What do you do when your files or your gutta percha are shorter than your canal? This scenario is probably most true for a canine tooth, but the bottom line is that sometimes you can have teeth that are way longer than your instruments, and that is pretty frustrating. So, most of you know that hand files and rotary files come in:
21mm
25mm and
31mm lengths
And if you’re like me, you invest in getting all of the lengths of every file type out there. Anytime I see a canine, I use a 31mm length file — it just makes my life so much easier. But, here is what to do when you don’t have that file or if your gutta percha is “too short” for your canal. Sometimes even when my file is long enough my gutta percha isn’t. So, these are the simple things that I do in order to compensate for that length discrepancy.
1. I reduce the occlusion. As long as it is not in the esthetic zone. This will not only decrease the length of your canal, but it will also decrease your patients’ postoperative pain. This should be standard operating procedure, if you ask me. And you should do this on every case before you even put the rubber dam on.
2. I change the location that I grab my gutta percha and reorient my locking plier. Instead of holding it horizontally and below the tip of the point like this:
I grab the point vertically and as close to the tip of the point as I can like this:
3. Last but not least, I simply change my reference point. Let’s say, for example, the maxillary canine. Yes, it is easier just to use the cusp tip as your reference, but you can also use the cavosurface margin instead. If you just grab the gutta percha point right where it exits the tooth and use that as your new reference, you just shrunk your working length instantly by a few millimeters and the struggle is over. Whatever you do, just make sure that your reference point is repeatable.
This is a detail that is so small, yet can have such a tremendous impact on the outcome of your case and the length of time that it takes to complete the case. So don’t overlook it! Remember, endo is all about the tiny little details.
As always, tell me what you think and leave a comment. I really hope this little tip saves you time and money.
-Sonia
P.S. I teach you more tips just like this in my online course E-School to help make everyday endo easier for you. Check it out!
Absolutely helpful
I’m so glad this was helpful for you, Priyanka!
-Sonia
Execllent. Very helpful tips.
Great! Thanks very much for reading.
-Sonia
Very helpful mam
Thanks! Glad to help!
I appreciate this tip! But there’s another problem with long canals which is the shaping with the NiTi rotary files. the latter have a length of 25 mm so it’s pretty impossible to reach the full working length!! How do you manage this situation?
Files come in 31mm length, so invest in those. You can also adjust your reference point just as I mentioned in the blog for your gutta percha. It works for your file too!!
-Sonia
This is a most informative course I have taken and it gives a great pleasure in recommending to all the general dentist to take the course.I always go to the videos when in doubt and the best part is life long access to the course..Thank you sonia once again.
Roma, I am so happy you took away so much from Eschool!!
-Sonia
I had a 36 mm wl, do you have special files for this situation ?
Wow!! That’s really long. In this situation, I would adjust your reference point to a different place on the tooth. I hope that makes sense.
-Sonia
Don’t you think occlusal reduction of all teeth would end up complicating our post Endo restoration? Sometimes we give post Endo restorations that do not involve the facial surface at all. In those cases, if we have done the occlusal reduction we have to invariably go for a crown or an onlay. So don’t you think we should reserve that for specific cases only?
Hi
Had a tooth with working length of 31 mm. I could work with protaper gold.of 31 mm but unfortunately there were no gp to March that length and I had a hard time at obturating. What could I have done
Anu,
Ususally just repositioning the college pliers works or perhaps you have to adjust your reference point. I find that most gutta percha is too short, so you have to think outside of the box like what I illustrated in this blog.
-Sonia