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Here is the third and final part of the series of articles in Dentistry magazine. In this one, associate dentist at Revive Dental Care, Dr Jonny Stevens describes his experience of implementing the new, standardised rotary endodontic therapy, which I introduced to my practices.
Having just qualified from university in 2014, I had already been lightly introduced to using rotary filing systems and was able to have some more hands-on with rotary endo during my foundation training.
Since completing my foundation year and becoming an associate, working with hand files again was the technique I used for root-treating teeth. As an associate, trying to complete endodontics on remotely curved canals when working with hand files has proven to be difficult, time consuming and unpleasant, for both me and my patients. I found that providing a root canal treatment of an adequate standard could take up to two hours in a molar tooth.
Honing my endo skills
In January 2018, however, all this changed, when I was given the opportunity by Ben Atkins to start using the new Waveone Gold rotary filing system. Ben has been working with Dentsply Sirona to provide all his practices with the best rotary system possible on the premise that if, as clinicians, we become more confident in our endodontic skills and competencies, this will in turn provide better overall quality of treatment for our patients.
Initially, training was carried out by watching a series of videos online. This covered the basics of how to use the Waveone Gold system and provided practical tips on how to use it most efficiently.
Once completed this was followed by an hour-long group session for the dentists, involving a presentation given by a representative from Dentsply Sirona. Again, the basics of how to use the filing system were reiterated and how to connect the X-Smart IQ to the iPad in order to send patient data via an email straight into the patient’s notes.
Unfortunately, this latter part was not discussed in great detail and therefore had to be reviewed with Ben before using the system. Ben was particularly keen to ensure this patient data was collected to help monitor and improve overall quality of treatment, and so once we were trained on this system in further detail we were able to ensure patient data was collected.
Getting a feel for the system
At the start of February, a day was booked out in the diary to carry out a number of root treatments using Waveone Gold in order for us to get a good feel for the system and to build our confidence.
The morning was very successful and dare I say it, almost enjoyable. Having never been the biggest endodontic enthusiast, I was able to complete three separate root canal treatments on a mix of premolars and molars. The kits organised by Dentsply Sirona were fantastic.
Ben had arranged for each kit to have all the necessary equipment to complete a treatment with a rotary system, but also included added extras, such as using the Proglider file and restoring the base of cavities with SDR, which will be fantastic for using on our private endo cases.
Back in my clinic, Hannah from Dentsply Sirona kindly attended for one of my patient treatments. This was to check I was happy with using the filing system and successfully sending the records created on the iPad into the patient notes.
Growing into endo
The journey of changing from hand files to a nickel titanium rotary system is going to allow me to grow as a young dentist and be enthusiastic about endodontics in the future. There are numerous benefits of the system, starting from the obvious one such as reducing chair time by almost 50%.
Also, the flexibility of the file instils confidence in the user and allows more difficult curved roots to be attempted and completed to a good standard. The simplicity of Waveone Gold must be its best feature. The combination of using, in the main, one primary file and obturating with one Gutta Percha point, cuts down chair time drastically and creates great radiographic results.
The introduction of a single-file system for providing endodontic treatment across the group has helped simplify the process and provide a more effective and efficient way for us to meet patient needs.