Endo Tribune United Kingdom Edition

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Moreaestheticthanmetalandfull-castgoldcrowns. Zirconiahasprovenbiocompatibility,havingbeenusedin medicalimplants. Compatiblewithanypreparation.     “Get my cash back stickers by calling CosTech” Moreaestheticthanmetalandfull-castgoldcrowns. Zirconiahasprovenbiocompatibility,havingbeenusedin Compatiblewithanypreparation. “Get my cash back stickers by calling CosTech” Zirconiahasprovenbiocompatibility,havingbeenusedin Compatiblewithanypreparation. “Get my cash back stickers by calling CosTech”Call CosTechToday 01474 320076 @CosTechEliteFollow us onTwitter for the latest offerswww.costech.co.uk RNT files are powered. Different reciprocating handpieces may have variations on the degree of clockwise or counter clockwise rotation and possibly include a vertical amplitude. The Synea W&H-62A is an example of a reciprocating hand- piece (MounceEndo) attachment with a 30o clockwise and 30o counter clockwise motion. Recip- rocation is the technique and file motion utilised in the Wave One canal preparation system (DENT- SPLY Tulsa). Clinically, using the SEC O K File as an example, the SEC O K File is placed to the TWL, the attachment placed over the file and reciprocation commences as described above. The file is re- ciprocated for 15 to 30 seconds, using a 1-3mm vertical amplitude movement. Clinically, the file will become less tightly bound as the canal is enlarged. If, for example, a #08 SEC O K file is the first file that binds in the canal at TWL this file is recip- rocated. Once the #08 SEC O K File is reciprocated, the canal will now accept a #10 SEC O K File to TWL. The #10 SEC O K File is reciprocated. Once reciprocation is complete, the canal will allow a #15 SEC O K File to reach the TWL. Once the canal is enlarged to approximately the size of a #15 or #20 hand file, the canal is ready for RNT enlargement. Aside from glide path creation, this technique is especially helpful in early enlargement of calcified canals, especially the MB2 canal of upper molars. Reciprocation is also valuable for rubbing out iat- rogenic ledges. Once the hand file can negotiate around the ledge, it is left in place and reciprocated as suggested above. It is not advised to place a hand file in a reciprocating hand- piece attachment and try to move the file apically while powering the file. While such a motion will work some of the time, it can ac- centuate ledges and other canal transportations and increase the risk of file fracture. Integration of the glide path with early RNT shaping If the clinician is using RNT shap- ing methods, the decision must be made to move either crown down, step back or possibly use a hybrid of the two strategies. While a comprehensive discussion of such RNT strategies is beyond the scope of this article, it has value to mention that judicious initial re- moval of restrictive dentin at the point of greatest root curvature (especially in complex cases) is essential to minimise subsequent iatrogenic events. Caution is ad- vised. RNT fracture is a risk when the wrong taper and tip size RNT is inserted into an acute curva- ture (immediately after glide path creation) with unnecessary force. In essence, a strict crown down sequence may not be indicated. Anatomically, the aforemen- tioned greatest curvature tends to be in either the middle root third or at the junction of the middle and apical thirds. Clinically, in complex multi-planar curvatures, after glide path preparation, re- gardless of whether the glide path was made with reciprocation or with a nickel titanium instrument, using a relatively smaller taper and tip size RNT file (for example, a 0.02/20, 0.03/20, or 0.04/20 file such as the MounceFile CM (con- trolled memory) can minimise the risk of subsequent fracture that may otherwise result in moving directly to a strict crown down ap- proach around such a curvature. Fractureriskisminimisedwiththe removal of restrictive dentin along the curvature through use of the instruments above (Figs. 7 & 8). Alternatively, instead of using the MounceFile, the clinician can make an equivalent enlargement through the curvature using a 0.04/25 Twisted File (Axis/Sybron) or similarly sized RNT file. Thisarticle,writtenforthegen- eral dentist, has described com- mon attributes of hand files, their clinical use, reciprocation, and in- tegration of glide path preparation with initial shaping procedures. Emphasis has been placed on interpreting tactile feedback and avoidance of iatrogenic events. Your feedback is welcome. DT Editorial note: A complete list of references is available from the publisher. About the authors Dr Rich Mounce is in full time endodontic practice in Rapid City, SD. He is the owner of MounceEn- do LLC and an endodon- tic supply company mar- keting the MounceFile in Controlled Memory© and Standard Nickel Titanium (SNT). MounceEndo is an authorized dealer of Mani Inc. products and W&H recipro- cating hand piece attachments in USA. He can be reached at RichardMounce@ MounceEndo.com, MounceEndo.com, Twitter: @MounceEndo 01474320076 01474320076

Endo Tribune United Kingdom Edition

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