Successful Root Canal Therapy with EdgeOne Fire
While there are now many options for dentists and endodontists when it comes to file systems, choosing to integrate EdgeOne Fire reciprocating files into my routine has reaped numerous benefits on both sides of the chair. Our office accepts insurance, so implementing a cost-effective file system like EdgeOne Fire allows me to pass those savings on to my patients. As a user-friendly reciprocating system, the steps required to achieve successful endodontic therapy are very straightforward and the system is both simple and efficient. This means I can schedule longer appointments and spend more time educating patients about their oral conditions and options before treatment begins.
Clinical Examination and Diagnosis
A 57-year-old male patient presented with acute pain to his upper right side. He complained of pain on biting and lingering sensitivity to hot and cold. A limited examination was completed and a periapical radiograph was taken. Tooth No. 3 had a previous history of a large amalgam fi lling with close proximity to the mesial buccal pulp horn (Figure 1).
Upon clinical examination, the amalgam margins appeared to have poor integrity with possible recurrent caries. Radiographic examination revealed widening of the periodontal ligament on the mesial root and associated periapical pathology. The patient had pain to percussion on tooth No. 3 with lingering pain to cold. He had no mobility, edema, or erythema evident in surrounding soft tissues. A diagnosis of irreversible pulpitis with periapical pathology was determined.
Treatment Recommendation
The recommended treatment was root canal therapy, a post and core buildup, and a zirconia crown. The need for a post and core was discussed with the patient and deemed necessary due to the amount of missing tooth structure that would be present after removal of the amalgam and any recurrent caries. The need for a zirconia crown was determined due to the patient’s history of bruxism and previous history of fracturing other porcelain crowns and layered ceramic crowns. Prior to the root canal visit, the patient was advised to complete a course of antibiotic therapy.
EdgeOne Fire in Action
After placing benzocaine topical anesthetic, the patient was injected with 1 carpule of Septocaine 4% with epinephrine 1:100,000 (Septodont) to anesthetize tooth No. 3. The tooth was accessed using a 556 carbide bur (SS White). Three canals were located and working lengths were established using a size 10 Edge K-File (EdgeEndo). The EdgeOne Fire reciprocating file shaping system was used to instrument the canals to the previously determined working length. Instrumentation was completed to length with the red primary EdgeOne Fire fi le (25/.07).
The canals were irrigated with copious sodium hypochlorite, dried (EdgeOne Paper Points, EdgeEndo), filled with gutta percha (EdgeOne Gutta Percha, EdgeEndo), and sealed with a ready-to-use bioactive paste (NeoPRO Bioceramic Sealer, EdgeEndo).
A Successful Outcome
A postoperative radiograph was taken immediately after root canal therapy (Figure 2) and a temporary filling material was placed (Cavit, 3M). A 24-hour follow-up revealed the patient had tolerated the procedure well and was asymptomatic. His previous complaint of temperature sensitivity had subsided, and after 1 week the patient stated he no longer had pain to biting and was able to chew normally. The EdgeOne Fire reciprocating file system—in tandem with EdgeEndo’s paper points, gutta percha, and bioactive sealer—was an integral part of this patient’s successful root canal therapy.
