Are endo files leaving you overwhelmed? Look for systems that give you options for all your cases
Featured Products Promotional FeaturesPosted by: Dental Design 10th October 2022
As an endodontist, you’ll know that canal preparation is key to achieving predictably successful outcomes. Quality shaping makes the removal of tissue, infected debris and other microorganisms easier; if you are doing an endo retreatment, it facilitates the efficient removal of filling material.
The instruments available for safe, ethical and comfortable endodontics mean root canals no longer need to be feared. Their bad press isn’t deserved, now that there are techniques – supported by exceptional tools and consumables – to ensure that having a root canal is often the best way to get out of pain and return to oral health. Patients can avoid an extraction – and people of all ages want to retain their natural teeth for as long as possible – and once they’ve recovered, enjoy all the benefits of full function.
Loyalty goes a long way
In today’s market, the choice of endo shaping files is vast, maybe even overwhelming – and that’s the same whether you favour rotary or reciprocating motion for your canal preparations. Although reciprocation has become an established method over the past decade, and is becoming increasingly popular among dentists, you may have remained loyal to the rotary, multi-file systems.
And why wouldn’t you? The latest generation of rotary files, created from NiTi alloys, have significantly improved canal shaping. These alloys – manufactured using thermal treatment – offer more flexibility for efficient cutting, and optimised fracture resistance. The combination of flexibility and fracture resistance means that you often only need to select one of two from the file sequence, whether you’re delivering everyday endodontics or have been presented with a complex case. Canals can be efficiently prepared, and the viable, healthy dentine preserved. You will get a good result, delivered safely, conservatively and fast.
Reciprocation and innovation
But being able to use files in a reciprocating motion will give you further options and enable use of some of the most innovative products on the market. These include files that, like the new generation of rotaries, have been manufactured using heat treatment, giving them not just flexibility, but controlled memory, also enabling curvature conservation and high cyclical fatigue resistance. These files can be pre-bent, too. Clever design makes debris removal easy, while demonstrating extreme respect for the root canal anatomy. Fans of reciprocation also say that there is less risk of fracture, and the simplified one file system cuts costs and makes the process faster. A reduced treatment time is a big selling point for patients who are reluctant to spend longer that is utterly necessary in the dentist’s chair.
But rotary files support efficient workflows too. So, what are the differences? Numerous studies have looked into both the properties and effectiveness of reciprocating files, reviewing features including shaping ability, preservation of the root canal anatomy and cleaning effectiveness. One concluded that the results, although indicating that reciprocating files are “viable alternatives” to rotary file systems “no filing system is able to entirely prepare the dentine of canals, totally eliminate sessile and planktonic microorganisms, or remove the filling material completely from the root canal system.”[i]
With no conclusive evidence to indicate that either is more straightforward and/or effective to use, perhaps personal preference is the most significant factor, when choosing preparation method and file system from the array of products out there. Proficiency in continuous rotary and reciprocation preparation techniques will give you the most options, though, and forward-thinking endodontic dentists will seek out manufactures that offer instruments that will let you do both, according to what is most appropriate to that clinical situation.
Exploring all the option
COLTENE’s endo range has file systems for whatever type of motion you prefer. Its HyFlex EDM rotary files can be used reliably by newcomers and experienced endodontists alike. Up to 700% mor resistant to cyclical fatigue compared to other NiTi files, they are flexible – literally and figuratively – and extremely fracture resistant. Fewer files will be required, for high value and fast preparation. Alongside HyFlex, and also available from COLTENE, is the MicroMega One RECI, a reciprocating file characterised by its superior cutting performance, while supporting the delivery of minimally invasive, ethical endodontics. With a diameter of just 1mm, this minimises the impact on healthy dental hard tissue when you’re doing your preparations and protects the peri-cervical area too.
For preparing root canals, endodontic dentists can choose from a wide range of files that have excellent properties, are highly effective will deliver good clinical outcomes. As reciprocation has become a more established method, high quality instruments have been developed to enable clinicians use this method, for safe, efficient and high value treatments. But as neither continuous rotary or reciprocating motion offer the answer to all cases, file systems from manufacturers that enable clinicians to do both will give you all the options to meet your, and your patients’ expectations.
For more on COLTENE, visit www.coltene.com, email: info.uk@coltene.com or call 0800 254 5115.
Author: Mark Allen, General Manager at COLTENE
[i] Plotino G, Ahmed HM, Grande NM, Cohen S, Bukiet F. Current Assessment of Reciprocation in Endodontic Preparation: A Comprehensive Review–Part II: Properties and Effectiveness. J Endod. 2015 Dec;41 (12):1939-50. doi: 10.1016/j.joen.2015.08.018. Epub 2015 Oct 23. PMID: 26480824.
