Conversely, to use larger files to try to “push through” the obstruction often only serves to worsen the ledge or pack the debris further into the root. Diligent work with K files that have small bends placed in their tips can often create patency if used as described. While not all ledges and obstructions can be bypassed, many can. It is important in such clinical entities to use gentle pressure, copious irritation, sharp new files, and never advance to the next larger K file until the smaller ones can predictably negotiate through and beyond the given obstruction and spin freely. Placing the bend onto the file followed by a series of gentle insertions into a canal that is resisting negotiation can often yield a soft spot in which the file will make headway and allow negotiation to take place. I have an EndoBender on each of my endodontic trays.īypassing ledges and negotiating blockages is also made far simpler with the bend that an EndoBender can impart into the apical 3-4mm of the file. While curvatures on files can be placed by hand or with cotton pliers, none of these other methods can duplicate the exacting smooth bend of the EndoBender. An ideal instrument to place such an apical J bend is the EndoBender pliers (SybronEndo, Orange, CA). This underscores the importance of the clinician using very small K files (6-10s) copiously especially in the negotiation of the apical third of root canal systems. The reason that a J bend negotiates the canal better than a straight file is that often canals make very acute directional changes in which forcing a straight file (if not easily bypassed) may only serve to begin the creation of a ledge or blockage. Once a curvature (to be described) is put into the file, it can much more easily travel down the same canal that previously could not be negotatiated.įor acute curvatures, placement of a very small J bend (3-4mm) at the end of a K file can often make the difference between negotiation and, in the worse case scenario, the creation of a ledge. Often times, especially in narrow and curved canals placement of a straight file will only allow the file to traverse the canal a limited linear distance. Files that are precurved tend to traverse curvatures present in all dimensions more easily than straight files. Said differently, if a canal appears radiographically straight in the mesial to distal dimension, it is a very good bet that the canal is curved buccal to lingual. No line in nature is straight and canals contain a dimension of curvature from buccal to lingual as well as mesial to distal. First off, canal systems are never straight, no matter how the radiograph may appear. In a word, yes! K files are indeed essential to pre-curve prior to use.
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