HAVE BEEN RECEIVING phone calls from dentists asking questions regarding
the SafeSiders® and other endo-related questions. I would like
to share some of those questions and answers here so that others may benefit
from them. Iím sure that a lot of this Q&A applies to some of
Q: Using the
sequence presented by Dr. Musikant for the SafeSiders technique, why am
I having a difficult time getting the #2 Peeso reamer down the canals after
the #20 SafeSiders reamer?
the #2 Peeso is a large instrument that has a wide tip. In certain
tight or curved canals, going down the canal with a #2 Peeso can be very
difficult. You can ledge out if you push too hard trying to get it
down the canal at that time. When I do my instrumentation, I deviate
a bit from the sequence taught by Dr. Musikant. I would instrument
up to a #25 SafeSiders reamer and then go down with a #2 Gates Glidden
(GG). The smaller head of the #2 GG will follow the canal easily
and the flexibility of the shank will allow the GG to negotiate curved
canals better. After I have gone down with the GG, I then go down
with the #2 Peeso reamer. The path made by the GG will be large enough
to allow the Peeso to negotiate the canal with ease.
canít seem to get the Gates Glidden down to 2 or 3 mm from the apex.
What should I do?
do not have to get the GG down that far. Stop pushing when there
is resistance with light pressure. This is as far as you will
go with the GG. Trying to force the GG down beyond that point will
cause the canals to get blocked up or separation of the head of the GG
in the canal. The Peeso reamer does not have to get down to the same
length as the GG. Stop when you feel resistance.
size gutta percha cone should I use to fit these canals with?
the correct size gutta percha point depends on the length of the canals
and the width at the apex. I have four different sizes of gutta percha
points in my armamentarium. I have the medium and large points by
Dentsply and the 25/.06 and the 30/.06 points by Diadent. If the
canal is 20 mm or shorter and is opened up to a #35 at the apex, the 30/.06
will fit nicely. If the canal is 21?22 mm, I would use the 25/.06.
Anything longer than 22 mm will require the medium points. All the
above is with the assumption that the Brown 25/.08 Safesiders instrument
is able to reach the apex. If you are not able to get the Brown NiTi
down to the apex, then use the medium points and cut 1?2 mm of the tip
away. It should fit nicely.
do you remove the EZ-Fill® cement for immediate bonding?
A: You can easily remove the EZ-Fill cement using a cotton pellet
soaked with alcohol. I keep a jar of #3 cotton pellets in alcohol
just for this purpose. The alcohol will also dry up the dentinal
tubules for bonding.
do you remove the hard zinc temporary cement you use?
zinc cement can be removed using a slow-speed #8 round bur. It actually
cuts better than a high-speed carbide and is much safer to use to prevent
April - June 2006