Endodontic Failures

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In review of the endodontic failures that come through the office, a great many of them are due to vertical root fractures rather then actual failure of the RCT. This particularly seems to be associated with treatment that uses the aging standard of greater taper. Greater tapered canal preparation of .06 and.04 result in more tooth structure removal hence weakening the root which makes the tooth more susceptible to vertical fracture. As the standard of care is changing to thinner and thinner canal preparation to conserve root structure, the expectation is to see less of an occurrence of fracture over time. The use of rotary or interrupted rotary NiTi is inconsistent with minimal root preparation since it it indiscriminate in both the buccal-lingual and medial-distal dimensions. The use of .02 stainless instruments in a reciprocating hand piece allows targeted instrumentation by internal routing of the canal walls in the buccal-lingual direction while conserving tooth structure in the thinner mesial-distal dimension. Additionally this easily accomplished with NO FEAR of instrument separation.