The push in finding the right endodontic files seems to be a trend in finding that magic combination of motorized motion (clockwise, counter clockwise, reciprocating) and file design. That material combination which produces a smooth canal all the way to the apical foramen, with no need to reach for that hand file or worry about glide paths. Well, we're not quite there yet.
Endodontic Files - A Little Assistance
No amount of practice on plastic blocks can prepare you for the inevitable endodontic file break during a procedure. While odds are, it will happen, there are a few things to consider which might make the probability a little less. If you haven't yet purchased an Apex Locator, consider it. While the latest electronic gadget can never replace experience, the value of knowing the exact depth of the canal is, lets say, immeasurable. We like the J. Morita Root ZX Mini. Morita is the number one name in apex location technology, and the mini makes that technology accessible, and portable. The Root ZX Mini retails for around $900. These are often listed on Ebay for about $100 less. Check here to see if any are listed on Ebay.
Nickle Titanium Vs Stainless Steel Endodontic Files
Nickel-titanium (NiTi)endodontic files work best for shaping of curved root canals. Nickel-titanium is very flexible, but firm enough to resist excessive bending and torsion to the point of break, as compared to stainless steel. Some say physical properties of these can be effected by repeated sterilization. One result of repeated sterilization is a reduction in cutting efficiency and flexibility, but the mechanical properties of NiTi hold up well. Stainless steel, while more rigid than NiTi, works well for use in hand files.
Endodontic Files - Sterilize or Dispose
In 2008, the USAF Dental Evaluation & Consultation Service (DECS) studied the effectiveness of using ultrasonics to remove debris prior to sterilization. While ultrasonics proved effective at removing organic debris from endodontic files, provided they were placed such that the sonic waves had adequate access to all surfaces, the authors also encourage users to consider endodontic files as single use disposable devices. Because of the challenges of cleaning files, deterioration of the cutting surfaces during cleaning and sterilization, and wear during normal use, the Centers for Disease Control and Prevention (CDC) also suggest considering endodontic files as single-use devices. Although some devices may be used multiple times, it may often be safer, as well as more efficient and cost-effective to consider them single use.
If you choose to re-cycle endodontic files, you should strongly consider brand quality, and inspect each file closely before use. They say time is money. You can buy a lot of new files with what an hour of your time, or lost time, is worth. And remember, regardless of material and brand quality, all metals are subject to various types of stress corrosion cracking, and many are not visible to the naked eye. Take care to not over use your files.
Consider Surgical Motor Manufacturer When Choosing Endodontic Files
Its always a good idea to consider the manufacturer of the surgical micromotor you use. Many times the manufacturer has a preference, or suggested type of endodontic file to be used with their equipment. Of course, they may have financial interest in a particular brand, but their concerns are typically well founded. A little investigation prior to purchasing a particular brand of endodontic files may be worth your time.
We'll just say that these guys know a little about endo. In 2008 they introduced one of the most advanced endodontic NiTi files, which patented the term Twisted Files (TF). TF combines three processes to develop strength and flexibility:
R-Phase heat treatment technology
TF twisting the file, not grinding, eliminating micro fractures for greater strength
Advanced surface conditioning finishes while protecting underlying grain structure.
The result is a rotary NiTi file strong enough to cut ideal file paths, and flexible enough to do it quickly. Users are discovering that with Twisted Files they are able to shape root canals safer, faster, more efficiently and with fewer files. Again, the fewer files motif. Its all about speed and efficiency now days.
ProTaper® Universal Rotary Files patented, progressive taper design, according to Dentsply, allow for as few as three files to be used to complete a fully tapered canal of uniform shape, safely and precisely. The ProTaper design employs a more rounded flexible tip which enables them to precisely follow the canal anatomy. Hard to argue with the physics of it, backed by a company that seems to have an excellent formula for success. Click here to see discounted Dentsply Protaper Rotary Files listed on Ebay.
One of the oldest and most respected companies in the industry, Miltex's flagship endodontic files are aptly named Liberator®. Capable of speeds reaching 2000 rpm, and made of rotary nickel-titanium. Miltex has invested years of research and development into this one. Miltex Liberator files incorporate a unique straight blade design that helps eliminate helical flutes found on most all rotary endodontic files. Miltex claims this result to be a vast reduction in Self-threading, which is a major contributor to the problem of file separation. Miltex Liberator Endodontic Files can occasionally be found on Ebay as well. Click here to see Miltex Liberator Files listed on Ebay.
Our Opinion on Brand Choice
If you choose to clean and sterilize endodontic files for multiple uses, be sure to consider sticking with the highest quality available. The internet is an excellent source for researching products. If a particular product has caused problems, you can bet that a disgruntled customer has expressed it somewhere online.
Endodontic files are tools, nothing more. Tools in the hand of experienced professionals can create wonderful products. Take the time to select the right tool for each application, understanding the intended use for each. Use the technology available, and don't take short cuts. Your patients will be the beneficiaries. The following is a link to a study performed by Dr. Susan Conrad which describes the various methods for endodontic files sterilization, and their effectiveness at eliminating contaminants: Dental Burs and Endodontic Files: Are Routine Sterilization Procedures Effective?