What is your total time of irrigation after instrumentation and before filling? How much is not enough and how do I know when to stop irrigating and that the canals are ready to be filled?
@@martinchrom4444 I agree; we're trying to achieve microbiotic annihilation and complete pulp tissue dissolution. I'm looking forward to hear what dr. Nasseh's take is, because even though we all know what we're trying to achieve, there's no common agreement on how to get there: it ranges from "Well, the irrigation during instrumentation is enough", to "X amount of seconds/minutes with Y device", to "I irrigate until the bubbles stops, which can take 20-40 minutes..".
Excellent video as usual! But I’ve got some questions: what US tips do you use for the agitation and how deep in the canal are they inserted? Can I evacuate the debris using a standard capilary tip on the suction device? Thank you! Hope to see you in Brazil lecturing any time soon!
Please upload full video approximate of 1hour of compleet case molar rct ,also showing you and your assistanc activity, support u during rct,i mean office view during procedures... Following u from many years... thank you sir
That's TotalVac.. it's the new Irrigation vacuum I've developed. It's sold through Brasseler USA. You can see my videos on it form the past two months on this channel.
@@AANasseh thank you doctor. I just finish purchasing the totalvac and endovac.hope it will fit to my suction .btw, im always watching your videos here from philippines. Kinda sad that there are no exclusive distributor here in the philippines of endosequence and kerr endo materials😞
@@Teeth_builder1991 Yes. It's unfortunately limited to North America at this time. But hopefully one day. Hey I was just in Thailand... would love to visit the Philippines at some point too! Maybe I'll come in for a talk at one of your universities. Cheers! :)
Dr Nasseh, Thank you for this beautiful video! The music and the edits are always on point. By pure curiosity, do you use the lowest settings for the E14D on the Forza V3?
Excellent question!! I should make a whole video on this topic of ultrasonic power... I do play with the power setting throughout the procedure... but for this activation/agitation component with water I have the power setting at around E1 (low power setting)... the idea is not to remove dentin but to agitate and create cavitation/acoustic streaming without cutting dentin! Cheers!
A crown is it needed in every posterior tooth after endo; but if you’re talking about the one in this video, then since the mesial and distal marginal ridges are gone from previous decay, some kind of cuspal protection is helpful in the long run in the form of an endo crown or only. Internal bonding with a new fully bonded restoration can also work; but we need to make that call base on how much remaining decay and leakage was present around the old restoration. There’s no question there are too many crowns. But w need to find that right parameter which is currently not solid. The ADA recommendation is a crown after endo in posterior teeth but this decision should be made in light of patient properties and individual occlusion and parafunctional habits, and remaining tooth structure, rather than one blanket statement that will get abused depending on bias. That’s at least my opinion. Everything is about understanding and managing risk. Good question! Cheers!
@@AANasseh Right sir . I am also a Dentist. your videos always open up our minds and broaden our thinking . And yes I was talking about the tooth which you just showed in this video . I am thankful to you for such a brief answer. Stay blessed !
Thanks, great video! What are your thoughts on using triton after you have enlarged the canal to a considerable extent, and not using it between files?
I gathered he is using water and intermittent PUI with microsuction during instrumentation to remove the debris generated while shaping the canals to WL. I don’t see harm in rotating 17% EDTA solution during instrumentation also. It provides additional lubrication to reduce stress on the rotaries.
I use the three steps.. ultrasonic and water to loosen up debris followed by removing the water and adding Triton. Triton is a solution that contains all the irrigation ingredients in one: NaClO 4%, Chelating agents, Surfactants, and lubricants. It’s all in one solution.
@@AANasseh excellent! The rational was explained well in the video, but I thought you were talking about irrigation once the shaping was complete. It wasn't clear that US activation with water was your preference during shaping. Do you believe that an access tip, like an e4d is sufficient for this purpose? I am assuming that you are recommending water-port tips for this application.
@@2thdoctom Thank you for your insight. I use the Endovac macrocanula lately for this purpose. I used EDTA solution for shaping, as you described, because when Dr. Stephen Buchanan described it, it made sense to me. When I heard Prof. Markus Hapasalo talk about dentine erosion due to edta use prior to NaOcl use, I stopped doing it. Even though the long term effect of dentine erosion is yet to be known, I was convinced to abandon this approach.
@@michaellupu2080 This is again another good point... the problem is I'm making too many assumptions. Obviously these are not scripted and why some areas I make this mistake. I ONLY and ONLY use water ported tips... in fact... I believe that non ported tips were designed by people who have no idea about ultrasonics and how it works! I have continuous flow of water from my ultrasonic and that's how it helps flush and agitate! Now I have to make a video on that specific point!
thanks for sharing!
thank you a lot! it does make sense, kind of game changer
What is your total time of irrigation after instrumentation and before filling? How much is not enough and how do I know when to stop irrigating and that the canals are ready to be filled?
This should be a whole video itself. Thanks for the question! 👍🙏
I love this question! Good one!
@@michaellupu2080 It is basicly an essence of what we trying to do, kill the bacteria and destroy the biofilm. Hope the video will be made.
@@martinchrom4444 I agree; we're trying to achieve microbiotic annihilation and complete pulp tissue dissolution.
I'm looking forward to hear what dr. Nasseh's take is, because even though we all know what we're trying to achieve, there's no common agreement on how to get there: it ranges from "Well, the irrigation during instrumentation is enough", to "X amount of seconds/minutes with Y device", to "I irrigate until the bubbles stops, which can take 20-40 minutes..".
thanks
Спасибо. Песок в Пенсикола как снег, белый.
thank you dear doc i am your fan from afg
thank you
Excellent video as usual! But I’ve got some questions: what US tips do you use for the agitation and how deep in the canal are they inserted? Can I evacuate the debris using a standard capilary tip on the suction device? Thank you! Hope to see you in Brazil lecturing any time soon!
Please upload full video approximate of 1hour of compleet case molar rct ,also showing you and your assistanc activity, support u during rct,i mean office view during procedures...
Following u from many years... thank you sir
I think the video is already available
@@drmahanthashok3685 where?put link please...
Enjoy Dr Sinbad
I like the angulated high vacum suction.where did you bought that one doctor?
That's TotalVac.. it's the new Irrigation vacuum I've developed. It's sold through Brasseler USA. You can see my videos on it form the past two months on this channel.
@@AANasseh thank you doctor. I just finish purchasing the totalvac and endovac.hope it will fit to my suction .btw, im always watching your videos here from philippines. Kinda sad that there are no exclusive distributor here in the philippines of endosequence and kerr endo materials😞
@@Teeth_builder1991 Yes. It's unfortunately limited to North America at this time. But hopefully one day. Hey I was just in Thailand... would love to visit the Philippines at some point too! Maybe I'll come in for a talk at one of your universities. Cheers! :)
Thank you for sharing doctor
My question is how deep the ultrasonic tip should be in the canal?
What about using the regular scaling tips and a stream of air-water spray?
Magnetorestrictive is not as good as piezo electric but it's definitely better than nothing! So, if that's all you got use it! :)
Dr Nasseh,
Thank you for this beautiful video! The music and the edits are always on point.
By pure curiosity, do you use the lowest settings for the E14D on the Forza V3?
Excellent question!! I should make a whole video on this topic of ultrasonic power... I do play with the power setting throughout the procedure... but for this activation/agitation component with water I have the power setting at around E1 (low power setting)... the idea is not to remove dentin but to agitate and create cavitation/acoustic streaming without cutting dentin! Cheers!
hi super Dentist . do you give a crown in such a conservatively approached tooth ?
A crown is it needed in every posterior tooth after endo; but if you’re talking about the one in this video, then since the mesial and distal marginal ridges are gone from previous decay, some kind of cuspal protection is helpful in the long run in the form of an endo crown or only. Internal bonding with a new fully bonded restoration can also work; but we need to make that call base on how much remaining decay and leakage was present around the old restoration.
There’s no question there are too many crowns. But w need to find that right parameter which is currently not solid. The ADA recommendation is a crown after endo in posterior teeth but this decision should be made in light of patient properties and individual occlusion and parafunctional habits, and remaining tooth structure, rather than one blanket statement that will get abused depending on bias. That’s at least my opinion. Everything is about understanding and managing risk. Good question! Cheers!
@@AANasseh Right sir . I am also a Dentist. your videos always open up our minds and broaden our thinking .
And yes I was talking about the tooth which you just showed in this video .
I am thankful to you for such a brief answer. Stay blessed !
Thanks, great video! What are your thoughts on using triton after you have enlarged the canal to a considerable extent, and not using it between files?
How much total volume of irrigation NAOCL do you use in each canal.
So just to clarify, having said all this, what solution would you use while instrumenting canals?
Thank you RWE and Dr. Nasseh!
I gathered he is using water and intermittent PUI with microsuction during instrumentation to remove the debris generated while shaping the canals to WL. I don’t see harm in rotating 17% EDTA solution during instrumentation also. It provides additional lubrication to reduce stress on the rotaries.
I use the three steps.. ultrasonic and water to loosen up debris followed by removing the water and adding Triton. Triton is a solution that contains all the irrigation ingredients in one: NaClO 4%, Chelating agents, Surfactants, and lubricants. It’s all in one solution.
@@AANasseh excellent! The rational was explained well in the video, but I thought you were talking about irrigation once the shaping was complete. It wasn't clear that US activation with water was your preference during shaping. Do you believe that an access tip, like an e4d is sufficient for this purpose? I am assuming that you are recommending water-port tips for this application.
@@2thdoctom Thank you for your insight. I use the Endovac macrocanula lately for this purpose. I used EDTA solution for shaping, as you described, because when Dr. Stephen Buchanan described it, it made sense to me.
When I heard Prof. Markus Hapasalo talk about dentine erosion due to edta use prior to NaOcl use, I stopped doing it.
Even though the long term effect of dentine erosion is yet to be known, I was convinced to abandon this approach.
@@michaellupu2080 This is again another good point... the problem is I'm making too many assumptions. Obviously these are not scripted and why some areas I make this mistake. I ONLY and ONLY use water ported tips... in fact... I believe that non ported tips were designed by people who have no idea about ultrasonics and how it works! I have continuous flow of water from my ultrasonic and that's how it helps flush and agitate! Now I have to make a video on that specific point!