Biomedical subjects
Publications and source records attributed to J T Barss.
A new method of magnified intracanal visualization using a fiberoptic endoscope has been developed for use in conventional endodontic treatment. The 0.7 mm flexible fiberoptic endoscope allows the endodontist to view canal morphology and biomechanical canal preparations, and helps to identify fractures, accessory canals, and remnant pulpal tissue.
Orascopic endodontics has helped bring visualization to what has literally been a "blind" specialty. The ease of operation and better operating ergonomics of fiber optic instrumentation has allowed the endodontist to identify and treat endodontic etiology more efficiently. The metamorphosis of understanding endodontics from an in vivo perspective is changing the way we "think" about the practice of endodontics. Prior to intracanal visualization, the cognitive process of determining when the canal was ready for obturation was merely an educated guess based on years of in vitro instrumentation research and postoperative follow-up studies.
This study evaluated and compared the corrosion susceptibility of stainless-steel and nickel-titanium (NiTi) endodontic files immersed in sodium hypochlorite. For each of the stainless-steel files (Kerr K-Flex, Caulk Flex-O, and Union Broach Flex-R) plus the NiTi files (Union Broach NiTi and Tulsa NiTi), the cutting flutes of 24 ISO size 20 files were immersed into 5.25% sodium hypochlorite. Their open circuit potential (OCP) was recorded for 1 h on a strip chart with high impedance. The strip chart recording for each file was classified into a stability score: (i) stable, (ii) unstable, or (iii) erratic. The OCP was measured by a potentiostat and a standard calomel electrode reference. The OCP classification of unstable and erratic for the files evaluated were as follows: K-Flex (16%), Flex-R (12%), Flex-O (75%), Union Broach NiTi (62%), and Tulsa NiTi (0%). After OCP testing, each of the 120 files was inspected by light microscopy at x 25. The frequencies of visually observed corrosion were detected as follows: K-Flex (2/24), Flex-R (1/24), Flex-O (6/24), Union Broach NiTi (2/24), and Tulsa NiTi (0/24). There was a significant difference in corrosion frequency between brands when evaluated by OCP and light microscopy; however, there was no significant difference between stainless steel and NiTi.
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The advent of orascopy as a cutting edge technique has changed the way endodontists visualize as well as think about endodontics. As practitioners begin to see and understand endodontic etiology, it will enable oral physicians to provide treatment based on visual confirmation rather than radiographic estimates. In the future, conventional orascopic endodontics will be done very much like physicians provide treatment. It will be more qualitative rather than quantitative. Dentists will not need to make measurements of canals from radiographs; they will use orascopy to instrument, irrigate, and obturate while viewing the root canal system in real time. Surgical orascopic endodontics will continue to improve surgical treatment results because enhanced visualization has enabled endodontic surgeons to identify and treat endodontic etiology.
One of the most significant advancements in the field of endodontics has been the change in the endodontic file. The new files have different metallurgy, taper, cutting efficiency, and rotary capabilities. This article reviews and updates the advancements in endodontic instrumentation.