tips and tricks

 When I was taught at uni by the clinical instructors in endodontics I was given a mix of advice on how to negotiate canals with hand files. One instructor said she never precurved hand files, another said to do it when there is a curve in the canal and push apically with the curve in different directions until you can bypass the curved area. Some provided no instruction at all. In hindsight, my endodontic instruction at university was misguided, limited and in some instances completely counter to sound endodontic principles.   The best way to solve a ledge is prevention and the best way to cause a ledge is to enter a canal with files that are too stiff to early and to put them in without precurving then. Below is a photo I got off the internet that shows a precurved file. You want a gentle curve as a sharp curve will concentrate stress and have more risk of breakage. You don't want too much of a curve as it will straighten itself out when you put it into the canal. A sli...

When making an occlusal splint, we need to provide the lab with an upper and lower impression (digital or analogue) and a bite registration. One arch record is used to make the appliance, the opposing is used to gain the correct occlusion and the bite record is used to mount the models so that the occlusion can be adjusted. The most common bite record that I see taken by my colleagues is either a bite registration in maximum intercuspal position or no bite record at all. This can work out sometimes but from my perspective it is not an accurate bite for splint construction. Essentially, I see a splint as a removeable tool to reestablish the patient's occlusion at an open vertical dimension. When the patient wears a splint, their vertical dimension is opened, and the teeth should ideally contact evenly all around the splint and dynamic movements should be controlled as well. This is what we are aiming for with tooth-tooth occlusion as well. Therefore, the bite records for a splint sh...