Believe me, he was not less expensive. If anything, more expensive. I call
him a "factory" dentist because of the way he advertises and gets a large
flow of business through the office. And you can't leave the place without
them trying to sell you some product or service.

I can't imagine what possessed me to let him do so much work on me in such a
short time. I must have been mad.

    Oh, it's much worse than that!  (I wouldn't know how to make it
compatible with any computer ports anyhow--it's a Tele-cam--the guys
went belly up about a year after we bought the two cameras.  For that
matter, I'm too lazy to change the bulb, which burned out months ago.  I
most often use it to blow up my retro--emulsion x-rays from the viewbox
for my patients' delectation.
    For that matter, I'm using DOS-based practice mismanagement software.
It's much worse than you know, and you already know I use temporaries.

Steve

This one deserves it's own thread.... so....
##################################

Have refined my endo technic and should go ahead and share.

Am using # 6, 8, and 10 C+ files for initial negotiation.
Almost every time a #10 will go to length, don't often need
the #8, and even rarer a #6.

Using some ProLube for initial instrumentation, and only at the
beginning, alternate with NaOCl-. You will be surprised how much
detritus floats out.

To flare the orfice, am using the SX rotary file (Dentsply/Tulsa)
The trick to using this file is to use the "side" of the file, not the
tip ! Use a circumfrential sweeping motion. Then switch to The S1
to length. Irrigate often and renegotiate often with the #10 or 15 C+.
Use your #10 C+ file freqently for patency.

Now use the apex locator (am using the Parkell model) to get your
final length.  The second YELLOW light next to the red is 1/2  to 1 mm
short of the apex. If you choose to go by the RED light that's fine
but be sure to shorten you length by 1/2 to 1 mm.
dabbing a cotton pellet, plus a blast of air. By now you will likely
need to use a larger file to get an accurate reading. If the
ApxLocator is giving you some funky readouts, go to the next larger
file size until you get a consistent reading.
An apex locator is much more accurate that a length film !!!

Depending on the size of the canal use an 40/06, 30/06, or 20/06
Most times this file will not go to length. If it does, you are
finished, if not switch to the XX/04. Renegotiate and Irrigate
often, and between every file.

Once to length with your final size rotary take a hand file of the
same size and gently instrument the apex by hand.

Did I say to Irrigate and Renegotiate often ?

For the final rinse am using Chlorhexidine (CHX)
use your final size hand file, and use the entire
little ampule. (~3 - 4 rinses) you want this irrigant
to the apex, total time about 1 minute.
Again you will be surprised how much detritus floats out.

Then flush with water and dry with paper points.

You are now ready to obturate.
Try in your master cone, if it goes to length, excellent !
Am doing this dry without any sealer and use the cotton pliers
(get some nice heavy duty ones and only use them for endo,
have been using Meriam pliers for years)
You can mark the GP point with the pliers, check your length.

Re-instrument if necessary or drop down in size.

Lentulo spiral Grossman's sealer and place your master cone.
use a spreader then place one or two fine points.
Use spreader before each new point. Now cut off excess
at the orfice (important !)  
Am using a Gutta Cut for this. Cordless, and has four tips. Forget who
I ordered it from, it's not expensive <$300 IIRC, that info is at the
office.

Use the spreader again and place either one more fine (then cut)
or start using mediums.  Repeat until you can't find anymore space.
Cut off excess after no more that 2 points.

Once all canals are obturated take a #6 or 8 round surgical lenth
low speed bur and trim the GP at the orfice for a clean, smooth
divot.

Remove excess sealer with Cavilax or CaviDry on a cotton pellet.
Use water to rinse as the excess sealer and solvent floats.
Two to three rinses like this are usually sufficient.
Dry with air.

Am using ClearFillSelfEtch next, RD is still in place BTW.
Cover the orfice(s) and floor with some flowable after curing
the bonding agent. Am using 3M white. 1 - 1 1/2 mm is sufficient.
Now place Fuji 9 or composite of your choice as your build up.

Take two final films, one with RD in place and one after removal.

Check the occlusion and adjust prn.

Have had great sucess with this method and must tell you
that post op pain is almost nil.

Also you can/should give the patient at least one carpule of Marcaine.
Am using Articaine for initial local anesthesia for its quick onset,
and then giving at least one  Marcaine carpule after the the onset
of the Articaine.

OK you guys I just saved you big bucks on an CE endo course.
Am willing to send a certificate for 8 hrs. of CE to those who request
one.

\

    I think I have some of the SX files, but I don't think I've used them
yet.  My motor was set close (but not exact) to the rotary
specifications.  The Tulsa guy did come into our office.  He didn't say
anything about a circumferential motion.
    I've had nothing but trouble with my apex locator (a Bingo, and it
wasn't cheap.
    Glad to hear I'm not the only fogie still using cold GP.

Steve

Pretty much my technique also, except I obturate with a Pac-Mac.

I also often use a GG #3 and #4 to open things up a little before
the SX.

Thanks,
D