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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 didn’t 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 didn’t go very far into that canal.I was wondering how Barry would
hybridize his approach in a canal like this there’s 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
(GG’s2-4/Protaper/GT combo) works in most roots, but there are still a bunch of cases I don’t
feel comfortable forcing the issue with those files and on which I finish with an .02/30 k3.
Maybe I’ll order some of those and play around on some ext’d 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 taper…just playing
the hunches that more taper would allow for better irrigant penetration.
I always gauge with k files and like you’ve 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 mm’s. - 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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