ENDODONTIC INSIGHT
Converting from ProTaper Universal to ProTaper Gold: “Why, how, and is it for me?” Dr. John West delves into an advance in NiTi technology Introduction The great endodontist is curious, collaborative, and courageous.1 The likely reason you are reading this article is mainly because of one of the three “c” words in my opening sentence: curious. Every endodontist and every endodontic clinician in the world wants to distinguish himself or herself; to set them apart from the rest of the pack. Characteristics of a great endodontist include having good bedside manner, understanding your job is to help grow the success of the referring dentist, and being a brilliant diagnostic and treatment plan decision-maker. The most critical distinction, however, is the quality of your technical skills. For referring restorative dentists, this is what truly matters. Clinical performance is the metric by which dentists measure the quality of your endodontic skills. This article is about the consistent quality of endodontic radicular shaping resulting in predictable and appropriate preparations for the structural root anatomy which surrounds and reflects the original canal size, shape, and contours. The great endodontist is like a great master: His/her learning is founded on curiosity. You are always a student, and you are always willing to “test” new products, technologies, and techniques against your current best skills and practices. You are always in the internal conversation: “Am I missing anything that can enhance both my standard of care and/or my level of care?” ProTaper Gold has redefined the way we shape and experience root canal system’s John West, DDS, MSD, is founder and director of the Center for Endodontics in Tacoma, Washington. He graduated from the University of Washington Dental School and received his MS degree and endodontic certificate at Boston University, where he was awarded the Alumni of the Year Award. He is an educator, a clinical visionary, and inventor with focus on interdisciplinary endodontics. He has authored several textbook chapters and is an editorial board member for Endodontic Practice US, Journal of Esthetic and Restorative Dentistry, and the Journal of Microscope Enhanced Dentistry. Dr. West is lead author of “Endodontics and Esthetic Dentistry” in Ron E. Goldstein’s 2016 Esthetics in Dentistry, 3rd edition. He can be reached at 800-900-7668, via email at johnwest@centerforendodontics.com, or visit centerforendodontics.com.
46 Endodontic practice
Figure 1: ProTaper Gold Rotary Shaping and Finishing Files: (Shapers SX, S1, S2, and Finishers F1, F2, F3). ProTaper Gold (PTG) is the simplest, most efficient, and yet most versatile rotatory system in the world. The reason is that the clinician has three different shaping choice successions depending on the canal intended to be shaped: 1) Full file series: Progress though Shapers until first Finisher that cuts radicular shape, fit cone, pack; 2) Two file series: S2 and select anticipated Finisher, confirm shape is cut by inspecting dentin in apical flutes, fit cone, pack; 3) Single file series: Select anticipated Finisher file, proceed gently though multiple Follow/Brush progressive passes until apical shape is cut, fit cone, pack
radicular preparations.2 The world’s No. 1 Rotary System has just gotten better. Advances in NiTi metallurgy technology have, indeed, revolutionized endodontic shaping files. This article will walk you through a game-changer technology that will profoundly improve your ease and efficiency of clinical canal preparation. After over 1 year of our 100% converting from ProTaper Universal (PTU) to ProTaper Gold (PTG), I can tell you neither I nor my two sons, Jason and Jordan, with whom I practice, have never looked back. And believe me; we have wanted from time to time to revert back to PTU because we have thousands of opened ProTaper Universal files that cannot be returned for Gold! Try as we might, however, we haven’t had an endodontic situation yet where it was better to substitute the old metallurgy of PTU for the new, more flexible metallurgy of PTG! This article may, at first glance, appear to be self-serving because I was one of the original ProTaper Designer Team members along with Dr. Cliff Ruddle and Professor Pierre Machtou, and we have financially benefited from the sales of the world’s No. 1 Rotary System. But this article is not about money;
it is instead about my personal journey of liberation from the previous fears and concerns of NiTi shaping. In 1995, the idea of progressive/regressive tapers on a single file was a desired geometry in the endodonticshaping world that would provide decisive and intentional progressive or sectional shaping of the radicular endodontic preparation. At the time, endodontics needed a Rotary System that gave the dentist control of the Rotary shaping versus the file being in control. Progressive tapers allow for selective shaping where fixed tapered files cut wherever the file choses, not where the clinician choses. Understanding the geometries and Directions for Use (DFU) of ProTaper Shapers versus Finishers has allowed clinicians worldwide to produce predictable, elegant, and anatomically correct shapes. Perhaps even more important than the shaped preparations, however, is that clinicians are reporting they are in control of the procedure and preparation. The ProTaper value has been sustainable and growing in spite of dozens and dozens of NiTi file systems that have come and gone over the last 15-plus years. Now copycats are pouring in, and comparisons by Volume 9 Number 1