1. Cleaning & Shaping Presented by:
Josef Ma. Karlos S. Bringas, D.M.D., D.D.S., M.S.
Department of Endodontics

2. Endo Guards

3. Prerequisites 1. Record the following information:
Length of root in mm = PATENCY LENGTH
b. Working length (WL)
= (Length of root) – 1.0 mm
c. Master Apical Rotary (MAR) length
= WL – 1.0 mm
= (Length of root) – 2.0 mm

4. Lengths
Record the following:
Tooth length WL
MAR length

5. Lengths
Record the following:
Tooth length WL
MAR length

6. Lengths
23 mm
Record the following:
Tooth length: 23mm WL
MAR length

7. Lengths Record the following: Tooth length: 23mm WL: 22mm MAR length

8. Lengths Record the following: Tooth length: 23mm WL: 22mm
MAR length: 21mm

9. Prerequisites 1. Record the following information: 2. Patency.
a. Length of root in mm = PATENCY LENGTH
b. Working length (WL)
= (Length of root) – 1.0 mm
c. Master Apical Rotary (MAR) length
= WL – 1.0 mm
= (Length of root) – 2.0 mm
2. Patency.

10. Patency
Set the stops to Patency Length.
#10
#15

11. Patency
23 mm
Set the stops to Patency Length.
#10
#15

12. Patency
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

13. Patency
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#15
#10

14. Patency
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

15. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

16. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

17. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

18. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

19. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#15
#10

20. Patency
23 mm
Determine if a #10 or #15 hand file can be inserted to the apical terminus.
Always use RC Prep.
#10
#15

21. Steps of C&S ( Technique)
Rotary file cleaning and shaping.
2. Apical preparation.

22. Steps of C&S ( Technique)
Rotary file cleaning and shaping.
35/.12
20 series
30 series
2. Apical preparation.

23. Coronal Preparation Use the ProFile GT .35/.12, 17mm file.
The color band denotes size.
Green band means a size 35.

24. Coronal Preparation Use the ProFile GT .35/.12, 17mm file.
The color band denotes size.
Green band means a size 35.
Each band denotes 0.02mm of taper,
thus 6 x (0.02) = 0.12mm taper.

25. Use of Rotary Handpiece
Use 8:1 gear reduction attachment.
Run at constant speed:
(500 rpm’s)
20 series & 30 series (300 rpm’s)
USE LIGHT PRESSURE.

26. Use of Rotary Handpiece
Start the handpiece before entry into the canal and maintain at a constant rpm’s.
The file should not be in contact with canal walls for more than 5 seconds.
Advance the file slowly and carefully in mm increments using constant light pressure.
NEVER FORCE A FILE IN A CANAL.

27. 35/.12
Hand fit file to binding point.

28. 35/.12
Hand fit file to binding point.
Back-up stopper by 1-2mm.

29. 35/.12
Hand fit file to binding point.
Back-up stopper by 1-2mm.

30. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

31. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

32. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

33. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

34. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

35. 35/.12 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.

36. 2mm advancement accomplished
35/.12
Hand fit file to binding point.
Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in 1mm increments.
2mm advancement accomplished

37. Recap Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

38. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

39. Rotary File Instrumentation
Use of 20 series Profile GT

40. 20/.10
Hand fit file to binding point.

41. 20/.10
Hand fit file to binding point.

42. 20/.10
Hand fit file to binding point.
Back-up stopper by 1-2mm.

43. 20/.10
Hand fit file to binding point.
Back-up stopper by 1-2mm.

44. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

45. Stop usage of file after:
21 mm
2mm advancement.
File stalls twice.
File advancement to MAR length.
Ex: MAR = 21mm

46. Stop usage of file after:
21 mm
2mm advancement.
File stalls twice.
File advancement to MAR length.
Ex: MAR = 21mm

47. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

48. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

49. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

50. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

51. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

52. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

53. 20/.10 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

54. 2mm advancement accomplished
20/.10
Hand fit file to binding point.
Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
Stop! Change file.
2mm advancement accomplished

55. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

56. Rotary File Instrumentation
After using the 20/.10 file, irrigation and recapitulation, the next file in the series, 20/.08, is used.
The sequence is:
20/.10, 20/.08, 20/.06, 20/.04
This is done until MAR is reached.

57. 20/.08
Hand fit file to binding point.

58. 20/.08
Hand fit file to binding point.
Back-up stopper by 1-2mm.

59. 20/.08
Hand fit file to binding point.
Back-up stopper by 1-2mm.

60. 20/.08 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

61. 20/.08 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

62. 20/.08
Hand fit file to binding point.
Back-up stopper by 1-2mm.

63. 20/.08 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
File stalls once.

64. 20/.08
Hand fit file to binding point.
Back-up stopper by 1-2mm.

65. 20/.08 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

66. 20/.08 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
STOP! Change file.
File stalls 2x

67. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

68. 20/.06
Hand fit file to binding point.

69. 20/.06
Hand fit file to binding point.
Back-up stopper by 1-2mm.

70. 20/.06
Hand fit file to binding point.
Back-up stopper by 1-2mm.

71. 20/.06 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

72. 20/.06 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

73. 2mm advancement accomplished
20/.06
Hand fit file to binding point.
Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
Stop! Change file.
2mm advancement accomplished

74. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

75. 20/.04
Hand fit file to binding point.

76. 20/.04
Hand fit file to binding point.
Back-up stopper by 1-2mm.

77. 20/.04
Hand fit file to binding point.
Back-up stopper by 1-2mm.

78. 20/.04 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.

79. 20/.04 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
MAR reached

80. 20/.04 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
Stop!
MAR reached

81. 20/.04 Hand fit file to binding point. Back-up stopper by 1-2mm.
Attach file to handpiece and advance apically in mm increments.
Stop!
Recapitulate.

82. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

83. Recap Irrigate with NaOCl
23 mm
Irrigate with NaOCl
Recapitulate with #15 file. Length should reach to entire length of the tooth. Ex. 23mm

84. FAQ #1 “I reached MAR with a 20/.06 file, do I still use a 20/.04?”
Answer: This is usually common with larger canals. There is no need to use the 20/.04 file, it is ok to move to the 30 series.

85. FAQ #2
“I am done using the 20/.04 file but I have not reached MAR length yet… what do I do?”
Answer: This is true for narrower canals. If this scenario happens, cycle through the files again until you reach MAR.

86. FAQ #2
“I am using the 20/.04 file but the file stalled twice. I have not reached MAR yet… what do I do?”
.10
.08
.06
.04

87. Rotary File Instrumentation
Use of 30 series Profile GT

88. 30/.04
21 mm
After the 20 series, the 30/.04 file is used.

89. 30/.04 After the 20 series, the 30/.04 file is used.
21 mm
After the 20 series, the 30/.04 file is used.
Stopper length is set at 21mm which is the MAR length.

90. 30/.04 After the 20 series, the 30/.04 file is used.
21 mm
After the 20 series, the 30/.04 file is used.
Stopper length is set at 21mm which is the MAR length.

91. 30/.04 After the 20 series, the 30/.04 file is used.
21 mm
After the 20 series, the 30/.04 file is used.
Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length.

92. 30/.04 After the 20 series, the 30/.04 file is used.
21 mm
After the 20 series, the 30/.04 file is used.
Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length.
MAR reached

93. 30/.04 After the 20 series, the 30/.04 file is used.
21 mm
After the 20 series, the 30/.04 file is used.
Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length.
STOP!
Recapitulate.
Change to 30/.06.
MAR reached

94. 30/.06
21 mm
Stopper length is set at 21mm which is the MAR length.

95. 30/.06
21 mm
Stopper length is set at 21mm which is the MAR length.

96. 30/.06 Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length is reached.

97. 30/.06 Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length is reached.

98. 30/.06 Stopper length is set at 21mm which is the MAR length.
The file is used until MAR length is reached.
STOP!
Recapitulate.
Proceed to Apical Preparation.
MAR reached

99. Steps of C&S ( Technique)
Rotary file cleaning and shaping.
2. Apical preparation.

100. Apical Preparation Apical Gauging
Master Apical File (MAF) determination

101. Apical Gauging
To determine the apical terminus diameter.

102. Apical Gauging
To determine the apical terminus diameter.

103. Apical Gauging

104. Apical Gauging
Use handfiles starting with the 20/.02

105. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)

106. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

107. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

108. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

109. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

110. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

111. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

112. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

113. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file.

114. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file. (ex. 25 is apical gauging file)

115. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file. (ex. 25 is apical gauging file)

116. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file. (ex. 25 is apical gauging file)

117. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file. (ex. 25 is apical gauging file)

118. Apical Gauging Use handfiles starting with the 20/.02
Stopper length is set at Patency Length. (ex. 23mm)
Insert file passively until apical resistance is encountered.
The 1st file that resists apical movement is the apical gauging file. (ex. 25 is apical gauging file)

119. MAF
22 mm
MAF is 1-2 sizes larger than the apical gauging file.(ex. Since apical gauging file is size 25, then a size 35 MAF is chosen.)

120. MAF
22 mm
MAF is 1-2 sizes larger than the apical gauging file.(ex. Since apical gauging file is size 25, then a size 35 MAF is chosen.)
Record MAF on your tx record.

121. Treatment Record

122. MAF
22 mm
MAF is 1-2 sizes larger than the apical gauging file.(ex. Since apical gauging file is size 25, then a size 35 MAF is chosen.)
Record MAF on your tx record.
The canal should be cleaned and shaped to MAF at Working Length.

123. MAF
22 mm
Set length of files to the Working Length.

124. MAF
22 mm
Set length of files to the Working Length.

125. MAF Set length of files to the Working Length.
22 mm
Set length of files to the Working Length.
Use reaming motion or watch winding motion to clean and shape the canal.

126. MAF Set length of files to the Working Length.
22 mm
Set length of files to the Working Length.
Use reaming motion or watch winding motion to clean and shape the canal.

127. MAF Set length of files to the Working Length.
22 mm
Set length of files to the Working Length.
Use reaming motion or watch winding motion to clean and shape the canal.

128. MAF Set length of files to the Working Length.
22 mm
Set length of files to the Working Length.
Use reaming motion or watch winding motion to clean and shape the canal.
Irrigate.
Recapitulate after each file.
Place MAF to Final Working Length and take a radiograph.

129. Steps of C&S ( Technique)
Rotary file cleaning and shaping.
35/.12
20 series
30 series
Apical preparation.
Apical Gauging
MAF
MAR
Patency length WL