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Use of Profile ® system. 主任敎授 金 滿 龍. 嘉泉醫大 吉病院. Operational sequence. Four phases Crown – down Determination of the working length Apical preparation Final shaping. 1. Crown-down.
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Use of Profile® system 主任敎授 金 滿 龍 嘉泉醫大 吉病院
Operational sequence • Four phases • Crown – down • Determination of the working length • Apical preparation • Final shaping
1. Crown-down • The first objective of the crown-down phase is to open up the root canal as far as the minimum estimated working length less 3mm ; the first depth-marking on Profile instruments is located at 18mm. • The working length should be determined; then the crown-down will be continued as far as the apex.
1. Crown - down • Profile® O.S. #3 (.06/40) • The Profile #3 O.S. is the first instrument in the sequence. As it is relatively the short (19mm), this instrument can easily be inserted in line with the root canal, without hindrance from the opposing teeth. • With the #3 O.S. already rotating, insert it without excessive pressure and apply a slight in and out movement, for about 5 to 10 seconds
1. Crown - down • Profile O.S. # 2 (.06/30) • It is now the turn of the #2 O.S. Since this is of a smaller diameter, it can work more apically. As before, when progression becomes difficult, withdraw the instrument without increasing the pressure and go on the next.
1. Crown - down • Profile .06/25 • This ProFile also has a smaller diameter than the previously used instruments, and is more flexible due to the greater length of its cutting section. Use this instrument in the same way as the preceding ones.
1. Crown - down • ProFile .06/20 • This instrument penetrates more apically than the proceding ones. Use it in the same way as before. • Profile .04/25 • Since this instrument has a less pronounced taper, it also penetrates more apically than the proceding one. Use it in the same way as before, withdrawing as soon as progression becomes difficult.
1. Crown - down • ProFile .04/20 • Continue operations with this instrument up until the exact working length. This working length is determined as described below.
2. Determination of the working length • The exact working length is determined during the crown-down pahse, by inserting a conventional #10, #15 K-file. This K-file is used after the first Profile has reached the minimum estimated working length less 3mm. • When the exact working length is known, complete the crown-down procedure up until this exact length.
3. Apical preparation up until the exact working length • ProFile .04/20 Profile .04/25 • Crown-down as far as the exact working length is now complete. The Profile with 4% taper are now used, this time from the smallest to the largest; first the .04/20 Profile, then the .04/25 Profile, each instrument up until the exact working length. If necessitated by the particular anatomy, use increasingly large Profile instruments each up until the exact WL.
4. Final flaring • Profile .06/20 • To facilitate filling and depending on the technique chosen, final flaring may be achieved by means of the Profile .06. With the Profile .06 rotating, insert it into the root canal without forcing and during its progression apply a slight in and out movement. Penetration to the exact WL is not systematically sought, except if the root canal easily receives the file.
To summarize : • Profile instrument are used in both descending order of diameter (for crown-down, from the largest to the smallest) and in ascending order of diameter (for preparation to the exact working length and for final flaring, from the smallest to the largest).
Wide canals • Upper maxillary incisors, canines, mandibular premolars • Yellow-code instruments replaced by re-code instruments • Red-code instruments replaced by blue-code instruments.
Wide canals • Crown-down : O.S. #4 (.07/50) O.S. #3 (.06/40) .06/30 .06/25 .04/30 .04/25
Wide canals • Determination of exact working length ( conventional K-file, 2% taper, N0 015 or 020) ;
Wide canals • Apical preparation : .04/25 .04/30 • Final flaring: .06/25