Hi, I'm Cliff Ruddle and I'm really happy to be with you today
and spend a little bit of time learning more about endodontics together.
There's an excitement in the world of endodontics
with the dedicated mechanical file called [WaveOne] Gold® Glider.
Gold Glider as its name implies,
is a heat-treated file.
The file's heated up to a proprietary temperature,
allowed to cool down,
and you have some significant metallurgical changes.
It shows up as, number one - a very, very big improvement in flexibility.
Also, heat treatment technology massively improves the resistance to cyclic fatigue.
So think about this instrument, towards its terminal extent,
snaking through a secured canal with a 10
and how it can get down there to achieve length.
Another important concept is, it's not a fixed tapered file.
Rather, it has multiple progressive tapers over its active portion.
And this means that the file does most of its work in the body of the canal -
the coronal one-third and the middle one third.
The apical one-third of this instrument just is pretty passive
and generally will then just follow
the pathway that the ten file achieved before it.
So, how does this instrument fit into
the traditional size 10 and 15 manual files?
Well, you can look carefully, and if you look at D0,
the Gold Glider is about the same as the 15 file,
gets a little bit bigger D4,
but we really start to see big,
bigger diameters at D8, 12, and 16.
And this would explain precisely why the instrument works
and is a pre-enlarger or a pre-shaping file,
because it's doing a lot of work up in the body of the canal.
This gives a bigger pathway then for the shaping file to follow.
So I propose, I would invite all of you to consider
dumping, getting rid of your 15 file,
because it is stainless steel,
and moving to a much more flexible
file that has resistance to cyclic fatigue.
And again, the good news is, it's just still two files.
The better news is, it makes a significant bigger pathway to length
than the 15 stainless steel hand file.
I like to use a plastic block that has a challenge.
A lot of colleagues will use a block that is called a J block
but this is the S block, and the S block
is a nice challenge in that it has multiplanar recurvature.
Also, we can see in the plastic block
when a file cuts,
how it cuts,
and we can see the debris that's being generated.
And we need to really then appreciate that what we see in this plastic block
is what's going on in the teeth inside the patients that visit us daily.
Let's take a look.
So if we draw a tangent line to the first curve,
relative to the straight away portions of the canal, that's about 30 degrees.
And if we draw a second tangent line to the second curve, relative the first curve,
that's about 35 degrees.
So you can see this is a good little challenge.
So we use isopropyl alcohol in the block,
but notice that how little the reciprocation wiggle is.
There's not these big gross movements.
When you get about a stops short, just slide in.
No reciprocation on the handle.
This is when you would get working length.
Once you have a known working length,
use intentional, deliberate,
and repeated little short, quarter of a millimeter strokes
to confirm patency.
With a known working length and a patent canal,
check the glide path.
Pull a stop, back a stop.
Two stops, three stops.
And if we can slip and slide -
slip, slide, and glide over that apical one third,
not only do we have a glide path,
we own the glide path.
And mechanical instruments will follow.
Everybody at home should say "follow".
Well here comes our Gold Glider
and notice it's cutting a little bit more up in its body.
The tip is just following the slide path from the 10.
And notice as we work, we brush a little bit.
That relieves pressure on the instrument,
allows debris to auger.
But the tip again is pretty free.
It's very little work done in the last 2-3 millimeters of a Gold Glider.
This is pre-enlarging the canal
and it's a pre-shaping file.
We're going to need a motor to drive this file in its unique bi-directional movement.
And the good news is, if you were a WaveOne® user,
you already have the motor that has the presets for you.
However, if you are interested in this technology,
which I would invite everybody that's serious about clinical endodontics to do,
then you would want to buy the X-Smart IQ™ motor.
This motor has a lot of capabilities
and they'll be other webinars to fully explain
how it can really help us with patient education,
storing and transfer of information,
and doing a variety of other things
like measuring to working torque and all that.
But we would want to operate at between 4 and 5.2 Newton centimeters.
That would be, some would consider, kind of a high torque
for a small file, but that's what it was validated at
over many years. So that is the torque, 4 to 5.2,
and the rotational speed is 300 rpms.
So,
go ahead and chuck up the instrument and bring it in.
Kind of get back on your handpiece
and try not to hold it so close to its most distal end.
Don't be pecking.
Let it run.
Let it float and follow.
And let it progressively advance along the glide path.
Lift it up a little bit on occasion,
and that'll let the debris more fully auger up the flutes and into the pulp chamber.
Sharp active blades can engage and help advance the file towards length.
So in one, two, or three passes, we can typically achieve length.
Well, you can still see that there's a lot of
debris left behind in the lateral anatomy
but we have a super smooth and reproducible glide path.
Now one last comment.
In shorter, wider, and straighter canals
you'll probably be able to achieve length in one single pass.
However, in longer, narrower, and more curved canals,
that's where it might take a second or third pass.
In between the passes we would irrigate the canal to remove debris.
We would clean the flutes on the file.
We would use a 10 file and go back to the terminus
to make sure that we had our glide path,
and then we re-irrigate to liberate that debris.