Legdes Management

Lesson transcript

Hi my name is Grzergorz Witkowski and I'm an endodontist. I'm also a member of Style Italiano Endodontics. And today I would like to share you with a very very important subject, which is ledges.
In order to deal with the ledge, the first thing we should understand is how the ledge is created. So we have two possibilities. The first possibility that we can have is when you use the file which is too stiff. It means that you take two big size, for example, you start to prep the curvature of the canal which if ISO 15 or 20 or 25: this is not a good idea, and with this approach we will create the ledge very fast and very efficiently. The second possibility for creating the ledge is just to use the files. You use the mechanical file and you create ledge sometimes especially when the system is very sharp, you can create the ledge easier than we've not so efficient system, but still, this can happen. 

Why ledges are created in the first place?

And let me explain you how we can create the ledge with the mechanical file. Well when you move with your file on the curvature and you stay on the curvature with the file rotating, this is wrong because the file with the outstenight state so it means that this file is more like shape memory then it will love to come back to its original shape. So when it comes to original shape again it transport the canal space and it creates, I think what is called a ZIP or canal transportation or a ledge in general. Now we know how to. Create the ledge but the most important thing is how to deal with these in everyday practice. As we are all clinicians and we want to have all these information clinically, that we can use it on in everyday practice, I will give you some tips on how to deal we have these ledges. Okay so let's start the details. We we are creating the ledges only on the outer curvature of the canal space. It means that the inner curvature is always free from ledges. What does it mean for us clinicians. It means that we have proper pre banding often to file. We can easily promote the file to past the ledge and we can easily prep the ledge with these outer curvature of the thigh.

How to prebend the files?

 So, how to prebend the file to pass the ledge. Well before you start prebending the file the most important thing when you create the ledge or you find the ledge in a canal is to pre-irrigate the canal. Before you start any file introduction into the ledge, please keep in mind that you need to irrigate before. So put a lot of fluid inside the canal space. After putting these irrigation, you activate you activate a lot. Why is that? Because when you irrigate and activate before introducing any file you remove the debris that the file which caused the ledge created.Well after this procedure you can go directly with the prebended file and I will repeat how to prebend the file. The file should be prebended in kind of a fishing hook. It means that it is very much prebended. As you can see here this is not small prebending. Have in mind that the size of the file should not be too big. So I think the most, the initial size of the file should be no more than ISO 10. I strongly recommend you to use a C file which is the file very flexible on the other hand very predictable. When you introduce the file into the canal space, you should follow the inner curvature so these prebended file the very tip of the file should go down in the inner curvature it will help you to locate the original canal space. After doing this, you pass the ledge and the outer curvature of the file we'll be able to prep the saddle. Which was created from the creating the ledge. So you just start to move the file up and down up and down with very slow motion and of course you're turning these in 60 degrees left and the right. Why is that movement is important? Because when you use these movement, you will remove the saddle and you will be able to introduce bigger files into the canal space. And as we talk about ledges then the final possibility will be to pass all the ledges like in this situation. These patient came to me with a lot of edges on to curvature so we can call this case as a festival of ledges. Lucky for us because of these simple and predictable and feasible and really teachable technique we can pass all the ledges.
Thank you very much for your attention. I hope you find this movie interesting and I hope that you will use these deep in your everyday practice just from scratch thank you very much for watching and we are inviting you to see more of our movies on Style Italiano Endodontics.