GLIDEPATH TECHNIQUE
There are 4 skills that you need to know in order to produce consistent Glidepaths for safe rotary. First, find the canal. When beginning an endodontic procedure, it is useful to know the number of canals typical to a particular tooth.It is also useful to know the typical anatomic variations of the specific tooth you have scheduled to treat . When reviewing Tooth Atlas teeth, the first realization is the typical root canal system anatomy of a specific tooth is not typical at all. None are the same and that is the lesson: always expect the unexpected; no 2 root canal systems are the same—root canal systems are literally like “banners in the breeze.” They are complicated and curved, their canal walls vary from smooth to rough, from wide to narrow, or from patent to clogged with pulp, necrotic debris, or calcifications. Once you know the typical number of canals for a particular tooth and you understand some of the anatomical possibilities, then magnification and illumination are essential to finding canals. Any dentist serious about endodontic treatment should be trained in the use of the operating microscope. With an aging population and therefore aging teeth with their root canal systems, normal calcific degeneration occurs and when these pulps become nonvital, the canals are smaller and more difficult to find without magnification and illumination.
Second, “follow” the canal to its radiographic terminus (RT). While the RT is always some distance past the physiologic terminus, the RT is the best default or home base position (Figure 11). By “following” to the RT, the clinician guarantees foraminal patency, which is prerequisite for a successful Glidepath. The technique is to clean to the RT and then shape inside using a wide variety of physiologic terminus location methods such as apex locator, paper point determination, different angle radiographs or digital images, and, finally, patient response to an endodontic file passing through the foraminal constriction where a lesion of endodontic origin exists and anesthesia is not being used or wearing off at the end of a visit.
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