Hybrid technique of root canal instrumentation

Cilj endodontskog liječenja zuba je uklanjanje intrakanalne infekcije kemo-mehaničkom obradom korijenskog kanala i prevencija reinfekcije što se postiţe punjenjem kanala i koronarnom restauracijom zuba. Danas su na trţištu dostupni brojni endodontski instrumenti i tehnike instrumentacije. Upotreba prvih nikal-titanskih instrumenata u obradi korijenskih kanala krajem 20. stoljeća rezultirala je ubrzanim razvojem novih instrumenata različitih konstrukcija, karakteristika i načina rada. Prednosti nikal-titanskih instrumenata su povećana fleksibilnost i superelastičnost zahvaljujući kojoj je moguće očuvati izvorni oblik korijenskog kanala s minimalnom mogućnošću ijatrogenih pogrešaka. Najnovije recipročne tehnike instrumentacije kanala primjenom samo jednog instrumenta omogućile su brzu instrumentaciju uz minimalne proceduralne greške. Nedavno se pojavila i ideja o hibridnoj instrumentaciji koja uključuje primjenu različitih tehnika i sustava. Kao rezultat toga pojavio se Twisted File Adaptive sustav obrade kanala koji tijekom instrumentacije prepoznaje izloţenost instrumenta stresu te, ovisno o tome, mijenja kretnju iz rotacijske u recipročnu. Twisted File Adaptive instrumenti izrađeni su od Ni-Ti legure u R-fazi što im daje svojstvo superelastičnosti i memorije oblika. Dosad su u znanstvenoj literaturi objavljeni brojni znanstveni radovi. Twisted File Adaptive instrumenti odlikuju se visokom reznom učinkovitošću, malom incidencijom loma instrumenta, smanjenim apikalnim potiskivanjem debrisa, a posljedično manjom incidencijom postoperativne boli.The aim of endodontic treatment is the elimination of intracanal infection by using chemomechanical root canal treatment as well as prevention of reinfection, which is achieved by filling a root canal and placing appropriate coronal restauration. Nowadays, numerous endodontic instruments and instrumentation techniques are available on the market. The use of the first nickel-titanium instruments for root canal treatment at the end of the 20th century has resulted in rapid development of new instruments of different constructions, characteristics and modes of operation. The advantages of nickel-titanium instruments are increased flexibility and superelasticity thanks to which it is possible to preserve the original root canal shape with the minimum possibility of iatrogenic errors. The latest reciprocating canal instrumentation techniques which use only one instrument enabled rapid instrumentation with minimal procedural errors. Recently, the idea of hybrid instrumentation has also appeared, which involves the application of different techniques and systems. As a result, Twisted File Adaptive instrumentation system emerged which recognizes the exposure of the instrument to stress during instrumentation, and according to this, changes its motion from rotary to reciprocating. Twisted File Adaptive instruments are made of NiTi alloy in R-phase which gives them superelasticity and shape memory effect. So far, in scientific literature numerous scientific works have been published. Twisted File Adaptive instruments are characterized by high cutting efficiency, low incidence of instrument fractures, reduced apical debris extrusion, and consequently less frequent postoperative pain