Balanced force, crown-down preparation, and inject-R Fill obturation.

The balanced force concept proposes that instruments are guided by the canal structure when rotational motion is used. Changing the direction of rotation controls the probability that instruments will become overstressed and controls the cutting of structure to give an efficient result. Crown-down progression of the cleaning and shaping is possible as a result of predetermined preparations and use of a recent modified tip file design, the Flex-R file. Preparation time is minimized, while cleaning is enhanced by the crown-down approach. After cleaning and shaping, the intracanal aseptic state must be preserved by obturation. System B condensation followed by Inject-R Fill, back-filling is described as an efficient method to accomplish this obturation.

Endodontics: errors in instrumentation.

The authors provide a pictorial review of technical errors in endodontic instrumentation. Examples of separated instruments, abrupt constriction, laceration, canal transportation, and control zone errors are provided. The potential problems and effect on prognosis associated with these errors are explained.

Incidence of postoperative pain after single- and multiple-visit endodontic procedures.

A series of 359 endodontic cases were followed and evaluated by the frequency of reported postoperative pain. A statistical analysis of the data obtained attempted to identify a relationship between pain experienced and the anatomic location, the pulpal vitality as determined by hemorrhage, or the number of treatment visits used in completing the case. Data obtained indicated no relationship between pain experience and pulpal vitality, no statistically significant relationship to the anatomic location, and a significant relationship to the number of visits used. The data indicate a 2 to 1 higher frequency of pain reported following treatment completed in multiple visits as compared to that reported for those completed in one visit.