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Shaping canals safely, effectively and economically

by Barry Musikant I'’ve read so much about the beautiful results one can get by incorporating rotary NiTi into one’s practice that I thought I would demonstrate another way to produce excellent results that have the added advantages of virtually eliminating instrument separation, gives the dentist the ability to widen canals to a minimum of 35, allows for multiple uses of the instruments and reduces the costs of endodontic shaping by about 90% compared to rotary NiTi. We use relieved reamers (SafeSiders) to make both the initial glide path as well as the entire preparation thru a minimum of 35 and an overlayed taper of 25/06. In wider canals we, of course, will make wider preparations to assure adequate cleansing and irrigation of the canals. The advantages of relieved reamers versus K-files are as follows: 1. The relieved reamers have fewer and more vertically oriented flutes. The fewer number of flutes produce less engagement along length that translates into less resistance when negotiating the canals. The more vertical orientation makes them more efficient at shaving dentin away from the canal walls when used with the typical watch winding motion than the more horizontally oriented flutes of the K-file that tend to embed into the dentin rather than shaving it away. With K-files the dentin is removed only when the pull stroke is incorporated. Used in curved canals this pull stroke tends to remove dentin from the outer wall causing distortions that are best avoided. 2. The relieved reamers are also more flexible and record the curvature of canals better than the non-relieved stiffer K-files. 3. Greater flexibility, less engagement along length and more efficient cutting blades produce a superior tactile perception compared to K-files giving the dentist the ability to discern when he is in a tight canal and when he is hitting a wall. The ability to make this distinction tells the dentist when he must remove the instrument from the canal, prebend it and negotiate around the blockage. 4. These instruments may be used manually or in a 30º reciprocating handpiece at 3000-4000 cycles/minute.The reciprocating action simulates the same watch winding motion that is used manually and does not lead to separation while appreciably accelerating the shaping process. 5. These instruments work so effectively that they replace the subsequent work that has been done with rotary NiTi after the glide path has been created. The entire shaping procedure is done with first regular non-relieved reamers and then after 10, with the relieved reamers doing away with the more vulnerable use of NiTi made even more vulnerable when they are used in a rotating handpiece. Below are several examples of the type of shaping we achieve with the relieved reamers used both manually and in the reciprocating handpiece.

These cases demonstrate there is more than one way to shape complex anatomy. That fact that the technique we employ virtually eliminates instrument separation while preparating canals to a greater width producing superior cleanliness and more effective irrigation can only be considered pluses. That they produce these results at a cost approximately 90% less than that of rotary NiTi is something else that logically should be pondered. Regards, Barry
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