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New from VDW!!
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RECIPROC® one file endo
A Brand New Concept of Root Canal Preparation
q
q
qWith one file only
qIn reciprocation
qNo hand filing in the majority of cases
Tooth 25 without manual instrumentation,
Dr. Ghassan Yared, Canada
RECIPROC® -
An innovation in drive systems and clinical procedures

No hand instrumentation means that there was no preparation of the root canal with a hand
instrument.
It is not necessary to create an initial glide path to either working length or to 2/3 of the
working length.
Exceptions:
1. Should RECIPROC® not be able to advance in the canal or should the advancement become difficult,
it is necessary to create a glide path.
2. If the ISO 10 hand instrument used for working length determination after preparation of 2/3 of
the length  will only go to working length if it is pre-curved, a glide path must be prepared.

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qSimplicity
–No need to change instruments
–Ready to use, sterile single-use instruments
–No hand filing in the majority of cases
–
–
qSafety:
–Reduced risk of instrument fracture
–Minimised risk of contamination
Benefits of the RECIPROC® concept

No need to worry about when to change to the subsequent instrument
Easy to learn (own tests under standard conditions with 13 users working on 520 plastic blocks
showed that, after a short training period, 92% of the users were able to prepare three consecutive
plastic blocks without procedural errors with RECIPROC, compared to 31% using a leading rotary NiTi
system).
Reduced risk of instrument fracture thanks to:
   a. Single use – no risk of over-use
   b. Reciprocation - the instrument does not rotate past its individual
                       elastic limit thanks to its specific motor settings
   c. Improved material - M-Wire offers greater resistance
                       to cyclic fatigue than traditional nickel-titanium
Thanks to single-use, cross-contamination among patients is eliminated and cross-contamination
involving the staff is minimised
Less procedural errors compared to rotary preparation (own tests)

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qTime-saving
–Less work steps
–Faster preparation
–No cleaning or sterilisation
–
Benefits of the RECIPROC® concept

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Basis of the treatment concept
qArticle by Dr. Ghassan Yared, JOE 2008
qArticle by Dr. Ghassan Yared for the RECIPROC® launch
q
Ghassan_Yared_228a_hr.jpg
Ghassan Yared DDS MSc, Endodontist

Dr. Yared has 12 years of clinical experience with reciprocation.
He invented the concept "single file reciprocation" and introduced it in 2008 in an article
published in the JOE.
He developed the RECIPROC concept in cooperation with VDW and is considered the pioneer of
reciprocation systems.

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Reciprocation

Instrument is first driven in a cutting direction
The subsequent reverse rotation releases the instrument
This allows the instrument to advance automatically towards the apex.
10 reciprocation cycles per second correspond to approx. 300 rpm. One complete rotation of 360° is
completed in three reciprocating movements.

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q
q
q
qRoot canal preparation with one single
instrument
qMinimisation of instrument fractures
–
–
Reciprocation
Benefits

The instrument works within its elastic phase, and so, therefore, relatively stress-free. Due to
the fact that the angle in the cutting direction is greater than the reverse angle, the instrument
progresses from apically almost automatically.
Causes for instrument fractures are:
Torsional stress
Cyclic fatigue caused by tension and compression
The angles of reciprocation are specific to the design of the RECIPROC® instrument so that the
instrument does not rotate past its individual elastic limit.

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Elastic Limit
Dr. Ghassan Yared, Canada
Reciprocation
Benefits
NiTi instruments in reciprocation
Plastic phase

Explanation of the graph:
If an instrument binds in the root canal and is further rotated, it will be subjected to stress in
torsion, torque. The structure of the metal will undergo changes. These changes can be reversible
or irreversible depending on the amount of the rotation when the instrument is binding. In this
example, any rotation between 0 and 400 degrees will not cause irreversible changes to the
structure of the metal. Any rotation beyond 400 degrees when the instrument is binding will cause
irreversible changes in the structure of the metal. In the end, the instrument in this example
fractures at approximately 1100 degrees of rotation. This zone between 0 and 400 degrees where the
changes are reversible is called the elastic phase. The zone from 400 degrees to the point of
fracture at around 1100 degrees is to the plastic phase. The point of transition between the
elastic phase and the plastic phase is called the elastic limit. In this example the elastic limit
is at approximately 400 degrees. If a rotary instrument engages dentine and the motor keeps
rotating it,  the metal of the instrument will undergo irreversible changes. This happens a first
time, a second time and a third time and so on... every time the metal will undergo irreversible
changes which will cause torsional fatigue and eventually lead to fracture. In reciprocation, the
clockwise and counterclockwise angles of rotation should preferably be set at a level lower than
the elastic limit (at a level which will not subject the instrument to a torque / stress exceeding
the elastic limit). The lower the angles of rotation the safer the procedure, as long as the
instrument can still cut dentine, advance apically in the canal and remove the cutting debris in a
coronal direction).

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qRECIPROC® shows high resistance to cyclic fatigue
60° angle of curvature, 5 mm radius
–
Cyclic fatigue
Dr. Nicola Grande, University of Rome La Sapienza, Rome, Italy
ProTaper® F2, 25/.08
Mtwo® 25/.07
RECIPROC® R25, 25/.08

RECIPROC was measured in reciprocating mode, Mtwo and ProTaper in continuous rotary mode
ProTaper and Mtwo are made of traditional NiTi alloy, RECIPROC of M-Wire
Result is significant compared to the two instruments Mtwo and ProTaper
The measurement was carried out in a curved metal pipe
Abstract of Dr. Nicola Grande's lecture at the AAE in April 2011:
New reciprocating nickel-titanium instruments have been recently introduced in the market, designed
to be used with a patented reciprocating motion (Reciproc^TM, VDW-GmbH), that makes 10 alternations
per second (approx. 300 clockwise and 300 counterclockwise partial rotations per minute). This
study aimed to compare the cyclic fatigue resistance of Reciproc files used with the patented
reciprocating motion with conventional nickel-titanium rotary files used in continuous rotation
(300 rpm). The following groups were tested: Reciproc R25, tip size #25 and variable taper (.08
apical taper, decreasing  coronally), Mtwo^TM (VDW-GmbH) tip size #25 taper .07 and ProTaper^TM F2
(Dentsply-Maillefer). Ten instruments of each group were driven until fracture using a cyclic
fatigue device with 60° degrees angle of curvature and a 5-mm radius. Time to fracture in seconds
was registered. Mean values and standard deviations (SD) were calculated. Data were analyzed by
one-way ANOVA and Tukey HSD test. Reciproc R25 fractured after a mean of 130 seconds (SD 15,7)
while Mtwo after 101 sec. (SD 12,4) and ProTaper after 58 sec. (SD 11,2). There were statistical
significant differences among all the groups (p<0.05).  Since Reciproc files are very similar in
cross-sectional and flute design to Mtwo, and very similar in dimensions to Protaper, the influence
of the reciprocating movement on cyclic fatigue resistance measured in seconds seems to be
significant. This could be a relevant clinical issue, if time of instrumentation needed to complete
root canal shaping by Reciproc is similar to those of conventional nickel-titanium instruments used
in continuous rotation.

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Test equipment to determine cyclic fatigue, Dr. Nicola Grande, Rome
q
qIllustration above
qTest device to determine
qcyclic fatigue
q
q
q
qIllustrations below:
qSteel plate with artificial root canals with diameter and taper corresponding to the instrument to
be tested

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Reciprocation
in vitro with RECIPROC® R25
Dr. Ghassan Yared, Canada

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Nickel-Titanium instruments
in continuous rotary
Dr. Ghassan Yared, Canada

This graph illustrates what happens when an instrument binds in the canal and the motor keeps
rotating it until fracture. The x-axis shows the degree of rotation until fracture occurs... in
this case at around 1100 (almost 3 full rotations). When the instrument is binding in the canal and
is being rotated by the motor, it will be subjected to a force that we call torque. The motor
continues rotating the instrument, and the torque will increase until the instrument fractures. The
instrument in this example fractured at a force of almost 100 gcm. This is what we call the torque
at fracture of the instrument. This instrument fractured after almost 3 rotations or 1100 degrees.
This is what we call the angle at fracture of the instrument. The torque and the angle at fracture
of an instrument are usually measured at the tip of the instrument, the most common area of
instrument fracture. Each instrument has a specific torque and angle at fracture.

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Dr. Ghassan Yared, Canada

The next few slides explain why a glide path is not required with the Single File Reciprocation.
If a rotary instrument binds in the canal, it will fracture. A glide path is required before using
the rotaries to minimize the incidence of binding and therefore the risk of fracture.
In reciprocation, CW and CCW angles determine the amplitude of reciprocation, the right and left
rotations. The reciprocating instrument will rotate CW; once it reaches the angle set on the motor,
it will rotate CCW until the CCW angle set on the motor is reached and then it will rotate CW and
so on.
Each instrument has a specific angle at fracture. The reciprocating instrument in this example has
an angle at fracture equal to 1100 degrees, almost 3 full turns. This means that if the instrument
is held tightly at its tip and rotated, it will fracture after 3 full turns. The angles set on the
motor are much lower than the angle at fracture of the reciprocating instrument. The angles on the
motor in this example are set at 200 degrees CW and CCW. When the instrument rotates 200 degrees in
one direction it will rotate into the other direction and so on, the angles of rotation in both
directions never exceed 200 degrees. So the instrument will never reach in any direction the point
of fracture which is 1100 degrees. This means that if the instrument binds in the canal, it will
never fracture. This is why a glide path is not required with the Single File Reciprocation
technique. The purpose of the glide path is to obtain a minimal canal enlargement to minimize the
risk of binding and therefore the risk of fracture. It is needed with the rotaries, because if a
rotary instrument binds it will fracture; it is not needed with the SFR because if the instrument
binds it will not fracture.

Endo Easy Efficient®
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Narrow canals
Medium canals
Large canals
The RECIPROC® system
Sizes and dimensions of instruments
[USEMAP]

Sizes/taper:     working part: 16 mm
R25 – ISO 25 taper .08
R25 – ISO 25 taper .08
R50 – ISO 50 taper .05
Regressive taper
A regressive taper allows for coronal shaping without unnecessary loss of tooth substance, compared
to instruments with constant taper such as e.g. Mtwo (25/.06 has a diameter at the end of the
working part of 1.21 mm, WaveOne 25/.08 measures 1.22 mm at the end of the working part)
Info buttons:
Left: dimensions RECIPROC / Mtwo
Right: dimensions RECIPROC / WaveOne

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qRegressive taper for a preparation without unnecessary loss of tooth substance
–RECIPROC® instruments have a smaller instrument diameter at the end of the working part than most
other conical NiTi instruments of equal size at the tip e.g.:
The RECIPROC® system
Sizes and dimensions of instruments
Mtwo®
RECIPROC®
after 16 mm
25/.06
Ø  1.21 mm
R25
Ø  1.05 mm
after 16 mm
40/.06
Ø  1.36 mm
R40
Ø  1.10 mm

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The RECIPROC® system
Instruments
q
q
q
q
q
qBenefits:
§Higher flexibility
§Reduced cyclic fatigue
q

Compared to a standard nickel-titanium alloy
M-Wire is thermally treated nickel-titanium

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The RECIPROC® system
Design
Dr. David Sonntag, University of Düsseldorf

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The RECIPROC® system
Why a "mirrored" design?
q
q
qRECIPROC® cuts in a counter-clockwise direction
–Safety aspect
–Certification of instrument for use
in reciprocation with VDW motors
e.g. VDW.SILVER® RECIPROC®
–

Rotary instruments cannot be used in reciprocation by accident
Current VDW NiTi systems as well as competitive products cannot be used in reciprocation with
VDW.SILVER®RECIPROC®
Statement regarding competitive motors with reciprocating mode:
Only VDW and Maillefer motors have been tested and approved for these instruments
It is not merely the angles of reciprocation which are important, but also how precisely the motor
controls the changes of direction (timing) and the acceleration rate of the motor
Angles of reciprocation are not disclosed.

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The RECIPROC® system
Development
•Tests with existing rotary systems
Conclusion:
None of the continuous rotary instruments on the market allow for safe and reproducible single-file
preparation in reciprocation

Existing rotary systems had weak points when used in reciprocation:
e.g. untwisting and instrument fractures; working length could not be reached

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The RECIPROC® system
Obturation products
qRECIPROC® Paper Points, sterile
qRECIPROC® Gutta-Percha
–Alpha-phase - suitable for:
§Single cone technique
§Vertical compaction
R25_Collage_gerade.jpg P:\Marketing Information\02 - Produkte\NiTi
Feilen\RECIPROC\Bilder\GP\Packaging\Reciproc_Guttapercha Box_ebenen_4_1_1.jpg P:\Marketing
Information\02 - Produkte\NiTi
Feilen\RECIPROC\Bilder\PP\Packaging\Reciproc-Papierspitzen_Schachtel_251110.jpg

GP quality and fit:
Gutta-percha manufactured by injection moulding procedure

Endo Easy Efficient®
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The RECIPROC® system
VDW.SILVER® RECIPROC® motorC
qNew endo motor for reciprocating and continuous rotary NiTi systems
qFile library:
–Reciprocating systems
§RECIPROC®, WaveOneTM
–Rotary systems
§Mtwo®, FlexMaster®, ProTaper®,
K3TM, Gates, Dr.`s Choice

–

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Total working time*
Time saved: 75%
Internal studies VDW Munich, 2010
The RECIPROC® system
Benefits

- No need to clean or sterilise instruments in the practice
- No need to change instruments during root canal treatment
- Pre-sterilised instruments make for single-use convenience

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qEasy to learn
qLess procedural errors for less experienced practitioners
Percentage of users who, after a short training period, managed to prepare three consecutive canals
under standard conditions without procedural errors
Internal studies , VDW Munich, 2010
The RECIPROC® system
Benefits

Endo Easy Efficient®
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qSafe preparation thanks to:
–Minimised risk of instrument fracture due to precise angles of reciprocation specific to the
instrument design
–Cyclic fatigue resistance thanks to single-use
–
qNo hand filing in the majority of cases
–"The reciprocation technique’s centring ability together with the design of the RECIPROC®
instrument and its increased  cutting ability render establishing a glide path unnecessary."  Dr.
Ghassan Yared, Ontario
q
The RECIPROC® system
Benefits

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qPreparation of narrow and severely
curved canals due to the centring ability
of the instrument
q
qThe shape obtained by RECIPROC®
enables cold and warm obturation
techniques
The RECIPROC® system
Benefits
Dr. Ghassan Yared, Kanada, Teeth 25 (left), Teeth 37 (right)

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qSterile instruments
q
qSingle use:
–Subject to higher stress compared to rotary systems
1 instrument instead of 4-5 instruments
–Max. one treatment
–Max. one molar
qCannot be autoclaved!
The RECIPROC® system
Specifics
SterilPunkt.PNG

Instruments are gamma-sterilised
Plastic band on the instrument shaft is not heat resistant and will be deformed by heat. The
instrument will no longer fit into the contra-angle.
Safety measures:
- Protection from material fatigue caused by material stress
- One RECIPROC instrument does the job of several hand or rotary instruments and is
  therefore subject to a considerably higher material stress than during
  traditional preparation with 4-5 instruments per canal.
- VDW as a manufacturer has the responsibility to ensure safe root canal preparation
  with its instruments (which also includes the determination of the frequency of use as well as
the use of an appropriate endo motor)
- Price discussion in this context: Price for RECIPROC is justified due to investment costs, see
chart “Development“

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Trend towards single-use
qRequirements regarding root canal preparation with rotary instruments (class B critical) are
increasing. qStudies have shown that current cleaning and decontamination procedures could not
completely remove remnants of tissue adhering to instruments (Dr. David Sonntag, 2009).

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Remnants of tissue after cleaning and sterilisation
Dr. David Sonntag, University of Düsseldorf

Picture left side:
Fig. 4: Nickel-titanium instrument with remnants of tissue after clinical use despite correct
cleaning protocol to ensure prion decontamination
Picture right side:
Fig. 5: Organic remnants on stainless steel hand instrument after sterilisation procedure

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Industrially cleaned and gamma-sterilised endodontic instruments by VDW

VDW has been distributing industrially cleaned, blistered and gamma-sterilised endodontic
instruments since the 1980s.
VDW therefore plays a leading role among all manufacturers of endodontic instruments.

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Validated processes and TÜV certified quality management at VDW
qVDW is a certified manufacturer of medical devices in accordance with ISO 13485 medical devices -
quality management systems
q
qVDW strictly adheres to the regulations of DIN EN ISO:
–[EN ISO 11607-1] Packaging of medical devices for sterilisation, requirements for materials,
sterile barrier systems and packaging systems
–[EN ISO 11137-1] Sterilisation of health care products - radiation - requirements for development,
validation and routine control of a sterilisation process for medical devices
–
–
1.
1.
1.
q
SterilPunkt.PNG

>

This leading role is further emphasised by numerous measures in connection with the required DIN EN
ISO standards.
Prior to distribution, all VDW endodontic instruments are cleaned during the manufacturing process.
Upon arrival at VDW's packaging department, all instruments pass through another extensive cleaning
process (validated washing process).
Only after the final washing process are VDW instruments transferred through a double door system
into the clean room and packaged in blister cell packaging.
The blisters (primary packaging) are then packed in boxes (secondary packaging) and
gamma-sterilised (radiation).
In order to ensure that only clean and hermetically sealed blister packages are delivered to
dentists, regular tests are carried out, such as cytotoxicity tests, endotoxin tests, particle
determination and bioburden tests.
Only after close examination by an independent certified company can VDW products subsequently be
distributed.

Endo Easy Efficient®
VDW-Logo ScreenSterile_B3.png ScreenSterile_B4.png ScreenSterile_B12.png ScreenSterile_B14.png
Washing machine for endodontic instruments
Cleaned endodontic instruments are transported through a double door system into the clean room
Instruments are inserted mechanically into blister packaging and sealed
Blister packaged instruments
Cleaned, blister packed and gamma-sterilised end product, e.g. RECIPROC®
Validated processes and TÜV certified quality management at VDW

Validated processes are a must for VDW's production: this has contributed for years to the
successful adherence to all required standards and to delivering exclusively cleaned and
gamma-sterilised, ready to use endodontic instruments.

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Enhanced safety for patients, practitioners and practice personnel
qNo sterilisation prior to first use
qReady to use instruments, individually packed
qSterile assortment: stainless steel instruments, rotary and reciprocating NiTi instruments,
obturation accessories
SterilPunkt.PNG

>

Industrially cleaned and gamma-sterilised endodontic instruments offer further advantages:
-Assistance with correct fulfilment of all legal requirements, guidelines and recommendations
-Safety in case of legal disputes
-Enable a simplified workflow in the dental practice with regard to quality management and
infection control requirements.

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Enhanced safety for patients, practitioners and practice personnel
þSterile endodontic instruments will support compliance with infection control regulations in your
dental practice.
þThe sterilisation procedure applied to VDW endodontic instruments
has been developed and validated for sterilisation in accordance
with [EN  ISO 11137-1]. Sterile endodontic instruments
are furthermore labelled with the symbol STERILE  R    to indicate
their sterilisation with gamma radiation.
þThe red dot        on each instrument package further helps
differentiation between sterile and non-sterile
instruments.
SterilPunkt.PNG
C-PILOT_Schachtel_006-010_25mm_040368025210.png

Industrially cleaned and gamma-sterilised endodontic instruments offer further advantages:
-Assistance with correct fulfilment of all legal requirements, guidelines and recommendations
-Safety in case of legal disputes
-Enable a simplified workflow in the dental practice with regard to quality management and
infection control requirements.

Endo Easy Efficient®
VDW-Logo P:\Marketing Information\02 - Produkte\Stahl\VDW
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VDW STERILE slogan - our promise: Look for the red dot. Over thirty years' experience in sterile
endo products.
-Endo
-Easy
-Efficient

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Single-use convenience
qEasy and safe
qNo change of instrument characteristics due to material wear
qElimination of cross-contamination
qAvoidance of fatigue fractures
qTime- and cost-efficiency due to the fact that root canal instruments do not need to be cleaned
and sterilised
qNo need to document frequency of use
qNo need for endo boxes
q

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Costs of single-use
qSingle-use of rotary NiTi instruments is expensive:
generally min. 5 instruments à € 6.50 (Ø value) equals € 32,50
q
qIn comparison, root canal preparation with a RECIPROC® instrument costs only € 13.00
q
qSaving per tooth € 19.50
q

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Affordable single-use
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RECIPROC® clinical procedure
qProcedure remains unchanged in comparison with traditional rotary systems:
–Pre-operative radiograph
–Straight canal access
–During root canal preparation, make sure the canal is free with a hand instrument
–Irrigation protocol

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Clinical procedure
Selecting the correct RECIPROC® instrument

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Clinical procedure
q
q
q
q
qEstimation of working length based on a pre-operative radiograph
qSet stopper at approx. 2/3 of estimated working length
q
q

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Clinical procedure
In this way, continue root canal preparation with RECIPROC® until approx. 2/3 of the working length
has been reached

No additional coronal enlargement necessary with RECIPROC (e.g. with a Gates Glidden drill)
Importance of the three peck movement
Difference to rotary preparation:
The three peck movement is important for practitioners switching from rotary to reciprocating
systems. The amplitude of the in-and-out movement should not exceed 3 mm. The instrument should be
cleaned after three pecks.
Reasons:
The instrument does the job of 4-5 rotary instruments and works from crown towards apex without
instrument change. If the instrument is not cleaned regularly as it works towards the apex, the
flutes will become blocked due to the high cutting efficiency. Friction would increase and the
instrument would not be able to work adequately within the canal.
This is the reason why the instrument needs to be cleaned in the interim stand after 3 pecks at the
latest.
Important! Even if the practitioner is of the opinion that the instrument advances easily within
the canal, the instrument needs to be cleaned regularly.
This is contrary to rotary preparation, whereby the instrument is often allowed to continue to work
and penetrate as deeply into the canal as it can advance automatically. With rotary preparation,
the instrument is only withdrawn to prepare the canal walls with lateral brushing movements (e.g.
Mtwo or ProTaper).
Checking if the canal is free with an hand instrument:
A hand instrument is inserted to max. 3 mm past the prepared length of the canal.
Especially at the beginning of a root canal preparation, the length has not yet been determined.
Therefore, the instrument should not be brought to working length. In the majority of cases, the
hand instrument is only inserted to full length for exact working length determination after
preparation of approx. 2/3 of the estimated working length!

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q
q
q
q
qAfter preparation of approx. 2/3 of the root canal length, the working length is determined.
q
Clinical procedure
Electronic length determination
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A radiograph is recommended based on forensic reasons:
1.With silver point after an ISO 10 hand instrument has reached the working length. The silver
point has a higher radiographic opacity than a size 10 hand instrument.
2.Radiograph of the master point after instrumentation

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Clinical procedure
after reaching 2/3 of the working length with R25
qHand instrument ISO size 10 used for working length determination goes to working length without
being pre-curved q
Preparation can be finished with R25.
q
q
Gradual curvature tooth 25
Dr. Ghassan Yared
Gradual curvature tooth 37
Dr. Ghassan Yared

Reasons why the creation of a glide path is not necessary:
1.Instrument's centring ability based on reciprocation
2.Instrument design (instrument tip)
3.RECIPROC's cutting efficiency
Definition: gradual curvature
If a hand instrument size 10 goes to working length even in radiographically strongly curved root
canals without being pre-curved, the curvature is classified as gradual. The radius of curvature
can be easily managed with a hand instrument even in case of a strong angle of curvature (see
illustrations).
If the hand instrument needs to be pre-curved, this could be an indication that there is an abrupt
curvature. The radius of curvature is so small that the hand instrument can only pass if
pre-curved.

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qHand instrument ISO size 10 used for working length determination only goes to working length if
it is pre-curved
q→ Glide path up to ISO 15
q
q If the ISO size 15 hand instrument goes
q to working length without being pre-curved, finish root canal preparation with R25.
q
q If not, complete preparation with hand instruments
q
Abrupt curvature tooth 47, root canal preparation was finished manually
Dr. Ghassan Yared
Clinical procedure
Glide path management

For creating a glide path, hand files ISO sizes 10 und 15 should be used to prepare the full
working length.

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qShould  RECIPROC®  stop advancing in the canal or should its advancement become difficult,
do not exert any apical pressure!!
q→ Glide path up to ISO 15
–
– If the ISO 15 hand instrument goes to working length without being pre-curved, finish root canal
preparation with R25.
q
q
q
Clinical procedure
Glide path management with complex anatomies
In case of a complex canal anatomy:  the section of a root canal where an ISO 15 hand instrument
can be brought without pre-curving can be prepared with R25 to that point.

The concept of root canal preparation without hand filing in the majority of cases is based on Dr.
Yared's positive practical experience. It is also based on his teaching experience and studies
which show that many during root canal preparation are caused by initial manual preparation.
If root canal preparation is possible without initial hand filing, why risk procedural errors by
creating a glide path prior to instrumentation?

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Clinical procedure
When is it necessary to create a glide path?

If the ISO 15 hand instrument does not go to working length without being pre-curved, root canal
preparation needs to be finished manually.
This limitation also applies to root canal preparation with rotary NiTi instruments!

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Clinical procedure
Selecting the correct RECIPROC® instrument

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Clinical procedure
Electronic length determination
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qInitial working length determination
qSet the stopper at approx. 2/3 of the estimated working length
qAfter preparation of 2/3 of the working length, the exact working length is determined.
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A radiograph is recommended based on forensic reasons:
1.With silver point after an ISO 10 hand instrument has reached the working length. The silver
point has a higher radiographic opacity than a size 10 hand instrument.
2.Radiograph of the master point after instrumentation

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What to observe when preparing a root canal with RECIPROC® !
qDo not put pressure on the instrument if it does not advance in the canal!
qDo not forget to clean the flutes regularly during preparation!
qMake sure RECIPROC® never rotates in one place should it not be able to advance apically!
qRECIPROC® instruments are sterile single-use instruments which cannot be re-used! qInspect the
instrument visually after each work step for signs of wear! qIt is not recommended to use
RECIPROC® or a continuous rotary system if the root canal has an abrupt curvature in the apical
section!
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qBrushing file movement
–Oval canals
–Enlargement of the canal orifice
–In general: to enlarge the root canal as necessary
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Clinical procedure

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Clinical procedure
What has been achieved?
qConical shape
–Suitable for optimum irrigation up to shortly before the apex
–Suitable for cold and warm obturation techniques
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qWhat is the benefit?
–Easier and safer preparation using just one instrument instead of 4-5 rotary NiTi instruments +
hand instruments
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Clinical procedure
Apical enlargement
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qRecommendations for apical enlargement after R25 and R40
– Apical gauging with hand file ISO 30 to check the diameter, if required use R40
– Apical gauging with hand file ISO 45 to check the diameter, if required use R50

Apical enlargement with rotary instruments is possible but not recommended for a dentist (GP) as it
would mean mastering both reciprocation and rotary systems.
If the apex is enlarged with rotary or manual instruments, RECIPROC gutta-percha points will no
longer be suitable

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Clinical procedure
Irrigation management
qTime saved for final irrigation
qUltrasound activated irrigation
qR25 complies with requirements for shaping prior to ultrasonic irrigation

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Clinical procedure
Step by Step - RECIPROC® R25
Dr. Ghassan Yared, Canada

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Preparation Result
Preparation with R25, lower molar
Prof. Sergio Kuttler, USA

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Prof. Sergio Kuttler, USA
before
after
Preparation Result
Preparation with R25, lower molar

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FAQ for the dentist
qFAQs

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Studies
qGustavo De-Deus et al., OOOOE, September 2010
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q ►No significant difference was found in the amount of the debris extruded between conventional
sequence of the ProTaper Universal NiTi files and the single-file ProTaper technique. In contrast,
the hand instrumentation group extruded significantly more debris than both NiTi groups.

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Studies
qGustavo De-Deus et al., IEJ, November 2010
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q► Reciprocating movement resulted in a significant longer cyclic fatigue life.

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Studies
qGustavo De-Deus et al., JOE, November 2010
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q►  The debridement quality of the single-file F2 ProTaper technique was suboptimal in oval canals.
The debridement quality of single-file F2 ProTaper was similar to the full range of ProTaper
instruments in round canals.

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Studies
qYou, et al., JOE, Dezember 2010
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q► One F2 file can be safely used to working length of curved canals at least six times under
reciprocating motion.

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Studies
qValera-Patino et al., JOE, Januar 2010
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q► The results indicate that instruments used with alternating rotation have a higher mean number
of uses compared with the continuous rotation group.

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