TruNatomy® Medium 36/.03v, 21mm (6)

TruNatomy® · Medium · 21 mm

Larger apexAfter PrimeStraighter canals

Medium on the short shaft, for when Prime is loose at length

Prime went to length, and came out loose with no dentinal debris in its apical flutes. Then the apex is larger than Prime, and Dentsply Sirona’s procedure continues with the Medium – 36.03v, the same slim heat-treated NiTi and the same 500 rpm and 1.5 Ncm. This is the 21 mm version, for short teeth or where opening is limited.

Sizes as Dentsply Sirona print them. The “v” means variable taper; the taper shown is the average along the file, not the taper at the tip. Motor settings from the Solution Guide.

This pack: TruNatomy® Medium Rotary File, ISO Size 36, .03v Taper, 21 mm (Pack of 6)
Dentsply Sirona · made by Maillefer Instruments Holding Sàrl, Ballaigues, Switzerland

What this file does

›  When, in their words. Step 13: “If TruNatomy® PRIME is loose at length with no dentinal debris in the apical flutes, continue shaping with TruNatomy® MEDIUM and subsequently with LARGE if needed.”
›  The same slim build. Dedicated heat-treated NiTi on a 0.8 mm wire, against up to 1.2 mm for most generic variable tapered files, with an off-centred cross-section and regressive taper.
›  Straight anatomies. The Solution Guide’s front page puts Medium and Large after Prime “if needed (straight anatomies)”.

Where it sits in Dentsply Sirona’s sequence

1  Prime first, and gauge it. Prime to length; loose with clean apical flutes means the apex is larger (step 13).

2  Medium to length. Guide it gently to full working length to ensure completeness of shape (step 13).

3  Still loose? Large. In larger and straighter canals only. Otherwise confirm length by hand and try in the Medium cone (step 14).

Quoted and summarised from the Dentsply Sirona TruNatomy® Solution Guide. Your clinical judgement governs the case; the instructions for use govern the file.

Questions we get asked

Can I go straight to the Medium?
Not in Dentsply Sirona’s procedure: every case begins shaping with Prime, and the Medium follows only when Prime is loose at length.

Which points and cone?
The Medium ones, matched to the last instrument used.

Which motor settings?
Dentsply Sirona give one setting for every TruNatomy® file: 500 rpm and 1.5 Ncm. Set it on any of the three endo motors we stock – X-Smart® Go · X-Smart® Pro+ · VDW.SILVER® RECIPROC®.

When do I throw a file away?
Dentsply Sirona’s procedure (step 11): inspect the cutting flutes routinely on removal for unwinding and straightening, and if deformation is noted, discard it and use a new TruNatomy® instrument.

Complete the case

Resources

›  TruNatomy® brochure (PDF, 0.7 MB, Dentsply Sirona, 06/2025) – the four shaping sizes, the product references and the published claims.

›  TruNatomy® Solution Guide (PDF, 0.1 MB, Dentsply Sirona, 06/2025) – the step-by-step technique at 500 rpm / 1.5 Ncm, from access cavity to obturation.

›  TruNatomy® Scientific Manual (PDF, 0.7 MB, Dentsply Sirona, 12/2022) – the laboratory and clinical research behind the system.

›  Clinical case – Dr Jonathan Cowie, Bath (PDF, 0.2 MB, Dentsply Sirona) – long roots and a calcified system, reviewed at 14 months.

›  TruNatomy® clinical case collection (Dentsply Sirona UK website) – more cases, and the full case booklet to download.

TruNatomy® Medium 36.03v, 21 mm (6) · heat-treated NiTi rotary · 500 rpm · 1.5 Ncm · Dentsply Sirona · REF BSTTNMY621MED