Dentaltown June 2014 - (Page 26)

endodontics message board The Art of Hand Filing Dr. Scott Weed, endodontist, shares endo techniques. Dentaltown.com > Message Boards > Endodontics > Endodontics -- The ENDO Files > The Art of Hand Filing Nigel Tufnel Member Since: 07/21/04 Posts: 1, 13-14, 19, 32-33 of 83 Related Message Boards Minimal Access Minimal Access Total Filling Technique with Bioceramic MTA? Total Filling Note: Hand files, especially above a size 10 can cause problems. After a size 15/20 it's best to stick to rotary files. This has been studied. There have been over a dozen published hand-filing techniques over the years, each one with strong advocates that their method solves all problems. I'm going to explain how I think of hand files and how I use them. I use C files, D finders, K files and H files. I don't use reamers or C+ files, but I understand these files and why people use them. These are cross sections of various files used for negotiation of tight canals. Most of you probably haven't heard of. This is from a paper out of Baylor in 2007. All of these files are right-handed screws and can be advances or retreated from the canal with clockwise or counterclockwise twisting. Some are twisted blanks...some are machined. The C+ file has a 3 percent taper so it helps create more room behind the tip and is stiffer. If you're heavy-handed this may be what you need. Regardless of which files you use, it is imperative that you know what canals actually are and how they were created. Canals calcify starting at the chamber and are usually loose at the apex. This is very important to understand. For large canals, it really doesn't matter what you use... any file will sail to length easily. No technique necessary. For tighter canals, you need to be careful. For really tight canals, you need to be really careful. The techniques I use are: 1. Watchwinding. This is where you basically reciprocate the file between your thumb and forefinger as you advance down the canal. This is always a safer way to advance a file down a canal. 2. Watchwind, pull. This technique is a little more dangerous but involves watchwinding to resistance and then pulling the file out of the canal or at least out of the area of resistance. This needs to be used carefully and judiciously. Sometimes if there's a tough curve, this will straighten it ever so slightly and make it easier to manage. Never saw at the canals. And if you pull and it doesn't want to come, give it a little counterclockwise turn to loosen it and then pull. 3. Balanced forces. I use this most and it's tricky to learn. Once you learn it you can do it without even thinking. Jim Roane from Oklahoma developed this technique. You advance the file into the canal to resistance. Then you screw the file into the canal with a right-handed (clockwise) turn... 270 degrees (3/4 of a turn). Then you apply apical pressure to the file and "unscrew" it (counterclockwise) until you hear or feel a click. The click is the flutes of the file shearing off small pieces of dentin. As you engage the dentin with the clockwise "setting" motion, when you turn it counterclockwise, it wants to back out but you don't let it...so it shears off the dentin engaged in the flutes (basically strips the screw). continued on page 28 26 JUNE 2014 » dentaltown.com http://www.Dentaltown.com http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=113&t=225381&g=1 http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=113&t=223190&g=1 http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown June 2014

Dentaltown.com Highlights
Howard Speaks
Professional Courtesy
Continuing Education Update
Insurance Changes--Buyer Beware (and Be informed)
The Art of Hand Filing
The Value of Magnification, Documentation and Ergonomics
Currently In-network with a Lot of Plans
High Tech, Low Overhead
Second Opinion: What Exactly is Modern Endodontics?
Patency and Profound Anesthesia
Eliminating the Ding of Endodontics
You Should Know: EdgeEndo
Improved Dentistry through Advanced Digital Radiography
Black and White: Diagnosing Doesn’t Have to be Gray Area
Ways to Make the Internet Your Best Source for New Patients
Digital Microscopy
You Should Know: Dentyzion
Poll: Implants
Function Meets Aesthetics: Advanced Materials for Posterior Restorations
Disability Insurance, Another Look…
Inside United Concordia
Ad Index
Perio Reports
Excuse Me, I’m Talking Here
Dentally Incorrect

Dentaltown June 2014