New materials, techniques and instruments are now available to assist endodontists in providing patients with more predictable and reliable endodontic treatment.  In addition, these new systems make the delivery of endodontic services more efficient.  Nickel titanium rotary instrumentation, microscopic endodontics, digital radiography, and new biocompatible sealing materials allow endodontists like Dr. Behrend to perform procedures at a level of sophistication never before attained.

Enhanced magnification and illumination systems have raised the “awareness level” of what the endodontist can visualize and perform.  Dr. Behrend uses surgical operating microscopes in his operatories. 

These provide enhanced visualization of the endodontic access or surgical area up to 25 times.  This is especially beneficial for accurate visualization of complex anatomy cases, for locating root fractures or defects, for root-end surgery, for removal of separated instruments, and for locating canals.

The introduction of nikel titanium, or NiTi, rotary instrumentation has made endodontics easier and faster than hand instrumentation, resulting in consistent and predictable root canal shaping and cleansing.  Nickel Titanium instruments have a remarkable combination of flexibility and shape memory.  The instruments are used to clean and shape the inside of the canal.  Previous stainless steel instruments had a tendency to break during use and could not curve to follow the shape of the canal, so it was difficult to clean the canal successfully.  Nickel Titanium is 500 times more flexible, so even canals that are sharply curved can be thoroughly cleaned and shaped.  Indeed, use of NiTi instrumentation has been found to decrease postoperative pain for the patient.  New instruments are used for each patient and discarded after use to prevent cross-contamination between patients and to reduce the likelihood of breakage. We use new electric handpieces that were designed to be used exclusively with nickel titanium rotary instruments.  These handpieces carefully control speed and torque, maximizing the efficiency and the capabilities of the new nickel titanium instruments.

It is important for the success of root canal therapy to clean and fill to within a half millimeter of the end of the root.  We use an electronic apex locator to measure the length of the canal.  It has been shown to be the quickest, easiest and most accurate way to find the end of the canal and significantly reduces the possibility of instrument breakage.

When radiation is detected, the sensor transmits the information to the computer, displaying the image on a screen. This instantaneous “digitized” image can be analyzed, manipulated, measured, stored and transmitted electronically.  The benefits of digitization are overwhelming.  For patients, there is a 60 to 90 percent reduction in radiation exposure, thus alleviating most concerns about radiation exposure.   Our patients also have the advantage of viewing an image of their tooth on a large screen.  As Dr. Behrend explains the nature of the endodontic problem, while showing it to the patients, patients become more involved in the clinical decision-making and their own treatment.  There is a digital radiography unit in each operatory, giving us the ability to obtain a superb image of the tooth using less than half of the radiation needed for a traditional dental X-ray.  The image is quickly available, in a matter of seconds, not minutes.  Each image is preserved in digital form on a central server and can be recalled for comparison in seconds.  Unlike traditional films, each image can be manipulated to enhance resolution and contrast, and measurements of the root canal length can be taken in real time.

Resilon is a thermoplastic polymer-based root canal filling material.  New research in the Journal of Endodontics has demonstrated that filling the canals with resilon material may increase the resistance to root fractures.    The primary function of the root canal filling material is to seal the canal.  When compared to gutta percha material traditionally used for this purpose, resilon shows significantly less leakage.  It attaches to the prepared canal walls and is therefore highly resistant to bacterial penetration, the most frequent cause of endodontic failure and persistence of disease. 

Mineral trioxide aggregate, or MTA, is one of the newest and most promising materials to enter the realm of endodontics in many years.  It is a root canal repair material used to seal the root end and repair perforations. In the presence of moisture it forms a gel that sets to become a strong material that seals better than amalgam and previously used materials.  Although costly and difficult to work with, it has been shown to be a superior material, especially in endodontic surgery.