Dental Student Question : Are H-Files Necessary in Step Back?

Apr 2, 2024
Hello. 2nd year dental student. We started shaping canals and filling on extracted teeth a month ago and I have worked on maxillary anterior teeth so far. We use the step back technique in our faculty and it is the only technique we are taught. I really really enjoy endodontics and considering to specialize in this field in the future.

Now my questions about step back technique that I am afraid to ask my professors :p

First one is, are H-Files really necessary? I did my first few canal shapings using both K and H Ni-Ti files in every step, but the filing action showed up some excessive broadening in my first tries. Maybe I was using them wrong. Then I tried using K files only on lateral maxillary incisors, some of them turned out OK, some of them not so much.
So are H files really necessary? Can I complete the process using K files only?

Second one is, we first measure the canal, and extract 1 mm from the length to determine working length. We never check that last 1 mm on the apical side of the canal, what if it gets filled up with some debris? Sometimes I check it with the smallest file and see if it can go beyond apex, but obviously I won't be able to do this on a patient. So, do I need to care about this, or will a lot of irrigation prevent that part from a build up?

And the last one is, although step back is good enough, I would like to experiment with other methods like crown down/step down. I saw the styleitaliano's guide on their step down technique but I was confused on how to determine the first file and how much to shape the canal. Do you know any good guides on this methods?

Thanks a lot to everyone for their help and going through my rookie questions in advance. I am not sure if this is the right place to ask, but this was the only dentistry forum I could find!

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