Hybrid Instrumentation Technique

Discus Dental Smart Endodontics endorses the concept of instrumentation hybridization, when appropriate.  Instrumentation hybridization removes barriers to the adoption of Smart Endodontics principles by incorporating LSX into the doctor’s current technique.  Discus Dental Smart Endodontics is committed to enabling dentist to properly clean the apical third, which can only be realized by incorporating LSX into their instrumentation technique.

It is important that instrumentation hybridization is applied only in the appropriate circumstances. Discus Dental Smart Endodontics sales representatives must learn about the doctor’s current situation to guide them to the approach that is best for them, and their patients.  For example:

A hybrid approach is applicable when the doctor is experienced, proficient and completely satisfied with their current tapered rotary technique but sees value in preparing to the correct size apically with LSX.

A hybrid approach may or may not be applicable when the doctor has tried using LSX but considers themselves unsuccessful in converting fully from their current technique, assuming that sufficient time has been invested in learning and applying the technique in their practice. If further training and mentoring are no longer options, than an attempt can be made to revert back to their current technique while still using LSX to finish the apical portion of the canal.

A hybrid approach is not applicable when:

• The doctor has never used tapered rotary instruments. Discus Dental Smart Endodontics is not about to teach them the proper techniques of another manufacturer’s instruments. Discus Dental Smart Endodontics does not have the time or expertise to do this properly and we don’t believe it will result in better patient outcomes than adopting the standard LSX technique.
• The doctor is not satisfied with their current technique and wants to learn and apply a simple technique, A to Z.
• The doctor currently uses LSX successfully. We don’t want to give them the impression that a hybrid technique is any better than the standard LSX technique they are using successfully now, because it isn’t.
• The doctor has very little experience in performing root canal treatment.

The term hybrid is meant to be sufficiently vague so that it may include most every technique, rotary, manual, reciprocating, ultrasonic, etc.  When we use “hybrid” we mean prepare the coronal and mid-root with the technique of your choice but, save the completion of the apical third for LSX.  This doesn’t mean other instruments can’t go into the apical third – it simply means that the apical portion of the canal has not been completed until LSX is used.  The apical third is only completed when prepared to the Final Apical Size with LSX using the recommended technique as confirmation that the correct FAS has been determined.

Efficiency of EndoVac System to Remove Artificially Placed Dentin Debris

H.S. SONG, Y.J. KIM, Y.B. CHO, and C.U. HONG, Dankook University, Cheonan, Chungnam, South Korea

Objectives: The purpose of this study was to evaluate the effectiveness of Endovac system to remove artificially placed dentin debris.

Methods: Twenty extracted single rooted permanent teeth were allocated randomly into two groups. The pulp chambers were accessed and the canals were prepared by #40,. 06 taper Profile system. After canal preparation, teeth were split longitudinally into two halves. Three standard saucer-shaped depression of 0.3 mm in diameter and 0.5 mm in depth were cut in the root canal at 2, 4, and 6mm from the apex to simulate uninstrumented canal irregularities. Each depression were filled with dentin debris mixed with 5.25% NaOCl to simulate a situation when dentin debris accumulates in the uninstrumented canal extensions. Two halves of each tooth were reassembled using wire and sticky wax. In group 1, the canal was irrigated by using the Endovac system, which uses negative pressure to deliver irrigating solutions to working length. In the other group, canal was irrigated with 27 gauge irrigating needle. All teeth were irrigated with sodium hypochlorite and EDTA according for a predetermined amount of time. The amount of remaining dentin debris in the depressions were evaluated by a microscope and SEM.

Results: Both irrigation methods reduced the debris score significantly. The debris score was stastistically lower after the Enodovac system than after conventional irrigation.

Conclusions: This study showed better debridement by using the Endovac system compared with conventional irrigation.

Endodontic Webinar Programs Available on the Internet

Be sure to watch for emails from Smart Endodontics about our new 2008 Webinar endodontic series. These are short courses offered through the Internet. Approximately one hour in length, these Webinars will cover a variety of Smart Endo topics and will be offered several times throughout the year.  The best part is the live Q&A with the presenter at the end of the program. 

Dates and speakers are announced a couple of weeks in advance via email.  If you would like to be contacted for future Webinar announcements, please contact Adam Aronson (AdamA@DiscusDental.com) by email or by calling 310.845.8318. 

Previously held Webinars (see list below) are available for viewing now.  Use the web links provided below or contact Adam for an email which will allow you to copy and paste these links into your web browser.

Presenters: John Schoeffel and Harry Suggs
Topic:           Converting from Dental Power to LightSpeed LSX (for Dental Power customers)
Summary:  Drs. Schoeffel and Suggs outline a strategy for converting from the Dental Power line of instruments to the LightSpeed LSX line.  Technique includes flaring the coronal third with Gates Glidden drills, or those of your choice, and completing the middle root with ProTaper instruments before beginning the final apical preparation with LSX.  

Web path: www.discusdental.com/endo, click on “Education” then click on “Webinars”

Presenter: E. Steve Senia
Topic:         Endodontic Success: It’s All about the Apical Third
Summary:  Dr. Senia outlines why preparation of the apical third is so critical to endodontic success and describes a technique for proper preparation, irrigation, and obturation of the apical third to give your patients the best hope for success.

Web path: www.discusdental.com/endo, click on “Education” then click on “Webinars”

Evaluation of New System for Root Canal Irrigation to Conventional: An Ex Vivo Study

Dr. Prashanth, Dr. Vasundhara Shivanna. Dept. Of Conservative Dentistry & Endodontics, College Of Dental Sciences, Davangere.

AIMS AND OBJECTIVES OF STUDY:
To compare the efficacy of the LightSpeedLSX^TM with and without the EndoVac^TM irrigation System to debride root canals at 1mm and 3mm from working length.

MATERIAL AND METHODS:
22 freshly extracted intact non carious human mandibular premolars with complete root formation were collected for the study from Department of Oral & maxillofacial surgery.  All teeth were instrumented with LightSpeedLSX and split into 3 groups: No irrigation, Conventional irrigation with NaOCL, and Irrigation with EndoVac (NaOCL).

Six micron serial histologic sections are made and stained with hematoxylin and eosin. Sections of each glass slide are compared using light microscope at 100X magnification. The amount of debris left in canals are quantified as percentage of canal lumen area. The data was statistically analyzed to compare percentage of debris and efficacy of irrigation techniques.

RESULTS: Mean % “Clean” – 100% = Completely Free of Debris

	LightSpeedLSX with No Irrigation	LightSpeedLSX with Conventional Irrigation	LightSpeedLSX with EndoVac Irrigation
1 mm from Working Length	70%	94%	99%
3 mm from Working Length	72%	96%	99.5%

The combination of LSX and EndoVac was able to render these canals 99%+ free of debris.  Average instrumentation time with LSX was 6.1 minutes.  EndoVac circulated 24ml through the canal system compared to only 3.4ml with conventional irrigation.

A New World of Endodontics is in Your Hands!

Welcome to the new Smart Endodontics blog.  Our intent is to use this vehicle to share useful information about Smart Endodontics techniques, upcoming courses and product information.  Simply stated, this is where you’ll find practical information for the Smart Endodontics community.