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ePaper created 2016-05-18, 11:28:18 | version 1.38.0
24 roots 2 2016 Given our clinical experience, along with the insights that are being documented from recent research, we can make the following conclusions regarding the use of this approach to endodontic instrumentation: 1. Instrument separation is virtually eliminated, producingamuchmorefavourablemind-setfor the dentist. 2. Dentinal micro-cracks associated with rotary NiTi are not associated with the short amplitudes of motionproducedbythe30-to45-degreerecipro- cating handpieces.1–4 3. Lesser tapered preparations reduce the amount of coronal dentin being removed increasing the resistance of the tooth to the forces that produce vertical fractures.1–4 4. The thin 02 tapered stainless steel relieved ream- ers are capable of removing tissue from the often thin buccal and lingual extensions that are not touchedbythegreatertaperedsystemsandwhere canal blockages occur when using K-files. 5. Therecommendedrelievedreamerswillnegotiate to the apex with far less resistance than the tradi- tional use of K-files. 6. Due to their limited exposure to torsional stress andcyclicfatigue,aresultofthe30-to45-degree reciprocatinghandpieces,theinstrumentsmaybe used several times before replacement, yielding dramatic savings.5 Inourendodonticpractice,thefeelingofsecurity is most important. We seek out ways to produce highly effective predictable results. For us, that means no instrument separation as a cause of con- cern with the full appreciation that our procedures mustprimarilymaintaintheoriginalintegrityofthe remaining tooth structure as much as possible._ References [1] DrImanM.Al-Zaka,B.D.S.,M.Sc.Theeffectsofcanalpreparation bydifferentNiTirotaryinstrumentsandreciprocatingWaveOnefile on the incidence of dentinal defects. Iraqi Academic Scientific Journals.2012;9(2). [2] Oguz Yoldas, DDS, PhD; Sehnaz Yilmaz, DDS, PhD; Gokham Atakan, DDS; Cihan Kuden, DDS; Zeynep Kasan, DDS. Dentinal MicrocrackFormationduringRootCanalPreparationsbyDifferent NiTi Rotary Instruments and the Self-Adjusting File. JOE. 2012; 38(2):232–235. [3] Capar I.D.,Arslan H.,Akcay M., Uysal B. Effects of ProTaper Uni- versal,ProTaperNext,andHyFlexInstrumentsonCrackFormation in Dentin.JOE.2014;40(9):1482–1484. [4] ErtugrulKaratasetal.DentinalCrackFormationduringRootCanal PreparationsbytheTwistedFileAdaptive,ProTaperNext,ProTaper Universal, and WaveOne Instruments. JOE Journal Of Endodon- tics.Published Online:December 02,2014. [5] AllanDeutschDMD,EndodonticInstrumentation.DoesKineticsof the System Matter? DentistryToday.2015 Jun; 98–101. [6] Ismail Davut Capar, DDS, PhD; Banu Uysal, DDS, PhD; Evren Ok, DDS,PhD,HakanArslan,DDS,PhD.EffectoftheSizeoftheApical Enlargement with Rotary Instruments, Single-cone Filling, Post SpacePreparationwithDrills,FiberPostRemoval,andRootCanal Filling Removal on Apical Crack Initiation and Propagation. JOE. 2015,41(2):253. contact Dr Barry Lee Musikant, DMD, FICD, is a member of the American Dental Association,American Association of Endodontists, Academy of General Dentistry, the Dental Society of New York, First District Dental Society,Academy of Oral Medicine,Alpha Omega Dental Fraternity and the American Society of Dental Aesthetics. He is also a fellow of the American College of Dentistry (FACD). He is a partner in the largest endodontic practice in Manhattan. Musikant’s 35-plus years of practice experience have established him as one of the top authorities in endodontics. info@essentialseminars.org www.essentialseminars.org Fig.2: Tango Endo. | opinion endodontic instrumentation Fig.2 22016