Originally posted by Rafael Costa Guerra:
[QB]"Maxillary anterior endo (easy access, and you can anesthetize, isolate, access, shape the canal (s) and obturate in about 30 minutes)"
30 Minutes?????maybe if I were that good I would like endo. Just to access and shape takes me about 20 minutes.
A little practice, a little technology, and a critical look at effiency and it is quite easy to do. The biggest speed factor once I really became comfortable with the technical aspects of the procedure, is utilizng all aspects of dental technology. First off, something as basic as anesthesia, I LOVE 4% Articaine with 1:100,000 epi for endos (I know that there is no current literature to support it, but from my personal experience and that of many of my collegues, it just flat out gives a quicker onset and a more profound level of anesthesia than lido with epi or mepivicaine with neo cobefrin). For access, find an extra course large(minimum #6 and preferably a #8) round diamond bur (they go through just about any tooth structure and/or crown like a hot knife through warm butter) and make a large enough access hole for complete visual access(after all you're going to cut away alot more tooth structure when you prepare it for the crown later, so do some more now and make your access/vision easier
). Utilizing rotary NiTi files and a crown down technique you can shape a canal in under 5 minutes. Warm gutta percha will have the canal obturated in about a minute. And my favorite time saver since I've had it in my office for the last 6 months is digital radiography (your working length, master cone, and final films are ready for your viewing in under 10 seconds from the exposure
)
After you're comfortable with the techniques, then pay attention to how long things take, and then take a critical look at how you and/or your assistant could have done things/anticipated things more efficiently. You'll likely not cut your procedure time in half over night, but in a relatively short amount of time you can shorten the length of the procedure quite substantially to make time in your schedule for that emergency patient that called your office that AM!
Think about it, professional athletes and coaches watch and analyze past game films to figure out ways to improve their performance, shouldn't we do something similar??
:wink:
