PathFile™ #019 to working length Canal shaping with any NiTi rotary system
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PATHFILE™ – OTHER SEQUENCES
LARGE AND EASY CANALS If 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.
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PATHFILE™ – OTHER SEQUENCES
“INTERMEDIATE” CANALS If 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.
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PATHFILE™ – OTHER SEQUENCES
THIN, CUVED, CALCIFIED CANALS In these cases the standard sequence is recommended, i.e. PathFile™ 013, 016 and 019
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PATHFILE™ – DIRECTIONS FOR USE
Rotation speed ≈ 300 rpm Instruments 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/file The rotating motion will carry debris in a coronal direction
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FEATURES AND BENEFITS Development in collaboration with Prof Berutti,
Prof Cantatore and Dr Castellucci support of 3 internationally renowned Opinion Leaders as well as of the Dentsply Maillefer OPL network quality evidence thanks to their expertise
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PATHFILE™ – FEATURES & BENEFITS
NiTi – Square Section – 2% Taper high strength against cyclic fatigue flexibility Tip diameters ( ) gradual increase that facilitates the progression of the files without the need for strong axial pressure
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PATHFILE™ – FEATURES & BENEFITS
Tip design (transition angle reduction) Reduced risk of ledges and canal transportation PathFile™ K-File
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PATHFILE™ – 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 aberrations 2. 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
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PATHFILE™ – 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 needed 4. allows General Dental Practitioners to obtain similar results to those achieved by endodontists
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PATHFILE™ EXAMPLE TREATMENTS
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PATHFILE™ – EXAMPLES Prof. Elio Berutti
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PATHFILE™ – EXAMPLES Prof. Elio Berutti
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PATHFILE™ – EXAMPLES Prof. Elio Berutti
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