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 Tooth #18: Apical periodontitis
The opinions within this web page are not ours.Authors have been credited for the individual posts where they are. - photographs courtesy: Fred Barnett

From: Fred Barnett
Sent: Tuesday, June 14, 2005 6:31 AM
Subject: [roots] clinical case

Tooth #18; apical periodontitis.
K3 VTVT sequence. Followed by K3/.04's from small to large.
FAS (final apical sizes): mesials= #40/.04; distals (joined)= #45/.04 - Fred

Gee Fred....I know you didn't squirt it...but you got some pretty good puffs.... you just as well convert to squirting....they look pretty much the same don't you think? - Joseph Dovegan Dear Fred, All great cases. BTW this VTVT technique is great!!! Have started using this since a while and I am more than happy with the shapes. The apex up still gives me a slight flutter though. :-) - Samir. No worries about the Apex-Up....light touch, no pushing. - Fred One question... with which ISO file are you creating a glide path prior to VTVT crowndown?? - Samir. Size #10 or #15. - Fred But then Fred.. are we not asking the rotary files' tip to work for us? If we start with say a 40/ the tip not binding in the canal increaing the torque requirements? Would it help to up the size for the glide path say to a 20 or even 25?? Just wondering...Samir Based on Johnís recommendation of a month or two ago, I did up my glide path from 15 to 20. what a difference. Rotaries advance easily (I usually start at a 25 .02), measurements are attained more easily, I havenít broken an instrument since following his advice. I now use the m4 with a hand file in it to establish the glide path, and life is much easier. - gary After glide path to WL (patency) I start with the K3 #25/.10, then the K3 #25/.08. Now I confirm WL with the EFL. Now enlarge to a size #20 hand file. Then the K3 #35/.06, the K3 #30/.04, the K3 #25/.06 and finally (if needed) the K3 #20/.04. After any of the above files reach WL, I usually change to larger .04's. For deeper shape, you can use again the K3#25/.10 and the K3#25/.08. - Fred Great as usual. Epiphany or Real Seal I guess? Guy

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