Amy Dukoff
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 DUCATION
is key at all stages of practice. A practice always in motion is vibrant
and attracts the attention of its staff and its patients. The key to being
and staying a success is always trying to better oneself. As endodontists,
we know that the more the referring doctor understands the art of endodontics
the more the patient benefits.
The general dentist plays the key role in diagnosis of
the tooth, but planning treatment in a case is difficult in itself. It’s
hard to look at a radiograph and know whether the root canal therapy failed
due to a missed canal, underfilled canal, or a crack. Whether to retreat
a case or just have the tooth extracted is usually a difficult decision.
Diagnosing the cause of pain can be troublesome to the practitioner.
As specialists, we believe that it is important
to share new trends in endodontics with general practitioners, for they
face a variety of different cases and treatment options. It is important
for the specialist to work as a team with the general practitioner, sharing
information. Staying current with the latest trends will allow the general
practitioner to better evaluate teeth that have previously had root canal
therapy, as well as diagnosing whether root canal therapy is indicated.
Endodontics has changed in many ways. Keeping up
with new techniques changes the way we evaluate previous root canal therapy.
When one encounters an old silverpoint fill without a rarefaction or symptom,
does that always mean that one should retreat? When a thin, filled case
looks good yet still has thermal and percussion symptoms, does one retreat
even if it looks “good” at first glance?
Our evaluation of previous root canal therapy has
also changed due to the way we now shape the canals. Today, we advocate
enlarging the canal system to a .08 taper with nickel titanium versus the
traditional step-back technique. Also, we encourage enlarging the apex
with a # 35 SafeSiders® reamer. The larger apex size along with the
greater taper allows for a cleaner and well shaped canal that tends to
correlate to the architecture of the canal structure. Looking at a finished
tapered canal is quite different from looking at a conventional 0.02 taper.
September - October 2005
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Keeping
up with new techniques changes the way we evaluate previous root canal
therapy.
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