Endodontic Glide path Preparation

A glide path has been defined as a smooth round tunnel from the orifice to the apical foramen. Minimum size of this tunnel should be superloose NO 10 endodontic file. It is a refinement of the original canal anatomy, which allows a safer passage of mechanical shaping instruments. The preparation of a glide path has been shown to reduce separation and torsional stress of rotary nickel-titanium (NiTi) instruments even during the preparation of constricted root canals. The Glidepath must be discovered if already present in the endodontic anatomy or prepared if it is not present. The Glidepath can be short or long, narrow or wide, essentially straight or curved.

There are two steps to this process

1. Find the canals

2. Follow the canal to terminus

Scouting with small K files (6-10) is undertaken after coronal and middle third shaping with the intent to “learn the path” of the canal or “know” the canal. This discovery in the apical third would include evaluating the canal for curvatures, calcifications, size, bifurcations, trifurcations, foramen diameter, etc.

Once scouting is complete, a “glide path” is created initially with hand files and refined with specialized rotary files. Once the canal is scouted to the apex with a 6, it is generally easy to do the same with an 8 and 10 K file. Once the 10 K file reaches the estimated pre-operative working length, the true working length (TWL) can be verified and the glide path created by hand. Refinement of the hand created glide path is easily accomplished with the .02 15 and .02 20 rotary niti files of your choice. After the glide path is refined, the final apical sequence of instrumentation can be initiated.

Initially, when rotary files were introduced there was no recommendation for glide path creation. Subsequently, instrument fracture became a significant issue until glide path creation became known as an adjunct to safe rotary use. A glide path is now recommended by virtually all manufacturers of rotary nickel titanium files. Without a glide path, rotary files can easily screw themselves into canals by engaging more dentin than ideal and separate.

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