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Individual case studies
Hybrid GTX/Vortex 3-File Prep
Using a hybrid technique to negotiate and shape a small canal with just 3 files.
DR. L. STEPHEN BUCHANAN: I’m going to show you a very effective hybrid technique using Tulsa Dentsply vortex files and GTX instruments. This is a really tight mesial buccal canal and lower molar. We have the buccal canal on the right. This is the first instrument I’ve had in the root canal. Okay. I haven’t used 8s, 10s, 15s. The 15-06 vortex file behaves in a truly amazing way. I’ve found that they will cut the length as the first negotiating file in probably 70 percent of the cases. And in the rest, I bring in an 08 K-file. If I can’t get to length with the vortex instruments, I bring in a K-file, and I’m there. That was the 15-04. You’re going to use both of these at a very low-torque setting.
Having a 15-04 to length should allow the 15-06 there. And I like this file because it’s very, very sharp, but the tip is so small that it’s flexible and less likely to transport. Wen you do the rough cut with this razor file and then follow up with the GTX file, things happen pretty quickly. Here’s the 15 K-file slipping through the end of the root canal. Here’s a 20. It slips past the mesial upper cusp tip. Here’s the 30. And it’s binding about a millimeter short. So I’m going to balance-force this little guy to length. I just need to cut a millimeter and a half or so. This will make it easier for me to get the single GTX file to finish the shape. So we know the tip diameter is at 30. I’m going to bring a 30-06 GTX file in at 300 RPM with a torque limit of about 350. And because the canal has been prepared by the negotiating instruments and the No. 30 K-file, that little guy cuts right to length. And that ideal outcome was accomplished with two rotary negotiating instruments, vortex 15-06, 15-04 and a single 30-06 GTX file. We can see the advantage of the hybrid technique, and using the very sharp blades to rough cut the prep and finishing with safe landed and blades.