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ePaper created 2016-01-20, 13:53:08 | version 1.38.0
I 39 new product technique _ shaping canals I roots1_2015 with most other commercially available rotary shap- ing techniques. After the Primary file reaches length, the flutes are inspected and if full of debris would indicate shaping is finished. If the Primary file is loose at length with no dentinal debris on the apical flutes, shaping continues with WaveOne GOLD Medium and/or WaveOne GOLD Large until the apical flutes are loaded. Apical gauging with ISO #25 or 35 hand files, respectively, will also confirm whether the api- calforamendiameterislargerandthataMediumor Large file is required. WaveOne GOLD files are used in a brushing action to reduce resistance and more effectively instrument canals that exhibit irregular cross-sections. Brushing eliminatescoronalinterferences,createslateralspace, andpromotestheinwardadvancementofthefile.Fur- ther, a brushing action reduces the contact between the file and dentine, mitigates undesirable taper lock, andallowstheinstrumenttorunmorefreely.Inorder toavoidtransportation,neverbrushatlength.Thefiles are used with a gentle inward 'stroking' motion of short2–3mmamplitude,topassivelyadvancethefile along a smooth, reproducible glide path. Reduced shaping time with WaveOne GOLD means there is more time available to focus on active irriga- tion methods. In order to enhance irrigation and im- prove effectiveness activation with sonic and ultra- sonic irrigation is now well accepted.31 Dynamic irri- gation in the apical one-third of highly curved canals hasbeenshowntosignificantlyimprovedisinfection.32 The stages of the shaping procedure can be sum- marised as follows (Figs. 7a–c): _Establish straight-line coronal and radicular access with emphasis on flaring, flattening and finishing the internal axial walls.32 _Inthepresenceofaviscouschelator,usea#10hand file to verify a glide path to length. In more restric- tive canals, use a #10 hand file in any region of the canal to create a glide path. _Expand this glide path to at least 0.15mm using eitheramanualoradedicatedmechanicalfile,such as the ProGlider or PathFile (DENTSPLY) (Fig. 8). _Initiate the shaping procedure with the Primary file in the presence of sodium hypochlorite (Fig. 9). _Use gentle inward pressure and let the Primary file passively progress through any region of the canal that has a confirmed glide path. After shaping 2–3mm of any given canal, remove and clean the Figs. 13a–c & 14a–c_The series of pre- and post-op radiographs of tooth #26 demonstrates the ability of WaveOne GOLD to shape considerable curvatures in canals that are long, curved and narrow, following the apical anatomy. All canals were obturated with WVC. Table 1_WaveOne GOLD tips. Fig. 13a Fig. 13b Fig. 13c Fig. 14a Fig. 14b Fig. 14c _Always initiate shaping procedures with WaveOne GOLD Primary. _Irrigate abundantly and frequently with sodium hypochlorite after removing any given WaveOne GOLD file from a canal. _RemovetheWaveOneGOLDfilewhenitdoesnoteasilyprogress.Cleanandinspectthe cutting flutes for wear and/or distortion and then irrigate, recapitulate with a #10 hand file and re-irrigate. _OwingtotheuniqueWaveOneGOLDpost-manufacturingprocess,thefilesmayappear to be slightly curved. This is not a defect and it is not necessary to straighten the file before use. Place the tip of the file in the canal entrance and start the motor. The file will followtheglidepathconformingtothenaturalcurvature.Theadvantageisthataslightly curved file can be more easily placed into canals of posterior teeth where access is restricted. Table 1