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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:: Gutta Percha synchronization.

Missing

Joined: June 2018

Rank: Rookie

Posts: 2

#1
Thanks for the videos and great resources. Because of them I have recently switched my system to KontrolFlex 2 files which I have been happy with. I need just some quick advice. I have switched to use crown down/SSC method. EDTA and NaOCL irrigation (with ultrasonic activation) throughout. My hand piece has an apex locator built in and I always take the finishing files to length. This can be confirmed radiographically. So far so good. 

My only issue is that I am finding with some canals my GP points do not go to length right away and sometimes, even with extra instrumentation, I struggle. Sometimes 1mm short and others 2mm short. I am wondering if this is a result of cutting efficiency of KontrolFlex? Should I always finish with an EndoSequence file? All files and GP points are Brasseler. I am using BC points with BC sealer. I always check for apical patency as well. 

Thanks for your time! 
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 293

#2
In reply to Mo H Dear Dr. Hashem, 
I'm sorry for the delay. Your post fell through the cracks. But you have a very good question that comes up quick often. The issue of cones not being an exact fit for some preparation is not uncommon. This happens to me to clinically. This is partially due to the heat treated files and the ever so slight unwinding that makes the file thinner than the perfect taper and partially due to the fact that dentin has a modulus of elasticity and can ever so slightly bounce back. Furthermore, cones can distort and sometimes the coating can be too thick on individual cones. Either way, the solution is simple. Rather than doing too much more instrumentation, as long as you feel the canal is clean and you have no more tissue left on the walls (clean dentinal shavings and paper points,) then you can drop down in size with the cones. In tight maxillary or mandibular molars I may commonly instrument a MB canal to a size 30 or 35/04 and then fit a size 25 or 30 BC Cones respectively. The key is to make sure to have have enough sealer in the canal to fill in the gaps. Higher flow sealer may also be helpful in that it can allow escape of the sealer around the cone during cementation so the cone does not hang up high. You can use either BC Sealer or BC Sealer HiFlow for that purpose. I've recently been enjoying the higher radioopacity obtained by the BC HiFlow but BC Sealer is good as well. 
Best wishes. 
Ali. 
Missing

Joined: June 2018

Rank: Rookie

Posts: 2

#3
Ali, 

Thanks for the help. 

For my own education purposes, what we're discussing here is essentially the difference between martensitic and austenitic files then?

I assume by going to a smaller GP point we are relying to BC sealer's minimal shrinkage properties then to provide a seal? 

Mo
Allen_ali_nasseh

Joined: August 2013

Rank: Faculty General

Posts: 293

#4
In reply to Mo H Yes, precisely. Heat Treated files will unwind slightly and this unwinding will decrease their cross sectional diameter. As a result, they might make for a slightly smaller size prep than their original shape. However, if the canal is already clean then you will simply have to fit a smaller cone that fits and allows tug-back and venting. You can only do this if you're using a bioceramic cement to bond/cement your cone in place. 
Best, 
Al