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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:: EndoSequence - or - ESX ?

Missing

Joined: October 2015

Rank: Rookie

Posts: 1

#1
I've been using WaveOne files w/GuttaCore for perhaps 3 years. One of the biggest problems I have is that I often have to wait for the final xray before I know if I got a good fill - as the GuttaCore relies on a bit of "luck" IMO (it can bind/fold). 

For the last year or so I've been tackling perhaps 3-4 endo cases/month, which is much better than the 1 every couple of months I was doing previously... obturation predictability being one of the limiting factors.

We had the Brasseler rep in here a few weeks ago and he briefly promoted their (endo) product. Didn't think much about it again until later that week when I had a case where the fill was perhaps 3 mm from the working length.

Found this website following some reading on Dentaltown and CEREC Docs. Most of the people who use EndoSequence or ESX seem to like it. Of course, I can find plenty of people who can find no fault with WaveOne/GuttaCore either!

I like the principle of the BC Sealer/Gutta Percha - the fact that you can also trial fit the final cone and have a high degree of confidence prior to the final "film".

As far as file systems, I know that the ESX is newer, and promises fewer (well, a couple fewer) files -- thus it seems attractive. What I'd like to know is, if I make the conversion to Brasseler products, which system would you suggest? Factors I'm interested in would include:

> The quality of the file itself (resistance to failure)

> The characteristics of the file (ability to make predictable progress down the canal without ledging or perforation)

> The range of applicable cases they can tackle

> The comparative cost of the file(s) necessary to complete a majority of cases

No doubt there's more to it than that, but those factors at least can get this conversation started.

THANKS,

Tom
1395272_1391018761135679_1940717384_n

Joined: July 2013

Rank: Officer

Posts: 28

#2
Tom, while we can not talk about the comparative cost differences we can tell you the just of the ESX System. You can then decide if it's for you or not. The main philosophical difference is between the idea of using rotary files vs. reciprocation. Rotation reduces the odds of pushing debris out the end of the root and by using 2 fils vs. a single file, acts like pre-tapping a screw hole before using a final screw, thus reduces the stresses on dental walls and odds of dentinal cracks. ESX, however, being a rotary system requires that you don't sit on the file like you would with reciprocating files! It requires a deft surgeon's hand vs. a carpenter's hand. 
On the obturation side, there's significant difference. The ESX Obturation is a cold obturation system. Heated systems like Thermafil and Guttacore use thermoplastic gutta percha that shrinks 2-7% upon setting. Using a bioceramic sealer that doesn't shrink and chemically bonds to the dentin is a whole different concept. It's like using amalgam vs. composite. 
Now obturation cost is significantly different between the two systems. Whereas each Guttacore Sealer cost is +$10 per canal, the Bonded Obturation cost ends up being 1/3 that cost! The BC GP cones are around 50 cents each and the per canal cost of the sealer is the cost of the serge divided by 50 (50 canals per syringe). It turns around to be around $3 per canal in North America. 
The ESX instrumentation and obturation system is a robust system that's very efficient and makes sense. Best of luck in your decision. 
-RWE