PtoTaper and GT Series X Hybrid technique

[Dgipg]

I've been using ProTaper files and technique for a few years.
It is in my opinion a all-around system with an easy learning curve.
However it is usualy sold as an easy, and fast technique by the manufacturers, and it is not. It is an agressive shaping technique that requires proper trainning and practice to master.

In my opinion it is the perfect system for the coronal and middle third of root canals. I like my shaping form to be large in the coronal third to allow proper irrigation so I use S1 file alot to remove dentin triangles and other coronal interferences along with Start X ultrasonic tips . In my opinion it is in the finishing files that lies the danger of Protaper.
For the majority of the straight canals they can be used safely, but what about severe curvatures? They are too agressive and stiff and when used without care can lead to errors or file separation.

Like I said before I use ProTaper for a while and usually I used to shape my severe curvatures or narrow canals in a hybrid technique using Profile for the apical shaping.
Recently I started using GT series X in my hybrid approach insted of ProFile.

What is your experience with GTseries x?
Do you usually use hybrid approaches in severe curvatues and narrow canals?

Comments welcome


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[oalothmani]

I totally agree with you regarding the shaping files. They are excellent for coronal 2/3 preparation. I also agree that the finishing files are dangerous regardless of their high efficiency. From my experience, F1 can negotiate most curves with no problems. F2 requires more caution as the curvature of the canal increases while F3 is a definite no no if the canal is curved; it is too stiff and the chances of its separation are high.
In case I needed, I usually combine ProTaper and ProFile during the instrumentation of curved canals and I think this is a useful technique. Unfortunately I didnt use the new GT files but the literature on their cyclic fatigue resistance is promising. I wonder however if they are good cleansers of debris and necrotic tissue because the earlier generation of GT usually left too much of the canal walls untouched as shown by Peters et al. 2001. I wonder if the design modification of GTX would improve its cleansing action. I am unaware of an investigation looking at this factor.

[Dgipg]

I was using ProFile also. What I like about Gtx is the fact that they are a bit more agressive in cutting dentin compared to ProFile. The improved flutes lenght also allows more tissue to be removed besides the fact that the pitch is optimized. There is a turn down that is the size numbers available in GT. With ProTaper I usually do my apical gauging before deciding F1-F2 or F3. In curved canals shapping the apical third with GTx (same with GT) we have 20/06 and 30/06 has options. In my opinion certain cases 20/06 might not be enough and 30/06 might be too much. But I am happy when compared to the shapping action of Profile. Try it out. Thanks for your comment also.

Best Regards

[Miss.Endo]

Dr.Dgipg
thank you very much for the post....
i'm still an undergraduate...but i've been working with protaper hand files for a year and half...
now i'm trying the protaper rotary files... it's really very aggressive...and the dentine engagement is very rapid as it moves in fast...and you can feel the crushing of dentine...which i often misunderstand as the file is broken....but fortunately it's not...

i'm trying also Race and it's more flexible and can help in more curved canals...
i'm looking forward to trying the lightspeed...from my point of view it's a great way for apical gauging...

i know that i didn't add anything new...
just wanna share this experience with others...

and if u can dr tell us more about ur experience with GTx...
that would be great...

thanks again

[Dgipg]

Thank you for sharing your experience miss endo.

About my experience with GTx, I personally think they are the most safe files I've worked with in the past 10 years. They have great cutting efficiency and their improved design and metalurgy make them very safe.

But like in other things in life, not everything is perfect.
In my opinion once you shape with multiple taper system like ProTaper, is really hard to go back to single taper systems.

Of course it ends up with personal taste about how you like your final shape, but I am one of those that like great tapers in the coronal third from the beggining of my cleaning and Shapping, so for me S1 from ProTaper is a must.

Honestly, and its my personal opinion, shapping can be made with so many systems nowadays that the best one is really the one you feel confortable with.

Beeing endodontics a sequencial process, each action reflects onto the next one. If you have a good access, if you remove the coronal interferances, if you create a glyde-path, confirm patency and make a manual pre-flaring, shapping is just a mean to provide good desinfection no matter what system you use. Always remember that mistakes in shapping happend usually when some of the previous stage failed.

Best regards and all the best for your endos :D