Real World Endo Forum
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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:: ESX Instrumentation of the Molars
I have been using ProTapers and one problem I usually face is the lack of control in choosing apical size and taper for the Palatal or the Distal Mandibular Canals as they are usually wide.
When I can't control the apical size and taper of my rotary files for such canals it ends up being more difficult to control working length specially in Palatal Canals that may not have a 20/25 apical diameter.
I'm considering switching completely to EndoSequence system and bonded obturation which I think is fabulous.
My question is in choosing the ESX file sizes (small, medium, large) - do you usually end up choosing smalls for the MB, DB and MB and ML and choosing medium/large for the palatal and the one distal canal or do you choose the same?
First sorry for the late reply. The holidays are busy times for all the faculty. Regarding your question, it couldn't have come at a better time. While the ESX protocol is great in triaging cases through the use of the screening file "the Expeditor," we're about to begin education on a new instrumentation system that exactly addresses your problem. This instrument is not yet released but will soon be available. Stay tuned and you will have your answer soon.
Meanwhile, there is no universal size for "a molar." A molar can be many different sizes and a palatal canal in the molar of patient A may be a size 35 but in patient B maybe 55. This is why the Expeditor is used to triage these cases based on the amount of engagement it experiences on its way to the working length.
Anyway. Stay tuned over the next few weeks to hear about the new instrument. It's a universal Master File that will replace all the ESX Finishing files with a Single File!!! ;)