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A Clinician’s Guide to Root Canal Therapy

A Clinician’s Guide to Root Canal Therapy. Dr. Michael Gonsky D.D.S. Poconorootcanal.com michaelgonsky@yahoo.com. Dentsply , Tulsa Dental. ProFile Rotary Files ProFile Vortex Files, Vortex Blue and Vortex Orifice openers GT and GT series X Files ProTaper and Protaper next Wave one.

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A Clinician’s Guide to Root Canal Therapy

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  1. A Clinician’s Guide to Root Canal Therapy Dr. Michael Gonsky D.D.S. Poconorootcanal.com michaelgonsky@yahoo.com

  2. Dentsply, Tulsa Dental • ProFile Rotary Files • ProFile Vortex Files, Vortex Blue and Vortex Orifice openers • GT and GT series X Files • ProTaper and Protaper next • Wave one

  3. EndoSequence, Brasseler • Quantec K3 files, SybronEndo • Twisted File, SybronEndo • LightSpeed and LigthSpeed LSX

  4. EDGE ENDO • Edgefile X1 for Waveone users • Edgefile X3 for Protaper users • Edgefile X5 for GT and GTX users • EdgefileX7 for Vortex, Profile,K3 Twisted file and EndoSequence users

  5. ProFile

  6. TWISTED FILES • Safer, faster, more flexible

  7. Hybridized Passive Crown Down Instrumentation Technique • Hybridized refers to using multiple systems • Passive means having a gentle touch that follows established guide paths • Crown down starts at coronal orifice and works to apical terminus • Advantages

  8. HPCD Technique • Orifice Widening • Glide path into apical third of the canal • Coronal Preflare • Glide path to apical foramen • Extension of access into apical terminus of preparation • Preparation of the apical seat

  9. Orifice Widening

  10. Strategies for Orifice widening

  11. Balanced Force Technique

  12. Establishing a Glide Path • Scouting files • Working length • Apical glide path (#20 file) • Recapitulation

  13. Glidepath into Apical Third • After orifice widening • Niti instruments require a glide path • In this technique it must extend beyond the 17 mm depth of the GT files • 08 and 10 file into apical one third using lubricant and irrigation

  14. Coronal Preflare • All Niti instruments require a glide path • Preflare reduces cyclic fatigue and taper lock • Allows debris removal early to prevent apical extrusion of infected material • Select job specific instrument (GT #20 17mm .12 .10 .08 .06)

  15. Hand Instrumentation with Nickel Titanium Files

  16. Glide Path to Apical Foramen

  17. Extension of Access To Apical Terminus

  18. Preparation of the Apical Seat • Everything preceding this step is designed to promote complete control of this most critical step • This is the BIOLOGICAL ZONE • Hybridization is key

  19. The Apical Seat • Apex Locater and then 08 file to radiographic apex (seat is 1mm short of radiographic apex) • Flexible files, Balanced force technique • Narrow vs wide apical preparation

  20. Apical Prep

  21. SENIA’S WORKING WIDTH • Apical preps approaching size 100

  22. WORKING WIDTH • Round instruments cleaning oval canals

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