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ePaper created 2017-06-21, 10:00:36 | version 1.38.0
| case report root canal preparation with NiTi fi les All roads lead south Author: Dr Alfredo Iandolo, Italy As usual in the human anatomy, root canals come in all forms and sometimes develop in very random structures. Luckily, pre-bendable nickel titanium (NiTi) fi les allow us to prepare and clean the canal in next to no time. In this article, we will compare three different endodontic cases, you will quickly fi nd that a thorough and effi cient root canal preparation is easy with the right set of instruments—regardless of the shape of the canal itself. Reading endodontic case reports, you sometimes get the impression that root canals always spot an extreme, double curved morphology. With the latest technology and treatment auxiliaries the endodon- tic world has to offer, you should, of course, feel confi dent to take on even the most unusual shapes of canals. Would not it be nice though to have a uni- versal, fl exible NiTi fi le system that allows you to prepare all sorts of canals, whether they are S- or J-shaped or lead straight down to the apex? In Italy, we say “tutte le strade portano a Roma”. For a well-versed endo expert “all root canals lead to the apex is just as true—you only have to know how to use your equipment the right way”. Fig. 4 Fig. 1: Pre-operative radiograph Case 1: Straight down to business of case 1. Fig. 2: Specially hardened surface of the HyFlex EDM fi le under the microscope. Fig. 3: Cutting in the canal using a HyFlex EDM 25/.12 Orifi ce Opener. Fig. 4: HyFlex EDM OneFile. A 48-year-old female patient introduced to our surgery complaining of pain caused by chewing in the maxillary left side. We quickly found that the necrotic pulp of tooth 24 caused the complaint. The pre-operative radiograph showed a deep caries as well as a medium-sized periapical lesion (Fig. 1). The root canals were positioned in a comparatively straight, almost parallel way with hardly any curva- ture. Quick preparation with a reduced sequence of NiTi fi les consequently should be possible in that particular case, as there were no contraindications to a root canal therapy in general. To provide a clean and dry operating fi eld, dental dam was applied to isolate tooth 24 for the follow- ing treatment. First of all, we handfi led the main canals up to ISO 10 size. We were thus able to create a suitable glide path, before the actual preparation took place. In our endodontic practice, we normally use the latest generation of nickel titanium fi les by Swiss dental specialist COLTENE for cleaning and shaping the canal. As the name already indicates, the HyFlex EDM is a “highly fl exible” NiTi fi le, which proves to be incredibly fracture resistant. In close coopera- tion with leading universities and international endo-specialists, the renowned research de- partment of the innovative provider of endo equipment developed a literally sharp solution for their instruments. To come up with a new, powerful tool they employed a clever idea that is widely used in other industry branches to den- tistry. The abbreviation "EDM" stands for a specifi c manufacturing process named "electrical dis- charge machining". Spark erosion improves the cutting performance of the instrument as it pro- duces a unique surface in the fi le. You can com- pare this kind of refi nement with the serrated Fig. 1 Fig. 2 Fig. 3 18 roots 2 2017