Minimizing the Mysteries of Root Canal Treatment

Education, experience, and product advancements have made endodontic treatment a cornerstone of dental care among general dentists and specialists

Root canal therapy has come a long way over the past 20 years, thanks to advancements in education, technology, and technique. As a result, general dentists and endodontists today have a greater rate of success and are able to provide better patient care than ever before. With proper training, experience, and an understanding of one’s own limitations, the general dentist is able to successfully provide endodontic treatment inhouse, offering a service that’s convenient for patients and a true practice builder.

“Sound endodontic therapy is based on several principles, all of which must come together for success: proper diagnosis, access to the canals, thorough canal cleansing, proper canal shaping, and complete obturation,” said Dr. Eugene Antenucci, an author and educator with a general dentistry practice in Bay Shore, NY. “It all begins with education beyond dental school. Advanced courses abound, providing access to the brightest minds in the profession and the highest levels of information available. With education and practice comes experience.”

The mysteries of endodontics are minimized thanks to advances in visualization. For example, 3D cone-beam imaging has transformed the ability to diagnose and plan treatment. Coupled with magnification—loupes, headlights, and microscopes—clinicians have a greater ability to visualize details and anatomy, and achieve successful outcomes. Instrumentation and materials also have evolved significantly, streamlining workflows and enabling more minimally invasive endodontics. “Proper shaping and cleansing of the root canal system is enhanced by reciprocating and rotary systems, along with space-age materials for files,” said Dr. Antenucci. The advent of nickel–titanium (NiTi) rotary instruments and their advancements over numerous generations have greatly improved the quality of the cleaning and shaping procedures while minimizing procedural errors.

This is combined with irrigants that optimally remove debris and disinfect canals and easy-to-use devices that accurately measure the length of the canal. Finally, Dr. Antenucci notes that proper obturation is facilitated by advanced materials such as form-fitted gutta-percha points and heated units for a complete apical seal of each canal.

“Whether being performed by a GP or endodontist, it is clear to see that the practice of endodontics today is not the endo taught in dental school,” Dr. Antenucci said. “Dental school provided the sound and universal basics to endodontic therapy. Leaders in practice provide the knowledge to both generalists and specialists on how to enhance skills and improve care. Academic dentistry, along with the dental industry, continues to provide a wealth of knowledge and technological advancements that make endodontic treatment the cornerstone of dental care that it is today.”

DENTSPLY SIRONA

With over 30 years of advancement in endodontics and the experience of a global leader in the dental industry, Dentsply Sirona provides innovative endodontic solutions that are proven by science, tested by the world’s leading endodontists, and trusted by dental professionals.

A recent addition, TruNatomy is a complete clinical solution designed to respect the true, natural anatomy of the root canal system featuring an intuitive file system with an orifi ce modifi er, glider, and a single shaping file. For smaller or larger canals, TruNatomy includes 2 additional shaping files, all complemented by corresponding paper points, gutta-percha points, and GuttaCore obturators, as well as a fl exible irrigation needle.

The well-known WaveOne Gold solution brings proven products designed to work together into one endodontic system for efficiency and confidence in a variety of cases. With the addition of a glide path file, GuttaCore for WaveOne Gold obturators, Conform Fit guttapercha points, and absorbent points, WaveOne Gold offers the convenience of an entire family of products working together as a complete system.

a high-performance bioceramic intracanal medication

BRASSELER

Brasseler’s restorative endodontics portfolio features everything a clinician needs, from access and instrumentation through obturation and post placement.

The endodontic handpieces and small equipment from Brasseler have ushered in a new generation of technology for successful root canal treatments. The EndoSync Plus is the most lightweight cordless handpiece in its class at only 100 grams while also being the most powerful with a massive 5.0 Ncm of torque. Just like the original EndoSync cordless, the EndoSync Plus has the ability to seamlessly integrate with the EndoSync A.I. Apex Locator, allowing it to utilize a wide array of safety features, such as auto start/stop and apical action to prevent perforation of the apex.

Brasseler’s EndoSequence BC Sealer is a highly radiopaque and hydrophilic sealer that forms hydroxyapatite upon setting and chemically bonds to both dentin and to Brasseler’s bioceramic points. BC Sealer is antibacterial during setting due to its high alkaline pH and exhibits zero shrinkage.

SS WHITE

The endodontic product line from SS White is designed to help general dentists and endodontists effi ciently address treatment challenges and conserve what is healthy to ultimately create better patient outcomes and practice growth.

EndoGuide Burs are an excellent example of instruments uniquely engineered to increase the clinician’s visibility during canal access, minimize intrusion on healthy dentin, and ultimately retain the inherent strength of natural tooth structure to provide a stronger foundation for restoration.

SS White’s DCTaper files are anatomically designed to provide greater safety, strength, and fl exibility. The product’s name stands for “dentin conservation” and refl ects its main benefit, the preservation of as much of the natural tooth as possible. The company’s EXACTTaperH DC files have a variable taper with a maximum flute diameter of 0.8 mm to allow for better negotiation of the canal while preserving more tooth structure. The proprietary heat annealing process of the fi les provides for exceptional controlled memory, superior strength, and fl exibility.

EDGEENDO

With the belief that premium technology shouldn’t have to come with a premium price tag, EdgeEndo sells direct to dental edgeone fire professionals—seeking to provide the top quality at a lower cost.

Designed to shape canals with the same sequence and reciprocating motion as gold-treated files, EdgeOne Fire files are available in 4 sizes (20, 25, 35, and 45) and 3 lengths (21 mm, 25 mm, and 31 mm). Because of the familiar sequence and reciprocating motion, switching from previous fi les to EdgeOne Fire is seamless.

A recent addition to the EdgeEndo product family, the EdgeMorphology Variable Taper Files feature a 0.8-mm max diameter and heat-treated NiTi for strength and flexibility. The conservative fi le design means fewer fi les and greater preservation of dentin material. The fi les are available in GlidePath, Primary, Small, Medium, and Large and in 21-mm, 25-mm, and 31-mm lengths.

ULTRADENT

A leading developer of high-tech dental materials, devices, and instruments, Ultradent’s endodontic portfolio runs the gamut from repair cement to irrigants to root canal sealers.

Endo-Eze MTAFlow White repair cement is a nonstaining formula of Ultradent’s versatile repair cement, which is designed to mix quickly, smoothly, and easily for a variety of procedures. Its thin consistency can be precisely delivered into the canal with an Ultradent 29 ga NaviTip for apexification and apical plug. The repair cement has bioactive properties to promote healing, sets quickly, and resists washout, allowing clinicians to lightly rinse the area (5 minutes after placement) without dislodging.

For irrigation, Ultradent’s ChlorCid Surf features the added cleansing power of surfactant to break the surface tension and allow for better sodium hypochlorite penetration into difficult-to-reach places like isthmuses and lateral canals. The 3% sodium hypochlorite solution and surfactant, which comes in both IndiSpense syringes and bottles, allows for better wall contact thanks to its unique formulation.

HENRY SCHEIN

Henry Schein offers a full line of endodontic instruments and products for diagnosing and managing tooth pain, performing root canal treatments, and other procedures related to the interior of the tooth. Endodontic instruments include hand files, rotary files, sealers and cements, canal prep solutions, temporary filling materials as well as paper points, gutta-percha, irrigating devices, and more.

Henry Schein Brand Products include Maxima Sterile Hand Files that are presterilized and come in easy-to-open blister packs to ensure sterility. The fi les are made of high-quality steel for effectively shaping the canal, and the handles have an hourglass shape to ensure maximum maneuverability and limit finger fatigue. The Maxima Apex Locator features a 4.5-inch color LCD display and adjustable audio feedback for accurate file location information. The product features automatic calibration and multifrequency impedance-measurement technology to ensure precise measurements.

PATTERSON DENTAL

Patterson Private Label products incorporate a strong balance of quality, value, and commitment to customer satisfaction. The Private Label products feature an extensive line of endodontic products. Patterson NiTi Rotary Files have radial-landed U-shaped flutes that lift debris coronally, allowing for a crown-down technique, continuously tapering preparation from orifice to apex. The safety tip design has minimal transition angle to prevent ledging and transporting. Patterson MTA Cement is a biological sealing permanent cement used for pulp capping and root end retrograde fillings, providing an excellent barrier against bacteria and fl uids. Light gray in color, the cement is as radiopaque as gutta-percha.

KERR DENTAL

A leading innovator of endodontics technology, Kerr Dental recently launched the ZenFlex NiTi Rotary Shaping File, featuring high cutting effi ciency, an ideal balance of strength and fl exibility, and a minimally invasive design. Initial comparative studies against other leading fi les on the market indicate that ZenFlex delivers exceptional resistance to torsional stress and cyclic fatigue, while offering the fl exibility and controlled memory to accommodate even the most complex canal anatomies.

CENTRIX

Quality endodontic accessory products from Centrix offer added insurance for successful root canals. Reliable materials packaged in time-saving delivery systems make sense when performing critical endodontic procedures.

Calciject is a fine-grain, calcium hydroxide paste packaged in single-dose NeedleTube syringe tips. The high pH and bacteriostatic activity of pure calcium hydroxide paste is indicated for temporary and intermediate root canal therapy. The delivery system ensures there is no messy mixing of powder and liquid.

With the Microaspirator, which connects to your HVE handpiece, root canals and post spaces can be dried faster and easier. The tips, which are single use and disposable for complete asepsis, reach deep into the canal to remove excess moisture and debris.

DIRECTA DENTAL

Directa´s products are developed and tested by a team of highly qualified international dental professionals with the aim of making daily work easier for dental professionals.

The company’s Calasept products range from calcium hydroxide paste for temporary root fillings to a complete assortment of liquids for effective irrigation of root canals. Calasept Plus pure calcium hydroxide is a ready-to-use paste in air-tight syringe for direct application through the Flexi-Tip. The very high concentration of >41% in combination with optimal calcium ion release generates the extremely efficient and long-lasting antimicrobial effect.

Directa has acquired and will begin offering Sendoline endodontic products, including a variety of fi les, instruments, and materials. A new addition is SendoSeal MTA, a biocompatible MTA-based root canal sealer for permanently sealing canals. The easy-to-use product comes premixed in a syringe.

HAGER WORLDWIDE

Delivering products that help dental practices operate efficiently, Hager’s endodontics line includes caddies and kits helpful in streamlining procedures.

Hager’s EndoGel root canal file lubricating gel is a single-use polytube containing EDTA that chelates calcifications. Sodium hypochlorite reacts with EndoGel’s urea peroxide to produce bubbling and help flush debris from the system.

Hager’s EndoRing I, an autoclavable kit, enables clinicians to directly place, store, measure, and clean endodontic hand and rotary instruments in the operating field. The disposable foam inserts eliminate cross contamination.

Endodontic Points & Medicaments