Thank you so much for joining me. I wanted to share this video with you (without the usual voice over), so I could at least get this case out. Trust me, MB2s are tough and you are not alone in your endo endeavours...
Thanks for the video! Is there ever a point you just say "there is no MB2" and move on? Since about 8% of upper 1st molars don't have an MB2, you have to have run into a bunch of those cases where you find nothing.
Hi Dr., I’ve noticed in other videos that you get glide path before you get working length measurement. I learned that glide path is a reproducible path from the canal orifice to the apex of the tooth. If you measure working length with an apex locator after developing the glide path, how do you know if you instrumented beyond the working length or short of the working length when developing the glide path? For example, say you took a file to length 21 mm for your glide path, but the measured working length is 22 mm or maybe even 20 mm. I guess the main question is how do you know when is the right time to take working length?
Hello, I try to answer you The first step is canal scouting, when you try to open canal of the tooth to achieve length. You know that calcifications go from coronal to apical, and it can happen that in some cases you are not able to achieve working length immediately nor glide path. You said correctly the definition of glide path, in fact with Wave one or other single file reciprocating instrument you have to achieve length with a 15 file (wave one glider or hand instrument). Is it mandatory ? NO it depends on the skills and on the case but it's always better to do it. Since we know that calcifications go from coronal to apical you start to preflare the canal (you make the coronal part wider), in this way you remove all the calcifications that are present. You can do it manually like -> 8 file->10 file -> 15 file until you reach wl or to make it a bit faster you can use manual file in combination with reciprocation file to make the process faster. At some point you try to put the 10 file and you have your red bar and you are happy (hoping not to have perforate D: ). In some cases due to heavy calcifications it's even impossible to achieve length with a small SS 8 file so in that case you prepare up to the length that you reached and it works (make sure you didn't ledge the canal). MB2 are really tricky and sometimes they merge with MB1 so you have to also take this into account. have fun with endo, the more you do the better you become. if I made some grammar mistakes, I have to say sorry... English is not my first language !!! Byeeee
Congratulations on getting into dental school. I would take caution with this approach, meaning no glidepath. I’ve worked with this file for almost 7 years and have approximately 4000 root canals done with them. It’s taking a long time to build a little bit of confidence to be able to do this. There are some times, were 68, 10 files will not engage the MB two orifice when it’s super constricted. As well, I don’t know how this technique works with Rotary files . This is a reciprocating file and has a little more leeway for tackling cases without glidepath.
Risky approach but I assume it worked because it's reciprocate motion, otherwise no.. For me best feeling is when the irrigation needle is within apical third and moving freely :)
I agree with you 100%. I’ve now gotten probably 100 of these cases on under my belt, so I feel confident in this approach when there is no obvious canal present. I do change the file out one or two times during the initial glidepath development. And you’re right about that file moving freely right at the end. It’s like hallelujah.
Such a great question!! I was at the 45 minute mark with this case, and because the MB two little white dot disappeared, I elected to try and see if I could get any movements apically with the reciprocating wave and gold yellow. I was able to get a little bit of movement and boom, we were good to go. With regards to perforation, I’m going to try the wave of gold digging into Denton whether there is no channel and let you know. However, you are correct in using the six and eight files normally to start these types of procedures. It is taken me many years to finally build a confidence to be able to tackle this with the wave and yellow in this manner.
I use the short glide path file and it finds MB2 plus instruments it pretty fast then I use the yellow and then the red but this makes the WO system a multiple file system and very expensive lol
You bring up a really good point about multiple file system. In 90% the cases I do, it’s two files, maybe three. I reflect back on using pro taper and I just struggle with using so many files. I’ll have to try using the glidepath file, I find it was so flimsy, it wouldn’t do anything
@@AllThingsDentistry it’s flimsy but using the short one makes it slightly less flimsy Is wave one the best system you’ve used ?? Protaper is so good but it’s simply not practical for most unless if you wana reuse files and risk breaking them all the time
