Problems with length control with rotary instruments

[Dr.Paidar]

Greetings;

Recently I’ve been having issues with length control when instrumenting using NiTi rotary files.

Initially I prepare the coronal portion using SX and afterwards I use an electronic apex locator to determine lengths and finally take a radiograph.

After WL determination, I proceed to shape and finish the canal and then take another radiograph with the appropriate GP point.

It all goes well up to now, then when obturating by lateral condensation technique, I sometimes get pain from the patient and unfortunately yesterday I found out that I had overfilled (even though my master cone had gone to the appropriate length) and had to refer to my local endodontist for further analysis.

Any tips on maintaining WL throughout the procedure will be greatly appreciated.

 

[honestdoc]

I like to instrument ~0.5 mm short of working length for an apical stop. I use Wave One with very light passive pressure. Sometimes on very infected apical areas, the apical stop may not be so solid and can allow for overfill. You might consider warm vertical fill with System B and Calamus back fill. Cold lateral fills have been around for a long time (I used to do them) but they can stress the root possibly leading to vertical root fracture.