BIOMECHANICAL

PREPARATION
PRESENTED BY: DR. ARCHANA
PAI
IST MDS
DEPARTMENT OF PUBLIC
HEALTH DENTISTRY
 INTRODUCTION
The successful endodontic therapy depends on
correct access opening followed by thorough
biomechanical cleaning and a three-dimensional
obturation...
Click icon to add picture

The preparation of the root canal space involves three separate

procedures:

Cleaning
Shaping
Apical preparation

These procedures are challenging and constitute a major portion of

the effort in root canal treatment. In addition to the removal of the
irritants, the preparation of the canal is important to ensure
adequate canal obturation.
CLEANING / DEBRIDEMENT
• The cleaning refers to the removal of all contents of
the root canal system before and during shaping.
• Organic substances, micro flora, bacterial by-
products, food, caries, denticles, pulp stones, dense
collagen, previous root canal filling material and
dentinal fillings resulting from root canal preparation.
 SHAPING
Click icon to add picture
o Shaping refers to a specific cavity
form with specific objectives.
o The shape permits vertical pluggers
to fit freely within the root canal
system and to generate the
hydraulics required to transform and
capture a maximum cushion of the
gutta percha and a micro film of
sealer into all foramina.
 o It is critical to prepare an
apical matrix or barrier at
proper working length..
o This barrier has two
functions:
o To serve as a stop against
which to condense gutta-
percha.
o To prevent materials,
irrigants, and instruments
from extruding into the
APICAL periapical tissues, with
resultant irritation &
PREPARATION inflammation.
DEFINITION

BIO MECHANICAL PREPARATION

It is the attainment of free access to the apical foramen,
through the root canal, by mechanical means without
injuring the periapical tissue.
 RULES FOR ROOT CANAL CLEANING
AND SHAPING
o Direct access should be obtained along the straight lines
o The length of the tooth should be accurately determined
o Instruments should be used in a sequence of sizes with periodic
recapitulation and without skipping of the sizes
o Instruments should be used with a quarter to half turn and
withdrawn with a full stroke
o The barbed broaches should be used cautiously and only when the
root canal is wide enough to permit their insertion and rotation
without binding
o Instruments should be fitted with stoppers
PRECAUTIONS DURING
INSTRUMENTATION
o A root canal instrument should not be forced if it binds
o Always only controlled finger pressure should be used in
manipulating an instrument in the root canal.
o Always instrumentation of root canal should be done in a
wet canal.
o Instruments must be used extravagantly particularly in
the smaller sizes
o Once the working length of a tooth is determined, all
instruments must be kept within the confines of the root
canal.
DIFFERENT MOVEMENTS
OF INSRUMENTS
 REAMING
• In endodontic practice, reaming is
commonly done by use of reamers ,
though files can also be used.
• It involves clockwise rotation of an
instrument. The instrument may be
controlled from insertion to generate a
cutting effect
 FILING
• The term filing indicates push-pull motion
with the instrument.
• But this active insertion of instrument
with cutting force is a combination of
both resistance to bending and apically
directed hand pressure. This may lead to
canal ledging, perforation and other
procedural errors.
 COMBINATION OF FILING AND
REAMING
• In this technique file is inserted with a quarter turn
clockwise and apically directed pressure (i.e.
reaming) and then is subsequently withdrawn (i.e.
filing).
• File edges get engaged into dentin while insertion
and breaks the loose dentin during its withdrawal.
• By performing this combination of reaming and
filing repeatedly, canal enlargement takes place.
• But this technique has also shown the occurrence
of frequent ledge formation, perforation and other
procedural errors
WATCH WINDING MOTION
• It is back and forth oscillation of the
endodontic instrument (file or reamer)
right and left as it is advanced into the
canal.
• The angle of rotation is usually 30 to 60
degrees
CIRCUMFERENTIAL FILING
• Used for canals that are
larger and are not round.
• The file is placed in the canal
and withdrawn in a
directional manner
sequentially against the
mesial, distal, buccal and
lingual walls
TECHNIQUES OF ROOT CANAL
PREPERATION
• STEP BACK PREPERATION
• CROWN DOWN PRESSURE-LESS TECHNIQUE
• PROFILE SYSTEM
• PROTAPER SYSTEM
 STEP BACK PREPARATION
Click icon to add picture
 ADVANTAGES
• It is less likely to cause periapical trauma
• It facilitates the removal of more debris
• The greater place that results from
instrumentation facilitates packing of additional
gutta percha cones by either the lateral or
vertical condensation method
• The development of apical matrix or stops,
prevents over filling of the root canal.
 DISADVANTAGES
• The pulpal debris and bacteria may be pushed
apically.
• Irrigation, critical part of debridement stage,
cannot penetrate to the apex because of
narrowness of the canals.
• Increased chances of errors like ledge formation
Click icon to add picture
CROWN DOWN
PRESSURE-LESS
TECHNIQUE
 ADVANTAGES
• Removal of coronal interference
• Straighter access to the apical third of the root
• Removal of canal contents and micro-organisms
before apical preparation
• Increased space for instrumentation and irrigation
of the apical third of the root
• Minimal apical extrusion of the debris
 DISADVANTAGES
• Coronal portion can be over prepared and under
irrigated.
• Could results in ledges and blockages, and with
over zealous use of the files a perforation or strip
may be created on the inner curve
• In calcified teeth, working length has to be
obtained first.
 ENGINE DRIVEN PREPARATION
WITH
NI-TI INSTRUMENTS
• Before using these instruments, one should take care to
have a straight-line access to the canal system.
• Canals should be thoroughly explored and passively
enlarged before using rotary instrument.
• Instruments should be constantly moving and speed of
rotation of each instrument should be known.
All of these Ni-Ti rotary systems incorporate:
• Crown down preparation.
• Apical preparation as finale.
• Increasing taper instruments
 PROFILE SYSTEM
1. Make a straight- line access to the canal orifice.
2. Estimate the working length of the canal from
preoperative
radiograph.
3. Create a glide path before using orifice shapers.
Establish
this path with a small, flexible, stainless-steel
number 15
or 20 file.
4. Use orifices shapers sizes 4, 3, 2, and 1 in the
coronal third
of the canal.
5. Perform crown down technique using the profile
instruments
6. Now determine the exact working length by
inserting
conventional number 15 K-file
7. After establishing the exact working length
complete the
crown down procedure up until this length. Use
profile 25, 30 for apical preparation
 PROTAPER FILES
1. The foremost step is gaining straight line access to the
canal
orifices.
2. Establish a smooth glide path before doing any
instrumentation
with ProTaper system.
3. Now prepare the coronal third of the canal by inserting
S1 into the canal using passive pressure. Don’t go more
than third fourth of the estimated canal length.
4. Irrigate and recapitulate the canal using number 10
5. In shorter teeth, use of Sx is recommended.
6. After this S2 is worked up to the estimated canal
length.
7. Now confirm the working length using small stainless
steel
K- files up to size 15 by electronic apex locators and/or
with radiographic confirmation.
8. Use F1, F2 and F3 (if necessary) finishing files up to
established working length and complete the apical
preparation. Then refine the apical preparation using
corresponding stainless steel file to gauge the apical
foramen
and to smoothen the canal walls
ULTRASONIC INSTRUMENT
1. After activation, ultrasonic file is moved in the
circumferential
manner with push-pull stroke along the walls of
canal.
2. File is activated for one minute. This procedure is
repeated
till the apex is prepared to at least size 25.
ERRORS WHILE CLEANING AND SHAPING
OF THE CANAL

• Loss of working length • Breakage of instruments in the

canal
• Blockage of the canal system
• Zipping (elliptication)
• Ledging
• Stripping or lateral wall
• Over-instrumentation perforation
• Overpreparation/under-
preparation
THANK YOU