Saturday, June 16, 2007
Preventing Rotary File Separation
Anyone using rotary files will occasionally have a file separation. Here are a few tips to prevent rotary file separation.
1. Always create a glide path for the rotary file to follow. I like to use a #10 and #15 hand file
2. Ensure straight line access to prevent coronal stress on the rotary instrument.
3. Use a light touch with your rotary file. Don’t force them to cut.
4. Use a touch-retract motion. Don’t lean on the file.
5. Don’t rush the instrumentation. You know when you are doing that!
6. Watch for signs of any problems. Listen for clicking. Examine your files continuously. If you
see any signs of fatigue, chuck the file.
7. Replace your files sooner.
8. Practice - operator skill is a major factor in preventing separation.
For an extensive review on the prevention and management rotary file separation see:
Journal of Endodontics, Nov. 2006, 32:11, pp 1031-1043.
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Files separate usually two ways. Binding torsional stress caused by the file tip binding in a small canal. The second way is when the file experiences cyclic fatigue caused by rotating in a shape curved canal. Glide Path Preparation is more than a loose #10 or #15 in the canal. An adequate Glide Path removes the shape curves and the small tight canals to a state that the rotary file has less risk of breakage. This is accomplished by adequate linear filing and coronal canal enlargement that produces a well defined "tapered glide path". When we win the glide path we win the case.
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