Endorotary Instrument

shape image

Endorotary Instrument

 

Endorotary system

  • What?

    Instrument used within the root canal and follow the dynamic of rotational motion

    • rotational motion

      Spin in one direction

    • Rpm

      Revolution per minute. speed of rotational motion

    • Torque

      ability of the rotational instrument to withstand lateral pressure without decreasing its speed or reducing its cutting efficiency

  • Instrument Used for Canal Preparation

    • Hand instrument
      • Barbed broaches/ ekstirpasi
      • Files (K and H)
    • Rotary instrument
      • Gates Glidden Drills
      • Peeso reamer
      • Lentulo
      • Reamers File
      • File rotary
    • Nomenklatur untuk Instrument menurut ISO (International Organization for Standarization)
      • Hand operated

        tK-file, reamer, file hedstorm (H)

      • Engine-driven (rotary)

        instrument yang digerakkan dengan handpiece low speed.

        • Contoh

          Gates Glidden drills,

          Peeso Reamer drills,

          Lentulo, Reamers dan Files rotary

        • Nickel-titanium

          diadaptasi untuk hand instrument dan rotary Instrument

        • Ultrasonic and sonic

          bbrp barbed broaches,

          file, dan

          diamond coated wires

  • Instrumen saluran akar rotasi

  • ?

    • Instrumen saluran akar rotary diproduksi dari paduan nikel-titanium telah terbukti sebagai tambahan yang berharga untuk terapi saluran akar
      • selama dua dekade terakhir desain instrumennya telah banyak dimodifikasi kemajuan telah dibuat di bidang manufaktur serta pemrosesan paduan (alloy Processing )
      • prosedur klinis dan parameter kerja ideal masih disempurnakan sebagai instrumen baru terus diperkenalkan ke pasar
      • pengenalan nickel Titanium ke endodontik hampir dua dekade lalu telah secara mengubah cara preparasi saluran akar dilakukan baik dalam praktek umum maupun spesialis
      • penggunaan instrumen putar membutuhkan perhatian terhadap detail misalnya mengenai kemanjuran pada antimikroba yang selanjutnya berkontribusi pada keberhasilan terapi endodontik
      • beberapa teknik preparasi saluran akan memerlukan instrumentatif dengan kecepatan rendah guna mempermudah preparasi terutama dalam memperoleh akses lurus
  • 3 ciri desain unik yg dimiliki

    • puncak tidak memotong
    • daerah terkikis sedikit shaft kecil
    • fleksibel

Nickel-Titanium

  • NiTI file rotary

    • File NiTi yang digerakkan dengan mesin, memungkinkan pengendalian yang lebih sempurna dalam saluran akar kecil dan bengkok. Puncak instrumen ini tidak memotong dan kecenderungan menimbulkan transportasi di daerah apeks tidak besar.

    • Kemampuan pembentukan saluran akar dari File NiTi rotary menjadi andalan dalam perawatan endodontik ok kemampuannya membentuk saluran akar dengan komplikasi yang lebih sedikit.

    • Penggunaan file NiTi yang aman membutuhkan pemahaman mengenai dasar mekanisme fraktur dan berkorelasi dengan bentuk anatomi saluran akar

    • Metode fraktur instrumen NiTi

      • Fraktur torsional

        akibat tekanan apikal yang berlebihan (file kecil)

      • Fraktur flexural

        metal yang sudah melebihi ambang maximal (file besar)

      • Faktor fraktur (Penelitian in vitro)

        • kondisi anatomis,
        • frekwensi penggunaan,
        • pengaturan putaran dan
        • pengalaman operator.
    • Pada saat preparasi menggunakan instrumen NiTi Rotary dapat timbul stress pada metal tersebut yang akan menyebabkan metal fatique.

    • Stress torsional yang berlebihan dapat mengakibatkan instrumen patah

      • Friksi yang besar jika byk permukaan instrumen yg berkontak dg dinding dentin
      • Ketika tip atau bag ujung dr instrumen lebih besar dr diameter sal akar
      • Adanya tekanan yg berlebihan pd file saat preparasi berlangsung
    • Terdapat beberapa fakta instrumen NiTi dengan cutting blades aktif (ProTaper, Race, Mtwo) membersihkan saluran akar lebih baik dibandingkan dg instrumen radial lands (ProFile).

    • Perbandingan instrumen dengan atau tanpa radial lands berdasarkan evaluasi SEM pada dinding saluran akar untuk debris residual menunjukkan bahwa radial lands cenderung menggesek dentin ke dlm dinding saluran akar, sedangkan inst dg pemotongan positif memotong dan menghilangkan dentin.

  • Rotary system

    nickel- titanium rotary file substantially simlify root canal preparation, particularly in curved resrtricted canal

  • Why nickel-titanium

    atom nikel dan Titanium → reversible arrangement pada tingkat molekuler

    • arranged in a body-centered cubic lattice (kisi)
    • tegangan yang diterapkan/ pembengkokan menyebabkan fase austenit
    • ketika File ditempatkan di kanal yang melengkung atom-atfomnya ini tersusun ulang menjadi susunan yang hexagonal sehingga kepadatan dan alloy tersebut juga menjadi struktur kristal martensitic yang lebih fleksibe
    • Transisi molekuler memungkinkan file dengan mudah dapat membengkokkan dan mengelilingi kurva yang tajam sekali pun tanpa deformasi permanen
  • Comparative Study of Metals

    Untitled

  • Advances in Nickel- Titanium Metalurgy

    • M-wire NiTi
      • developed by

        Dentsply Tulsa Dental Specialities (Tulsa, OK, USA)

      • fleksibilitas lebih besar dan

      • meningkatkan resistensi cyclic dibandingkan dengan tradisional

    • R-phase NiTi
      • developed by

        SybronEndo (Orange,CA,USA)

      • mengurangi kekakuan dan

      • resisten fraktur dibandingkan dari NiTi file standar

    • Controlled Memory (CM) NiTi
      • mempunyai resisten Superior siklik
      • meningkatkan torsi kekuatan melebihi niTi file tradional
  • Generation of Motor

    • Gen 1; Tanpa torsi kontrol

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/e57802bb-1eee-409c-817b-c03d17014ce1/Untitled.png

    • Gen 2: Torque limiter

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/69d7f82b-6061-4a4f-9c4c-12b355b131f6/Untitled.png

    • Gen 3: Kontrol torsi sederhana

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/d75859ed-4495-4774-a885-f2bf59521556/Untitled.png

    • Gen 4: Apex locator dan torque control

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/b6ba751b-c9fb-4f7b-853b-e38a95e66b6e/Untitled.png

    • Advacement

      • Motor

      • tubing

      • remote controller

      • attachment

        https://s3-us-west-2.amazonaws.com/secure.notion-static.com/5b6375b2-532d-4701-af48-8d4c39e2d315/Untitled.png

        • red 1:5 attachment and high-speed work
        • Blue 1:1 low speed work
        • Green 10:1 → rotary endodontics
        • straight 1:1 → attachment for trimming, adjusting, prophy

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/9f2048b8-5bc9-490e-a467-74166a0f5418/Untitled.png

  • Protaper (dentsply Maillefer)

    • Modified K type file with sharp cutting edge
    • Flexible
    • Protaper Rotary Instruments, terdiri dari ProTaper shaping files dan ProTaper finishing files
  • Reciprocating

    • Accepts only latch type of instruments
    • The quarter turn motion deliveres 3,000 times per minute
    • Kerr , M4 handpiece which has 30 degree reciprocating motion
    • Endo gripper handpiece has 10:1 gear ratio and a 45 degree turning motion.

    Untitled

    • Research possibilities
      • ion implantation and thermal nitridation to provide harder and wear resistant cutting edges in the file
      • Mengembangkan model matematika model Ni-Ti file
      • Optimisasi flexibilitas, bending, kekuatan torsi tanpa mengorbankan cutting ability dengan menggunakan analisa mekanik modern dan analisis: pasti
  • What are the design features of ProTaper Gold files?

    3 shaping filesSX, S1, S25 finishing filesF1 - F5Variable taperShorter handles 11mm

  • What is a Glide Path?

    A smooth radicular tunnel from canal orifice to physiological terminus (AC)Glide path must be followed, not made

  • What should the minimal size of the glide path be?

    Super loose size 10 k-file

  • Why is the Glide Path important?

    • Gives info about canal morphology
    • Creates or confirms a smooth reproducible path BEFORE introducing rotary files - reduces risk of fractureFor quality control (excellent obturation not always possible without it)
  • Reciprocating

    • defined

      as a repeated backward and forward (clockwise/counter-clockwise) movement, has been extensively used in endodontics for many years and can be applied to many endodontic files.

    • Advantages of reciprocation

      • Binding of the instruments into the root canal dentin walls is less frequent, reducing torsional stress.
      • The reduction in the number of cycles within the root canal during preparation results in less flexural stress on the instrument.
      • There is decreased risk of instrument fracture.
    • MECHANICAL PROPERTIES OF RECIPROCATING FILES

      • CYCLIC FATIGUE RESISTANCE

        • Nickel-titanium fifi les have been incorporated into endodontics because of their flexibility and resistance to cyclic fatigue
        • Reciprocating motion provided greater resistance to cyclic fatigue than continuous rotation.
        • Cyclic fatigue of rotary instruments are influenced by several factors, such as rotational speed, angle of curvature of the root canal, torque, instrument design, alloy, and type of kinematics used.
        • From these studies, it could be concluded that kinematics had an influence on cyclic fatigue and that reciprocating motion had better resistance to cyclic fatigue than its counterpart.
        • Cyclic fatigue occurs as the file rotates in a curved canal.5

        instruments

      • TORSIONAL RESISTANCE

        • Torsional forces develop because of frictional resistance; therefore, as the surface area increases along the flutes, the greater the friction and the more potential for fracture.
        • Torsional forces may produce an unraveling of the flutes before fracture, and inspection of the instruments after each use is critical.
        • Torsional stress can be reduced by limiting file contact, using a crown-down preparation technique, and lubrication.
        • In terms of maximum torsional load, both Reciproc and WaveOne showed significantly higher torsional resistance than ProTaper.
        • WaveOne had a higher torsional resistance than Reciproc and OneShape.

Post a Comment

© Copyright 2019 DENTSIVE: materi dan soal kedokteran gigi

Form WhatsApp

This order requires the WhatsApp application.

Order now