I need help w/ endo

[DancingKoala]

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Hi guys,
I just did endo and had hard time finding working length.
When I put #10 file about 22mm and took a picture, it was about 3 mm too short.
I believe that working length was about 25mm.

However, I could not put the file any deeper.
I am not sure if the apex was calcified or maybe I just don't know how to make it go deeper.

So here is my question.
If you put #10 file in the canal and you still need to go down a couple more mm, what do you do? Is there a trick to make it go deeper? I have used RCprep lubricant but I still struggled and I was worried that putting any more force would result in breakage of file or bending the file.

 

[Wax n Relax]

Look up balanced force technique. Or you could just ask your instructors for help.

 

[jay47]

Hi guys,
I just did endo and had hard time finding working length.
When I put #10 file about 22mm and took a picture, it was about 3 mm too short.
I believe that working length was about 25mm.

However, I could not put the file any deeper.
I am not sure if the apex was calcified or maybe I just don't know how to make it go deeper.

So here is my question.
If you put #10 file in the canal and you still need to go down a couple more mm, what do you do? Is there a trick to make it go deeper? I have used RCprep lubricant but I still struggled and I was worried that putting any more force would result in breakage of file or bending the file.

First, determine why you are not getting to length.

1. Have you blocked yourself off with debris?
2. Is it calcified?
3. Is there an apical split you can't negotiate?
4. Is it ledged?


Then, determine how to get around this problem.

1. Use balanced force technique.
2. Go up 1 file size and step back (many files will bind in the coronal third preventing them from going further.
3. Use a smaller file (#8, #6 - careful, don't break them off)
4. If you haven't already, put a small bend in the file in the very end to work around any problems.

Join Dental Town and go to the Endo Files forums, there is more info there on Endodontics than probably anywhere on the internet. Read the stickied threads and you will never be the same again. Specifically, check out the thread "The Art of Handfiling" by Nigel

 

[Wax n Relax]

First, determine why you are not getting to length.

1. Have you blocked yourself off with debris?
2. Is it calcified?
3. Is there an apical split you can't negotiate?
4. Is it ledged?


Then, determine how to get around this problem.

1. Use balanced force technique.
2. Go up 1 file size and step back (many files will bind in the coronal third preventing them from going further.
3. Use a smaller file (#8, #6 - careful, don't break them off)
4. If you haven't already, put a small bend in the file in the very end to work around any problems.

Join Dental Town and go to the Endo Files forums, there is more info there on Endodontics than probably anywhere on the internet. Read the stickied threads and you will never be the same again. Specifically, check out the thread "The Art of Handfiling" by Nigel

Join dental town. You'll thank us later.

 

[djeffreyt]

Use a large file with EDTA to open the coronal more and irrigate regularly to remove debris. Then try a smaller, stiffer file like a size 6 or 8 and see if you can negotiate. If you still can't, try a small bend at the end of the file and make small push pull movements to see if there is a ledge or a split in the canal that you find and can enter. If that fails, I would clean out the other canals fairly well, like doing an endo access, and take some RC prep and inject or place it down the obstructed canal by spinning a file counter clockwise. cotton pellet and cavit and have the patient return in a few days or a week and see if you can go further.