2012: A Great Year For Tri City and Fallbrook Micro Endodontics
Seven years into private practice, we find ourselves continually picking up new endo tricks and techniques to help refine our final result and to improve our root canal therapy.
As we quickly approach the end of 2012, I thought I would include some helpful (or at least I hope helpful ) techniques, new instruments and new additions that we have added to our armamentarium this year. We are always looking to improve and never remain comfortable or static in our thinking or process of performing endodontics. One major change in my line of thinking this year was to move away from the traditional thought of larger shapes/cleaner canals and more towards a refined root canal preparation that helps conserve axial dentin and preserves the strength of the tooth. The endodontic pendulum has swung back towards a smaller preparation and conservative access that attempts to retain as much tooth structure as possible. The more tooth at the end of our endodontic treatment, the stronger the tooth will be and the longer the treatment will last. We still want to create enough taper to allow our irrigants proper access to the end of the root but I’ve tended to stay away from the Gates Glidden drills or orifice openers that remove a lot of dentin in the coronal 1/3 of the root canal preparation. More instrumentation is required for larger canals (palatal canals or distal canals of mandibular molars), however a smaller shape and smaller apical size can help retain the apical foramen in its natural position and I believe contribute to the long term success of treatment. The two cases below are some of my last cases of 2012 which I hope demonstrates our current thinking in root canal instrumentation.
In addition to conceptual changes we have also added several instruments to our quiver that have helped throughout the year. Tulsa Dentsply introduced the Pathfinder files that are extremely flexible and help negotiate a nice glide path for our instrumentation. We are firm believers in establishing patency with up to a 15 or even 20 handfile before any rotary instruments are introduced into the canal. After our initial “scouting” handfiles are introduced these pathfiles can be operated at a low RPM (we run them at 200 rpm) to help the initial instrumentation of acute curvature within the canal system. The case below illustrates the use of these files to help with strong curves. Please be careful with curvy cases though, a pathfile can help but they are not a substitute for careful and cautious instrumentation.
Our biggest and most exciting change this year is the introduction of the Cone Beam CT to our office. The dynamic ability of this machine to visualize a tooth in three dimensions is a game changer in the field of endodontics. Please tune in next week as I hope to dedicate the next Blog to 3D technology and the use of the Cone Beam in our office.
Have an awesome new year!!! I will continue to post new changes and helpful tips throughout 2013!
Thanks for visiting Tri City and Fallbrook Micro Endodontics.