Shape Clean Pack: Glide Path Management - Irregular Glidepath: Dr. Ruddle Advanced Endodontics скачать в хорошем качестве

Shape Clean Pack: Glide Path Management - Irregular Glidepath: Dr. Ruddle Advanced Endodontics

All content has been transcribed from original audio recordings. As a result, transcribed text may contain certain grammatical, spelling, or other language artifacts which don’t reflect the original audio recording. Please refer to the audio for the most accurate information and messaging. Any reproduction of the video content, audio, or transcribed text is strictly forbidden. Shape Clean Pack: Glide Path Management - Irregular Glidepath: Dr. Ruddle Advanced Endodontics This show will identify the three causes that lead to an irregular glide path. Clinically, you will be shown exactly how to negotiate canals and then determine with 100% confidence, if you do or do not have a smooth, reproducible glide path. Importantly, how to pre-curve small-sized hand files and negotiate abruptly curved canals will be reviewed. Finally, you will be excited to see how to pre-curve NiTi shaping files so you can more safely prepare canals that exhibit an irregular glide path. * this show will deal with the situation where we do not have a regular glide path and there are several factors that would give us an irregular glide path one of them would be anatomical obviously some anatomical configurations are very treacherous to try to use mechanical preparation methods notice this 90-degree bend well away from the full working length another reason anatomically that we may not have a glide path is in the instance of a bifida T any time a canal divides there's an opportunity for the file to get caught and not be able to track along the negotiated portion of the canal sometimes pathological conditions exist like internal resorption and it's not easy to slide a file through the resort of defect to pick up the canal on the more apical side other pathological conditions occur when teeth degenerating ionically and that could be the presence of stones you can notice in this beautiful illustration from Lars Bergman's that he showed in the yellow area is a transverse section through the mesial-buccal root and at that level you can see that the smaller canal is open and paitent but where the arrow is there is a stone attached to the internal wall the green arrow shows us a deeper calcification in the distal buccal system and again at this slice at this level all the roots have opened paetynn canals but the DB again has a stone these stones can prevent instruments from sliding to length so we've looked at anatomical instances and pathological conditions the other instance where we'll frequently not have a regular glide path is in retreatment often times bigger instruments were inappropriately carried deep ledges resulted and that ledge can prevent a file from easily passing around the curve to length well we've talked about negotiating canals and other just-in-time shows and you can imagine using tens and 15 hand files in the presence of a viscous key later to arrive perfectly at length but once the instruments at length it means you have a pilot hole but it doesn't mean you have a reproducible glide path so withdraw the 15 file a couple millimeters and without reciprocating the handle slide it back to length now pull the 15 file back three or four millimeters and see if you can slide the file back to length now pull the file back even further when the file is inserted back towards length sometimes it can hang up in this example and a bifida T notice that a rotary instrument wouldn't know which way to go it would hit the septum and roll over and frequently break in the instances where we don't have a smooth reproducible glide path the pro taper file system comes with manual handles these handles can very easily chairside be attached to the rotary handle rendering the instrument manual you're still thinking okay cliff there's a handle on it but it's still a nickel titanium file so we use an orthodontic bird beak plier to put a pre curve on the tip of the instrument we have to exaggerate the curve because when we let go because of shape-memory nickel titanium wants to straighten out so we have to exaggerate the curving move so when we release the file it's curved appropriately the teardrop stop can be torqued to correspond to the curve of the instrument so you can see in this maxillary first molar post-operative film that if we looked specifically at the MB root we could imagine a 15 file was at length if you pull it back a few millimeters you can see as you slide it back towards the terminus it would go right out the lateral aspect of the root in this instance we have an ill positioned lateral canal and because nickel titanium has shape memory it'll always follow the path of least resistance and that's straightline in other words it would go out the lateral canal and out the lateral side of the route but it wouldn't make the deeper recurvature this is a manual finishing procedure notice this mandibular posterior abutment noticed the distal route is Triffids and in these instances we must come back and look