Background: Effective root canal treatment involves cleaning and shaping root canals using a range of instrumentation procedures and techniques. The aim of this review was to provide an update on root canal hand instrumentation techniques and how to overcome iatrogenic errors. Purpose: Purpose of this review was to provide an update on root canal hand instrumentation techniques commonly used in endodontics, including how to overcome iatrogenic errors and optimize the quality of endodontic treatment outcomes. Methods: A comprehensive search was carried out using multiple databases, PubMed, Medline, Google scholar, and Scopus, to identify relevant studies addressing the objective of this study and to summarize the current evidence to readers. Results: The hybrid technique is a commonly used approach that combines the benefits of both the crown-down and step-back techniques and was reported to be one of the best techniques to produce an optimal root canal preparation outcome. Hand-instrument manipulation using the balanced forced technique is also favored as it rapidly and safely permits removal of canal contents allowing irritants and medications to reach deep inside canal spaces. Conclusion: The use of hand files is still recommended for initial canal negotiation and preparation and is essential for the correction of procedural errors. This study provided an update on several hand instrumentation techniques commonly used in endodontics. The correct and safe application of these techniques can prevent iatrogenic procedural errors from occurring which optimizes the quality of treatment outcome.
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