Hi pierre,I think nothing is impossible in endodontics by looking at ur cases. What is the last apical size used in this case and what do u think should be the minimum apical preparation. Some endodontist say do minimum apical preparation and lot of irrigation. While some prefer maximum preparation to completely eliminate bacterias from apical region.what is ur opinion regarding this? Regards
Thanks for your nice comment Dr Narandra, I am sorry not to have given you a sooner answer, I have been busy preparing a lecture lately and I had to put my blog aside for the last two months.
Apical preparation is dictated by apical canal initial diameter, I will enlarge until no more pulp tissue can be seen in the last file flutes. NaOCl with no activation (sonic or ultrasonic) will not be of much help because it won’t dislodge pulp tissue and it will be stopped by the vapour lock. Thus, my routine goal is also to be able to reach a 35 file size for my apical preparation since it is the minimum that would allow for passive ultrasonic irrigation (PUI) with a number 15 file in straight canals. If you do not enlarge enough, irrigant will never reach the apical third and number 15 size file won’t be able to move freely into the canal when activated.
Needle size for irrigation is also important to consider, size 30 or 27 is enough. Larger gauge cannot reach canal with small diameter in apical part. I have never used a single side vented needle design because they cannot deliver the irrigation solution where it is most needed.
In this case last apical size in palatal canal is 40
Hi pierre,I think nothing is impossible in endodontics by looking at ur cases. What is the last apical size used in this case and what do u think should be the minimum apical preparation. Some endodontist say do minimum apical preparation and lot of irrigation. While some prefer maximum preparation to completely eliminate bacterias from apical region.what is ur opinion regarding this? Regards
Thanks for your nice comment Dr Narandra, I am sorry not to have given you a sooner answer, I have been busy preparing a lecture lately and I had to put my blog aside for the last two months.
Apical preparation is dictated by apical canal initial diameter, I will enlarge until no more pulp tissue can be seen in the last file flutes. NaOCl with no activation (sonic or ultrasonic) will not be of much help because it won’t dislodge pulp tissue and it will be stopped by the vapour lock. Thus, my routine goal is also to be able to reach a 35 file size for my apical preparation since it is the minimum that would allow for passive ultrasonic irrigation (PUI) with a number 15 file in straight canals. If you do not enlarge enough, irrigant will never reach the apical third and number 15 size file won’t be able to move freely into the canal when activated.
Needle size for irrigation is also important to consider, size 30 or 27 is enough. Larger gauge cannot reach canal with small diameter in apical part. I have never used a single side vented needle design because they cannot deliver the irrigation solution where it is most needed.
In this case last apical size in palatal canal is 40
Thank u doctor for your valuable suggestion. This will definately guide me in my future cases.thank u and regards