Hints and Tips

Canal preparation and cleaning

• Good canal preparation and cleaning is of paramount importance for any root canal treatment – this is no exception.
• Copious irrigation with sodium hypochlorite is recommended, followed by rinsing and “drying” with paper points.
• Select the point taper that matches the file taper you have used.

Selecting the correct point to use

• For constant tapered files, you need to use a propoint with either 4% or 6% taper to correspond to the files you have used.
• For variable taper files such as ProTaper or Sendoline S5, use the propointPT or propoint S points as these are specifically designed for these systems.
• Remove the point by perforating the foil from the blister pack – I use a flat plastic. Remove with tweezers or by pushing the point out from the well.
• Oval canals: If you have a very oval canal, I have achieved very good results by placing two points into the canal.

Trimming to the correct tip size (constant taper points)

• The propoints are designed to be trimmed to the apical tip size that you wish. This reduces the need to carry large stocks of pre-trimmed points and also allows a custom fitting. I start by trimming to one less tip size that I have prepared to, i.e. if I have prepared to a size 40, I trim to a 35; trim by pushing the point through the corresponding hole in the smart gauge and cut off the excess with a scalpel. Since you are able to try the point in and out of the canal, you can “nibble” the apex until you feel a snug fit with positive tug back at the correct working length.

propointPT

• propointPT has been designed to give the best passive fit when the following protocol is observed:
  Once you have made the canal patent to the correct working length, use the shaping files in the sequence S1 then S2.
  It is important that you get these files to the full working length. You then proceed with the finishing files. Once you are satisfied that you have finished the canal preparation select the point which represents the finishing file which you took to the full working length, i.e. if you finished with a F2 file to length then use an F2 point. If you used a F1 and an F2 finishing file but only took the F1 to working length, then use the F1 point.

propoint S

• propoint S has been designed to give the best passive fit when the following protocol is observed:
  Use the files as per the manufacturer’s instructions. Select the propoint S which matches the final file used i.e. if the last file used was an S2 then use an S2 point.

Mixing smartpaste

• smartpaste has two distinct setting phases. The first phase is from when you add the active powder until it reaches a “plastic” phase. This initial set takes about 3 to 5 minutes from mix (depending on the amount of active powder and the surgery temperature) – I get my nurse to delay mixing until I am ready to place the points.
• smartpaste can be applied into the canal by either using a “spiral filler” at very low revolution or by applying the paste to the point by using the gutter on the mixing tray. I make two or three applications using a plunging and twisting action with the point as it is reinserted.

smartpaste bio

• When using smartpaste bio, simply place a disposable tip onto the syringe, place the tip two-thirds into the canal and gently squeeze the syringe to apply the sealer.
• If the tip becomes blocked, simply snip off the tip just behind the blockage and the paste should flow out freely.

Trimming the coronal part of the point

• I have found that using a long flame tungsten bur is excellent for cutting the point. I also trim the point until it is flush with the orifice of the canal using a pear diamond bur. The smarttrim trimming kit contains both types of bur and does the job perfectly. Keep the water on when using smartpaste, but off with smartpaste bio.
• Alternatively, dry ultrasonics (not cavitron) with an endo diamond tip works well to remove the excess at the base of the point while in situ.
• Another method is to place a coloured endo stop onto the base of the propoint. Place the point into the canal and use the stop to mark the working length you require the point to be. Remove the propoint and trim to size using sharp scissors before seating back into the canal.
• I recommend placing glass ionomer into the pulp chamber to cover the trimmed points.

Radiographic appearance

• You will notice that the radiographic appearance is exactly like conventional materials

Immediate preparation

• Occasionally, when someone comes in with a fractured tooth or crown prep., one would need to do immediate root canal treatment and post preparation. I have not found this to be a problem, I simply ensure I have a good initial fit of the point (good tug back).
• Next make sure the post has been trimmed back to at least flush with the orifice of the canal with a round diamond bur, such as the pear diamond bur in the smarttrim trimming kit.
• I use the Fibre post system (3M) and they have a small “introducer” post bur which will cut into the white core of the smartpoint. The difference here is the problem of the point wrapping round the bur – unlike with GP, this does not seem to happen. I then use the standard preparation burs.
• If I am having a problem, I then irrigate with warm water as this quite quickly will hydrate the point and thus soften the polymer. I think the key is to keep good downward pressure and make the bur cut the polymer.
• I have also used the “parapost” burs and the titanium post burs as well. If you are having trouble getting started, then a fine diamond with the water on is a good way to start the post preparation.

Delayed preparation

• All the above apply, however this tends to be easier as the polymer is generally much softer as it has hydrated.

Watch how it works…

The links below take you to our YouTube video and animations which show you how to obturate a root canal with smartseal.

• To view a video demonstrating smartseal on a real tooth, click here.
• To view our animation on how to use smartseal if you are a constant taper file user, click here.
• To view our animation on how to use smartseal if you use ProTaper, click here.
• To view our animation on how to use smartseal if you use Sendoline S5, click here.
• Our latest animation showing smartpaste bio can be seen here.

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