Change is a significant evolutionary tool provided it rests upon a solid and secure foundation. Innovations in materials and technologies occurring within the dental field are impacting powerfully on its art and science; however, dentistry, like all health care, is both a business and a profession. The pendulum swings that predicate trends and transitions within … Read more
Philippe Sleiman PhD, FICD; Samia Abou-Jaoude DDS, DES and Roula Berberi DDS, DES
Electronic Apex Locators (EAL) were introduced to the dental profession in the early ’60s by Sunada in 1962 based on the work of Suzuki first described in 1942, where he found that the electrical resistance between a file inserted into a root canal and an electrode attached to the oral mucosa was relatively constant. The … Read more
In the July, 2004 issue of Oral Health in an article called “Bonded Obturation, A Quantum Leap Forward for Endodontics” Dr. Gary Glassman and I stated, “The surgical operating microscope and the advent of rotary nickel titanium instrumentation have both provided a quantum leap forward towards a higher standard of endodontics. Adhesion has done much … Read more
Infection, like some diseases, may have many different manifestations. It may surface at the primary site of the source, it may present with atypical signs and symptoms or it may even present at a distant site from its primary source of origin.1 Cutaneous chronic draining sinus tracts can be a manifestation of many diseases such … Read more
The focus on aesthetics has dominated both the dental profession and dental industry for the past decade. Fortunately, the pendulum’s arc has reversed and dentistry is reframing yet again. The profession is revisiting treatment planning, with all its fundamentals and rudiments, from a more functionally integrated perspective. The transition has impacted most upon the specialties, … Read more
In reviewing the literature, I found an article that has important clinical relevance with regard to the determination of TWL and that is worthy of wider discussion (“Frequency of Over instrumentation with an Acceptable Radiographic Working Length” by El Ayouti, et al, JOE, Vol. 27, No.1, January 2001). The purpose of this study was to … Read more
1) Carefully study the tooth before beginning treatment. Anticipating clinical challenges and developing strategies is always far preferable to dealing with iatrogenic problems after they occur. 2) Always use a rubber dam, always. If the patient will not tolerate one, the tooth should be extracted. 3) Break treatment into a number of smaller steps, each … Read more
Being able to perform endodontic treatment as safely and efficiently as possible is a function of primary three components: 1. Choosing cases correctly for treatment or for referral. It is difficult to give simple and arbitrary rationale for cases which might be referred, and when they can or should be done in-house. Empirically, 75% of … Read more
Electronic length determination… is superior to radiographic localization of the apical constriction” from a recent statement of the German Society for Dental, Oral and Maxillary Medicine. I agree wholeheartedly with this statement. Of the various methods of determining true working length (TWL), radiographic measurement of the position of the minor constriction (MC) of the apical … Read more
Having used all the rotary nickel titanium (RNT) systems available in North America, I have come to rely upon the K3 RNT system (SybronEndo, Orange, CA) as my preferred file. K3 stands in distinction to the other RNT root canal shaping instruments due to its asymmetrical design. The asymmetry of K3 makes the clinician power … Read more
Recently, I was on a technical scuba diving training dive where a serious accident occurred. The situation was caused by a lack of communication and a faulty dive plan. It was completely preventable. While not potentially fatal, in an endodontic context, the vast majority of problems that bedevil clinicians are also, very fortunately, completely preventable. … Read more
The functional success rates for endodontically treated teeth are without equal.1 As it is manifest that a natural tooth is preferable to an unnatural replacement, it is therefore incumbent on the practitioner to be familiar with what is possible in terms of maintaining a natural tooth (Fig. 1). The success rates of primary treatment, retreatment … Read more
Regardless of what system is used to shape canals, the goal is to render a canal devoid of as much tissue as possible, producing a shape that can be obturated as close to 100% as possible. Knowing that tissue in canals can be in a variety of invaginations that prevent its physical removal, we also … Read more
Recently I was asked this question by a reader. The answer is primarily dependent on the brand of rotary nickel titanium (RNT) file used, taper, tip size, how many times it has been used previously and under what conditions. Obviously, clinicians want to obtain the greatest benefit from the given RNT while not having to … Read more
In my opinion, the advent of predictable implant therapy is a good stimulus for endodontics. Implant therapy has, in one view, called on endodontics to improve its predictability, safety and efficiency. If endodontics has a rival in implants, endodontics must meet its competition head on. Observance of two key principles, amongst others, can maximize endodontic … Read more
The conventional wisdom has traditionally been that, all things being equal, it didn’t matter what was put into root canal systems to obturate them. The old saying “What you take out is more important than what you put in” dominated thinking to a significant degree. Such a statement was often followed up by something along … Read more
At hands on courses, we are frequently asked how to remove separated rotary nickel titanium files (RNT). It is a skill that has taken years to learn and will continually evolve. Removal of separated rotary files can be addressed from many perspectives, materials science, ultrasonic tip choice, risk of iatrogenic events, clinical technique, etc. Suffice … Read more
This article provides the clinicians a higher success ratio in endodontic treatment by focusing on advanced mechanical preparation. The protocol of advanced technique is not only increasing quality of prognosis but also the efficiency. Since the introduction of Giromatic (90 degrees reciprocating contra angle) in late ’60s; Techniques and equipment to perform automated root canal … Read more
