GOOD MORNING

RECIPROCATION IN
ENDODONTICS

GUDIED BY:
DR. P. KARUNAKAR
PRESENTED BY:
DR. ASHISH JAIN
A. SARIKA
DR. UMRANA FAIZUDDIN
 Contents

1. Introduction
2. History
3. Types of reciprocations
4. File systems
5. Mechanical properties
6. Conclusion
7. references

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INTRODUCTION

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5
 HISTORY

Early Era of Mechanical Instrumentation

• Mechanical instrumentation : early objective of endodontic

science, beginning in the 19th century when pioneers were
trying to develop endodontic mechanical instruments.

• In 1912, Kerr Company had in its catalogue ‘‘K’’-style

rotary ‘‘broaches’’ made of carbon steel to be activated
by treadle-type, foot-powered hand pieces.

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 HISTORY

• The first endodontic motor: 1925 : Endocursor, which

allowed the use of conventional K or Reamer SS files with
a complete 360 rotating motion combined with vertical
strokes
• Reciprocation was first introduced in the late 1950s by
the French dentist, Blanc.

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 HISTORY

• In 1985 - Manual reciprocation using stainless steel

instruments (Balanced force technique)
• In 1964 – Automated reciprocation with the Giromatic ,
utilizing stainless steel files moving with a 90 degree
clockwise and anticlockwise motion.
• In 2008 – The concept of reciprocating files was re-introduced
this time using single NiTi instruments. Especially with F2
Protaper instrument by YARED
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 Definition

The reciprocating motion can be described as an oscillating

motion where an instrument rotates in clockwise &
anticlockwise direction before completing a full rotary cycle.

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Variations of reciprocating motion

There are many variations of RM, including:

1. Complete reciprocation (oscillation)
2. Partial reciprocation (rotational effect)
3. Hybrid reciprocation (combined movements)

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Nicola MG et al. The reciprocating movement in endodontics. FEBRUARY 2016 ENDODONTIC PRACTICE
Different types of
reciprocating motions

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Complete reciprocation with vertical
oscillations

• Racer
• Self-Adjusting File

Reciprocation in slow motion (Up and down type)..mp4

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Complete reciprocation with horizontal
rotational oscillations

• Giromatic
• Intra-Endo 3 LD
• Dynatrak system
• M4 Safety Handpiece
• Endo-Gripper
• NSK TEP-E10 R,
• Endo-Eze AET system,
• Tilos system, and
• Endo-Express SafeSider

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Complete reciprocation with combined
oscillations

• Canal Finder System

• Excalibur
• Canal-Leader 2000
• Endolift
• Endoplaner
• EndoPulse system

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Partial reciprocation with rotational effect

1. ATR Teknica
2. WaveOne
3. WaveOne Gold
4. Reciproc

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Hybrid reciprocation

TF Adaptive/Elements motor

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Giromatic reciprocate at 90
Intra-Endo 3 LD alternating 80 horizontal rotational movement
Dynatrak system reciprocate at a higher speed between 3000
and
6000 reciprocations/min

The Racer reciprocating handpieces, vertical stroke,

amplitude of 1 to 2 mm
vertically.
The Canal Finder System vertical stroke of 0.3 to 1 mm.
Excalibur (W&H), mixed horizontal rotational movements
with multilateral pendulum oscillations;
the Canal-Leader 2000 helicoidal motion combining vertical
movements (0.4 to 0.8 mm) and horizontal
rotations (20-30);
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The endolift Vertical
And horizontal oscillations

The endoplaner and the The horizontal rotational component was 360
intra-endo 3-LDSY
Self-adjusting file A vertical RM of a 0.4-mm amplitude with a
frequency of 3000–5000 vertical reciprocations/
Min under continuous irrigation.
M4 safety handpiece A 30 horizontal rotational RM and a chuck that
locks regular hand files
Endo-gripper 45 and 90 horizontal
Nsk tep-e10 r Rotational motion
Endo-eze AET system, 30 horizontal rotational RM
endo-express safesiders

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 ENDOMOTORS with reciprocation :

1. M4 (Sybron Endo, USA)

2. The Endo Eze AET (Ultradent products, USA)
3. The Endo Express (Essential dental systems, USA)
4. VDW gold
5. VDW silver
6. X-mart plus

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 M4 (Sybron Endo, USA)

1. Available for E-style motors or TC Cordless

Handpieces
2. Compatible with most hand files.
3. Mimics watch-winding motion.
4. Greatly reduces fatigue.

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The Endo Express (Essential dental systems,
USA)

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 Endo Express and Safe Sider
• Safe Siders have 16 flutes compared to 24
flutes for files.
• Less flutes leads less engagement with the
walls of the canal which means less
resistance, binding and virtually no
instrument separation.
• Flat-side of the SafeSider: Act as chisels in
the clockwise and counter clock-wise motion
allow to remove debris easily. 22
Endo Eze AET

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ENDO-EZE RECIPROCATING FILES:

• Recently introduced addition for Giromatic

handpieces

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 The Modern Use of SS Files Mounted
on Reciprocating Handpieces

• First scouting phase of root canal preparation is with

stainless steel instruments

• Path finder 0.06 and 0.09mm tip diameter with a taper of 0.02mm

• Materials used include stainless steel and carbon steel with 30

complete horizontal reciprocation

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 Why reciprocation

Rotation
‘‘separation’’ problem :continuous rotation

The endurance limit (EL) of niti

files : this can be defined as the level
of torsional stress or strain at which
the file can be subjected to a virtual
infinite cycles without failure, where
a cycle is intended as a loading stress
or strain and releasing. .

This value will be a specific deflection

angle (DA) characteristic of each instrument,
and it will depend on the size and design
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features
Over come this problem by :
limiting the angle of rotation
• Development of a movement that could be defined as partial or asymmetrical
reciprocation with a rotary effect, in which the angle of rotation in the cutting
verse is higher than the angle of rotation in the opposite noncutting verse

• This determines the final rotation of the instrument that will perform a
complete turn for a certain number of reciprocating cycles.

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• First introduced, a motor was programmed with this kind of motion
(ATR Teknica; ATR, Pistoia, Italy) together with files designed for
rotary use (ProTaper F2; Dentsply Maillefer).

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VDW silver

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VDW gold

VDW Dental · How To- VDW.GOLD RECIPROC – Motor functions.mp4

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X smart plus

WAVEONE, PROTAPER
NEXT, PROTAPER
UNIVERSAL, PROGLIDER,
PATHFILE, GATES,
RECIPROC
6 free programs for individual
settings in continuous rotation
• Auto reverse rotation at pre-
set torque limit
Torque range: 0.6 – 4.0 Ncm
Speed range: 250 – 1’200 rpm

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 Protaper
Wave One Universal
F2

Wave
Reciprocating Reciproc
Reciprocatingfiles
files one gold

TF
ADAPTIVE
SAF

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 Wave One

Convex triangular cross section Modified Convex triangular cross section

in the coronal third in the apical third

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• Single file system
• M-wire technology
• Counterclockwise
(CCW) movement
170 is greater than
the clockwise (CW)
movement 50
• Three reciprocating
cycles complete- one
360º reverse rotation 35
 Reciproc

• Single file system

• M-wire technology
• Reverse balanced force technique
• Driven first in a cutting direction and then
• reverses to release instrument
• One complete rotation of 360°- 3 movements-
stopper
• Angle in cutting direction is greater than angle in
reverse direction
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• Developed from Mtwo design
• S-shaped cross section
• Two contact points
• No radial lands
• Non cutting tip
• 150 CCW and 30 CW

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 Wave One Gold

 metallurgical improvements of Gold-wire thermal

treatment to increase the elasticity and reciprocation
motion
 parallelogram cross-sectional shape
 two 85° cutting edges, which is enhance cutting
ability and debris removal

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 Self Adjusting File(SAF)

• Hollow file designed as a compressible, thin-walled

pointed cylinder either 1.5 or 2.0 mm in diameter
composed of 120um thick nickel-titanium lattice.
• • The surface of the lattice threads is lightly abrasive
which allows it to remove dentin with a back-and forth
grinding motion.

Self-Adjusting File (SAF) instructional video (Nov 2013).mp4

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 TF ADAPTIVE

"Rotary when you want it, Reciprocation when

you need it“

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MECHANICAL PROPERTIES
OF RECIPROCATING FILES

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 Cyclic Fatigue and Bending
Resistance

• RFs are claimed to travel a shorter

circumferential distance than a rotary
instrument.
• Movement kinematics is the main
factors determining the resistance of
rotary nickel-titanium (NiTi) files .

• Eg: Protaper F2

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 Cyclic Fatigue and Bending Wave one

Resistance

• Mean life for reciproc is 62% higher

than waveone at 5 mm from the tip and
100% higher at 13 mm

Amplitude of reciprocation

• Increasing the angle of reciprocation and

consequently increasing the angle of
progression for each reciprocation cycle
can reduce the resistance to cyclic fatigue.
Recipro

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 Cyclic Fatigue and Bending
Resistance

Progressive RM

• Most critically
strained locations
move forward to new
locations during the
periodic angular
increment instead of
remaining stationary.

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 Cyclic Fatigue and Bending
Resistance

• This effectively distributes fatigue damage to different

points on the circumference, thus reducing the detrimental
effect of localized damage.
• The progressive increment should preferably be small and
should not completely divide 360 to be effective

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 Cyclic Fatigue and Bending
Resistance

Cyclic fatigue resistance of different continuous rotation and

reciprocating endodontic systems
de Almeida-Gomes F, de Matos HR, Nunes RF, Arrais AM, Ferreira-Maniglia C, de
Morais Vitoriano M, et al. Indian J Dent Res 2016;27:278-82.

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 Torsional Resistance

• Torsional resistance of reciproc and waveone operated at the

maximum rotating angle in their proprietary motors

• In terms of maximum torsional load, both Reciproc and

WaveOne showed significantly higher torsional resistance
than ProTaper , and WaveOne had a higher torsional resistance
than Reciproc and OneShape.

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 Int Endod J. 2018 May;51(5):522-528. Pedulla et al

Within the limitations of this study, the instruments tested were associated
with greater cyclic fatigue resistance in reciprocation of OTR motion than
continuous rotation.
Mtwo and TF files had the greatest cyclic fatigue resistance, in both
motions.
PTN instruments displayed greater cyclic fatigue resistance than Revo-S
and EndoWave, both in continuous and in OTR reciprocating motion.
No difference was observed between Revo-S and EndoWave, in both
movements

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 Cutting Efficiency

1. Number of flutes,
2. Cross-sectional area design,
3. Sterilization,
4. Chip removal capacity,
5. Helical and rake angle,
6. Tip design,
7. Metallurgical properties, and
8. Surface treatment of the files

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• No significant difference in the cutting ability of
reciproc and twisted file (TF) adaptive used in their
proprietary RM or CR, thus showing that this
movement does not reduce the cutting ability of these
files

• Reciproc and TF Adaptive showed a significantly

higher cutting efficiency than WaveOne

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 Surface Analysis

• No significant
difference in the surface
alteration for waveone
and reciproc after 1, 2,
or 3 rcss were shaped

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• when reused in up to 10 canals showed slight wear
of the file tip (apical blunting) and microdefects on
the surface

• 60% of ProTaper files used in reciprocation showed

the initiation of microcracks on the surface

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 Shaping Ability and Preservation of
Anatomy of the RC Space

Adequate shaping ability of contemporary RFs while preserving

the original RC shape mainly is a result of the interplay of 3
main factors:
1. the reciprocation kinematics,
2. the file cross section, and
3. the M-wire alloy.

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• Both waveone and R25 were able to prepare the apical
portion of j-shaped simulated rcs adequately, but a
greater number of pecking times after reaching the
WL may result in an apical size that is larger than the
actual file size

A glide path before RF usage !!!!!........

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• A small-size k-file followed by a more flexible and less
tapered niti rotary file maintained the original canal
anatomy better, minimized procedural errors, and required
fewer pecking motions to reach the WL.

• larger core diameter and greater number of spiraling flutes

of WaveOne increases the stiffness of the tip, which results
in alterations of the original RC shape and length

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 Shaping Time

• ST using Reciproc was

significantly faster than WaveOne,
but slower than OneShape.

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 Cleaning Effectiveness

• There was no significant difference in

cleaning ability among the SAF,
waveone, and K3 except in the isthmus
where the shaping was the worst after
waveone usage.

In microCT analysis –
• WaveOne usage led to more debris accumulation than
ProTaper, especially in the isthmuses
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• When comparing volume of debris generated after
different apical enlargement with RFs or rotary files,
it showed that all canals contained packed debris with
no significant difference between the system

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 Microcracks

• WaveOne could be associated with less DMs than

ProTaper Universal. Similarly, Reciproc caused fewer
DMs than ProTaper and OneShape .

• Other studies did not yield significant differences

regarding the frequency of DMs after RCP using
reciprocating or rotating systems

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 Bacterial Reduction

• Disinfection of the RCS is of utmost

importance in endodontic therapy.
• Investigators compared the bacterial reduction
in oval-shaped RCs using Reciproc R40 and
BioRaCe under the same irrigation protocol,
and they found that both systems were
comparable, yielding significant bacterial
reduction.

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• The mechanical action of endodontic files on dentin
together with adequate exposure to naocl irrigation is
more effective for disinfection than the number of files
used.

• A clinical study showed that both rfs and rfsss showed

similar effectiveness in reducing endotoxins and
cultivable bacteria.
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 Extrusion of Debris

• During RCP, dentin chips, pulp tissue,

microorganisms, endotoxins, and/or irrigants
may be extruded into the periradicular
tissues, which may potentially cause
postoperative complications.

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• SAF system showed the least debris extrusion followed
by ProTaper Next and WaveOne, which were
significantly better than ProTaper Universal.
• However, WaveOne showed less debris extrusion than
ProTaper Next and TF

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 Removal of Root Canal Fillings

• The proper removal of RCFMs from inadequately

prepared and filled RCs requires a substantial effort
and can be challenging and time-consuming.

• Many studies evaluated the application of RFs to

remove gutta-percha from the RCS . With the
exception of 4 studies , there is a general agreement

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1.The application of RFs is as effective as CRFs , yet no
one system is able to effectively remove RCFM
completely from the RCS.
2. The extrusion of RCFMs can occur in both systems

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• ProTaper used with adaptive motion enhanced
the removal of RCFMs from the RCS
compared with CR.
• This might be attributed to the synergistic
effect of both CR and RM.

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 centering ability

All instruments maintained the original canal curvature with significant differences
between the different files. Data suggested that Wave One files presented the best
outcomes for both the variables evaluated. Wave One files caused lesser
transportation and remained better centered in the canal than One Shape and
Rotary ProTaper files.

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Single file reciprocating systems: A systematic review
and meta-analysis of the literature: Comparison of
reciproc and WaveOne

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 Advantages

Journal Authors Conclusions

Quintessence Int Blake McRay et al Reciprocating files have

2014 centering ability in
comparable to continuous
rotation files
Aust Endod J 2011 Jeffrey Wan et al A reciprocating instruments
travels shorter angular distance
than a rotary instrument = lower
stress values = extended
fatigue life

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 Advantages
Journal Authors Conclusions

J Endod 2010 Sung-Yeop You et al An instrument with reciprocating motion

can be used at least six times more safely
than the instrument with rotation motion
which is even faster in its action

J Endod 2013 Sebastian B€urklein et The amount of the dentinal cracks produced
al. with reciprocating files is less when
compared to files with continuous rotation.

J Endod 2014 Wael H. Kamel et at . Using the rotary CanalBrush in canals

prepared with WaveOne produced the
cleanest canal wallsc, and the WaveOne
system gave superior results compared with
the ProTaper system.
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 Disadvantages

Journal Authors Conclusions

Roots international By Prof. Gianluca Gambarini, The cutting efficiency of instruments in

magazine of Italy & Dr Gary Glassman,
endodontology No. 3/2013 Canada
continuous rotation is more when
compared to instruments in reciprocation ,
since cross-sectional and flute designs are
meant to perform at their best in a CW
motion

J Endod 2012 Sebastian B€urklein et al

It is shown that the amount of apical
debris extrusion is more with
reciprocating files than with the continuous
rotation files.

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 Summary

1. extends the life span of the NiTi

2. cyclic fatigue life of the files.
3.cutting efficiency of the files.
4. adequate shaping ability
5.cleaning effectiveness
6. reduces the ST

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7. significant bacterial reduction but are not able to
completely disinfect the RCS.
8. extrude less debris controversial
9. Removing the RCFMs in less time

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CONCLUSION

Reciprocation is an exciting concept in endodontics.

The three important element for shaping the canals are
safety, efficiency and simplicity . Which are
successfully accomplished with the help of
reciprocation . However, it has to be substantiated
with clinical trails in order to standardized the results.

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 References

1. Yared, G: Canal preparation using only one NiTi rotary instrument:

preliminary observations, Int Endod J 41:4, pp. 339-344, 2008.
2. Nicola Maria Grande, et al. Current Assessment of Reciprocation in
Endodontic Preparation: A Comprehensive Review—Part I: Historic
Perspectives and Current Applications. J Endod 2015;41:1778–83
3. Tambe VH, Nagmode PS, Abraham S, Patait M, Lahoti PV, Jaju N.
Comparison of canal transportation and centering ability of rotary
protaper, one shape system and wave one system using cone beam
computed tomography: An in vitro study . J Conserv Dent
2014;17:561-5. 80
THANK YOU

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