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Palatal canal
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From: Mark Dreyer To: ROOTS Sent: Friday, March 04, 2005 9:20 PM Subject: [roots] Underprepared? I usually can get a 20/.08 GT file to length in most canals. On the palatal canal, the 20/.04 GT went to length, and due to the feedback the files were giving me, I didnít think it was wise to force the issue trying to get a more tapered file to length. The canal was nice and clean to a paper point and was a vital case so I accepted the shape. BTW, the 2 gg & peezo didnít go very far into that canal.I was wondering how Barry would hybridize his approach in a canal like this thereís no way he would have gotten an 08 taper in this one at least not likely in my opinion.- Mark
Dear Mark! Nice as usually! I always look at your cases, i have much to learn from you. This case is HA with Protaper& GT' s? If the F1 (taper 0,7) was going to the working length i don't understand why bringing the 20/0.4 GT was a problem? I am most of the time a big fan of 0,10 taper :-))))))))))), as you can see from my cases. I have a question for you, pleas answer me, if your precious time permits. I have read from your post that you can do a molar RCY in aprox 1h 30 min. I need 3 h :-)))))))))). Please help me! - Camil The F1 protaper didn't go to length-it only got within a couple mm's of length. As for time needed, some docs are more efficient than others. Part of my secret is doing 4-6 cases/day with the same assistant over a long period of time. We get into a groove and things tend to go efficiently. I really think that's the secret. It's hard to become efficient if you are doing endo sporadically, or don't have a long term assistant. Also, some docs are just naturally more efficient than others not only in endo but also restorative. - Mark Tanks for your prompt answer. Finally i understand my problem with the working time. I work alone, i don't have a assistant. Regarding your case, the preparation was made with system GT? - Camil As to your question of shaping, no, I didn't do the entire case with GT's. I use a hybrid approach and the GT's are the files I use frequently in my finishing phase. - Mark Dear Mark, If you are interested in getting an 08 apical taper, I think the V-Taper #25(V08) by Guidance Endo would have given you the shape you wanted. - Chuck Goodis I do need something for a bit more taper in some of these canals. What I have on my shelf now (GGís2-4/Protaper/GT combo) works in most roots, but there are still a bunch of cases I donít feel comfortable forcing the issue with those files and on which I finish with an .02/30 k3. Maybe Iíll order some of those and play around on some extíd teeth. - Mark Dear Mark ! In my book this is very good and no problems should arise from this "under-prepared" endo. Now I have seen underprepared. I think .4 taper is more then enough in canals like this. Why do you think you need more ? Do you have any literature to back you up (beside Ruddle&Machtou that just state it as a proverb without any evidence). For years people did endo with .2 files getting probably .4 taper or less with very high success rate. I am more concerned about the apical size though, did you try to gauge it ? It's very long time since I finished a case with 20 size. Always happy to see your cases, - Thomas Thomas, Thanks for your comments. No lit to back up my desire for increased taperÖjust playing the hunches that more taper would allow for better irrigant penetration. I always gauge with k files and like youíve stated, a size 20 is a pretty rare occurrence. In a canal like this in which it was tough getting a 20/.04 to length, if it gauged higher than 20 with k files I usually would do the Rosenberg 1/4mm step back to assure I had some nice taper in the apical 2 mmís. - Mark Dr. Rosenberg's technique is excellent. The following is a company promo: Also for forming the glide path consider using the three V-Taper Glide-Path hand files, which have a variable taper along the length of the file, not a constant taper. The three (3)Glide-Path files, #10(V02)->10(V04)->10(V06) create the same glide-path that is formed by six (6)- 02 tapered #10, 15, 20, 25, 30, 35 hand files. Therefore creating an 06 apical taper. This not only eliminates three files, but also the difficulty of jumping from the 10 to 15 to 20. This can be the hardest part of forming the glide-path. Company promo over - Chuck Goodis Mark, it takes me an hour and a half to two hours. I think time also depends on the technique you are using. If you are going to do like some people do and continuously flush with bleah for half and hour then you are going to take much longer than someone who simply uses it during filing and shaping. Guy

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