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ePaper created 2016-03-31, 16:35:38 | version 1.38.0
file separation technique | 23roots1 2016 OncetheLoopwireisfelttotightenaroundthefile segment, it is carefully tugged in several directions until the file is pulled out of the canal (Fig. 8). If, as often happens, the wire lasso slips off the file seg- ment,itissimplyremovedfromthecanal,reformed, placedbackoverthefilesegmentandtightenedonce again. Developing adequate coronal canal shape without weakening the root When file segments are below the orifice level, a staging preparation to the broken file end is usually requiredandisaccomplishedwiththeTFRKModified #3 Gates Glidden bur (1,000 RPM CW), then the TFRK Micro-Trephine bur (Fig. 9) at 600 RPM rotating in a counter-clockwise direction, so as to encourage a bound file segment to reverse thread back coronally andloosen.Ifthefilesegmentisaroundacurveinthe canal, the TFRK includes a 70-0.12 GT Accessory File to create a bit more visual access to the file segment. All three of these instruments have tip diameters of 0.7 mm, a very safe size to cut a staging preparation to the separated file segment. Removal of file segments beyond the middle third of the canal This is where my experience level is still develop- ing, and I usually refer clinicians to Terauchi’s Face- book page for review of his cases or advice about their own cases, and as such I will leave this to our own god of file retrieval. There are several YouTube videos of his simple and more difficult cases, and I find them an excellent review before tackling my nextexperienceintheartoffileretrieval—askillthat Ineverexpectedtomasteratthelevelhehasbrought me so far. In my own experience, understanding Terauchi’s concepts of file retrieval made it possible to remove broken files—mine and other’s—that I would have never expected to be possible. Using the tiny, elegant tools in his File Retrieval Kit have made it a wonder- fully predictable procedure to have in my bag of end- odontic tricks. For further information about the TFRK, check these links to Dental Education Laboratories at delendo.com and DentalCadre—the provider of Terauchi’s TRFK—at dentalcadre.com._ about Dr L.Stephen Buchanan,DDS,FACD,FICD, is a diplomate of theAmerican Board of Endodontics, a fellow of theAmerican and International Colleges of Dentists and serves as part-time faculty to the UCLA and USC graduate endodontic programs.He holds patents on the Endobender Plier (SybronEndo),System-B and ContinuousWave obturation tools and methods (SybronEndo),GT and GTX file systems (DENTSPLYTulsa Dental Specialties),LAAxxess Burs (SybronEndo),and Buc ultrasonic tips (Spartan/Obtura).Buchanan lives in Santa Barbara,Calif.,where he enjoys a practice limited to conventional and microsurgical endodontics and dental implant surgery.He is the founder of Dental Education Laboratories,a hands-on training facility in Santa Barbara that he has directed for 28 years. Fig.8: Yoshi Loop with file segment secured and retrieved from canal. Fig.9: TFRK Micro-Trephine bur. Fig.8 Fig.9