How We Choose Good Endodontic Instruments

Currently, there is a large number of endodontic motor instruments and instrumentation techniques on the market and being used today. Usually, when there are so many instruments and techniques to do the same job, it tells us that no single technique or instrument has found the answer to accomplishing the task in the easiest, most favorable way when compared to the others.

We can choose from hand instrumentation, rotary or reciprocal handpiece-driven instrumentation, ultrasonic and sonic instrumentation, and any combination of these. Not only are the delivery systems different, but there also are many different types of instruments themselves; for instance, files, reamers, headstroms, etc., and each can be made of either stainless steel or nickel titanium.

Each instrument and its accompanying technique have their own advantages and disadvantages. The key is to find a system to use in which all of the components are made to work together synergistically, such that they result in a procedure that is easy for the dentist to achieve the desired end results. In this instance, the desired end result is a debrided, clean canal that has been enlarged, shaped, and finished to receive a gutta-percha and sealed obturation. This should be able to be achieved in an easy, quick, not too expensive, predictable, operator friendly manner. The dentist should not have to be Michelangelo to achieve the desired result consistently on every patient.

We can make access, open into the pulp chamber, and find the root canal treatment equipments. Once the canals are found, I usually use a size #08 gray reamer to obtain my measurement. The measurement is achieved with the use of an apex locator. The apex locator is the only instrument we have that will give us the measurement to the constriction of the canal. Read the instructions for your apex locator, because each manufacturer marks a different point on its measurement scale indicating where the constriction or anatomic apex is located.

In other words, the foot pedal is pushed down in a continuous motion and kept down; the handpiece with the instrument is moved up and down with apical pressure being applied. Each downward peck cuts and opens up the canal wall, and the instrument moves closer to the working length. If the instrument is short of the measurement, it should not be pushed; rather, more pecks should be used to get the instrument to length. Once the canal is enlarged to a size #20 yellow SafeSider, the glide path is considered complete.

Take Serious of the Cleaning and Sterilization Process

Today’s busy dental practices face a serious challenge: to maintain or increase productivity while ensuring that patient safety remains a top priority. At times, these may seem like incompatible goals. Advances in processing dental equipment, however, have empowered practices to develop safer processes while realizing efficiencies and ultimately, saving money.

Effective and efficient infection control in the dental office is essential for the safety of patients and to ensure that productivity does not suffer. Infection control programs all include the cleaning and sterilization of reusable dental instruments and devices. Care must be taken by the dental healthcare professional to ensure that all instruments are cleaned prior to sterilization, and that this is carried out in a safe manner to avoid injury and puncture wounds.

A cleaning and sterilization process that meets ADA and CDC guidelines is vital to an effective infection control program. Streamlining of this process requires an understanding of proper methods, materials, and devices. Many methods of instrument reprocessing are available. Use of a complete system that encompasses and fulfills all elements that are critical maximizes efficiency and minimizes risks.

Closed cassette systems provide a more efficient and safer way to process, sterilize and organize instruments in a dental office- these eliminate manual steps during instrument reprocessing such as hand scrubbing and time-consuming sorting of instruments, thereby improving safety and increasing efficiency.

To prevent accidental injury with the contaminated instruments, special handling should be used to transport the instruments to the cleaning and sterilization area. The Centers for Disease Control and Prevention (CDC) states that, “Contaminated instruments should be handled carefully to prevent exposure to sharp instruments that can cause percutaneous injury. Instruments should be placed in an appropriate container at the point of use to prevent percutaneous injuries during transport to the instrument processing area.”

The fine tactile sensitivity needed during dental procedures is not necessary during instrument cleaning and sterilization; therefore, heavy-duty gloves pose no problem in this regard. Additionally, nitrile utility gloves are available in a variety of sizes, allowing a more secure fit.

The Proper Autoclave for Your Dental Practice

There are our guide of recommended questions every dentist should ask themselves before deciding on the best dental autoclave.

First, write a list of what you need to sterilise in your autocalve. Will you only place handpieces for cleaning or are you also planning on sterilising other items such as wrapped or hollow instruments in the machine? Also ask how many instruments you need to place to maximise space. Not enough room will mean extra cycles and too much room is a waste of water and energy. You want every cycle to be filled up as efficiently as possible.  This information will then determine the optimal chamber size you require.

If you haven’t already decided on the allotted bench space for your autoclave you’ll need to make this decision fairly quickly. Find out how much room you have and look for autoclaves within those dimensions. This then needs to relate back to step 1 to make sure the chamber size is large enough to sterilise all the instruments you need.

The space allocated will dramatically narrow down your search for an autoclave. You’ll also want to make sure there is plenty of room to open the autoclave door allowing staff to easily access instruments. If you need something narrow the Melag Melaquick 12+ is 20.5cm width x 45cm depth allowing for instruments up to 20 cms long. If you have plenty of space then you might consider Melag Vacuklav 24BL+ which is 75 x 42.5 x 48.5cm with a sterilisation chamber of up to 60cm.

One of the most frequent questions we get from dentists is whether to buy an autoclave that’s plumbed in or should they buy a stand-alone machine. With a plumbed in machine the autoclave will fill and empty itself as it’s attached to plumbing lines for drainage. On the other hand the stand alone machines need to have distilled water added manually plus staff also need to drain the machine, this can be unproductive on time management for your staff.

If you want to opt for a plumbed in machine and don’t already have the correct plumbing in place then you’ll need to budget this cost, but once it’s done then your staff will be able to work more productively as they won’t need to fill in the drain the machine manually. With the stand alone machine you are only able to use distilled water so if you don’t already have one you also need to purchase a water distiller.

How much do you have to spend? This will outline the number of features that will be available to you on this budget. There are many dental equipment for sale in our website, please take as a example. Plus think about operational costs such as servicing and the water and electricity bills that will happen every time you run the machine. The cheapest autoclave we stock is Melag Euroklav 29VS Autoclaves at $6495 and 17L in size this model is only available as a standalone machine and a printer attachment can be sold separately.

To keep your machine running optimally you complete a daily test cycle as per manufacturer’s regulations. It’s also recommended to have your autoclave professionally serviced every 12 months. Learn more about maintenance tips for your autoclave by clicking here and remember that better maintenance will keep your steriliser running longer avoiding unnecessary breakdowns leaving you without a machine.