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Review Article

ENDODONTOLOGY Volume: 26 Issue 1 June 2014

Glide path in endodontics


Anil Dhingra # *
Neetika # *

ABSTRACT
What is a glide path? Does it help in root canal procedure? Glide-path is a smooth radicular tunnel from canal orifice
to physiologic terminus (foraminal constriction). Its minimal size should be a super loose No. 10 endodontic file.
The Glidepath must be discovered if already present in the endodontic anatomy or prepared if it is not present. Glide
path creation is essential for prevention of rotary file separation and most effective rotary use. Creating an.02 tapered
glide path is critical for the safe and effective use of nickel-titanium rotary shaping instruments. Glidepath can be
further described as a manual glide path created with handfiles, or a mechanical glide path created with rotary files.
Routine glide path establishment and enlargement with glide path files can increase the lifespan of rotary instruments
with a reduced risk of instrument fracture. Aim is to provide information about glide path with which we can
maintain the original canal anatomy with less modification of canal curvature and fewer canal aberrations.
Key words : Glide-path, rotary instruments, root canal anatomy, root canal treatment

Introduction

The Glidepath can be short or long, narrow or

Cleaning and shaping of the root canal is the

wide, essentially straight or curved, (Figure 1)

single most important phase of endodontic therapy.

without the endodontic Glidepath, the rationale of

The goal of root canal instrumentation is to obtain

endodontics cannot be achieved 2.

a continuous tapering funnel flowing with the shape


of the original canal from the coronal access to the
apex 1.
And so the Glidepath is the answer. It is the

Figure 1: Glidepaths occur in multiple widths, lengths


and curvatures

starting point of radicular preparations. Without it,


cleaning and shaping becomes unpredictable or

In summary, glide path creation is essential for

impossible because there is no guide for endodontic

prevention of rotary file separation and most

mechanics.

effective rotary use 3. In order to be safe, before

The endodontic Glide-path is a smooth

rotary shaping, the dentist must always discover that

radicular tunnel from canal orifice to physiologic

a glide path already exists or that one needs to be

terminus (foraminal constriction). Its minimal size

created 4.

should be a super loose No. 10 endondontic file.

Importance of Glide Path

The Glidepath must be discovered if already present

Nickel-titanium (NiTi) rotary instruments were

in the endodontic anatomy or prepared if it is not

introduced to improve root canal preparation 5. In

present.

clinical practice these instruments are associated

# Department of Conservative Dentistry & Endodontics, * D.J. College of Dental Sciences & Research, Modinagar

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ANIL DHINGRA, NEETIKA

with an increased risk of fracture, mainly because

A glide path is now recommended by virtually

of bending normal stresses (failure by fatigue) and

all manufacturers of rotary nickel titanium files.

torsional shear stresses (failure by torque) 6.

Without a glide path, rotary files can easily screw


themselves into canals by engaging more dentin

Various aspects might contribute in increasing

than ideal and separate.

these stresses, such as excessive pressure on the


handpiece 7, a wide area of contact between the

The glide path assures the operator that the tip

canal walls and the cutting edge of the instrument,

of the file will not become locked as it moves

or if the canal section is smaller than the dimension

apically and that the canal is free and clear of

of the non-active or non-cutting tip of the

significant debris and blockage, could lead to

instrument8, the latter case might lead to a taper

iatrogenic events 3.

lock, especially with regularly tapered instruments9.

Instruments in Preparation of Glide Path

The risk of taper lock might be reduced by

Manual

Mechanical

glidepath before using NiTi rotary instrumentation5,

K- Files

PathFiles

both manual and mechanical.

C + files

G files

C- Pilot files

Safesiders

C files

V-files

Hi-5 Files

PreShaper

Pathfinders TM CS

EndoWave

performing coronal enlargement

10

and creating a

What the rationale of endodontics requires is


the entire length of the root canal system be cleaned
and shaped. Glidepath is pre requisite to this
mechanical objective 2.
A glide path is achieved when the file forming
it can enter from the orifice and follow the smooth

PathfindersTM

canal walls uninterrupted to the terminus 11.

Senseus Profinders
K-Finders

The lack of glide path establishment may result in:

Ledge Formation.

S-Finders

Blockage of root canals.

D-Finders

Transportation.
Creating an .02 tapered glidepath is critical for

Zip Formation.

the safe and effective use of nickel-titanium rotary

Perforation.

shaping instruments. Glidepath can be further

A glide path helps prevent torque failure and

described as a manual glide path created with

cyclic fatigue. Initially, when rotary files were

handfiles, or a mechanical glide path created with

introduced there was no recommendation for glide

rotary files 12.

path creation. Subsequently, instrument fracture

Methods of Preparation of Glide Path

became a significant issue until glide path creation

According to Mounce (2005), there are several

became known as an adjunct to safe rotary use.


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GLIDE PATH IN ENDODONTICS

Various manual files are:


1) K-Files

Various Mechanical Files are:

6) Pathfinders
CS(SybronEndo)
TM

1) PathFile (Dentsply/
Maillefer)

3) SafeSiders with
EndoExpress System
(Essential Dental Systems)

Figure 13A: PathFile # 1 (0.13mm)

Figure 2: K files No.6 (Pink), No 8 (Grey),


No 10 (Purple) one of the first instruments
used to create a glide path

2) C+Files
(Densply/Maillefer)

Figure 3: C+ file (Dentsply/Maillefer)


no.10 (Purple)

Figure 13B: PathFile #2 (0.16 mm)

Figure 7: PathfindersTM CS
Sybron Endo K1 (25mm)

Figure 13C: PathFiles #3(0.19 mm)

Figure 15:SafeSider files used to create a


glide path

2) G-Files (MicroMega)

4) V-Glide Path2 File


System (SSWhite)

7)PathfinderTM
(SybronEndo)

3) C-Pilot Files(VDW)
Figure 14: G1 File (MicroMega)
Figure 16: V-Glide Path
2 File System (SS White)

advantages for using stainless steel K-files to prepare


Figure 4: C-pilot files ( VDW)
no.6 (pink),no.8(grey),no.10(purpl),
no.12.5(orange),no.15(white)

4) C-Files
(Roydent/Schwed/

a glide path:

Figure 8: PathfinderTM (SybronEndo) (25mm)

K-files have excellent tactile sensation

8) SenseusTM Profinders
(Densply/Maillefer)

Low potential for file separation


When a small size K-file is removed from the
canal, the file often has an impression of the
canal, there by guiding the operator to the

Figure 5a: C- files (Roydent)


no.010, 12.5, 015

curvatures present in the canal.


Figure 9: Senseus ProFinders (Densply /
Maillefer)

The stiffness of hand steel files aids in negotiating

Figure 5b: C- files by (SchwedAntaeos)


no. 6(pink)

blockages and calcifications 13.


9) K-Finders (Sendoline)

In 2006 West recommended using a K-file


with an initial watch winding motion to remove

Figure 10: K -Finder no.15 (Sendoline)

restricted dentin in very narrow canals, followed

10) S-Finders (Sendoline)

by a vertical in and out motion with a 1mm

Figure 5c: C-files by (Dentsply/Maillefer)


no.6 (pink)

5) Hi- Files(Miltex)

amplitude and gradually increasing the amplitude


as the dentin wall wears away and the file advances

Figure 11: S-Finders no 10 (Sendoline)

apically 11.

11) D-Finders (Mani)

Kinsey and Mounce described a technique


using a reciprocating handpiece attached to small
size K-file for glide path preparation. The main
Figure 6: Hi-5 files (Miltex) no.6(pink),
no.8(grey), no.10(purple),no 15(white)

advantage of using the reciprocating handpiece is

Figure 12: D-Finders no 10 file (Mani)

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ANIL DHINGRA, NEETIKA

to reduce glide path preparation time and hand

confirmed. Proceed with rotary NiTi files of your

fatigue with narrow, multiplanar root canals

choice to complete canal preparation.

compared to the conventional manual technique14.

Recently, PathFile NiTi rotary files (Dentsply

Glide path preparation using a reciprocating

Maillefer) were introduced to for glide path

handpiece

enlargement. The system consists of three rotary

Establish working length and patency of root

instruments that can be used for glide path


enlargement 15.

canals with 08 or 10 K-file.


Select the smallest size K-file that fits tightly

Establish an initial glide path with the K-files

into the root canal. Pre-curve the tip of the file and

by using a watch-wind or in-and-out movements

work the file down the canal using a watch-wind

by hand or by attaching a reciprocating handpiece.

motion until the file has reached working length.

The above procedure is then repeated but the

Attach the M4 reciprocating handpiece to the

file is respectively withdrawn up to 3 and 5mm from

handle of the file. While keeping the file at working

the root canal. When the file can travel 5mm from

length activate the handpiece. Let the handpiece

working length up to the established working length

watch-wind the K-file for 5-10 seconds until you

in the root canal, a successful glide path has been

feel that the file becomes loose in the root canal.

established.

Keeping the hand piece activated, withdraw the

PathFile no.1 (0.13 mm) is introduced into the

file approximately 0.5mm from canal and move it

root canal at a rotation speed of 300 rpm in a delicate

back to length. Withdraw 1mm and move it passively

in and out movement until working length is reached

back to length. This process can be repeated until

(3-5 seconds). The instrument is then removed from

the file can be with drawn and moved back to length

the canal.

over a distance of 3-3.5mm. This will confirm glide

Irrigation after each PathFile is recommended

path preparation with a number 08 K-file.

to remove dislodged debris from the root canal.

Negotiate (by hand) the next ISO sized precurved K-file in the canal up to working length.

PathFile no.2 (0.16 mm) is then introduced

Repeat procedure. Follow the same procedure with

followed by PathFile no 3 (0.19 mm) following the

size 15 K-file. To check if a glide path was

same protocol as described above.

established the clinician must be able to place size

Start preparing the root canal with NiTi rotary

15 or 20 K-file in root canal up to working length,

instruments of choice 16.

withdraw the file 1.5mm from canal and push it

Recently introduced G-files (Micro Mega), G1

back to working length without any difficulty (by

and G2 are the rotary Ni-Ti files used to create the

hand). Repeat the above but withdraw the file 3mm

glide path. The system consists of two rotary

and then 5mm from working length. When the file

instruments that can be used for glide path

can travel 5mm in the root canal without any

enlargement after and establishment of a glidepath

obstruction, a successful glidepath preparation is

with a number 10 K-file.


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GLIDE PATH IN ENDODONTICS

G-File Instrumentation Sequence

Determine the working length with small


diameter number 8 or number 10 k-files.

Rotating G1 instrument is introduced into the


canal, progressing with a slow movement

Figure 18: Instrumentation sequence V-Glide Path TM system

without any apical pressure until the working

Conclusion

length has been reached.

It may be concluded that the endodontic

After irrigation, the G2 instrument is used in the

Glidepath is the secret to radicular rotary safety and

same way.

The last file is used again to check canal patency

marks the path of modern endodontics. Routine glide

and confirm the working length. (Fig. 17) 17.

path establishment and enlargement with glide path


files can increase the lifespan of rotary instruments
with a reduced risk of instrument fracture.
By creating a glide path we can maintain the
original canal anatomy with less modification of
canal curvature and fewer canal aberrations. It also
provides the clinician with more confidence to
prepare more complex & challenging endodontic

Figure 17: Protocol for use of G-files

cases.

Acknowledgement

V-Glide Path2 File Instrumentation Sequence

The authors deny any conflicts of interest

Establish patency with no.10 K File.

First no. 13 file is introduced into the canal, till

related to this study.

the working length.

References :
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North Am 1974;18 :269-96.

The canal is first irrigated and then no 17 file is


used up to the full working length (Fig.18) 18.

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Dentistry Today 2010; 29(9): 86, 88, 90-93

Pre Shapers Instrumentation Sequence

Pre Shapers are single use instruments.

Achieve patency and determine the working

3. Richard Mounce. An excellent glide path , the road to


smoother endodontics; Oral health journal 2004; vol. 94,part
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length with a size 10 hand files.

Use Pre Shapers size 14/0.2 to full working

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Use Pre Shapers size 18/0.2 to full working

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Daehn GS. SEM observations of nickel-titanium rotary
endodontic instruments that fractured during clinical use. J
Endod 2005; 31:403.

length.

Glide path in done 19.


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ANIL DHINGRA, NEETIKA

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