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ePaper created 2018-02-22, 10:04:34 | version 1.38.0
A2 ◊Page A1 from. .04 to .06 there is a six fold in- crease in the risk of cyclic fatigue. Cy- clic fatigue of fi les is determined by the cross sections area, taper, degree of curvature and most importantly the radius of the curvature (Ugur 2007). Glide path provision was achieved with an FKG 02/10 Scout RaCe® fi le running at 900rpm. The .02 taper and triangular cross section, alternat- ing cutting edges to prevent a screw- ing in effect, make the fi le highly fl exible, while electroplating reduces the effects of cyclic fatigue (Lopes et al, 2010). Although cyclic fatigue for the scout fi le maybe higher than that of Pathfi les (Dentsply), results for angular defl ection favour the scout fi les for the advancement with severe curvatures (Lopes et al, 2012). The scout race fi le was placed in con- tact with the EAL to allow for a guide as to the canal length. This is a safe technique as the ISO 10 fi le will not “Blow out” the apical constriction, as it is narrower than the stated aver- age for a molar of around ISO 30 (El Ayouti, 2014) and potentially wider in individuals under the age of 30. With the exception of the mesial canals, the 16 was shaped with a modifi ed Race® protocol of 25/02, 25/04 and a fi nal fi le of 35/04. There is a 70% increase in the amount of irrigant than can be placed in the apical 3mm if the ISO is increased from a 25-35 (Trope 2010, Card 2002, McGurkin-Smith 2005) while Kha- demi et al, 2005 found that the mini- mal apical size for effective irrigation was ISO 30 and above. The mesial canals were again shaped and cleaned to a size 35/04 with a differing protocol. Race Scout fi les were used at 900 rpm in sequence from 10/02, 15/02, 25/02 and 35/02 (BR4C fi le) with continued use of 2% NaOCL, due to the .02 constant taper being fl exible than the conventional systems that may involve a multi- tude of tapers to clean differing por- tions of the canals. The fi nal preparation size was a con- stant 35/04 tapered instrument. Cleaning was achieved with a combi- nation 2% NaOCL and Passive ultra- sonic irrigation for a minimum of 3 x 20 seconds per canal. The effect Canal MB1 MB2 DB PAL Zero reading 21 21 21.5 19.5 Working length 20.5 20.5 21 19 ENDO TRIBUNE Dental Tribune Middle East & Africa Edition | 4/2017 of cavitation and acoustic micros- treaming has been found to be more effective than syringe irrigation (Gu et al, 2009.,Van de Sluis et al, 2010). With NaOCL in situ a working length periapical radiograph was taken to assess the position of the work- ing length. This is mainly to rule out over extension and potential reduced outcome, as radiographic apex is found to be on average at least 0.9mm from the position of the apical constriction and this can increase with age due to cementum deposition up to 2-3mm. (El Ayouti et al, 2014). Constant 04 taper paper point were used to dry the canals and assess for any residual moisture in the canals which may indicate a period of dress- ing the tooth prior to obturation. TotalFill® bioceramic sealer was placed into each canal, and vibrated to working length with Endoacticva- tor® to spread the sealer and to pre- vent an apical air lock which could prevent seating of the bioceramic impregnated gutta percha single cone. Bioceramic sealer has been found to be biocompatible, anti- bacterial, expand (by 0.02%), seal as effectively as MTA and also cause deposition of apatite into the dentin- al tubules. The apical 4mm was then coated in sealer and place gently into the canals, seared coronally with Sys- temB® and down packed to create a seal at the orifi ce level to prevent washout of the sealer. The combination of bioceramic sealer and bioceramic impregnated cones has been found to make root treated teeth more resistant to frac- ture in comparison to AH plus and gutta percha, potentially due to the formation of a tertiary monoblock (Ghoneim et al, 2014), with fracture resistance being almost that of un- treated roots. Coronal restoration is an essential part of obturation (Ray and Trope, 1995. Gillen et al, 2011) The access cavity was etched, scrubbed with 2% CHX to reduce failure of the hybrid layer due to pro- duction of matrix-metaloproteases (MMP) (Carrilho et al, 2007) and then primed and bonded. The cavity was restored with incremental compos- ite. A fi nal treatment letter was sent back to the referring dentist for the provi- sion of a full cuspal coverage restora- tion. Dr. Justin Dinley, UK BDS, MSc, DipImpDent. RCS., DPDS, MFGDP Dr. Justin Dinley, UK is part of the CAPP- Tipton and BARD faculty team currently teaching the Clinical Endodontics Cer- tifi cate and Diploma programme in Dubai, UAE. For more information about the Clinical Endodontics Diploma pro- gramme visit www.cappmea.com/endo. Senior lecturer and fi rst year clinical and academic lead for the MClinDent at BPP University in London associated with City Of London Dental School. He is a full time clinician with a practice limited to referral endodontics. He has worked for specialist practices for 6 years but holds a passion for teaching and academia. He has an MSc in Endodontics,a diploma in restora- tive dentistry and the Diploma in implant dentistry from the prestigious Royal Col- lege of Surgeons (Eng), the gold standard of training in the U.K. He is an opinion leader for various international compa- nies on Endodontic equipment and also in biological regeneration in dentistry with PRGF. Justin has lectured nationally in the U.K. And Internationally in Endodontics, Surgi- cal Endodontics, Orofacial pain and Diag- nosis and the use of growth factors and regenerative dentistry. The ProTaper® Upgrade: ProTaper® Turns to Gold ProTaper Gold™ By Dentsply Sirona Dentsply Sirona is pleased to an- nounce that we are upgrading our ProTaper® Universal fi les to ProTa- per Gold™ (excluding retreatment and hand fi les). • A complete solution with dedicated obturation products, including new variable tapered gutta-percha points specially moulded to fi t canals pre- pared with ProTaper Gold™ fi les. ProTaper Gold™ is the latest addition to the world famous ProTaper® fam- ily developed by Dentsply Sirona Endodontics (previously known as Dentsply Maillefer) in collaboration with international endodontic key opinion leaders. The ProTaper Gold™ solution has been produced for our ProTaper® users who do not want to change their technique to the ProTa- per Next® or WaveOne® Gold offer- ings. ProTaper Gold™ is an upgrade from ProTaper® Universal, keeping the same philosophy and technique as the fi rst generation of ProTaper® but with strong additional benefi ts such as extended fl exibility and greater resistance to cyclic fatigue. ProTaper Gold™ - the same ProTaper® Philosophy • Same sequence of shapers and fi n- ishers. • Same rotary motion (Compatibility X-Smart®, X-Smart® Plus, X-Smart iQ™). ProTaper Gold™ - Strong Ad- ditional Benefi ts • Covers a wider range of canal mor- phologies thanks to: o Higher fl exibility (new metallur- gy): +24% on average vs. ProTaper® Universal fi les. o Increased memory shape and fl ex- ibility on all fi les. • Reinforced safety for the patient thanks to: o Higher cyclic fatigue resistance: Pr- oTaper Gold™ F3 fi le lasts x2.6 times longer than a ProTaper® Universal F3 fi le. On average, all fi les last x2.4 times longer than ProTaper® Univer- sal fi les. • No new shaping technique to learn, simply a better tool to do it with. By the end of the year we aim to have all new orders for ProTaper® Univer- sal switched to ProTaper Gold™. For more information or to try a sample, please contact your local Dentsply Sirona representative.