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Endodontic Topics 2005, 10, 176–178 All rights reserved
Copyright r Blackwell Munksgaard ENDODONTIC TOPICS 2005 1601-1538
Reamer with alternating cutting edges – concept and clinical application MICHAEL A. BAUMANN
Background Within the last decade numerous Nickel–Titanium (NiTi) instruments have been designed and dentists, physicists, chemists and manufacturer have worked hard to optimize instrument geometry and their surfaces in order to maximise their potential in every day practice. The reamer with alternating cutting edges (RaCe) instrument system is unique and this article summarizes its design, outlines its clinical application and describes the various scientific reports that have been published.
Instrument design In 1999, 10 years after the first NiTi instruments were introduced, the RaCe system (Table 1) became available; it had a number of new features: A RaCe with twisted areas similar to conventional files alternating with straight areas, to giving a larger space for debris and to reduce the tendency to thread (Fig. 1). Sharp cutting edges resulting from a square crosssectional shape in the small instruments (15/0.02 and 20/0.02) and a convex triangle (similar to ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) or FlexMaster (VDW, Mu¨nchen, Germany)) in the remaining RaCe instruments. Reduced active cutting regions on some instruments (9–16mm). The two largest instruments (35/0.08 and 40/ 0.10) are available in NiTi and stainless steel, the latter being more efficient.
176
The NiTi surface is treated chemically resulting in an obviously smoother surface than other instruments (Fig. 1). As a consequence of this design the manufacturer has recommended that a dedicated endodontic motor is not essential. This is only a claim and has not been investigated independently. Daily practice and personal experience shows that the tendency for threading into the canal is less with RaCe than with other NiTi systems, however, this finding is only empirical and scientific evidence is lacking.
Scientific evidence Within the last 15 years a considerable amount of research has been carried out on NiTi instruments. In common with most NiTi instruments the RaCe system allows a well-centered canal shape to be prepared, often within a shorter time than hand instrumentation. Ledges and zipping occur rarely and the cleaning ability in terms of debris and smear layer removal is equal or better than with hand techniques. In 2002 the first description of the RaCe system appeared in the German journal ‘Endodontie’ giving detailed information on the design, the sequences and a comparison with other NiTi products on the market together with case reports (Baumann, 2002). An expanded version of the article in English followed in Endodontic Practice (Baumann, 2003). In 2002 the first scientific results were published as abstracts at the Chicago meeting of the American Association of Endodontists (AAE) comparing the centering ability of ProTaper and RaCe using the Endo Cube. At 3 mm from the apex RaCe showed ‘the least
Ni/Ti
NiTi
NiTi
NiTi
SS or NiTi
SS or NiTi
Total length/cutting part
19/9
19/9
19/10
25/16
25/16
25/16
Ground section
}
}
}
}
&
}
Material
10/0.08/0.06/0.04/0.02 40/35/30/25/25
0.10 and 0.08: stainless steel (SS) or NiTi
06/0.06/3 0.04 30/40/25/30/35
NiTi
0.06/4 0.02 30/25/30/35/40
Nickel–Titanium (NiTi)
Taper ISO
Fig. 1. Design of the reamer with alternating cutting edges file (SEM): twisted areas alternate with straight parts. The surface is very smooth because of a special chemical treatment.
Code
01.720.25.S25
01.721.25.S25
01.722.25.S40
Taper
0.10
0.08
0.06
0.04
0.02
0.02
Step back 0.06/0.02
Step back 0.06/0.04
Crown down 0.10–0.02
Files available
40
35
30/40
25/30/35
15/20
25/30/35/40/50/60
Fig. 2. Upper left second premolar after treatment with reamer with alternating cutting edges files and filling with Resilon/Epiphany and glass fiber postinsertion.
Sets
Table 1. Available sets and totally available instruments of RaCe.
Material
RaCe
amount of deviation form the canal centre’ . . . and ‘. . . the greatest amount at the level of maximum canal curvature’. In the following AAE meeting in Tampa the cleaning effectiveness and shaping ability was investigated in an SEM study (Baumann et al., 2003): It was shown that RaCe enabled an obviously better canal form at all levels of the root canal than by hand and smear layer removal – after irrigation – superior to hand instrumentation. At the AAE meeting in Anaheim in 2004 two additional abstracts on RaCe were presented. Cyclic fatigue of ProFile, K3 and RaCe was compared in a special setting. The first study by Elasaad et al. (2004) demonstrated that overall, K3 25/0.04 files were
177
Baumann significantly more resistant to cyclic fatigue compared with the other instruments in this study. The second study focused on the torsional testing of ProFile, K3 and RaCe in the sizes #25 with 0.02, 0.04 and 0.06 taper and #40 in all three tapers of K3 and ProFile (Fessenden et al., 2004). In this study the RaCe file series exhibited lower values for maximum torque and rotations to fracture. The authors speculated that a smaller diameter at 3 mm could be a possible reason for the lower resistance to torque of RaCe. At this time only a small number of peer-reviewed articles on RaCe is available. Two recently published articles compare ProTaper with RaCe regarding their ability to shape canals in resin blocks or extracted teeth. In plastic blocks, RaCe was superior to ProTaper regarding shaping ability and comparable in operational safety. These findings were confirmed in extracted teeth (Scha¨fer & Vlassis, 2004b). Summarizing the research on RaCe, it shows lower resistance to cyclic fatigue and seems to have some advantageous properties compared with other well-known systems regarding maintenance of the canal curvature or cleaning ability. Cases treated (Fig. 2) and daily use of RaCe instruments confirm they are efficient and a rapid method to achieve predictably good results in root canal treatment.
Further reading 1.
178
Baumann MA. Maschinelle Wurzelkanalaufbereitung mit dem RaCe-system. Endodontie 2002: 11: 239–249.
2. Baumann MA. The RaCe system. Endodontic Practice 2003: 6: 5–13. 3. Baumann MA Nickel–titanium – options and challenges. Dent Clin North Am 2004: 48: 55–67. 4. Baumann MA, Leinbrock O, Hellmich M, BaumannGiedziella UA. Effectiveness of root canal instrumentation with RaCe: an SEM study. J Endod 2003: 29: 286 (abstract OR8). 5. Elasaad MG, Isler AE, McDonald NJ. An evaluation of the root canal centering abilities of ProTaper and RaCe Ni–Ti rotary files and flexofiles. J Endod 2002: 28: 247 (abstract OR50). 6. Fessenden SD, Byrne BE, Carter JM. Torsional testing of RaCe, K3 and ProFile nickel titanium endodontic files. J Endod 2004: 30: 275 (abstract PR10). 7. Glosson CR, Haller RH, Brent Dove S, del Rio CE. Comparison of root canal preparations using NiTihand, NiTi engine-driven, and K-Flex endodontic instruments. J Endod 1995: 21: 146–151. 8. Hu¨lsmann M. Wurzelkanalaufbereitung mit Nickel– Titan-Instrumenten. Ein Handbuch. Berlin: Quintessenz, 2002. 9. Scha¨fer E, Vlassis M. Comparative investigation of two rotary nickel–titanium instruments: ProTaper versus RaCe. Part 1. Shaping ability in simulated curved canals. Int Endod J 2004a: 37: 229–238. 10. Scha¨fer E, Vlassis M. Comparative investigation of two rotary nickel–titanium instruments: ProTaper versus RaCe. Part 2. Cleaning effectiveness and shaping ability in severely curved root canals of extracted teeth. Int Endod J 2004b: 37: 239–248.
Copyright r Blackwell Munksgaard ENDODONTIC TOPICS 2005 1601-1538
Reamer with alternating cutting edges – concept and clinical application MICHAEL A. BAUMANN
Background Within the last decade numerous Nickel–Titanium (NiTi) instruments have been designed and dentists, physicists, chemists and manufacturer have worked hard to optimize instrument geometry and their surfaces in order to maximise their potential in every day practice. The reamer with alternating cutting edges (RaCe) instrument system is unique and this article summarizes its design, outlines its clinical application and describes the various scientific reports that have been published.
Instrument design In 1999, 10 years after the first NiTi instruments were introduced, the RaCe system (Table 1) became available; it had a number of new features: A RaCe with twisted areas similar to conventional files alternating with straight areas, to giving a larger space for debris and to reduce the tendency to thread (Fig. 1). Sharp cutting edges resulting from a square crosssectional shape in the small instruments (15/0.02 and 20/0.02) and a convex triangle (similar to ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) or FlexMaster (VDW, Mu¨nchen, Germany)) in the remaining RaCe instruments. Reduced active cutting regions on some instruments (9–16mm). The two largest instruments (35/0.08 and 40/ 0.10) are available in NiTi and stainless steel, the latter being more efficient.
176
The NiTi surface is treated chemically resulting in an obviously smoother surface than other instruments (Fig. 1). As a consequence of this design the manufacturer has recommended that a dedicated endodontic motor is not essential. This is only a claim and has not been investigated independently. Daily practice and personal experience shows that the tendency for threading into the canal is less with RaCe than with other NiTi systems, however, this finding is only empirical and scientific evidence is lacking.
Scientific evidence Within the last 15 years a considerable amount of research has been carried out on NiTi instruments. In common with most NiTi instruments the RaCe system allows a well-centered canal shape to be prepared, often within a shorter time than hand instrumentation. Ledges and zipping occur rarely and the cleaning ability in terms of debris and smear layer removal is equal or better than with hand techniques. In 2002 the first description of the RaCe system appeared in the German journal ‘Endodontie’ giving detailed information on the design, the sequences and a comparison with other NiTi products on the market together with case reports (Baumann, 2002). An expanded version of the article in English followed in Endodontic Practice (Baumann, 2003). In 2002 the first scientific results were published as abstracts at the Chicago meeting of the American Association of Endodontists (AAE) comparing the centering ability of ProTaper and RaCe using the Endo Cube. At 3 mm from the apex RaCe showed ‘the least
Ni/Ti
NiTi
NiTi
NiTi
SS or NiTi
SS or NiTi
Total length/cutting part
19/9
19/9
19/10
25/16
25/16
25/16
Ground section
}
}
}
}
&
}
Material
10/0.08/0.06/0.04/0.02 40/35/30/25/25
0.10 and 0.08: stainless steel (SS) or NiTi
06/0.06/3 0.04 30/40/25/30/35
NiTi
0.06/4 0.02 30/25/30/35/40
Nickel–Titanium (NiTi)
Taper ISO
Fig. 1. Design of the reamer with alternating cutting edges file (SEM): twisted areas alternate with straight parts. The surface is very smooth because of a special chemical treatment.
Code
01.720.25.S25
01.721.25.S25
01.722.25.S40
Taper
0.10
0.08
0.06
0.04
0.02
0.02
Step back 0.06/0.02
Step back 0.06/0.04
Crown down 0.10–0.02
Files available
40
35
30/40
25/30/35
15/20
25/30/35/40/50/60
Fig. 2. Upper left second premolar after treatment with reamer with alternating cutting edges files and filling with Resilon/Epiphany and glass fiber postinsertion.
Sets
Table 1. Available sets and totally available instruments of RaCe.
Material
RaCe
amount of deviation form the canal centre’ . . . and ‘. . . the greatest amount at the level of maximum canal curvature’. In the following AAE meeting in Tampa the cleaning effectiveness and shaping ability was investigated in an SEM study (Baumann et al., 2003): It was shown that RaCe enabled an obviously better canal form at all levels of the root canal than by hand and smear layer removal – after irrigation – superior to hand instrumentation. At the AAE meeting in Anaheim in 2004 two additional abstracts on RaCe were presented. Cyclic fatigue of ProFile, K3 and RaCe was compared in a special setting. The first study by Elasaad et al. (2004) demonstrated that overall, K3 25/0.04 files were
177
Baumann significantly more resistant to cyclic fatigue compared with the other instruments in this study. The second study focused on the torsional testing of ProFile, K3 and RaCe in the sizes #25 with 0.02, 0.04 and 0.06 taper and #40 in all three tapers of K3 and ProFile (Fessenden et al., 2004). In this study the RaCe file series exhibited lower values for maximum torque and rotations to fracture. The authors speculated that a smaller diameter at 3 mm could be a possible reason for the lower resistance to torque of RaCe. At this time only a small number of peer-reviewed articles on RaCe is available. Two recently published articles compare ProTaper with RaCe regarding their ability to shape canals in resin blocks or extracted teeth. In plastic blocks, RaCe was superior to ProTaper regarding shaping ability and comparable in operational safety. These findings were confirmed in extracted teeth (Scha¨fer & Vlassis, 2004b). Summarizing the research on RaCe, it shows lower resistance to cyclic fatigue and seems to have some advantageous properties compared with other well-known systems regarding maintenance of the canal curvature or cleaning ability. Cases treated (Fig. 2) and daily use of RaCe instruments confirm they are efficient and a rapid method to achieve predictably good results in root canal treatment.
Further reading 1.
178
Baumann MA. Maschinelle Wurzelkanalaufbereitung mit dem RaCe-system. Endodontie 2002: 11: 239–249.
2. Baumann MA. The RaCe system. Endodontic Practice 2003: 6: 5–13. 3. Baumann MA Nickel–titanium – options and challenges. Dent Clin North Am 2004: 48: 55–67. 4. Baumann MA, Leinbrock O, Hellmich M, BaumannGiedziella UA. Effectiveness of root canal instrumentation with RaCe: an SEM study. J Endod 2003: 29: 286 (abstract OR8). 5. Elasaad MG, Isler AE, McDonald NJ. An evaluation of the root canal centering abilities of ProTaper and RaCe Ni–Ti rotary files and flexofiles. J Endod 2002: 28: 247 (abstract OR50). 6. Fessenden SD, Byrne BE, Carter JM. Torsional testing of RaCe, K3 and ProFile nickel titanium endodontic files. J Endod 2004: 30: 275 (abstract PR10). 7. Glosson CR, Haller RH, Brent Dove S, del Rio CE. Comparison of root canal preparations using NiTihand, NiTi engine-driven, and K-Flex endodontic instruments. J Endod 1995: 21: 146–151. 8. Hu¨lsmann M. Wurzelkanalaufbereitung mit Nickel– Titan-Instrumenten. Ein Handbuch. Berlin: Quintessenz, 2002. 9. Scha¨fer E, Vlassis M. Comparative investigation of two rotary nickel–titanium instruments: ProTaper versus RaCe. Part 1. Shaping ability in simulated curved canals. Int Endod J 2004a: 37: 229–238. 10. Scha¨fer E, Vlassis M. Comparative investigation of two rotary nickel–titanium instruments: ProTaper versus RaCe. Part 2. Cleaning effectiveness and shaping ability in severely curved root canals of extracted teeth. Int Endod J 2004b: 37: 239–248.
