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13EndoTribuneJuly 19-25, 2010United Kingdom Edition • Once the first HKF reaches the EWL, the clinician should at- tempt to obtain a true working length (TWL) with an electronic apex locator (EAL). It is impor- tant that if the clinician is men- tally focused on the resistance of the HKF, they may feel a tactile ‘pop’ as the HKF passes through the MC. This tactile sensation should correlate quite accurately with the measurements of the TWL obtained by the EAL. After apical patency is ob- tained, reciprocation can be in- valuable in making the canal ready for TF (and all RNT files). Reciprocation is the non-rota- tional movement of a HKF mov- ing, for example, in a 30-degree clockwise and 30-degree counter clockwise motion. This action is a highly efficient means to en- large a canal from a #6 HKF to a #8 HKF size, a #8 HKF size to a #10 HKF size, etc. One means of delivering reciprocation to a HKF is the M4 Safety Handpiece.* Clinically, to use M4 recipro- cation for the initial enlargement of the canal, the HKF is inserted to the TWL. The HKF is left in the canal and while under the rub- ber dam, the M4 is attached onto the file handle. Using a one-three mm amplitude movement for 15- 30 seconds, the HKF is recipro- cated. The M4 attachment fits into any E type attachment on an electric endodontic motor at 900 RPM at the 18:1 setting. Using the M4 clinically, in 15-30 sec- onds, reciprocating the #6 HKF placed to the TWL will create the diameter of a #8 hand file in the manner described here. Because reciprocating the #10 HKF cre- ates the diameter of a #15 HKF, the canal is ready for TF shaping. Dentin debris produced by the M4 is routinely channelled onto the pulpal floor where it can be easily irrigated away. • Prior to starting treatment, the clinician should decide what the final anticipated taper of the root will be and have some reasona- ble idea of the anticipated master apical diameter. With regard to taper, large roots are usually pre- pared to a .10 TF taper. Medium sized orifices and roots are usu- ally prepared to a .08 TF taper. Small and highly curved roots are usually prepared to either a .08 or a .06 TF taper. • To prepare the basic taper of the final preparation, TF is used in diminishing tapers to the TWL. Generally, this means that in large roots, as defined above, a .10 TF can be inserted to the TWL in approximately three- four insertions. In more inter- mediate sized roots, this means a .08 TF can be inserted to the TWL in approximately three- four insertions. In more complex roots, this means a .06 TF can be inserted to the TWL in approxi- mately three-four insertions. If a .08 taper is the final taper de- sired, generally, if the canal will accept the single .08/25 TF file, it is used with successive inser- tions until the TWL is reached. If excessive pressure is required to move the .08/25 TF down the canal, the .06/25 TF should be used instead in tandem with the .08/25 TF. If the .06/25 TF re- quires more pressure to insert apically than desired, the .04/25 TF can be used in tandem in the sequence of .08/25, .06/25 and .04/25 TF. In any event, TF (and all RNT files) are used primarily crown down to prepare the basic taper, that is, from larger tapers and tip sizes to smaller. If for ex- ample, the .06/25 was the first file in this sequence to reach the TWL, the .08/25 TF can inserted again to prepare the larger taper (.08 taper versus .06) as desired. • To prepare the ideal master apical diameter, TF is used step back, ie from smaller tip sizes to larger. With TF, this means that the .06/30, .06/35 and .04/40 TF are used in succession from the apex up. Because each of these files is only cutting on its tip, generally these files will reach the apex in one insertion. • After preparation, the canal is irrigated, the smear layer re- moved and the canal dried and obturated as per the clinicians chosen technique. Irrigation can be optimised through the use of either ultrasonic activation (Min- iEndo*) or negative pressure (EndoVac II, Discus Dental, Cul- ver City, CA, USA) depending on the clinician’s preferences. The EndoVac II uses a macro cannula EXTRAORDINARY FLEXBILITY – TF® files from SybronEndo are up to 70% more flexible than other rotary NiTi files.* The proven design of TF signifi- cantly reduces file breakage and allows you to work with greater efficiency and confidence. TF REQUIRES JUST 1, 2 OR 3 FILES FOR MOST CASES – TF’s variable pitch design and improved surface finish ensure fast, ideal canal shaping every time. CONFIDENCE IN ENDODONTICS – TF provides unsurpassed safety and ease of use. *Data on file, Sybron Dental Specialties, Inc. < This case required just 1 file. For a copy of the Single TF File Technique by Dr. Mounce, email keith.morgan @ sybrondental.com REALSEAL 1 Warm-Bonded Obturator All the components of RealSeal 1™ – sealer, filler and core – are resin-based materials that chemically bond with each other to form a superior seal. As an added benefit, this system’s core is engineered to be easily seen on a radiograph. SybronEndo Europe, Basicweg 20, 3821 BR Amersfoort, The Netherlands tel: +31 33 4536 159 fax: +31 33 4536 153 email: endo@sybrondental.com UK local number 01442 876 002 or email keith.morgan@sybrondental.com ©2010 SybronEndo EndoInnovationsIII SybronEndo offers you advanced technology for safer, more efficient procedures. Everyday Endo FEWER FILES. LESS WASTE. endo inno III uk_europe 10 july_Layout 2 6/30/10 9:23 AM Page 1 ‘TF requires fewer files, fewer inser- tions and allows the preparation of larger tapers and master apical di- ameters than many other systems.’ page 14DTà