CliniCal hintS4 2. Tapers Most dentists are now aware of the concept of tapers. For nearly 50 years...
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COMPILED BY DR. GAVAN O’CONNELL M.D.Sc (Melb) L.D.S. (Vic) WITH THANKS TO DR CLIFF RUDDLE D.D.S. CLINICAL HINTS
Transcript of CliniCal hintS4 2. Tapers Most dentists are now aware of the concept of tapers. For nearly 50 years...
Compiled by dr. Gavan o’Connellm.d.Sc (melb) l.d.S. (vic)with thankS to dr Cliff ruddle d.d.S.
CliniCal hintS
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Contents
advantages of niti rotary Systems 3
protaper universal technique Guide 8
preparation Sequence
1. Scout Coronal �/3rds 9
�. pre-enlargement of Coronal �/3rds 10
3. Scout apical 1/3rd 1�
4. finish apical 1/3rd 1�
finishing the preparation with protaper universal for hand use 15
obturation 16
retreatment 17
ordering information 18
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Advantages of NiTi Rotary Systems
In the last decade, after generations of little change, various technological advances (e.g. microscopes, ultrasonics, new obturation concepts and materials) have revolutionised the discipline of endodontics. It is the rotary Nickel Titanium (NiTi) instruments, however, that have had the greatest impact. Particularly advantageous was the advent of instruments of increased taper with their crown down preparation creating predefined shapes.
The 5 main advantages of the NiTi rotary systems are:
1. Predictable results every time even when dealing with curved canals.
2. Time Saving: with practice a standard molar can be totally cleaned and shaped in far less time than hand instrumentation.
3. Less Fatigue for the operator compared to hand instrumentation.
4. Less post-op pain owing to debris being extruded from the canal during the crown-down technique instead of being pushed through the apex during step-back.
5. Less Transportation of canals
There are 4 aspects of NiTi rotary files that need to be discussed in order to obtain a clearer understanding of their correct and safe use.
1. The use of Hand Files There is a misconception that hand files are unnecessary when using NiTi rotary files. This could not be further from the truth. In fact, the role of hand files has been redefined since the introduction of NiTi rotary files. Hand files are complementary to NiTi rotary files, and serve the following functions:
• To determine straight line access• To give information regarding the root canal system anatomy• To 'scout' the canal to either create or confirm a 'glide path'• To act as 'patency finders'• To determine working length• To finish the preparation when there is an 'irregular glide path'
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2. Tapers Most dentists are now aware of the concept of tapers. For nearly 50 years 'conventional' hand files have had a constant taper of 2% i.e. measuring from the tip for every millimetre we move coronally, the diameter of the instrument increases by 0.02mm. Since the introduction of NiTi rotary instruments we have seen a whole range of tapers up to 12%. However, regardless of the percentage taper of the file, the taper was always constant for each individual file (see figure 1).
That rule has also changed recently with the advent of the ProTaper NiTi rotary filing system. The files have variable tapers within each individual file (see figure 2).
ProTapers were the brainchild of four endodontists who were looking to design a safer file which would give increased torque strength and increased resistance to metal fatigue.
Adequate taper is so important to ensure better penetration of irrigants in order to obtain better cleaning of the root canal system. It also provides better hydraulics for better Gutta Percha compaction.
3. Separations The benefits of using rotary NiTi files are well documented. Therefore, why isn’t everybody using them? Price is not the reason; although more expensive per individual file compared to hand files, rotary NiTi files are more cost effective owing to their efficiency. It is the fear factor of separated instruments that is still preventing some practitioners from taking the next step into NiTi rotary files.
There are only 2 ways NiTi rotary files will separate:
1. Excessive Torque: Torque is a resistance to rotation; basically you have exceeded the strength of the instrument.
2. Metal Fatigue: When a NiTi rotary file is rotated around a curve it goes from maximum stretch to maximum compression. Sooner or later it will experience metal (or cyclic) fatigue. Metal fatigue is accumulative.
figure 2
Advantages of NiTi Rotary Systems
figure 1
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Advantages of NiTi Rotary Systems
figure 3 – X-Smart Unit
Please refer to the following chart for factors affecting both Torque Failures and Metal Fatigue failures. As an example, with ALL OTHER FACTORS BEING THE SAME, if you increase the pressure on the file you increase the likelihood of Torque Failure.
Torque Failures Metal Fatigue Failures
Pressure Ò Curvature ÒCurvature Ò Radius ÚSurface Area Ò Diameter of instrument ÒR.P.M. Ú Taper ÒLubrication Ú No. of forward/reverse cycles Ò
Referring to this chart, it now makes sense that in the straight portion of a canal we need high torque strength (large tapers/diameters). However, around the curve we need flexibility and increased resistance to metal fatigue. Therefore, we choose a small taper instrument. It can now be seen that if you have a constant taper in a file then that file cannot have high torque strength and at the same time have high resistance to metal fatigue.
The uniqueness of a variable tapered instrument e.g. ProTaper S1 is that it gives apical flexibility (small apical taper and minimum metal fatigue), but at the same time increased torque strength because of its larger coronal tapers.
In recent times with the introduction of the latest generation of torque controlled motors (see figure 3), an increase in the safe use of NiTi files has occurred. These motors are programmed so that the optimal torque for each file can be selected.
Rotary files should be used passively within the canal, and their use continued as long as they move easily in an apical direction. Never force NiTi rotary files. Nickel Titanium is so flexible that if forced it will buckle and eventually succumb to metal fatigue.
There are typically 3 factors affecting a rotary file from passively moving in an apical direction:
1. Canal size/Instrument size 2. Debris – INTRACANAL and INTRABLADE. Ensure that the canal is free of debris
by using copious irrigation and frequent recapitulation. Ensure that flutes are free of debris.
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3. Root Canal Anatomy e.g. mid-root curvature (may appear calcified on the radiograph) or abrupt apical curve. We are aiming to obtain a smooth, reproducible glide path so that the tip of our rotary instrument can passively, accurately and safely follow the canal.
4. Cross-Section of Cutting Blades Rotary NiTi files can either be classified as ACTIVE (in one example semi-active) or PASSIVE (see figure 4). Basically an active file will rotate and cut in a canal without pressure; a passive file needs apical pressure to cut.
When using a rotary NiTi file it is essential to know the cross-sectional design of that file in order to know how it can and should be used. For instance figure 4 shows the ProFile in cross-section which is an example of a passive cutting blade. The radial lands 'plane' the walls of the canal, and although repeated return is not recommended, if you do you are less likely to get transportation of the canal.
Figure 5 shows the ProTaper (SX, S1, S2, F1, F2) in cross-section, which is an example of an active cutting blade. No radial lands, and the slightly convex triangular shape reduces the contact area between the blade of the file and dentine. This feature serves to enhance cutting efficiency, reduces torsional friction and improves safety. However, this type of cutting blade needs to be used in a technique where repeated return is prohibited to prevent transportation of the canal.
To follow is an explanation of the files in the ProTaper system and a detailed step-by-step technique on their safe use. Figure 6 serves to emphasize the typical anatomy found in a mandibular molar. One needs to appreciate the position, size and morphology of the pulp chamber. Often the floor of the pulp chamber is constricted creating internal triangles of dentine. Additionally, one should be alert to root curvatures, external root concavities and root canal system anatomy.
figure 5 – ProTaper
figure 6
Advantages of NiTi Rotary Systems
figure 4 – ProFile
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figure 7
The NiTi ProTaper system is comprised of just three shaping and five finishing instruments. The instruments have handles that are 13mm long to facilitate access and are available in 21, 25 or 31mm lengths. The ProTaper files have non-cutting guiding tips to help auger soft tissue out of the canal. The ProTaper instruments are only used in canals that have a confirmed 'smooth, reproducible glide path' (more on this shortly).
The SX file (figure 7) has a gold coloured handle without any identification rings. It has an overall length of just 19mm. This shorter length allows it to be introduced into more restrictive areas where access is a problem. SX may be used to optimally shape canals in shorter roots, relocate canals away from external root concavities and produce more shape, as desired, in the coronal one-third of canals in longer roots. SX has 9 increasingly larger tapers ranging from 3.5% to 19%.
The SX diameters between D6–D9 may be equated to the Gates Glidden drills 1–4. Strategically, the SX file is used with a lateral brushing motion to cut dentine, between D6–D9, on the outstroke. Importantly, the apical extent of SX should NOT engage dentine; rather passively follow a canal that has a confirmed smooth, reproducible glide path. The S1 (figure 8) has a purple identification ring and exhibits 12 increasingly larger tapers over the length of its cutting blades. The S2 has a white identification ring and exhibits 13 tapers over the length of its cutting blades. The S1 is designed to prepare the coronal one-third whereas the S2 is designed to enlarge and prepare the middle one-third of the canal. In general, each instrument engages, cuts and performs its own crown-down preparation.
The first three finishing files, termed F1, F2 and F3 (figure 9) have yellow, red and blue identification rings on their handles corresponding to tip diameters of 0.20, 0.25 and 0.30mm respectively. The F1, F2 and F3 have fixed tapers of 7%, 8% and 9% in their apical extents, respectively, and decreasing percentage tapers in the coronal two-thirds of their cutting blades.
figure 8
figure 9
Advantages of NiTi Rotary Systems
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figure 11
figure 10
Advantages of NiTi Rotary Systems
Decreasing percentage tapers over a portion of a file’s larger cutting blades improves flexibility and decreases the potential for dangerous 'taper lock' and/or strip perforations.
The final two finishing files, termed F4 and F5 (figure 10) have two identification rings each. The F4 has black rings corresponding to a tip diameter of 0.40mm. The F5 has yellow rings corresponding to a tip diameter of 0.50mm. The F4 and F5 have a fixed taper of 6% and 5% in their apical extents, respectively, and decreasing percentage tapers in the coronal two-thirds of their cutting blades.
F4 and F5 are primarily for cases where the apex is larger or for those clinicians who philosophically subscribe to making anatomically smaller-sized canals larger. The torque settings for F4 and F5 are the same as for F3.
ProTaper Technique GuideThe following technique guide is designed to make the use of ProTaper straightforward, user-friendly and safe. The intention is not to be a textbook on endodontic principles. It is assumed that all the necessary infection control procedures have been adhered to and rubber dam has been used etc. The principles of access cavity design will not be discussed and it will also be assumed that this most important aspect of root canal procedure has been performed adequately. It is also given that all canals have been found, and hence the use of ultrasonic instruments like ProUltra will also not be discussed.
Shaping of the root canal means gaining adequate taper, without over-enlargement of the coronal portion of the canal, without ledging, without canal transportation and without zipping (figure 11) of the foramen. Correct shaping (= adequate taper) gives:
• Better cleaning of root canal system • Better penetration of irrigants • Better hydraulics for G.P. compaction
Our cleaning and shaping objectives, therefore, should be:
• To have a continuous tapering preparation • Maintain the original canal anatomy • Maintain the original position of the foramen • Keep the foramen as small as practical
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Preparation Sequence
figure 12
The preparation sequence that will be described involves the following steps:
• Scout the coronal 2/3rds of the canal • Pre-enlargement of the coronal 2/3rds • Scout the apical 1/3rd of the canal • Finish the apical 1/3rd preparation
1. Scout Coronal 2/3rds For the purposes of this exercise, 'scout' means using #10 and #15 handfiles. These scouting files give you an idea of:
• cross-sectional diameter of the canal• canal anatomy• access: where is the handle? Is it standing up tall? Do I have radicular and coronal
access? The handles of small handfiles are frequently off axis in furcated teeth due to internal triangles of dentine (see page 6).
Following complete straightline access, a #10 handfile may be used to scout a portion of the overall length of the canal (figure 12). The #10 handfile will create more space than its numerical name would suggest as it is 0.10mm at D0 and tapers to 0.42mm at D16. Small #10 and 15 handfiles are used to either create sufficient space or to confirm available space prior to using more efficient NiTi rotary files.
We will use 2/3rds as our step 1 scouting distance, but this will vary from case to case. Wiggle in (can use small ‘watch winding’ motion) #10 handfile until it meets resistance (until it is snug), and then pull back. Note the length that the #10 reached. Feed it in again, snug, pull back etc. Do this about 6 times. Remember at this stage you are not trying to get to working length.
The #15 handfile is 50% larger at D0 than the #10. It is 0.47mm at D16, and serves to expand and refine the glide path. Before safely introducing a ProTaper into a canal, sufficient space must exist to accommodate and guide its modified guiding tip.
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Wiggle in #15 handfile until snug and then pull back (figure 13). Again do this about 6 times. It should reach the same length as the #10 handfile. If experiencing any problems (especially in vital cases) use a lubricant such as Glyde. Irrigate, recapitulate with #10 handfile (push/pull) and re-irrigate.
You have completed Step 1: Scout Coronal 2/3rds of the canal
2. Pre-enlargement of Coronal 2/3rds
ProTaper instruments are not end cutting, but are rather designed to safely follow a smooth reproducible glide path. S1 has a D0 diameter of 0.17mm and its modified guiding tip easily follows the part of the canal that was previously scouted with #10 (0.10mm) and #15 (0.15mm) handfiles.
The S1 is used with virtually no apical pressure. When any rotary instrument ceases to progressively and passively advance deeper into a canal, it should be removed and its blades cleaned. Importantly, the S1 expands, refines and smooths the glide path. I like to think of the S1 as our 'workhorse'.
• Set the motor at the correct torque for S1 (figures 15 & 16). Advance the S1 to the same length as the #15 handfile reached (figure 14). DO NOT GO ANY DEEPER. If you have reached the required depth, DO NOT RE-ENTER canal with S1. Remember these files have active cutting blades and repeated
return is unnecessary and fraught with danger. If you did not reach the required depth, then take the S1 out of the canal, clean the flutes and reintroduce in to the canal, but deeper this time.
DO NOT GO BACK TO THE SAME LENGTH.
figure 16
Preparation Sequence
figure 14
figure 13
figure 15
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Shaping files can be used with a 'brushing' motion.• Once required depth obtained then irrigate,
recapitulate with #10 handfile (push/pull) and re-irrigate.
Furcated teeth have internal triangles of dentine (figure 17) which should be removed during the initial stages of treatment to facilitate shaping procedures. Uprighting the handle of the smaller sized hand files often requires refining and expanding the access preparation in conjunction with removing the mesial triangle of dentine from the cervical third of the canal. With just a single instrument, the ProTaper SX file may be used to rapidly, effectively and safely remove restrictive triangles of dentine (figure 18). • Set the motor for the correct setting for SX • The SX is carried in to the canal and passively
allowed to advance until its apical movement slows.
• The SX file is then lifted coronally about 1mm and its middle one-third blades between D6 and D9 (remember from page 7, these diameters equate to Gates-Glidden 1–4 drills) may be used. These middle one-third blades are used in a lateral brushing motion to cut dentine on the outstroke. Cut away from the furcation. Once lateral space has been created, then SX will invariably advance passively deeper into the canal.
The cycle of passive advancement followed by brush-cutting dentine on the outstroke is repeated to create lateral space so the rapidly tapering blades can progressively shape deeper into the canal. Importantly, the apical extent of SX is NOT designed to cut dentine, but passively follow the glide path. The reason for the cutting blades on the apical portion of SX is to help auger soft tissue out of the canal. The use of SX is continued until about 2/3rds of the overall length of its cutting blades are below the orifice (figure 19). DON’T FORGET: Irrigate, recapitulate with #10 handfile (push/pull) and re-irrigate.
You have completed Step 2: Pre-enlargement of Coronal 2/3rds.
figure 17
figure 18
Preparation Sequence
figure 19
1�
3. Scout Apical 1/3rd • With excellent radicular access, a pre-measured
and pre-curved #10 handfile is used to scout and negotiate the rest of the length of the canal (figure 20).
• The #10 handfile is moved gently to the terminus, then minutely through the foramen to establish patency. Repeat the 6 pullback movements done previously.
• Irrigate • The #15 handfile follows the path of the #10,
improves the glide path and dictates the next clinical move. When it is difficult to pass small handfiles to length, then viscous chelators (e.g. Glyde) should be used to encourage the mechanical objectives.
• Determine working length with an electronic apex locator (e.g. PROPEX) and confirm radiographically (with #15 handfile) (figure 21).
• Repeat the 6 pullback movements (as done previously) to length with the #15 handfile (figure 22). Irrigate, recapitulate (#10 handfile push/pull), re-irrigate.
We are now ready to finish the apical 1/3rd preparation. However, we first must determine if we can use rotary files to do this or whether we finish with handfiles. We do this by verifying if we have a smooth, reproducible glide path.
You have completed Step 3: Scout Apical 1/3rd of the canal.
4. Finish Apical 1/3rd A smooth, reproducible glide path is important. A #15 handfile may be used to verify whether the apical one-third of a pre-enlarged canal has either a smooth or irregular glide path (figure 23).
Preparation Sequence
figure 20
figure 21
figure 22
figure 23
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Preparation Sequence
figure 24
A smooth, reproducible Glide path is verified if a brand new #15 handfile can be gently pushed over a few millimetres, and can passively slide to length.
If you encounter obstructions when trying to move the #15 handfile passively (as outlined below) then you do not have a smooth, reproducible glide path. You, therefore, cannot expect a rotary file to be used in an area where a handfile could not go freely.
This is a critical technique: 1. Move the #15 file 1mm short of the working length and gently push back to
working length. Do this WITHOUT any twisting. 2. Move the #15 file 2mm short of working length and repeat the above. 3. Move the #15 file 3mm short of working length and repeat the above. 4. Move the #15 file 4mm short of working length and repeat the above. 5. Move the #15 file 5mm short of working length and repeat the above.
Did you obtain a smooth, reproducible glide path?
NO then finish the apical one-third by hand filing. See p.15 for details on finishing with ‘ProTaper Universal for hand use’.
YES then it is safe to finish the apical one-third with ProTaper.
Let’s assume that we have a smooth, reproducible glide path and, therefore, will complete the preparation with ProTaper.
• We commence with the S1 file (and NOT ProTaper finishing files).• Check correct torque setting on motor.• Remember all ProTaper shaping files can be used with a 'brushing' motion.
S1 will now be taken to full working length (figure 24). When the S1 will not achieve length, passively remove the instrument, clean its cutting blades and irrigate, recapitulate and re-irrigate. Appreciate that depending on the degree of apical curvature, it may require one, two or three passes to safely move the S1 to length. Once you have reached working length with the S1, do NOT go back into the canal with this instrument.
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4. Finish Apical 1/3rd (continued)
• Set the motor at the correct torque for S2 The ProTaper S2 (figure 25) with the white identification ring on its handle is designed to perform its own crown-down work.
It carries another wave of shaping deeper into the canal and will typically move easily to the desired working length on the first pass. Do NOT go back in to the canal with this instrument once working length has been achieved. Irrigate, recapitulate and re-irrigate.
The first ProTaper finishing file selected is the F1 (#20/.07) with the yellow identification ring (figure 26).
• Set the motor at the correct torque for F1 The F1 is designed to smoothly blend the deep, apical 1/3rd shape into the middle 1/3rd of the canal. Before using the F1 it is wise to reconfirm working length, as a more direct path to the terminus has been created. The finishing files are used passively with short penetrating strokes until length is achieved. When the F1 achieves working length, then it is withdrawn as the shape is cut. Do NOT go back in to the canal with this instrument. Irrigate, recapitulate and re-irrigate.
• Following the use of the F1 (#20/.07) to length, the foramen is gauged using a #20 handfile (figure 27). If the #20 handfile is snug at length, gently tap the handle of the file. If it remains in position, the canal is fully shaped and ready to obturate. A #20/.07 F1 ProTaper to length is consistent with our cleaning and shaping objectives in that it has kept the foramen size as small as practical. If using lateral condensation, use the F1 GP for ProTaper. If using a ProTaper Obturator, use size F1.
• If the #20 handfile is loose at length, then gauge the size of the foramen with a #25 handfile. If the #25 handfile is snug at length, then the canal is fully shaped and ready to pack.
Preparation Sequence
figure 25
figure 26
figure 27
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The following procedures are only necessary if the #25 handfile as previously described was short of length. The next ProTaper finishing file selected is the F2 (#25/.08) with the red identification ring (figure 28).
• Set the motor at the correct torque for F2The F2 is used passively and when length is achieved, it is withdrawn. Following the use of the F2 to length, the foramen is gauged using a #25 handfile. If the #25 is snug at length and tapping the handle does not move the file beyond the foramen, the canal is fully shaped and ready to obturate. If the #25 is loose at length, then gauge with the #30 handfile. If the #30 handfile is snug at length, then the canal is fully shaped and ready to pack. If the #30 handfile is short of length, then proceed to F3.
• Set the motor at the correct torque for F3 F3 (#30/.09) has the blue identification ring (figure 29). The F3 is used passively and, in more curved canals, just short of length as the previous rotary files have created a more direct path to the terminus. Following the use of the F3, the foramen is gauged using a #30 handfile. If the #30 is snug at length (do ‘tapping test’), the canal is fully shaped and ready to obturate.
If the #30 handfile is loose at length, then proceed to F4 and F5 as necessary to easily complete these more open and straightforward cases. Also in short canals or large straight canals, after initial negotiation ('scouting') use the SX in a circumferential mode. It is not necessary to use the S1 or S2 in these cases. Instead, after confirming working length, proceed to gauge the foramen diameter. Then use the appropriate ProTaper Finishing file to prepare the apical terminus.
Finishing the preparation with ProTaper Universal for hand use ProTaper Universal for hand use, with silicone handles, has the same design as its rotary equivalent. The deep shape produced ensures superior root canal preparations than those obtained using conventional stainless steel files (figure 30).
The sequence is identical to that used when using rotary ProTaper Universal files.
figure 28
figure 29
Preparation Sequence
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As mentioned previously, sometimes it is not possible to obtain a glide path in the apical third of the preparation (e.g. complex root canal anatomies). In these cases hand filing is recommended over rotary to complete the preparation. ProTaper for hand use gives superior control, predictability and quality than currently available stainless steel files. ProTaper Universal for hand use can be used either in a modified balance force technique or in a reaming (back and forth) motion.
ObturationNow that we are more frequently finishing our apical preparations with larger tapers we need to review how we obturate these canals more efficiently. We need to be more aware of tip sizes and apical tapers of the finishing files we are using.
Let us first look at Lateral Condensation having prepared a canal with ProTaper NiTi rotary files. If, for instance, our last ProTaper to length was the F1 (remember it has an ISO tip size of 20 and 7% apical taper) then don’t waste your time trying conventional 2% GP cones as your master points. Instead use a GP point for ProTaper F1 which will give a snug fit to length. Minimal accessory GP points will now be needed. In fact, single cone obturation may be sufficient (figure 31).
The use of warm obturation techniques has become popular in recent years. Materials such as Thermafil result in ideal 3-D fills, thanks to the excellent shapes produced by NiTi rotary files like ProTaper Universal. Continuing the tradition of Thermafil, the colour-coded ProTaper obturators correspond to the matching ProTaper Universal finishing files (figure 32).
figure 30
figure 31
figure 32
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RetreatmentRetreatment of endodontically filled teeth is now a relatively common occurrence. However, the techniques to carry out this procedure are limited, and often time-consuming.
The ProTaper Universal range now includes a series of RETREATMENT files. As they are ProTapers, they are Nickel Titanium rotary files with variable tapers. There are three ProTaper Universal Retreatment files, all with silver handles for identification as Retreatment files within the ProTaper Universal endodontic treatment system. The Retreatment files are designated D1 (one white ring), D2 (two white rings) and D3 (three white rings) (figure 33).
In general, D1 is for the coronal third, D2 for the middle third and D3 for the apical third. These files have short 11mm handles for improved visibility and access. When removing Gutta Percha (and carrier-based Gutta Percha) the speed of the torque-controlled motor needs to be increased to 500-700 r.p.m. There is no need for using solvents when removing Gutta Percha with this technique.
The D1 is only 16mm in length and it has a cutting tip as it is only used in the straight portion of the canal. The initial apical taper is 9% and it has a #30 tip size. D1 has the same torque setting as the F3.
The D2 is 18mm in length, has a size #25 non-cutting tip with an initial apical taper of 8%. D2 has the same torque setting as the F2.
The D3 is 22mm in length and also has a non-cutting tip which is size #20. D3 has an initial apical taper of 7% and uses the same torque setting as the F1.
figure 33
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etre
atm
ent A
sst.
6
HA
ND
FIL
ES
A04
1802
1901
00Pr
oTap
er U
ni F
HU
Ass
t. 21
mm
6
A04
1802
5901
00Pr
oTap
er U
ni F
HU
Ass
t. 25
mm
6
A04
1803
1901
00Pr
oTap
er U
ni F
HU
Ass
t. 31
mm
6
A04
1601
9101
00Pr
oTap
er U
ni F
HU
SX
19m
m6
A04
1602
1101
00Pr
oTap
er U
ni F
HU
S1
21m
m6
A04
1602
1102
00Pr
oTap
er U
ni F
HU
S2
21m
m6
A04
1602
5101
00Pr
oTap
er U
ni F
HU
S1
25m
m6
A04
1602
5102
00Pr
oTap
er U
ni F
HU
S2
25m
m6
A04
1603
1101
00Pr
oTap
er U
ni F
HU
S1
31m
m6
A04
1603
1102
00Pr
oTap
er U
ni F
HU
S2
31m
m6
A04
1702
1101
00Pr
oTap
er U
ni F
HU
F1
21m
m6
A04
1702
1102
00Pr
oTap
er U
ni F
HU
F2
21m
m6
A04
1702
1103
00Pr
oTap
er U
ni F
HU
F3
21m
m6
Ordering Information
19
COD
E N
UM
BER
DES
CRIP
TIO
NPA
CK
SIZ
E
HA
ND
FIL
ES (c
ontin
ued)
A04
1702
1104
00Pr
oTap
er U
ni F
HU
F4
21m
m6
A04
1702
1105
00Pr
oTap
er U
ni F
HU
F5
21m
m6
A04
1702
5101
00Pr
oTap
er U
ni F
HU
F1
25m
m6
A04
1702
5102
00Pr
oTap
er U
ni F
HU
F2
25m
m6
A04
1702
5103
00Pr
oTap
er U
ni F
HU
F3
25m
m6
A04
1702
5104
00Pr
oTap
er U
ni F
HU
F4
25m
m6
A04
1702
5105
00Pr
oTap
er U
ni F
HU
F5
25m
m6
A04
1703
1101
00Pr
oTap
er U
ni F
HU
F1
31m
m6
A04
1703
1102
00Pr
oTap
er U
ni F
HU
F2
31m
m6
A04
1703
1103
00Pr
oTap
er U
ni F
HU
F3
31m
m6
A04
1703
1104
00Pr
oTap
er U
ni F
HU
F4
31m
m6
A04
1703
1105
00Pr
oTap
er U
ni F
HU
F5
31m
m6
SEQ
UEN
CERS
A04
1300
0003
00Pr
oTap
er S
eque
ncer
Tre
atm
ent
1
A04
1300
0004
00Pr
oTap
er S
eque
ncer
Ret
reat
men
t1
PAPE
R P
OIN
TS
A02
2W00
0101
00Pa
per P
oint
s Pr
oTap
er U
ni F
118
0
A02
2W00
0102
00Pa
per P
oint
s Pr
oTap
er U
ni F
218
0
A02
2W00
0103
00Pa
per P
oint
s Pr
oTap
er U
ni F
318
0
A02
2W00
0901
00Pa
per P
oint
s Pr
oTap
er U
ni F
1-3
180
A02
2W00
0902
00Pa
per P
oint
s Pr
oTap
er U
ni F
4-5
180
COD
E N
UM
BER
DES
CRIP
TIO
NPA
CK
SIZ
E
GP
POIN
TS
A02
2X00
0101
00G
P Po
ints
ProT
aper
Uni
F1
60
A02
2X00
0102
00G
P Po
ints
ProT
aper
Uni
F2
60
A02
2X00
0103
00G
P Po
ints
ProT
aper
Uni
F3
60
A02
2X00
0901
00G
P Po
ints
ProT
aper
Uni
F1-
F360
A02
2X00
0902
00G
P Po
ints
ProT
aper
Uni
F4-
F560
OBTU
RA
TORS
A14
1100
0101
00Pr
oTap
er O
btur
ator
F1
6
A14
1100
0102
00Pr
oTap
er O
btur
ator
F2
6
A14
1100
0103
00Pr
oTap
er O
btur
ator
F3
6
A14
1100
0104
00Pr
oTap
er O
btur
ator
F4
6
A14
1100
0105
00Pr
oTap
er O
btur
ator
F5
6
A14
1100
0111
00Pr
oTap
er O
btur
ator
F1
20
A14
1100
0112
00Pr
oTap
er O
btur
ator
F2
20
A14
1100
0113
00Pr
oTap
er O
btur
ator
F3
20
A14
1100
0114
00Pr
oTap
er O
btur
ator
F4
20
A14
1100
0115
00Pr
oTap
er O
btur
ator
F5
20
STA
RTE
R K
ITS
A04
1522
1901
00Pr
oTap
er S
tarte
r Kit
T 21
mm
6
A04
1522
5901
00Pr
oTap
er S
tarte
r Kit
T 25
mm
6
A04
1523
1901
00Pr
oTap
er S
tarte
r Kit
T 31
mm
6
A14
1500
0900
00Pr
oTap
er U
ni R
etre
at S
tarte
r Kit
6
Ordering Information
CLINICALHINTS
DENTSPLY New Zealand 16 Morgan Street, Newmarket, Auckland,1023Tel: 0800 DENTSPLY (33 68 77) Fax: 0800 DENTFAX (33 68 32)Email: [email protected] Website: www.dentsply.co.nz
DENTSPLY (Australia) Pty Ltd ABN 15 004 290 322
11–21 Gilby Road Mt Waverley VIC 3149Tel: 1300 55 29 29 • Fax: 1300 55 31 [email protected] • www.dentsply.com.au
