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Endo Questions for the RWE Faculty:

In this area, users are encouraged to ask questions from the RWE Faculty regarding Endodontics in General and the EndoSequence Technique.

Endo Questions for the RWE Faculty:: EDTA paste

Missing

Joined: December 2013

Rank: Sergeant

Posts: 11

#1
Hi everyone, many greetings from Greece!!! My consideration (it may be stupid) is if we should use EDTA paste when using rotary instrumentation? In my opinion it is mandatory to use EDTA paste while confirming patency but the concept of lubrication in conjunction with rotary instruments is controversial! I am thinking that irrigant solutions are enough to lubricate the rotary files and if you avoid any paste you can see what parts of rotary files are engaging dentin from the dentin all chips...... What are your thoughts and you suggestions?
Again I am sorry if the subject is boring!!!!!
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 299

#2
In reply to Tasos Koursoumis Tasos, I hardly ever use RC-Prep or lubrication for instrumentation. Having said that, I do use Citric Acid solution during the early phase of instrumentation but it's just in the liquid form and not a gel like RC-Prep. However, it's just personal preference as I don' think it makes much of a difference either way. I'm in the process of making some videos regarding rotary motion which hopefully addresses the issue of loose debris in the canal. To sum it up, it all depends on the way someone uses files. If you create a lot of debris and don't clean files regularly during instrumentation, you will end up with a lot of loose dentinal chips in the canal. In that situation a gel would help in keeping the debris suspended. Otherwise, if you clean the file regularly by wiping it (like me,) you don't need to use a gel like RC-Prep. Regarding the apex locator, I'm not sure there's any consensus on RC-Prep creating false positive or negative readings on your Apex Locator. Any good conductor should hopefully improve reading like dentifrice helps with the electric pulp tester! Just an opinion. 
Missing

Joined: November 2016

Rank: Rookie

Posts: 2

#3
Dear Dr

i have a doubt while using lubricants in rotary.one of my professors told me use EDTA liquid with edta gel while using a s1 file rotary.but i have heard that using viscous chelators like edta gel can mix with debris,lock the file and create breakage.This was told to me by dr sergiua nicola from romania.

so i would like to know,in calcified and curved canals,its better to use edtagel+liquid edta or edta liquid only or sodium hypochlorite or a mixture of edta liquid with sodium hypo

which of the above will be beneficial in tight canals,calcified and double s curved canals.
i would also like to know the efficiency of citric acid also also chelator and lubricant compared with edta.

also sir,if i am using hypo only as lubricant..means the pulp chamber flooded with hypo....this will only remove the debris by dissolving...but what about to soften the canal dentine in calcified and narrow canals...so when has to be edta liquid used?
or sir, work with edta liquid in rotary and flusing with hypo periodically is helpful.

Answers to the above questions will be great help to me as well as millions of dentist following you sir

thank you

Missing

Joined: November 2016

Rank: Rookie

Posts: 2

#4
In reply to Dr Vineeth vinayakumar
Dear Dr

i have a doubt while using lubricants in rotary.one of my professors told me use EDTA liquid with edta gel while using a s1 file rotary.but i have heard that using viscous chelators like edta gel can mix with debris,lock the file and create breakage.This was told to me by dr sergiua nicola from romania.

so i would like to know,in calcified and curved canals,its better to use edtagel+liquid edta or edta liquid only or sodium hypochlorite or a mixture of edta liquid with sodium hypo

which of the above will be beneficial in tight canals,calcified and double s curved canals.
i would also like to know the efficiency of citric acid also also chelator and lubricant compared with edta.

also sir,if i am using hypo only as lubricant..means the pulp chamber flooded with hypo....this will only remove the debris by dissolving...but what about to soften the canal dentine in calcified and narrow canals...so when has to be edta liquid used?
or sir, work with edta liquid in rotary and flusing with hypo periodically is helpful.

Answers to the above questions will be great help to me as well as millions of dentist following you sir

thank you


Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 299

#5
In reply to Dr Vineeth vinayakumar Yes, too much EDTA is not good. Especially in calcified canals or ledges around curves. If the operator is not careful it can lead to ledging, or worse, root perforation. I dont use EDTa that frequently as using the right gentle motion and SSC can help engage and remove debris much more gently than using too many decalcifyong agents and chemicals. Furthermore, IMHO, using aome calfuciation and debris with ultrasonic agitation is more efficient and safer in most situation. However, EDTA some specific uses for early phase of identifying calcified canals. But instrumentation with EDTA for too long can be risky in curved, calcified roots.