The analogy with carpentry was spot on! I was thinking exactly the same just a sec before you mentioned Dr, it shows I have many carpenters in the family! Nontheless there must be specific cases where reciprocating might have some kind of advange over continous rotation, what could that be?
Thank you dr. Nasseh . On my prezentation I speak about this problem and it is very huge. If you look on the reserches about :hard tissue debris accumulation during the root canal instrumentation with rotary files - we still have very big problem ( Micro -CT analysis - hard tissue debris accumulation Paqué et al. J Endod 35: 1044-1047, 2009) . But reciprocation instrumentanioin has a biger problem - all the debris is still in the root canal and we pack it in all iregularity of root canal anatomy. Dr. John McSpaden has a very good video demostrating this problem.
Yes Dr. McSpadenn really helped explain this phenomenon the best. The current way people recommend the use of reciprocation is incorrect and it creates large amount of debris that's counterproductive to the cause of RCT. I've been working on ways to help address this issue. Stay tuned and I'm hoping to discuss at some point the way I think Reciprocation should be used to reduce its debris issue. Cheers and thanks for great point you brought up! : )
Thank you. I have been using rotation successfully for better than twenty years. Younger dentists and sales people accuse me of being "behind the times." Nice to find some validation. Thanks again!
It’s been six year since the video is published, and it might need an update. There are new studies regarding rotary vs reciprocation, and not a lot difference were shown.
Just from my own experience: I have been using wave one for about 5 years time after using protaper for probably 10 years before and did not noticed any increase in the postoperative pain... Now. as far as the chances of causing microfractures during the instrumentation with reciproc files.... i really don't know but, obviously, your point is valid. I can see/feel that the forces and shocks are greater so yes, it might be possible. On the other hand, if the tooth is accessed with manual first up to 25 k file and the coronal third is flared with either sx from protaper or gates glidden I think the stress is reduced. What is your opinion about using files designed for rotary motion (for example protaper S1, S2,F1,2,3) in reciproc mode? I am thinking to get the benefit of reducing the chances of separating them but I am not sure if their cross section is suitable for that motion. cheers
You are right. If one uses the reciprocation motion correctly, extruded debris can be diminished and minimized to a controllable level. There will be tutorials on that subject in 2018. Stay tuned. Cheers!
Yes. It can be done; but it has to be the correct type of reciprocation angle and direction based on the file design. We will cover that in detail in 2018.
Very interesting video! You help me to take a decision to purchase a new endo motor and I was divided between rotation and reciproc motion. Thank you for sharing your experience.
Great. I just ordered a bunch of Wave One files to restock my supply. I wonder if I could just turn the motor to rotation as I get close to the apex with the wave one file. I use the Endo Sequence sealer and points with Wave one files as I didn't like the thermoplastic obturators with the wave one system.
WaveOne is designed specifically for reciprocation and you should not use it with rotation as it will push even more debris apically (it cuts in a counterclockwise direction.)
Endodontists who teach Wave One do NOT advocate simply going directly to final shaping file after establishing working length anymore. If you have been using Wave One and haven't been to a continuing ed course specifically on it for a while, you should. Many of the pitfalls described here will be addressed.
Thanks .I learned something about carpentry too. But I still do not know why we have to kill birds while doing root canal therapy, and not just one but two birds!!!!
It's recommended by the manufacturer. Whether the motion is rotation or reciprocation, cyclic fatigue does take place. Single use is the only way to reduce chance of file separation since cyclic fatigue is invisible to the eye... until the file breaks! So, that's why single use is the recommended method, for safety. If there was a way to measure actual cyclic fatigue in the file shank you would find out in some situation you can use the file more .. the problem is that no one knows when... unless you take a chance. The problem is that we'd be taking a chance with your patient's tooth, and potentially wellbeing! That's the main problem.
I use the EndoSequence and ESX system. However, I have been playing with some reciprocation motion as well. I think all system work if you understand their limitations and maximize their benefits. I use rotation because my priority is efficiency. Cheers!
Yes! But only CCW OTR on EndoSync PLUS, not regular EndoSync. You can actually make those files much more efficient on EndoSync PLUS programmed at CCW Torque Setting 0.6Ncm!
It's not necessarily wise. It's a personal choice to use mechanical motion with the handpiece vs. using hand/fingers to move the file forward. It's personal preference. I'm not a big fan of M4 personally but you can try it and see if it works better in your hands. Cheers!
The important question here is what does "Better" mean? Is it safer, faster, cheaper, or has a higher success rate? I'm not sure that question has been answered yet to any clear degree. I also use and talk about the ESR CM, which is reciprocating. But the ideal motion is different than the practical motion.
The analogy with carpentry was spot on! I was thinking exactly the same just a sec before you mentioned Dr, it shows I have many carpenters in the family! Nontheless there must be specific cases where reciprocating might have some kind of advange over continous rotation, what could that be?
Thank you dr. Nasseh . On my prezentation I speak about this problem and it is very huge. If you look on the reserches about :hard tissue debris accumulation during the root canal instrumentation with rotary files - we still have very big problem ( Micro -CT analysis - hard tissue debris accumulation Paqué et al. J Endod 35: 1044-1047, 2009) . But reciprocation instrumentanioin has a biger problem - all the debris is still in the root canal and we pack it in all iregularity of root canal anatomy. Dr. John McSpaden has a very good video demostrating this problem.
Yes Dr. McSpadenn really helped explain this phenomenon the best. The current way people recommend the use of reciprocation is incorrect and it creates large amount of debris that's counterproductive to the cause of RCT. I've been working on ways to help address this issue. Stay tuned and I'm hoping to discuss at some point the way I think Reciprocation should be used to reduce its debris issue. Cheers and thanks for great point you brought up! : )
@@AANasseh Thank you so much for you answer ! I'm very big fan of all your videos and I learn a lot from them.
thank you dr.Nasseh for sharing your knowledge. it is huge help for beginner like me.
Thank you. I have been using rotation successfully for better than twenty years. Younger dentists and sales people accuse me of being "behind the times." Nice to find some validation. Thanks again!
It’s been six year since the video is published, and it might need an update. There are new studies regarding rotary vs reciprocation, and not a lot difference were shown.
i think the issue is not so much reciprocation but more about very fat files in a single file systems.
Wonderfully explained Dr, very easy to understand that too highlighting recent research and data👍👍
Just from my own experience: I have been using wave one for about 5 years time after using protaper for probably 10 years before and did not noticed any increase in the postoperative pain...
Now. as far as the chances of causing microfractures during the instrumentation with reciproc files.... i really don't know but, obviously, your point is valid. I can see/feel that the forces and shocks are greater so yes, it might be possible.
On the other hand, if the tooth is accessed with manual first up to 25 k file and the coronal third is flared with either sx from protaper or gates glidden I think the stress is reduced.
What is your opinion about using files designed for rotary motion (for example protaper S1, S2,F1,2,3) in reciproc mode? I am thinking to get the benefit of reducing the chances of separating them but I am not sure if their cross section is suitable for that motion.
cheers
You are right. If one uses the reciprocation motion correctly, extruded debris can be diminished and minimized to a controllable level. There will be tutorials on that subject in 2018. Stay tuned. Cheers!
Thank you for your answer. How about using the rotational files in reciprocating mode?
Yes. It can be done; but it has to be the correct type of reciprocation angle and direction based on the file design. We will cover that in detail in 2018.
@@gabisivoglo nice thought,it should work imho,plz share the details if you have tried it,thank you
that's great! thanks dr, please tell the name of the endo file cleaning pad being used here?
EndoSwipe. It's sold by Brasseler. Disclosure: I developed it. :)
@@AANasseh thanks for responding, thats a great invention dr :)
Very interesting video! You help me to take a decision to purchase a new endo motor and I was divided between rotation and reciproc motion. Thank you for sharing your experience.
so u bought reciprocal or rotational motor
Reciprocating motors can do regular rotation too as far as I know. You might as well get reciprocating then to have both options.
Great. I just ordered a bunch of Wave One files to restock my supply. I wonder if I could just turn the motor to rotation as I get close to the apex with the wave one file. I use the Endo Sequence sealer and points with Wave one files as I didn't like the thermoplastic obturators with the wave one system.
WaveOne is designed specifically for reciprocation and you should not use it with rotation as it will push even more debris apically (it cuts in a counterclockwise direction.)
Endodontists who teach Wave One do NOT advocate simply going directly to final shaping file after establishing working length anymore. If you have been using Wave One and haven't been to a continuing ed course specifically on it for a while, you should. Many of the pitfalls described here will be addressed.
What specific type of rotaries does Dr. Nasseh use?
Probably esx ? He's big on brasseler
very well explained, very informative. thank you.
Your vedios are life saver 😍
Thank you Dr Nasseh for this amazing information
Amazing video session Doc! thank you for clearing this topic out , i was perplexed about this for some time now. love your work!
Sir..Do you prefer M4 handpiece as better addition to the armamentarium before rotary endomotor? Share your thoughts on m4 handpiece please
I’ve never been a fan but some people like it. If you’ve used it and like it the. It’s fine. But I have not found it to be helpful.
Hi sir,can u talk about the different instrument tapers ?
Nice explanation sir.. thanks a lot
Is there any recent improvement with reciproc files
Thanks .I learned something about carpentry too. But I still do not know why we have to kill birds while doing root canal therapy, and not just one but two birds!!!!
HI Real World Endo? I'd like to know why reciprocating files require single use, nonetheless reciprocating motion provides fatigue.
It's recommended by the manufacturer. Whether the motion is rotation or reciprocation, cyclic fatigue does take place. Single use is the only way to reduce chance of file separation since cyclic fatigue is invisible to the eye... until the file breaks! So, that's why single use is the recommended method, for safety. If there was a way to measure actual cyclic fatigue in the file shank you would find out in some situation you can use the file more .. the problem is that no one knows when... unless you take a chance. The problem is that we'd be taking a chance with your patient's tooth, and potentially wellbeing! That's the main problem.
nicely explained sir, what's your personal choice of file system?
I use the EndoSequence and ESX system. However, I have been playing with some reciprocation motion as well. I think all system work if you understand their limitations and maximize their benefits. I use rotation because my priority is efficiency. Cheers!
Very well explained!! Thank you sir
Which one is better forbiginners sir?
Very educational! Thanks for your insight!
sir wat is peaking motion
thank you very much bro!
can you use wave one files with OTR?
Yes! But only CCW OTR on EndoSync PLUS, not regular EndoSync. You can actually make those files much more efficient on EndoSync PLUS programmed at CCW Torque Setting 0.6Ncm!
As usual great explication
Thanks ❤️
which is better ?
Rotation is ideal. But one has to learn how to use it properly. Reciprocation is really meant for heavy handed operators.
Sir it is wise to use m4 reciprocation for glide path preparation then switch to rotatory for final preparation
It's not necessarily wise. It's a personal choice to use mechanical motion with the handpiece vs. using hand/fingers to move the file forward. It's personal preference. I'm not a big fan of M4 personally but you can try it and see if it works better in your hands. Cheers!
Try to check literature dear dr
Literature showing that reciprocation is much better
The important question here is what does "Better" mean? Is it safer, faster, cheaper, or has a higher success rate? I'm not sure that question has been answered yet to any clear degree. I also use and talk about the ESR CM, which is reciprocating. But the ideal motion is different than the practical motion.
❤
endoswipe good
Thank you doctor for this helpful video.
really its new trend in end
Thank you!
disagree all this info
Would you care to explain why?
he has his own non evidence based research :P