From: Mark Dreyer
To: ROOTS
Sent: Thursday, September 03, 2009 9:45 PM
Subject: [roots] Severe curvature

First case of the day.  Hopefully this won't turn out to be the easiest case of the day.  The mb1 and mb2
were just as tough to instrument as they look

This doc posts every tooth.  I put ultra-cal in the post space I leave for him - Mark Dreyer, DMD








Mark, hell of a curvature... nicely managed!
As for posting every tooth... well, it's better than posting every canal (yikes!) what i see a frequent
technique in my town.. Dmitri

Great case Mark, keep it up! - Jose

Mark Dreyer- Endo stud! Really nice case. - Arturo

Dear Mark, Incredible work as always.
Can you comment on your instrumentation protocol for the mesial buccal canals? - Patrick Wahl

Thanks guys. Patrick, as usual I did the gg thing, size 2-5.  Then I created my glide path to a 20.
This went pretty straightforward in the mb1, but in the mb2 it required use of several pre-curved 6 C files
and some exquisitely delicate probing to finally get past the curve.  Once there, I left the 6 in place and
ran the M4 a good 30 seconds with liquid edta in the canal.  I repeated the efforts with precurved files of
increasing size up to a size 20, using the m4 less time as I increased my file size so as to minimize the
risk of transportation.  Once the glide path thing was done, I used S1 S2 F1 F2 protapers taking them
as far as they would go without any pressure to speak of, cognizant of the fact that any extra pressue would
likely result in leaving a souvenier behind.  I then went through 20/.12, .10, .08, 06 GT's, then I used a
30/.04 k3 and finally a 20/04 GT.

Yes that's a lot of files, but I don't do single use so it is affordable.  I always use a lot of files on
my cases and figure that I'm placing less stress on each file because of this, so use each file 3 times.
Breakage isn't an issue....maybe 4-5 files/yr out of 800-1000 cases - Mark Dreyer