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Use of the Dental Assistant During Endodontic Cleaning and Shaping (Video)

Terry Pannkuk, DDS, MScDInstructional, Clinical Endodontic Technique Instruction, Cleaning and Shaping, All by Date

Video Description

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It is my opinion that the assistant scope interferes with the efficiency and attention of the dental assistant when passing endodontic files and keeping them set to the proper length with a curved tip. There are other techniques taught by others that have the assistant utilizing the assistant scope. There are specific procedures where the assistant scope may be useful (for example surgical suturing) but these instances are rare in my specific practice. Each clinician tends to find his or her own ergonomic comfort zone and apply a unique armamentarium to suit their specific needs. This video demonstrates one successful "style".

Notable differences in cleaning and shaping without the assistant microscope:

  1. The assistant precurves and sets the lengths of the files.
  2. The clinican can pick the files out of the sponge efficiently with nonverbal communication as the dental assistant monitors the needs of the operator.
  3. The dental assistant can monitor the patient’s needs while the doctor is looking through the microscope

Maxillary molars, bicuspids, and anterior require less movement outside the microscope. A simple glance outside the scope is required to pick up files. On mandibular molars it is more comfortable to slide from the 12 O’Clock position to the 3 O’Clock position for wrist and arm comfort minimizing contortion. On some very simple mandibular molars with ideal access design, the files can slide into the orifices along the corners without magnification during each recapitulation series.

Key Learning Points: regarding the treatment of a mandibular molar.

  1. The length measurement was checked a few times to assess the level of an "irregularity" within the canal

  2. Once the 'bumps" are smoothed, a recapitulation series can be resumed at a larger beginning file size

  3. The operator can slide back and forth to the scope to copiously irrigate and efficiently recapitulate through a file series

  4. Once satisfied with the tactile feel of the canal prep, the gutta percha cone can be fit to a proper cutback size with tug back

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