Hello, I'm with Wilhelm Pertot. I'm a practicing
endodontist in Paris and one of the
co-developers of the WaveOne Gold
instruments. These reciprocating
instruments exhibit a number of
enhancements over traditional rotary
NiTi files. In addition to their
incredible flexibility and extraordinary
resistance to fatigue, they have been
engineered to follow what is undoubtedly
the most straightforward protocol I've
ever seen. Let's walk through that
protocol. I want to show you the basic
step in this plastic block. Now we all
know that the plastic block is not a
tooth, but the concepts are the same.
Whether you're working in curves like
this or the torturous mesial buccal
canal on a molar. As with any file, good
access and good irrigation are keys to
success. I'm starting with my number 10
file to negotiate the canal. I'll
irrigate the space with sodium hypochlorite.
I like using a five percent
concentration. Then I drop my hand file
in and confirm patency. While at the same
time breaking up loose debris
between every step of our process. I'll
also flush the space with more sodium
hypochlorite.
Once I've established my length, I'm
going to develop my glide path. I'm using
the ProGlider® for this.
It's taken gently to length in a push
and pull motion.
The irrigation - recapitulation - irrigation
protocol is followed again. Then it's
time to introduce the primary WaveOne
Gold to develop the shape. You will start
nearly every case with the primary which
is a 25 at the tip with an 07 taper. Just
let the file do the work. The only action
you have to take is to brush a bit to
free up some space at the coronal aspect
of the canal. Don't try to push it. When
the instrument is done progressing
easily and you feel you need to put more
pressure on it, just remove it. Clean the
file, irrigate, recapitulate and irrigate
again. Don't try to make it to the
working length in one pass.
Reintroduce the same WaveOne Gold
primary. Let it cut further like you see here.
Remove it again. The flutes need to be
cleaned after every passage. It will make
your file more efficient and you will
avoid pushing debris apically. Go
through the irrigation, recapitulation
and irrigation steps again. Now you are
two or three millimeters away from your
working length. The WaveOne Gold primary
is used again in the same manner. Let the
file go, cut, out, cut deeper, out, cut
deeper, out. Every time you go in, the file
has to go deeper. Never cut at the same
level over and over again. That is how
you block a canal or create a ledge. Once
you reach length, you're done. Remove the
file. If after gauging your foramen
size is 25, you're done with the shaping.
Then it's on to good disinfection
protocol. Shaping a canal takes just a
minute or two. That will give you plenty
of time for disinfection. Remember,
irrigation is most efficient when your
shape is complete, so take advantage of
your shorter shaping time and spend more
time on your cleaning and disinfection.
Matching gutta-percha points
combined with the quality sealer complete
these steps and you are on to restoring
the tooth. Remember, no root canal is
complete without restoration done with
the same kind of care that you put into
the shaping, disinfection and obturation
of your tooth. Of course there are
variations of anatomy which require
slight modifications of the technique. We'll
address those in another one of these clips.
In the meantime, these basic steps will,
with a little practice, have you well
on your way to handling eighty to
eighty-five percent of the cases you
encounter. That's how it works in my
practice and I'm certain you will find
similar success.