Tulsa Dental ProTaper Rotary File: Too Costly, Too Narrow?

Dr. K asks:

ProTaperI just took a course in using the Tulsa Dental ProTaper nickel titanium rotary file system. I did not fracture any of the files while instrumenting the extracted teeth.

However, I am a bit concerned about the cost. The instructor recommended using each file once and then discarding it. He said that after you use a rotary nickel titanium file once, it is liable to fracture if used again. You also have to buy their electric motor and handpiece too. I do not understand how to set the torque value on their motor.Seemed very confusing to me.

I am also concerned about the size of their master apical file. I always used to go to at least a #35 file to the apex. Their system uses a really narrow file at the apical terminus, like A #20. Is that wide enough? Seemed easy to obturate the canal afterwards using either their Thermafill or similar sized cold gutta-percha master cones.

What are your experiences with this system? Is it as good as they say it is? I’d be interested in your thoughts.

12 thoughts on “Tulsa Dental ProTaper Rotary File: Too Costly, Too Narrow?

  1. I’ve been using the system for awhile. I paid big bucks for an early motor without torque control, and then almost immediately after, they came out with torque control, and told me my old motor was no good. I am not real happy with Tulsa. I use the Brasseler chargeable cordless motor. Very handy. I have reused instruments for more than one patient with no problem, and I have fractured a brand new one, first time in a canal. I suspect they’re right when they say not to force the file, and always have lots of lubricant. A critical thing to do is carefully inspect the file after you use it, and if it is the slightest bit out of shape, dump it. I have purchased some files on eBay. Those clever rascals at Tulsa sell files to students at a very good price and the even more clever students sell them on eBay. Go figure. Everybody is happy but the Tulsa salesman. Good luck. FBS

  2. I have used the system for three years now. I have had some fractures but most of the times because I want to go in too quickly. Most times I use the files 5 times, but when I treat a very curved canal or scleroyic canal I will change them quicker. I always start to make a glide-path with my handfiles and edta-gel. When Iam at the working length then I use the protapers ( there are now protapers up to F5). When I feel that i have to put on too much pressure I will go to the file before: in a sense I use the step-down pressureless technic. I don’t use the special motors anymore, but a special handpeace with
    1: 128. When you use torque-control devices then as soon as the motor starts to reverse its action you get a lot of stress on your files and it is better to through them away then, because they will fracture! I have used many differend systems because they told me this system is better and the files don’t break. I think you have to try differend systems and one will work better in your hands then the other: that’s your best system.

  3. Look into the LIGHTSPEED SYSTEM. The endodontist I worked with uses them in his own private practice and has been for many yrs. They can be used up to 8 times. If they do break, they break at their most coronal aspect..just as gates gliddens..simple to retrieve. When tulsa files break, they break mid root or further apically. Look into the Lightspeed file system as they also use a cordless handpiece. I have been using these for years now, and have tried all the rest.

  4. the average apical diameter in smaller canals is 0.27mm
    standard deviation = 0.045. It doesn’t sound like you are interested in 50% of cases failing due to insufficient apical shaping! To reach 2SD over mean in distribution, one must enlarge (0.09 + 0.27 = 0.36. 35f is close / many go to 40f and custom cut tip of feathered M – GP to 0.35. system B and obtura works well, i’m pretty skeptical of mono-cone cementation.

    glide path formation sequences are essential in adapting rotary instruments in molar teeth. try several: 15f-patency, 25f -2mm; begin crn down series; 20f -rt, 25,30,35 -1mm apical serial stepback,F-1(.07)
    usually goes into place; wristwatch wind 30,35,40F to
    -1mm, 25f patency/apical clearing : done.

    I believe this reduces wear on insts. set up form for tracking use. can use ‘em this way at least 3 times–maybe 5. .02 stainless files / glide path / makes it easier + saves $. Also, there’s nothing wrong with Gates…they can still be used –if wisely–for coronal shaping….get ride of the (what is it) Sx??

  5. I have been doing molar endo for the past 29 years. A general rule in determining master file size is to enlarge the canal three more sizes after the file that binds apically.

    In younger patients, a standard size forty or more is likely, but in older patients, I have completed hundreds of successful cases filling to a thirty (in MB ML DB canals of molars.)

    BTW, I still use GP and a ZOE based sealer to obturate with lateral condensation. Call it old school, I suppose, but it’s hard to argue with success. As Weine use to say…”You can fill a canal with sterile horseshit, as long as it is properly cleansed and shaped.”

  6. I used rotary ProTaper to prepare extracted single rooted teeth and reached to F3. The canals were obturated using Lateral condensation with #30 master cone and accessory cones. And the rest obtrated by syetme B using medium Size non-standard gp and plugger. For both techniques I ensured the presence of tug-back. So can you give me your openion if that was correct please?

  7. I agree with the LIGHTSPEED LSX technique. I like taking the apex to a larger apical size. These files allow me to do that while still leaving the midroot and coronal part of the tooth alone. The files have to be ran at 2500 rpms but are great at cleaning out all the apical debris.

  8. I use Protaper 5 times a day!!!. I am very satisfied. I have sets of files for molars and premolars which I use 5-8 times 9 (maximum 15 canals)and I note on every set the number of canals used, and sets for incisives/canines which I could use (sometimes) 20 times (it means 20 canals). Protaper is the best shape file system, in my opinion. Concerning the speed and torque, experience taught me to play with depending on teeth/canal/age of pacient, but I could provide the recommended values. I had extraordinary good results even on third molars. It happened to break some files due to a very curved canal or difficult access, but I consider that it was entirely my fault of not using enough first the Kerr files to enlarge the canal on the working length for allowing a rotary instrument to work safely and efficient. My advice: start to use ProTaper, results will make you proud.

  9. The risk of rotary file breakage is always there. I’ve found that a “more” and adequate Glide-Path is the best way to reduce rotary file separation. Your patients deserve a great Glide-Path prior to rotary instrumentaion. A great way to prep the GlidePath is with the EndoHandle. Check it out on the web.

  10. lightspeed is a quick and safe system but it can be used to enlarge the apex to the requiered size then other system with a taper better be used.

  11. i was using these files for last 6 years and iam very much satisfied with the instrument i have some clinical tips to avoid breakage. any way apical tug back is always questionable.

  12. I guess my biggest concern with this post is that a) These files cost too much….we, as Dr’s charge $800-$1500 per case in a root canal and we’re complaining about a premium file costing $6-$7 per file….hmmmm. Secondly…files separating….mainly because they are being used more than once. Again…files are supposed to be single patient use, you autoclave them..knowing it weakens the NiTi, and complain about separation….amazing.

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