File List
Protocol
1. Access & Working Length
Pre-op radiograph to evaluate primary tooth root anatomy and resorption status. Open access cavity. Explore canal with #10 K-file and determine working length radiographically.
2. Coronal Flaring
SX (#19, 3.5-19% progressive taper) for coronal 2/3 enlargement. Use brushing motion, pulling outward. Place 3mm beyond the orifice (IJCPD 2023 protocol).
3. Shaping
Use S1 or S2 with crown-down technique to working length. Take S2 to working length (IJCPD 2023). 250-300 RPM, torque: SX/S1 = 5.1 Ncm (DFU), S2 = 1.5 Ncm (DFU). In pediatric cases, 250 RPM, 3 Ncm may be preferred. Note: DFU states settings are 'for example only'.
4. Irrigation
Irrigate with NaOCl after each file change. Use caution with aspiration in primary teeth — risk of periapical extrusion.
5. Apical Finishing
F1 (#20/7%) for final shaping. F2 (#25/8%) for wider canals. Do NOT use brushing motion with F files (DFU). Torque: F1 = 1.5 Ncm, F2 = 3.1 Ncm (DFU).
6. Obturation
Dry canal and obturate with CaOH or ZOE-based paste. Use resorbable material (Metapex, Vitapex, ZOE).
Clinical Tips
- •Crown-down technique: progress from coronal area toward the apex
- •Use brushing motion with SX and S files; do NOT use brushing motion with F files (DFU)
- •Verify working length radiographically in primary teeth — resorption risk
- •Gold metallurgy provides enhanced flexibility and cyclic fatigue resistance
- •Typical pediatric sequence: SX + S2 + F1 (3 files)
- •Working length adjusted to primary tooth root length
Warnings
- ⚠This is NOT a dedicated pediatric product — standard ProTaper Gold adult files are used in primary teeth
- ⚠Single patient use only — do not reuse, resterilize, or reprocess (DFU)
- ⚠Inspect files before use for deformation and corrosion (DFU)
- ⚠Discard after use in severely calcified or curved canals (DFU)
- ⚠Risk of instrument separation if used improperly (DFU)
- ⚠Primary tooth root resorption risk — do not advance beyond the apex
Clinical Notes
- →This is not a dedicated pediatric product — standard ProTaper Gold files are used in primary teeth at shorter working lengths
- →Variable (progressive) taper design optimizes canal preparation by region
- →Gold heat treatment (400-450°C): martensitic phase (Af >37°C), enhanced flexibility and cyclic fatigue resistance
- →Convex triangular cross-section — efficient cutting and debris removal
- →IJCPD 2023 study: ProTaper Gold used for primary tooth pulpectomy at 250 RPM, 3 Ncm
References
- Dentsply Sirona. ProTaper Gold Directions for Use (DFU).
- Patil AS et al. Comparison of Dentinal Crack Formation: ProTaper Gold vs Kedo-S in Primary Teeth. IJCPD 2023.
- Singh K et al. Pediatric Rotary Endodontics: A Comprehensive Review. Cureus 2025.
- Jeevanandan G. Kedo-S paediatric rotary files for root canal preparation in primary teeth. J Clin Diagn Res 2017;11(3):ZR03-06.