You Can Have Both Rotation & Reciprocation 

You Can Have Both Rotation & Reciprocation 

Brasseler’s innovative approach to root canal therapy combines the safety of reciprocation with the efficiency of rotation to preserve more dentin and save time

For endodontists, root canal therapy treatment plans have typically fallen into one of two approaches. Rotary file systems, in which the fi le rotates down the canal to the apex uninterrupted, tend to be favored by experienced endodontists for their greater effi ciency, while reciprocating file systems, where the file cuts in a back-and-forth, washing-machine motion, tend to be preferred by newer clinicians due to their increased safety and simplicity.

Now, thanks to a new file system from Brasseler USA, you can have the best of both worlds.

The ESR (EndoSequence Reciprocating) CM file system, combined with the EndoSync Plus handpiece, allows the file to rotate down the canal until it meets resistance, and then automatically switches to reciprocation to ease through the tight spots. Endodontist and educator Allen Ali Nasseh, DDS, MMSc, says that this technique pays off in 3 big ways:

1. Greater efficiency when the going is easy, and greater safety when the canal is tighter

2. A more conservative preparation that preserves dentin coronally

3. The ability to combine reciprocating-motion canal prep with hydraulic condensation obturation

The ESR CM, part of Brasseler’s EndoSequence family, incorporates small improvements that make a big difference. “This combines the advantage of the safety of reciprocation with the effciency of rotation, and as a result, you do not have to do so much dentin removal as is typical with conventional reciprocating fi les,” Dr. Nasseh explained. “This gives us the ability to marry hydraulic condensation obturation with reciprocation.”

Here’s how the ESR CM stacks up against competitors’ reciprocating files:

• A proprietary heat-treatment process allows maximum flexibility to respect the anatomy of the canal. The ESR CM is up to 3.3 times more flexible than competing systems and has up to 3.6 times more resistance to cyclic fatigue.

• A thinner fi le core size diminishes the risk of excessive dentin removal coronally. That improves tooth structure, reduces fracture stress during RCT, and prepares the way for obturation via hydraulic condensation.

• With a reverse-cutting flute, modified triangular cross-section, rounded safety tip, and constant-taper shape, the fi le is optimized for reciprocation and accommodates rotation.

The ESR CM system comes in 5 sizes: #15 (03) scout fi le; #25 (06) triage fi le; and #30, #40, and #50 (04) finishing files. “Typically, I use the scout fi le to find working length, and then I use the triage fi le to determine the complexity of the case,” said Dr. Nasseh. “If it reaches the apex easily, I can finish with the #30. If not, I may finish with the #40 or occasionally the #50.”

Using the EndoSync Plus with Optimum Torque Reverse technology, clinicians can adjust the torque threshold from a low of 0.2 Ncm to a high of 1.0 Ncm. When torque hits the threshold, the handpiece automatically switches from rotary to reciprocating motion. “This gives you a happy medium between rotation and reciprocation, which you can adjust depending on preference and the needs of each case.”