Protaper Benefits: Shaping the Future of Endodontics

Protapers are a modern version of nickel-titanium instruments that are actively used during root canal preparation. They are ultra-flexible, so they work in areas that are difficult to reach with traditional tooling. Let's consider the structural features of manual tapepers, their advantages and disadvantages, as well as the procedure for use.

Advantages of working with universal propapers

Protapers are made of a special alloy, which is 56% nickel and 44% titanium. They have the same design as the machine versions, but are used in more complex clinical situations. Due to their ultra-flexibility, high safety and cutting efficiency, they are widely used by dentists in clinics.

Advantages of manual pro tapers:

Easy to use.

Thanks to color coding, it is easy to select the sequence of instruments, regardless of the shape of the root canal. Drying and obturation products have the same color scheme.

Speed.

The work requires only three tools that have high cutting efficiency.

High performance.

Treatment of the root canal and removal of dentinal filings occurs efficiently due to the increased taper of the apical part.

Safety.

The likelihood of deviating from the channel passage is minimal due to the rounded guide tip.

Most dentists prefer the manual option due to better tactile control when performing complex manipulations from an anatomical point of view.

Protapers Universal - instruments for endodontic treatment

Protapers are a new version of the world's most popular endodontic nickel titanium instrument system, meeting the requirements of all dentists in all clinical situations.

Nickel-titanium instruments should not be used to remove polymer pastes from root canals.

Protapers are unique, ultra-flexible files of a new generation that allow the preparation of root canals that are difficult to handle with traditional instrumentation.

Composition: the cutting part of these tools is made of nickel-titanium alloy.

+ Easier

a single sequence of instruments, regardless of the shape of the root canal;
just remember the application protocol (color coding);
Root canal drying and obturation products are specifically designed to work with the ProTaper system and are color coded in the same way.

+ Faster

in most cases only 3 tools are needed;
high cutting efficiency.

+ More efficient

increased taper of the apical part for better root canal processing;
Better removal of dentinal chips thanks to the unique “multiple taper” of the instruments.

+ Safer

the rounded guide tip minimizes the likelihood of deviation from the channel;
There is a manual version of the instruments for anatomically complex clinical situations, as well as for clinicians who prefer to use manual instruments due to better tactile control.

Protaper instruments for endodontic treatment:

ProTaper shaping files

As the name suggests, this class of tapers is used to shape the root canal into the desired shape. It includes files Sx, S1, S2

Protapers Sx

It is used both for treating short root canals and for giving the desired shape to the coronal part of long canals.

The tip of the working part of this tool has a diameter of 0.19 mm, and the diameter of the base is 1.20 mm. The Sx Pro Taper is 19mm long and has a higher taper than the other two shapers.

It should be noted that the taper of this prop taper first increases from D1(.035) to D9(.19) and then drops to .02.

Protapers S1

Designed for preparation of the upper third of the root canal. The tool is available in sizes 21mm and 25mm. The tip diameter of the S1 pro taper is 0.17 mm, and the taper increases throughout the entire working part from .02 to .11.

Protapers S2

Designed for preparation of the middle third of the root canal and, like S1, has a length of 21 mm and 25 mm. The tip diameter of this tool is 0.20 mm, and its taper is 0.04, which gradually increases and reaches 0.115 in section D16.

ProTaper Finish Files

Protapers F1 Protapers F2

Protapers F3

Finishers are designed to finalize the apical third of the root canal, as well as to level and widen the middle third of the canals. They, like shapers, include 3 tools: F1, F2, F3.

The tip diameter of the F1 pro taper is 0.20 mm, F2 0.25, F3 0.30. It is characteristic that all 3 tools in the interval D0-D3 have a fixed taper (.07, .08, .09%, respectively). After D3, although the tool diameter continues to increase, the taper decreases to 0.

055, which increases the flexibility of the propaper.

1. Indications for use: Protapers are intended for use only in a clinical setting by specially trained specialists.

Scope of application: formation and cleaning of the root canal system.

2. Contraindications: Not known.

3. Warnings: None known.

4. Precautions:

ProTaper D3 – for the apical part of the canal

Rules for using ProTaper instruments to remove filling material from root canals

instruments are inserted into the canal by applying light pressure in the apical direction;
regularly remove the instrument from the canal, check its working part and clean it;
if the instrument does not advance deeper, use a hand instrument to overcome resistance and confirm patency of the canal.

Recommended speed:

for removing gutta-percha or Thermafil/ProTaper obturators: 500 – 700 rpm;
for removing pastes based on zinc oxide and eugenol: 250 – 300 rpm.

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Working with manual tapepers: classification

Dental tapepers for endoscopic treatment are used strictly according to the instructions. Each set contains six tools, which can be divided into two groups: shaping and finishing files.

Shaping files are designed to give the root canal a specific shape.

Types of forming files:

SX - used to work with short root canals or to give the required shape to the coronal part of long passes (the length of the protaper is 19 mm, the diameter at the tip of the working part is 0.19 mm, the base circumference is 1.20 mm).

S1 – used for preparing the upper third of the root canal (the size of the manual taper can be 21 or 25 mm, the diameter at the tip is 0.17 mm, the taper increases along the entire length of the working part from 0.02 mm to 0.11 mm).

S2 – equal in length to the previous version, but designed for preparation of the middle third of the root canal (circumference at the tip – 0.2 mm, taper increases gradually from 0.04 mm to 0.115 mm).

Finishing files are used at the final stage to shape the apical third, align and widen the middle third of the canals. They are divided into the following categories: F1, F2 and F3. All have a fixed taper, are quite flexible, but differ in length. Size F1 - 0.2 mm, F2 - 0.25 mm and F3 -0.3 mm.

It is possible to use auxiliary shaping files (shapers), which are used to give the optimal shape to short channels, to access long passages or to determine the directional channel.

Forming files

As the name suggests, this class of tapers is used to shape the root canal into the desired shape. It includes files Sx, S1, S2.

Protaper Sx

The Sx Protaper is used both for processing short root canals and for giving the desired shape to the coronal part of long canals.

The tip of the working part of this tool has a diameter of 0.19 mm, and the diameter of the base is 1.20 mm. The Sx Pro Taper is 19mm long and has a higher taper than the other two shapers. It should be noted that the taper of this prop taper first increases from D1(.035) to D9(.19) and then drops to .02.

Protapers S1

Protaper S1 is designed for preparation of the upper third of the root canal. The tool is available in sizes

21mm and 25mm. The diameter of the tip of the S1 pro taper is 0.17mm, and the taper increases throughout the entire working part from .02 to .11.

Protapers S2

Protapers S2 are designed for preparation of the middle third of the root canal and, like S1, have a length of 21mm and 25mm. The tip diameter of this tool is 0.20mm, and its taper is 0.04, which gradually increases and reaches 0.115 in section D16.

Marking of hand tools

The manual ProTaper is used for the same manipulations as the machine one, but in more complex cases. However, the markings on the products are the same. The standard set consists of six tools, which are distinguished by the color of the handle depending on the technical data.

Standard marking of the handles of assorted manual tapers:

Sx – orange;

S1 – purple;

S2 – white;

F1 – yellow;

F2 – red;

F3 – blue.

These symbols make it convenient to use hand tools in the required order. There are also F4 (with a black handle) and F5 (with a black and yellow), the length of the active area is 22 mm. They are intended for initial or final treatment of root canals.

Design Features

Knowing the operating features and order of manual protapers, it is worth noting their design characteristics. It is thanks to them that the dentist’s work in hard-to-reach places is greatly facilitated.

The design feature that provides operational benefits is as follows:

Multi-stage taper.

Improves flexibility and cutting efficiency, making it unnecessary to go through the canal repeatedly. For example, an Sx file between D1-D9 has a progressive taper from 3.5% to 9% and a fixed taper of 2% between D10-D14. Also, file S2 has nine values, and S1 has 12.

The trihedral cross-section is convex.

Thanks to this, the main rod is strengthened, and the tool itself becomes super flexible. It also significantly increases safety, since the torsional load is reduced and the likelihood of contact between the walls of the channel and the tool blade is minimal.

The spiral steps and angles change.

The helix and pitch angles are constantly changing, making it easier and more efficient to extract waste material.

The tip diameter differs depending on the file.

Files, both finishing and forming, have different diameters for safe and efficient advancement deep into the canal.

The guide tip is modified.

Due to the shape of the tip, the use of the instrument does not damage the canal walls, penetrating through soft tissue.

Short handles.

The handles are up to 12.5 mm in size, which improves access to chewing teeth.

Set of six tools.

Allows you to prepare canals of any complexity, making hand instruments universal.

ProTaper Geometry

Forming Files

The auxiliary shaping file, or Shaper X (Sx), is easy to recognize as there is no identifying ring on its gold-painted handle. Shaper X, also called Sx, has a total length of 19mm, providing excellent access into the depth of the root canal. The Sx file has a D0 diameter of 0.19mm, a modified tip and a D14 diameter of about 1.20mm. Shaper X has a much higher degree of taper from D0 to D9 compared to the other two shaping files. For example, at the location of diameters D6, D7, D8 and D9, these tools have transverse diameters approximately equal to 0.50, 0.70, 0.90 and 1.10 mm, respectively (Fig. 4). This file is used to give the optimal shape to short root canals, to determine the direction of the canal and to form the coronal part for access when preparing long root canals. Shaper X offers significant performance advantages over Gates Glide and other root canal shaping instruments currently in use.

Figure 4

SX (Shaper X) has 9 progressively larger tapers from 3.5% to 19% and is used to cut dentin with light scraping movements in a reverse direction between D6 - D9.

Shaping file #1 and shaping file #2, called S1 and S2, are easily identified by the purple and white identification rings on their handles. Files S1 and S2 have D0 diameters of 0.17mm and 0.20mm respectively, modified guide tip, and their maximum D14 notch diameters approach 1.20mm (Fig. 5). Shaping files have a progressively increasing taper along the length of their cutting blades, allowing each instrument to process, cut and prepare a specific area of the canal. Shaping file No. 1 is designed to prepare the coronal third of the canal, while shaping file No. 2 enlarges and prepares its middle third. Although both instruments optimally prepare the coronal two-thirds of the canal, they also consistently increase the apical third.

Figure 5

S1 and S2 have a progressive increase in taper along the entire length of the blades, allowing each instrument to prepare a different area of the canal using the crown-down method.

"Finish" Files

The three finishing files, called F1, F2 and F3, have yellow, red and blue rings on the handles, corresponding to D0 diameters of 0.20, 0.25 and 0.30mm respectively. In the interval D0–D3, files F1, F2 and F3 have a fixed taper of 7%, 8% and 9% (Fig. 6). Between D4 and D14, each tool has increasing transverse dimensions, but more importantly, over the same length, each tool has a decreasing percentage of taper. On a separate section of the file's cutting blades, this promotes flexibility and also reduces the risk of tool locking. Although these instruments are designed to optimally complete the apical third, they also consistently widen and shape the middle third of the canal. Preparation of the apical third usually requires only one finishing instrument.

Figure 6

Finishing files have different diameters and D0 tip tapers to create a smooth transition from the apical preparation to the middle third.

Indications and contraindications for use

The method used by manual tapers is so delicate and filigree that the devices are used only in a medical facility by specialists who have undergone special training. The instruments are designed for shaping and cleaning root canals. Their super flexibility makes the channel easier to clean.

Their introduction is carried out with light pressure, which ensures patency of the area. But at the same time, you must observe the speed limit within 500-700 rpm. There are no contraindications to the use of hand tools.

Disadvantages of working with propapers

Despite having many advantages, manual tapers also have disadvantages.

The disadvantages include:

inability to process wide canals (more than size 30), since there is no instrument with a large apical diameter;

the maximum length of the canal that can be processed reaches 31 mm;

a mechanism to prevent obstruction is not provided; a layer of lubricant may remain on the canal walls, which will subsequently prevent medications from entering the canal.

Precautionary measures

When using hand tools, you should adhere to certain rules.

Precautions are as follows:

many instruments are marked for “single use” (reusable sterilization and disinfection increase the risk of file fracture);

Protapers are not immersed in sodium hypochlorite solution, the concentration of which exceeds 5%;

cleaning is carried out strictly according to the instructions;

manual propapers are used at a constant speed within 150-350 rpm;

the file is checked for possible deformation, the grooves should be cleaned as often as possible;

to create straightforward access to the canal, it is worth using shaping files with separate sweeping movements;

sweeping movements are not applied to finishing files;

Using finishing files over the entire working length, you should immediately remove the tool.

Method of mechanical treatment of root canals

Processing of canals using hand instruments is carried out in different ways, which directly determines the use of manual protapers in order.

Types of processing techniques:

Standard.

Manual endotonic instruments are used starting from the smallest size. As you move along the channel, increasingly larger diameter propapers are used, reaching all the lengths of the passage. Processing occurs with one large K-file. Once fully inserted into the canal, the instrument is rotated 90 degrees clockwise in depth.

The reverse rotation occurs with slight pressure counterclockwise 270 degrees. Then follows another turn in the opposite direction by 180 degrees. After this, the instrument is removed from the mouth, treated with medications and reinserted into the canal for its entire length.

Step-back.

First, the root canal must be expanded to the apical foramen, after which a K-file is inserted one size larger, but 1 mm less than the working length. Afterwards, the tool is changed, in which the working length gradually changes (by 2, 3 mm, and so on). With the help of H-files, the surface of the root is smoothed, and thus its taper is formed.

Crown-down.

The formation of the ostial middle part and access to the apical third of the canal is carried out after expansion of the orifice. Next, the working length and tooling are determined. The canal walls are leveled in the final part.

Finish files

Finishers are designed to finalize the apical third of the root canal, as well as to level and widen the middle third of the canals. They, like shapers, include 3 tools: F1, F2, F3.

General recommendations

According to the methodology, manual protapers undergo disinfection, cleaning and sterilization before use (18 minutes using an autoclave and at a temperature of 134 degrees, pressure no more than 3 bar).

General provisions include the following:

Disposable instruments cannot be reused.
The doctor who uses the instrument is responsible for the sterility of the product.
To avoid contamination, you should use personal protective equipment (goggles and gloves).
Disinfectant solutions must be of high quality.
Hydrogen peroxide destroys tungsten carbide burs, nickel titanium instruments and plastic stands.
Do not use caustic soda solutions, alkali or mercury salts.
The maximum number of hand tool processing is limited to five. After this they begin to collapse.

PROTAPERS - STEP-BY-STEP INSTRUCTIONS FOR USE

Create direct access to the root canal orifice.
Constantly irrigate and check the patency of the carpet with an ISO 15 size hand file.
Usage protocol:

Locate the mouth.
Passively use an ISO size 15 hand file until you feel resistance.
Use the S1 shaping file, working in a sweeping motion until you reach the penetration depth of an ISO size 15 hand file.
Repeat this sequence until you have determined the working length using an ISO size 15 hand file and have gone through the entire working length of the canal using the S1 tool.
Use the S2 shaping file, working in a sweeping motion until you reach working length.
Confirm the working length.
Use the F1 finishing file (without sweeping movements), moving it deeper with each insertion until you reach working length.
Calibrate the apical foramen using hand files.
Use the appropriate finishing file (F2, F3, F4, F5) without sweeping movements to the full working length if additional expansion is needed or if the apical foramen is larger. If necessary, use Sx sweeping movements to remove ostial dentin and/or to create a wider coronal portion of the canal.

Protaper Universal - video, operating method

6. Disinfection, cleaning and sterilization: Clean the instruments and stand first. Then sterilize the instruments in the bags using an autoclave at 134ºC, 3 bar pressure for 18 minutes.

6.1 General recommendations

Tools marked "disposable" are not intended to be reused.
The user is responsible for the sterility of the product upon first use and each subsequent use, as well as for the use of damaged or contaminated instruments.
For your own safety, please use personal protective equipment (gloves, goggles).
Use disinfectant solutions with proven effectiveness (listed by the German Society for Hygiene and Microbiology; CE marked; approved by the German Inspectorate for Hygiene and Microbiology).
quality of food products and medicines).
Tungsten carbide burs, plastic stand, hand tools and nickel - titanium tools are destroyed by hydrogen peroxide (H2O2) solution.
Nickel-titanium instruments are destroyed when immersed in a NaOCl solution for more than 5 minutes with a concentration of more than 5%.
Aluminum instruments are destroyed in a solution of caustic soda with mercury salts.
Do not use acidic (pH < 6) or alkaline (pH > solutions.
After 5 processing cycles, markings may be destroyed