![]() ![]() The hybrid technique, as with all other techniques, requires direct access into the apical third of canals-the area of the canal system considered most difficult to clean, shape, and fill. This paradigm shift will not occur overnight, but eventually apical preparation sizes of 45 and higher (for most molars) and 60 and higher (for most anteriors and premolars) will be considered normal to those willing to accept the scientific and clinical evidence. Fortunately, with the introduction of nickel-titanium technology approximately 10 years ago, the capability to prepare canals safely and effectively to larger sizes already exists. We anticipate an urgent interest by the research community in obtaining more information about apical canal diameters to support existing research indicating that “uninstrumented” apical diameters are not as small as we are led to believe. 20 to 35 range) will be considered small in the future. Recently, considerable evidence has surfaced that effective bacterial removal requires apical preparations larger than many would currently consider “normal.” We believe that sizes considered normal today (Nos. The justification for single-visit endodontics depends upon the ability of the chosen instrumentation technique to render canals almost bacteria-free predictably in one appointment. In part 1, we mentioned that the removal of all or most of the bacteria during the cleaning process was crucial for successful endodontics. It is widely accepted that bacteria (and their toxins) are the immediate cause of dental problems that often require root canal treatment, and that bacteria also are the cause of treatment failures. SINGLE-VISIT ENDODONTICS: PART 1 REVISITED The hybrid technique described in this article (including 3 case reports by 3 different clinicians) uses K3 tapered NiTi rotary instruments (Sybron Endo) and LightSpeed NiTi nontapered instruments (LightSpeed Endodontics). Mixing and matching various instruments and techniques is commonly practiced because no single technique is suitable for every possible root canal configuration. NiTi tapered rotary instruments are used in a crown-down fashion to prepare quickly and efficiently the coronal and midroot portions of the root canal, while nontapered, highly flexible NiTi rotary instruments are used for the final cleaning and shaping of the apical part of the canal. In this article, we describe a technique for cleaning and shaping canals using a combination (“hybrid”) of 2 different types of instruments: tapered rotary instruments and nontapered rotary instruments.Ī hybrid technique combines the desirable features of 2 different instrumentation systems. But, above all, we stressed that single visits could be justified only when certain criteria were met-namely, that canals be well cleaned, shaped, and obturated in the single appointment, and that additional visits would not improve the quality of treatment. We also listed our 5 exceptions to single-visit treatment. ![]() In part 1 last month, we gave our reasons and supporting evidence for considering single-visit endodontics as a viable treatment option in many cases. ![]()
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