Barry Musikant

1. Simplified Endodontic Techniques (S.E.T.) allow for rapid completion of root canal therapy. 
2. The results are better than the results of techniques of lateral condensation and thermoplastic methods. 
3. S.E.T., as the name implies, makes the process significantly easier 
4. Not only is S.E.T. a better and easier technique, it is less expensive to the dentist.

The disadvantage of the traditional step-back shaping with .02 tapered stainless steel K files and lateral condensation: 

1. Sizes larger than a #25 stainless steel reamer or file produce apical distortions when negotiating around a curved canal, something that is done in the majority of cases. 
2. The push-pull stroke often advocated in this technique tends either to impact debris near the apex, preventing the patency needed for complete instrumentation, or to push excessive debris beyond the apex, resulting in an increased frequency of post-operative flare-ups. 
3. Because of the minimal .02 taper (close to parallel) it is easy to push the fitted gutta-percha points over the apex during vertical condensation, introducing a major inaccuracy from fit to fill.
4. Wispy, uncondensed fills often occur in this technique because: 
• The .02 tapered preparations do not allow a gutta-percha point of adequate dimensions. 
• The cement interface is not covering the entire internal root surface. 
• Less vigorous lateral and vertical condensation is used to prevent overfills.
5. Excessive lateral stress to the root may be produced by either the tapered spreader or plugger.

The disadvantages of crown down rotary instrumentation coupled to obturation with thermoplastic gutta percha on a carrier:

1. An inadequate cement interface because of the small amount placed initially, a necessity due to the blockage of the coronal escape route inherent with this type of obturation. 
2. Shrinkage of the gutta-percha over a period not less than 45 minutes, far surpassing the recommended 10 seconds of apical pressure applied to compensate for the shrinkage of the cooling gutta percha. 
3. Difficulty in removing the carrier when a post-hole or retreatment is necessary. 
4. Apical denudation of the gutta-percha exposing the carrier when going around a curve. 
5. The recommendation of crown down rotary Ni-Ti is associated with greater time consumption, a higher incidence of fractured instruments, expensive gutta-percha points, expensive Ni-Ti rotary instruments, expensive reduction hand piece and motor, and an expensive gutta-percha heater.

The disadvantages of GT files used with a balanced-force technique: 

1. Balanced force is a high-torque technique that places high levels of stress on the instruments when clockwise and counterclockwise pressure is applied, causing a greater incidence of fractures. 
2. Recognizing the high possibility of fracture, it is recommended that the GT files be used very few times before replacement, making the technique quite expensive and still unpredictable. 
3. Prior to fracture, the GT files show no visible signs of fatique, therefore not letting you know when to replace them. 

In contrast, S.E.T. provides the following advantages: 

1. Eighty percent of the instrumentation is performed with tough, inexpensive .02 tapered stainless steel hand reamers using an exaggerated step-back sequence preventing distortion of the canals, fracture of the instruments, and the creation of an .05 taper through a size #45 reamer. 
2. The #2 Peeso reamers are used in a crown-down fashion to open the coronal aspects of the crown allowing further instrumentation in a non-stressful manner. They are safe and inexpensive, and when they do fracture, it is along the shank, so they are easily removed. They are used about four times at different phases of canal preparation. 
• After the #20 reamer has gone to the apex, the #2 peeso goes apically approximately one-third to one-half the length of the canal, depending upon its curvature. 
• After step-back to a #45 stainless steel .02 tapered reamer, the #2 Peeso is easily advanced one or two additional millimeters. 
• After use of the #30 .04 tapered Ni-Ti reamer, but before the use of the .08 GT file. 
• Occasionally the #2 or #3 Peeso is used coronally to make sure that the medium point goes to the apex. It can also be used in this manner to fit a large point. 
3. Peeso reamers are much easier to master than rotary crown-down Ni-Ti files and also are a fraction of the cost. 
4. To maintain the anatomy of curved canals, S.E.T. uses Ni-Ti instruments, but only manually. It alternates between .04 tapered non-aggressive hand reamers that are advanced to the apex without a significant bind into the dentin. This prevents major torque to the shank, which minimizes the incidence of fracture. The highly aggressive GT files are used in such a way that they are predominately employed as sizing instruments that gently plane the dentin rather than as the cleaving instruments they were designed to be.

    This sequencing is necessary because it became obvious that if GT files were used as advocated by Buchanan they had a high incidence of fracture that would not be completely eliminated even with minimal usage before replacement. Ni-Ti instruments and the balanced force technique are not compatible and will lead to rapid and unpredictable failure of the instrument. S.E.T. does not use the GT files with a balanced force technique where cleaving of the dentin results. Rather, it uses a modified light-handed technique that planes the dentin off, resulting in much less torque to the instrument and a minuscule chance of fracture. A financial benefit of S.E.T. accrues from the multiple uses of GT files before they must be discarded. 
5. With S.E.T., obturation consists of thoroughly coating the canals with EZ-Fill epoxy resin cement, using the patented bi-directional spiral that directs and controls the flow of cement and a single gutta-percha point, either fine medium, medium, or large, depending upon the canal’s dimensions.

   The placement of the point is left undisturbed because there is no subsequent vertical or lateral condensation. The highly radiopaque epoxy cement neither shrinks nor expands. The gutta-percha expands approximately 1.75 percent because it goes from a room temperature of 24 degrees Centigrade to a body temperature of 37 degrees Centigrade. The E-Z Fill Cement is non-inflammatory even if over the apex, resorbed outside the canal, and has the strongest bond to dentin of all root canal cements.