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ePaper created 2018-03-06, 08:52:14 | version 1.38.0
| industry report Fig. 7 Fig. 8 Fig. 9a Fig. 9b Fig. 9c ment is then reused in the same manner until it reaches two-thirds of the estimated length. The canal is irrigated and a size 10 file is used to determine the working length with the aid of an apex locator and a radiograph. After that, RECIPROC blue is used as described until it reaches the working length. As soon as the working length has been reached, the instrument is withdrawn from the canal to avoid unnecessary over-enlargement. The RECIPROC blue instrument can also be used with a brushing motion against the walls of wide canals. With continuous rotation, it is necessary to create a glide path in order to minimise instrument binding and the risk of fracture.5, 6 Binding is less likely to occur when an instru- ment is used in reciprocation with unequal forward and reverse angles and with the limited in and out movements as described earlier. Therefore, a glide path is not required in the majority of canals when instruments are used in this manner. It has been shown the incidence of fracture of in- struments used in reciprocation with unequal forward and reverse angles and with a pecking motion is very low7, 8 in comparison with rotary instruments. However, just as with any continuous rotary system, it is possible to use the RECIPROC blue instruments after creating a glide path with, for example, R-PILOT (VDW; Fig. 7), a new recipro- cating instrument specifically designed for this purpose. 30 roots 1 2018 A glide path should be created with R-PILOT prior to using RECIPROC blue in some canals, or for example when the RECIPROC blue instrument stops advancing in the canal or if advancement becomes difficult. In such a canal, apical pressure should not be exerted on the RECIPROC blue file. The instrument should be removed from the canal and the canal should be irrigated. Patency is then established to the working length with a size 8 file and the R-PILOT instrument is used to create a glide path to the working length. The RECIPROC blue instru- ment can then be used safely to the working length. The R-PILOT instrument is used with the same reciprocating motor and settings, with a light and short pecking motion similar to the use of RECIPROC blue. A glide path can also be created with R-PILOT to reduce the stresses on the RECIPROC blue instruments, for example in canals with difficult access or canals presenting with a curvature in their coronal thirds (Fig. 8). Access to the orifices of some canals, such as the me- siobuccal orifice of a mandibular second molar, may be difficult. Owing to the thermal treatment of the RECIPROC blue files, it is safe to gently pre-curve their tips in order to make the access to these orifices easier. If an increased apical enlargement is required, a larger RECIPROC blue instrument or a nickel-titanium hand or rotary instrument can be used. In conclusion, the use of instruments in reciprocation with unequal forward and reverse rotation and with a lim- ited pecking motion has been shown to be very safe.7, 8 The introduction of the RECIPROC blue instruments with enhanced physical properties4 makes the procedure even safer with respect to instrument fracture and maintenance of canal curvature (internal evaluation; Figs. 9a–c). Editorial note: A list of references is available from the publisher. about Dr Ghassan Yared is an endodontist practising in Guelph and Waterloo in Ontario in Canada. He has been extensively involved in teaching. He joined the Department of Endodontics at the University of To- ronto in Canada in 1999 for a full-time position as assistant head and director of the endodontic undergraduate programme. He remained in this role as an associate professor until summer 2004. Dr Yared is an internationally recognized educator, focusing on clinical interdisciplinary endodontics and reviewer for several international scientific magazines. He is also a Fellow of the Royal College of Dentists of Canada, and a member of the Canadian Academy of Endodontology and the American Association of Endodontists.