In this special video for our RU-vid viewers, Dr. Nasseh discusses and demonstrates apical gauging in large anterior canals. With a special thanks to our RU-vid viewers for their loyalty and patronage! :)
Thank you for discussing this subject, which is an everyday decision in the clinical routine, and also lacks more literature. Congratulations on your 50K subscribers.
THANK YOU Dr for your videos. It goes without saying you’ve inspired me to be passionate with what I do and to love Endo. I like to add that your videos keeps us always reminded of the real principles that endo is based on. Again thank u for sharing the blessing of knowledge. Greetings from Egypt 🇪🇬♥️
Thank U doctor for your interesting videos as usual May I ask How did you know that the file which 3 mm away from the apex is gonna eliminate all the biofilm there ? Maybe the biofilm was inflitrating deep in dentin the apical third than the width of flutes of the files and need more wider apical diameter file?
Great question. Like anything else, I think there's a certain amount of doubt we just have to live with. We currently can't know the information you want to know; so we're left with approximations of things we can know. Luckily, the apical third does not have the same number of dentinal tubules as the coronal 2/3 of the root. The dentin is more amorphous. So growth into the tubules is not as important as the top. Here, just cleaning the surface and slightly deeper would suffice. But I agree that the on top microbes can go much deeper. Luckily, cleaning on top is much easier with ultrasonics and irrigants than at the apex. That's why we can still expect good results despite the complexities of the root canal. Cheers!
Nicely explained boss.But can you please throw some more light on this procedure in narrow canals of posterior teeth most probably maxillary. What are the chances of file separation? I really appreciate any help you can provide.
Sorry for delay. I used a file that fit/engaged about 2-3mm short of the apex, which meant if I worked it down to the end I would end up touching the walls completely and cleaning with more contact the apical 2-3mm with the file. Essentially, gauging the apex first and then using.a file that would fit a little short of it to complete the corking out and cleaning of that last segment. Cheers! :)
What are you thoughts on Gentle Wave and Lasers? I see repeated cases done with this enhanced irrigation and stuff being finished at 17/04 or 20/06 and successful/bony cbct healing at 3 month recalls
First, that's something that has to be validated by independent studies. Currently, you're only seeing results from people on their board and TDO folks. They're all in financially. The only independent study out there so far is by U. of Toronto and it showed no significant difference with Intermittent ultrasonic irrigation. So, I'll pick one up myself as soon as I see actual independent studies showing success. Until then, I'd say if you want to go minimally invasive Ca(OH)2 is the better way. But better yet, enlarge to an anatomical size and you won't waste your time and your patients time with an unnecessary second visit.
Hello sir. Thanks for all the educational and informative videos. Just a random question though, who handles your youtube channel? Coz I've seen so many times that the commentator referring to you in third person. Thanks
Hi Girish! Mostly myself, when I have the time. But occasionally my staff reply to easy or repeat questions! This one is myself since it’s an original question!! 😉 Cheers!
@@AANasseh thanks for the reply. Also I'm implementing many techniques you've taught. And also ordered an ultrasonic for irrigation. Keep it up. Love from India❤️
Hi sir hope ur doing well,what if we r using zno eugenal based sealer? Cuz if we go large sizes like 50 or larger(like u did here) we essentially will have questionable tug back and we should go for mta ? Thank you
In obturation, what happens if fill the canal completely with calcium hydroxide aqueous solution/gel, and then obturate with zinc oxide eugenol cement coated on gutta percha,and seal it in canal. ???? what will happen, chemical reaction, idealistic, longevity, durability. Etc...?
All Ca(OH)2 should be removed during the second appointment and canal reinstrumented clean and fully dried (with alcohol rinse) before attempting to seal with ZOE/Gutta Percha. If Ca(OH)2 is not removed completely there will not be an adaptation of the sealer to the canal wall.
@@ZACY1234 You only need to do that for hydrophobic sealers like ZOE and Resin. For bioceramic sealers you don't need to do that. Just a paper point or two is enough. Cheers!
When you melt the Gutta Percha about 1mm above the orifice and come back immediately and plug it down with a size 10 (large) plugger. You end up spreading the mass of Gutta Percha around the orifice wider than the base of it. It looks like a nailhead in cross section and it covers the seams of sealer.
Only if adequate cleaning can not be achieved in a single visit: such as very minimally invasive preparation that does not touch most of the canal walls. That's when Ca(OH)2 is best used to further clean the walls beyond the file's reach.
