Endo Tribune Asia Pacific Edition

Endo TribuneAsia Pacific Edition | 12/201522 TRENDS&APPLICATIONS The objective of endodontic treat- ment is the elimination of pulp debris or the bacterial biofilm and its toxins from the root canal sys- tem in order to prevent or elimi- nate any periapical lesion.1 For this purpose, root canal shaping is an essential, necessary and complex step. Essential because it allows indispensable irrigation, necessary to achieve 3-D obturation of the endodontic root canal system2 and complex because of the infinite complexity of the root canal ana- tomy.3 Over the past several years, the definition of an endodontically successful root canal treatment haschangedconsiderably.In1986, successwasbasedonthecomplete disappearanceoftheperiapicalle- sion.4 In2004,theconceptevolved and the terms “recovered tooth”, “tooth on the way to recovery” and “diseased tooth”5 were used. In 2011, the terminology of “functional tooth” versus “non- functional tooth” was finally in- troduced.6 Despite this, the con- cepts for root canal shaping estab- lished by Schilder in 1974 remain unchanged,7 namely with respect to the initial root canal anatomy and position of the apical fora- men, as well as conservation of rootcanalpatencyandobtainment of a sufficient taper to guarantee the penetration of the irrigating solutions to the apex. Practitioners are familiar with these concepts and try to imple- ment them in the best possible way. However, endodontic treat- ment remains an area that poses great difficulties for dental sur- geons, and time constraints can often lead to inadequate treat- ments.Thus,generalpractitioners desireasimple,efficientandrapid solution that allows reproducible treatments. The introduction of rotary nickel-titanium (NiTi) in- struments in endodontics in the late 1980s has revolutionised the discipline. The material’s extreme elasticity imparts great flexibility to instruments with greater diam- eters and tapers than those of hand files. Stainless-steel hand files are more rigid and can lead to the creation of an apical ledge, canal transportation, a crack in the apical foramen or even in- strument fracture.8, 9 Although NiTi instruments al- low reliable and reproducible results, they present a higher risk of fracture than do stainless-steel files, particularly those used in continuous rotation, which is due to cyclic fatigue or higher tor- sionalstress.Instrumentfractures caused by cyclic fatigue occur without prior deformation visible to the naked eye. They are there- fore impossible to foresee with certainty.10 Too often does this elevated risk of instrument fracture result in general practitioners abandoning endodontics altogether. However, respecting several simple prin- ciples, such as using the speed and torque recommended by the instrument manufacturer, pre- enlarging the root canal, using vertical up-and-down movements, aswellascleaningandperforming visual control of the instrument after each passage, makes the practitioner’s work less stressful and more relaxed. The introduction of single-use instruments not only eliminates the risk of cross-contamination, but also considerably reduces the risk of instrument fracture due to cyclic fatigue and simplifies the operating procedure. MICRO- MEGAhasdesignedtheOneShape Procedure Pack, which contains an ENDOFLARE file, a #10 MMC file,aOneGfile,a#15MMCfileand aOneShapefile(Fig.1).Itsimplifies the operating procedure, removes the need for instrument mainte- nance and makes stock manage- ment easier. All of the necessary instruments for the endodontic treatment are single-use files sup- plied in sterile packaging. Operating procedure Each endodontic treatment re- quires a preoperative radiograph taken with a radiograph film holder (Fig. 2). Once a dental dam has been placed and the access cavity has been prepared, the root canal entrances are localised and the pulp chamber is irri- gated with sodium hypochlorite (Fig.3). The first step of the root canal preparation is the enlargement of the canal entrances. As the first instrument in the One Shape ProcedurePack,ENDOFLARE(with adiameterof0.25anda0.12taper) is used with up-and-down move- ments and pressure on the canal walls in the first 3–4 mm of the root canal to enlarge the canal orifices. In this case, ENDOFLARE eliminates the dentinal over- hang at the entrance to the distal root canal (Fig. 4) and lays open the second mesiobuccal canal (Fig.5). The One Shape Procedure Pack A unique solution for root canal shaping DrTara Mc Mahon,Belgium Fig. 1: One Shape Procedure Pack.—Fig. 2: Pre-op radiograph of tooth #17.—Fig. 3: Opening of the pulp chamber (P: palatal canal; DB: distobuccal canal; MB: mesiobuccal canal).—Fig. 4: Elimination of overhangs with ENDOFLARE (P: palatal canal; DB: distobuccal canal; MB: mesiobuccal canal).—Fig. 5: After the passage of ENDOFLARE, access to the distobuccal canal is straightened (P: palatal canal; DB: distobuccal canal; MB1:ﬁrst mesiobuccal canal;MB1:second mesiobuccal canal).—Fig.6: Exploration ﬁle,#10 MMC,in the distobuccal canal.—Fig.7: One G.—Fig.8: Radiograph of One G in the second mesiobuccal canal. 5 6 7 8 9 10 11 12 13 14 15 16 1 2 3 4 Fig. 9: Photograph of One G in the second mesiobuccal canal (P: palatal canal; DB: distobuccal canal; MB1: ﬁrst mesiobuccal canal; MB1: second mesiobuccal canal).—Fig. 10: One Shape.—Fig. 11: Passage of One Shape in the canal:two-thirds of theWL,3 mm short of theWL,andWL.—Fig.12: Radiograph of One Shape in the second mesiobuccal canal.—Fig.13: Photograph of One Shape in the second mesiobuccal canal.— Fig.14: Radiograph with the master cone.—Fig.15: Post-op radiograph.—Fig.16: Post-op radiograph of tooth #17. 5678 9101112 13141516 1234

Endo Tribune Asia Pacific Edition

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