A Day at the Track By: Martin B. Goldstein, DMD
Official DentalTown Townie

Endodontic Nirvana
It’s impossible to teach someone how to shape and obturate a root canal with PowerPoint slides and a microphone. No one knows this better than the folks of Dental Education Laboratories. If there was any doubt in my mind as to the true hands-on nature of my FastTrack experience, they disappeared quickly as I entered NYU’s brand new ultramodern teaching facility. My desire to experience the latest endo gadgetry was about to be fulfilled under the tutelage of a bevy of board certified endodontists with Dr. Buchanan at the helm. Endodontic nirvana!

FastTrack’s originator, Dr. L. Stephan Buchanan serves as an adjunct clinical professor at the University of the Pacific School of Dentistry and is a diplomat of the American Board of Endodontics and a fellow of the International and American Colleges of Dentistry. He has lectured extensively throughout the world and lays claim to a long list of published articles. Dr. Buchanan’s name is synonymous with endodontics.

Specifically, FastTrack is a one-day hands-on course that focuses on rotary shaping, cleaning and obturating root canals in a laboratory setting. Teaching is based upon the GT System-based approach to root canal therapy. It’s set up to handle as many as 100 dentists and provides all the equipment necessary to learn how it’s done. Participants need only bring half-a-dozen teeth that are accessed and pre-measured. Sessions begin at 8 a.m. and end at 6:30 p.m. (no lie…6:30 p.m.). FastTrack provides participants with 7 participation and 3 lecture credit hours. A comprehensive course manual and a pre-course multi-media CD arrived at my office weeks before the course so that I had time to grasp the essentials before getting down to the nitty-gritty. The CD and manual are almost worth the price of admission in their own right. Toss in lunch and you’re out the door for $1,085. My first impressions of “hey, that ain’t cheap” were ultimately replaced with “hey, that was a bargain!”

How’d they fit all this stuff in here?
Jim Kelley, DEL’s general manager, informed me that no less than nine key vendors are enlisted to provide close to $250,000 worth of products. Picture the semi backing up to the door of NYU and unloading products from Dentsply/Tulsa, Maillefer, VDW, Obtura/Spartan, SybronEndo, KaVo, Dentsply Gendex, Jordco and Global Microscopes; the who’s who in endodontics, if you will. Along with the goods come the reps composing somewhat of an entourage.

If you’ve done your homework and gone over the CD, you should already have a good idea of the theory behind the use of Greater Taper (GT) instruments. FastTrack’s course objectives are many, but my primary goal was to learn how to use the GT armamentarium safely and efficiently. I was also interested in learning about “centered compaction 3D obturation” with both Sybron’s System B and the newer Dentsply Thermafil GT obturators. Owing to the excellent student to preceptor ratio, I was able to become familiar with the subtle nuances that make the GT system effective for shaping all root canal forms, including large apical diameters, large canal-small terminus, narrow canal-small terminus, and abrupt apical curvatures. Use of variably tapered GT rotary files facilitates the creation of ideal shapes, often in less than 10 minutes. Couple this with learning how to three dimensionally obturate intricate anatomy faster than you could imagine via the continuous wave of condensation technique, and you’ve a formidable hands on experience.

Great Setting for a Super Bowl Party
DEL knows AV. No matter where one was situated in the lab a large video display was nearby to keep participants fully apprised of whatever Dr. Buchanan was doing. A microscope connected to the same video feed that monitored his activities allowed us to hear as he explained the procedures.

Our morning was spent primarily on canal preparation. Using the teeth we had brought, and following a live video demo of Dr. B preparing several root canals, GT style, we jumped in and began making use of the “endo cockpit” that was found at each station. Every row of participants was graced with the services of a board certified endodontist to answer any and all questions.

The full complement of Dentsply Tulsa GT rotary and hand files were made available to every participant along with either a Tulsa or Technika rotary handpiece; the latest versions that included torque limiting control and pre-programmed RPM and torque settings. All the necessary irrigants were present as well. For those hard to find canals, Spartan’s Piezo unit was available. If you’ve ever wanted to evaluate the usefulness of the trough and chase approach for those troublesome extra canals on the MB root of a maxillary molar, this is the place. Global Microscopes allowed us to feel like the real deal, in essence stepping into the shoes of our endo-dedicated specialists for the day.

The afternoon found us exploring obturation. Many of us focused on becoming familiar with Dr. Buchanan’s continuous wave condensation technique, courtesy of Sybron’s System B heat source/condenser. Obtura’s warm gutta percha gun, famous for rapid-fire backfills was there to complement the System B methodology.

Others elected to spend time with the newer Thermafil GT carriers. Mid-afternoon, Dr. Buchanan summoned our attention while on camera, as he obturated a two-rooted bicuspid with both methods. Fortunately, one of the canals presented with an obstruction enabling for us to see how the master worked around such issues.

Upcoming FastTrack Seminars

November 1/2, 2002 Miami, FL (University of Miami Conference Center)

March 21/22, 2003 San Francisco, CA (University of the Pacific School of Dentistry)

Radiographic concerns were handled in high-tech fashion. Several digital x-ray workstations were up and running courtesy of Gendex, for instant monitor viewing of any necessary digital radiographs. A unique shielded box allowed participants to mount their teeth in a wax holding device at any desired angle. Following exposure, the digital image was then transferred to each participant’s personal folder as part of a class database. Obturation results that were considered exemplary were also stored in a “best in show” folder for all to view at the end of the session.

We’ve Arrived!
Taking the mystery out of endodontic preparation and obturation appears to be what FastTrack is all about. Making use of modern day materials and even more importantly, gaining a contemporary understanding of what constitutes endodontic success, should be on every generalists’ plate if they wish to practice endodontics predictably. While DEL isn’t the only approach to today’s endodontic therapy, its variant is logical, easy to grasp and firmly tied to extensive clinical research. Learning how to do it in a warm atmosphere, with an emphasis on maximizing the time spent, fulfills the needs of those educated in the days of reamers, broaches and cultured canals. The importance of such training is obvious.

Wrapping it Up
We ended our day in the fourth floor lecture hall where we viewed the aforementioned “best of the best” slide show and received a short debriefing of the day’s events. Dr. Buchanan spent as much time as was needed to answer questions about all things endodontic. At 6:30 p.m. we all waved a fond farewell knowing that our endodontic horizons had been expanded and that we had participated in something special. Since returning to my practice, I’ve noticed a definite upward trend in my endodontic results.

As of April 2002, DEL has trained over 1,850 general dentists and endodontic specialists plus more than 150 faculty trainers in FastTrack Programs. Changes are also being made at the grass roots level, with several dental universities seeking to integrate many of DEL’s teaching methods and products into their undergraduate and graduate programs. Maybe it’s time for you to spend a day at the track as well. All of its participants become winners!

Dr. Goldstein is a 1977 graduate of the University of Connecticut School of Dental Medicine and practices general dentistry in a group setting in Wolcott, Conn. He can be reached at martyg924@cox.net or at his office at 203-879-4649.