[Allen Ali Nasseh]

A case review during vacation! Learn to use EndoSynch and EndoSynch A.I. with ESX instrumentation and Obturation with OTR motion
[See the full post at: CBL 19: Advanced ESX Instrumentation using EndoSynch and OTR Motion]

[Mounir Mallek]

Hi Dr. Nasseh,
I was wondering, since you had to remove dentine from the canal walls in order to get the 15/05 to the apex, which implies there is only enough space for the 15/05 at that moment, wouldn’t the engagement be maximal in every case? If not, what would an advanced case w/ minimal engagement look like?

• This reply was modified 1 year, 4 months ago by Mounir Mallek. Reason: typo

[Allen Ali Nasseh]

@Mounir Mallek: I think there is no Advance case with minimal engagement because that’s the definition of an advance case, a case in which a size 15/02 hand file does not easily reach the apex. So, you will always have extra engagement in these cases. Currently you can use the 15/05 or some of the newer 17/04 and 17/06 EndoSequence Scout files in such cases to get down first since they are more flexible. I hope this makes sense.
Best wishes,
Ali

[Auste Liegute]

Hello, thank You for the case presentation. I would like to ask, did You use any hand files? Or only rotary?

Best wishes,
Auste

[Allen Ali Nasseh]

@Auste Liegute: I very much limit the use of hand files in my personal instrumentation protocol since I use a strict crown down protocol. However, I generally recommend the less experienced user to make sure the canal is at least open to a size 10 hand file, and or ideally a size 15 hand file before attempting to get to the apex with rotary files. This is a matter of preference and safety. I have done enough cases to know how to use the rotary files gently enough not to over torque them in a tight canal. So, I don’t necessarily teach what I do myself since it takes a certain number of cases before people are comfortable doing what I do. I also use hand files 6 and 8 and occasionally 10 in very very calcified cases. So, there still are cases I use hand files but in general I use rotary files exclusively, especially now with the EndoSync+ where even my working length measurement is done with rotary files (generally either a 15/02 ESX or a 17/04 EndoSequence Scout.) Cheers!

[Author]

Posts