Dentaltown December 2024 - 55
Figs. 1
Figs. 2
1
Access and locate all the
canals. Th is is a key step. Use
drilling cycles and gently
brush away 2-3 mm of dentin in each
cycle and then rinse, dry and inspect
the access cavity. Course correct and
perform another drilling cycle. On
molars, it takes on average four or fi ve
drilling cycles to pop into a non-calcifi
ed pulp chamber. Take your time
and gently brush away the dentin to
the pulp. Do not gauge the access
cavity fl oor.
The history
I developed what I call the " Slider
Gold " method a few years ago when
I started experimenting with a new
fi le system designed to fast-track the
negotiation phase (getting down the
canal). Th e uniqueness of this method
is that it supplants the use of a hand
fi le (e.g., a #10 K fi le) to negotiate down
to the canal to working length.
Before this, negotiation to working
length was accomplished with hand
fi les, and it was not recommended
to use rotary nickel titanium fi les to
accomplish this procedural step. In
my cases, I use a ProTaper Ultimate
Slider-M-wire, #15 tip with variable
taper, which is designed as a rotary
negotiator.
Th e fi le I work with was designed
to carefully negotiate down the canal
and advance to working length or
more specifi cally to patency (exiting
the foramen) so you can establish an
accurate working length from the
electronic apex locator. In my offi ce
I have used it in over 1,500 canals
and have a success rate of 80.1%. Th is
means in 80.1% of the canals, the fi le
advanced down the canal to patency
(exited the foramen), and I was able to
obtain a working length by attaching
the clip of the electronic apex locator
to the handle of the Slider.
So, in other words, I did not have
to use a #10 K hand fi le to negotiate
to patency in those canals-which
saved valuable time and enabled me
to quickly negotiate to working length
and then shape and clean the canals in
a very effi cient manner.
What about the other 20% of cases?
In those canals there was usually a
small apical curve, and it required
traditional negotiation with a #8 or
#10 K hand fi le and a small 45-degree
apical bend. No big deal! Th is is what
we have all been doing for years so we
know how to do this eff ectively.
The method
I would like to now outline the exact
method I use to effi ciently and eff ectively
negotiate and shape the canals.
DECEMBER 2024 | 55 | DENTALTOWN.COM
2
3
Obtain a stick with the endodontic
explorer (DG-16) in
each canal.
Use a #10 C 21 mm fi le and
perform a coronal negotiation.
Explore the coronal
third and make sure the canal is open
and loose (approx. 10-15 mm down).
4
Select the ProTaper Ultimate
Slider or other appropriate
fi le (400 RPM) and dip the
tip into RC Prep or any fi le lubricant.
Place the fi le into the canal and allow
it to advance down the canal. Use
passive hands and never push on this
fi le or it can separate. Take your time
and perform shaping passes. Each
pass consists of four or fi ve engagements/disengagements
of the fi le as
it advances down the canal. Irrigate
with sodium hypochlorite between
each pass. On average, it takes me
two shaping passes to advance down
to patency and obtain an accurate
working length with the Slider. If after
three passes the fi le will not advance
down to the estimated working length
or it feels as if it is hitting a brick wall,
then I stop and move to traditional
STEP
STEP
STEP
STEP
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Dentaltown December 2024
Table of Contents for the Digital Edition of Dentaltown December 2024
Dentaltown December 2024 - Intro
Dentaltown December 2024 - Cover1
Dentaltown December 2024 - Cover2
Dentaltown December 2024 - 1
Dentaltown December 2024 - 2
Dentaltown December 2024 - 3
Dentaltown December 2024 - 4
Dentaltown December 2024 - 5
Dentaltown December 2024 - 6
Dentaltown December 2024 - 7
Dentaltown December 2024 - 8
Dentaltown December 2024 - 9
Dentaltown December 2024 - 10
Dentaltown December 2024 - 11
Dentaltown December 2024 - 12
Dentaltown December 2024 - 13
Dentaltown December 2024 - 14
Dentaltown December 2024 - 15
Dentaltown December 2024 - 16
Dentaltown December 2024 - 17
Dentaltown December 2024 - 18
Dentaltown December 2024 - 19
Dentaltown December 2024 - 20
Dentaltown December 2024 - 21
Dentaltown December 2024 - 22
Dentaltown December 2024 - 23
Dentaltown December 2024 - 24
Dentaltown December 2024 - 25
Dentaltown December 2024 - 26
Dentaltown December 2024 - 27
Dentaltown December 2024 - 28
Dentaltown December 2024 - 29
Dentaltown December 2024 - 30
Dentaltown December 2024 - 31
Dentaltown December 2024 - 32
Dentaltown December 2024 - 33
Dentaltown December 2024 - 34
Dentaltown December 2024 - 35
Dentaltown December 2024 - 36
Dentaltown December 2024 - 37
Dentaltown December 2024 - 38
Dentaltown December 2024 - 39
Dentaltown December 2024 - 40
Dentaltown December 2024 - 41
Dentaltown December 2024 - 42
Dentaltown December 2024 - 43
Dentaltown December 2024 - 44
Dentaltown December 2024 - 45
Dentaltown December 2024 - 46
Dentaltown December 2024 - 47
Dentaltown December 2024 - 48
Dentaltown December 2024 - 49
Dentaltown December 2024 - 50
Dentaltown December 2024 - 51
Dentaltown December 2024 - 52
Dentaltown December 2024 - 53
Dentaltown December 2024 - 54
Dentaltown December 2024 - 55
Dentaltown December 2024 - 56
Dentaltown December 2024 - Cover3
Dentaltown December 2024 - Cover4
Dentaltown December 2024 - ElitePractice1
Dentaltown December 2024 - ElitePractice2
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