Access is about the radicular area of the root canal space,not simply geing into the canal, no maer how elastic afile, it can’t go where it won’t fit
Oﬀ axis orientationmandates crowndown approach - glidepath - large to smalltapers, small to largetip size - NEVER rushwith nickel-titanium -no maer the design,no maer the brand,no maer themetallurgy, theirsuper-elasticity haslimits
One file cannot possiblydo all canal systems...it’s a dangerous andslippery slope... There isno reason to rush tojudgment, took the toothyears to calcify, you needto soften, debride,disinfect - shape is but acomponent of the finalresult - Michaelangelo didnot care the Piata withone chisel...
M.-K. Wu, D. Barkis, A. Roris, P. R. Wesselink. Does the first file to bind correspond to the diameter of the canal in the apical region? International Endodontic Journal Volume 35, Issue 3, pages 264–267, March 2002AbstractAim The aim of this study was to determine whether the first file that binds at the working length corresponds tothe canal diameter.Methodology Two similar groups (n = 10) of mandibular premolars with curved canals were selected on the basisof their morphology. Following access and pulp tissue removal, the first instrument that bound in each canal at theworking length was determined. In one group the instrument used was a K-file, in the other group a Lightspeedinstrument was used. After fixing the instruments in place, the apices were ground to the level of the workinglength and the diameters of both the instrument and the apical canal were recorded.Results In 75% of the canals, the instruments bound at one side of the wall only; in the other 25%, the instrumentdid not contact the wall. In 90% of the canals, the diameter of the instrument was smaller than the short diameterof the canal; this discrepancy was up to 0.19 mm. No significant difference in discrepancy was found betweeninstruments (P 0.05).Conclusions Neither the first K-file nor the first Lightspeed instrument that bound at the working length accuratelyreflected the diameter of the apical canal in curved mandibular premolars. It is uncertain whether dentine can beremoved from the entire circumference of the canal wall by filing the root canal to three sizes larger than the filethat binds first.
Hand syringe - level 1.0 mm Ultrasonic Delivery - level 1.0 mm
Hand syringe -level 2.0 mm Ultrasonic Delivery - level 2.0 mm
Comparison of the Cleaning Efﬁcacy of Different Final Irrigation TechniquesAbstract IntroductionThe aim of this study was to evaluate the removal of dentin debris from artiﬁcially made grooves in standardized rootcanals by 6 different ﬁnal irrigation techniques.MethodsConventional syringe irrigation, manual dynamic activation (MDA) with tapered or nontapered gutta-percha (GP)cones, the Safety Irrigator system, continuous ultrasonic irrigation (CUI), and apical negative pressure (ANP) irrigationwere testedex vivo in 20 root canals with a standardized, debris-ﬁlled groove in the apical portion of one canal wall.After each irrigation procedure, the groove was photographed, and the residual amount of dentin debris was scored.ResultsThere was no signiﬁcant difference between the MDA with a nontapered GP cone, the Safety Irrigator, and the ANPirrigation. These techniques produced better cleaning efﬁcacy than syringe irrigation (P .005) but signiﬁcantly worsethan the MDA with a tapered cone (P .05). CUI was signiﬁcantly better than all the other techniques tested in thisstudy (P .001).ConclusionsCUI was the most effective technique in dentin debris removal from the apical irregularities, and syringeirrigation alone was the least effective. MDA technique was more effective with a tapered GP cone than witha nontapered one. Jiang LM, Lak B, Eijsvogels LM, Wesselink P, van der Sluis LWM - J Endo 26, April 2012