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Medical Forum / General / Dentistry / May 2007how to deal with curved root canals without NiTi files?
I am trying to treat the upper first molar with curved root canal. The ploblem is I'm doing it in a small community hospital where have fews insttrnents. There is no NITi files. How can I deal with these curved root canals with K-files or H-files and not to create ledge or lateral perforation? Thank you very much If you feel you can't do the endo, then send them to someone who can. If that is not possible, be honest with the patient and either take the tooth out or try your best with the endo (with the patient knowing this situation maybe beyond your experience). By the way, NiTi files only do the shaping...you should get to length with at least a size 15 hand file anyway. At least that is how I was taught and how I use NiTi files. Out of curiosity, what did they teach you in school about NiTi files? John if you don't have niti files, why don't you just buy some? they aren't tremendously expensive. if it will make you more comfortable to do the case get them, but i tend to agree with john, if you don't have the right tools probably should refer. >if you don't have niti files, why don't you just buy some? they >aren't tremendously expensive. if it will make you more comfortable >to do the case get them, but i tend to agree with john, if you don't >have the right tools probably should refer. The files may be reasonable but you must use a torque controlled motor for the rotaries. Not so inexpensive. > >if you don't have niti files, why don't you just buy some? they > >aren't tremendously expensive. if it will make you more comfortable [quoted text clipped - 3 lines] > The files may be reasonable but you must use a torque controlled > motor for the rotaries. Not so inexpensive. they make very flexible hand files. don't need a engine. just takes a lot longer. >>> if you don't have niti files, why don't you just buy some? they >>> aren't tremendously expensive. if it will make you more comfortable [quoted text clipped - 5 lines] > they make very flexible hand files. don't need a engine. just takes > a lot longer. I find hand NiTi files to be just about useless. But an endodontist I know taught us the "balanced force technique" which can easily be used with small stainless steel K-files, and it works pretty well negotiating curves near the apex. Steve >>>> if you don't have niti files, why don't you just buy some? they >>>> aren't tremendously expensive. if it will make you more comfortable [quoted text clipped - 12 lines] > >Steve Please explain the "balanced force technique". > Please explain the "balanced force technique". I was looking for a good web explanation, but haven't found one yet--only some evaluations of the technique: http://tinyurl.com/2f6k4d As I remember it, once you have established measurement, you use this as a crown-down technique. The instrument is inserted until it JUST binds. It is then rotated 1/2 turn counter-clockwise. The flutes are supposed to cause the tip of the K file to follow the curve of the canal. The instrument is then rotated clockwise to JUST engage the dentin, and withdrawn straight out. Patency and measurement are re-established with small instruments, as you sequentially use smaller instruments to work toward the apex. I use this only very occasionally--usually rotary. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Please explain the "balanced force technique". > [quoted text clipped - 14 lines] > >Steve Thanks Steve, you da man ! >> >if you don't have niti files, why don't you just buy some? they >> >aren't tremendously expensive. if it will make you more comfortable [quoted text clipped - 6 lines] >they make very flexible hand files. don't need a engine. just takes >a lot longer. Yeah, I know, but what's the point ? Modern endodontic therapy is all about rotary IMO. > I am trying to treat the upper first molar with curved root canal. The > ploblem is I'm doing it in a small community hospital where have fews [quoted text clipped - 3 lines] > > Thank you very much Dentists managed to do root canals for decades before NiTis appeared. That said, NiTis would be able to better negotiate root canals without zips/transportations. Depending on how curved the roots are and where the curves are, you might be able to use hand files and gates and achieve a good result. Be careful with the gates and don't attempt to take them past the curve and it'll be fine. >I am trying to treat the upper first molar with curved root canal. The >ploblem is I'm doing it in a small community hospital where have fews [quoted text clipped - 3 lines] > >Thank you very much Start with a 10 or smaller (8, 6) use frequent recapitulation and copious irrigation. Hedstrom files can be useful in these types of cases. Take your time and all should be well. take it up to a ~20 or larger and make sure your master cone goes to length. Ditto Work the small size files a lot. Signature/ Amatus / > >>I am trying to treat the upper first molar with curved root canal. The [quoted text clipped - 11 lines] > take it up to a ~20 or larger and make sure your master > cone goes to length. |
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