Young Bui

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?
A:  Well, 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. 

Q:  I can’t seem to get the Gates Glidden down to 2 or 3 mm from the apex.  What should I do?
A:  You 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. 

Q:  What size gutta percha cone should I use to fit these canals with? 
A:  Choosing 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.

Q:  How 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.

Q:  How do you remove the hard zinc temporary cement you use?
A:  The 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 accidental perforation.
 

FEEDBACK?

We welcome your responses and questions. 
Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail.