Shape Clean Pack: Canal Preparation - ProTaper: Dr. Ruddle Advanced Endodontics

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This show will focus on ProTaper Universal. The assumption of using any mechanical system is you need to have a secured canal, or what that really means is a canal that has a smooth, reproducible glide path. We will look at how the design of endodontic instruments dictate safety, efficiency and simplicity. You will see how the ProTaper progressively tapered design, utilized in continuous rotation, can safely and efficiently create a deep shape of 8-10% and generally with only 2, 3 or 4 files. Finally, this segment features clinical footage showing how to utilize the ProTaper rotary system to successfully shape the canals within a mandibular molar.
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welcome to another episode of Ruddell on shape clean and packed today my assignment will be to talk about canal preparation and certainly when we think about canal preparation we think of a lot of different things that mean something different to each one of us but certainly the instruments we use to create the shapes in these various routes are critical and will in some extent dictate final results today I'm going to talk about specifically ProTaper Universal and of course we can reciprocate instruments we can spin instruments and these critical distinctions will be covered later in the show but when you think about the micro-ct work that we see in various text books in online around the world some of these systems are very complicated and formidable our job is always the same a complete access and then of course we have to catheterize the canal and create a smooth reproducible glide path so all my discussions about shaping are limited by the assumption is you have a glide path and we talked about previously the instances where you have a reproducible glide path versus when you have an irregular glide path and those have different management schemes well when you look at all the file systems in the world today it's a staggering upwards of 30 different systems are available to clinicians internationally but one thing that can immediately be said is that all instruments in the world today have fixed tapers except for the pro tape or family of instruments and waveone today I'm talking about Pro Taper but I think it's important to look at all other systems to appreciate there tapered files what we know about a fixed tapered file is the following maybe not the first instrument maybe not the second but certainly by the third or fourth instrument the shape of the file is rapidly preparing the canal so that the canal is rapidly becoming the shape of the instrument and when an instrument has a long engagement zone it invites taper lock and taper lock means there's a lot of excessive contact between the blades of the instrument and the surrounding dentin this means the instrument has a tendency to screw or feed into the canal inadvertently so various manufacturers have done different machining concepts to mitigate taper lock and you can find these in the various systems but all instruments except for pro taper and wave one have fixed tapers the problem then with fixed tapers is the screw effect taper lock and it usually takes quite a few instruments to impart the desired shape in 2001 Pro Taper launched and it launched as the first active file in the world it was also the first file that had changing tapers on a single instrument it was also the first system in the world that could give you the fewest instruments to create an ideal deep shape of about eight to ten percent the fewest instruments to create the most optimal deep shape pro taper shapers have increasing percentage tapers and on the image on the left you can see that the tip of the file is basically not active the tip of the file is to guide the instrument through the glide path so there's a big assumption here and the assumption is you have a smooth reproducible glide path Pro Taper file should not be used in any route until the canal has been catheterized expanded and enlarged to a 15 hem file when you have a 15 hand file that's loose within any region of a canal it is not possible for the end of a pro taper shaper to engaged in and this pushes the workload up to the bigger stronger and more efficient blades this is the antithesis of how all other files on the planet work because in crown down techniques instruments typically lead with their more delicate smaller and less efficient blades the finishers are just opposite of the shapers the finishers have decreasing percentage tapers over the length of a single blade as an example if