These instruments do reciprocate but here’s the critical distinction. you should be able to pick the appropriate file for that canal and then it requires one instrument. So, it’s a single-file technique because if you have some experience, if you look at well-angulated, multiple horizontally-angulated films, if you safely drop into pulp chambers and assess the cross-sectional diameter of the orifice, if you begin to scout the canals to secure a glide path. So, we have three instruments again: the small, 21/06, the primary, 25/08, and the large, 40/08. And then there’s a larger D0 file and it’s a 40/08. The medium-size instrument is a 25/08 it’s called the primary file because it will be used virtually in all cases. Is it snug? Is it really tight in there? Or, is it sloppy loose and floating around like a molecule? So, you can learn a lot about a hand file. Of course, the third thing is when you begin to talk about glide path management, you’re going to do small-sized hand files, ISO hand files, like 06s, 08s and 10s into these canals and you’ll begin to appreciate how much space is available for these instruments to move through. This is another piece of information that might help direct you on which file to select. But then once you access into a tooth and drop in, you can immediately look at the cross-sectional diameter of the orifices at the floor of the chamber. You could also use cone-beam technology to further appreciate the anatomy. But, that’s just a two-dimensional picture of a three-dimensional object. You’re looking at canals radiographically for the length, the curvature and the diameter of the canal. I will repeat – this is a single-file technique and of course, which file you choose from among is based on your radiographic observation. So, reciprocation has been claimed to be a way to dramatically increase the safety when shaping canals.ĭentsply Tulsa Dental Specialties in 2011 (launched) what’s called WaveOne technology. And, importantly, the biggest report in the literature and advocated in lectures and workshops is that reciprocation is significantly safer because we’re not overloading a file and we could either talk about torque failures or cyclic fatigue. Just to quickly answer the rhetorical questions – It has been purported that reciprocation is faster because presumably you’re not changing files and the time that takes. So, which is best? I’ll discuss this on another blog, right now we’re just talking about ways to shape a canal. So, you’re not unfamiliar with reciprocation as a distinction from a full rotary preparation. We know Essential Dental Systems out of New York has a reciprocating handpiece. We know SybronEndo has a reciprocating handpiece. In other words, the operator holds the handpiece but yet the file is being driven, again, in short amplitude strokes and there was some reciprocation. His handpiece, he thought, was quite innovative because again it could do a complex movement. Well, then a little bit later a Frenchman, Guy Levi, he visited my office, also in the late 70s, and he wanted me to notice his handpiece. Angelo Sargenti back in the 70s had a handpiece that would chuck-up an instrument and the instrument would be moved vertically up and down, in little short 1/2 to 1mm strokes, and listen carefully, it also additionally reciprocated clockwise and counterclockwise as it was simultaneously moving up and down on these short amplitude strokes. So, what I’d like to talk about is some new technology. First there were two instruments in about 1992-3, and I think today you could count up internationally something close to perhaps as many as 30 different file systems that colleagues have to choose from among in order to shape canals in the safest, most efficacious way. Nickel-titanium, because of its shape memory and its flexibility, it allowed us to overcome a lot of the deficiencies that we used with using hand files, specifically stainless steel files. With the advent of rotary, we spun files clockwise in canals and that was the new thought process. That’s not really the discussion today, it’s just to say that there’s been a lot of different ways to shape a canal. First, in the older era where we were doing it with stainless steel files and we might have done it with balanced-force technique, we might have done it push-pull, we might have done it with reciprocation. Many of you have heard about shaping canals using a reciprocating method so when you begin to think about shaping canals there’s been so many different methods to describe doing it. I would like to briefly talk about new technology and the new "kid" on the block.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |