Introduction:
The evolution of endodontic techniques has seen significant milestones, with innovations like the “balanced force” concept paving the way for more refined and efficient root canal preparation. Building upon this foundation, the introduction of reciprocating motion with Super Flexi Rotary Files represents a quantum leap in endodontic instrumentation, promising heightened precision, enhanced safety, and streamlined workflow. This article explores the transformative potential of reciprocating motion with Super Flexi Files through a blend of historical insights, scientific principles, and a compelling clinical case study.
Balanced Force Concept:
The groundbreaking work of Rogin and colleagues introduced the concept of “balanced force,” fundamentally changed how we approach endodontic procedures. Their meticulous refinement of file placement, cutting, and removal through specific rotation marked a significant advancement in canal preparation. This approach emphasized the importance of both clockwise placement and counterclockwise cutting rotations, laying the foundation for further innovations in endodontic instrumentation, including the development of reciprocating motion techniques.
The Emergence of Reciprocating Movement with rotary files:
Dr. Yared’s groundbreaking research represents a major breakthrough in the advancement of endodontic instrumentation. Through meticulous study of file rotation angles and torque, Dr. Yared pinpointed the optimal movement for root canal preparation: a forward angle of 144° followed by a reverse rotation of 72°. This pivotal discovery laid the groundwork for the creation of reciprocating files, ushering in a new era of precision and efficiency in endodontics.
Clinical Case Study:
At Crete Endodontics Endodontic Specialist Referral Clinic, we use ROGIN rotary files in reciprocating motion for the challenging root canal treatment cases with abrupt curvatures, limited mouth opening etc. This increases the safety and prevents file separation to the highest degree.
Now, let’s take a look at a specific case. A middle-aged female patient came to us with irreversible pulpitis and symptomatic apical periodontitis associated with the UL7 tooth. Using the remarkable flexibility and cutting efficiency of Super Flexi Rotary Files, we were able to navigate through difficult root canal anatomy effortlessly, achieving excellent shaping and disinfection results. The use of reciprocating motion, with a 150° attack angle followed by a 30° relief angle, made the instrumentation process smooth and seamless, even when dealing with the complexity of an independent mb2 canal. This case was performed in a single visit and the patient was symptom free within a few hours after the treatment.
Which are the Key Advantages of Reciprocating Motion:
- Simplified Glidepath Establishment: Reciprocating motion reduces the need for rigorous manual glidepath preparation, streamlining the treatment workflow. (De- Deus et al. 2013)
- Enhanced Instrument Lifespan: Studies have demonstrated the longevity of instruments used in reciprocating motion, minimizing the need for frequent replacements. (De-Deus et al.2010, Kiefner et al.2014)
- Versatility in Canal Complexity: Reciprocating files exhibit remarkable resilience, making them suitable for a wide range of canal morphologies.
- Exceptional Safety Profile: With proper technique and experience, the risk of file fracture is substantially reduced, ensuring predictable outcomes and patient safety. (Bueno et al 2020)
- Conservative Coronal Preparation: Reciprocating motion preserves coronal tooth structure, minimizing the need for aggressive coronal flaring.
- Optimized Workflow Efficiency: By reducing the number of technical stages and instruments required, reciprocating motion enhances treatment efficiency and clinician’s productivity.
Of course, Super Flexi Rotary Files has many other cases worthy of reference in the clinical practice of many of dentist:
As we strive for excellence in endodontics, the incorporation of reciprocating motion with Rotary Files marks a significant milestone. This technique empowers clinicians to navigate the intricate root canal anatomy with precision, efficiency, and confidence. As we push the boundaries of what’s achievable in endodontics, reciprocating motion reflects our steadfast dedication to improving patient care and enhancing clinical outcomes. Another positive result of this technique is the need for less files as they can be skipped. Sometimes, a single file can be used for the whole treatment.
Authors: Dr. Antonios Glynis (UK DMD, MSc Endodontics)
