New endodontic order

Nickel–titanium (NiTi) rotary files were a great invention that changed the world of endodontics, and the science of this alloy keeps on developing. In 2006, the first heat-treated files were released, a game-changer in the production of rotary files. The changes brought additional flexibility and torque resistance, increasing the safety of using NiTi rotary files. More recently, through yet another innovation in this field, flexibility and cutting resistance were combined in one file. The ZenFlex and Traverse files (Kerr Endodontics) have opened the way for a new era in file production. This innovation will give us the opportunity to use files in a very simple sequence whether in primary treatment or retreatment (Fig. 7).

Zero apicectomy, the art of combining root canal treatment and microsurgery to preserve tooth integrity and no longer removing the apex, has been proved a very successful technique not only in preserving the tooth structure but also in recreating a new periodontal ligament where the bone can grow vertically—an idea that was impossible before—in order to save the natural teeth, a new approach in endodontic microsurgery. In a trauma case in which there was an absence of cortical bone and apical bone around the mandibular central incisors and a very deep pocket reaching the apical area, a zero apicectomy and a root canal treatment were done, and 18 months later, against all odds, the bone had grown vertically, covering the buccal part of the root almost completely, and the apical bone was completely restored (Fig. 8).

These ideas and more are based on understanding what the problem is and how to create solutions that are focused on the preservation of teeth in their natural environment.