Styleitaliano Endodontics has the mission of setting excellence standards while simplifying protocols in this vast world of Endo, by the full understanding and respect of biology, of the all time concepts and specially for the contemporary findings. With precise rules, methods and instruments we have many messages to deliver in this new era of simplification for excellence. With our team of experts we are constantly working to do so.
Fabio Gorni
Endodontic diagnosis, therapies and follow-up procedures can be the most complex of dental treatments; among these, shaping the root canals has always been considered as the basic and most important procedure. Various instruments and techniques have been developed in the history of endodontics, to deal with the almost infinite anatomical variations of root canals; this topic has been extensively debated elsewhere in this web site (http://www.styleitaliano.org/history-of-endodontic-instruments). A relatively recent technological evolution has put forth a variety of endodontic files, more aggressively shaped, flexible but resistant to breakage, made from new alloys, with new surface treatments, mechanically driven with rotary or reciprocating motion. These instruments should be chosen and used according to the manufacturer’s instructions, in a precise sequence or sometimes as a single file, after evaluation of canal anatomy, curvature and gauge. This evaluation is either made with an initial scouting of the canal with small instruments, or even directly examining a periapical x-ray. Obviously, each commercial brand of endodontic instruments proposes a different protocol, based upon the use of instruments of its own production. The possibility to choose instruments of different brands for different canals, or the use of simplified sequences, is ruled out ......
Fabio Gorni
Root canal procedures have the reputation of being painful; without effective pain control, an endodontic treatment cannot be performed in a calm, precise fashion. Achieving clinically acceptable anesthesia in the maxilla is rarely a problem, while anesthesia of mandibular teeth is more difficult to achieve on a consistently reliable basis. Patients who are experiencing pulpal pain, particularly in mandibular molars, have additional anesthetic problems. The inferior alveolar nerve block does not always provide profound pulpal anesthesia in mandibular molar with pulpitis, and supplemental local anaesthesia is often required. A “bull’s eye approach” is useful in difficult cases: inferior alveolar nerve - buccal / lingual - intraligamental - intraosseous - intrapulpal. Other problems arise with apprehensive patients, who report a history of previous difficulty with anesthesia; because of technical problems or individual factors, sometimes a larger dose of anesthetic is required. A “rule of the thumb” for remembering maximal dosages with currently formulated local anesthetic cartridges (Mepivacaine3%, Mepivacaine2% with ephinephrine 1:100.000, Articaine 4% with ephinephrine 1:100.000) is to use one cartridge of local anesthetic for every 12 kg of patient weight. Anyway, the inferior alveolar nerve block unfortunately has an high percentage of failures, even when properly administered. Mandibular teeth may receive innervation from more ......
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