Passive step back technique

Used for

Curved canals

Primary objectives

• Remove infected soft + hard tissue

• Disinfection acess to apical canal space.

• Makes space for meds.

• Keep integrity of root structure.

Passive step back - General info

• Uses combo of files & GG drills to make enough coronal flare b4 apical root canal prep.

• Provides unforceful & gradual enlargment of canals in apical-coronal direction.

• Understanding prep of 3-root cnals part is important

—> Like coronal, middle & apical third.

1. Coronal third

2. Middle third

3. Apical third

Passive step back - Step 1

• Measurement of length B4 treatment

→ Locate canal orifice, penetrate with K15 file few m. 

→ K10 introduced in canal, using wind watch or reciprocated motion to gradually achieve est. WL of root canal. 

→ If K10 file has resistance = use smaller file. 

→ Determine WL w/ electronic apex loctor using small file. 

→ Perep w/ light strokes & establish apical canal patency w/ little or no resistance. 

→ N10 file placed in WL and analysed via X-Ray. 

Passive step back - Step 2

• Cleaninf middle part of canal. 

→ K-files: 20 to 40 carried into canal, inserted passively = canal prepared using filing motions.

→ Only performed in middle of canal. 

Passive step back - Step 3

• Passive use of GG-drills. 

→ Nr 2 GG drill insterted into mildly flared canal to point that it bind slightly. 

→ Then pulled back ca. 1-1,5mm & slow speed handpiece activated. 

→ Up & down motion w/ slight pressure used

→ Desiired canal walls is planed & flared. 

→ Similar technique used to pland & flare coronal region but uses GG-drill nr. 3.

Passive step back - Step 4

• Confirm working length

→ Flaring & removal of curved reduce WL ≈ Need to confirm corrected WL b4 apical prep. 

→ Place Nr. 10 patency file or Nr. 15 file in canal.

→ WL confirmed with electronic apex locator OR x-ray. 

Passive step back - Step 5

• Apical preparation

→ Apical prep using K-file 15 to 25/30 to WL- 

→ Last file entered to WL = apical/master file

→ Canal prep with gradually placinf larger instruments along WL. 

→ Narrow/curved root canals should NOT be enlarged beyond files size of 25/30.