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I 35 opinion _ instruments I roots1_2010 learns how to use the instruments, the less they are used. Now depending upon your point of view, you couldconsidertheselectiveuseoftheseinstrumentsas a study in sophistication, that only the best and most trained dentists will use them safely and this is some- howaplus.Learningtouseasystemthatisdefinedby a narrow window of success may appear to be a study in professional growth. I consider it as just the oppo- site: the need to expend a great deal of energy in mastering a system that will produce results that are (at best) no better than those attained by simpler, far lessexpensiveandfarsaferapproaches. I teach many dentists, and when a dentist comes to me to learn I always ask him or her what he or she is presentlyusing.TheothernightIwasteachingadentist from Virginia who came to our NYC endodontic office. ShehadbeenusingtheGTrotaryNiTisystem.Iaskedher ifsheisconcernedaboutseparationandshesaidshe’d onlybrokeoneinstrumentinthepastfewyears. Despite that single incidence of breakage, she now takes extreme precautions not to separate an instru- ment. I then asked her how she handles curved canals andshesaidiftheyaremildlycurved,shewouldusethe GTsinadoublesequence(otherwiseknownasrecapit- ulation) after shaping the canals up to a #15 or 20 usingK-files.Ifthecanalsaremorethanmildlycurved, shewouldsendthepatienttothespecialist. As an endodontist, I have no problem in having patients sent to me, but from an academic point of view, I don’t like systems whose vulnerabilities are so obvious they force a dentist to refer. It should not be the vulnerability of the system that determines a referral. A good reason to refer is the referring dentist not being able to negotiate calcified canals, or failing at finding them. Fear of instrument breakage should not be a reason. Ironically, these referrals are made because of the fearofbreakageofrotaryNiTi.However,theendodon- tist has the same concerns, and he or she will use al- ternative means to shape the curved part of the canal atleastuptothepointatwhichtheconcernforinstru- ment breakage has passed. Certainly, if the specialist attains safer results using a more cautious approach, thedentistcouldalsoadoptthisapproach.Weteacha far safer approach and those using it find the shaping ofcanalsnotonlysafer,butalsosohighlyefficientthat thereisneveranyneedtotransitiontorotaryNiTi. I have read a number of articles about the less distorted shaping that rotary NiTi produces, but these results are always in comparison to the use of K-files used with a twist-and-pull motion. When K-files are used with a balanced force technique, the results of non-distorted shaping favour the K-files. The results will favour stainless-steel instruments even more if theinstrumentisarelievedreamerratherthanthetra- ditional K-file and it is negotiated to the apex using a tightwatch-windingmotionorusedinthe30-degree reciprocatinghandpiece.Withtheunderstandingthat boththetightmanualwatch-windingmotionandthe 30-degreereciprocatinghandpiecevirtuallyeliminate all the torsional stress and cyclic fatigue that causes rotary NiTi (and for that matter, stainless steel) to break, we address the basic concerns of dentists. Solving these basic problems gives dentists the ability to become more productive by turning out superior work on a greater variety of cases than they would have attempted in the past. Extending the den- tists’ skills by the invention of systems that produce compatibility between the metal and what is asked of it, is what progress is all about—despite being a David, itisworthbattlingtheGoliaths.(Isupposeyouhaveto beadentisttoappreciatethislastremark.) Forthosewhoareinterestedinlearningaboutthere- lievedreamersusedinthereciprocatinghandpieceand learninghowtofillcanalsthree-dimensionallywithout the need for expensive thermoplastic approaches, call me at +1 212 582 8161 for a free two- to three-hour one-on-one workshop in our office. This hands-on experience will definitely open your eyes to a far safer, farlessexpensiveandmoreefficientwaytoperformex- cellentendodontics.Informationonadditionalcourses canbefoundatwww.essentialseminars.org. Yourwalletandyourstomachliningwillappreciate thechange._ Fig. 1 DrBarryLeeMusikant EssentialDentalSystems,Inc. 89LeuningStreet S.Hackensack,NJ07606 USA E-mail:info@edsdental.com _contact roots Fig. 2 Fig. 1_Undistorted shaping even in long, curved roots. Fig. 2_Canals with curves greater than 90º can be shaped without concern for instrument separation.