One of the most difficult parts of root canal treatment to teach is the actual way to use hand files during cleaning and shaping.
There are some clinicians who maintain that you need to have your eyes in the microscope during the entire procedure. I do not. In fact in my opinion it strains and contorts your wrists and arms limiting your ability to comfortably and efficiently perform a series of recapitulations. In this impromptu video segment, I found a very nice patient who allowed me to videotape a recapitulation series and describe my feelings and sensations as I cleaned and shaped a very simple maxillary first molar MB system. With all our technology we still cannot see past the first curve of a root and tactile sensation is key to achieving deep shape and debridement in the apical third of a root. My assistant is specially trained to keep each file precisely curved, and deliver them efficiently at the set working length. Almost every clinician I know has his or her own unique style. Cleaning and shaping is a nuanced clinical art. Hopefully sharing my personal technique will be of help and foster some interesting discussion. My hope was to provide a spontaneous real time description of the process.
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