Doug Kase
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AN OFFICE, particularly a large office, it is extremely important to be
able to communicate with your staff efficiently and of course equally as
important, vice versa. Good intra-office communication results in
an efficiently run practice. When your front desk can notify you that your
next patient has arrived, the chart is filled out, and the patient is ready
to be seated without staff members’ having to leave their posts, and without
your having to divert your attention from your present task, practicing
in general becomes that much easier. If this communication for the most
part is silent, then your patient in the chair will never have the feeling
that you are rushing a procedure to move to your next appointment. For
some strange reason, screaming down the hallway just doesn’t set the right
professional atmosphere. Additionally, a silent communication system becomes
much more important with the increased need for confidentiality when communicating
information regarding patient treatment.
When I talk of silent communication, I am referring
to a light signaling system. For years, dating from the time when our office
was originally built, we used the Visicom system with a series of indicator
lights and private intercom. As the office aged, so did the system, and
eventualy it suffered from old age. When we reconstructed the office, we
considered a new Visicom system; however, that system’s higher cost and
our history of repairs led us to choose the Comlite 4000 series unit (Figure
1). This very affordable system offered a quiet and discreet way to communicate
our intra-office messages, such as “new patient arrival,” “important phone
call,” “patient seated,” “come to location,” and “personal message.” The
system uses lights and chimes to communicate these messages. Since it was
similar to what we had and so easy to customize to our needs, the transfer
and learning curve for our staff was quick and easy.
The Comlite 4000 series we chose was the LAS4000,
which also includes voice intercom communication, which can be routed to
any of the 17 individual units we have throughout the office. The units
can be placed on a desktop or wall mounted. There is no master unit, and
all can send or receive messages. They can be customized to your needs
with appropriate included adhesive labeling. This system uses your power
grid in your office to link up; hence all that is necessary to get started
is to just plug it in. However, in a larger office such as ours with more
individual stations, it was suggested to use the option of hardwiring the
units together using standard telephone wire to insure that all units would
communicate properly, which they did flawlessly. Using a series of dip
switches on the back, each unit was designated individually for intercom
communication that allows one to one or one to all voice communication.
The buttons can be lit in a steady mode by pressing once or be made to
blink by pressing twice and each message is followed by a pleasant chime
which is volume controlled at each unit. The LAS4000 front surfaces are
flat membranes that are easily cleaned and also can be protected easily
with additional plastic wrap for infection control purposes. These can
also be controlled with an optional IR remote up to 35 feet away, which
makes placement an easy task.
So how do they perform? I have to give them five out of five
stars. After working through some wiring issues that had nothing to do
with the system itself, they have functioned flawlessly. They were easy
to customize for our inter-office communication purposes and continue to
help maintain a quieter and less stressful atmosphere. The quality of the
voice communication feature is good when we need it and simple to implement
and direct. The Comlite LAS4000 is a valuable addition to our office.
A Case From Kase
Danger Curves Ahead!
Curved roots are a pain in the ass. There I said it. I am quite sure
we all feel the same way. You take a look at your pre-op film (see Figure
2) and say to yourself “Oy veh! Maybe with a little luck and lots
of sealer I can squash something around that curve.” With a little persistence
and patience, curved roots and curved root apices can be somewhat easily
instrumented and obturated. This case was a doozie. The need for endodontic
therapy was self-explanatory after taking a glance at the x-ray; however,
a successful completion was in question. The mesial canals were a no brainer,
so I will confine my technique explanation to the much more complicated
distal canal on tooth # 18.
To attain measurement control with my apex locator
I had to pre-bend the tip of a .08 stainless steel file at about 45 degrees,
and with very gentle hand reciprocation I was able to negotiate the apex
after a few tries. Using plenty of RC Prep and hand placement of my instrument
in the canal to apex, I placed my reciprocating handpiece on the head of
the .08 while still in the tooth and stepped on the gas. There was very
little fear of instrument separation due to the nature of the 45-degree
arc of movement from center not creating instrument stress as less accurate
hand motion could while in such a curved apex. Once I was able to move
the handpiece coronally and back apically with little resistance, I moved
on to a # 10 reamer and repeated the process, which I also did for a #
15. I then widened the coronal aspect of the canal with Gates Glidden and
# 2 Peeso reamer. I reiterated the apex with a pre-bent # 15 and
continuous reciprocation, and I continued the sequence of instrumentation
up to a # 25. I then re-widened the coronal portion with a # 2 Peeso. At
this point I started to back step with # 30, 35, and 40 one mm per instrument
and each time re-negotiating the apex with my # 25. Once this was accomplished,
I was able to move my pre-curved #30 and 35 to the apex, still using reciprocation.
Then I additionally gave each of my new NiTi instruments a bit of a bend
at the tip and under reciprocation they moved readily to the apical measurement.
The case was obturated using the standard EZ-Fill® technique, and I
patted myself on the back for mission accomplished! (See Figure 3.)
In most canals—and especially curved canals—reciprocation
is the instrumentation technique of choice. Due to the nature of the circumscribed
arc the instrument takes in the reciprocating handpiece, there is much
less mechanical stress on the instrument because you never reach and surpass
mechanical engagement. Additionally as an instrument increases in diameter
it becomes stiffer. Thus pre-programmed reciprocation in a handpiece greatly
reduces mechanical distortion or zipping of the curved canal apex because
there is no rotation of the instrument, either stainless or NiTi. Here
is a second case of a curved canal that was instrumented with SafeSiders®
and obturated with the EZ-Fill technique. (See Figures 4 and 5.)
July-September 2005
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FIGURE 1: The Comlite 4000
series unit.
FIGURE 2: “Maybe with a little
luck . . .”
FIGURE 3: Mission accomplished!
FIGURES 4 AND 5: A second
case of a curved canal.
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