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preparation with one NiTi rotary - Courtesy ROOTS

From: "Dr. Ghassan Yared"
To: "ROOTS"
Sent: Friday, March 23, 2007 7:23 AM
Subject: [roots] preparation with one NiTi rotary

Hello everyone, I attach the description of the canal preparation technique with only one rotary instrument.

This has been my sole technique for a little bit more than a year now. It is an amazing technique. I truly believe it is an amazing technique; just try it. All the attached cases were done with only one rotary instrument after an initial hand preparation to a size 10 or 12.9 (size 2 in the Series 29).

This technique uses a reciprocating movement with specific degrees of clockwise and counterclockwise rotation (see the attachment for more details). I am aware of only one motor, available on the North American market, with the reciprocation feature. Presently, only Dentsply Tulsa carries this motor and it is not their main product (with respect to motors).

Just try it. Ask your Dentsply Tulsa rep to lend you an ATR motor to try. I have no financial interest in this. It is a wonderful technique; give it a try and you will be very appreciative.

I will be very happy to try and answer any questions - Ghassan

Thanks for your description of the technique. I do have a couple of comments.

(1) Your technique is based on the premise that you can get a #.08 or .10 file to the apex at the initial stage. ( I see no description of GGs, preflaring or any body work prior to the file placements.) I'm an endodontist. I can do this in most cases. Why? Because I have spent 20+ years learning how to bend files and how to translate the sensations in my fingertips to what I think is the canal map. ( I'm not always right, especially with initial exploration and patency is not always possible at first.) This can be very difficult and challenging to do. This is also why it is much easier to do the body work first before you attempt to "go for the apex". I am convinced that few clinicians have the patience, file bending expertise and desire to go through this exercise with such small files. You can rapidly go through a nice pile of hand files in short order. That's frustrating. I'm not sure this technique can be taught to someone who is more likely to NOT know how to properly bend files. Placing an apically straight 10 file into a canal without preflaring is a recipe for ledging. Following that with one end cutting Ni-Ti rotary file will no doubt lead to further loss of patency. I'm not saying you can't do it. I'm merely saying that it is very technique sensitive.

(2) It may be just my perception, but the canals look very "machined". They have nice flow but I just don't see a lot of "non-taper" anatomy in the cases. I don't see the irregularities, webs, bi and trifidities that I know exist. Those features are obtained by recapitulation and repeated exploration with hand files and irrigation. Its not just a "machining" process. Some of the cases also show some "GG-like" characteristics in the coronal aspect - some limited straightening. That's OK. I do that too but it suggests that some kind of rotary instrument is being used in this area that creates coronal parallelism. Limited purposeful straightening is good but you have to be careful about stripping. Again, there is a potential problem here and this requires technique sensitivity.

I would be interested in the observations of other ROOTs members - Rob K


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