LOOK

Look, Compare and Perhaps Discuss....... Look, Compare and Perhaps Discuss Two Distinct Methods of Canal Instrumentation Here is a list of undesirable effects that are produced by the use of continuous and interrupted greater tapered NiTi instrumentation: All these conditions have been documented in research studies and are available on request for anyone interested. 1. Produces a smear layer that clogs lateral spaces reducing the effectiveness of irrigation particularly in the buccal...
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DIFFERENT ENDODONTIC SITUATIONS DEMAND DIFFERENT APPROACH

Different Endodontic Situations Demand Different Approaches When we choose an endodontic instrumentation system the attributes we want include: 1. Remaining intact as it shapes the canals 2. Effectively removing the bulk of the pulp tissue 3. As little weakening of the root consistent with effective tissue removal. These attributes are determined by the design and utilization of the instruments and the canals they are shaping. An instrument may remain intact when the canals are fairly w...
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CONTESTED ISSUE

Contested issue #3: Greater Tapered Rotary Instrumentation For many dentists rotary instrumentation is not a contested issue. It is an engine-driven system that speeds up the shaping process, reduces hand fatigue and imposes a shape to the canal that has been described as faithfully recreating the original canal anatomy in larger form. We have been taught that the results, observed in periapical x-rays, are not only superior to the previous outcomes achieved with 02 tapered K-files used in a ...
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CONTENTIOUS ISSUE

Contentious issue #4: Thermoplastic versus room temperature obturation For a change of pace, let’s consider the pros and cons of thermoplastic and room temperature obturation. We’ll start with thermoplastic oburation. My understanding of thermoplastic obturation is its supposed superior adaption of gutta percha to the walls of the canal maximizing the presence of gutta percha and minimizing the thickness of the cement interface, an interface that has been considered a weak link due to it...
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A POINT

Look, Compare and Perhaps Discuss....... Look, Compare and Perhaps Discuss Two Distinct Methods of Canal Instrumentation Here is a list of undesirable effects that are produced by the use of continuous and interrupted greater tapered NiTi instrumentation: All these conditions have been documented in research studies and are available on request for anyone interested. 1. Produces a smear layer that clogs lateral spaces reducing the effectiveness of irrigation particularly in the buccal...
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WHAT IS THE REAL MEANING OF ENDODONTIC INNOVATION?

What is the Real Meaning of Endodontic Innovation? The word innovation has been applied to the introduction of rotary NiTi, further enhancing it by describing the innovations as paradigm improvements in the endodontic instrumentation of teeth. A combination of increased flexibility, greater tapers, metals increasingly resistant to torsional stress and cyclic fatigue, reduced armamentarium and a reduction in procedural time requirements add to the aura of a new paradigm. From the point of view...
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THOUGHTS ON PATHWAYS OF PULP

I was perusing through the 11th edition of Cohen’s Pathways of the Pulp, the latest edition that came out this past October. I was particularly interested in the book’s assessment of pulpal anatomy, how its removal was most effectively addressed and the impact of instrumentation on the integrity of the remaining tooth structure. What I wanted to see was whether or not the latest edition, a book used by many dental schools as the basis for the students’ endodontic education was reflecting the r...
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What we should learn from this video

A few days ago I posted a video on the endodontic shaping of highly oval canals that is unlike any other video that I know of in terms of conservative, but thorough instrumentation. I say this because, heretofore, thorough shaping has been defined as a greater tapered preparation that not only cleanses the canal in the thinner mesio-distal dimensions of oval canals, but is wide enough to include a major portion of the broader bucco-lingual anatomy. The downside to this approach includes excessiv...
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What is the goal of good endodontics

Good Endodontics Means Sacrificing Less Dentin While Removing More Tissue So many new endodontic instrumentation products have come to market that our power to analyze exactly what we want from instrumentation is overwhelmed by the sheer variety that is being offered to us. This situation does not happen by accident. The constant introduction is necessary to steal the limelight from the previous newly released instrument that might spur the interest of dentists who like so many of us are attrac...
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Some images that bely conical shaping

It’s been said many times that one picture is worth a thousand words. When it comes to rotary NiTi preparations of teeth, we now have access to literally thousands of pictures that undermine the concept of conical shaping as a constructive event. Rotary NiTi can make a case for itself in the few situations where original canal anatomy is conical, but those situations are the exception rather than the rule. Below is a small sampling of the imagery that has been produced over the past few years th...
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