Shaping that Produces Excellent Irrigation Proven by the Filling of Lateral Canals
As I’ve already mentioned in previous posts, I became an enthusiast for rotary instrumentation only after I became secure enough to use such a system without fear of separation. To date that state of enthusiasm is holding up since over the past 5 months of using the SafeSiders HF rotary system I have not had any separated instruments. Of equal importance, the system works with little potential for being drawn into the canal apically, something I call “stickiness” that gives me the tactile sense that what I am doing is being done with a great deal of safety.
I base this sensation and reality on the patented design of the SafeSiders HF, namely the incorporation of a helical flat that wraps around the working length of the instrument two and one half times minimizing engagement, significantly reducing the ability to be drawn in, making the instrument more flexible and providing an extra space for debris that further decreases resistance along length. It works in the handpiece at a slow 310 revolutions per minute in the autoreverse mode minimizing the potential for incurring excessive torsional stress. The autoreverse mode in turn is an excellent teaching tool that rapidly schools the dentist in using the correct light pecking motion that further enhances safety.
Now all this is well and good, but the ultimate function of any system is to cleanse and debride the canals as much as possible. One measure of cleanliness is the ability to fill any lateral canals that are present. The instrumentation system should be able to create a space that provides the adequate placement of irrigants that are activated sufficiently to attack any residual tissue and bacteria that are present in lateral space. That goal appears to be met by the SafeSiders HF instruments.
In the case shown above, please note the lateral canals that are filled at the apical ends of both roots. The sequence of instruments I used include the original 15/02 relieved SafeSider reamer driven by the 30o handpiece oscillating at 3000-4000 cycles per minute, followed by the rotary SafeSiders HF 20/02, 30/02 and 30/04. I then went back to a 20/02 original SafeSider in the oscillating handpiece to sonically activate the Irritrol irrigant (a combination of EDTA, CHX and surfactants) that produces a 99.99 % kill rate in 30 seconds. The canals were subsequently filled with a combination of 30/04 gutta percha points and EZ-Fill epoxy resin cement and the access double sealed with glass ionomer and bonded Herculite.
Over the past 5 months, with the present interruption heading into its second week as it is for many of us, I have completed a number of cases with a variety of challenges all of which have been successfully overcome using predominantly the SafeSiders HF, but with important contributions from the original oscillating SafeSiders (glide path creation and irrigant activation). That I have been able to treat these teeth without fear of separation is a delight for me and provides me with the confidence to tackle any case I may encounter.
Regards, Barry