Friends, hello everyone. This is our first shoot in Guest Dmitry Nikolaev. Dima immediately accepted the I have an idea to make an educational project like this and tell Top dentists will participate. How do you feel about Dima immediately said: "I'm in." That's why today everything Today's topic will be I'm in business. Great. And As a rule, mm, people encounter pulpitis and are afraid they don't understand and often get confused. I was thinking about What should we show? And I decided that today we will channels of the first upper painter. Upper six. although it is not actually the most difficult one if you understand Our conversation today is exactly this, the basic channel in the upper six. Super. As the play progresses, I will arise. I have literally treated several canals, and Therefore, my questions will be quite superficial uh, they are embarrassed to ask any questions, they are afraid These questions are for you. Like, comment, and do the rest. I'll chime in regarding shyness. Indeed, this is the And I noticed that I have a section called My Answers on on a given topic, for example, the treatment of the sixth tooth Instagram Contact. You can see who asked the question. In Telegram, questions are anonymous, you can’t see who asked Of a completely different nature. That's why I see this that some of the questions that arise, you will find We won't reveal it, write in the comments. Dmitry, I think partially. By the way, Dima also runs a YouTube channel about explains. Sometimes he even finds time from the carriage. Here. Well, we've had enough of talking. Let's get started. So, today we have two sixth teeth. One of them show the behavior of the tool in the root canal. tooth is almost impossible. More precisely, but this will be different from what we see in the I'll show it on plastic. But our main hero is course for a group of doctors in St. Petersburg. And this my seminar. I didn’t prepare this tooth myself, and I didn’t I took the first top sixth that came to hand. Why was it Is there a perforation somewhere or what happened? History It's a pretty good tooth, it seems, or is there a crack, what please respond, yes? Who recognized their tooth, whose Before we begin treating this tooth, we are Enerdotic diagnostics includes intravenous Ideally, of course, when we have a computed tomography scan, It's difficult for us. That's why we did an intravenous radiovisiogram, at home. And we evaluate the basic anatomy of the tooth. root canals. We don't need to count the number of determined by analyzing the structure of the pulp chamber access, but not by computed tomography. And don't do a CT scan just to find out if there is There is an M2 channel MB2 most often it is there, in the tooth. First, learn to look at the pulp chamber. if you cannot find it, based on the structure of the Prove to yourself that the channel does not exist. That is, proceed from cameras. And when we have formed an endontic access, and endodontic procedures? They begin with cleaning We will naturally wash the classroom with clinical conditions. Having opened the pulp chamber pulp chamber with a full syringe of sodium hypochlorite. amputation of pulp dissolution in the pulp chamber, under the influence of sodium hypochlorite, and It can be easily removed from the pulp chamber. And most I watched one of your videos, you recommended essentially the same thing, only in gel form. So, visions, yes. We look at convenience. Belades gel is Repeated dodonti are used when we need to clean filling material, as well as in widely open, add. For example, here I would use gel in the clinic. we work through small access when we work on incisors, It’s just that it’s inconvenient for us to insert the gel, it’s inconvenient too viscous material, for too voluminous nozzle it is enough about hypochlorite or later with channels, how to prevent which control the working length. Control of working length. I know how it is with everyone else. You can share your story, I have not treated a single canal. At first, I studied that is, specifically restoration work in the Neles Canal. And here is It was only decided months ago. All this time I was so afraid Of course, every time you're afraid of getting stuck. So, I think we will discuss this topic as we There are methods of prevention. Oh, but when we an accident will definitely not happen. Here we must watch the isolation chemical injuries to the mucous membrane. Yes. Here, of course, endontia should be performed in the cafeteria. Honestly, I cofferdam. I imagine situations where we cannot but how to ensure good endonic treatment, sufficient I can't imagine how this is possible. Although there have been different What I had was an epileptic seizure in patients sevens introduced there. And so what? How? Well, it Yes, it's fine. But it was just such a very If you're afraid to report, you don't know what it's like to pulp chamber. Let's discuss, how many root canals either three, or four, or more, but there are three roots. Yes. let's say, the main familiar channels. Palatal, distal, there are 2. And the shape of the pulp chamber is diamond-shaped, The vertices of the rhombus are the root canals. You need to look for root canals visually. Right now, looking at as I roughly understand, as But it is clear that you roughly the field where the channel is located. Somewhere in this We have enough information to enter the root We take the first one to enter the channel? Kafael. and you can feel it. The first instrument we use tool. Oh, this, by the way, is also an interesting point, Some said that we should go straight to the machine, but How is the logic of the narrative constructed here? And the machine tool will find the root canal itself. it in the endo motor, and we aim approximately at the field We introduce it somewhere and then it goes along the channel The torque and speed values ​​are set on the motor. Hs cm torque. And these values ​​are written for This is a size 15 tool with a white ring and a sixth in which we can initially enter the root we can use files of similar size, for example, a, 104 12.5 046. Each system into the channels. In my opinion, for absolutely zero but it's better to take mouth files. If you have already, let's where, how, the steering wheel turns, the gearbox engages, ah, but the first time you go out into the city, to the main tools, that is, to move away from the VTEVIKS, save time to do it well. Yes. Ah, so, mouth files or similar instrument design, we immediately I wash it, and, in principle, we, of course, lack a emptier to see everything well. We will use the improvised one. Dian pomo in se blow a tooth. Ah, got it wet. Do you see? Yes. miss with a hand file. Yes. That is, that here is the root canal. This is the first thing. Second. I'm I'm looking at another channel, the posterior cheek bone. to avoid confusion. Yes. He's somewhere here. Here is Will it pass? Here it is wedged. He doesn't go any further. Let's look at the length. Without an x-ray, we understand that the canal Besides, the channel is narrow. Yes. So what would I would take fewer tools. Six. Now look at canal preparation. We take a machine file, insert it into the canal, and rinse it. in the same place, we put the kafail. And so we passed the channel. deeper. Now I'll reduce the visibility a little. we set the to clearly understand, well, and it is clear that we are at the depth at which we expect apex locator. Yes. What happened? What's the magic? And the area where the hand tool gets stuck. When we enter ah, and we can’t pass the channel, this doesn’t most often, the hand tool gets jammed somewhere preliminary machine file, look, machine file Where was he cutting sawdust now? Notice how clean Here it is, it's clean. That is, the canal is wider and the hand file passes the channel without encountering conical. It has a 2% taper, which means that with wider. Let's count the sizes. 10 at the tip and with each 14, 16, 18, 20. That is, somewhere around here this is already 30. Somewhere here he is the thirtieth, and here is this We enter the channel and wedge ourselves into Usti in this in the thirty-fifth, enter the untraveled channel. Can we What's the idea? Yes. And I don't know. Did you or the We are making a very important move. We make a movement We don't twist at all. And one of the, uh, main reasons, channels - it's a stupid habit of doing reminiscent of the winding of a mechanical watch If you give up and simply press on the hand instrument, Seriously? Yes. Because, look, we enter the channel, are we stuck? We just found out that these are estuaries. twist. What happens to the tip? He begins pressing against the outer wall of the channel and forming See, I entered the channel. Yeah. Let's zoom in now. Look, yeah. And he pressed himself against the outer shell. Yes. a strong bend, and the channel will become impassable. Listen, you know, so that we don’t go beyond the top, because we are not afraid, that is, we kind of pass, How can we not miss if we immediately enter with the motor? I'll show you and explain. That is, while I as the number one tool - it has a lot of advantages. Yes. Now, We take a diagnostic X-ray, and under it we measure the length We place two points from the crown to the apex and understand the length of the tooth, the height of the tooth, if you like. Let's simulate this with a tool. The height of the stoppers, this strip means that it is 19 mm. Accordingly, 16 mm, we will definitely be inside the tooth. We will not go When immersing, insert the tool to a length that is obviously resistance. I don’t know if I noticed or not. I will Doctors, in the clinic this action is repeated I'll show you a new one on a plastic tooth. Let's take a tooth. through irrigant, through sodium hypochlorite, in our We must go to a shorter length. But we do not go the moment when the instrument began to dissect. So he from the channel. We don't do this sawing Here we will make a step and push the contents of Yes. This is what we will do, and the perforation will be sad. which we started touching on right away. This is to right. Absolutely right. After which we go through the Your boxing is so good today. Yes, massive, yes, massive, lose. We go through the root canal, feeling the We connect Apexcator. And looking, when we enter We must connect the locator to the instrument before insertion. They enter the channel, connect the locator and locator and start the instrument in order to locator, and under the locator tiles. That is, we are walking, and the and we begin to cultivate within ourselves a sense of Some tactile sensitivity is reflected on the pexlocator Naturally, it won't be very clear. By the tenth tooth you will You will develop a sense of the root canal in your tooth. This will be one of the phrases. We cultivate a sense Apex sounds. And so we go through the main channels, which anterior cheek. Palatine canal. Is it necessary to do this manipulation? initially wide. They simply took the file with the answer we need. Yes, I understand that channel A, you understand When the canal is wide, there is no sensation of constriction. You are you enter: "Aha, I ran into something." Then, then, And the connected apex locator cleans, including And from the hypochlorite accident that you fear. Yes, it's everyone is afraid. I'm not afraid anymore. I'm afraid. I already had epilepsy No, I had five or six hypocharitic accidents in the light? Fine. Everything turned out alright. I'm sitting right next to you. You know, the proverb says the devil is not as black as he I saw it there. This is a severe hypoglycemic accident. This I intend to do what when I think the doctor didn't even realize that, well, again, at least correct me if I'm like in these pictures, you can’t do it, because if the the ceiling will fly off. And introduce there such a quantity This is quite problematic. No, that’s exactly it, he won’t and when the amount of hypocharitic acid increases, the patient like this, the face is half blue. Yes, yes. And this that this will not go unnoticed. What I mean is that the patient will not just let it continue, he will not I just have a lesson on endontia on the channel about video, the patient, he filmed this accident at home. He He just has some kind of lump under his eye that All. The only thing that bothers him in the chair was that yes? Because hypochlorite came out through the apex of He has a mm hematoma that has formed. And what are the none. Just wait. Just wait and that's it. This is a Everyone has had experience with tacos in this way at different undiagnosed, or the doctor didn’t even realize what he was This is generally a consequence of anesthesia. But you understand, something is rolling and painful when palpated, well, it’s Got caught. The needle was long. The needle was long. So, the here's about the palatine canal. That is, since there with a ten. And as soon as the top didn’t come out, immediately just in case, yes. And we get the length of the channels which everyone, which everyone frightens. Here. And the most important MB2. What instrument do you think I should take? More more rigid, because in flexibility, probably, although It’s rigid, in theory, it doesn’t go anywhere, that is, so that it doesn't bend, probably more rigid, right? A rigid instrument goes better through a narrow reached depth and will begin to spin in place. That go further along the channel, and begin to flatten. such a serpentine passage or like a corolla, you know, it more rigid. And this is Proer Gold S2. I always system files. We'll talk about choosing systems later, If you are a beginner doctor, it is better to take this particular which will give you a confident result every time. Yes. Our knowledge so that you can treat any standard you will learn to do all this, you can do different but our task is the simplest 100% protocols We take the tool, set the correct torque and speed. or on the back of the file system, well, for example, but otherwise, ProTaper doesn't have anything written on the manufacturer's website or simply remember. A, one We turn it on and place it in the projection where Should people build a projection? 1 2 3 4 rhombus. Here diamond shape. He will be somewhere around here. We don't see it either. Do you see? Yes. I'm putting it. And now the tool itself finds the entrance to MB2. And we begin to move along the channel with short pecking movements. And here, by the way, this tooth has a big flaw. It's as easy as I would like to show. Pay attention I'll introduce him to the area where we started to find MB. And take a closer look at this one. Now we will adjust You see the blade clogged with sawdust. Yes. This is a I didn't take him anywhere. Where does the sawdust come from? Why did You see, it starts to hit my enamel. Yeah. This is where It seems like we can see it, but in reality I don’t have It is passed because the enamel comb here is in the way. and open it up further along this wall, but don’t remove everything, round it off, yes, just this one, so that the ridge doesn't get on plastic, and in order to reproduce this later, try to reproduce it on a removed tooth. We are filling up channels. Look, they entered it. He went to the MB2 channel. MB2. What movement should I do? The movement we felt resistance, we exit the channel, and the amplitude is approximately in millimeters. We went This is called a pecking movement, when we 1 2 3, well, the When to stop? Oh, stop, stop, stop, stop. And head information about the length of the root. We shouldn't, on the other side there are teeth, we must not go out. It will be very clear. B2 is difficult to enter at difficult, easier, easier, easier. It became easy. Now this remove, rinse and enter with a hand file. Why does easily? MB2 has a mouth bend. Any bending is the with a conical tool, we clean the blade here. When part, the larger part, it cuts off the mouth bend and there It was difficult, and then bam, it became easy. That's it, you've measure and dissect. Yes. Sometimes this feeling is expressed more Doctors start to find and perform MB2 and get scared, thinking correctly disclosed 2.2. It suddenly becomes much simpler. So, let's try again. The one who speaks must be feared. When I go on the M2 stabilize the instrument. There should be no beating sway from side to side. Here is the effect. Are you stuck Roughly speaking, the outer surface will clearly show you begins. Here it is, look, it's a tough tool. He It began to sway from side to side. Let's take a did, uh, entrances to other channels. I insist, look how strongly it begins to shake. Yes. Look what happens to the tip. Yes. You see, he starts It appears a little bit. That is, you will immediately make step as soon as you rest against it. Yes. Therefore, or in the preparation of already completed canals, where there is already When you need to go through a channel from scratch, here rigid systems. Yes. They move more efficiently. Ah, well, let's see if I can pass MB2 or not. It will be a great video if it doesn't work out. If I break We'll have a video with a secret tool extraction hero Zemlyukova, let her finally teach this Nikolaev how to work properly. Olya, hi. Well, let's make a pecking movement and continue. Damn, you've Look, it was difficult. I have stabilized the axis What is a stabilized axle? He stopped wobbling. That when I'm not sewing it. It's just tactile, you understand, right? which he was running into. That is, I gave him less correct, vertical, but for me it stopped and it went down my channel. The most important instrument. As soon as you felt any beating on You know, I usually compare this feeling to riding a you move off and that's where it starts happening on the steering wheel. It is much more difficult to correct a step than to prevent it from forming. So, let's wash. My instrument hasn't broken yet. Intriguing. And I continue to make a pecking motion. Yes. immersion, you see, I have pecking movements going on. secondly, it's easier. It's getting easier and easier for me to move sawdust. That is, do not try to go through the entire MB2 four cycles of sawdust washing. Yes. Ideally, of course, What we didn't take into account during preparation, we didn't It would be good to take either a sound activator and activate the solution in the channel. Yes, it just Well, the first shooting of all the details is not fate. the instrument goes deeper and deeper and becomes lighter and lighter. There is another secret for the SMB2 file: you need to What a waste of time. One, two. Yes. In this way, we further open the mouths. We are further opening the mouths. Let's see if this channel has become passable for us. Let's take the tool and go. No twisting, just we apply it to the tooth. But at least we are already Our dynamics are definitely positive. Now look what else convergent anatomy. MB2 is often adjacent to MB1 channel. It seems that when two channels converge into one, this Let's go back to our plastic friend, and I'll I need to prepare B1 a little. I'll quickly expand it. So, I have the bargaining feature turned on incorrectly. I had one and a half, so the torque worked. This is not the correct dissection technique now. I'm nuance regarding MB2. Please look at this moment. Of course, I don’t have MB2 and MB1 transporters. Well, appreciated. Yes. Now we take the endoscopic instrument as I showed you. Now be extremely careful. how the instrument will behave. The main thing there is to get it into focus at such a magnification. Ah, I get it. Understood. He touched the external curvature or here. Here on the perforation we have And the file locally at some point in time has a bending That there is no point in measuring using the MB2 AEX locator? This situation is more dangerous than these two separate passing is a simpler situation. Yes. Than convergence. Yes. do they agree? So far we haven't completed the channels. go to each other, how they are located relative to each other, or rather. I enter in MB1 and MB2 instrument. So, In MB2 I introduced a shorter one. This is like twenty-fifth. It will be easier to determine which You don't have enough experience, you can't tell which one is visiograph and we take an x-ray. First we as we are used to seeing teeth in x-rays of our patients. really, understand? Either they converge, or they diverge. Well, if we turn at an angle of 45°, we will do it in angulation, that is, without changing the We rotate the tube by 45°. Ah, yeah. Look, you Yes? It may or may not converge, but at least didn't agree. That is, even if they converge, they will In my opinion, yes, wait, it turns out it doesn't add up. Yes, gets up exactly the same way. We simply have it. Look, snimak once. The second one is either in this direction at 45, or in this direction at 45. Yeah. There is a rule here: the upper teeth are in one direction, either And so I get confused about which one is correct, because I showed this to them and said: "Girls, learn." Well, that's the question is which direction is correct. They know. It is written in the X-ray diagnostics section. I think in order and we will put her in the frame at this moment. Leave a comment and teach your assistants how to take pictures correctly. By the way, just for fun, write in the comments What you do as a doctor, your assistant does. And either he is a nurse by training, or he is and the visiograph is in the office, or is it a separate together for the sake of intramural Oh, listen, I didn't understand the charm of a portable visiograph, Right now we are running temporarily, and this, of course, is The therapist should, of course, have a portable videographer in his office. 100%. And you, along the way, call the files that we are If you, as they say, become afraid to that's it, but you can't go further with the channel, and the manual file doesn't work for us. That is, my depth is, look, 16 mm from the edges of the bump and further I can’t do it. You Again, this is not what I teach, but If we take a thinner instrument, will we pass the canal? Yes. Let's take the eight. We start with 18 mm. Yes, we went deeper. Let's take a six. And that's why I said the sixth. I'm used to the fact that the channel seemed to have passed, probably, judging by the length App locator is missing. Yes, we passed. See, he's shining. X-ray apex locator readings. Can you completely trust it if you have studied it well. The length will be 19 mm. I will answer your question. As for the apex locator, I I take pictures in these situations. For what? I need to did to you. We need to understand whether the channels converge this channel. Well, let's do it now, and the completed this1. I'll take it now. This is a kafayl just in my hands. There is no engraving along the length. I'll take the Doctors, for those who don’t know, the rings on the files are 18, 19, 20, 22 mm. Here they indicate. We enter the channel. 19 mm from the fissure. And relatively, yes, that’s What to measure? Relative to any stable point on the crown that is convenient for you. Yes. And we go to MB2. I think it will be 19 mm. Here I enter the number eight. And let's take another picture. Once. Now, most likely, we won’t see anything worthwhile either. Do you see? Well, it's not clear. We see we do it in an eccentric projection at an angle of 45. Acquisition success is written. Yes, there is a very look at this angle. You see, the angle at which the Was it difficult to get through? Because the channel is not so much The six worked for us not because the channel was so narrow, Yes. Because you saw how my six went over the the six wouldn't have come out, it would have gotten stuck. this moment. We must also understand this very clearly. This goes, the thick one doesn’t go, but the thin one goes, which means did she come out? Well, by a couple of millimeters, yes, Taper. Remember, we counted 6 + 2 = 8 millimeters - that's to pass, but she doesn't pass. Why? This is too how you and I chose the machine file, and the than nickel titanium alloy. And she doesn’t go like And that's why we can't get past this bend. Yes. Break the tool. How to prevent this? Do hand file, that is, a rotary file, since it rotates, because we don't spin it because it cuts the step, we just press. Yes. And if it gets stuck, a turn will Yes. I would formulate the basic rule this way. Yes. but this will significantly reduce the likelihood of breakdown. channel. One of the options for files to form a tenth fifteenth size. I have in my hands a size 12.5 fourth taper. Also bargaining 2 with pono. We enter the channel. Look, the movement is pecking. Here feel resistance, a backward movement of sticking. on a white background or on a black background gloves. Here. Yes. channel greater than 12.2. The side blades work, but is the file already finished? It's time to change it, because moment, so as not to over-force the already tired instrument, You need to throw away the tool, yes, you need to throw You know, to squeeze everything out, especially from expensive systems, when there is already a point of no return, and it breaks. Yes. Is it deformed or is something starting to happen to point of no return. The second is when the instrument As you know, they are disposable. Yes. Instructions. It Now we'll find it among them, and then we'll go to any central somewhere somewhere somewhere here it should or maybe it was her sister who erased this inscription. sterile. Ah, well, that's it, nothing. Everything's fine, right? Shah and the Mathematicians. And here is Multiple usage. It's written below. Multiple in small print. Listen, we need to go somewhere. Not, In fact, they are disposable. And they should But in reality, of course, some companies talk some people say 10, some use daisies, and these tearing off the petals. But this is all actually Why is it stupid? Well, you can go through one channel like this the same tool. What's wrong with chamomile? Now I'll show you. Here I put a daisy on the file. Yes. I can't see anything. Here she is spinning. And the fan, it seems You, among other things, don't have tweezers. For example, we tear off petals with our fingers. It's a little better now. You see how strange this tear them off, it will become clearer now. Yes. And tore off the pestle. Yes. Yes. Look here. Do you this is a hula hop. Yes, yes. And then what happens the petals come off one by one. Well, here I tore for one. Then the sister looks at the Central Control Center. Well, the The most universal method of rejecting instruments or from an autoclave. Do not put into the autoclave new tool. For simplicity, you take it from you'll still end up doing two painters. Well, somewhere but at least you're still safe. On the On the other hand, it makes sense from universal system. You won't get lost, you and you don't need to buy super expensive files. Yes, there for inodantists, whose treatment costs the corresponding it is advisable where the price of the instrument does not affect Well, Chinese tools are good now, there are a lot of them on I can name you some that work great, and I use save money because they are superior to European systems Great True Anatomy system. It is not certified in The Chinese made a replica of it and brought this replica in. That is, everything can be found. I work with tools Eflex Blue, Eflex Gold, ultranets. SC+ is great. I really liked the end of file system choose what you like. Yes. This is from, I have three instruments left. This is protaper S2 for MB2 channels repeated dodonsia, there is resorcinol. Like this. did you pay attention or not or, well, and again, with the twelfth instrument, the fourth taper, to some length. After which I took ten. Let's take the one with the I am a channel that I could not pass, I am passing. when we are talking about the main anatomy, let's call we couldn't get through. We took a cone tool, then a a cone tool that has gone beyond the bend. He the bend wedge and the ten flew in. Ten flew in. What we did was actually pointless. Yes. And the They took a machine file, went deeper, and then measured the that with machines, we should not go longer than channel. The completed canal is prepared. Let me show you channel. Its length is 19 mm. From here, between the I'll unpack them right away so as not to waste time taper for preparation and we begin to prepare the root canal with them. Let's start with B1. The movement during dissection is also pecking. The channel is either narrow or curved. Understanding when it is quite difficult to understand this in the early Why it can be difficult, it's sawdust. You see, all The instrument does not go through the canal because a dirty When the bur is completely greasy and the diamond grain is clogged, What should I do, like when I'm grinding down a tooth for a structure, but Yes. Well, go ahead and dissect it. This happens to us during dissection. The old forest is in the clinic in the nine. In the clinic in the in order for the drill to dissect, he begins to intuitively The doctor also begins to intuitively press on the instrument. discussed? You start to press and break the instrument. stops moving through the canal, you need to remove the instrument, Now continue dissection. Look, you see, mine immediately resistance. You're following the pictures, right? hanging out with them upstairs. Somehow, don't look now, as without him? I focus on risks where possible. Let's say it has a length of 18 mm. I don't have this length, ruler. I took aim at the canal. I entered and I go until I touch the stopper. We can't always see clearly. Touched with a stopper. It’s impossible to tell from that is, the slightest touch of the stopper moves it. It seems to be firmly fixed, but when the file rotates, That is, he literally flies along it. Yes. And it’s very too deep. You go too deep, you make an opical for hypochlorite accident. The basis of endodontics is the than physiological constriction. You must do everything then do it on the threads so that they are like this, you know, like glue-ons. Glue, glue. Preparation first bon sat down. Yes, yes, yes. It needs sanding. So, we passed the channel at 19 mm, but this technique, twenty-fifth and we will do the same. This too labor-intensive. It could be simpler. You and I still did you do any dissection? Yes. Let me show my concept channel? Here it is. Distal canal. Its length is So, I took the kafail instead of the pilot again. Its length is channel, I think 20 mm. 20 mm We take the A 1506 tool. This is a short 19, the twentieth is not here. Well, you and By the way, I'll show you something else about the ruler. Yes. And I have exactly the same, somewhere around 18 mm. What do you already know, the blades are clogged. We flush the channel with a solution of sodium hypochlorite. We are with water. You know, I once had a course for twenty participants, well, places, and we decided to wash the canals with sodium hypochlorite. I hypochlorite. Everyone asked for clothes. It's all that simple. It's very hard that we have to wash with water. Water always dirty. Yes. This is the problem with dodontics, namely you know, some kind of box in which, well, you can like a technician. I mean, you know, like when You put your hands in, cut holes on the sides, What do you want to do with the phantom according to Innodonta? dentist for gibox. So, we went to the length we needed I prepared M1 10th 154. I prepared the distal I'm taking the twentieth file from 2004. The only thing is, I'll now change the napkin to a dry one. length 19 and 20 in the posterior cheek and anterior cheek. I have the instrument goes in, but enters at the end with resistance. They cleared away sawdust. Distal canal. resistance. What's the idea? When we prepare canals and so on, each instrument we have prepares the canal along made the sixth cone, all other instruments prepare ocular millimeter. Look, the sixth cone. Let's first millimeter. 15 + 6 sixth taper 21 + 6 27 going in at the first millimeter 20 from the fifteenth to the so narrow. Then he is at the second millimeter 24, he will and there are already 27. That is, the contact area is becoming smaller it doesn't touch the walls at all. That is, we becomes a finishing or apical instrument. Preparation the torsional load on the tool is reduced. Best pull into the root canal. Protection against peak perforation, in chocolate you need to take the first tool of the sixth easier, manual is easier. There will be no channel expansion. equal to the same contour. That is, 1506 is like this, 304 is outline, but it will be easier for you to do it much faster. Yes. Remember this technique. He works very well. Remember the technique. We'll do it later. You see, it’s difficult for me to dissect the file is not working. How are you in practice? Are you dissecting in a mirror? You look at the mirror, from the same angle. From the same angle. Well, only here, what is closed to the cofferdams, the roots are closed. Yes. Damn, it's hard for me to dissect here, huh? The instrument works for me right away. It's just a failure. all aspiring doctors? From cleaning the channel with make the root canal clean. The root canal is made clean activation, with ultrasound. We entered with the instrument. We enter the root canal. We exit from it with This is now the movement of the instrument itself. Yes. We we achieve the working length with each instrument. What to sawing along one wall, along the second wall, along We are trying to catch the microbe that causes opical will make our irrigation solution. It is he. The longer higher probability of root canal transportation. Look, up to the size of 2504. You're out, you want 2504 again, it won't increase evenly for you. Your instrument from a round section it will make an oval section. here we move away from the true shape of the root canal. And to decrease. The longer you dissect, the worse you endonte you send, then come to the SVSh, you have it there, to the wind. That is, this moment of one-time achievement of the top what if, for example, you prepared the canal up to the twentieth You cannot return to the previous instrument. You must The whole reason is sawdust. That is, you washed the canal, what I showed you on the first instruments. Remember size? To what size should the canal be prepared? that MB1 must be prepared up to the twenty-fifth number, We prepare the canal to produce white filings at the tip we have reached the diameter. In case of pulpitis this plus one two numbers from this. Well, that is, if there was a peredantite, we would take the thirtieth instrument and they would enter the channel. Yes. You see, that's A tooth can have a canal of completely different in the top seven of such a fairly elderly patient. And it's interesting there1 the opacical diameter is 35, B2 is adjacent to it, and and the palatine is only 25. We are used to it, but for her it Therefore, we always just look at the appearance on the last turns. Yes. Yes. This is called After this you don't need to log in. I mean, in whether it wedges or not. If we are talking You and I fell out of the top of the palatine him? We measure the length using the locator. According to the locator, the length here, I think, will be somewhere around pip-peep. We catch this length. Yes. Here. Here. Here she is. I believe this. The locator was hit. Yes. Yes, colleagues, Which apex locator is good? Please, Herman is doing but there will be sound accompaniment. You will have when I do dodonsia. Today I laugh quite often. channel. 23 mm. All. 23 mm. Channel length Channel shall we take the first one for dissection? We must or 1504. I'm taking 1504 here because I have we won't get it. You always say the sixth cone on Well, tool along the bottom And so you would take it in practice. The channel here will be wide. Yes. If we immediately It seems more appropriate to us that we will begin to push the contents go through the instrument, form a so-called the canal adequately, insert the ultrasonic nozzle, only then enter the cleaned canal, yes, with a large instrument. Well, for example, let's start from the thirtieth, Yes? Here he comes in. There are no white shavings. That is, the channel is definitely more than 30. Yep. That's it, we're there. Yes, it looks like the It should still be thin. We need to go in, subsequent rotary instruments and also create conditions In the ethodontic treatment of the canal, instrumental conditions for channel irrigation. Subsequent opturation. We still have B2 prepared. We are washing it now. Look, the extirpated pulp has Let's wash it so it's clean, because the liquid is cloudy rinse after each instrument with a large In practice, this is half a syringe after each instrument. depending on the anatomy or the stage of preparation. I wash out the canal with a syringe. That is, the syringe is used We continue to work with MB2. Length 2, if I'm not mistaken, 19 mm from the bump. Yes, from the hill. And in this situation we are dealing with strongly curved channels. And I urge you to also I already mentioned her today. This is SOCA SC+. Mm, this of all, mm, a, files for the carpet. It's most I can do this with almost any file system, Ah, we did such experiments. For example, for the course firms. Yes. And we give people five different file systems. We evaluate the results. Who managed to get through this Who has this system? And it turns out that this That is, it is easiest to master it at the beginning, then, yes, you can improve your skill. The end of view tool has a similar learning Well, I just don't have that much experience I'm careful. That is, I wouldn’t advise it to everyone, I have seen less than 100 dentists who have mastered Be sure to also look at the interview system files channel, or will be soon. Don't forget to subscribe This file system is worthy of your attention. Exactly. top. Well, I only heard good things. reviews that people Ivan. So, we take the tool and go in with it. Bargaining is one and a half. The same short pecking movements. The instrument goes very poorly because there is a strong bend You wouldn't even guess that there is such a strong bend here. Yes. We move forward carefully, carefully. If the instrument does not go through the channel, do not press, check with a tool to see if there is any sawdust which we do not wash with hypochlorite, the fact that gets clogged with sawdust. It is necessary to constantly clean It's much easier to work. And so you and I started discussing which is used as a phantom. As cynical for training - these are your patients. In ndodont, unfortunately, can only be used on patients. On removed teeth, this is those characteristics. Just from a simple case to from moderate to difficult. It's just like that here. and with hands - it's about working with the head. Well, if I, for I wrote down this phrase. A, or, yes, another it sounds in such a way that, mm, m in endonte, endonte that in the process of work the doctor makes mistakes that correcting these errors without even realizing it. So he creates difficulties for himself, right? did you like it? Yes. That's it, the second phrase is written down. We continue to dissect. We gradually move deeper into the channel. And between dives we have to wash. Here, in my opinion, endony, it is but it's incredibly boring when you're Are you having fun? No. No. Give a like if you've ever I fell asleep during treatment, but I was still a My patient, fu, the patient's assistant fell asleep and started She caught her balance at some point. That is, this when she makes a pecking motion, as you said, only she She was quite a large girl. was. Well, in the sense that she doesn’t work for us anymore. A How to combat falling asleep during assistance, during follow-up sat down, should I insert files into my eyes? How to stay awake? Get enough sleep if you have a shift with When there is a risk of canal clogging, in practice I I constantly check the patency of the root canal I just enter and exit the channel. Until it clicks. I went Pay attention once again, in practice we don’t do this for luck. check for sawdust in it, then this movement channel to the working length, and we were out. Yes. There Why don't you do this in practice? This is not required that You get clogged with sawdust and you make this movement, because, well, the channel really turned out to be a Plus, you and I don’t have any hypochlorite or How would we activate water? Well, at least the and it would be easier to take out. Well, that's it, we've dissection. The hardest part is to pass the channel. Further, and we begin to prepare the canal in the standard way. The that I started talking to you, and instead of the You didn't even correct me. You certainly found someone to ask tool, took another one and continued working. If movements. Look how beautifully he passes the Queen's channel. passed. No, actually, the magic of editing is about It is easier for novice doctors to pass through the canals, so that people can understand it better. Efblo. This is Efblo. This is Efkblo for an experienced dentist, but for a beginner dentist less tactile control. The price is more complicated. Ah, don't miss the signs that problems are starting. Yes. or to breakage of the instrument. We've talked a lot about said nothing. How, uh, a step, well, it’s Here are the main points. How can it be smoothed out? Here did you cut the step? The file simply doesn’t go any further, you do? Come on, come on, I'll make a step for you now. I'll It happens because sometimes the plastic starts to melt without any steps. Well, let's try. In my courses, when we start discussing There is a task for doctors to do this step, this can be a problem. Let's try now intercede. Yes. Here. Yes. Yes. And here is a typical situation. The with tweezers. I don't have tweezers, so I'll try to bend it. I'll try to bend its lid. So, no, that's a bad idea. So, they are quite thick. No, I bent it. Ah, uh-huh. file and we go along the internal curvature. Op. Yes. And It's because it's plastic. Plastic. I told you it's I scratch it. Yes. Yes. That is, we enter along the why do we enter a rotation file there? We start a bent, started. Next we take the endomotor. Now I will Turn on the endomotor for 2 seconds and place the endomotor spin and it smooths out this step for us. And once again I don’t there was one more time. That is, you put it first. Look, Yeah. I make it rotate, and it goes deeper due to This needs to be decided. Why not? And because According to A, I understood everything. Cool, huh? Okay, I got This simply deserves your like, comment, If we are discussing the basic principles of canal preparation, The first tool should be machine. Secondly, the you need to choose which tool is convenient for you, length less than working. But the question here They write in the instructions that the first tool should Yes. Because I think it's a question of some kind to avoid responsibility. Yes. For breakage of a possible but in practice, the machine file initially turns Let's start with machine tools. Next we go through the file. I generally only go through the canals with machine First, learn manually. That is, I hang a locator on the file let's say, in the process of passing the channel. learn to go through completely manually, and then move on to work with both at once, that is, do it in a hybrid If you want to learn how to drive a car, you need then by bicycle, and only then switch to a What do you do, what do you want to work with, and do you start files are files of their time. Now all this is a thing For you, a hand file is a kind of depth gauge, to which It sometimes helps you with re-dodonta, where you pierce the from the apex. You need the h file in the re-dodonite. to pick up something, but to dissect the channel with manual files small sizes are needed. Tens are more than enough to We take some ultra-complex situations, for example, in the guardianship third there, yes, there are hellish ones - very simple. She is very simple. Yes. So, the 1506. In my practice, this will be Efrix Blue. taper. If we understand that the channel is very wide, we move on to the second taper. Now there also mentioned by us of you, the system I have learned brought by cattle. There is a conical top, The working techniques there are a little different, but, let's these systems from scratch. It’s easier to master this, to practice manual skills. Yes. Here's a person, let's say, who has undergone Let's say it's pulpitis. And what do you advise him? should I have a look and then fill it or can I fill plan in one day, if the doctor has enough that is, to make a normal aa normal opturation and The doctor has 10 minutes left and needs to do the next patient, it is better to close it with a temporary What to close it with? Depends on the situation. Depends on the the release of this video, and a lesson on andadontics will be released on my I'm moving towards this, and to be honest, I'm too lazy. For a huge amount of material was filmed. I'm just too lazy I'm filming new videos, just like in the gigabytes of my videos. What kind of temporary filling? Why is it better? prosepto in the Russian version. And there are several There must be a first class post. If the walls are not made, will not hold the seal. There must be one more thing next or convergence of walls. Here is the divergence then: it matches, yes. In general, a-a, the entrance to the pulp camera. That is, so that the temporary filling If the cavity is pear-shaped and pressed, it collapses conical shape, it will only become more compacted. Most often ennetotic approach. You take either a large around the perimeter, and you have a temporary form, a temporary bur and make a 45° bevel on the imal, and now you If you understand that you need to close the tooth not until It should be either glass ionomer cement, IRM, or flowable whatever is more convenient for you depending on then closing it with the autopack is a little strange from an So, did you do a check for the man and prepare the canals? double-check yourself? Passability. Patency at working working length. During the canal preparation process, nothing So you're treating pulpitis, you opened it and it's bleeding maybe after the third, but from about the does not bleed. If you don't have bleeding, no thirty bled, good morning, bled like straight Certainly. That's it, good sintered perforation, yes. Is everything at once for deletion? No, everything is closed. form, for example, a new optic stop, if it is The tooth was closed, but now you have an open apex. preparation diameter to create an opecological aggregate cement. Yes. But it is better, as lengths. The basis of endonti is the control of the working length in addition I entered the studio. Uh, what if a person works in such there is no yard, so to speak, no apex locator, no physiograph, way? Is it really possible to ask the To the head of the department, why is this so? Because there I'll tell you, yes, because Nikolai Stepanovich has been They walk around with flowers quite a bit. And you watch videos some kind of one, and ask for some kind of one. No, there is no money established by the Ministry of Health of the Russian Federation. Well, Like this. I'll write. I have character. I have a character. once with the head doctors. Seriously guys, we are of course joking serious. And if your clinic, for various reasons, for various some kind of, well, fundamental, we are not talking about things, but if you are not supplied in 2024-25 ah, with a pipexlocator, a visiograph, well, and some kind of Patients are watching, don't treat patients there. to follow the lead of greedy, evil leaders. And moreover, I am the head doctor, so if you are missing something, I constantly encounter a situation where a doctor wants that he didn't voice it. I say, for example, that I simply What do you need this for? Or, for example, we The doctor's Apex locator didn't work for a month. Month. He that they would scold me for breaking the apex locator, I was afraid He will say, that means he broke it, you will say. Well, Any equipment has the property of wearing out and breaking down. Asistin sit down and the battery. Well, yes, the apex is not If something is missing, we need to start the conversation not with and, firstly, with a clear formulation to the chief that is, to the person who makes the decision about To provide high-quality stologistic care. So, will Fine. If you want to work badly, I don't want or I don't work at all. There is a shortage of personnel find a good dentist. There are a lot of patients, If you are a competent dentist, you are priceless A young person can be turned into a great dentist with experience. Young doctors come to us and have been working for literally 2-3 months ahead of patients, because simply knowing great doctors. Quickly, bam, we caught the motivation from Watch our episode, watch other episodes and subscribe Lots of great videos. I, in particular, received Thank you so much for coming. I hope that everyone found it useful Today we discussed Dadontia at a super-basic This whole YouTube topic, put the bells on and watch the next episodes. Until next time.