Single file rotary endodontics- How this marketing hype is taking Endodontics backward ?

Viewpoint1

So here is my unequivocal opinion and position I’ve maintained my entire practice career. Commercial interests are no friends of the endodontic specialty
and they try to shit on science making up their own junk infomercials. The product industry preys upon the greedy, stupid, and weak. That doesn’t mean I don’t’ appreciate and respect free enterprise and the products which have been developed for us to use, it just means I hate false advertising and think the science and profession of dentistry should have not only an arm’s length distance from the industry but would be better off at this point having a barbed wire fence with a guard gate and German shepherds.

I’ve declared war on all assholes screwing over the specialty of endodontics. and hope that I will have enough loyal subscribers supporting my efforts and projects so that they don’t have to filter out the few pearls of wisdom amongst the commercialized filth that other people are teaching. I hope I will survive: I don’t know if I will, but there is nothing more important to the integrity of dentistry than this effort in my opinion. Someone needs to set a philosophical example by leading and not be a hypocrite.

Endodontic excellence is about principled ethical clinical wisdom, not some cheesy tool which will be replaced by another cheesy tool in a matter of months with a higher price tag. by Terry

See pic from a Study from Brazil, in a simple mandibular incisor, when you take proximal (mesiodistal) radiograph, it shows just by using tapered files we are unable to clean large parts of canal, focus on tag C, image shows file in grey color-( leaving so much debris in infected canal makes your treatment fail)

Viewpoint2

The reasoning was sound: Making root canals "easy" is a lie. They aren't easy if you recognize the true pulp anatomy and see dealing with ALL of it as part of good treatment.

On the other hand, if all you want to do treat Endo as just one more "Operative" dental procedure then you basically take the root canal system anatomy/biology out of the equation. You ignore the kind of anatomy that Craig Barrington’s tooth clearing studies show very eloquently. You mechanically watch-wind an engine driven Ni-Ti file to the point where you get a red light on your apex locator. (BINGO!) That’s the "instrumentation" part.

BTW : I’ve always found it fascinating that most of these Ni-Ti techniques usually require you to :
(1) get a #15 to the terminus first (frequently the most difficult part of doing endo – once you’ve got a file to the apex, it doesn’t much matter WHAT you use to shape the rest of the canal

(2) The Wave One technique PRESUPPOSES that you can decide how big the apex is BEFORE you start treatment. (That’s how it’s a ONE file technique - you preselect "the file"!) I’m not sure about anyone else, but I think its ridiculous to think that you can “predetermine” an apical size BEFORE you instrument the body of the canal to gain access to that region.

Then fill the canal with sealer and insert "Corresponding Size" Cold Gutta Percha cone (it looks better on the final PA that way – no voids) and you're DONE! "Minimalist" preparation, dentin conservation, spaghetti canal fills with nice curves, and fill to the apex. If you're merely interested in radiographic appearance as a measure of quality and your goals is a white line to the apex...this is your technique.

It is very disappointing that clinicians who we had previously THOUGHT respected true canal anatomy have whored themselves out for this. But I suppose everyone has his or her price. I think its particularly disingenuous when articles like the one published in ROOTS magazine do not CLEARLY indicate that the authors get PAID (either through patents, as consultants or with free instruments) to shill this stuff. It is an infomercial masquerading as science. by Rob

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