Here is a lower molar we will be using to demonstrate ProTaper Gold™ technique.
Upon completion of the initial access, a canal lubricant with a viscous chelating agent is
introduced to aid in exploring the canal spaces.
As with any instrumentation technique, a small
hand file is introduced. In this case, a number 10, is placed in the mesial lingual canal.
This is the only canal we will focus on in this video.
The hand file has been precurved and is gently worked to our estimated length.
Irrigation of the space is next.
The canals are filled with sodium hypochlorite.
Creating a good radicular access is the purpose of the SX instrument.
This is worked into the canal space. The focus is on the coronal aspect.
As you can see, we are employing a brushing technique, always working away from the furcation.
Upon removal, the debris pattern in the flutes clearly shows that the instrument was only
working in a very small area of the canal.
Here you can see how the SX flared the access to this canal.
After more irrigation, the glide path must be established.
In this case, we utilize the ProGlider™ instrument. This is carefully taken to length.
For this video, we've edited out the irrigation and confirmation of patency to get right to the shaping.
The S1 is taken into the canal. In this case, the instrument makes easy progress with each dive.
Pressure is very light. And the flutes do not feel as if they've been filled up,
and we are able to brush our way to length.
While we did this in one pass in this particular canal,
every situation is different, and you should be prepared to make multiple passes to get to length.
As you look at the debris pattern on the S1, there are virtually no
tissue remnants in the apical flutes. Cutting is concentrated in the coronal and mid-root area by design.
The S2 follows the usual irrigation and patency check.
We again emphasize the brushing motion,
moving back and forth as well as up and down in the canal space.
We take a few extra strokes here just so you can see it clearly.
With length achieved, let's look at the debris pattern.
What little debris is generated is concentrated in the middle of the file's flutes.
The hand file gently worked into the space here, shows us
that we are still on target with our working length. This moves us into the finishing phase.
With the ProTaper Gold technique, we always go in order from smallest up, so the F1 is introduced.
This instrument is a twenty at the tip so it's going to be very close to
the apex with its initial insertion.
And because of the decreasing-taper design, this instrument
is not going to do much work beyond the apical zone.
We work the instrument in the space very gently,
until we are satisfied that we will not progress any further, or we've reached length.
Our finishing criteria is based upon the debris pattern in the flutes.
As you can see, there is very little debris in the most apical flutes.
So the shape at the apex can stand to go a little larger.
The F2 is a twenty-five at the tip and is worked toward the apex.
If it looks like we are brushing with this instrument, you're seeing it correctly.
The ProTaper Gold finishers can be used in this fashion where appropriate.
In this mesial lingual canal, we are creating more shape between the mid-root area and the apex, as
we work our way toward the canal terminus. Again, the lack of the apical debris in the
flutes of the F2 indicate that the final shape is not quite complete and that we should move to the F3.
The F3 has a thirty tip. We know, based on anatomical norms, that this is probably
as big as we are going to go.
The instrument is gently worked into the canal, taking little bites with each brush stroke.
When length is achieved, the file is removed and a good debris pattern is displayed in the flutes.
Full apical flutes on the file means a finished shape.
We can be confident that when it is time to obturate, we have a beautiful shape
that will easily accept our filling materials.