protaper next technique paper - dr. ruddle · the protaper next sequence is always the same...

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DENTISTRYTODAY.COM • JUNE 2013

DENTSPLY Tulsa’s ProTaper NEXTA New Standard in Safety and Efficiency

Clifford J. Ruddle, DDS

The recently launchedProTaper NEXT (PTN) ro-tary file system (DENTS-

PLY Tulsa Dental Specialties)has 3 unique design featuresthat influence performance.The system consists of 5 files of

varying D0 diameters and tapers that can be uti-lized for shaping virtually any canal. Generally,only 2 or 3 files are used to optimally shapemost canals.

Like ProTaper Universal, PTN utilizes thehighly successful variably tapered design featureon a single file. Specifically, a file with a decreas-ing tapered design strategically improves flexi-bility, limits shaping in the body of the canal, andconserves coronal two-thirds dentin. Anothercritical PTN design feature is the utilization ofheat treatment technology, resulting in M-WIRE.Research has shown that M-WIRE, a metallurgi-cally superior version of Ni-Ti, improves theresistance to cyclic fatigue by 400% when com-paring files of the same D0 diameter, cross sec-tion, and taper.

The third critical designfeature of PTN is related toutilizing the most recenttechnological advance-ment: an offset mass of rota-tion. A file with an offsetdesign generates an as-symetrical wave of motionalong its active portion,resulting in only 2 points ofcontact between the fileand dentin (Figure 1). Assuch, this feature serves todecrease engagement andincrease the capacity toauger debris out of a canal.Importantly, a file with anoffset mass of rotation willmore safely and efficientlycreate the same-sized shapeas would be required from alarger, stiffer, fixed-taperedfile with a centered mass ofrotation.

CLINICAL PROCEDURE1. Prepare straightline access to canal orifice.2. Explore the canal using small-sized handfiles, determine working length, verify patencyand confirm a smooth, reproducible glide path(Figures 2 and 3).3. Expand the glide path using a size 15 handfile or an equivalently sized dedicated mechan-ical glide path file.4. Use the X1 file (17/04) in an outward brush-ing manner to passively progress inward.Continue in one or more passes until workinglength is reached (Figure 4).5. Use X2 (25/06) exactly as described for X1until working length is reached (Figure 5).6. Inspect the apical flutes of the X2 file. If theyare loaded with dentin, then the shape is cut,the correspondingly sized gutta-percha mastercone or size verifier may be fitted, and the canalis ready for disinfection.7. Alternatively, gauge the foramen with a Ni-Tisize-25 hand file and—if this file is snug atlength—the canal is shaped and ready for dis-infection.8. If the Ni-Ti size-25 hand file is loose at length,

then continue shaping with the X3 (30/07) and,when necessary, the X4 (40/06) or X5 (50/06),gauging after each instrument with Ni-Ti sizes30, 40, or 50 hand files, respectively.

TECHNIQUE TIPS1.Use PTN files at 300 RPM and a torque of 4 to5.2 Ncm.2.Use PTN files in any region of a canal that hasa confirmed and reproducible glide path.3. Irrigate with NaOCl, recapitulate, and re-irri-gate after using each PTN file.4. Frequently clean and inspect the PTN flutes.5. Use a deliberate brushing motion away fromexternal root concavities to facilitate file pro-gression, wall contact, and subsequent 3-D dis-infection.

The ProTaper NEXT sequence is always thesame regardless of the length, diameter, or cur-vature of the canal. This remarkable systempromises to set a new standard for safety, effi-ciency, and simplicity for shaping canals.Shaping canals facilitates 3-D cleaning and fill-ing root canal systems (Figure 6).

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Figure 1. Figure 2. Figure 3.

Figure 4. Figure 5. Figure 6.

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