Basic description of the Dentsply Trunatomy system suggested for the students in our courses, part of the guide for the main systems available in Brazil.
Trunatomy instruments are conservative and ideal for the preparation of curved, long and atrophic teeth.
Description of the Trunatomy technique, according to the manufacturer:
1) Estimate the working length using preoperative radiographs with good angulation according to
item 6.1.
2) Prepare a conservative access cavity, sufficient to reveal all root canal orifices.
3) Explore the coronal 2/3 of the canals with a K file #010 in the presence of lubricant such as GLYDE™ FILE
PREP and irrigate.
4) Followed by a TruNatomy™ Orifice Modifier at 500 rpm and 1.50 Ncm.
With irrigant in the canal advance the TruNatomy™ Orifice Modifier at 2-3 gentle amplitudes approximately
2-5 mm into and out of the canal. Repeat until the coronal third is instrumented. The instrument has 7 mm of cutting spirals that should not extend beyond the canal orifice. Irrigate the canal and clean the
cutting spirals periodically.
5) Explore the entire root canal with a K file # 010, determine the working length (WL) using a
electronic apical locator (EAL) in combination with radiographs, irrigate and confirm patency.
6) With irrigant in the canal, create and confirm a reproducible permeability pathway using a TruNatomy™
Glider at 2-3 gentle amplitudes approximately 2-5 mm. Irrigate and repeat until the previously confirmed WL with an EAL has been achieved.
7) ALWAYS begin instrumentation with the TruNatomy™ PRIME file (500 rpm / 1.5 Ncm) passively in the
presence of sodium hypochlorite at no more than 2-3 smooth amplitudes approximately 2-5 mm to
in and out of the canal. Irrigate and repeat as needed for WL.
Upon reaching the length, remove the file to prevent over-widening of the apical foramen.
8) Periodically irrigate the canal and clean debris from the cutting edges of the files upon removal.
9) If the TruNatomy™ PRIME file does not advance easily, remove, irrigate, and recap with a K file # 010
to confirm canal patency and switch to the TruNatomy™ SMALL file.
10) Periodically inspect the cutting spirals on removal for unwinding or straightening. If deformation is observed, discard and use a new TruNatomy™ file.
11) Advance the TruNatomy™ SMALL file passively in the presence of sodium hypochlorite with no more than
2-3 smooth amplitudes approximately 2-5 mm in and out and remove the file. Irrigate and repeat
as needed up to the WL in a gentle/passive in-and-out motion (as described
above) and then use the TruNatomy™ PRIME file to the working length to optimize instrumentation*.
Upon reaching the length, remove the file to avoid over-widening the apical foramen.
12) When instrumentation is confirmed, perform 3-D disinfection protocols.
13) Use specific TruNatomy™ paper cones to dry root canals and Conform Fit™ TruNatomy™ gutta-percha cones for obturation.
- If the TruNatomy™ PRIME file is loose in length, with no dentin debris on the apical
spirals, continue instrumentation with the TruNatomy™ MEDIUM file.
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