Apical Gauging: Do it truthfully
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If someone said one size of shoes will fit all ! or one size of pants will fit all! Will you believe ? But you so easily believe that 2-3 files can successfully do endodontic treatment for 32 teeth of all ages and all population. Marketing People can make you believe anything ?

With little bit of commonsense it is easy to understand that in order to achieve clean canal it is essential that we take an instrument size which is slightly larger than the original canal size. (there is unanimous agreement that apical part is most important part of canal to clean). To do this you need to know how much is the apical diameter to start with. Apical gauging can only be done correctly with a non tapered instrument which has a flexible shaft and a tip larger than the shaft. CLICK TO See THIS IMAGE.

Once you know correct apical size to startwith then you can clean the canal to 1-3 size larger and then you can feel satisfied that you have done ethical work as per the dictates of science. To see an excellent study published on this aspect of apical gauging CLICK HERE To see more on technique of using LSX CLICK HERE

To see how you get false binding of instrument and can not do proper apical gauging, read the example below:

In this maxillary molar, palatal canal was completely prepared with a popular Tapered instrument. The final instrument is F2 (tip size #25) . It gave a tactile sense of being fit in the apical area. But it is clear from this Xray that the apical walls are not touched by the tip of the instrument. Hence the tactile sense is from the binding instrument in a more coronal area. Just to verify this, I inserted a #25 LSX instrument in the same canal

This makes it crystal clear that the apical size is much more than 25 to start with. So, absolutely no cleaning has been accomplished by the tapered instrument. I proceeded to find out the apical size by inserting larger LSX instruments sequentially.

Yes, here it is. #40 LSX was binding. In a canal of # 40 apical diameter, what cleaning and disinfection are being achieved by a tapered instrument of tip size 25?

And if you have cleaned apex well (using non tapered instrument)it is usual to see superb healing, see the case below (Healing took place without systemic antibiotics)in a patient aged 72 years.

For more CLICK HERE