February 2009, Volume 5, Issue 2
Published by AEGIS Communications
Never Break a File Again With Endo Pulse™
Today, root canal therapy (RCT) gives the endodontist and general dentist many options to offer state-of-the-art endodontics to their patients. Endodontics, once the domain of the specialist, is one of the fastest-growing components of many general dentists’ practices. With the aging baby-boomer population, the frequency of diagnosing a need for RCT will continue to rise.
The advances in technology and materials for conducting RCT has never been greater and the product choices are numerous. Too many choices can lead to confusion for the general dentist and even the endodontist. The Endo Pulse endodontic handpiece is an easy option to simplify your instrumentation (Figure 1; Figure 2; Figure 3).
What Is the Endo Pulse Handpiece?
Endo Pulse is the newest generation of Endo Technic’s long line of vertically reciprocating endodontic handpieces. Previously known as the Canal Finder System (CFS), the Endo Pulse offers the practitioner more power and versatility. It is the only vertically reciprocating handpiece to offer irrigation while excavating the canal. Using the stainless steel Master File (designed for vertical reciprocation), Endo Pulse will reduce your file costs and you will “never break a file.”
The Rotary Filing Problem
Most endodontic handpieces today use slow-speed rotary instrumentation. Over the years, practitioners have found that no matter which rotary system they use or rotary file choice they make, the files can still separate, despite following the protocol closely. The laws of physics dictate that rotation applies torque stress to instruments (drill bits, dental drills, etc). This stress causes the instrument to fracture (or fail) at the weakest point, which, for a rotary file, is at the tip. When a file fails at the tip it requires very difficult removal (if it even can be removed). Therefore, “torque stress” causes “practitioner stress.”
Why Use Vertical Reciprocation?
Vertical reciprocation is the only natural way to eliminate file torque stress. Think of it as an automated replication of the natural hand-file movement. Other reciprocating handpieces use a watch-winding motion but this still applies stress to the file. The Endo Pulse with vertical reciprocation rapidly cuts through all curved, calcified, and tight canals (eg, the second mesiobuccal canal) and the dentist does not need to worry about file failure even at faster speeds (8K to 10K revolutions per minute). Endo Pulse has a smart-head design that changes the vertical reciprocation amplitude from 1 mm (with no resistance) to 1/3 mm (with resistance), depending on canal conditions, for added safety.
Complimenting this is the 90° passive file movement of the Endo Pulse. Passive file movement means that the longitudinal axis of the Master File floats freely in the canal and self-centers in the middle of the canal as it files. No mechanical torque stress is applied.
Irrigation and Cavitation
One of the most talked about subjects in endodontics today is irrigation. The top opinion leaders continually lecture on it, recommending liberal use of water, sodium hypochlorite (NaOCl), ethylene-diamine-tetra-acetic acid (EDTA), or other irrigants. The reason is simple: the better the irrigation, the cleaner and better prepared the canal will be for obturation. This allows for improved obturation with good apical seals and filled lateral canals.
Here again, there are many choices for the practitioner. Endo Technic reduces the confusion by offering built-in irrigation (water or NaOCl) on the Endo Pulse. Automatic irrigation allows the dentist to perform the procedure, clean, lubricate, and wash out debris. Endo Pulse irrigation will prevent debris from blocking the surgical zone. It will also act as an extra lubricant to reduce postoperative patient discomfort.
Cavitation is the other benefit of effective irrigation. Endo Pulse not only automatically irrigates the canal but cavitates while it drills, because of its fast cutting pace. This promotes a cleaner canal and can infuse NaOCl into dentin tubules. Set Flow (Endo Technic’s NaOCL irrigation system) allows a tiny pill of 50% NaOCl to dissolve and flow down the file into the canal while drilling. The water flow is light, so NaOCl does not pass the apex. If the practitioner wishes to rinse with full-strength bleach after using Set Flow, the time this needs to be left in the canal is reduced. Overall, chair time is significantly reduced because the patient can go directly from instrumentation to obturation.
1-2-3 Endo Technique
Fast, safe, simple (or access, instrument, obturate).
- Gain “straight line” access in the canals using Gates Glidden burs, Peeso drills, or an orifice opener. Stay above the curve of the root.
- Start with a hand file to determine length or use Endo Pulse and a #10 or #15 Master File. Work the file against opposite walls to add space and find a path to lengthen safely (use Endo Pulse irrigation or hand irrigate).
- Enlarge the canal space with Endo Pulse in a step-back procedure. Remember to move the Master Files in a paint-stroke motion, upgrading from #15 to #25+ (liberally use Endo Pulse’s irrigation or hand irrigate). If a specific canal taper is desired, use a rotary handpiece and select the rotary file that best matches the last Master File used. The rotary file will glide down the canal to the right length. Note that only one rotary file is necessary.
- Obturate. Any obturation method will work or use a gutta-percha point matched to the last rotary file.
When using Endo Pulse, and with small files, a slight feeling of pulling into the canal may be experienced. This is natural with vertical reciprocation.
Rotary endodontic systems require expensive, space-taking equipment and rotary files are very expensive and recommended for one-time use. The Endo Pulse and Master File will save dental offices thousands of dollars per year. Master Files have costs similar to that of hand files and can be re-used.
The Endo Pulse is versatile with a micro-detachable 20K air-powered E-motor that practitioners can use with other attachments. Snap on a prophy angle or another slow-speed handpiece and use it in multiple operatories.
For more information, contact:
The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products or services or their effectiveness, quality, or safety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the preceding material.