Barry Musikant
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BIT OF A DICHOTOMY exists when it comes to the excellence in results produced
by rotary NiTi instruments. As Bill Watson, a well-known endodontist
from Kansas, has pointed out, there are often collateral spaces that can
harbor tissue. Finding these canals requires placing bends on instruments
and probing the walls of the canals. Yet placing bends in this way
is difficult at best with rotary NiTi instruments, which do not take bends
well and weaken substantially when they are bent, making routine usage
of rotary NiTi instruments after bending a potential problem. Unfortunately,
NiTi’s flexibility is directly related to its fragility, magnifying its
dichotomous nature. NiTi’s flexibility is most needed in the shaping
of curved canals, but that is where NiTi instruments are most vulnerable
to functional separation.
The problem of weakening upon bending is solved
with the SafeSiders® approach. These instruments, which are all stainless
steel until the last two in the sequence, may be prebent to more efficiently
explore for collateral spaces. Once the spaces have been found with
the reamer, the probing instrument can then be attached to a reciprocating
handpiece, which will enlarge the space, debriding it in the process without
any concern for separation of the instrument or distortion of the probed
space because the motion is limited to 90 degrees.
So I look at the SafeSiders from the viewpoint that
they are designed for maximum manual exploration if so desired, yet retain
the adaptability to be engine-driven for ease of use. This duality
of usage gives the dentist the ability to comprehend the internal anatomy
with excellent tactile perception yet not have to pay for that fine tactile
perception with eventual hand fatigue when it comes to debriding these
collateral spaces through sequential canal enlargement.
In short, no other system that I know of gives the
dentist instruments that are designed to have the least resistance to apical
negotiation, bring debris coronally, be routinely prebent for fine probing
and then attached to an engine that eliminates hand fatigue without producing
distortions, excess torsional stress, or cyclic fatigue. The Endo-Express
with SafeSiders approach is thoroughly compatible with all endodontic situations
from the simplest to the most complex. The dentist does not have
to know the degree of difficulty he or she is going to face before starting
the case, which if you think about it, makes things much simpler in its
own right.
The SafeSiders produce a tapered canal preparation
equal to or better than that produced by rotary NiTi instruments, but are
far superior in finding those accessory canals that would be missed by
a rotary system that stays centered in the main canal. A far better
case can be made that the SafeSiders have a greater potential for thorough
debridement than rotary NiTi because of NiTi’s strict limitation in probing
sharp curves and the difficulty of then trying to shape them with a rotary
system. The design of the rotary systems simply does not allow for
this type of action. The fact that this limitation can be compensated
for with the use of other systems does not minimize the inadequacies of
the rotary NiTi approach to instrumentation.
The ability to consistently produce excellent endodontic
results in all the various anatomic challenges that confront us produces
confidence in the operator whether that operator is a G.P. or a specialist.
Consistently good results increase confidence in one’s own abilities as
well as the system through which those abilities work. Because I
teach the SafeSiders technique to so many people, I am constantly re-evaluating
just what this system is all about. Over a period of four years of
use and the last year of use with the instruments coupled to the reciprocating
handpiece, I have found no shortcomings attached to this system.
Some dentists voiced initial fears of the No. 2 Peeso that is incorporated
into the system. Yet, when I show them the proper use of the No.
2 Peeso, the two fears they have (strip perforation into the furca and
ledging) are no longer a concern. In fact, I learned early on in
the teaching process that many of the fears that dentists have originate
in their dental education at a point in time where they had no choice but
to accept academic dogma because they were not in a position to test the
inhibitions imposed by their teachers.
Dogma left untested can solidify into hard held
beliefs. That is part of the challenge when teaching dentists with
diverse educational backgrounds. Teaching is our new mantra, whether
we do it with the free hands-on workshops we offer in our dental office
in Manhattan or the more formal intensive two-day courses we give at the
Hands-On Dental Education Center (HODEC) in New Jersey. We find that
dentists are hungry for effective methods of producing excellent endodontic
results that are simpler, less stressful, and dramatically less expensive.
The feedback on our educational courses has been so positive that we are
in the process of expanding our commitment to hands-on education.
We believe that ultimately our own success is directly dependent upon our
commitment to the dental community and the degree of effort we put into
constantly refining that commitment.
It’s taken us more than 30 years to truly believe
that we have something of significant substance to offer our colleagues.
Active practice is an essential if we are to continue to innovate both
in products and our teaching. When asked a question during our lectures,
I always want to be able to relate what I did clinically the day before.
When we tout endodontic reality, that reality must be backed up by daily
practical experience. Without it, any dental lecturer would quickly
become hollow, if not to the audience then to himself.
January-March 2005
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The Endo-Express
with SafeSiders approach is thoroughly compatible with all endodontic situations
from the simplest to the most complex.
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