Choosing the right endodontic system
The best endodontic system provides the optimum cleaning with the adequate obturation.
An affordable complete easy system could be the solution for every general dentist or endodontist. During this presentation will compare different present systems to guide the dentist choose the best to conserving tooth structure in cases of primary treatment and retreatment .
The aim of root canal therapy is to conserve the tooth functionality in a healthy periodontium.
The anatomy of teeth is variable and may present with curved canals especially apically, where the most intricate anatomy and lateral canals may exist. Canal systems are cleaned mechanically with shaping instruments and chemically with irrigants mainly sodium hypochlorite and EDTA. Irrigation could be improved with various sonic or ultrasonic devices and filled tri-dimensionally to entomb bacteria and preserve the canal cleaning.
Common alloys used in endodontics, over the last few decades, include stainless, conventional, and treated NiTi. In the 50’s till late 80’s, the main instruments used were stainless steel K-files and rotary Gates Gliden. The main disadvantage of stainless steel is stiffness and large diameter weakening the tooth especially in the coronal zone and leading to mishaps in the canals. In addition, many files were needed to prepare the canals. In the early 90’s, NiTi alloys were developed which allowed the manufacturing of more flexible instruments, improved design and dynamic action resulting in increased efficiency and easier use and conserving the tooth structure. In 2007, thermo-mechanical treatment of conventional NiTi allowed instruments more resistance to cyclic and torsional fatigue.
Since then, the NiTi technology continued the improvement in instrument alloy, design and dynamic action approaching to an extent the development of an ideal file that is more flexible and has better cutting efficiency and resistance to breakage. However, torsional fatigue is still a main concern if canals are not patent. Recently, a new pink alloy was developed and since then, manufacturers started to mix alloys in the same system. In the market, there are different alloys used such as M-Wire, CM Wire, Gold , Blue, EDM, MaxWire, T-Wire among others.
The presentation will describe the criteria of an ideal file and present tips about choosing the preferred system that could adapt adequately to the canal anatomy, as well as its technique. In addition, the basics of irrigation, optimal obturations and recommendations will be discussed.
Learning objectives:
- Know how to choose the adequate shaping file depending of anatomy
- Understand alloys, design and dynamic action of new shaping files system cost-effectively.
- Realize the efficacy of irrigation system in minimally prepared teeth.
- Understand the range of customized gutta cones used either in single cone or warm vertical condensation after drying canal with customized paper points