Expanded endo tip range for efficient root canal treatment

Introduction

The operation should be performed using a surgical microscope. If none is available, it is advisable to use dental loupes at least. Use of a rubber dam is recommended in all cases and is an indispensable element of a lege artis treatment. When the tips are used in the canal, dental loupes should be employed as a bare minimum at all times. In the case of deep canal preparation for the removal of broken-off canal instruments, the use of a surgical microscope is obligatory, as otherwise the risk of a perforation is too high. Canal instruments and posts can only be removed from the upper canal section without the aid of a microscope.

Case 1: Primary treatment of a tooth

Following opening of the pulp chamber with a W&H contra-angle handpiece, which also ensures optimal spray cooling, the crown pulp is thoroughly removed. In the next step, the ultrasonic tips are used in combination with the W&H Tigon+ piezo scaler. The settings of the Tigon+ are perfectly coordinated to the tips, making the instrument ideal for this purpose.

The 6E and 4E tips are then used to prepare the cavity floor, round off the canal transitions and expose the canal openings. In very narrow channels such as the MSB2 in the maxillary molars, the 3E tip should be used.

With the 3E and 6E tips it is even possible to prepare the upper sections of the canal conically at the same time. NB: Formation of steps. Applications in the canal should only be conducted by experienced surgeons. The canal can be processed in the same way with the Gates Glidden bur, although this often results in edges at the transition to the cavity floor. Any such edges can be rounded off using the 4E tip.

Following the visualization of the canals, the rounding off of the canal openings, the removal of any dentine overhangs and the preparation of the cavity floor, the canal preparation can be started. There is a whole range of manual and automatic instruments available for this purpose, but the scope of this article does not allow for them to be described in detail. It is particularly important that rinsing fluid is always employed when preparing canals. The canal should be rinsed multiple times after the use of each instrument (including when the same instrument is used each time) and in cases of complex anatomical conditions in order to remove any shards of dentine.

Following preparation right up to the final length and preparation size, the canal is rinsed as per the rinsing protocol. With the help of the 6E tip, the rinsing fluid is repeatedly activated, rinsed out and activated again for 20 to 30 seconds. This procedure is repeated until the rinsing protocol with the different, recommended rinsing fluids and quantities has been completed.
Following this step, the canals are dried and filled laterally or vertically, cold or hot, depending on the options and available materials.

Case 2: Removal of a fractured root post

The canal access is prepared as described for case 1. This should always be performed using a surgical microscope or dental loupes. In order to avoid a perforation, only the upper canal section should be prepared.

The following additional approach is recommended

Case 3: Removal of a fractured root canal instrument

These treatments should always be performed using a surgical microscope. NB: Via falsa (perforation). The treatment may only be performed once the indication has been confirmed precisely. It is important to be able to estimate the success of the treatment in advance. The surgeon must be able to assess his own skills precisely for this class of indications.

The following approach is recommended for removal of a fractured root canal instrument