Decision No. 6: What Rotary Shaping System is the Right One for You (Figures 4a to 4e)?
Q: So many rotary systems and so little time: What really matters in rotary?
A: First, remember that the biggest difference in rotary systems is not the rotary system. It is the dentist using the system. Are you careful, do you follow the rotary companies’ specific directions for use for the rotary files that they produce, do you always use new files for every treatment, are you sufficiently irrigating, are you constantly cleaning and inspecting the file’s flutes to detect unwinding?8
Second, be aware of a company that changes its file design about as soon as you have learned the system. Any reputable system’s geometries should be able to stand the test of time. Choose a file line that has been around a few years and can demonstrate sustainability and consistency. Rotary endodontics is too challenging and too dangerous for you to be part of the market test. Let someone else do it with someone else’s patients. Not yours.
Third, the essential qualities you should look for in rotary endodontics are safety, simplicity, efficiency, and consistency. In total, the rotary file system should give you a sense of control. You tell the rotary file what to do; not the reverse, as in many file systems where the file is nothing more than a fixed taper drill. The only difference is that you are not drilling into wood; you are carving delicate human tissue. The file design you choose should reflect this understanding in every file in its sequence. Each file should have a specific purpose and you should be able to easily measure that purpose has been served.
Fourth, the best way to compare rotary systems is through your own education. Take the rotary systems that you are considering learning. Then collect 3 mandibular molars for each rotary system you want to test. Prepare access cavities and make a GlidePath in all mesial canals. Then compare the systems head to head with your dental assistant, who may also be a good and less biased observer. Shape the ML canal with one file system and the MB with another, and discover which is right for you. The best education in the world is your own!
Be sure to follow the directions for use. It will not take long to discover the rotary system that’s for you. It’s really that easy. It will be the system that puts you in control and actually does what it says it will do.
Guideline No. 6: Choose the rotary system that is best for you by testing them yourself. You will discover the truth about which rotary concept and technique is the safest, simplest, and most efficient.
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| Figures 4a to 4f. Decision No. 7: Cleaning, No. 8: Conefit, and No. 9 Oburation. (a) Conefit. (b) Image from ToothAtlas.com. (c) Pretreatment image of mandibular molar. (d) Perpendicular image of obturation. (e)Oblique image of obturation. (Endodontic treatment by Dr. Jason West.)(f) ToothAtlas image of typical atypical molar. |