The introduction of nickel-titanium rotary instruments has changed the way most people practice endodontics. The use of rotary instrumentation allows an experienced practicioner to do consistent, reproducible shaping procedures on his/her patients.
As part of the AAE Colleagues for Excellence program, which produces a biannual clinical newsletter for all practicing general dentists, " Rotary Instrumentation: An Endodontic Perspective " reviews the basics of NiTi instrumentation design, prevention of fracture & clinical tips for use of rotary instrumentation.
There are over 30 different NiTi instrument systems on the market. The two main factors to consider when selecting a NiTi system are cross sectional design and tip configuration.
The biggest challenge with using rotary instrumentation is fracture of the NiTi instrument. Understanding the metallurigical properties of NiTi rotary files and some clinical "Golden Rules" are critical for success with rotary instrumentation.
The "Golden Rules" for NiTi rotary preparation are as follow:
1. Assess Case Difficulty
2. Provide Adequate Access
3. Prepare with hand files up to size #20 prior to rotary use
4. Use light touch and low RPM
5. Proceed with crown-down sequence
6. Replace rotary instruments frequently
Separated instruments can be a source of stress that can be reduced or eliminated from your practice. If you have not received the latest "Collegues for Excellence" publication from the AAE, contact your local endodontist or the AAE to get a copy.