Endodonti av Lars Polhagen
Apex Localizators and LightSpeed
It was my planning to intruduce now an evaluation of the apex localizators that are
available on the Swedish market (Apit, Analytic technology, Rotex Zx, Dentometer,
Odontometer and Neosono), but unfortunately I haven´t finished the evaluation vet, and so
I shall be back on this later on. However, so far it is quite clear that most of the apex
lokalizators available now are generally reliable, when in daily use within the clinical
work. It is essential to decide, though, whether the machines that combine root canal
measuring with sensibility tests are any alternative to the machines having only either of
these functions. Partly it is a matter of economics, a matter of rationality, and how
frequently the equipment is used. Furthermore, you might have to change your way of
working and your routines before the advantage of this new equipment can be shown. This is
often the case with high-technology. The personal adjustment is often as important as the
new technical facility itself.
Since about one year I am using to an ever increasing extent mechanical root canal
cleansing. As a basic concept I am using LightSpeed, i.e. the instrument which has a
"cutting" part most apically and thus resembles a "Gates". As to my
opinion the LightSpeed is of great help in my clinical work. It differs from other systems
for mechanical root canal cleansing in that way that with LightSpeed you first shape the
apical part of the root canal according to the conditions in every single case. Modern
endodontics and a biological approach require us not to cut less nor more than is
necessary, i.e. we should not under- nor overprepare. After that you shape and form the
rest of the root canal by using the "stepback" technique. In order to make the
many exchange of instruments quick and easy, which is a prerequisite for using the
LightSpeed system, it is essential to train this part of the work, and after having been
using it for some time there should be no difficulties. I recommend you to use EDTA on the
very preparation and flush the canal with Dakin´s solution on every third exchange of
instrument. LightSpeed works at a rotation speed of 700 rpm to 2000 rpm and bear in mind
to keep the speed at an even level all the time while working with the instrument within
the root canal. Never stop and linger and never force ! LightSpeed is a reamer and so it
widens an existing canal and it must never be used to force a canal which has not
previously been cleansed up to at least file No 15. There is a risk of causing fractures
like with other instruments, but it can minimized through working in the right way. The
instrument must be used no more than 24 times in the root canal, and if this bends sharply
or more than 30 degrees, there is an increased risk of having problems unless you are
careful. Once thoroughly learnt this technigue is time saving, and according to my opinion
it will also decrease the risks of acquiring occupational injuries, which otherwise are
caused by a monotonous and static muscle.work, as compared with the traditional cleansing
technigue.
Fracturated instruments can practically always be removed or bypassed. If there is a
fracture at the most apical location, which is very rare, the tooth is root-filled up to
the location of the fracture, and a follow-up will show whether supplementary
microsurgical endodontics is needed.
By using LightSpeed there is a decreased risk of zipping, transporting, ledging as well as
perforations of various kinds.
To sum upp I venture to say that the LightSpeed technigue is easy to use and it is time
saving at the same time as it makes it possible to enhance the quality of treatment. And
in the long run it will be further developed.
