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Files & Forceps Academy

@filesforcepsacademy

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Practical Endo Education for General Dentists
Root Canal Pearls • Case Breakdowns • Product reviews
Alan C. Wong, DMD @filesandforceps

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Welcome to Files & Forceps Academy Instagram Page!

My name is Dr. Alan Wong. I’m a general dentist based in the Dallas, Texas, and my practice is focused primarily on root canal treatment and surgical extractions, including wisdom teeth removal.

I graduated from @tuftsdental in 2014 and completed a GPR at Wyckoff Heights Medical Center. Today, I travel to dental offices throughout DFW to provide treatment for patients in a private practice setting.

I created this page to share clinical pearls and candid product reviews from the perspective of a private practice dentist. I remember what it felt like as an early career GP trying to navigate root canal treatment. My goal is to provide advice that is both practical and relatable for the everyday dentist, without the ivory tower tone.

Every dental manufacturer says their product is great. Some claim their product performs just as well as the mainstream option, but at a lower cost. Sometimes that may be true. Sometimes it may not be. My aim is to offer real world feedback based on actual clinical use.

Follow along and share this page with a dentist who wants to get better at root canal treatment.

Disclaimer: Content on this page is for general educational purposes only and is not a substitute for clinical judgment, formal training, manufacturer instructions, or applicable laws and regulations. Product comments reflect my personal opinions and clinical experience unless otherwise stated. Views expressed here are my own. by @filesforcepsacademy

44

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5 months ago

Distal canal systems of lower molars can have various presentations. If there is an Isthmus, scout it with a hand file even when you think "I've found all the canals"

In this SIP case, there was a PON adjacent to the ML canal. This middle distal canal ultimately merged with the ML in the apical third.

The area between the MB and ML canals were also scouted. Aside from some fin tissue that merged with the main canals in the coronal third, no mid mesial canal was found.

It goes without saying - every tooth is distinct, always be on the lookout for additional anatomy 🔍👀

Shaping Protocol:
@jmudentalinc PT-G "S1"
@brasselerusa Endosequence Scout
@edgeendo EdgeSequel Utopia

#endodontics #endodoncia #molarendo by @filesforcepsacademy

27

1

15 days ago

If you ever spot a canal that abruptly disappears on a PA, be on the lookout for a possible canal bifurcation, or in some cases, a trifurcation.

I use the neighboring teeth as a reference. If the patient is young and/or the root canals in the neighboring teeth are relatively visible, I would consider it unlikely for an isolated tooth to develop severe canal sclerosis in a canal that should otherwise be relatively wide open. This is especially true in the absence of a history of traumatic insult to the pulp.

#endodontics #endodoncia #endodontia by @filesforcepsacademy

28

0

a month ago

A lower premolar that bifurcated halfway down WL. The tooth was slightly rotated, which helped with identifying the level of the split.

Clinical pearl: when first scouting these canals with hand files, the buccal canal usually deflects the handle of the file towards the lingual, and the lingual canal deflects the file towards in the buccal. That's one way to identify which file is in which canal when one is having difficulty directly visualizing the bifurcation.

#endodontics #endodoncia #endodontia by @filesforcepsacademy

50

8

a month ago

Took an army of files to get down the last few mm on this MB2. Postop CBCT scan explained why. MB root had a 2-1-2-3 canal configuration if you can believe it! You can also appreciate the PARLs, particularly the large one surrounding the palatal root

Dx: 🦠 Pulp Necrosis/Chronic Apical Abscess

🌟 Featured files
@jmudentalinc PT-G
@brasselerusa Endosequence Scout
@edgeendo EdgeOnyx and EdgeSequel Utopia

🫧 Sonically activated @vistaapex Chlor-XTRA and EDTA using the @flexivodental SurfyOne. Obturated via hydraulic condensation using @diadent.group Dia-Root Bio Sealer. An intraorifice barrier was placed and patient had buildup/crown prep completed on the same visit with the restorative dentist.

MAF sizes
MB1 and DB 30/.04
MB2 25/.04
Palatal 50/.04

#endodontics #endodoncia #mb2sday #molarendo by @filesforcepsacademy

43

5

2 months ago

🎥 Just a glimpse of my clinical protocol

Not the most pretty of social media cases but if anything it's reflective of everyday clinical practice. I typically finish small canals at 30/.04 but rhese canals were sclerosed and were finished at 25/.04 instead. Irrigants were sonically activated with the Eighteeth Surfyone. An intraorifice barrier and provisional fill was placed, before sending the patient back for definitive restoration with their restorative dentist.

Featured files:
@jmudentalinc PT-G
@edgeendo EdgeX7 and EdgeSequel Utopia

What's your favorite rotary file system and why?

#endodontics #endodoncia #molarendo by @filesforcepsacademy

38

5

2 months ago

Hess's work gave us a glimpse into just how intricate root canal anatomy can truly be. It's not every day you get to witness a mesial root isthmus obturated in this kind of detail.

The mesial root system had three canals: MB, Middle Mesial, and ML, with MB and ML having their own exit. Aspirating irrigant from one canal drained fluid from all three, revealing that the exchange was happening through the isthmus connecting them.

This was a vital case, and it came down to a few things working together: @vistaapex Chlor-XTRA (a surfactant-enhanced NaOCl) broke down the tissue, while sonic activation from the @flexivodental SurfyOne Sonic activator pushed fluid into the intricate anatomy and sped up the process. Equally important were the flow characteristics of the sealer, in this case Dia-Dent Dia-Root Bioceramic, which allowed it to reach the isthmus.

Goes to show the important role irrigants play in breaking down tissue in areas our files can't reach!

#endodontics #endodoncia #generaldentistry #midmesial by @filesforcepsacademy

55

8

2 months ago

Had to two-step this one. On the 1st visit we performed a pulpectomy and I&D of the AAA. The pre-op showed the condition after pulpal debridement and CaOH dressing. On the 2nd visit the abscess resolved and we completed the RCT.

Lower 2nd molars can vary in root canal morphology. This one had 3 canals that shared a portal of exit.

#endodontics #endodoncia by @filesforcepsacademy

24

2

2 months ago

A routine 🍞 🧈 premolar case diagnosed with SIP/SAP

Shaped with @brasselerusa Endosequence Scout and @edgeendo EdgeSequel Utopia with a MAF 30/.04

#endodontics #endodoncia #dentistry by @filesforcepsacademy

21

0

2 months ago

Quick tip on organizing endodontic files

Every RCT you do is unique. Some cases require no hand files, others will require an army of them.

I use a color coded system to organize my files in individual sponges.

🟣 Rotary files
⚫ K Files (one for 06, 08, 10, and another for 15+)
🔵 Glidefinders
🟡 D-Finders

Once they're pouched and autoclaved, this method keeps the files sterile, neatly organized, and minimizes disruptions to workflow. You can customize which files best suit your office.

When youre already frustrated dealing with a calcified canal (and all the other things happening outside the operatory), not having to rumage for files is a huge asset for preserving your mental sanity 😂

If you ask your assistant for Glidefinders, or C Files, or K files, most will ask "which one is that"? If you ask for the blue sponge, it's hard to get that wrong.

It goes without saying but every dental practice has their own unique workflow and stocks different files. Read the IFUs for the items you use and do what works best in your office. Hope this helps.

#endodontics #dentistry #endodoncia #molarendo by @filesforcepsacademy

23

2

2 months ago

#3 RCT with 4 PONs / 3 POEs

Diagnosis: #3 gross caries, Pulp Necrosis / Chronic Apical Abscess

After caries removal, a pre-endo buildup was placed for isolation. Hypo and EDTA for irrigation, along with Sonic Activation using the @flexivodental SurfyOne. Coronal pre flaring using @jmudentalinc S1, and final shaping with @edgeendo EdgeSequel Utopia .04 taper. The access was temporized and patient referred back to referring dentist for buildup and crown.

Some sealer 🎆 in the palatal, highlighting the apical deltas that are often histologically present in the apical third.

#endodontics #mb2sday #endodoncia by @filesforcepsacademy

43

0

3 months ago

#7 Endodontic Retreatment

This patient's upper lateral incisor was diagnosed as being Previously Treated / Chronic Apical Abscess. Sinus tract was present on the facial gingiva.

VRF and crack with radicular extension obviously come to mind with J-shaped lesions. Which is why ascertaining trauma history (in the case of anterior teeth), checking for coronal cracks, and radiographically assessing the shape and size of the previous obturation are important in determining diagnosis.

Patient denied history of trauma (previous access also suggested mesial decay led to RCT, not trauma). No cracks were visualized after crown removal. And the previous obturation did not appear excessive. All this led me to rule out VRF.

The periradicular radiolucency made me suspicious of lateral canal leaching bacteria and endotoxins.

Removed the previous obturation using @jmudentalinc F1, XP-4D, solvent, and H files. Fished out the coronal portion of the carrier but the apical portion was wedged against the wall. Wicked up the remaining melted GP and was able to bypass the carrier up to size 35/.04. Activated hypo using the @flexivodental Surfyone and @brasselerusa XP-4D, and obturated via Continuous Wave with Single Cone Backfill using GP and @septodont Bioroot Flow.

Nice to see the lateral puff which confirmed a lateral canal, along with apical anatomy filled. Now we wait! by @filesforcepsacademy

38

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3 months ago