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Preparation with RECIPROC®

First Steps
Ensure you have achieved a straight line access to the root canal entrance.
It is not necessary to widen the root canal entrance with a Gates Glidden drill or an orifice opener. The design of the RECIPROC® instrument allows any obstructions in the coronal third to be removed.

Selecting the Correct RECIPROC® Instrument
In most cases, the R25 will be suitable in size for the root canal treatment. Consult the pre-operative radiograph to see if the canal is likely to be considered as narrow, medium or wide:

If the canal is partially or completely invisible on the radiograph:
R25_logoThe canal is considered narrow; use an R25.


If the canal is completely visible on the radiograph:
R50_logoTake a size 30 hand instrument; insert it passively into the canal. If it reaches working length, the canal is considered large; use the R50.

R40_logoIf a size 30 hand instrument does not go passively to working length, try a size 20 hand instrument. If this goes passively to length, the canal is considered medium; use R40.

R25_logoIf a size 20 hand instrument does not go passively to length, use R25.


NOTE: Passively means that the instrument goes directly to working length with a gentle watch winding movement (small right left rotations) but without filing action.


Decision


Preparation Step by Step
Before commencing preparation, the length of the root canal is estimated with the help of an adequately exposed and angulated pre-operative radiograph. The silicone stopper is set on the RECIPROC® instrument at 2/3 of that length.

irrigate








1. Place irrigant in the access cavity of the root canal.

2. Select the appropriate RECIPROC® instrument and secure it in the handpiece
of the VDW.SILVER® RECIPROC®.

3. Check that the RECIPROC® motor setting has been selected.

introduce







4. Introduce the RECIPROC® instrument into the canal. Press the motor foot pedal when the instrument is at the root canal orifice.

pecking





5. Move the file in a slow in-and-out pecking motion. Let the instrument advance into the canal without pressure for approx. 1-2 seconds and then withdraw it approx. 2 mm until it is freed. without taking it out of the root canal. This is one peck. The pecking motion allows the instrument to advance apically but without pressure.

Interim_stand




6. After three pecks, remove the instrument from the canal. Clean the debris from the flutes in the interim stand.

irrigate








7. Irrigate the canal.

cpilot







8. Make sure the canal is free to 2/3 of the estimated working length with a size 10 C-PILOT® File.

9. In this way, continue with the RECIPROC® instrument until approx. 2/3 of the working length has been reached as indicated by the silicone stopper. Use a size 10 C-PILOT® File to determine the working length (see "Electronic Length Determination").

10. Continue with the RECIPROC® instrument until full working length has been reached.

11. As soon as full working length has been reached, withdraw the instrument from the root canal.

Electronic Length Determination

Narrow canals:
Before commencing preparation, the length of the root canal is estimated with the help of an adequately exposed and angulated pre-operative radiograph. The silicone stopper is set on the RECIPROC® instrument at 2/3 of that length.

During preparation with R25, after approximately 2/3 of the root canal has been prepared, use a C-PILOT® File or a K-File and an apex locator such as RAYPEX®5 to determine the length of the root canal. The silicone stopper can be set on the RECIPROC® instrument at this determined length.

Medium or wider canals:
Before starting preparation with R40 and R50, determine the working length with an apex locator such as RAYPEX®5 by using a C-PILOT® File or a K-File. Set the silicone stopper at that length. After the coronal and middle thirds of the canal have been prepared, the working length should be re-checked.

Tips
1. RECIPROC® instruments are very efficient when used in a lateral brushing motion. They can be used in a brushing motion to enable preparation of irregular shaped canals or in order to enlarge the root canal entrance.

2. Clean RECIPROC® instrument flutes after 3 pecks.

3. Use an ISO size 10 C-PILOT® File to check that the canal is not blocked after 3 pecks with RECIPROC®.

4. Irrigate the root canal according to the appropriate irrigation protocol.

- Never apply pressure if resistance is encountered, instead repeat points 2 to 4 above.
- Remove the instrument from the canal as soon as working length has been reached. Working with a mechanical instrument too long in one spot will cause canal transportation.
- Pull the RECIPROC® instrument out of the canal after 3 pecks or when resistance is encountered.

Creating a Glide Path During the Use of the RECIPROC® Instruments: Indication and Management
In some canals, the RECIPROC® instrument may stop from advancing in the canal or its advancement may become difficult.

1. Do not put pressure on the instrument. Remove it from the canal. Clean the debris from the flutes in the interim stand. Irrigate the canal.

2. Continue with the RECIPROC® instrument. If it still advances with difficulty or if it does not advance, remove it from the canal. Clean the debris from the flutes in the interim stand. Irrigate the canal.

3. Use C-PILOT® Files ISO sizes 10 and 15 to create a glide path to the working length

4. Continue with the RECIPROC® instrument until the working length has been reached.

Using Hand Files to Finish the Apical Canal Preparation
In rare cases, the ISO size 10 C-PILOT® File used for the working length determination (after the RECIPROC® instrument has reached 2/3 of the estimated working length) has to be pre-curved to reach the working length, otherwise it cannot reach working length. This indicates the presence of an abrupt apical curvature. The use of the RECIPROC® instruments is contra-indicated in this instance. The canal preparation has to be finished with hand files. This limitation also applies to continuous rotary instruments.