Chances are you use a file in your daily work that you like or at least tolerate. Why not love the instruments you use? When you give the K3™XF, the new NiTi file from Axis |SybronEndo, a try, you will never look back. Here’s why:
- The K3XF is the most robust file available. The new NiTi file can handle the most pressure without separating or breaking. Period. To learn more, read When Strength and Flexibility are Key by Dr. Philippe Sleiman.
- The new K3XF is one of the most flexible files offered. The elasticity of the file allows clinicians to go around several or severe curvatures within the same canal.
- You may not need to upgrade your endodontic motor. As a long as you already have a motor that you use for endodontics, and you can set the speed at a minimum of 500 rpm, you can use your current endodontic motor.
- Convenience is offered with new taper and tip sizes. Do you use the GT File System? Good news: the new K3XF offers all of the corresponding taper and tip sizes to make your procedure prep and execution even more efficient.
- The K3XF offers a complete shaping and filling technique. While the original K3 provided you with appealing safety and self-centering features, the K3XF offers these plus a new level of flexibility and resistance to cyclic fatigue. The robust yet flexible file is developed by proprietary R-phase Technology.
K3XF is the ultimate in safety, flexibility and control.
If you have previously used the K3 file but found it too rigid, give the K3™XF a try. The new NiTi file has all the same great elements of the K3, including safety and self-centering features, but has undergone a proprietary heat treatment that allows it to be not only the most robust file, but one of the most flexible on the market.
Half the Stiffness, Twice the Resistance
The K3XF is actually the same instrument as the K3 throughout the manufacturing process. However, after the instrument is manufactured, the new file undergoes the Axis | SybronEndo R-Phase™ Technology, which enables it to become more flexible.
This R-Phase Technology is the process of heating, cooling and twisting to produce a cutting instrument that resists fracture and possesses ultimate tactile control. This slight modification in the file’s crystalline structure gives these instruments the desired flexibility while making them strong enough to uphold patient safety. Following this treatment, the K3XF offers half the stiffness but twice the resistance to fracture.
New Tip and Taper Sizes Correspond to the GT File System
To ensure the K3XF delivers the most convenient experience possible, we have also added tip and taper sizes that correspond to the GT File System. Convenience, strength and flexibility can now be found in one file: the K3XF.
At Axis | Sybron Endo, clinicians often ask us what makes the K3™XF Nickel Titanium File different from other NiTi files on the market. Our answer? Unparalleled robustness and flexibility. In fact, the K3XF possesses only half the stiffness of other files but provides two times more resistance to fracture.
What Makes the K3XF Different?
The K3XF is indeed the most robust file on the market—it can handle the most pressure without separating or breaking. The new file is also one of the most flexible NiTi files (outmaneuvered only by our own Twisted File). The elasticity of the file allows clinicians to go around several or severe curvatures within the same canal.
Why is it so Robust and Flexible?
With advancements in manufacturing and technology, dental files have reached a new level of strength and flexibility. Heat treatments have allowed manufacturers to modify the crystalline structure of NiTi metal, helping to create several different alloy files, including the K3™XF.
However, working with the natural grain structure of nickel titanium creates micro fractures along the length of the instrument often, which often undermine the strength of files.
Our proprietary R-Phase™ Technology is the process of heating, cooling and twisting to produce a cutting instrument that resists fracture and possesses ultimate tactile control. This slight modification in the file’s crystalline structure gives these instruments the desired flexibility while making them strong enough to uphold patient safety. Reducing fracture risk helps the clinician achieve better clinical results, increased confidence and predictable profitability.
At the Dubai Sky Clinic, Dr. Philippe Sleiman often performs challenging root canal retreatments following referrals from other doctors in the area. In our last blog we learned how he successfully treated a patient who had two files trapped and separated in the mesial canals and whose distal canal had not been originally treated to full working length. Here, we find out how Dr. Sleiman performed a retreatment with several challenges, including a crown placed on the tooth and a fiber post inside the distal canal.
When the patient arrived at Dr. Sleiman’s office, she was experiencing pain in her lower molar. “The preoperative X-ray showed an apical lesion with an incomplete root-canal treatment,” he says. “Because diagnostics found no sign of a root-canal crack, retreatment was my choice. However, we had to overcome two obstacles: the crown placed on the tooth and the fiber post inside the distal canal.”
When he discovered the roots were fused, Dr. Sleiman’s plan of action included going through the crown without removing it as to not place any unnecessary tension on the distal canal. He managed to remove the filling surrounding the post, and with the use of the ultrasonic WHAT, removed the fiber post itself together with the previous filling from the access cavity. “Using the K3XF after removal of the fiber post was a great help in reshaping the root-canal system, which appeared very convergent,” he says. “The files displayed no sign of metal fatigue and the 25.06 was taken deeper into the canal compared with the standard K3 files. The extra flexibility and strength of the K3XF allowed me to perform crown down and final apical shaping.”
Dr. Sleiman continued the treatment using Elements Obturation Unit and RealSeal material. Post-operative x-rays showed the merging canals and the fiber-post space had successfully been cleaned, shaped and filled.
When each challenge is approached using the most precise, appropriate instruments, success is much more likely.
Choosing the right instruments for root canal retreatment is imperative, as discussed in our previous blog. This has become simpler since the development of heat treatments that allow the crystalline structure of NiTi metal to be modified, resulting in a more accommodating combination of strength and flexibility found in files. The K3 system files, known to be robust yet safe, are a particular favorite of Dr. Philippe Sleiman of the Dubai Sky Clinic. In Roots, Dr. Sleiman discusses the K3™XF files in detail, sharing two clinical studies in which the files helped him successfully perform root canal retreatments.
When the first patient reached Dr. Sleiman’s office after a two-hour drive, two files had been trapped and separated in the mesial canals. “The separated files in the mesial canals were clearly visible,” Dr. Sleiman says. “It was also noticeable that the distal canal had not been treated to full length.” Using ultrasonic tips and an operating microscope, Dr. Sleiman retrieved both of the separated files. He then needed to reshape the canals and retreat the distal canal.
“Owing to the combination of requirements for the treatment of this case—shaping and retreatment in one tooth—my instruments of choice were K3XF files,” Dr. Sleiman says. He started with 25.08, followed by 26.06 and finished crown-down with 25.04. “This gave access to the apical part,” he says, “which was enlarged to 35.04 in the mesial and distal canals in order to prepare the apical portion of the root-canal system.”
During the treatment, the micromotor used for the shaping procedure was operated at 500 rpm, and a sequence of push-and-pull movements (four to five strokes per canal) with each file was completed to reach the canal’s full working length. The obturation of the canals was then performed with RealSeal after both separated files had been removed and the root-canal system reshaped.
Check back next time to find out how Dr. Sleiman performed a retreatment with several challenges, including a crown placed on the tooth and a fiber post inside the distal canal.
The biggest challenge for endodontists during root canal retreatment is often the task of re-establishing the initial pathway of the canal and its original apex. This is partly due to the use of gutta percha to fill root canals over the past 10 years. To retreat the canal, this gutta percha must be removed and the canal renegotiated.
While NiTi rotary files are used in many of these cases to expedite the procedure, other complications arise when debris from the previous obturation and the density of the obturation material are particularly complicated to work with. So how do you overcome these difficulties to successfully retreat the canal? Choose the right instrument.
Let’s consider two issues that must be overcome and how to do so with the most appropriate instruments:
- First, you must penetrate the mass of the obturation material. Therefore you need to choose a file with a strong tip that can endure pressure and engage the mass of the gutta percha, ultimately splitting it and breaking it down.
- You should also choose an instrument that can enter the root-canal structure and engage the obturation material, moving it out coronally, while remaining flexible enough to maneuver around curves and shape the canal surface.
With advancements in manufacturing and technology, dental files have reached a new level of strength and flexibility, a combination that leads to retreatment success. Heat treatments have allowed manufacturers to modify the crystalline structure of NiTi metal, helping to create several different alloy files, including the K3™XF. The K3 system files are known to be robust yet very safe. “The slight modification in their structure gives these files much-needed flexibility, while preserving their very high safety levels,” says Dr. Philippe Sleiman of the Dubai Sky Clinic.
“My favorite sequence of theK3 system is the G-pack, which allows me to do crown-down using the taper of the files and keeping the tip stable at ISO 0.25. This sequence allows for a very nice start, removing the obturation material from the coronal third with relatively short files, such as orifice openers, and doing so in a relatively short time,” Dr. Sleiman says. “The deeper we go, the more we need to decrease the taper, especially when curves are present inside the canals and smaller taper files are needed.” At this point, it is the file’s flexibility (achieved by the heat-treated alloy) that gives the instrument the ability to navigate curves without distorting the canals or damaging the file structure.
These claims have been demonstrated in research as well as clinically, so check back as we discuss cases in which Dr. Sleiman uses the K3XF to successfully retreat root canals.
In our previous blog
, we discussed that even the most diligent and accurate endodontists experience file fracture and separation. We also revealed three best practices professionals can implement to decrease the likelihood of instrument fracture:
- Ensure there is straight line access to the canal
- Create a glide path to serve as a map from the canal orifice to the canal terminus
Here, we continue our list of best practices for reducing file separation during root canal treatments and retreatments:
- Choose the right file size to set the tone for canal treatments and retreatments
- Never push apically on any file system. While there are many file systems available on the market, it’s imperative that you never push apically on any file system. The Golden Rule for working with any file is to never push any harder than with the pressure that would break a sharp lead pencil.
- Use the optimum amount of lubrication. Using enough lubrication in the canal is key in helping prevent file fracture and separation. The pulp chamber should always be filled with some type of lubricant—sodium hypochlorite (NaOCl) is the most common solution used. EDTA, water, H2O2, and anesthetic are also commonly used. Whichever solution you choose to work with, it is imperative NiTi rotary files never be used in a dry canal.
- Inspect the file after use. While proper technique and instrument care can decrease the frequency of fracture, it cannot totally eliminate the risk of file fracture and separation during canal treatments. That’s why it’s imperative to inspect the file after use; look for marks of fatigue that would cause fracture if you were to use the file again.
It is important to note that different manufacturers have various directives when it comes to speeds and torques that should be used with their files. However, the best thing to keep in mind is that no files should be pushed. If the file does not progress easily in the root canal system, it should be switched to the next smallest tip or taper in that file system.
Root canal treatments and retreatments are meticulous, intricate procedures that not only require skillful, nimble hands, but also strong, sterile instruments. Professionals who do not dedicate time and effort to ensure proper technique will experience fracture and separation regularly, oftentimes without prior warning.
But even the most diligent and accurate endodontists experience fractures. After all, most files endure fractures as part of the machining process to begin with.
While avoiding file fracture and separation during all canal treatments isn’t yet possible, there are a few best practices endodontists can implement to decrease the likelihood of instrument fracture. Here, we discuss three:
- Ensure there is straight line access to the canal. Before placing files into the canal, all impediments and obstructions must be removed. When you place your first file into the canal, it should literally stick straight up in the mouth.
- Create a glide path. Creating a glide path will serve as a map from the canal orifice to the canal terminus, which rotary shaping files can then follow. (Glide paths are often created with size 10, 15, and 20 stainless steel hand files.) Creating a .02 tapered glide path is imperative for the safe use of larger tapered rotary instruments. Even with magnification, you cannot see down inside the canal; using these tools gives you a sense of what is in the root canal system.
- Choose the right file size. The file sizes you select will set the tone for your canal treatments and retreatments. The fit and tightness of the hand files in the canal will dictate which system you should use.
- For small canals, a .04 tapered #25 file is recommended
- For medium canals, a .06 tapered #25 file is recommended
- For large canals, a .08 tapered file with a #25 tip is recommended
Check back next time for additional best practices you can use to decrease the likelihood of file fracture and separation.