The use of the operating microscope has revolutionized the field of endodontics. The ability to see deep into the canals makes previously impossible procedures such as instrument retrieval and conservative apicoectomy now possible. In Dr. John Stropko’s published research using the microscope, it was observed that 93% of maxillary first molars had MB2 canals, while 60.4% of maxillary second molars also had MB2 canals. Since the success of endodontic treatment depends on the disinfection and obturation of the root canal system, it’s imperative to improve the precision with which endodontics is performed. At Amber Endodontics, all procedures are performed under microscope.

Nickel-Titanium rotary instruments dramatically improve the quality and efficiency of root canal treatment. However, the use of rotary instruments has also caused endodontic failures involving file breakage, zipping, stripping and perforation of the canals. To offer the best and most efficient treatment to patients, it is imperative that the operator has significant knowledge and experience with rotary file systems. Opposite to what the manufacturers of the rotary files might suggest, we don’t believe in the one-size-fits-all approach. Since each canal exhibits different morphology, and each tooth has different dentinal hardness, the operator’s knowledge and experience to select and utilize the best file system for the canal is important to treatment success.

In Endodontics, ultrasonics are useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intracanal materials and obstructions, and endodontic surgery. In a study by Dr. Rubin Gutarts, mandibular first molar mesial roots cleaned by rotary, hand file and traditional irrigation only achieved 70% cleanliness in ML canal, 95% in MB canal and 27% in isthmus. After adding ultrasonic agitation and irrigation, 100% of ML and MB canals were cleaned and 99.8% of isthmus were cleaned. To properly disinfect a root canal system for all root canal treatments, usage of ultrasonic is indispensable.

Mineral Trioxide Aggregate (MTA) is a bioactive and biocompatible material that influences its surrounding environment. Since the introduction of MTA in 1993, MTA has been used for endodontic procedures such as: Apicoectomy, Apexification, Pulp Capping, Pulp Regeneration, Repair of Iatrogenic and Resorption Perforations, Root Canal Sealing and Obturation. Studies have shown MTA exhibits antibacterial and antifungal properties. MTA has some known drawbacks such as a long setting time, high cost, and potential of discoloration. Operator’s experience in handling MTA is critical for the proper application. Due to the many biologic advantages of MTA, and our expertise in handling the material, MTA will be chosen as the obturation material in certain cases to optimize the prognosis.

Conventional intraoral radiography furnishes clinicians with a cost-effective, high-resolution, and accessible imaging modality that is of important value in endodontic therapy and should be the first-line diagnostic tool. However, there are specific situations, either pre- or postoperatively, where the understanding of spatial relationships and 3-dimensional details afforded by CBCT facilitates diagnosis and influences treatment. CBCT serves as an important technology in comprehensive endodontic evaluation and treatment planning and offers extraordinary details at low exposure levels. At Amber Endodontics, we acquired top-of-the-line Carestream 9000CD CBCT. Our imaging system can be available to you for surgical and implants placement planning on top of serving as an endodontic diagnostic tool.

The GentleWave Procedure is a state-of-the-art alternative to standard root canal treatment. The ultraclean technology of the GentleWave Procedure is an advanced combination of fluid dynamics and a broad range of soundwaves that work together to reach into the microscopic spaces1,2 and remove bacteria, debris and tissue.2 The GentleWave Procedure is so effective at cleaning and disinfecting the root canal system, there’s less chance of failure over time.3
The GentleWave Procedure uses a minimally invasive1 protocol to access the infected root canal system, which means it is preserving more of the natural tooth and, in doing so, is helping to keep the tooth’s structure strong. With the GentleWave Procedure, we can also typically clean and fill the tooth in just one appointment,3 which may reduce the number of appointments required.