# TruNatomy®

> True, Natural, Anatomy

- **Manufacturer:** Dentsply Sirona
- **Motion:** Continuous Rotation
- **Alloy:** Heat-Treated NiTi
- **Key feature:** Slim 0.8mm MFD with off-centered parallelogram cross-section preserves peri-cervical dentin while maintaining shaping efficiency

## Specifications

| File | Tip (mm) | Taper | Length | Cross-section | Motion | Speed (rpm) | Torque | Role |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Orifice Modifier | 0.20 | 8% | 16mm | Off-centered parallelogram | Continuous Rotation | 500 | 1.5 Ncm | — |
| Glider | 0.17 | 2%v | 21mm, 25mm, 31mm | Centered parallelogram (2 cutting edges) | Continuous Rotation | 500 | 1.5 Ncm | — |
| Small | 0.20 | 4%v (regressive) | 21mm, 25mm, 31mm | Off-centered parallelogram | Continuous Rotation | 500 | 1.5 Ncm | — |
| Prime | 0.26 | 4%v (regressive) | 21mm, 25mm, 31mm | Off-centered parallelogram | Continuous Rotation | 500 | 1.5 Ncm | — |
| Medium | 0.36 | 3%v (regressive) | 21mm, 25mm, 31mm | Off-centered parallelogram | Continuous Rotation | 500 | 1.5 Ncm | — |
| Large | 0.46 | 2%v (regressive) | 21mm, 25mm, 31mm | Off-centered parallelogram | Continuous Rotation | 500 | 1.5 Ncm | — |

## Protocol

### Glide Path

1. **Scout Canal** — Scout coronal 2/3 of canals with #10 K-file in presence of lubricant such as ProLube or Glyde and irrigate. Determine working length with apex locator in combination with radiographs. Confirm canal patency.
   - Pre-curve file for curved canals
   - Conservative access sufficient to reveal all root canal orifices (per 2025 IFU); product page positions as no need for straight-line access
   - Use ProLube Root Canal Conditioner or Glyde File Prep as lubricant (per IFU)
2. **Orifice Modification** — Use Orifice Modifier (20/.08) to adapt the shape of the orifice and create the ideal entry point. Advance in 2-3 gentle amplitudes approximately 2-5mm in-and-out. Repeat until coronal third is shaped. Insertion should not exceed 7mm (length of cutting flutes). _(File: Orifice Modifier (20/.08) · 500 RPM · 1.5 Ncm)_
   - Instrument has 7mm of cutting flutes - do not insert deeper (per IFU)
   - Preserves coronal anatomy due to slim diameter and heat treatment
   - Fixed (non-variable) taper - unlike shaping files
3. **Glider** — Use TruNatomy Glider (17/.02v) to create and confirm a reproducible glide path. Advance in 2-3 gentle amplitudes approximately 2-5mm in-and-out. Irrigate and repeat until working length is reached. _(File: Glider (17/.02v) · 500 RPM · 1.5 Ncm)_
   - Centered parallelogram cross-section with only 2 cutting edges for less resistance (per Scientific Manual)
   - Progressive (variable) taper for smooth transition to shaping files
   - Heat treatment provides greater flexibility vs ProTaper Next (manufacturer data)

### Shaping

1. **ALWAYS Start with Prime** — ALWAYS initiate shaping with Prime file (26/.04v) passively in presence of NaOCl. Use no more than 2-3 gentle amplitudes approximately 2-5mm in-and-out. Irrigate and repeat until working length is reached. Upon reaching length, remove file to avoid over-enlarging apical foramen. _(File: Prime (26/.04v) · 500 RPM · 1.5 Ncm · Gentle in-and-out (no brushing action per DFU))_
   - Small is not needed in most cases — start with Prime (per guide material)
   - Slim 0.8mm MFD removes only dentin where clinically needed
   - If Prime doesn't progress, irrigate, recapitulate with #10 K-file, then use Small
   - Approximately 3-5 sets of 3 amplitudes to reach WL (per tip card)
   - ⚠ Do not force file apically — always use minimal apical pressure (per IFU)
2. **Small (For Narrow Canals)** — Use Small file (20/.04v) for narrow or calcified canals where Prime doesn't progress easily. After Small reaches working length, return to Prime to optimize the shape. _(File: Small (20/.04v) · 500 RPM · 1.5 Ncm)_
   - Use when Prime encounters resistance (per IFU step 10)
   - Return to Prime after Small reaches working length to optimize shape
   - Small not needed in most cases (per tip card)
3. **Medium or Large (For Larger Canals)** — If Prime is loose at working length with no dentinal debris in apical flutes, continue shaping with Medium (36/.03v). Use Large (46/.02v) in larger and straighter canals only, such as maxillary central incisors, some palatal or distal canals of molars (per IFU). _(File: Medium (36/.03v) or Large (46/.02v) · 500 RPM · 1.5 Ncm)_
   - Medium for moderately large canals
   - Large for very wide and straighter canals only (per IFU step 13)
   - Guide each instrument gently to full working length to ensure completeness of shape

### Finishing

1. **Verify Preparation** — Confirm final working length by passively placing last TruNatomy instrument by hand. If it reaches WL passively, try-in the matching TruNatomy Conform Fit gutta-percha point (per IFU step 14).
   - Small = #20 hand file verification
   - Prime = #26 hand file verification (may need #25)
   - Medium = #35-40 hand file verification
   - Large = #45 hand file verification
   - Shape Verifier available for GuttaCore workflow (per tip card)
2. **Irrigation** — Proceed with 3-D disinfection protocols. TruNatomy Irrigation Needle is designed to flex and follow canal anatomy below 12mm.
   - Slim preparations leave more space for irrigant
   - Use TruNatomy Irrigation Needle — soft polypropylene, back-to-back 2-sided vent design (per product page)
   - Activate with EndoActivator (small yellow tip) or SmartLite Pro EndoActivator
3. **Obturation** — Use dedicated TruNatomy paper points to dry canals and TruNatomy Conform Fit gutta-percha points to obturate (per IFU). Sealer selection (e.g., AH Plus, AH Plus Bioceramic) per solution guide — not specified in IFU.
   - Conform Fit GP variable taper matches file preparation
   - Precise fit and accurate tug-back
   - Compatible with warm vertical compaction (GuttaSmart small pluggers) and cold techniques
   - GuttaCore for TruNatomy also available — use Shape Verifier to confirm passive fit (per tip card)

## Clinical Tips

- All files operate at same settings: 500 RPM and 1.5 Ncm - no need to change between files (per IFU)
- 0.8mm MFD (vs up to 1.2mm for most variable-tapered files) preserves peri-cervical structural dentin (per product page)
- 9.5mm handle (shortest on market) plus pre-curving capability enables molar access with contra-angle micro heads (per product page)
- Regressive taper on shaping files — all shaping files have same coronal diameter, differ only at apical third (per Scientific Manual)
- Conservative Endodontic Cavity (CEC) is recommended — prepare access sufficient to reveal all root canal orifices (per 2025 IFU). Note: GuttaCore tip card recommends confirming straight-line access for obturation.
- Proprietary post-machining heat treatment — files reach martensitic phase at body temperature for enhanced flexibility (per Scientific Manual)
- Off-centered cross-section on shaping files reduces stress during cutting and increases debris removal space (per Scientific Manual)
- Files may appear slightly curved from manufacturing — this is normal, not a defect; do not need to straighten before use (per IFU)
- For shaping extremely curved canals, use file for single canal only to reduce breakage risk (per IFU)
- TruNatomy Prime showed improved cyclic fatigue resistance vs ProTaper Next X2 — Dentsply brochure reports 3.5x improvement (bench data); Peters et al. 2020 (PMID 32389382) supports directional claim in vitro

## Warnings

- Single use only — do not resterilize or reuse (per IFU)
- Contains nickel-titanium — allergic or toxic reactions may occur in sensitive patients (per IFU)
- Do not fully immerse in NaOCl — only working part in max 5% concentration (per 2025 IFU)
- Do not use in canals with abrupt apical curvature — use pre-curved hand files instead (per IFU)
- Inspect for distortion, unwinding, or straightening before and after use — discard if deformation noted
- Do not exceed recommended speed (500 RPM) and torque (1.5 Ncm)
- Always maintain apical patency during shaping — irrigate, recapitulate with #10 K-file between files
- Do not use brushing action with TruNatomy files (per IFU)

## Best for

- dentin preservation
- conservative access
- minimally invasive

## Technical profile

- **Category:** multi-file-rotary
- **Heat treatment:** Other — Proprietary post-machining heat treatment from standard NiTi wire — files reach martensitic phase at body temperature for pre-bendability and enhanced fatigue resistance (per Scientific Manual)
- **Manufacturing method:** ground
- **Pre-bendable:** yes
- **Reuse:** Single-use
- **Motor:** any-rotary
- **Glide path requirement:** mechanical-recommended — TruNatomy Glider (17/.02v) with ProLube Root Canal Conditioner or Glyde File Prep
- **Canal suitability:** Curvature: mild, moderate, severe; Canal size: narrow, normal, wide; Calcified canals: no; Retreatment: no; Conservative access: yes
- **Matching gutta-percha:** TruNatomy Conform Fit Gutta-Percha Points (Small, Prime, Medium, Large)
- **Matching paper points:** TruNatomy Absorbent Paper Points (Small, Prime, Medium, Large)
- **Content revision:** 2026-02-15

## FAQ

**What alloy is TruNatomy made from?**

TruNatomy® is manufactured from Heat-Treated NiTi.

**How many files are in the TruNatomy sequence?**

The TruNatomy® system includes 6 files: Orifice Modifier, Glider, Small, Prime, Medium, Large.

**What is the TruNatomy file sequence?**

TruNatomy® is used in this order: Orifice Modifier → Glider → Small → Prime → Medium → Large. Per-file speed, torque and technique are in the protocol section above.

**What motion type does TruNatomy use?**

TruNatomy® uses continuous rotation motion.

**What cases is TruNatomy best for?**

TruNatomy® is best suited for: dentin preservation, conservative access, minimally invasive.

**What speed and torque settings are recommended for TruNatomy?**

Recommended settings: 500 RPM and 1.5 Ncm across the file sequence (refer to official DFU for full per-file parameters).

## References

- [Manufacturer instructions for use (DFU/IFU)](https://www.dentsplysirona.com/services/asset/download?path=/content/dam/master/product-procedure-brand-categories/endodontics/product-categories/full-solutions/trunatomy-solution/ifu/END-IFU-TRUNATOMY-SINGLE-USE-STERILE-V04-WEB-ROW-Multilingual-2025-06.pdf)

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_Educational reference for dental professionals. Always confirm settings against the official manufacturer instructions for use before clinical procedures._