Dental Tribune International
Clinical
The ProTaper technique: Shaping the future of endodontics

February 18, 2009

There are enormous differences in opinion regarding the best methods for shaping root canals. A review of the literature reveals virtually no agreement on a variety of fundamental clinical issues. There is ongoing controversy regarding the sequence of canal preparation, working length, and the use of patency files. There is vigorous debate related to the question of how large to prepare the apical foramen. There is no consensus regarding deep shape, or what is the appropriate percentage taper of a canal that ensures a root canal system can be both three-dimensionally cleaned and filled. There is confusion trying to identify and integrate the best technologies and instruments.

Evaluating instrumentation techniques

February 18, 2009

With the continuous introductions of endodontic rotary files, recommended techniques for their use seem to proliferate even more rapidly. Although a desired canal shape can be prepared with virtually any series of instruments, voices of advocates confuse the choices with differing and sometimes conflicting approaches for accomplishing that shape. One is inclined to ask, “Can they all be right?”

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Endodontic success: It’s all about the apical third

February 18, 2009

It goes without saying that as professionals we should strive for the highest success possible. Yet, defining and determining long-term success isn’t always black and white. For example, is a tooth that hurts while chewing really a success? Some say yes—it’s still in the mouth. I have a problem with that kind of thinking. Successful cases should be fully functional and pain free. Similarly, how much time should elapse until you can consider a root canal treatment successful? Three years is a common figure. Inadequate and even very poorly done root canal procedures often last at least that long—or even longer—thanks to an efficient immune system.

New possibilities for managing severe curvature: The Twisted File

February 18, 2009

Definitive competent management of apical third anatomy, especially severe curvature, is the net result of performing all the previous steps (beginning with access) in treatment correctly. In essence, the final desired result is an accumulation of many small steps that were optimally performed. The converse is true. Many of the strategies described in this paper can be used with any rotary nickel titanium (RNT) file system. The purpose of this paper is to describe, in a sequential manner, what I believe to be the optimal strategy going forward to manage this case and do so using the new Twisted File (TF) (SybronEndo). (Fig. 2.)

Aesthetic restoration of posterior teeth with composite resins and ceramic inlays

March 17, 2008

The restorative dental treatment possibilities available to practicing dentists have grown immensely over the past few decades. Considerable progress has been made in the development of composites. Problems which were encountered with earlier materials, for example, polymerization shrinkage, excessive wear and lack of shade stability have been resolved in the meantime.2,9 The current developments of a number of manufacturers are focused on further improving the biocompatibility of their products.2,8

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