Endo Sequence [EndoWave] NiTi-Files

As a result of quest for a better, simpler technique, Real World Endo in partnership with Brasseler, USA has developed a new endodontic file and sequence. It is hoped that this file and sequence will satisf man of the current demands of modern root canal therap , while at the same time, be user friendl . It is also been mar!eted as EndoWave b " #orita. Real World Endo Sequence File design $%&' Blank design (he blan! desi)n of the Sequence *ile is absolutel revolutionar . It is desi)ned in such a wa that there are alternate contact points +A,-s. alon) the shan! of the instrument. (his innovative desi)n not onl !eeps the file centered in the canal but the A,-s also )reatl reduce the torque requirements of the file. (his is because A,-s )reatl reduce the resistance of the file. Sequence file with ACPs

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(here are other si)nificant features to the A,- desi)n. Because the A,-s, in combination with a precision tip !eep the file centered in the canal, there is no need for radial lands. (his desi)n chan)e is profound because the lac! of radial lands allows the instrument to be sharper and, consequentl , more efficient.

Electro 2 polishin) of the file removes man of the imperfections in the 3i(i that can have catastrophic consequences. In addition, the creation of a superior finish will !eep the ed)e of the 3i(i instrument sharper, cleaner, and more durable. Electropolishin) can e4tend the life of a rotar file, but the Sequence *ile has been desi)ned to be part of a sin)le2use s stem. Simpl put, electropolishin) ma!es an rotar file safer and better. It also must be noted that at the current time, the Real World Endo Sequence *ile

is the only constant-taper rotary file system that is sub5ected to an enhancement procedure such as electropolishin). (he authors believe that this is a si)nificant advance in the manufacturin) of constant2taper files. Quality of manufacturing Real World Endo is with the concept of 6-recision2Based Endodontics,6 and this precision is a function of the qualit of manufacturin). After inspectin) the ed)es, one can confirm the sharpness7 when the file is pulled across the fin)ernail +cuticle to tip., it will bite and en)a)e. (he sharp ed)es are a function of its manufacturin) process. 8n inspection, one can also confirm the fle4ibilit of the Sequence *ile and more important, the shape memor of its 3i(i blan!. (he shape memor is superb. It is ne4t to impossible to separate the handle from the shan!. It is with supreme confidence that the authors can sa that the Sequence *ile has been manufactured to the hi)hest possible standards. (he Real World Endo Sequence *ile is available in both 9.9: and 9.9% tapers. #ost important, these are full tapered files, which means that the wor!in) shan! is /% mm, not a reduced ; or /9 mm. A full wor!in) shan! is si)nificant because it will allow the practitioner to 6machine6 a preparation in a precise, crown down fashion.

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Tip design (he Sequence *ile uses a precision tip. A precision tip, b definition, is a noncuttin) tip that becomes active ri)ht at <2l. (he result is safet +non2perforatin). combined with efficienc . (his is e4actl what we want to have in a tip desi)n. (his abilit to remain centered is the result of a precision tip combined with A,-s of the blan! desi)n. (his concept is a new and revolutionar one.

Electro polishing Cutting efficiency (he Sequence *ile has superb cuttin) efficienc . (he onl other file with a similar efficienc is the -ro(aper. What )ives the Sequence *ile e4tra cuttin) efficienc is the electropolishin) that results in its characteristicall sharp ed)es. *urthermore, the A,- desi)n allows the portion of the instrument that is en)a)ed to reall wor! in an efficient manner because the full shan! is not totall en)a)ed and there is no encumbrance of radial lands. E4perience has shown that the Sequence *ile cuts so effectivel that the operator must be aware to wipe clean or chan)e the file after three pec!s +or en)a)ements. of the file. (he file should be in the canal onl for = to & seconds before cleanin). Another wonderful aspect of its cuttin) efficienc is how well and fast the sequence file can enlar)e a canal preparation. (he abilit of sequence file to withstand transportation is a function of A,-s, precision tip and e4cellent fle4ibilit . /=9

Resistance (he Sequence *ile, without question, )enerates the least lateral resistance of an constant2tapered rotar file s stem, which is a result of its trian)ular reamer2li!e desi)n, e4tremel sharp ed)es, electropolishin), and lac! of radial lands. (he manufacturer has combined all these features into a sin)le file, with the result bein) the lowest torque requirements of an constant2tapered rotar file s stem. (he fle4ibilit of this file is outstandin). *le4ibilit becomes a tremendous asset in rotar endodontics as the clinician be)ins to tac!le more difficult cases. (he !e point to remember concernin) fle4ibilit is this7 fle4ibilit is not the same amon) the various rotar files and it most certainl should not be ta!en for )ranted. Pitch/ helical angles (he Sequence *ile has both variable pitch and variable helical an)les. (he result is less of a tendenc to pull down into the canal, which is further enhanced b its blan! desi)n +A,-s. and the lac! of radial lands. (he net result of these features is )reater control. ,ontrol over the file means control over the procedure. Speed ,oncernin) speed and its influence in rotar instrumentation,is represented as formula E > S? ( @ E is ener) required to re move the dentin it is the function of both speed S and torque (. As ou reduce torque requirements , one m increase speed . (he sequence file has been shown, throu)h test cases +both clinicall and Bench top., to wor! best in a ran)e of :&9 to %99 rpm. <ue to the A,- desi)n no lands and its lac! of torque requirements, however, the Sequence *ile runs superbl in a portable handpiece. It also is a )oal of Real World Endo to remove as man rheostats as possible from the treatment room. (he da is comin) when clinicians will be able to perform rheostat2free endodontics.

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It must also be pointed out that the Sequence *ile has a tendenc to clic! in the canal. In the past, this clic!in) mi)ht have been cause for alarm@ however, it is not unusual for a trian)ular2shaped blan!. (he clac!in) will disappear when the file is not pushed as hard. (he rpm should not be reduced because the clac!in) is a result of e4cessive force, not rpm.

Real World Endo Sequence File technique (he Real World Endo Sequence *ile comes in pac!a)es of four files each. (he selection of Sequence *iles includes an Expeditor file +four to a pac!. and 9.9% taper rotar files in siAes e4tra smallBsmall, medium, and lar)e. In addition, there are 9.9: taper Sequence *iles available in siAes e4tra smallB small and medium. All root canal preparations are be)un b confirmin) coronal patenc . (his confirmation is achieved with a siAe /9 stainless steel hand file. After reachin) the halfwa point in the canal, the siAe /9 file is 6wor!ed6 in a bac! and forth motion to ensure a )lide path. After coronal patenc has been confirmed, an Expeditor file is the first rotar file placed into the canal. (he use of an E4peditor is a new concept, usin) a totall different file. (he Expeditor is a size 27, 0.04 taper rotar file that incorporates a wor!in) shan! of /% mm and an overall len)th of 21 mm. (he purpose of the E4peditor is to determine the appro4imate siAe of the canal and which pac!a)e of files should be opened. Sequence Expeditor file

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After enterin) the canal with the E4peditor, this file is ta!en down into the canal until si)nificant resistance is encountered. Cavin) met resistance with the E4peditor, this file is now removed from the canal, and the operator chooses which pac!a)e of files to open. (his decision is based on information )leaned from the preoperative radio)raph, the resistance of the siAe /9 hand file, and the depth of penetration of the E4peditor.

Real World Endo Sequence File technique extra small canals $%%' When the E4peditor )oes down half ay into the canal, it signifies a small canal! however, when the E4peditor )oes down more than half ay, it means the canal is medi"m siAed. A totall loose E4peditor that goes to its entire length si)nifies a large

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canal. After the canal siAe is determined the operator simpl pic!s up the appropriate pac!. After choosin) the appropriate Sequence *ile, a crown down technique is performed in the recommended manner. *or e4ample, in a small canal, be)innin) with a siAe =9, 9.9% taper +=9B9.9%. file, the author ta!es that to resistance. *ollowin) the initial file, a 0&B9.9% Sequence *ile and then a 09B 9.9% file are ta!en to resistance. (he crown down preparation is complete after the first rotar file that reached the wor!in) len)th with resistance has been used. (here will be times, however, when the 09B9.9% Sequence *ile falls short of reachin) the wor!in) len)th with resistance. In this case, crown down should be continued to a /&B9.9% file, and )enerall , this file should ta!e the clinician to the final wor!in) len)th.

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