Endo Tribune Middle East & Africa No. 1, 2018
XP-endo® Shaper Plus sequence / Irrigating the root canal
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DTMEA_No.1. Vol.8_ET.indd
www.dental-tribune.me
PUBLISHED IN DUBAI
January-February 2018 | No. 1, Vol. 8
XP-endo® Shaper Plus sequence
FKG Dentaire presents its new single file sequence
SUBSCRIBE NOW
www.me.dental-tribune.com/e-paper/
Vol. 13 • Issue 4/2017
issn 2193-4673
roots
international magazine of
endodontics
4
2017
By FKG
A new generation of Swiss-made instruments enables safer and more effective root canal treatments, thanks
to unique 3D extension capabilities.
The XP-endo® Shaper Plus sequence,
launched by leading Swiss endodontic firm FKG Dentaire SA, solves a
common problem for dentists: how
to treat complex root canal systems
without causing damage to the
dentinal structure. FKG combined
unique Adaptive Core™ technology
with 3D design to create instruments
that can easily adapt to the canal
anatomy to clean once impossibleto-reach areas. The result is enhanced
debris removal and irrigation for a
more gentle, conservative treatment
compared to instrumentation using
traditional NiTi files.
“The main problem with conventional files is their lack of flexibility,
which means that dentists can’t remove all the debris, but sometimes
end up taking off too much healthy
dentin,” says Thierry Rouiller, CEO of
FKG Dentaire.
“But that all changes with this XPendo® generation of instruments.”
The patented MaxWire® alloy reacts
to the body’s temperature, making
the tools highly flexible compared to
instruments of the same final size. A
small, free-floating adaptive core de-
research
Photodamage of dental pulpa stem cells
during 700 fs laser exposure
signed in 3D allows the instruments
to expand and progress with agility
along the canal while resisting to cyclic fatigue.
• The XP-endo® Shaper (XP-S) performs 3D debridement of the canal
while respecting its natural shape.
• The XP-endo® Finisher (XP-F)
achieves 3D cleaning and biofilm removal, including in areas impossible
to reach with traditional files.
• The instruments are delivered in a
sterile blister pack destined for single
patient use, thus maximising safety.
With the XP-endo® Shaper Plus sequence, dentists have the most advanced Swiss precision tools at their
fingertips to perform a complete,
minimally invasive root canal instrumentation.
case report
Apexification treatment with MTA REPAIR HP
interview
Understanding sonic-powered irrigation
XP-endo® Shaper Plus sequence, 25
mm (K-File 10 + K-File 15 + XP-S + XPF): S1.XB0.00.SAD.FK
References FKG
XP-endo® Shaper Plus sequence
XP-endo® Shaper Plus sequence, 21
mm (K-File 10 + K-File 15 + XP-S + XPF): S1.XB0.00.SAC.FK
FKG Dentaire SA
www.fkg.ch
3D agility_
The One to Shape your Success
3D anatomical root canal preparation
Exclusive Adaptive Core™ Technology
Remarkable cyclic fatigue resistance
3D efficiency_
Optimal Cleaning while Preserving Dentine
3D cleaning and biofilm removal
Free ps
o
ksh
Wor ooth!
on B
Swiss Pavillion, Hall 8
Booth 8E17-8F10
Enhanced irrigation and debridement
Unique expansion capacity
FKG Dentaire SA
www.fkg.ch
[2] =>
DTMEA_No.1. Vol.8_ET.indd
A2
ENDO TRIBUNE
Dental Tribune Middle East & Africa Edition | 1/2018
Drilling treatment
using the new MTA Repair HP
Clinical Case Report
By Prof. Dr. Fábio Duarte da Costa
Aznar, Brazil
Female patient, 47 years old, presented with a clinical picture of extensive
iatrogenic perforation of the furcation region of the dental element 36
(Figs. 1 and 2), associated with radiographic bone loss, vestibular fistula
and pain on palpation. The patient
reported history of having been previously subjected to an urgent intervention in this tooth by other professional, as it presented acute pain
characteristic of pulpitis.
Fig. 1-2: Initial clinical and radiographic appearance of teeth 36
Figs. 4-5: Clinical and radiographic appearance of drilling filling with MTA Repair HP.
The tooth was submitted to endodontic therapy, and after the initial
approach with the patient, anesthesia was given, followed by preparing
absolute isolation. Subsequently,
the coronary access was performed,
where it was possible to clinically
verify the presence of pulp necrosis
and perforation. A disinfecting penetration of root canals (crown-down)
was performed using as irrigator
agent NaOCl to 5%, and the odontometry determined by the use of
foraminal locator. The preparation
was carried out by Reciproc system
(VDW/Germany), and as irrigator
agent was employed NaOCl 2.5% associated with ultrasonic activation
performed with straight inserts (Irrisonic/Helse/Brazil).
Next, the drilling was treated, with its
cleaning and the regularization, employing ultrasonic diamond insert
(E7D/Helse/Brazil). As a complement
to the intra-channel decontamination process and the furcation region, a biweekly exchange of Calcium Hydroxide (Ultracal/Ultradent/
USA) was held, observing remission
of all symptoms.
The obturation was performed using
the thermomechanical Hybrid Tagger technique (Fig. 3), by employing
GutaCondensor (Maillefer/Switzer-
Fig. 3: Obturation of root canals.
Fig. 6: Drilling region protection sealed with glass
ionomer cement.
land), TP gutta-percha cones (Dentsply/Brazil) and MTA-based sealer
Fillapex (Angelus/Brazil) (Fig. 4). After thermo compaction, the obturation cutting was performed, as well
as vertical condensation using cold
pusher; and again the region of the
perforation was cleaned and filled
with Calcium Hydroxide.
After 15 days, again, we proceeded
to seal the drilled region, and initially verified the proper possibility
of drying the area. The filling of the
drilled region was carried out with
the use of MTA Repair HP (Angelus/
Brazil), previously prepared as recommended by the manufacturer,
Fig. 7: Follow-up X-ray after two months.
and it was inserted using an MTA Applicator (Angelus/Brazil). Clinical and
radiographic criteria were used to determine the correct filling using the
material (Figs. 4 and 5); and the glass
ionomer cement (Vitremer/3M/
USA) used for the protection of the
sealed region (Fig. 6). After the temporary restoration, radiographically
it was observed proper sealing of
furcation region by MTA Repair HP,
as well as no postoperative complications.
Follow up was conducted after two
months, observing bone neoformation in the furcation region and absence of symptoms (Fig. 7).
Prof. Dr. Fábio Duarte
da Costa Aznar, Brazil
He is a specialist in Endodontics HRAC (Centrinho)/USP/Bauru.
Doctor of Applied
Dental Sciences - Dental School by Bauru Q
University of São Paulo.
Additionally, Prof. Dr. Fábio is the Coordinator of Specialization Course in
Endodontics Facoph/Bauru-SP, FACESC/
Chapecó-SC, FAIPE/Goiânia-GO, GOE/
Macapá-AM, Funorte/Ji-Paraná-RO.
Irrigating the root canal
A Case Report
By Dr Vittorio Franco, UK and Italy
The patient reported on in this article is a student in dentistry and
his parents are both dentists. They
referred their son to a good endodontist, who then referred the case
to me. As always, peers are more
than welcome in either of my
practices, in Rome and London, so
when I treated this case, I had three
dentists watching me, a future
dentist on the chair, placing a great
deal of pressure on me.
The 22-year-old male patient had a
history of trauma to his maxillary
incisors and arrived at my practice
with symptoms related to tooth
#21. The tooth, opened in an emergency by the patient’s mother, was
tender when prodded, with a moderate level of sensitivity on the respective buccal gingiva.
Sensitivity tests were negative for
the other central incisor (tooth
#12 was positive), and a periapical
radiograph showed radiolucency
in the periapical areas of both of
the central incisors. The apices of
these teeth were quite wide and
the length of teeth appeared to
ÿPage A3
Fig. 1: Pre-operative radiograph.
Fig. 2: Intraoperative radiograph of apical
plug of tooth #21
Fig. 3: Post-operative radiograph
[3] =>
DTMEA_No.1. Vol.8_ET.indd
Dental Tribune Middle East & Africa Edition | 1/2018
A3
ENDO TRIBUNE
◊Page A2
exceed 25mm. My
treatment plan was
as follows: root canal therapy with
two apical plugs
with a calcium
silicate-based bioactive cement. The
patient provided
his consent for the
treatment of the
affected tooth and
asked to have the
other treated in a
subsequent visit.
After isolating with
a rubber dam, I
removed the temporary filling, and
then the entire
pulp chamber roof
Fig.4: EDDY in action
Fig. 5: Intraoperative radiograph of apical
plug of tooth #11 (after 6 months from the
first treatment).
Fig. 6: Post-operative radiograph
Fig. 7: Four months follow-up radiograph
with a low-speed round drill. The
working length was immediately
evaluated using an electronic apex
locator and a 31 mm K-type file. The
working length was determined to
be 28 mm.
As can be seen in the photographs,
the canal was actually quite wide,
so I decided to only use an irrigating solution and not a shaping instrument.
Root canals are usually shaped so
that there will be enough space
for proper irrigation and a proper
shape for obturation. This usually means giving these canals a
tapered shape to ensure good control when obturating. With open
apices, a conical shape is not needed, and often there is enough space
for placing the irrigating solution
deep and close to the apex.
I decided to use only some syringes
containing 5 per cent sodium hypochlorite and EDDY, a sonic tip
produced by VDW, for delivery of
the cleaning solution and to promote turbulence in the endodontic space and shear stress on the
canal walls in order to remove the
necrotic tissue faster and more effectively. After a rinse with sodium
hypochlorite, the sonic tip was
moved to and from the working
length of the canal for 30 seconds.
This procedure was repeated until
the sodium hypochlorite seemed
to become ineffective, was clear
and had no bubbles. I did not use
EDTA, as no debris or smear layer
was produced.
THE SAME EFFICIENCY
WITH BETTER PLASTICITY
I suctioned the sodium hypochlorite, checked the working length
with a paper point and then obturated the canal with a of 3mm
in thickness plug of bioactive cement. I then took a radiograph before obturating the rest of the canal with warm gutta-percha. I used
a compomer as a temporary filling
material.
The symptoms resolved, so I conducted the second treatment only
after some months, when the
tooth #11 became tender. Tooth
#21 had healed.
I performed the same procedure
and obtained the same outcome
(the four-month follow-up radiograph showed healing).
Editorial note: The article was originally published in International Magazine for Endodontics 4/2017.
Dr Vittorio Franco
He is an endodontist who runs an endodontic referral practice in London and in
Rome. An active member of the European
Society of Endodontology, Franco is also
the President-elect of the Italian Society
of Endodontics.
Endodontics
MTA Repair HP
Bioceramic high-plasticity
reparative cement
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• Low solubility: More prolonged action and quicker tissue recovery
• Setting expansion: High marginal sealing capacity which prevents
the migration of microorganisms and fluids into the root canal
• Stimulation of regeneration: Excellent biological sealing of root
perforation (channel and furcation) to induce formation of
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• Stimulation of pulp regeneration: Induces the formation of a
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