|  | | | | | Online Catalogue > Protocols > Root Canal Preparation Using triniti® Rotary Files Root Canal Preparation Using triniti® Rotary Files I cannot stress too strongly that the use of NiTi rotary systems for the preparation of root canals should be regarded as a concept, not a stated technique.The purpose of the entire procedure is to rapidly create a sufficiently wide and deep shape in the root canals to permit the percolation of copious amounts of antiseptic irrigation throughout the entire canal system.All the NiTi instruments on the market at present will do this effectively and efficiently.
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Practitioners would be well advised to select a system that suits aspects such as their own operating techniques, nursing assistance, budget, etc., and having perfected the technique should be reluctant to change. triniti® files are an excellent, well-priced system which, with the moves to single use instruments, should be carefully considered.
ACCESS AND CORONAL PREPARATION
-Access - Remove roof of pulp chamber and locate canal orifices with the use of QED Safe Ended Access Bur and QED Endo Probe DG16
-Irrigate pulp chamber with sodium hypochlorite (NaOCl)
-Estimate the working length from pre-operative radiograph
-Establish a glide path by advancing size #08, #10, #15 and #20 K-type hand file(QED SteriFile®) to about 2/3 of the estimated working length using a watch winding or balanced force technique and EDTA chelating agent/lubricant (eg FileCare). Do not force the file if resistance is met at any point, but return to a smaller file. A glide path must be established before using a rotary instrument that is designed to cut on its sides, not at the tip. Open up the canal orifice and prepare the straight coronal part of the canal using the triniti® IntroFile 1/3 to 2/3 of the estimated working length depending upon the tooth being treated.
The triniti® Rotary File System should be rotated at a speed of 150 to 250 rpm and used with a light pecking motion, keeping the instrument rotating within the canal at all times.
APICAL PREPARATION AND SHAPING
-Confirm the Working Length using an electronic apex locator (eg ROOT ZX) or with a hand-file and further radiograph
-Negotiate canal to working length with sizes #10, #15 and #20 K-type hand files (QED SteriFile®) using balanced force motion
-Continuing irrigation with NaOCI and with the use of lubricant introduce the rotating 06 Taper Size 30 triniti® File to the canal, progressing until resistance is felt.A light touch must always be used as described above.The file should not be used within the canal for any longer than 6-8 seconds.
-Whilst the dental nurse is cleaning and inspecting this file, irrigate with NaOCl and then insert the 06 Taper Size 25 triniti® File repeating the procedure to penetrate further down the canal
-Check canal patency using size #15 K Sterifile® with copious irrigation NaOCI and repeat the action with 06 Taper Size 20 triniti® File.This file should normally progress to full working length but do not push
-If working length is not achieved then repeat the sequence with a second wave of instruments starting with the 06 Taper Size 30 triniti® File
-In a difficult canal, for example one with an acute apical curvature, the 04 Taper triniti® File sequence may be used giving greater flexibility
-Continue irrigation with NaOCI as required followed by final rinse of EDTA Solution to remove the smear layer prior to obturation or intervisit dressing with Ca(OH)2 (e.g. QED Pure Calcium Hydroxide).
The above procedural protocol may have to be adapted taking into account the apical constriction, working length, apical curvature and general canal anatomy as seen from the pre-operative radiograph and as encountered clinically.
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Peter Carrotte MDS, LDS, RCS Eng, MEd
Senior Clinical University Teacher and Endodontic Specialist
Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow G2 3JZ.
Tel: 0141 211 9861. Mobile 07710 179917 |
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