Thanks Dr for explaining so well and I personally feel better to handle the apical area by Manuel method of instrumentation after completing the entire length with rotary
Hi Allen! I'm a student and I find your videos really helpfull and motivating to see how you can overcome different challenges. We had a essay question in school that goes like this:" Your are doing ET on a tooth with undeveloped roots, the apex locator is giving you uncertain readings, what will you do, to still be able to use your apex locator, to determine your working lenght". My guess was apexification therapy would be the logical thing (besides checking all the usual disturbing factors for apex locator) since the open apex is the major concern. Anyway we have a verbal exam next week and I figure this topic will pop up too. Also i think it is a interesting topic and would like to hear your go on this.
Urban Chorba Good question!! The working length is a byproduct of the file touching walls as it comes out of the root. Since most pole pole use smaller size files an open apex creates a problem as the file slips through the apex without sensing any construction. The way around that is to first make sure the coronal part of the canal is dry and there are no short circuits, then use the largest file that feels resistance when it wants to get passed the apex. Depending on the opening that could be any size. You’ll have to gauge the apex to find out. You can go with series of larger files until you find a stable and consistent reading with the largest file in that series. Lastly, you confirm this length with radiographs and finally check the length with a paper point’s consistent dry-wet point just before obturation. Good luck on your exam! ;)
You all prolly dont give a shit but does someone know of a way to get back into an Instagram account?? I stupidly forgot my password. I would love any tips you can give me
@Lionel Mitchell i really appreciate your reply. I got to the site on google and I'm in the hacking process now. Looks like it's gonna take quite some time so I will get back to you later with my results.
Hi Allen. am a fan of your endo tips. i have watched all of you videos and now i am also using ESX file system. My question is Why do patients feel heavyness in jaws and the tooth treated endodontically in a single visit?
Thanks! I'm not sure what you mean by heaviness in the jaw; but if you mean pressure then it can be due to pushing more debris out past the apex which results into inflammation. The goal is to reduce debris extrusion to the extent possible by having good motion habits and being cognizant of the role of debris in post operative response. Cheers!
Great video. Dead on about ruler differences. As a hobby woodworker, I always use only one ruler or one measuring tape in set up as they vary so much. Never thought of it in dentistry but I will now.
I noticed by using endo sequence and root ZX at the same give we get false readings many times. I am not sure why is that? When I use other files it doesn't happen.
fay mansouri You need to see what you’re doing. Obviously RootZX is an established brand and files, EndoSequence or any other brand don’t differ in their length measurement. So you need to see what you’re doing that you’re getting this. Most likely you are getting a short circuit which is due to having too much fluid or a breach coronally in your access. Be sure you fully dry the access fluids leaving only fluid in the root canal. Also that the files is not touching nothing metallic coronally. Lastly, be sure you are using the largest file that can get through the apex. A size 15 is more predictable than a size 6, or 8. Good luck .
Of course not. Only if the tooth is planned for a crown. If not, then use the anatomical markings but try to stay consistent on the chosen location. Cheers.
It's equivocal. Some studies show it helps while another study shows it doesn't! I do it when a crown is needed or planned since it won't harm anyway and can potentially help with both the post op pain and definitely with the working length management.
I agree that J Morita technology is the good standard for apex location. I don’t know the cost specifically but I would think around $1000 (maybe less.)
The key to your question is the first word: if! We have no evidence currently that they can do the same thing as conventional instrumentation and give the same results. Do you know of an independent, longitudinal, case controlled clinical study comparing the two?
@@AANasseh I don't, and I would think it's in the best interest of everyone with teeth, that the dental profession conduct legitimate ethical research to find out. This hasn't already been conducted with conclusive results? I was under the impression from the opinion of other dentists that lasers are better for hygienic purposes and more precise for tissue removal than mechanical files/burrs. Any advice on what organizations or groups are doing this research?
i am just a dentistry student watching clips for my profession. in this video i've confused bcuz of that information you said " flattering cusps for better preparationing and measuring length". in class we are learning that enamel and natural tooth tissues are important and if it not necessary we should not touch them. isn't it a bit much to removing high amount of enamel to get Length correct ?
Murat Tugaç It was mentioned in the video that this is only indicated when a crown is to be made afterwards. It's not indicated if you plan to restore with a filing. If you have to do a crown you will be removing this portion anyway and you are not removing it unnecessarily.
+Darbzen if u r going to put a crown on their, u will reduce 2 mm occlusally. u might as well just flatten the cusps so it will be easier for doing WL. Also, after RCT you should take the tooth out of occlusion because it is weakened. I didn't do it 1 time and the patient came back with a fractured L wall and I ended up paying for his crown lengthening procedure. Also Endodontist Real World endo said something brilliant: you can always add some composite to make a "flat" occlusal plane.
