Compact, cordless device provides objective evidence of canal cleanliness in just 10 seconds, boosting confidence before obturation
"I felt more confident that I could check if the canals are actually clean."
Bruce Schulman, DDS
Boynton Beach, FL
"It provides an additional objective data point of canal cleanliness."
Sayeed Attar, DDS, MS
Keller, TX
"It was easy to use and seamlessly introduce into my armamentarium."
Steven Berk, DDS
Annandale, VA
Understanding the numerous variables in root canal treatment, Dr. Mouhannad Almajdalani points to a common clinical question among his peers: “Are the canals truly clean?”
“The issue is that—even after using all known disinfection protocols—we still debate if we did a good job or not,” Dr. Almajdalani explained. With that, he embraced the opportunity to evaluate VistaApex’s Endocator for this DPS product review.
The first and only chairside device for detecting residual contamination invisible to microscopes and radiographs, the Endocator measures the amount of adenosine triphosphate (ATP) and other biomarkers present in an endodontic sample. Once the sample is added and mixed in the test swab, the tester is inserted into the Endocator and the device displays a quantitative Endoscore of canal cleanliness in just 10 seconds. A lower score indicates lower levels of bioburden inside the root canal.
“When you use this technology and see a result of 1 or 2, you can rest assured that you did a good job disinfecting those canals,” Dr. Almajdalani said. “I was blown away with the ease of use and quickness of the results. It could be easily and constantly utilized for root canal treatment.”
Seamless Workflow Integration
The Endocator’s compact, cordless design and intuitive interface allow for seamless integration into any clinical workflow. Dr. Steven Berk said, “It was easy to use and seamlessly introduce into my armamentarium,” and Dr. Almajdalani noted, “It’s fast, user-friendly, and easy to integrate into any practice. It took just a few minutes to adopt.”
“It allows us to move from art to science,” Dr. Bruce Schulman said. “It’s quick and easy to use, and it allows us to recheck results quickly. This appears to be a game changer.”
Confidence in Canal Cleanliness
The Endocator affords clinicians improved confidence by providing visible evidence of canal cleanliness while reducing the likelihood of retreatments. VistaApex especially recommends testing the canals for debris prior to obturation or before sealing a tooth with calcium hydroxide in cases when a second visit is necessary.
Seeking to verify that his disinfection protocol was truly effective, Dr. Jason Ingber noted, “It basically showed me that I need to do a better job cleaning the canals. I thought I had cleaned and shaped the root canal and would have finished it normally, but after using the Endocator, I realized I had more work to do.” Although the system adds more items to his tray, he acknowledged, “It allows for better confidence in finishing the root canal with a higher success rate.”
“A higher reading definitely makes me go back to double-check and re-evaluate the tooth. I can do additional filing and/or activated irrigation to clean out any remaining tissue/debris, when before we would proceed straight to obturation,” Dr. Sayeed Attar said, that “it provides an additional objective data point of canal cleanliness.”
Before adopting the Endocator, Dr. Casey Turner routinely questioned the bacterial load for a given tooth and whether the canals were ready to obturate. “By giving a quantity, it tells us as clinicians to dig a bit deeper into potential causes that could impede success,” she explained.
“It is a great product that helped me feel confident in the ability to get all of the canals clean during my root canal procedures,” Dr. Berk said. “On multiple occasions, it told me that my canals were not as clean as they needed to be and allowed me to rewash them.”
Dr. Schulman performed testing before and after using laser-assisted irrigation, saying he “felt more confident that I could check if the canals are actually clean.”
Application in Clinical Practice
“I had a case with a deep restoration (no caries) and prior to obturation got a very high reading,” Dr. Turner recalled. “All canals were located and I wondered why the reading was so high.” Then, she realized that the previous restoration was slightly leaking. “I corrected that, retested, and voilà—a low reading of 1,” she said. “If I had not noted the barely leaking restoration, that could have led to an unsuccessful outcome over time.”
Dr. John Sheets highlighted the Endocator’s value in a case involving “a canal with previous purulence and knowing it was ready to complete,” and Dr. Attar said it has flagged hidden anatomy he might have otherwise missed, “such as a middle mesial canal in lower first molars or additional tissue within a lateral groove or isthmus on a maxillary first molar.”
Dr. Almajdalani described one case in which he “didn’t have a buildup, so the results came back more than 60. I had to do a buildup, then tested again, and sure enough it was a 2,” noting how the experience underscored the value of the product.
Overall Satisfaction
“I would highly recommend this to everyone who does root canal treatments,” Dr. Almajdalani said. “You sleep with confidence that the tooth is cleaned efficiently, and patients have more confidence because we are using the best and latest technologies.”
“Clean canals are where it’s at,” Dr. Schulman said. “Now, we can ascertain if our treatment protocol is effective.”
Takeaways
- Delivers an adjunctive canal cleanliness score in 10 seconds
- Detects trace amounts of ATP and other biomarkers inside a root canal prior to obturation
- Lower scores indicate lower levels of bioburden inside the root canal; higher scores suggest the presence of higher levels of cellular debris
- Improves clinical confidence with visible evidence of canal cleanliness while reducing the likelihood of retreatments
